nurse aide 1 book

North Carolina

NURSE AIDE

to testBEFORE JULY 1, 2012 click here

to test ON orAFTER JULY 1, 2012 click here

written (or oral) examination & skills evaluation

CANDIDATE HANDBOOK

PEARSON VUE

Stock #0734-00 6/11

nORTH CAROLInANURSe aide ICandidate Handbook

June 2011

QUICK REFEREnCE

TABLE OF COnTEnTS

PRInT

SEARCH DOCUMEnT

QuiCk RefeReNCe

NACES Plus FouNdAtIoN, INC.North Carolina NNAAP®

7600 Burnet Road, Suite 440 Austin, TX 78757-1292

(888) 282-6904 Fax: 1 (866) 95 NACES

Hours of Operation 8:30 a.m. – 6:30 p.m. (Eastern Time Zone)

Call NACES Plus Foundation, Inc. to:• Obtain a Candidate Handbook• Obtain an Application for testing• Obtain registration information• Cancel and/or reschedule an examination• Arrange special examination requests

and services• Change your current address or name

before testing• Request an excused absence

PEARSoN VuE®North Carolina NNAAP®

PO Box 13785 Philadelphia, PA 19101-3785

(888) 204-6207Hours of Operation 8:00 a.m. – 5:00 p.m.

(Eastern Time Zone)

Call Pearson VUE to:• Ask questions about On-Line Registration• Obtain information regarding your Score Report• Request a duplicate Score Report • Obtain information regarding your examination

Go to Pearson VUE’s website (www.pearsonvue.com) to:

• Register On-Line• Download a Candidate Handbook• Download an Application • View Regional Test Site testing dates• Download a Nurse Aide Practice Written

Examination• View the Nurse Aide Program Overview• View Frequently Asked Questions• View a list of the Nurse Aide Registries (by State)• View Skills Listing

Refer any additional questions to:

NoRtH CARolINA dEPARtmENt oF HEAltH ANd HumAN SERVICES Center for Aide Regulation

and Education*2709 Mail Service Center Raleigh, NC 27699-2709

(919) 715-0562 (919) 855-3969

Hours of Operation 8:00 a.m. – 12:00 p.m. and 1:00 p.m. – 3:00 p.m.

(Eastern Time Zone, weekdays) The phone lines will be closed between 12 noon and 1 p.m.

*Please do not send application or fee for testing to this address

Pearson VUE and NACES do not discriminate on the basis of age, sex, race, creed, disabling condition, religion, national origin, or any other protected characteristics.

Copyright © 2011 Pearson Education, Inc., or its affiliates. All Rights Reserved.

NNAAP® Written Exam Content Outline and Practical Skills Listing Copyright © 2010 National Council of State Boards of Nursing, Inc. (NCSBN®). All rights reserved.

table Of CONteNts

Quick Reference........................... . inside.front.cover

Introduction......................................................... 1National Nurse Aide Assessment Program ............... 1Exam Overview ........................................................ 2

Eligibility....................................................................2Nurse Aide Trained Candidates................................ 3Community College Refresher

Course Candidates ................................................ 3Other NC Nurse Aide Trained Candidates .............. 3Challengers ............................................................... 3Student Nurse Candidates ........................................ 4North Carolina Nurse Aide I Registry Candidates .... 4

Application and Scheduling...............................4Filling Out an Application ....................................... 4Proper I.D. ................................................................ 4Exam Fees ................................................................. 6Exam Scheduling ...................................................... 6Authorization to Test Notice .................................... 7Testing Locations ...................................................... 7Special Exam Requests and Services ......................... 7Telecommunication Devices

for the Deaf (TDD) .............................................. 7

Cancellation and re-scheduling......................8Refunds .................................................................... 8Absence Policy .......................................................... 9Weather Emergencies ................................................ 9

Exam day................................................................. .10Checking In ............................................................. 10What to Bring ......................................................... 10Proper Identification ................................................ 10Security ................................................................... 11Testing Policies ....................................................... 12 Lateness ............................................................... 12 Electronic Devices ............................................... 12 Study Aids ........................................................... 12 Eating/Drinking/Smoking ................................... 12 Misconduct .......................................................... 12 Guests/Visitors ..................................................... 12

continued on next page

the Written (or oral) Exam..............................13Written Exam .......................................................... 13English or Spanish Oral Exam ................................ 13

Written (or oral) Exam Content outline..... .14

Sample Questions................................................. .15

self-assessment reading test....................... .16-19

the Skills Evaluation .................................................20What to Expect ...................................................... 20 Setting ................................................................ 20 Who Will Act As a Client? ................................. 20 Candidate Volunteer Requirements .................... 20 Candidate Dress Requirements ........................... 20The Tasks ................................................................ 21Recording a Measurement ...................................... 22Sample Recording Sheet for Measurement Skills .... 23 Tips for the Skills Evaluation .............................. 24

Skills listing .................................................... .25-40

Score Reporting................................................... .41Exam Results ........................................................... 41 Written (or Oral) Exam ....................................... 41 Skills Evaluation .................................................. 41Failing ..................................................................... 42Reading a Failing Score Report .............................. 42Sample of a Failing Score Report ............................ 43Passing .................................................................... 43Duplicate Score Report ........................................... 43

Grievance Process.................................................44Overview ................................................................ 44Process .................................................................... 44

the Registry............................................................ .45Initial Listing ........................................................... 45Change of Address or Name .................................... 45Listing Renewal ...................................................... 46

AppendixAppendix A: Request for Duplicate Score Report

or Handscored Answer Sheet Form

iNtROduCtiON

This handbook is designed for candidates seeking Nurse Aide I certi fi cation in North Carolina. It describes the process of applying for and taking the National Nurse Aide Assessment Program (NNAAP®) Examination.

The North Carolina Department of Health and Human Services (DHHS) has contracted with Pearson VUE, a nationally recognized leading provider of assessment services to regulatory agencies and national associations. Pearson VUE will administer, score, and report the results of the NNAAP® Examination for the North Carolina Nurse Aide I Registry. The Nurse Aide Competency Evaluation Service (NACES) will be working with Pearson VUE to schedule and administer the examination.

NAtIoNAl NuRSE AIdE ASSESSmENt PRoGRAm (NNAAP®)The Nursing Home Reform Act, adopted by Congress as part of the Omnibus Budget Reconciliation Act of 1987 (OBRA ’87), was designed to improve the quality of care in long-term health care facilities and to define training and evaluation standards for nurse aides who work in such facilities. Each state is responsible for following the terms of this federal law.

The National Nurse Aide Assessment Program (NNAAP®) is an examination program designed to determine minimal competency to become a certified nurse aide in your state. The NNAAP was developed by the National Council of State Boards of Nursing, Inc., (NCSBN) to meet the nurse aide evaluation requirement of federal and state laws and regulations. Pearson VUE is the authorized administrator of the NNAAP in your state.

The NNAAP Examination is an evaluation of nurse aide-related knowledge, skills, and abilities. The NNAAP Examination is made up of both a Written (or Oral) Examination and a Skills Evaluation. The purpose of the NNAAP Examination is to test that you understand and can safely perform the job of an entry-level nurse aide.

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ExAm oVERVIEWYou will be allowed to choose between a Written or Oral Examination. The Written Examination is available only in English; the Oral Examination is available in English or in Spanish. The two parts of the NNAAP Examination pro-cess, the Written (or English or Spanish Oral) Examination and the Skills Evaluation, will be administered on the same day. You must pass both parts to be certified and listed on the North Carolina Nurse Aide I Registry. The Written Examination consists of seventy (70) multiple-choice questions written in English. Sample examination questions are provided in this handbook.An Oral Examination available in English or in Spanish may be taken in place of the Written Examination. The Oral Examination consists of sixty (60) multiple-choice questions and ten (10) multiple-choice reading comprehension ques-tions provided on a cassette tape. You will be asked to listen to a cassette tape of the Oral Examination and follow along in the test booklet as the questions are read aloud on the tape. If you want to take the Oral Examination, you must request it when you submit your application. At the Skills Evaluation you will be asked to perform five (5) randomly selected nurse aide skills. You will be given thirty (30) minutes to complete the five (5) skills. You will be rated on these skills by a Nurse Aide Evaluator. You must successfully demonstrate all five (5) skills to pass the Skills Evaluation. A complete listing of the skills is shown on pages 25 to 40.See The Written (or Oral) Exam and The Skills Evaluation for more details about the NNAAP Examination.

eligibility

All candidates applying to take the NNAAP Examination in North Carolina MUST complete an Application for Registration by Competency Examination form using one of the eligibility routes listed on the following two (2) pages.

north carolina state-approved nurse aide I trained candidatesAll applicants who have successfully completed a North Carolina state-approved Nurse Aide I training program. Candidates must pass both portions within two (2) years from the completion date of a training program or within three (3) attempts, whichever comes first, in order to be placed on the North Carolina Nurse Aide I Registry.

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north carolina community college refresher course trained candidatesAll applicants who have completed a Nurse Aide I refresher course at a North Carolina Community College. Candidate must pass both portions within two (2) years from the completion date of a refresher course or within three (3) attempts, whichever comes first, in order to be placed on the North Carolina Nurse Aide I Registry.

other north carolina Nurse Aide Trained CandidatesAll applicants who have attended training in North Carolina for preparation for this exam at any program other than a North Carolina state-approved training program or Community College Refresher Course. Candidates must pass both portions of the exam within two (2) years from taking the first test or within three (3) attempts, whichever comes first, in order to be placed on the North Carolina Nurse Aide I Registry. Failure to do so will require train-ing at a North Carolina state-approved training program or Community College Refresher Course and retesting of both portions of the examination.If you return to school and have not completed testing or passed both portions of the examination, you must test (retest) BOTH portions of the examination.

challengersAll applicants who have completed nurse aide training out-side North Carolina, or are listed on another state’s Nurse Aide Registry (other than North Carolina), or EMT’s, or other health professionals, or those with NO nurse aide training. Candidates must pass both portions of the exam within two (2) years of taking the first test or three (3) attempts, whichever comes first, in order to be placed on the North Carolina Nurse Aide I Registry. Failure to do so will require training at a North Carolina state-approved train-ing program or Community College Refresher Course and retesting of both portions of the examination.If you return to school and have not completed testing or passed both portions of the examination, you must test (retest) BOTH portions of the examination.

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Eligibility routes continue on next page

north carolina state-approved student nurse training candidatesAll applicants who are currently enrolled in a North Carolina approved nursing education program preparing for registered or practical nurse licensure. Candidates must pass both portions within two (2) years from completion of the state-approved portion of the training program or within three (3) attempts, whichever comes first in order to be placed on the North Carolina Nurse Aide I Registry.

North Carolina Nurse Aide I Registry CandidatesAll applicants who are listed on the NC Nurse Aide I Registry and are not eligible to test under any other eligibil-ity routes or are unable to renew under required qualify-ing work experience. (Current registry listing is Active or Inactive.) Must pass both portions of the exam within two (2) years of taking the first test or three (3) attempts, which-ever comes first, in order to become/remain active on the North Carolina Nurse Aide I Registry.

appliCatiON aNd sCheduliNg

FIllING out AN APPlICAtIoN

Proper IdentificationCandidates are required to bring two (2) forms of current, not expired, official signature-bearing identification (one of which must be photo-bearing) to the test site. One form of identification must be a U.S. government-issued Social Security card, signed and non-laminated. Name and SSN must match what is on the application (for both on-line and paper registration).

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ON-LINE REGISTRATION(pRefeRRed MethOd) On-line registration is quick, convenient and an environ-mentally responsible way to register for your examination. This process will eliminate the transit time associated with mailing a paper application. Once your application is com-pleted, your information will be transmitted to NACES and the scheduling process can begin almost immediately. • Payment is in the form of a credit card or pre-paid credit

card (American Express, MasterCard or Visa). Fees are non-refundable and non-transferable once submitted.

• You can access the On-Line application through the PULSE Portal link www.pulseportal.com

• You must complete all required fields on your application before it will be submitted to NACES for your examina-tion scheduling. Please check www.pearsonvue.com for the link for required information.

Should you not have access to the internet, credit card or pre-paid credit card, you may still submit a paper application.

PAPER APPLICATION

NOTE: As of August 1, 2011, there is a $20 service fee for paper applications or failing score reports submit-ted to NACES. This information must be received by NACES twelve (12) business days before the examination date.

• You are responsible for completing the appropriate sections of the Examination Application. You may ask someone from your nurse aide training program or facility employer for assistance in completing the application.

• Payment must be in the form of a money order, cer-tified check, or company check made payable to “NACES”. The money order, certified check, or com-pany check must display your name so it can be applied to your examination. Company checks may pay for more than one candidate. Personal checks and cash will not be accepted. Fees are non-refundable and non-transferable once submitted to NACES.

• If you need help or have any questions about the application, please contact a NACES Customer Service Representative at (888) 282-6904.

• Mail your completed application and fee together in one envelope to:

NACES Plus Foundation, Inc. North Carolina NNAAP®


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ExAm FEESThe fees listed below have been established for the NNAAP

Examination in North Carolina.

examination type fees

Written Examination & Skills Evaluation $101

Oral (English or Spanish) Examination & Skills Evaluation $101

Written Examination ONLY (re-test) $24

Oral (English or Spanish) Examination ONLY (re-test) $24

Skills Evaluation ONLY (re-test) $77Additional fee for any paper application or failing score report submitted to NACES on or after Aug. 1, 2011

$20

The first time you test, you must schedule bOTh the Written (or Oral) Examination

and the Skills Evaluation.

Under federal and North Carolina state laws, candidates employed as nurse aides in nursing homes that participate in Medicaid/Medicare programs are prohibited from paying their examination fees. Employers must pay the examination fee and any re-test fee for those candidates in their employ as nurse aides or candidates who have a written commitment or signed acceptance of employment on file in a Medicaid-certified nursing home. Candidates who become employed as a nurse aide by a Medicare/Medicaid skilled nursing facility within 12 months of suc-cessful completion of the competency evaluation may be reimbursed by the facility for training and competency testing costs. Therefore candidates should save all receipts to submit to the skilled nursing employer.

ExAm SCHEdulING Once NACES receives your application, required docu-ments, and fees, they will schedule you for testing. NACES will mail your Authorization to Test Notice (yellow postcard) to you at the address listed on your application within forty-eight (48) hours.

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AutHoRIzAtIoN to tESt NotICEYour Authorization to Test Notice (yellow postcard) has important information about the examination. If you do not receive your notice within seven (7) business days, call NACES. NACES is NOT responsible for lost, misdirected, or delayed mail.

tEStING loCAtIoNSThe NNAAP Examination is given by NACES at Regional Test Sites.

The complete testing schedule, titled North Carolina Regional Test Sites &

Schedules, is available on the Pearson VUE website (www.pearsonvue.com) or at

https://www.ncnar.org, then click on the word Pearson VUE.

SPECIAl ExAm REQuEStS ANd SERVICESPearson VUE complies with the provisions of the Americans with Disabilities Act (42 U.S.C. § 12101 et seq.) and Title VII of the Civil Rights Act, as amended (42 U.S.C. § 2000e et seq.), in accommodating disabled candidates who need special arrangements to take the examination.

If you have a disability, you may ask for special arrangements for testing when you apply. All requests must be approved in advance. Be sure to:

• provide statement of diagnosed disability from your health care provider

• explain specific type of accomodation requested

Nurse Aide Evaluators administering the Written (or English or Spanish Oral) Examination and the Skills Evaluation will be prepared to meet the needs of nurse aide candidates who have approved accomodations.

tElECommuNICAtIoN dEVICES FoR tHE dEAF (tdd)Pearson VUE is equipped with Telecommunication Devices for the Deaf (TDD) to assist deaf and hearing-impaired candidates. TDD calling is available during all Pearson VUE hours through a special toll-free number, (866) 274-2777. This TDD phone option is for the express use of individuals equipped with compatible TDD machinery.

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CaNCellatiON aNd Re-sCheduliNg

If you are unable to attend your scheduled examination, you MUST notify NACES at least seven (7) business days before the examination date to re-schedule. Saturday and Sunday and national holidays are not considered busi-ness days.

If you provide at least seven (7) business days advance notice, you may re-schedule one (1) time, without pen-alty charges, and your fee may be transferred to your new examination date.

If you need to re-schedule an examination in less than seven (7) business days before the examination date, you must apply for an excused absence. (Please refer to the Absence Policy section in this handbook.)

If you do not call NACES at least seven (7) business days before your examination date to re-schedule, and do not show up for your scheduled examination, your fee will NOT be refunded and cannot be transferred to a new examination date. Also, you may not give your examina-tion date to another person.

REFuNdSOnce payment of exam fees is received, NO REFUNDS WILL bE ISSUED.

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AbSENCE PolICySince unexpected situations occur, NACES will consider excusing an absence from a scheduled examination.

Acceptable reasons for re-scheduling are as follows:• Illness of yourself or a member of your immediate

family• Death in the family• Disabling traffic accident• Court appearance or jury duty• Military duty• Weather emergency

Requests for excused absences must be made in writing and received within ten (10) business days following the scheduled examination. This request must include veri-fication of your absence from an appropriate source. For example, if you had jury duty, you must supply a copy of your court notice.

The decision of NACES to approve or deny the excused absence is final.

WEAtHER EmERGENCIESExaminations will be delayed or cancelled only in emergen-cies. If severe weather or a natural disaster makes the test cen-ter inaccessible or unsafe, the examination will be delayed or canceled. If the examination has been canceled, you will be re-scheduled for the next available examination at that site.

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exaM day

CHECkING INYou must arrive 30 minutes prior to your scheduled time for BOTH the written and skills examinations. If you are late for the written examination you will not be allowed to test and your fees will not be refunded. If you missed your written examination and are scheduled for a skills evalua-tion, please arrive 30 minutes prior to your scheduled time. Skills Evaluation test times are approximate.You will be required to check in for both the written and for the skills examinations. You will be required to present proper identification.

WHAt to bRINGYou must have the following items with you when you take the examination:• Two (2) forms of proper identification• Three (3) No. 2 pencils (sharpened)• Eraser• Watch with a second hand

No other materials will be allowed.

PRoPER IdENtIFICAtIoNCandidates are required to bring two (2) forms of current, not expired, official signature-bearing identification (one of which must be photo-bearing) to the test site. One form of identification must be a U.S. government-issued Social Security card, signed and non-laminated. Nurse Aide I applicants who are in the armed services may use their current U.S. Military I.D. in place of a Social Security (SS) card. The test taker’s SS number must be on the I.D. if used. Sponsor or Dependent Military I.D.s are NOT accept-ed in place of SS card, but can be used as a second I.D. (one with photo) when presented with a valid SS card.

The second form must be any of those listed below. Photocopies of identification will NOT be accepted.Original signature bearing SS cards are required to test in NC. If you have scheduled your exam and have misplaced your SS card 7 business days prior to your exam, call NACES to reschedule. If there are extenuating circumstances such as fire or theft and your exam is scheduled in less than 7 business days from the time of the incident, you may apply for an excused absence. Refer to page 7, Cancellation and Rescheduling in

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the NC Nurse Aide I Handbook. Documentation substan-tiating the event must be provided. NACES’s decision to approve or deny a credit request will be final.

Proper.photo.identification.includes.one.of.the.following:

• Current, non-expired driver’s license (Candidates who do not have their new license by exam day MUST bring their expired driver's license AND the 20 day temporary permit)

• U.S. government-issued Military I.D. (if not used in lieu of social security card)

• State-issued identification card• Passport (US or foreign, current, non-expired)• Alien registration card

The name on your identification must be the same as the name you used on the application to register for the exami-nation. If your name has changed you must:

• Contact NACES if you are NOT on the North Carolina Nurse Aide I Registy

• If you ARE on the North Carolina Nurse Aide I Registry, contact NACES AND the Registry

You must do this at least seven (7) business days prior to your scheduled exam. Be prepared to provide official gov-ernment documentation of the name change.If you do not bring proper identification, you will not be allowed to test and your examination fee will not be refunded.

SECuRIty ANd CHEAtINGIf you give help to or receive help from anyone during the examination, the examination will be stopped. The incident will be reported to the North Carolina Division of Health Service Regulation (DHSR) for review, and your examination will not be scored (see Testing Policies).

Please note that all examination questions, each form of the examination, and all other examination materials are copy-righted by, the property of, or licensed by Pearson VUE. Consequently, any distribution of the examination content or materials through any form of reproduction, or through oral or written communication, is strictly prohibited and punishable by law. Anyone who removes or tries to remove examination materials or information from the test site will be prosecuted.

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tEStING PolICIESThe following policies are observed at each test center.

Lateness

You must arrive thirty (30) minutes before the examina-tion starts. If you are late for your scheduled examination, or do not bring all of your required materials, you will NOT be allowed to test and your examination fee will NOT be returned. If you are late for the Written (or Oral) Examination, but arrive on time for the Skills Evaluation, you will be allowed to take the Skills Evaluation.

If you are late for your Skills Evaluation or do not bring all your required materials, you will NOT be allowed to test and you will be required to re-apply and pay another examination fee (see Cancellation for more details).

Electronic Devices

Cellular phones, beepers, or any other electronic devices are not permitted to be used and must be turned off during testing. There is no place for storage of personal belongings at the test center.

Study Aids

You are not permitted to take personal belongings such as briefcases, large bags, study materials, extra books, or papers into the examination room. Any such materials brought into the examination room will be collected and returned to you when you have completed the examina-tion. Pearson VUE is not responsible for lost or misplaced items.

Eating/Drinking/Smoking

You are not permitted to eat, drink, or smoke during the examination.

Misconduct

If you are discovered causing a disturbance of any kind or engaging in any kind of misconduct, you will be dis-missed from the examination and the incident will be reported to the North Carolina Division of Health Service Regulation.

Guests/Visitors

No guests, visitors, pets, or children are allowed at the test center.

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the WRitteN (OR ORal) exaM

WRIttEN ExAmThe Nurse Aide Evaluator will hand out materials and give instructions for taking the Written Examination. The Written Examination has seventy (70) multiple-choice questions. You will have two (2) hours to complete the Written Examination. You will be told when fifteen (15) minutes remain. Fill in only one (1) oval on the answer sheet for each question. Markings in the test booklet will NOT be accepted as answers. Your answers must appear on the separate answer sheet. Sample questions for the Written Examination are located on page 14.

ENGlISH oR SPANISH oRAl ExAmAn Oral Examination may be taken in place of the Written Examination. The Oral Examination may be taken in English or in Spanish. You must request an English or Spanish Oral Examination when filling out your application. The Oral Examination is provided on a cassette tape. A cassette player and earphones are provided at the test center. You will be asked to listen to a tape of the Oral Examination and follow along in the test booklet as the questions are read aloud on the tape. The Oral Examination consists of two (2) parts, and you must pass both parts to pass the Oral Examination. The first part of the Oral Examination has sixty (60) multiple-choice questions. Each of these questions is read twice. As each question is read, you will be asked to choose the correct answer and mark it on your answer sheet. The second part of the Oral Examination has ten (10) multiple-choice questions. These questions test your abil-ity to speak a minimum amount of English by recogniz-ing common words used by nurse aides in long-term care facilities. Each word is read three (3) times. You are asked to match the word you hear on the tape to the written word in the test booklet. As you find the match, mark your answer on the answer sheet.The Oral Examination takes two (2) hours to complete. You will be told when fifteen (15) minutes remain. Fill in only one (1) oval on the answer sheet for each question. You may write in the test booklet, but markings in the test booklet will NOT be accepted as answers. Your answers must appear on the separate answer sheet.

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2011 WRitteN (OR ORal) exaM CONteNt OutliNe

The revised 2011 NNAAP® Examination Content Outline is based on the findings from the 2009 Job Analysis of Nurse Aides published by NCSBN in spring 2010. The examination content outline will go into effect January 2011.

The NNAAP written examination is comprised of 70 multiple-choice items; 10 are pretest items (non-scored) on which statistical information will be collected. The NNAAP oral examination is comprised of 60 multiple-choice items and 10 reading comprehension (word recog-nition) items. The candidate is allowed to choose between a written and an oral examination. # of % of questions I. Physical Care Skills the exam in the exam

A. Activities of Daily Living ........ 14% ............8 1. Hygiene 2. Dressing and Grooming 3. Nutrition and Hydration 4. Elimination 5. Rest/Sleep/Comfort B. Basic Nursing Skills .................39% ............ 24 1. Infection Control 2. Safety/Emergency 3. Therapeutic/Technical Procedures 4. Data Collection and Reporting C. Restorative Skills ...................... 7% .............4 1. Prevention 2. Self Care/Independence

II. Psychosocial Care Skills A. Emotional and Mental Health Needs ..............11% .............6

B. Spiritual and Cultural Needs ....2% ..............2

III. Role of the Nurse Aide A. Communication ....................... 8% .............5

B. Client Rights ........................... 7% .............4

C. Legal and Ethical Behavior ...... 3% .............2

D. Member of the Health Care Team ................... 9% .............5

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saMple QuestiONs

The following questions are samples of the kinds of ques-tions that you will find on the Written Examination. Check your answers to these questions in the box below.

1. The client's call light should always be placed:(A) on the bed(B) within the client's reach(C) on the client's right side(D) over the side rail

2. Which of the following items is used in the pre-vention and treatment of bedsores or pressure sores?(A) rubber sheet(B) air mattress(C) emesis basin(D) restraint

3. When caring for a dying client, the nurse aide should:(A) keep the client's room dark and quiet(B) allow client to express his feelings(C) change the subject if client talks about death(D) contact the client's minister, priest or rabbi

4. What does the abbreviation ADL mean?(A) Ad Lib(B) As Doctor Likes(C) Activities of Daily Living(D) After Daylight

5. After giving a client a back rub, the nurse aide should always note:(A) the last time the client had a back rub(B) any change in the client's skin(C) client's weight(D) amount of lotion used

6. how should the nurse aide communicate with a client who has a hearing loss?(A) face the client when speaking(B) repeat the statement(C) shout so that the client can hear(D) use a high-pitched voice

Correct Answers

1. B 2. B 3. B 4. C 5. B 6. A

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self-assessMeNt ReadiNg test

The two-part Self-Assessment Reading Test that appears below will help you decide if you should consider taking the Oral Examination instead of the Written Examination. To complete the reading test, follow the instructions provided below and select the answer to each question. When you have completed the reading test, you will be able to deter-mine the number of questions you answered correctly.

PARt 1: VoCAbulARy

1. Circle the best answer to each question.

2. When you have finished, check your answers using the answer key on page 18.

3. Count up the number of correct answers.

4. If your score is less than 17, you may have difficulty reading the Written Examination and should con-sider taking the Oral Examination.

1. You go to a doctor when you _____.(A) feel sleepy (D) need money(B) need socks (E) need clothes(C) feel sick

2. A person who flies an airplane is its _____.(A) pilot (D) surgeon(B) steward (E) director(C) mother

3. You use a _____ to write.(A) bow (D) carpenter(B) calculator (E) needle(C) pencil

4. To ExIT a room means to _____ it.(A) enter (D) read(B) leave (E) interrupt(C) forget

5. A wedding is a joyous _____.(A) focus (D) occasion(B) vehicle (E) civilization(C) balloon

6. To REqUIRE something means to _____ it.(A) need (D) understand(B) have (E) hear(C) forget go to next page

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7. You _____ something to find its length.(A) slice(B) lock(C) measure(D) force(E) tape

8. Soup is served in a _____.(A) plate(B) bowl(C) fork(D) chair(E) closet

9. To accompany someone means to _____.(A) disagree with him(B) work for him(C) go with him(D) speak to him(E) choose him

10. A nursing home resident receives _____ from the staff.(A) quality(B) fame(C) interruption(D) care(E) work

11. Medicine is used to _____ pain.(A) widen(B) conjure(C) enliven(D) increase(E) relieve

12. To DRENCh the flowers means to ____ them.(A) steam(B) drink(C) touch(D) soak(E) anger

13. A bicycle is a means of _____.(A) nourishment(B) transportation(C) prediction(D) collision(E) walking

14. When someone speaks in a whisper, it may be difficult to _____.(A) deceive(B) understand(C) frighten(D) estimate(E) regulate go to next page

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self-assessMeNt ReadiNg test

PARt 2: ComPREHENSIoNIn this part of the reading test you will be provided with a series of brief paragraphs. You are to read each paragraph and then answer the questions that appear after the paragraph.

There are many different kinds of fish. All fish live in water. They use their tails and fins to swim.

15. Fish live in _____.(A) cups(B) houses(C) air(D) water(E) fountains

16. Fish use their _____ to swim.(A) tails(B) heads(C) gills(D) lungs(E) floats

Maria grew up on a farm. She loved the work on the farm. She knew when all of the crops had to be planted. She would like a job on a farm or in a flower garden.

17. Maria has had experience as a _____.(A) guide(B) farmer(C) driver(D) nurse(E) teacher

18. She would like to work in _____.(A) an office(B) a library(C) a garden(D) a hospital(E) a supermarket

19. As a child Maria lived _____.(A) in the city(B) in an apartment(C) on a farm(D) in a large house(E) on the beach go to next page

18

Carolyn has a good job. She is a nurse in a large hos-pital. Every day she can help many people. She enjoys this very much. She also makes a good salary. Each month she can pay her bills and save some money.

20. Carolyn works in a _____.(A) hospital(B) doctor’s office(C) garage(D) school(E) library

21. One of the things Carolyn enjoys is _____.(A) working in an office(B) helping people(C) reading books(D) working late hours(E) driving a car

22. With her salary she can pay her bills and _____.(A) buy furniture(B) give to charity(C) save money(D) buy new clothes(E) pay for college

This completes the Self-Assessment Reading Test.

Answers

1. C 7. C 13. B 19. C

2. A 8. B 14. B 20. A

3. C 9. C 15. D 21. B

4. B 10. D 16. A 22. C

5. D 11. E 17. B

6. A 12. D 18. C

If your score is less than 17, you may have difficulty reading the Written Examination and should consider taking the Oral Examination in place of the Written Examination.

19

the skills evaluatiON

WHAt to ExPECt

Setting

The Skills Evaluation is set up to resemble an actual care-giving situation. The Skills Evaluation area will look similar to your work setting. It will have all the equipment neces-sary to perform the assigned skills. The Skills Evaluation will be administered by a Nurse Aide Evaluator. Before your skills evaluation begins, the evaluator will show you where equipment is located and answer questions about operating the equipment.Please arrive 30 minutes early. Test times are approxi-mate. Please plan to spend the day.

Who Will Act as a Client?

The part of the “client” will be played by a candidate who volunteers to act as a weakened elderly person. While you perform the skills, speak to the candidate volunteer as you would speak to an actual client in a nurse aide work setting. You are encouraged to speak to the candidate volunteer not only because it is part of quality care, but also because it will help you to relax as you perform the skills.

Candidate Volunteer Requirements

You will need to act as a candidate volunteer for another candidate’s Skills Evaluation and play the role of a nursing home patient (client). The evaluator will give you verbal instructions that will describe how you should act in per-forming the role of the client.

Candidate dress Requirements

You must wear flat, slip-on, non-skid shoes, a loose-fitting top with short sleeves that can be rolled up to the shoulder or tank top, and loose fitting pants that can be rolled up. You will be required to put a gown on over your clothing. In no case may candidates remove clothing down to undergar-ments.

Prior to beginning the exam, you should inform the evalu-ator of any food or latex allergy or sensitivity to skin soaps or lotion. Any limitations to range of motion must also be communicated to the evaluator prior to the start of the skills examination.

20

For infection control purposes, you should not come to the test site with open areas/sores on the skin. Candidates with any open areas or sores on their skin should reschedule their skills test to a later date after their skin fully heals.

tHE tASkSThe NNAAP Skills List contains all of the skills that you may be asked to demonstrate during the Skills Evaluation. Each skill represents a task that you will be asked to per-form in your job and has been broken down into a series of steps.

See pages 25-40 for the complete skills listing.

A step that is highlighted in bold type is called a Critical Element Step. Critical Element Steps are important steps that must be performed correctly in order for you to pass the skill. If you leave out a Critical Element Step or do not perform a Critical Element Step properly, you will not pass the skill. However, if you perform only the Critical Element Step correctly in a skill, you do not automati-cally pass that skill. You must also correctly demonstrate enough steps to meet the passing standard (or cut score) for each skill.

Before your Skills Evaluation begins, the Nurse Aide Evaluator will give you an instruction card that will list the five (5) skills selected for you to perform. Hand-washing will always be one of the skills to be performed. The remaining four (4) skills are randomly chosen from the complete set of skills listings on pages 25 to 40 of this handbook. You are strongly encouraged to perform the skills in the order they are listed on the instruction card. If you make a mistake, say so, and you will be instructed to tell the evaluator which step(s) is to be corrected and then to perform the step(s). You will not have to redo the entire skill, just the steps you wish to correct. There are, however, some exceptions to this rule. If you fail to put on gloves or take them off when it is required to do so and the evaluator reminds you to do so, for infection control purposes, then you will not receive credit for attempting to correct this step. If you wish to correct an order-dependent step (a step stating that an action should be performed before or after another step) and you fail to say when the corrected step should be performed, you will not receive credit for the correction.

21

Once you begin a new skill, you may not go back to correct a previous skill. The Nurse Aide Evaluator will not answer questions during the Skills Evaluation and will not tell you whether you performed a skill correctly. You may not receive help from anyone during the Skills Evaluation. If you do have any questions, please ask them before the Skills Evaluation begins.One (1) of the four (4) randomly-selected skills will include a measurement skill (see the section below, Recording A Measurement, for more information regarding measure-ment skills).

You will be asked to decontaminate your hands (with hand sanitizer) before proceeding from skills performed on a live client to skills that are not. This is for infection control purposes and will not effect the result of your evaluation.

When you have completed your skills evaluation, the evaluator will direct you to wash your hands. Although this will not affect your examination results, for the pur-poses of infection control, you must wash your hands.

You must successfully complete all five (5) skills to pass the Skills Evaluation. You will have thirty (30) minutes to demonstrate all five (5) skills.

RECoRdING A mEASuREmENtThe NNAAP Skills Evaluation requires every candidate to perform one measurement skill, such as blood pressure, radial pulse, respirations, urine output, or weight. You will be given a special form, called a Recording Sheet for Measurement Skills, to write down, or record, the measure-ment. For example, if performing the Measures and Records Blood Pressure skill, you will write the complete systolic and diastolic pressures of your blood pressure reading in a box labeled Candidate Results.

On the following page is a copy of the recording sheet that will be used during the skills exam. The candidate must record his/her results in the Candidate Results box on this sheet. This sheet will be used to record the results of the following measurement skills:

• Measures and Records Blood Pressure• Measures and Records Weight of

Ambulatory Client• Measures and Records Urinary Output• Counts and Records Radial Pulse• Counts and Records Respirations

22

23

Date

Test Site ID

CANDIDATE NAME

CANDIDATE ID

EVALUATOR NAME

EVALUATOR ID

SKILL TESTEDEvaluator must check one box next to the skill being tested.

� Blood Pressure � Respirations

� Oral Temperature � Urine Output

� Radial Pulse � Weight

RECORDING SHEET FOR MEASUREMENT SKILLS

TM

CANDIDATE EVALUATORRESULTS RESULTS

Copyright © 2005 Promissor, Inc. All Rights Reserved. Stock# 0699-02 6/05

SAMPLE

Tips for the Skills Evaluation

• You will be expected to perform the skills as you would in a nursing home setting. When water is required, you must use running water. All candidates will be required to perform the Washes Hands skill. The evaluator will inform you after you have washed your hands for the first time that you should just tell him or her when you would wash your hands during your performance of the rest of the skills, rather than actually washing them for each skill. For all steps other than hand-washing, you must actually perform the skill in order to receive credit. You may not simply tell the evaluator what you would do for simulating a step. For example, you may not simply tell the evalua-tor that you would wash the client. You must actually demonstrate washing the client. You may not simply tell the evaluator that you would feed the client. You must actually demonstrate feeding the client.

• After you have introduced yourself to the client for the first time, it is not necessary for you to introduce yourself each time you begin a new skill.

• To receive full credit for a measurement skill, you must accurately make the required measurement and then write that measurement on the Recording Sheet for Measurement Skills. The evaluator will provide the Recording Sheet to you at the test site. A sample of the Recording Sheet is shown on page 22 of this hand-book. You are encouraged to become familiar with the Recording Sheet before your scheduled test date.

• You must know how to operate both a standing and a non-digital bathroom scale and must know how to set both types of scales to zero.

• You may not bring any of your own equipment to the test site (e.g. transfer/gait belt).

• It is important for you to place the call signal within the client’s reach whenever you leave the client.

• Where the word “client” appears, it refers to the person receiving care.

24

skills listiNg

The 24 skills that follow are arranged in alphabetical order, except for the Washes Hands skill. Washes Hands is listed first as a reminder of the importance of perform-ing this skill before all other skills. The numbered lines below each skill are the steps needed to perform that skill. Critical Element Steps are in bold type.

Washes haNds 1 Address client by name and introduces self to client

by name 2 Turns on water at sink 3 Wets hands and wrists thoroughly 4 Applies soap to hands 5 Lathers all surfaces of wrists, hands, and fingers,

producing friction for at least 15 (fifteen) seconds 6 Cleans fingernails by rubbing fingertips against palms

of the opposite hand 7 After lathering for at least 15 seconds, rinses all

surfaces of wrists, hands, and fingers keeping hands lower than the elbows and the fingertips down

8 Uses clean, dry paper towel to dry all surfaces of hands, wrists, and fingers then disposes of paper towel into waste container

9 Uses clean, dry paper towel to turn off faucet then disposes of paper towel into waste container or uses knee/foot control to turn off faucet

10 Does not touch inside of sink at any time

applies ONe kNee-high elastiC stOCkiNg 1 Explains procedure, speaking clearly, slowly,

and directly, maintaining face-to-face contact whenever possible

2 Privacy is provided with a curtain, screen, or door 3 Client is in supine position (lying down in bed) while

stocking is applied 4 Turns stocking inside-out 5 Places foot of stocking over toes, foot, and heel 6 Pulls top of stocking over foot, heel, and leg 7 Moves foot and leg gently and naturally, avoiding

force and over-extension of limb and joints

25

Skill continues

8 Finishes procedure with no twists or wrinkles and heel of stocking (if present) is over heel and opening in toe area (if present) is either over or under toe area (Evaluator: If stocking toe is completely open, or if client has large foot, it is okay if toes go through opening)

9 Signaling device is within reach and bed is in low position

10 Washes hands

assists tO aMbulate usiNg tRaNsfeR belt 1 Explains procedure, speaking clearly, slowly, and

directly, maintaining face-to-face contact whenever possible

2 before assisting to stand, candidate ensures client is wearing shoes

3 Before assisting to stand, bed is at a safe level 4 Before assisting to stand, checks and/or locks bed

wheels 5 Before assisting to stand, client is assisted to sitting

position with feet flat on the floor 6 Before assisting to stand, applies transfer belt securely

over clothing/gown 7 Before assisting to stand, provides instructions

to enable client to assist in standing including prearranged signal to alert client to begin standing

8 Stands facing client positioning self to ensure safety of candidate and client during transfer. Counts to three (or says other prearranged signal) to alert client to begin standing

9 On signal, gradually assists client to stand by grasping transfer belt on both sides with an upward grasp (candidate’s hands are in upward position), and maintaining stability of client’s legs

10 Walks slightly behind and to one side of client for a distance of ten (10) feet, while holding onto the belt

11 After ambulation, assists client to bed and removes transfer belt


13 Washes hands

26

assists With use Of bedpaN 1 Explains procedure speaking clearly, slowly, and directly,

maintaining face-to-face contact whenever possible 2 Privacy is provided with a curtain, screen, or door 3 Before placing bedpan, lowers head of bed 4 Puts on clean gloves before handling bedpan 5 Places bedpan correctly under client’s buttocks 6 Removes and disposes of gloves (without contaminating

self ) into waste container and washes hands 7 After positioning client on bedpan and removing

gloves, raises head of bed 8 Toilet tissue is within reach 9 Hand wipe is within reach and client is instructed to

clean hands with hand wipe when finished 10 Signaling device within reach and client is asked to

signal when finished 11 Puts on clean gloves before removing bedpan 12 Head of bed is flat before bedpan is removed 13 Avoids overexposure of client 14 Removes, empties, and rinses bedpan and pours rinse

into toilet 15 After rinsing bedpan, places bedpan in designated

dirty supply area 16 After placing bedpan in designated dirty supply area,

removes and disposes of gloves (without contaminating self ) into waste container and washes hands


CleaNs uppeR OR lOWeR deNtuRe 1 Puts on clean gloves before handling dentures 2 Sink is lined and/or sink is partially filled with water

before denture is held over sink 3 Rinses denture in tepid/moderate temperature

running water before brushing them 4 Applies toothpaste to toothbrush 5 Brushes surfaces of denture 6 Rinses surfaces of denture under tepid/moderate

temperature running water 7 Before placing denture into cup, rinses denture cup

and lid 8 Places denture in denture cup with tepid/moderate

temperature water and places lid on cup 9 Rinses toothbrush and places in designated toothbrush

basin/container

27

Skill continues

10 Maintains clean technique with placement of toothbrush and denture

11 Sink liner is removed and disposed of appropriately and/or sink is drained

12 After rinsing equipment and disposing of sink liner, removes and disposes of gloves (without contaminating self ) into waste container and washes hands

COuNts aNd ReCORds Radial pulse* 1 Explains procedure, speaking clearly, slowly, and


2 Places fingertips on thumb side of client’s wrist to locate radial pulse

3 Count beats for one full minute 4 Signaling device is within reach 5 Washes hands 6 After obtaining pulse by palpating in radial artery

position, records pulse rate within plus or minus 4 beats of evaluator’s reading

* Count for one full minute.

COuNts aNd ReCORds RespiRatiONs* 1 Explains procedure (for testing purposes), speaking

clearly, slowly, and directly, maintaining face-to-face contact whenever possible

2 Counts respirations for one full minute 3 Signaling device is within reach 4 Washes hands 5 Records respiration rate within plus or minus 2

breaths of evaluator’s reading * Count for one full minute. For testing purposes you

may explain to the client that you will be counting the respirations.

dONNiNg aNd ReMOviNg ppe (gOWN aNd glOves) 1 Picks up gown and unfolds 2 Facing the back opening of the gown places arms

through each sleeve 3 Fastens the neck opening 4 Secures gown at waist making sure that back of

clothing is covered by gown (as much as possible) 5 Puts on gloves 6 Cuffs of gloves overlap cuffs of gown

28

Skill continues

7 With one gloved hand, grasps the other glove at the palm, pulls glove off

8 Slips fingers from ungloved hand underneath cuff of remaining glove at wrist, and removes glove turning it inside out as it is removed

9 Disposes of gloves into designated waste container without contaminating self

10 After removing gloves, unfastens gown at neck and waist

11 Removes gown without touching outside of gown 12 While removing gown, holds gown away from body,

turns gown inward and keeps it inside out 13 Disposes of gown in designated container without

contaminating self 14 Washes hands

dResses ClieNt With affeCted (Weak) Right aRM 1 Explains procedure, speaking clearly, slowly, and


2 Privacy is provided with a curtain, screen, or door 3 Asks which top he/she would like to wear and dresses

him/her in top of choice 4 While avoiding overexposure of client, removes gown

from the unaffected side first, then removes gown from the affected side

5 Assists to put the right (affected/weak) arm through the right sleeve of the top before placing garment on left (unaffected) arm

6 While putting on items, moves body gently and naturally, avoiding force and over-extension of limbs and joints

7 Finishes with clothing in place 8 Disposes of gown into soiled linen container 9 Signaling device is within reach and bed is in low

position 10 Washes hands

29

feeds ClieNt WhO CaNNOt feed self 1 Explains procedure to client, speaking clearly,

slowly, and directly, maintaining face-to-face contact whenever possible

2 Before feeding, candidate picks up name card from tray and asks client to state name

3 before feeding client, client is in an upright sitting position (45-90 degrees)

4 Places tray where it can be easily seen by client 5 Client’s hands are cleaned with hand wipe before

beginning feeding 6 Candidate sits facing client during feeding 7 Tells client what foods are on tray and asks what client

would like to eat first 8 Using spoon, offers client one bite of each type of food

on tray, telling client the content of each spoonful 9 Offers beverage at least once during meal 10 Makes sure client’s mouth is empty before offering

next bite of food or sip of beverage 11 At end of meal, client’s mouth is wiped and hands are

cleaned with hand wipe 12 Removes food tray and places tray in designated dirty

supply area 13 Signaling device is within client’s reach 14 Washes hands

gives MOdified bed bath (faCe aNd ONe aRM, haNd aNd uNdeRaRM) 1 Explains procedure, speaking clearly, slowly, and


2 Privacy is provided with a curtain, screen, or door 3 Removes gown while keeping client covered 4 Before washing, checks water temperature for safety

and comfort and asks client to verify comfort of water 5 Puts on clean gloves before washing client 6 Beginning with eyes, washes eyes with wet washcloth

(no soap), using a different area of the washcloth for each eye, washing inner aspect to outer aspect then proceeds to wash face

7 Dries face with towel 8 Exposes one arm and places towel underneath arm 9 Applies soap to wet washcloth

30

Skill continues

10 Washes arm, hand, and underarm, keeping rest of body covered

11 Rinses and dries arm, hand, and underarm 12 Moves body gently and naturally, avoiding force and

over-extension of limbs and joints 13 Puts clean gown on client 14 Empties, rinses, and dries basin 15 After rinsing basin, places basin in designated dirty

supply area 16 Disposes of used gown and linen into soiled linen

container 17 Avoids contact between candidate clothing and used

linens 18 After placing basin in designated dirty supply area,

and disposing of used linen, removes and disposes of gloves (without contaminating self ) into waste container and washes hands


Makes aN OCCupied bed (ClieNt dOes NOt Need assistaNCe tO tuRN) 1 Explains procedure, speaking clearly, slowly, and


2 Privacy is provided with a curtain, screen, or door 3 Lowers head of bed before moving client 4 Client is covered while linens are changed 5 Loosens top linen from the end of the bed 6 Raises side rail on side to which client will move and

client moves toward raised side rail 7 Loosens bottom used linen on working side and

moves bottom used linen toward center of bed 8 Places and tucks in clean bottom linen or fitted

bottom sheet on working side and tucks under client 9 Before going to other side, client moves back onto

clean bottom linen 10 Raises side rail then goes to other side of bed 11 Removes used bottom linen 12 Pulls and tucks in clean bottom linen, finishing with

bottom sheet free of wrinkles 13 Client is covered with clean top sheet and bath

blanket/used top sheet has been removed 14 Changes pillowcase

31

Skill continues

15 Linen is centered and tucked at foot of bed 16 Avoids contact between candidate’s clothing and used

linen 17 Disposes of used linen into soiled linen container and

avoids putting linen on floor 18 Signaling device is within reach and bed is in low


MeasuRes aNd ReCORds blOOd pRessuRe* 1 Explains procedure, speaking clearly, slowly, and


2 Before using stethoscope, wipes bell/diaphragm and earpieces of stethoscope with alcohol

3 Client’s arm is positioned with palm up and upper arm is exposed

4 Feels for brachial artery on inner aspect of arm, at bend of elbow

5 Places blood pressure cuff snugly on client’s upper arm, with sensor/arrow over brachial artery site

6 Earpieces of stethoscope are in ears and bell/diaphragm is over brachial artery site

7 Candidate does one of the following: a. Inflates cuff between 160 mm Hg to 180 mm Hg. (If beat heard immediately upon cuff deflation, completely deflate cuff.) Re-inflate cuff to no more than 200 mm Hg. OR b. Inflates cuff 30 mm Hg beyond where radial or brachial pulse was last heard or felt

8 Deflates cuff slowly and notes the first sound (systolic reading), and last sound (diastolic reading) (If rounding needed, measurements are rounded UP to the nearest 2 mm of mercury)

9 Removes cuff 10 Signaling device is within reach 11 Washes hands 12 After obtaining reading using bP cuff and

stethoscope, records both systolic and diastolic pressures each within plus or minus 8 mm of evaluator’s reading

* This is a one-step blood pressure procedure. However, if a candidate correctly performs a two-step blood pressure procedure that includes step 7b, the candidate will not be penalized and will be given credit for step 7.

32

MeasuRes aNd ReCORds uRiNaRy Output 1 Puts on clean gloves before handling bedpan 2 Pours the contents of the bedpan into measuring

container without spilling or splashing urine outside of container

3 Measures the amount of urine at eye level with container on flat surface

4 After measuring urine, empties contents of measuring container into the toilet

5 Rinses measuring container and pours rinse into toilet 6 Rinses bedpan and pours rinse into toilet 7 After rinsing equipment, and before recording

output, removes and disposes of gloves (without contaminating self ) into waste container and washes hands

8 Records contents of container within plus or minus 25 ml/cc of evaluator’s reading

MeasuRes aNd ReCORds Weight Of aMbulatORy ClieNt 1 Explains procedure, speaking clearly, slowly, and


2 Candidate ensures client has shoes on before walking to scale

3 Sets scale to zero before weighing client 4 While client steps onto scale, candidate stands next to

scale and assists client, if needed, onto center of scale, then determines client’s weight

5 While client steps off scale, candidate stands next to scale and assists client, if needed, off scale before recording weight

6 Records weight based on indicator on scale. Weight is within plus or minus 2 lbs of evaluator’s reading (If weight recorded in kg weight is within plus or minus 0.9 kg of evaluator’s reading)

7 Washes hands

peRfORMs passive RaNge Of MOtiON (pROM) fOR ONe kNee aNd ONe aNkle 1 Explains procedure, speaking clearly, slowly, and


2 Privacy is provided with a curtain, screen, or door 3 Instructs client to inform nurse aide if pain is

experienced during exercise

33Skill continues

4 Supports leg at knee and ankle while performing range of motion for knee

5 Bends the knee and then returns leg to client’s normal position (extension/flexion) (AT LEAST 3 TIMES unless pain is verbalized)

6 Supports foot and ankle close to the bed while performing range of motion for ankle

7 Pushes/pulls foot toward head (dorsiflexion), and pushes/pulls foot down, toes point down (plantar flexion) (AT LEAST 3 TIMES unless pain is verbalized)

8 While supporting the limb, moves joints gently, slowly, and smoothly through the range of motion, discontinuing exercise if client verbalizes pain


10 Washes hands

peRfORMs passive RaNge Of MOtiON (pROM) fOR ONe shOuldeR 1 Explains procedure, speaking clearly, slowly, and


2 Privacy is provided with a curtain, screen, or door 3 Instructs client to inform nurse aide if pain is

experienced during exercise 4 Supports client’s arm at elbow and wrist while

performing range of motion for shoulder 5 Raises client’s straightened arm from side position

upward toward head to ear level and returns arm down to side of body (extension/flexion) (AT LEAST 3 TIMES unless pain is verbalized)

6 Moves client’s straightened arm away from the side of body to shoulder level and returns to side of body (abduction/adduction) (AT LEAST 3 TIMES unless pain is verbalized)

7 While supporting the limb, moves joint gently, slowly, and smoothly through the range of motion, discontinuing exercise if client verbalizes pain


9 Washes hands

34

pOsitiONs ON side 1 Explains procedure, speaking clearly, slowly, and


2 Privacy is provided with a curtain, screen, or door 3 Before turning, lowers head of bed 4 Raises side rail on side to which body will be turned 5 Slowly rolls onto side as one unit toward raised side

rail 6 Places or adjusts pillow under head for support 7 Client is positioned so that client is not lying on arm 8 Supports top arm with supportive device 9 Places supportive device behind client’s back 10 Places supportive device between legs with top knee

flexed; knee and ankle supported 11 Signaling device is within reach and bed is in low


pROvides CatheteR CaRe fOR feMale 1 Explains procedure, speaking clearly, slowly, and


2 Privacy is provided with a curtain, screen, or door 3 Before washing checks water temperature for safety

and comfort and asks client to verify comfort of water 4 Puts on clean gloves before washing 5 Places linen protector under perineal area before

washing 6 Exposes area surrounding catheter while avoiding

overexposure of client 7 Applies soap to wet washcloth 8 While holding catheter near meatus without

tugging, cleans at least four inches of catheter nearest meatus, moving in only one direction, away from meatus, using a clean area of the cloth for each stroke

9 While holding catheter near meatus without tugging, rinses at least four inches of catheter nearest meatus, moving only in one direction, away from meatus, using a clean area of the cloth for each stroke

10 While holding catheter near meatus without tugging, dries four inches of catheter moving away from meatus

35

Skill continues

11 Empties, rinses, and dries basin 12 After rinsing basin, places basin in designated dirty

supply area 13 Disposes of used linen into soiled linen container and

disposes of linen protector appropriately 14 Avoids contact between candidate clothing and used

linen 15 After disposing of used linen and cleaning

equipment, removes and disposes of gloves (without contaminating self ) into waste container and washes hands


pROvides fiNgeRNail CaRe ON ONe haNd 1 Explains procedure, speaking clearly, slowly, and


2 Before immersing fingernails, checks water temperature for safety and comfort and asks client to verify comfort of water

3 Basin is in a comfortable position for client 4 Puts on clean gloves before cleaning fingernails 5 Fingernails are immersed in basin of water 6 Cleans under each fingernail with orangewood stick 7 Wipes orangewood stick on towel after each nail 8 Dries fingernail area 9 Candidate feels each nail and files as needed 10 Disposes of orangewood stick and emery board into

waste container (for testing purposes) 11 Empties, rinses, and dries basin 12 After rinsing basin, places basin in designated dirty

supply area 13 Disposes of used linen into soiled linen container 14 After cleaning nails and equipment, and disposing of

used linen, removes and disposes of gloves (without contaminating self ) into waste container and washes hands

15 Signaling device is within reach

36

pROvides fOOt CaRe ON ONe fOOt 1 Explains procedure, speaking clearly, slowly, and


2 Privacy is provided with a curtain, screen, or door 3 Before washing, checks water temperature for safety

and comfort and asks client to verify comfort of water 4 Basin is in a comfortable position for client and on

protective barrier 5 Puts on clean gloves before washing foot 6 Client’s bare foot is placed into the water 7 Applies soap to wet washcloth 8 Lifts foot from water and washes foot, including

between the toes 9 Foot is rinsed, including between the toes 10 Dries foot, including between the toes 11 Applies lotion to top and bottom of foot, removing

excess (if any) with a towel 12 Supports foot and ankle during procedure 13 Empties, rinses, and dries basin 14 After rinsing basin, places basin in designated dirty

supply area 15 Disposes of used linen into soiled linen container 16 After cleaning foot and equipment, and disposing of

used linen, removes and disposes of gloves (without contaminating self ) into waste container and washes hands

17 Signaling device is within reach

37

pROvides MOuth CaRe 1 Explains procedure, speaking clearly, slowly, and


2 Privacy is provided with a curtain, screen, or door 3 Before providing mouth care, client is in upright

sitting position (45-90 degrees) 4 Puts on clean gloves before cleaning mouth 5 Places clothing protector across chest before providing

mouth care 6 Moistens toothbrush 7 Applies toothpaste to toothbrush 8 Cleans mouth (including tongue and surfaces of

teeth) using gentle motions 9 Maintains clean technique with placement of

toothbrush 10 Holds emesis basin to chin while client rinses mouth 11 Wipes mouth and removes clothing protector 12 Empties, rinses, and dries basin 13 Places used toothbrush in basin 14 After rinsing basin, places basin in designated dirty

supply area 15 Disposes of clothing protector appropriately 16 After placing basin in designated dirty supply area,

and disposing of used linen, removes and disposes of gloves (without contaminating self ) into waste container and washes hands


38

pROvides peRiNeal CaRe (peRi-CaRe) fOR feMale 1 Explains procedure, speaking clearly, slowly, and


2 Privacy is provided with a curtain, screen, or door 3 Before washing checks water temperature for safety

and comfort and asks client to verify comfort of water 4 Puts on clean gloves before washing perineal area 5 Places pad/linen protector under perineal area before

washing 6 Exposes perineal area while avoiding overexposure of

client 7 Applies soap to wet washcloth 8 Washes genital area, moving from front to back,

while using a clean area of the washcloth for each stroke

9 Using clean washcloth, rinses soap from genital area, moving from front to back, while using a clean area of the washcloth for each stroke

10 Dries genital area moving from front to back with towel

11 After washing genital area, turns to side, then washes and rinses rectal area moving from front to back using a clean area of washcloth for each stroke. Dries with towel

12 Repositions client 13 Empties, rinses, and dries basin 14 After rinsing basin, places basin in designated dirty

supply area 15 Disposes of used linen into soiled linen container and

disposes of linen protector appropriately 16 Avoids contact between candidate clothing and used

linen 17 After disposing of used linen, and placing used

equipment in designated dirty supply area, removes and disposes of gloves (without contaminating self ) into waste container and washes hands


39

40

tRaNsfeRs fROM bed tO WheelChaiR usiNg tRaNsfeR belt 1 Explains procedure, speaking clearly, slowly, and


2 Privacy is provided with a curtain, screen, or door 3 Before assisting to stand, wheelchair is positioned

along side of bed, at head of bed, and facing the foot of the bed

4 Before assisting to stand, footrests are folded up or removed

5 Before assisting to stand, bed is at a safe level 6 before assisting to stand, locks wheels on

wheelchair 7 Before assisting to stand, checks and/or locks bed

wheels 8 Before assisting to stand, client is assisted to a sitting

position with feet flat on the floor 9 Before assisting to stand, candidate ensures client is

wearing shoes 10 Before assisting to stand, applies transfer belt securely

over clothing/gown 11 Before assisting to stand, provides instructions to

enable client to assist in transfer including prearranged signal to alert when to begin standing

12 Stands facing client positioning self to ensure safety of candidate and client during transfer. Counts to three (or says other prearranged signal) to alert client to begin standing

13 On signal, gradually assists client to stand by grasping transfer belt on both sides with an upward grasp (candidates hands are in upward position) and maintaining stability of client’s legs

14 Assists client to turn to stand in front of wheelchair with back of client’s legs against wheelchair

15 Lowers client into wheelchair 16 Positions client with hips touching back of wheelchair

and transfer belt is removed 17 Positions feet on footrests 18 Signaling device is within reach 19 Washes hands

41

sCORe RepORtiNg

ExAm RESultSThe Nurse Aide Evaluator may not answer questions about your Score Report. If you have questions about your Score Report, or the content of the examination, call Pearson VUE at (888) 204-6207. Results will not be given over the telephone.

Written (or english or spanish Oral) Exam

After you finish the Written (or English or Spanish Oral) Examination, the Nurse Aide Evaluator will fax your answer sheet for scoring. Within approximately ten (10) minutes (from the time the answer sheet was faxed), you will receive an official Score Report. The Score Report will indicate whether you have passed or failed the Written (or English or Spanish Oral) Examination.

Skills Evaluation

The Nurse Aide Evaluator will also fax your Skills Evaluation results for scoring. After the Nurse Aide Evaluator evaluates your performance, he or she will fax the Skills Evaluation answer sheet for scoring. Within approximately ten (10) minutes (from the time the answer sheet was faxed), you will receive an official Score Report. The Score Report will indi-cate whether you have passed or failed the Skills Evaluation.

Occasionally, due to technical difficulties, Score Reports may not be received at the test center on the day of testing. If this happens your answer sheet will be mailed overnight to Pearson VUE for handscoring. Your Score Report will then be mailed out to you within 5-7 business days after testing. For questions regarding delayed Score Reports, please contact Pearson VUE at (888) 204-6207.

42

FAIlINGIf you fail the Written (or English or Spanish Oral) Examination or the Skills Evaluation, your Score Report will provide you with information on how to re-take either or both parts of the evaluation. A new examination fee is required each time you re-take any part of the NNAAP Examination. To re-take either or both parts, you must sub-mit your official Score Report and a re-take fee to NACES.

State and federal regulations allow you three (3) attempts to pass both the Skills Evaluation and the Written Examination. If you should fail either part or both parts three (3) times, within two (2) years, you will be required to successfully complete a state-approved training program and re-take both parts. See page 3 "ELIGIBILITY" for route specific rules and regulations. You must take and pass both the Written (or Oral) Examination and the Skills Evaluation to be placed on the North Carolina Nurse Aide I Registry.

If you return to school and have not completed testing or passed both portions of the examination, you must test (retest) BOTH portions of the examination.

HoW to REAd A FAIlING SCoRE REPoRtIf you do not pass the Skills Evaluation, you will receive a Failing Score Report. The score report will list the five (5) skills that you performed and a score of Satisfactory or Unsatisfactory for each skill. Any skill with an Unsatisfactory result is considered a failed skill. You must receive a Satisfactory result on all five (5) skills to pass the Skills Evaluation.

Use your failing Score Report as an aid in studying to re-take the Skills Evaluation. A failed skill will show the reason for the failure. You may not have performed the steps of a skill correctly, or you may have forgotten a step, especially a Critical Element Step.

The failing Score Report will list steps that were missed or incorrect—look for numbers printed directly under a skill marked Unsatisfactory. A list of all the skills and the steps needed for each skill can be found in this handbook. Find the skill you failed, and study the steps, especially steps listed as Unsatisfactory on the score report.

In the example on the next page, a candidate received a result of Unsatisfactory on the skill Washes Hands. The numbers 1, 5, and 10 printed below the skill refer to steps that were

43

missed or performed incorrectly. To study for re-taking the Skills Evaluation, this candidate should turn to the Skills Listing in this handbook, look for the Washes Hands skill, and review all the steps, especially steps 1, 5, and 10.

North Carolina NNAAP® Examination Results

Exam: Skills Result: Fail

Skills Performance:

Washes Hands 1, 5, 10

Unsatisfactory

Provides Fingernail Care On One Hand

Satisfactory

Measures and Records Blood Pressure

Satisfactory

Puts One Knee-High Elastic Stocking on Client

Satisfactory

Measures and Records Weight of Ambulatory Client

Satisfactory

A sample of a Failing Score Report

PASSINGOnce you have passed bOTh the Written (or English or Spanish Oral) Examination and the Skills Evaluation, your name will be submitted to the North Carolina Nurse Aide I Registry. You may view your name on the Registry by going to www.ncnar.org. If you have any questions regarding your listing on the Registry you may contact the North Carolina Division of Health Service Regulation, Monday through Friday from 9:00 a.m. to 3:00 p.m. (EST) at (919) 855-3969 or (919) 715-0562.

duPlICAtE SCoRE REPoRtIf you lose your Score Report or need a duplicate Score Report, or would like a handscoring of your Written (or Oral) Examination or Skills Evaluation, complete the Request for Duplicate Score Report or Handscored Answer Sheet Form and mail it to Pearson VUE (see Appendix A).

44

NuRse aide testiNg gRievaNCe pROCess

oVERVIEWEach candidate has a right to file a grievance to complain or contest the results of their Nurse Aide Exam. The NACES Plus Foundation, Inc. (NACES) will follow-up on each grievance within thirty (30) days of receipt of the candidate grievance letter.

No grievance will be investigated if it is not received in writing by the NACES Plus Foundation, Inc.

PRoCESSAll grievances must be in writing. The candidate must provide as much detail as possible in a grievance letter and forward it to the NACES Plus Foundation, Inc. within 30 days of their exam date.

After receipt of the grievance letter, the appropriate RN Associate Program Director will investigate the complaint.

Once the investigation is complete, the RN Associate Program Director will draft a letter back to the candidate informing him/her of the outcome of the investigation. If an error was made by the evaluator, NACES, or Pearson VUE, the candidate will be allowed to retest at no additional cost.

45

the RegistRy

INItIAl lIStINGYou must pass both the written and skills portions of the NNAAP competency evaluation to be listed on the Nurse Aide I Registry. Once on the registry, your listing will remain current for 24 months from the month you passed both parts of the NNAAP exam. A letter advising you of your initial listing will be mailed to the address you provided on your exam application. You will not receive any other form or notice. Address corrections can be made at the exam site. Please check the letter for accuracy of your listing information and notify the registry if there are any errors.

CHANGE oF AddRESS oR NAmEThe North Carolina Nurse Aide I Registry must be kept informed of your current address and name.

There is no charge for changing your name or address on the registry. You may notify the registry of a name or address change by using the Name/Address Change Reporting Form on the Nurse Aide I Registry website (www.ncnar.org). Alternately, you may call the Nurse Aide I Registry at (919) 715-0562 or (919) 855-3969 to change your mailing address on the registry.

If your name changes at any time after you are placed on the registry, you must send written notification of this change to the registry. Please remember, however, that if you changed your name, you MUST provide official documentation along with your notification. Written docu-mentation must include 1) a COPY of your signed social security card with the new name on it, AND 2) a COPY of a court-issued marriage certificate, divorce decree, or other legal document that demonstrates the name change. Your notification must include your previous name, current name, mailing address, phone number, and Social Security number. All documents provided to the registry in sup-port of your name change MUST be official and legal documents. Any documents provided may be subject to verification with the issuing source.

Failure to inform the registry of an address or name change may jeopardize your listing status.

lIStING RENEWAlNurse aides on the North Carolina Nurse Aide I Registry must renew their registry listing to remain eligible for employment as a nurse aide. To be eligible for renewal based on employment, you must work for pay, performing nursing-related services (as a nurse aide or medication aide), under RN supervision, for at least eight (8) hours every twenty-four (24) months. This employment must be documented and reported to the Nurse Aide I Registry prior to each listing expiration date. A new competency examination is required if you do not work in a qualifying position for a 24-month period or more.

• Failure to inform the registry of an address or name change may jeopardize your listing status.

• It is your responsibility to renew. Current renewal procedures can be found at https://www.ncnar.org.

• There is no fee for re-listing on the North Carolina Nurse Aide I Registry.

For more information regarding Nurse Aide I list-ings and policies go to https://www.ncnar.org. Additional information is available to nurse aides and nurse aide candidates at the Frequently Asked Questions (FAQ) link.

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North Carolina

NURSE AIDEwritten (or oral) examination & skills evaluation

CANDIDATE HANDBOOKJuly 2012

PEARSON VUE

Quick RefeRence

NACES Plus FouNdAtioN, iNC.North Carolina NNAAP®


(888) 282-6904 Fax: 1 (866) 95 NACES

Hours of Operation 8:30 a.m. – 6:30 p.m. (Eastern Time Zone)

Call NACES Plus Foundation, Inc. to:• ObtainaCandidateHandbook• ObtainanApplicationfortesting• Obtainregistrationinformation• Canceland/orrescheduleanexamination• Arrangespecialexaminationrequests

andservices• Changeyourcurrentaddressorname

beforetesting• Requestanexcusedabsence

PEARSoN VuE® North Carolina NNAAP®

POBox13785 Philadelphia,PA19101-3785

(888) 204-6207Hours of Operation 8:00 a.m. – 5:00 p.m.

(Eastern Time Zone)

Call Pearson VUE to:• AskquestionsaboutOn-LineRegistration• ObtaininformationregardingyourScoreReport• RequestaduplicateScoreReport• Obtaininformationregardingyourexamination

Go to Pearson VUE’s website (www.pearsonvue.com) to:

• RegisterOn-Line• DownloadaCandidateHandbook• DownloadanApplication• ViewRegionalTestSitetestingdates• DownloadaNurseAidePracticeWritten

Examination• ViewtheNurseAideProgramOverview• ViewFrequentlyAskedQuestions• ViewalistoftheNurseAideRegistries(byState)• ViewSkillsListing

Refer any additional questions to:

NoRth CARoliNA dEPARtmENt oF hEAlth ANd humAN SERViCES Center for Aide Regulation

and Education*2709MailServiceCenter Raleigh,NC27699-2709

(919) 715-0562 (919)855-3969

Hours of Operation 8:00 a.m. – 12:00 p.m. and 1:00 p.m. – 3:00 p.m.

(Eastern Time Zone, weekdays) The phone lines will be closed between 12 noon and 1 p.m.

*Please do not send application or fee for testing to this address

PearsonVUEandNACESdonotdiscriminateonthebasisofage,sex,race,creed, disablingcondition,religion,nationalorigin,oranyotherprotectedcharacteristics.

Copyright©2012PearsonEducation,Inc.,oritsaffiliates.AllRightsReserved.

NNAAP®WrittenExamContentOutlineandPracticalSkillsListing Copyright©2011NationalCouncilofStateBoardsofNursing,Inc.(NCSBN®).Allrightsreserved.

Table of conTenTs

Quick Reference .......................... inside front cover

introduction ....................................................... 1NationalNurseAideAssessmentProgram............... 1ExamOverview........................................................ 2

Eligibility .................................................................. 2Nurse Aide Trained Candidates................................ 3CommunityCollegeRefresher

Course Candidates................................................ 3OtherNCNurseAideTrainedCandidates.............. 3Challengers............................................................... 3Student Nurse Candidates........................................ 4NorthCarolinaNurseAideIRegistryCandidates.... 4

Application and Scheduling ............................. 4FillingOutanApplication....................................... 4ProperI.D................................................................. 4ExamFees................................................................. 6ExamScheduling...................................................... 6AuthorizationtoTestNotice.................................... 7TestingLocations...................................................... 7SpecialExamRequestsandServices......................... 7TelecommunicationDevices

fortheDeaf(TDD).............................................. 7

Cancellation and re-scheduling .................... 8Refunds.................................................................... 8AbsencePolicy.......................................................... 9WeatherEmergencies................................................ 9

Exam day ................................................................ 10CheckingIn............................................................. 10WhattoBring......................................................... 10ProperIdentification................................................ 10Security................................................................... 11TestingPolicies....................................................... 12 Lateness............................................................... 12 ElectronicDevices............................................... 12 StudyAids........................................................... 12 Eating/Drinking/Smoking................................... 12 Misconduct.......................................................... 12 Guests/Visitors..................................................... 12

continued on next page

the Written (or oral) Exam ............................ 13WrittenExam..........................................................13EnglishorSpanishOralExam................................13

Written (or oral) Exam Content outline .... 14

Sample Questions ................................................ 15

self-assessment reading test ...................... 16-19

the Skills Evaluation .................................................20WhattoExpect...................................................... 20 Setting................................................................ 20 WhoWillActAsaClient?................................. 20 CandidateVolunteerRequirements.................... 20 CandidateDressRequirements........................... 20TheTasks................................................................ 21RecordingaMeasurement...................................... 22SampleRecordingSheetforMeasurementSkills.... 23 TipsfortheSkillsEvaluation.............................. 24

Skills listing ................................................... 25-40

Score Reporting .................................................. 41ExamResults........................................................... 41 Written(orOral)Exam....................................... 41 SkillsEvaluation.................................................. 41Failing..................................................................... 42ReadingaFailingScoreReport.............................. 42SampleofaFailingScoreReport............................ 43Passing.................................................................... 43DuplicateScoreReport........................................... 43

Grievance Process ............................................... 44Overview................................................................ 44Process.................................................................... 44

the Registry ........................................................... 45InitialListing........................................................... 45ChangeofAddressorName.................................... 45ListingRenewal...................................................... 46

AppendixAppendix A:RequestforDuplicateScoreReport

orHandscoredAnswerSheetForm

inTRoducTion

Thishandbook isdesigned forcandidates seekingNurseAide I certification in North Carolina. It describes theprocessofapplyingforandtakingtheNationalNurseAideAssessmentProgram(NNAAP®)Examination.

TheNorthCarolinaDepartmentofHealthandHumanServices (DHHS) has contracted with Pearson VUE,a nationally recognized leading provider of assessmentservices to regulatory agencies andnational associations.PearsonVUEwilladminister,score,andreporttheresultsof the NNAAP® Examination for the North CarolinaNurse Aide I Registry. The Nurse Aide CompetencyEvaluationService(NACES)willbeworkingwithPearsonVUEtoscheduleandadministertheexamination.

NAtioNAl NuRSE AidE ASSESSmENt PRoGRAm (NNAAP®)TheNursingHomeReformAct,adoptedbyCongressaspartoftheOmnibusBudgetReconciliationActof1987(OBRA’87),wasdesignedtoimprovethequalityofcarein long-termhealth care facilities and todefine trainingandevaluationstandardsfornurseaideswhoworkinsuchfacilities.Eachstateisresponsibleforfollowingthetermsofthisfederallaw.

TheNationalNurseAideAssessmentProgram(NNAAP®)isanexaminationprogramdesignedtodetermineminimalcompetencytobecomeacertifiednurseaideinyourstate.TheNNAAPwasdevelopedby the NationalCouncilofStateBoardsofNursing,Inc.,(NCSBN)tomeetthenurseaide evaluation requirementof federal and state laws andregulations.PearsonVUE is the authorized administratoroftheNNAAPinyourstate.

The NNAAP Examination is an evaluation of nurseaide-relatedknowledge,skills,andabilities.TheNNAAPExamination is made up of both a Written (or Oral)ExaminationandaSkillsEvaluation.ThepurposeoftheNNAAPExaminationistotestthatyouunderstandandcansafelyperformthejobofanentry-levelnurseaide.

1

ExAm oVERViEWYouwill be allowed to choose between aWritten orOralExamination.TheWrittenExaminationisavailableonlyinEnglish;theOralExaminationisavailableinEnglishorinSpanish.The twopartsof theNNAAPExaminationpro-cess,theWritten(orEnglishorSpanishOral)ExaminationandtheSkillsEvaluation,willbeadministeredonthesameday.YoumustpassbothpartstobecertifiedandlistedontheNorthCarolinaNurseAideIRegistry.TheWrittenExaminationconsistsofseventy(70)multiple-choice questions written in English. Sample examinationquestionsareprovidedinthishandbook.An Oral Examination available in English or in SpanishmaybetakeninplaceoftheWrittenExamination.TheOralExaminationconsistsofsixty(60)multiple-choicequestionsand ten (10) multiple-choice reading comprehension ques-tionsprovidedonacassettetape.YouwillbeaskedtolistentoacassettetapeoftheOralExaminationandfollowalongin the test booklet as the questions are read aloud on thetape.If you want to take the Oral Examination, you must request it when you submit your application. AttheSkillsEvaluationyouwillbeaskedtoperformfive(5)randomlyselectednurseaideskills.Youwillbegiventhirty(30)minutestocompletethefive(5)skills.Youwillbe rated on these skills by aNurseAideEvaluator. Youmustsuccessfullydemonstrateallfive(5)skillstopasstheSkillsEvaluation.Acompletelistingoftheskillsisshownonpages25to40.See The Written (or Oral) Exam and The Skills Evaluation formoredetailsabouttheNNAAPExamination.

eligibiliTy

AllcandidatesapplyingtotaketheNNAAPExaminationin North Carolina MUST complete an Application for Registration by Competency Examinationformusingoneoftheeligibilityrouteslistedonthefollowingtwo(2)pages.

north carolina state-approved nurse aide I trained candidatesAll applicants who have successfully completed a NorthCarolina state-approved Nurse Aide I training program.Candidatesmustpassbothportionswithintwo(2)yearsfromthecompletiondateofatrainingprogramorwithinthree (3) attempts,whichever comes first, in order to beplacedontheNorthCarolinaNurseAideIRegistry.

2

north carolina community college refresher course trained candidatesAll applicants who have completed a Nurse Aide Irefreshercourseat aNorthCarolinaCommunityCollege.Candidatemust pass both portionswithin two (2) yearsfromthecompletiondateof a refresher courseorwithinthree (3) attempts,whichever comes first, in order to beplacedontheNorthCarolinaNurseAideIRegistry.

other north carolina Nurse Aide Trained CandidatesAll applicants who have attended training in NorthCarolinaforpreparationforthisexamatanyprogramotherthanaNorthCarolinastate-approvedtrainingprogramorCommunity College Refresher Course. Candidates mustpassbothportionsoftheexamwithintwo(2)yearsfromtakingthefirsttestorwithinthree(3)attempts,whichevercomesfirst, inorder tobeplacedon theNorthCarolinaNurseAideIRegistry.Failuretodosowillrequiretrain-ing at aNorthCarolina state-approved training programorCommunityCollegeRefresherCourseandretestingofbothportionsoftheexamination.Ifyoureturntoschoolandhavenotcompletedtestingorpassedbothportionsof theexamination,youmust test(retest)BOTHportionsoftheexamination.

challengersAllapplicantswhohavecompletednurseaidetrainingout-sideNorthCarolina,orare listedonanother state’sNurseAide Registry (other thanNorthCarolina), or EMT’s, orother health professionals, or those with NO nurse aidetraining.Candidates mustpassbothportionsof the examwithin two (2) years of taking the first test or three (3)attempts,whichevercomesfirst,inordertobeplacedontheNorthCarolinaNurseAideIRegistry.FailuretodosowillrequiretrainingataNorthCarolinastate-approvedtrain-ing program or Community College Refresher Courseandretestingofbothportionsoftheexamination.Ifyoureturntoschoolandhavenotcompletedtestingorpassedbothportionsof theexamination,youmust test(retest)BOTHportionsoftheexamination.

3

Eligibility routes continue on next page

north carolina state-approved student nurse training candidatesAllapplicantswhoarecurrentlyenrolledinaNorthCarolinaapprovednursingeducationprogrampreparingforregisteredor practical nurse licensure. Candidates must pass bothportionswithintwo(2)yearsfromcompletionofthestate-approvedportionofthetrainingprogramorwithinthree(3)attempts,whichevercomesfirstinordertobeplacedontheNorthCarolinaNurseAideIRegistry.

North Carolina Nurse Aide I Registry CandidatesAll applicants who are listed on the NC Nurse Aide IRegistryandarenoteligibletotestunderanyothereligibil-ityroutes or are unable to renew under required qualify-ing work experience. (Current registry listing isActiveorInactive.)Mustpassbothportionsoftheexamwithintwo(2)yearsoftakingthefirsttestorthree(3)attempts,which-ever comes first, in order to become/remain active on theNorthCarolinaNurseAideIRegistry.

applicaTion and scheduling

FilliNG out AN APPliCAtioN

Proper IdentificationCandidatesarerequiredtobringtwo(2)formsofcurrent, not expired, official signature-bearing identification (oneofwhichmustbephoto-bearing)tothetestsite.OneformofidentificationmustbeaU.S.government-issuedSocialSecuritycard,signedandnon-laminated.Name and SSN must match what is on the application (for both on-line and paper registration).

4

ON-LINE REGISTRATION(pRefeRRed MeThod) On-line registration is quick, convenient and an environ-mentally responsibleway to register for your examination.Thisprocesswilleliminatethetransittimeassociatedwithmailingapaperapplication.Onceyourapplicationiscom-pleted,yourinformationwillbetransmittedtoNACESandtheschedulingprocesscanbeginalmostimmediately.• Paymentisintheformofacreditcardorpre-paidcredit

card(AmericanExpress,MasterCardorVisa).Feesarenon-refundableandnon-transferableoncesubmitted.

• You can access the On-Line application through thePULSEPortallinkwww.pulseportal.com

• YoumustcompleteallrequiredfieldsonyourapplicationbeforeitwillbesubmittedtoNACESforyourexamina-tionscheduling.Pleasecheckwww.pearsonvue.comforthelinkforrequiredinformation.

Should younot have access to the internet, credit card orpre-paidcreditcard,youmaystillsubmitapaperapplication.

PAPER APPLICATION

NOTE: As of August 1, 2011, there is a $20 service fee for paper applications or failing score reports submit-ted to NACES. This information must be received by NACES twelve (12) business days before the examination date.

• Youareresponsibleforcompletingtheappropriatesectionsof the Examination Application. You may ask someonefromyournurseaidetrainingprogramorfacilityemployerforassistanceincompletingtheapplication.

• Paymentmustbe in the formofamoney order, cer-tified check, or company check made payable to “NACES”. Themoneyorder,certifiedcheck,orcom-panycheckmustdisplayyournamesoitcanbeappliedto your examination. Company checks may pay formore than one candidate.Personal checks and cash will not be accepted. Fees are non-refundable and non-transferable once submitted to NACES.

• If you need help or have any questions about theapplication,pleasecontactaNACESCustomerServiceRepresentativeat(888)282-6904.

• Mailyourcompletedapplicationandfeetogether in one envelope to:

NACES Plus Foundation, Inc. NorthCarolinaNNAAP®


5

ExAm FEESThefeeslistedbelowhavebeenestablishedfortheNNAAP

ExaminationinNorthCarolina.

examination type fees

WrittenExamination&SkillsEvaluation $101

Oral(EnglishorSpanish)Examination&SkillsEvaluation $101

WrittenExaminationONLY (re-test) $24

Oral(EnglishorSpanish)ExaminationONLY (re-test) $24

SkillsEvaluationONLY (re-test) $77Additional fee for any paper application or failing score report submitted to NACES on or after Aug. 1, 2011

$20

The first time you test, you must schedule bOTh the Written (or Oral) Examination

and the Skills Evaluation.

UnderfederalandNorthCarolinastatelaws,candidatesemployedasnurseaidesinnursinghomesthatparticipatein Medicaid/Medicare programs are prohibited frompaying their examination fees. Employers must pay theexamination fee and any re-test fee for those candidatesin their employasnurse aidesor candidateswhohaveawrittencommitmentorsignedacceptanceofemploymentonfileinaMedicaid-certifiednursinghome.Candidateswho become employed as a nurse aide by a Medicare/Medicaidskillednursingfacilitywithin12monthsofsuc-cessful completion of the competency evaluationmay bereimbursed by the facility for training and competencytestingcosts.Thereforecandidates shouldsaveall receiptstosubmittotheskillednursingemployer.

ExAm SChEduliNG OnceNACES receives your application, required docu-ments, and fees, they will schedule you for testing.NACES will mail your Authorization to Test Notice (yellow postcard) to you at the address listed on yourapplicationwithinforty-eight(48)hours.

6

AuthoRizAtioN to tESt NotiCEYour Authorization to Test Notice (yellow postcard) has important information about the examination. If you do not receive your notice within seven (7) business days, call NACES. NACES is NOT responsible for lost, misdirected, or delayed mail.

tEStiNG loCAtioNSTheNNAAPExaminationisgivenbyNACESatRegionalTestSites.

The complete testing schedule, titled North Carolina Regional Test Sites &

Schedules, is available on the Pearson VUE website (www.pearsonvue.com) or at

https://www.ncnar.org, then click on the word Pearson VUE.

SPECiAl ExAm REQuEStS ANd SERViCESPearsonVUEcomplieswiththeprovisionsoftheAmericanswithDisabilitiesAct(42U.S.C.§12101et seq.)andTitleVIIof theCivilRightsAct, as amended (42U.S.C.§2000e et seq.),inaccommodatingdisabledcandidateswhoneedspecialarrangementstotaketheexamination.

If you have a disability, you may ask for special arrangements for testing when you apply.Allrequestsmustbeapprovedinadvance.Besureto:

•providestatementofdiagnoseddisabilityfromyourhealthcareprovider

•explainspecifictypeofaccomodationrequested

Nurse Aide Evaluators administering the Written (orEnglish or Spanish Oral) Examination and the SkillsEvaluationwill be prepared tomeet the needs of nurseaidecandidateswhohaveapprovedaccomodations.

tElECommuNiCAtioN dEViCES FoR thE dEAF (tdd)PearsonVUEisequippedwithTelecommunicationDevicesfor the Deaf (TDD) to assist deaf and hearing-impairedcandidates.TDDcallingisavailableduringallPearsonVUEhours through a special toll-free number, (866) 274-2777.ThisTDDphoneoptionisfortheexpressuseofindividualsequippedwithcompatibleTDDmachinery.

7

cancellaTion and Re-scheduling

Ifyouareunabletoattendyourscheduledexamination,you MUST notifyNACES at least seven (7) business daysbeforetheexaminationdatetore-schedule.SaturdayandSundayandnationalholidaysarenotconsideredbusi-nessdays.

If you provide at least seven (7) business days advancenotice, you may re-schedule one (1) time, without pen-altycharges,andyourfeemaybetransferredtoyournewexaminationdate.

If you need to re-schedule an examination in less thanseven(7)businessdaysbeforetheexaminationdate,youmust apply for an excused absence. (Please refer to theAbsence Policy sectioninthishandbook.)

IfyoudonotcallNACESatleastseven(7)businessdaysbeforeyourexaminationdatetore-schedule,anddonotshow up for your scheduled examination, your fee willNOT be refunded and cannot be transferred to a newexaminationdate.Also,youmaynotgiveyourexamina-tiondatetoanotherperson.

REFuNdSOncepaymentofexamfeesisreceived,NO REFUNDS WILL bE ISSUED.

8

AbSENCE PoliCySinceunexpectedsituationsoccur,NACESwillconsiderexcusinganabsencefromascheduledexamination.

Acceptable reasons for re-scheduling are as follows:• Illnessofyourselforamemberofyour immediate

family• Deathinthefamily• Disablingtrafficaccident• Courtappearanceorjuryduty• Militaryduty• Weatheremergency

Requests for excused absencesmust bemade inwritingandreceivedwithin ten (10) business daysfollowingthescheduled examination. This request must include veri-ficationofyourabsence fromanappropriate source.Forexample,ifyouhadjuryduty,youmustsupplyacopyofyourcourtnotice.

ThedecisionofNACES toapproveordeny the excusedabsenceisfinal.

WEAthER EmERGENCiESExaminationswillbedelayedorcancelledonlyinemergen-cies.Ifsevereweatheroranaturaldisastermakesthetestcen-terinaccessibleorunsafe,theexaminationwillbedelayedorcanceled.Iftheexaminationhasbeencanceled,youwillbere-scheduledforthenextavailableexaminationatthatsite.

9

exaM day

ChECkiNG iNYoumustarrive30minutespriortoyourscheduledtimeforBOTHthewrittenandskillsexaminations.Ifyouarelateforthewrittenexaminationyouwillnotbeallowedtotestandyourfeeswillnotberefunded.Ifyoumissedyourwrittenexaminationandarescheduledforaskillsevalua-tion,pleasearrive30minutespriortoyourscheduledtime.SkillsEvaluationtesttimesareapproximate.Youwillberequiredtocheckinforboththewrittenandfortheskillsexaminations.Youwillberequiredtopresentproperidentification.

WhAt to bRiNGYoumust have the following items with you when youtaketheexamination:• Two(2)formsofproperidentification• Three(3)No.2pencils(sharpened)• Eraser• Watchwithasecondhand

No other materials will be allowed.

PRoPER idENtiFiCAtioNCandidatesarerequiredtobringtwo(2)formsofcurrent, not expired, official signature-bearing identification (oneofwhichmustbephoto-bearing)tothetestsite.OneformofidentificationmustbeaU.S.government-issuedSocialSecuritycard,signedandnon-laminated.NurseAideIapplicantswhoareinthearmedservicesmayusetheircurrentU.S.MilitaryI.D.inplaceofaSocialSecurity(SS)card.Thetesttaker’sSSnumbermustbeontheI.D.ifused.SponsororDependentMilitaryI.D.sareNOTaccept-edinplaceofSScard,butcanbeusedasasecondI.D.(onewithphoto)whenpresentedwithavalidSScard.

The second form must be any of those listed below.PhotocopiesofidentificationwillNOTbeaccepted.OriginalsignaturebearingSScardsarerequiredtotestinNC.If youhave scheduledyour examandhavemisplacedyourSScard7businessdayspriortoyourexam,callNACEStoreschedule.Ifthereareextenuatingcircumstancessuchasfireortheftandyourexamisscheduledinlessthan7businessdaysfromthetimeoftheincident,youmayapplyforanexcusedabsence.Refertopage7,CancellationandReschedulingin

10

theNCNurseAideIHandbook.Documentationsubstan-tiating the event must be provided. NACES’s decision toapproveordenyacreditrequestwillbefinal.

Proper photo identification includes one of the following:

• Current, non-expired driver’s license (Candidateswho do not have their new license by exam dayMUSTbringtheirexpireddriver'slicenseANDthe20daytemporarypermit)

• U.S.government-issuedMilitaryI.D.(ifnotusedinlieuofsocialsecuritycard)

• State-issuedidentificationcard• Passport(USorforeign,current,non-expired)• Alienregistrationcard

The name on your identificationmustbethesameasthenameyouusedontheapplicationtoregisterfortheexami-nation.Ifyournamehaschanged,youmust:

•ContactNACES(ifyouappliedbymail/paperappli-cation)orPearsonVUE(ifyouappliedonline),and

•IfyouWEREpreviouslylistedontheNorthCarolinaNurseAideIRegistry,alsocontacttheRegistry.

Youmust contactNACES/PearsonVUE at least seven (7)businessdayspriortoyourscheduledexam,andtheRegistryatleast(9)businessdayspriortotheexam.Bepreparedtopro-videofficialgovernmentdocumentationofthenamechange.If you do not bring proper identification to the exam, you will not be allowed to test and your examination fee will not be refunded.

SECuRity ANd ChEAtiNGIf you give help to or receive help from anyone during theexamination, theexaminationwillbe stopped.The incidentwill be reported to theNorthCarolinaDivision ofHealthServiceRegulation(DHSR)forreview,andyourexaminationwillnotbescored(seeTesting Policies).

Pleasenotethatallexaminationquestions,eachformoftheexamination, andallother examinationmaterials are copy-righted by, the property of, or licensed by Pearson VUE.Consequently, any distribution of the examination contentormaterials throughany formof reproduction,or throughoral or written communication, is strictly prohibited andpunishablebylaw.Anyone who removes or tries to remove examination materials or information from the test site will be prosecuted.

11

tEStiNG PoliCiESThefollowingpoliciesareobservedateachtestcenter.

Lateness

Youmust arrive thirty (30)minutes before the examina-tionstarts.Ifyouarelateforyourscheduledexamination,or do not bring all of your required materials, you willNOT be allowed to test and your examination fee willNOTbereturned.IfyouarelatefortheWritten(orOral)Examination,butarriveontimefortheSkillsEvaluation,youwillbeallowedtotaketheSkillsEvaluation.

IfyouarelateforyourSkillsEvaluationordonotbringallyourrequiredmaterials,youwillNOTbeallowedtotestandyouwillberequiredtore-applyandpayanotherexaminationfee(seeCancellationformoredetails).

Electronic Devices

Cellularphones,beepers,oranyotherelectronicdevicesare not permitted to be used and must be turned offduring testing.There is no place for storage of personalbelongingsatthetestcenter.

Study Aids

You are not permitted to take personal belongings suchas briefcases, large bags, studymaterials, extra books, orpapers into the examination room. Any such materialsbrought intotheexaminationroomwillbecollectedandreturned to youwhen you have completed the examina-tion.PearsonVUEisnotresponsibleforlostormisplaceditems.

Eating/Drinking/Smoking

Youarenotpermittedtoeat,drink,orsmokeduringtheexamination.

Misconduct

If you are discovered causing a disturbance of any kindorengaging inanykindofmisconduct,youwillbedis-missed from the examination and the incident will bereportedtotheNorthCarolinaDivisionofHealthServiceRegulation.

Guests/Visitors

No guests, visitors, pets, or children are allowed at the test center.

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The WRiTTen (oR oRal) exaM

WRittEN ExAmThe Nurse Aide Evaluator will hand out materials andgiveinstructionsfortakingtheWrittenExamination.TheWritten Examination has seventy (70) multiple-choicequestions. You will have two (2) hours to complete theWrittenExamination.Youwillbe toldwhenfifteen (15)minutes remain. Fill in only one (1) oval on the answersheetforeachquestion.MarkingsinthetestbookletwillNOTbeacceptedasanswers.Youranswersmustappearon the separate answer sheet. Sample questions for theWrittenExaminationarelocatedonpage14.

ENGliSh oR SPANiSh oRAl ExAmAn Oral Examination may be taken in place of theWritten Examination. The Oral Examination may betaken in English or in Spanish. You must request anEnglish or Spanish Oral Examination when filling outyourapplication.TheOralExaminationisprovidedonacassettetape.Acassetteplayerandearphonesareprovidedatthetestcenter.YouwillbeaskedtolistentoatapeoftheOralExaminationandfollowalonginthetestbookletasthequestionsarereadaloudonthetape.TheOralExaminationconsistsoftwo(2)parts,andyoumustpassbothpartstopasstheOralExamination.ThefirstpartoftheOralExaminationhassixty(60)multiple-choice questions. Each of these questions is read twice.Aseachquestionisread,youwillbeaskedtochoosethecorrectanswerandmarkitonyouranswersheet.The second part of the Oral Examination has ten (10)multiple-choicequestions.Thesequestionstestyourabil-itytospeakaminimumamountofEnglishbyrecogniz-ingcommonwordsusedbynurseaidesinlong-termcarefacilities.Eachwordisreadthree(3)times.Youareaskedtomatch theword you hear on the tape to thewrittenwordinthetestbooklet.Asyoufindthematch,markyouranswerontheanswersheet.TheOralExamination takes two (2)hours to complete.Youwillbetoldwhenfifteen(15)minutesremain.Fillinonlyone (1)ovalon theanswer sheet foreachquestion.Youmaywriteinthetestbooklet,butmarkingsinthetestbookletwillNOTbeacceptedasanswers.Youranswersmustappearontheseparateanswersheet.

13

WRiTTen (oR oRal) exaM conTenT ouTline

The currentNNAAP® ExaminationContentOutline isbasedonthefindingsfromthe2009 Job Analysis of Nurse AidespublishedbyNCSBNinspring2010.

The NNAAP written examination is comprised of 70multiple-choice items; 10 are pretest items (non-scored)on which statistical information will be collected. TheNNAAP oral examination is comprised of 60multiple-choiceitemsand10readingcomprehension(wordrecog-nition)items.Thecandidateisallowedtochoosebetweenawrittenandanoralexamination. # of % of questions I. Physical Care Skills the exam in the exam

A.ActivitiesofDailyLiving........ 14% ............8 1.Hygiene 2.DressingandGrooming 3.NutritionandHydration 4.Elimination 5.Rest/Sleep/Comfort B.BasicNursingSkills.................39%............ 24 1. InfectionControl 2.Safety/Emergency 3.Therapeutic/TechnicalProcedures 4.DataCollectionandReporting C.RestorativeSkills...................... 7%.............4 1.Prevention 2.SelfCare/Independence

II. Psychosocial Care Skills A.Emotionaland MentalHealthNeeds..............11%.............6

B.SpiritualandCulturalNeeds....2%..............2

III. Role of the Nurse Aide A.Communication....................... 8%.............5

B.ClientRights........................... 7%.............4

C.LegalandEthicalBehavior...... 3%.............2

D.Memberofthe HealthCareTeam................... 9%.............5

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saMple QuesTions

Thefollowingquestionsaresamplesofthekindsofques-tions that you will find on the Written Examination.Checkyouranswerstothesequestionsintheboxbelow.

1. The client's call light should always be placed:(A) onthebed(B) withintheclient'sreach(C) ontheclient'srightside(D) overthesiderail

2. Which of the following items is used in the pre-vention and treatment of bedsores or pressure sores?(A) rubbersheet(B) airmattress(C) emesisbasin(D) restraint

3. When caring for a dying client, the nurse aide should:(A) keeptheclient'sroomdarkandquiet(B) allowclienttoexpresshisfeelings(C) changethesubjectifclienttalksaboutdeath(D) contacttheclient'sminister,priestorrabbi

4. What does the abbreviation ADL mean?(A) AdLib(B) AsDoctorLikes(C) ActivitiesofDailyLiving(D) AfterDaylight

5. After giving a client a back rub, the nurse aide should always note:(A) thelasttimetheclienthadabackrub(B) anychangeintheclient'sskin(C) client'sweight(D) amountoflotionused

6. how should the nurse aide communicate with a client who has a hearing loss?(A) facetheclientwhenspeaking(B) repeatthestatement(C) shoutsothattheclientcanhear(D) useahigh-pitchedvoice

Correct Answers

1.B2.B3.B4.C5.B6.A

15

self-assessMenT Reading TesT

The two-part Self-Assessment Reading Test that appearsbelowwill help youdecide if you should consider takingtheOralExaminationinsteadoftheWrittenExamination.Tocomplete thereadingtest, followthe instructionspro-videdbelowandselecttheanswertoeachquestion.Whenyou have completed the reading test, youwill be able todeterminethenumberofquestionsyouansweredcorrectly.

PARt 1: VoCAbulARy

1. Circlethebestanswertoeachquestion.

2. Whenyouhavefinished,checkyouranswersusingtheanswerkeyonpage18.

3. Countupthenumberofcorrectanswers.

4. Ifyourscoreislessthan17,youmayhavedifficultyreadingtheWrittenExaminationandshouldcon-sidertakingtheOralExamination.

1. You go to a doctor when you _____.(A) feelsleepy (D) needmoney(B) needsocks (E) needclothes(C) feelsick

2. A person who flies an airplane is its _____.(A) pilot (D) surgeon(B) steward (E) director(C) mother

3. You use a _____ to write.(A) bow (D) carpenter(B) calculator (E) needle(C) pencil

4. To ExIT a room means to _____ it.(A) enter (D) read(B) leave (E) interrupt(C) forget

5. A wedding is a joyous _____.(A) focus (D) occasion(B) vehicle (E) civilization(C) balloon

6. To REqUIRE something means to _____ it.(A) need (D) understand(B) have (E) hear(C) forget go to next page

16

7. You _____ something to find its length.(A) slice(B) lock(C) measure(D) force(E) tape

8. Soup is served in a _____.(A) plate(B) bowl(C) fork(D) chair(E) closet

9. To accompany someone means to _____.(A) disagreewithhim(B) workforhim(C) gowithhim(D) speaktohim(E) choosehim

10. A nursing home resident receives _____ from the staff.(A) quality(B) fame(C) interruption(D) care(E) work

11. Medicine is used to _____ pain.(A) widen(B) conjure(C) enliven(D) increase(E) relieve

12. To DRENCh the flowers means to ____ them.(A) steam(B) drink(C) touch(D) soak(E) anger

13. A bicycle is a means of _____.(A) nourishment(B) transportation(C) prediction(D) collision(E) walking

14. When someone speaks in a whisper, it may be difficult to _____.(A) deceive(B) understand(C) frighten(D) estimate(E) regulate go to next page

17

self-assessMenT Reading TesT

PARt 2: ComPREhENSioNInthispartofthereadingtestyouwillbeprovidedwithaseriesofbriefparagraphs.Youaretoreadeachparagraphandthenanswerthequestionsthatappearaftertheparagraph.

Therearemanydifferentkindsoffish.Allfishliveinwater.Theyusetheirtailsandfinstoswim.

15. Fish live in _____.(A) cups(B) houses(C) air(D) water(E) fountains

16. Fish use their _____ to swim.(A) tails(B) heads(C) gills(D) lungs(E) floats

Mariagrewupona farm.She lovedtheworkonthe farm.Sheknewwhen all of the cropshad tobeplanted.Shewouldlikeajobonafarmorinaflowergarden.

17. Maria has had experience as a _____.(A) guide(B) farmer(C) driver(D) nurse(E) teacher

18. She would like to work in _____.(A) anoffice(B) alibrary(C) agarden(D) ahospital(E) asupermarket

19. As a child Maria lived _____.(A) inthecity(B) inanapartment(C) onafarm(D) inalargehouse(E) onthebeach go to next page

18

Carolynhasagoodjob.Sheisanurseinalargehos-pital.Everydayshecanhelpmanypeople.Sheenjoysthisverymuch.Shealsomakesagood salary.Eachmonthshecanpayherbillsandsavesomemoney.

20. Carolyn works in a _____.(A) hospital(B) doctor’soffice(C) garage(D) school(E) library

21. One of the things Carolyn enjoys is _____.(A) workinginanoffice(B) helpingpeople(C) readingbooks(D) workinglatehours(E) drivingacar

22. With her salary she can pay her bills and _____.(A) buyfurniture(B) givetocharity(C) savemoney(D) buynewclothes(E) payforcollege

This completes the Self-Assessment Reading Test.

Answers

1.C 7.C 13.B 19.C

2.A 8.B 14.B 20.A

3.C 9.C 15.D 21.B

4.B 10.D 16.A 22.C

5.D 11.E 17.B

6.A 12.D 18.C

If your score is less than 17, you may have difficulty reading the Written Examination and should consider taking the Oral Examination in place of the Written Examination.

19

The skills evaluaTion

WhAt to ExPECt

Setting

TheSkillsEvaluationissetuptoresembleanactualcare-givingsituation.TheSkillsEvaluationareawilllooksimilartoyourworksetting.Itwillhavealltheequipmentneces-sary to perform the assigned skills.The Skills Evaluationwill be administered by a Nurse Aide Evaluator. Beforeyour skills evaluationbegins, theevaluatorwill showyouwhere equipment is located and answer questions aboutoperatingtheequipment.Please arrive 30 minutes early. Test times are approxi-mate. Please plan to spend the day.

Who Will Act as a Client?

Thepartofthe“client”willbeplayedbyacandidatewhovolunteerstoactasaweakenedelderlyperson.Whileyouperformtheskills,speaktothecandidatevolunteerasyouwouldspeaktoanactualclientinanurseaideworksetting.Youareencouragedtospeaktothecandidatevolunteernotonlybecauseitispartofqualitycare,butalsobecauseitwillhelpyoutorelaxasyouperformtheskills.

Candidate Volunteer Requirements

Youwillneedtoactasacandidatevolunteerforanothercandidate’sSkillsEvaluationandplaytheroleofanursinghomepatient (client).The evaluatorwill give you verbalinstructionsthatwilldescribehowyoushouldactinper-formingtheroleoftheclient.

Candidate dress Requirements

You must wear flat, slip-on, non-skid shoes,aloose-fittingtopwithshortsleevesthatcanberolleduptotheshoulderor tank top, and loosefittingpants that canbe rolledup.Youwillberequiredtoputagownonoveryourclothing.Innocasemaycandidatesremoveclothingdowntoundergar-ments.

Priortobeginningtheexam,youshouldinformtheevalu-atorofanyfoodorlatexallergyorsensitivitytoskinsoapsor lotion.Any limitations to range ofmotionmust alsobecommunicatedtotheevaluatorpriortothestartoftheskillsexamination.

20

Forinfectioncontrolpurposes,youshouldnotcometothetestsitewithopenareas/soresontheskin.Candidateswithanyopenareasorsoresontheirskinshouldrescheduletheirskillstesttoalaterdateaftertheirskinfullyheals.

thE tASkSTheNNAAPSkillsListcontainsalloftheskillsthatyoumaybeaskedtodemonstrateduringtheSkillsEvaluation.Eachskillrepresentsataskthatyouwillbeaskedtoper-forminyourjobandhasbeenbrokendownintoaseriesofsteps.

See pages 25-40 for the complete skills listing.

Astepthatishighlightedinbold typeiscalledaCritical Element Step.CriticalElementStepsareimportantstepsthatmustbeperformedcorrectlyinorderforyoutopassthe skill. If you leave out aCriticalElement Step or donotperformaCriticalElementStepproperly,youwillnotpass theskill.However, ifyouperformonlytheCriticalElement Step correctly in a skill, you do not automati-callypassthatskill.Youmustalsocorrectlydemonstrateenough steps tomeet the passing standard (or cut score) foreachskill.

Before your Skills Evaluation begins, the Nurse AideEvaluatorwillgiveyouaninstructioncardthatwilllistthefive(5)skillsselectedforyoutoperform.Hand-washingwillalwaysbeoneoftheskillstobeperformed.Theremainingfour(4)skillsarerandomlychosenfromthecompletesetofskillslistingsonpages25to40ofthishandbook.Youarestronglyencouragedtoperformtheskillsintheordertheyarelistedontheinstructioncard.Ifyoumakeamistake,sayso,andyouwillbeinstructedto tell the evaluatorwhich step(s) is tobe correctedandthentoperformthestep(s).Youwillnothavetoredotheentireskill, just thestepsyouwishtocorrect.Thereare,however, some exceptions to this rule. If you fail toputonglovesortakethemoffwhenitisrequiredtodosoandthe evaluator reminds you to do so, for infection controlpurposes,thenyouwillnotreceivecreditforattemptingtocorrectthisstep.Ifyouwishtocorrectanorder-dependentstep (a step stating that an action should be performedbefore or afteranotherstep)andyoufailtosaywhenthecorrected step should be performed, you will not receivecreditforthecorrection.

21

Once you begin a new skill, you may not go back tocorrect a previous skill. The Nurse Aide Evaluator willnot answer questions during the Skills Evaluation andwillnottellyouwhetheryouperformedaskillcorrectly.Youmaynot receivehelp fromanyoneduring theSkillsEvaluation.Ifyoudohaveanyquestions,pleaseaskthembeforetheSkillsEvaluationbegins.At least one (1) of the four (4) randomly-selected skillswill include a measurement skill (see the section below,Recording A Measurement,formoreinformationregardingmeasurementskills).

Youwillbeaskedtodecontaminateyourhands(withhandsanitizer)beforeproceedingfromskillsperformedonaliveclient to skills that are not. This is for infection controlpurposesandwillnoteffecttheresultofyourevaluation.

When you have completed your skills evaluation, the evaluator will direct you to wash your hands. Although this will not affect your examination results, for the pur-poses of infection control, you must wash your hands.

You must successfully complete all five (5) skills to pass the Skills Evaluation. You will have thirty (30) minutes todemonstrateallfive(5)skills.

RECoRdiNG A mEASuREmENtTheNNAAPSkillsEvaluationrequireseverycandidatetoperformatleastonemeasurementskill,suchasbloodpres-sure,radialpulse,respirations,urineoutput,orweight.Youwillbegivena special form,calledaRecordingSheet forMeasurementSkills,towritedown,orrecord,themeasure-ment.Forexample,ifperformingtheMeasures and Records Blood Pressureskill,youwillwritethecompletesystolicanddiastolicpressuresofyourbloodpressurereadinginaboxlabeledCandidateResults.

Onthefollowingpageisacopyoftherecordingsheetthatwillbeusedduringtheskillsexam.Thecandidatemustrecordhis/herresultsintheCandidateResultsboxonthissheet.Thissheetwillbeusedtorecordtheresultsofthefollowingmeasurementskills:

• MeasuresandRecordsBloodPressure• MeasuresandRecordsWeightof

AmbulatoryClient• MeasuresandRecordsUrinaryOutput• CountsandRecordsRadialPulse• CountsandRecordsRespirations

22

23

Date

Test Site ID

CANDIDATE NAME

CANDIDATE ID

EVALUATOR NAME

EVALUATOR ID

SKILL TESTEDEvaluator must check one box next to the skill being tested.

� Blood Pressure � Respirations

� Oral Temperature � Urine Output

� Radial Pulse � Weight

RECORDING SHEET FOR MEASUREMENT SKILLS

TM

CANDIDATE EVALUATORRESULTS RESULTS

Copyright © 2005 Promissor, Inc. All Rights Reserved. Stock# 0699-02 6/05

SAMPLE

Tips for the Skills Evaluation

• You will be expected to perform the skills as youwould in a nursing home setting. When water isrequired,youmustuserunningwater.Allcandidateswill be required to perform theHand Hygiene skill.Theevaluatorwillinformyouafteryouhavewashedyourhandsforthefirsttimethatyoushouldjusttellhimorherwhenyouwouldwashyourhandsduringyourperformanceoftherestoftheskills,ratherthanactually washing them for each skill. For all stepsotherthanhand-washing,youmustactuallyperformtheskillinordertoreceivecredit.Youmaynotsimplytelltheevaluatorwhatyouwoulddoforsimulatingastep.Forexample,youmaynotsimplytelltheevalua-torthatyouwouldwashtheclient.Youmustactuallydemonstratewashingtheclient.Youmaynotsimplytelltheevaluatorthatyouwouldfeedtheclient.Youmustactuallydemonstratefeedingtheclient.

• Afteryouhaveintroducedyourselftotheclientforthefirsttime,itisnotnecessaryforyoutointroduceyourselfeachtimeyoubeginanewskill.

• To receive full credit for a measurement skill, youmustaccuratelymaketherequiredmeasurementandthenwrite thatmeasurementon theRecording Sheet for Measurement Skills.TheevaluatorwillprovidetheRecordingSheettoyouatthetestsite.AsampleoftheRecordingSheet is shownonpage22of thishand-book.YouareencouragedtobecomefamiliarwiththeRecordingSheetbeforeyourscheduledtestdate.

• Youmustknowhowtooperatebothastandingandanon-digitalbathroomscaleandmustknowhowtosetbothtypesofscalestozero.

• Youmay not bringanyofyourownequipmenttothetestsite(e.g.transfer/gaitbelt).

• Itisimportantforyoutoplacethecallsignalwithintheclient’sreachwheneveryouleavetheclient.

• Where the word “client” appears, it refers to the person receiving care.

24

skills lisTing

The 24 skills that follow are arranged in alphabeticalorder,exceptfortheHand Hygiene (Hand Washing)skill.HandHygiene is listedfirstasa reminderof the impor-tanceofperformingthis skillbeforeallother skills.Thenumbered linesbelow each skill are the stepsneeded toperformthatskill.CriticalElementStepsareinboldtype.

hand hygiene (hand Washing) 1 Addressclientbynameandintroducesselftoclientby

name 2 Turnsonwateratsink 3 Wetshandsandwriststhoroughly 4 Appliessoaptohands 5 Lathers all surfaces of wrists, hands, and fingers

producing friction, for at least 20 (twenty) seconds, keeping hands lower than the elbows and the fingertips down

6 Cleansfingernailsbyrubbingfingertipsagainstpalmsoftheoppositehand

7 Rinse all surfaces of wrists, hands, and fingers, keeping hands lower than the elbows and the fingertips down

8 Usesclean,drypapertowel/towelstodryallsurfacesofhands,wrists,andfingersthendisposesofpapertowel/towelsintowastecontainer

9 Usesclean,drypapertowel/towelstoturnofffaucetthendisposesofpapertowel/towelsintowastecontainerorusesknee/footcontroltoturnofffaucet

10 Doesnottouchinsideofsinkatanytime

applies one knee-high elasTic sTocking 1 Explainsprocedure,speakingclearly,slowly,and

directly,maintainingface-to-facecontactwheneverpossible

2 Privacyisprovidedwithacurtain,screen,ordoor 3 Clientisinsupineposition(lyingdowninbed)while

stockingisapplied 4 Turnsstockinginside-out,atleasttotheheel 5 Placesfootofstockingovertoes,foot,andheel 6 Pullstopofstockingoverfoot,heel,andleg

25

Skill continues

7 Movesfootandleggentlyandnaturally,avoidingforceandover-extensionoflimbandjoints

8 Finishes procedure with no twists or wrinkles and heel of stocking, if present, is over heel and opening in toe area (if present) is either over or under toe area

9 Signalingdeviceiswithinreachandbedisinlowposition

10 Aftercompletingskill,washhands

assisTs To aMbulaTe using TRansfeR belT 1 Explainsprocedure,speakingclearly,slowly,and


2 before assisting to stand, client is wearing shoes 3 Beforeassistingtostand,bedisatasafelevel 4 Beforeassistingtostand,checksand/orlocksbed

wheels 5 before assisting to stand, client is assisted to sitting

position with feet flat on the floor 6 Beforeassistingtostand,appliestransferbeltsecurely

atthewaistoverclothing/gown 7 Beforeassistingtostand,providesinstructionstoenable

clienttoassistinstandingincludingprearrangedsignaltoalertclienttobeginstanding

8 Standsfacingclientpositioningselftoensuresafetyofcandidateandclientduringtransfer.Countstothree(orsaysotherprearrangedsignal)toalertclienttobeginstanding

9 Onsignal,graduallyassistsclienttostandbygraspingtransferbeltonbothsideswithanupwardgrasp(candidate’shandsareinupwardposition),andmaintainingstabilityofclient’slegs

10 Walksslightlybehindandtoonesideofclientforadistanceoften(10)feet,whileholdingontothebelt

11 Afterambulation,assistsclienttobedandremovestransferbelt


13 Aftercompletingskill,washhands

26

assisTs WiTh use of bedpan 1 Explainsprocedurespeakingclearly,slowly,and


2 Privacyisprovidedwithacurtain,screen,ordoor 3 Beforeplacingbedpan,lowersheadofbed 4 Putsoncleanglovesbeforehandlingbedpan 5 Places bedpan correctly under client’s buttocks 6 Removesanddisposesofgloves(without

contaminatingself )intowastecontainerandwasheshands

7 Afterpositioningclientonbedpanandremovinggloves,raisesheadofbed

8 Toilettissueiswithinreach 9 Handwipeiswithinreachandclientisinstructedto

cleanhandswithhandwipewhenfinished10 Signalingdevicewithinreachandclientisaskedto

signalwhenfinished11 Putsoncleanglovesbeforeremovingbedpan12 Headofbedisloweredbeforebedpanisremoved13 Avoidsoverexposureofclient14 Emptiesandrinsesbedpanandpoursrinseintotoilet15 Afterrinsingbedpan,placesbedpanindesignated

dirtysupplyarea16 Afterplacingbedpanindesignateddirtysupply

area,removesanddisposesofgloves(withoutcontaminatingself )intowastecontainerandwasheshands


cleans uppeR oR loWeR denTuRe 1 Putsoncleanglovesbeforehandlingdenture 2 Bottomofsinkislinedand/orsinkispartiallyfilled

withwaterbeforedentureisheldoversink 3 Rinsesdentureinmoderatetemperaturerunning

waterbeforebrushingthem 4 Appliestoothpastetotoothbrush 5 Brushessurfacesofdenture 6 Rinsessurfacesofdentureundermoderate

temperaturerunningwater 7 Beforeplacingdentureintocup,rinsesdenturecup

andlid

27

Skill continues

8 Placesdentureindenturecupwithmoderatetemperaturewater/solutionandplaceslidoncup

9 Rinsestoothbrushandplacesindesignatedtoothbrushbasin/container

10 Maintainscleantechniquewithplacementoftoothbrushanddenture

11 Sinklinerisremovedanddisposedofappropriatelyand/orsinkisdrained

12 Afterrinsingequipmentanddisposingofsinkliner,removesanddisposesofgloves(withoutcontaminatingself )intowastecontainerandwasheshands

counTs and RecoRds Radial pulse 1 Explainsprocedure,speakingclearly,slowly,and


2 Placesfingertipsonthumbsideofclient’swristtolocateradialpulse

3 Countbeatsforonefullminute 4 Signalingdeviceiswithinreach 5 Beforerecording,washeshands 6 After obtaining pulse by palpating in radial artery

position, records pulse rate within plus or minus 4 beats of evaluator’s reading

counTs and RecoRds RespiRaTions 1 Explainsprocedure(fortestingpurposes),speakingclearly,

slowly,anddirectly,maintainingface-to-facecontactwheneverpossible

2 Countsrespirationsforonefullminute 3 Signalingdeviceiswithinreach 4 Washeshands 5 Records respiration rate within plus or minus 2

breaths of evaluator’s reading

28

donning and ReMoving ppe (goWn and gloves) 1 Picksupgownandunfolds 2 Facingthebackopeningofthegownplacesarms

througheachsleeve 3 Fastenstheneckopening 4 Securesgownatwaistmakingsurethatbackofclothing

iscoveredbygown(asmuchaspossible) 5 Putsongloves 6 Cuffsofglovesoverlapcuffsofgown 7 before removing gown, with one gloved hand,

grasps the other glove at the palm, remove glove 8 Slips fingers from ungloved hand underneath cuff of

remaining glove at wrist, and removes glove turning it inside out as it is removed

9 Disposesofglovesintodesignatedwastecontainerwithoutcontaminatingself

10 Afterremovinggloves,unfastensgownatneckandwaist

11 Afterremovinggloves,removesgownwithouttouchingoutsideofgown

12 Whileremovinggown,holdsgownawayfrombodywithouttouchingthefloor,turnsgowninwardandkeepsit inside out

13 Disposesofgownindesignatedcontainerwithoutcontaminatingself

14 Aftercompletingskill,washeshands

dResses clienT WiTh affecTed (Weak) RighT aRM 1 Explainsprocedure,speakingclearly,slowly,and


2 Privacyisprovidedwithacurtain,screen,ordoor 3 Askswhichshirthe/shewouldliketowearanddresses

him/herinshirtofchoice 4 Whileavoidingoverexposureofclient,removesgown

fromtheunaffectedsidefirst,thenremovesgownfromtheaffectedsideanddisposesofgownintosoiledlinencontainer

5 Assists to put the right (affected/weak) arm through the right sleeve of the shirt before placing garment on left (unaffected) arm

6 Whileputtingonshirt,movesbodygentlyandnaturally,avoidingforceandover-extensionoflimbsandjoints

29Skill continues

7 Finisheswithclothinginplace 8 Signalingdeviceiswithinreachandbedisinlow

position 9 Aftercompletingskill,washeshands

feeds clienT Who cannoT feed self 1 Explainsproceduretoclient,speakingclearly,

slowly,anddirectly,maintainingface-to-facecontactwheneverpossible

2 Beforefeeding,looksatnamecardontrayandasksclienttostatename

3 before feeding client, client is in an upright sitting position (75-90 degrees)

4 Placestraywherethefoodcanbeeasilyseenbyclient 5 Candidatecleansclient’shandswithhandwipebefore

beginningfeeding 6 Candidatesitsfacingclientduringfeeding 7 Tellsclientwhatfoodsareontrayandaskswhatclient

wouldliketoeatfirst 8 Usingspoon,offersclientonebiteofeachtypeoffood

ontray,tellingclientthecontentofeachspoonful 9 Offersbeverageatleastonceduringmeal10 Candidateasksclientiftheyarereadyfornextbiteof

foodorsipofbeverage11 Atendofmeal,candidatecleansclient’smouthand

handswithwipes12 Removesfoodtrayandplacestrayindesignateddirty

supplyarea13 Signalingdeviceiswithinclient’sreach14 Aftercompletingskill,washeshands

30

gives Modified bed baTh (face and one aRM, hand and undeRaRM) 1 Explainsprocedure,speakingclearly,slowly,and


2 Privacyisprovidedwithacurtain,screen,ordoor 3 Removesgownandplacesinsoiledlinencontainer,

whileavoidingoverexposureoftheclient 4 Beforewashing,checkswatertemperatureforsafety

andcomfortandasksclienttoverifycomfortofwater 5 Putsoncleanglovesbeforewashingclient 6 beginning with eyes, washes eyes with wet washcloth

(no soap), using a different area of the washcloth for each stroke, washing inner aspect to outer aspect then proceeds to wash face

7 Driesfacewithtowel 8 Exposesonearmandplacestowelunderneatharm 9 Appliessoaptowetwashcloth10 Washesarm,hand,andunderarmkeepingrestofbody

covered11 Rinsesanddriesarm,hand,andunderarm12 Movesbodygentlyandnaturally,avoidingforceand

over-extensionoflimbsandjoints13 Putscleangownonclient14 Empties,rinses,anddriesbasin15 Afterrinsinganddryingbasin,placesbasinin

designateddirtysupplyarea16 Disposesoflinenintosoiledlinencontainer17 Avoidscontactbetweencandidateclothingandused

linens18 Afterplacingbasinindesignateddirtysupplyarea,

anddisposingofusedlinen,removesanddisposesofgloves(withoutcontaminatingself )intowastecontainerandwasheshands


31

MeasuRes and RecoRds blood pRessuRe 1 Explainsprocedure,speakingclearly,slowly,and


2 Beforeusingstethoscope,wipesbell/diaphragmandearpiecesofstethoscopewithalcohol

3 Client’sarmispositionedwithpalmupandupperarmisexposed

4 Feelsforbrachialarteryoninneraspectofarm,atbendofelbow

5 Placesbloodpressurecuffsnuglyonclient’supperarm,withsensor/arrowoverbrachialarterysite

6 Earpiecesofstethoscopeareinearsandbell/diaphragmisoverbrachialarterysite

7 Candidateinflatescuffbetween160mmHgto180mmHg.Ifbeatheardimmediatelyuponcuffdeflation,completelydeflatecuff.Re-inflatecufftonomorethan200mmHg

8 Deflatescuffslowlyandnotesthefirstsound(systolicreading),andlastsound(diastolicreading)(Ifroundingneeded,measurementsareroundedUP to thenearest2mmofmercury)

9 Removescuff10 Signalingdeviceiswithinreach11 Beforerecording,washeshands 12 After obtaining reading using bP cuff and

stethoscope, records both systolic and diastolic pressures each within plus or minus 8 mm of evaluator’s reading

32

MeasuRes and RecoRds uRinaRy ouTpuT 1 Putsoncleanglovesbeforehandlingbedpan 2 Poursthecontentsofthebedpanintomeasuring

containerwithoutspillingorsplashingurineoutsideofcontainer

3 Measurestheamountofurineateyelevelwithcontaineronflatsurface

4 Aftermeasuringurine,emptiescontentsofmeasuringcontainerintotoilet

5 Rinsesmeasuringcontainerandpoursrinseintotoilet 6 Rinsesbedpanandpoursrinseintotoilet 7 Afterrinsingequipment,andbeforerecording

output,removesanddisposesofgloves(withoutcontaminatingself )intowastecontainerandwasheshands

8 Records contents of container within plus or minus 25 ml/cc of evaluator’s reading

MeasuRes and RecoRds WeighT of aMbulaToRy clienT 1 Explainsprocedure,speakingclearly,slowly,and


2 Clienthasshoesonbeforewalkingtoscale 3 Beforeclientstepsonscale,candidatesetsscaletozero

thenobtainsclient’sweight 4 Whileclientstepsontoscale,candidatestandsnextto

scaleandassistsclient,ifneeded,ontocenterofscale 5 Whileclientstepsoffscale,candidatestandsnext

toscaleandassistsclient,ifneeded,offscalebeforerecordingweight

6 Beforerecording,washeshands 7 Records weight based on indicator on scale. Weight

is within plus or minus 2 lbs of evaluator’s reading (If weight recorded in kg weight is within plus or minus 0.9 kg of evaluator’s reading)

33

peRfoRMs Modified passive Range of MoTion (pRoM) foR one knee and one ankle 1 Explainsprocedure,speakingclearly,slowly,and


2 Privacyisprovidedwithacurtain,screen,ordoor 3 Instructsclienttoinformcandidateifpainis

experiencedduringexercise 4 Supportslegatkneeandanklewhileperformingrange

ofmotionforknee 5 Bendsthekneeandthenreturnslegtoclient’snormal

position(extension/flexion)(ATLEAST3TIMESunlesspainisverbalized)

6 Supportsfootandankleclosetothebedwhileperformingrangeofmotionforankle

7 Pushes/pullsfoottowardhead(dorsiflexion),andpushes/pullsfootdown,toespointdown(plantarflexion)(ATLEAST3TIMESunlesspainisverbalized)

8 While supporting the limb, moves joints gently, slowly, and smoothly through the range of motion, discontinuing exercise if client verbalizes pain



34

peRfoRMs Modified passive Range of MoTion (pRoM) foR one shouldeR 1 Explainsprocedure,speakingclearly,slowly,anddirectly,

maintainingface-to-facecontactwheneverpossible 2 Privacyisprovidedwithacurtain,screen,ordoor 3 Instructsclienttoinformcandidateifpain

experiencedduringexercise 4 Supportsclient’supperandlowerarmwhile

performingrangeofmotionforshoulder 5 Raises client’s straightened arm from side position

upward toward head to ear level and returns arm down to side of body (flexion/extension) (AT LEAST 3 TIMES unless pain is verbalized). Supporting the limb, moves joint gently, slowly, and smoothly through the range of motion, discontinuing exercise if client verbalizes pain

6 Moves client’s straightened arm away from the side of body to shoulder level and returns to side of body (abduction/adduction) (AT LEAST 3 TIMES unless pain is verbalized). Supporting the limb, moves joint gently, slowly, and smoothly through the range of motion, discontinuing exercise if client verbalizes pain



posiTions on side 1 Explainsprocedure,speakingclearly,slowly,and


2 Privacyisprovidedwithacurtain,screen,ordoor 3 Beforeturning,lowersheadofbed 4 Raisessiderailonsidetowhichbodywillbeturned 5 Slowlyrollsontosideasoneunittowardraisedside

rail 6 Placesoradjustspillowunderheadforsupport 7 Candidatepositionsclientsothatclientisnotlying

onarm 8 Supportstoparmwithsupportivedevice 9 Placessupportivedevicebehindclient’sback10 Placessupportivedevicebetweenlegswithtopknee

flexed;kneeandanklesupported11 Signalingdeviceiswithinreachandbedisinlow

position12 Aftercompletingskill,washeshands

35

pRovides caTheTeR caRe foR feMale 1 Explainsprocedure,speakingclearly,slowly,and


2 Privacyisprovidedwithacurtain,screen,ordoor 3 Beforewashing,checkswatertemperatureforsafety

andcomfortandasksclienttoverifycomfortofwater 4 Putsoncleanglovesbeforewashing 5 Placeslinenprotectorunderperinealareabefore

washing 6 Exposesareasurroundingcatheterwhileavoiding

overexposureofclient 7 Appliessoaptowetwashcloth 8 While holding catheter at meatus without tugging,

cleans at least four inches of catheter from meatus, moving in only one direction (i.e., away from meatus) using a clean area of the cloth for each stroke

9 While holding catheter at meatus without tugging, rinses at least four inches of catheter from meatus, moving only in one direction, away from meatus, using a clean area of the cloth for each stroke

10 Whileholdingcatheteratmeatuswithouttugging,driesatleastfourinchesofcathetermovingawayfrommeatus

11 Empties,rinses,anddriesbasin12 Afterrinsinganddryingbasin,placesbasinin

designateddirtysupplyarea13 Disposesofusedlinenintosoiledlinencontainerand

disposesoflinenprotectorappropriately14 Avoidscontactbetweencandidateclothingandused

linen15 Afterdisposingofusedlinenandcleaning

equipment,removesanddisposesofgloves(withoutcontaminatingself )intowastecontainerandwasheshands


36

pRovides fooT caRe on one fooT 1 Explainsprocedure,speakingclearly,slowly,and



andcomfortandasksclienttoverifycomfortofwater 4 Basinisinacomfortablepositionforclientandon

protectivebarrier 5 Putsoncleanglovesbeforewashingfoot 6 Client’sbarefootisplacedintothewater 7 Appliessoaptowetwashcloth 8 Liftsfootfromwaterandwashesfoot(including

betweenthetoes) 9 Footisrinsed(includingbetweenthetoes)10 Driesfoot(includingbetweenthetoes)11 Applieslotiontotopandbottomoffoot,removing

excess(ifany)withatowel12 Supportsfootandankleduringprocedure13 Empties,rinses,anddriesbasin14 Afterrinsinganddryingbasin,placesbasinin

designateddirtysupplyarea15 Disposesofusedlinenintosoiledlinencontainer16 Aftercleaningfootandequipment,anddisposingof

usedlinen,removesanddisposesofgloves(withoutcontaminatingself )intowastecontainerandwasheshands

17 Signalingdeviceiswithinreach

37

pRovides MouTh caRe 1 Explainsprocedure,speakingclearly,slowly,and


2 Privacyisprovidedwithacurtain,screen,ordoor 3 Beforeprovidingmouthcare,clientisinupright

sittingposition(75-90degrees) 4 Putsoncleanglovesbeforecleaningmouth 5 Placesclothingprotectoracrosschestbeforeproviding

mouthcare 6 Securescupofwaterandmoistenstoothbrush 7 Beforecleaningmouth,appliestoothpasteto

moistenedtoothbrush 8 Cleans mouth (including tongue and surfaces of

teeth), using gentle motions 9 Maintainscleantechniquewithplacementof

toothbrush10 Candidateholdsemesisbasintochinwhileclient

rinsesmouth11 Candidatewipesmouthandremovesclothing

protector12 Afterrinsingtoothbrush,empty,rinseanddrythe

basinandplaceusedtoothbrushindesignatedbasin/container

13 Placesbasinandtoothbrushindesignateddirtysupplyarea

14 Disposesofusedlinenintosoiledlinencontainer15 Afterplacingbasinandtoothbrushindesignateddirty

supplyarea,anddisposingofusedlinen,removesanddisposesofgloves(withoutcontaminatingself )intowastecontainerandwasheshands


38

pRovides peRineal caRe (peRi-caRe) foR feMale 1 Explainsprocedure,speakingclearly,slowly,and



andcomfortandasksclienttoverifycomfortofwater 4 Putsoncleanglovesbeforewashingperinealarea 5 Placespad/linenprotectorunderperinealareabefore

washing 6 Exposesperinealareawhileavoidingoverexposureof

client 7 Appliessoaptowetwashcloth 8 Washes genital area, moving from front to back,

while using a clean area of the washcloth for each stroke

9 Using clean washcloth, rinses soap from genital area, moving from front to back, while using a clean area of the washcloth for each stroke

10 Driesgenitalareamovingfromfronttobackwithtowel

11 After washing genital area, turns to side, then washes and rinses rectal area moving from front to back using a clean area of washcloth for each stroke. Dries with towel

12 Repositionsclient13 Empties,rinses,anddriesbasin14 Afterrinsinganddryingbasin,placesbasinin

designateddirtysupplyarea15 Disposesofusedlinenintosoiledlinencontainerand

disposesoflinenprotectorappropriately16 Avoidscontactbetweencandidateclothingandused

linen17 Afterdisposingofusedlinen,andplacingused

equipmentindesignateddirtysupplyarea,removesanddisposesofgloves(withoutcontaminatingself )intowastecontainerandwasheshands


39

40

TRansfeRs fRoM bed To WheelchaiR using TRansfeR belT 1 Explainsprocedure,speakingclearly,slowly,and


2 Privacyisprovidedwithacurtain,screen,ordoor 3 Beforeassistingtostand,wheelchairispositioned

alongsideofbed,atheadofbedfacingfootorfootofbedfacinghead

4 Beforeassistingtostand,footrestsarefoldeduporremoved

5 Beforeassistingtostand,bedisatasafelevel 6 before assisting to stand, locks wheels on

wheelchair 7 Beforeassistingtostand,checksand/orlocksbed

wheels 8 before assisting to stand, client is assisted to a

sitting position with feet flat on the floor 9 Beforeassistingtostand,clientiswearingshoes10 Beforeassistingtostand,appliestransferbeltsecurely

atthewaistoverclothing/gown11 Beforeassistingtostand,providesinstructionsto

enableclienttoassistintransferincludingprearrangedsignaltoalertwhentobeginstanding

12 Standsfacingclientpositioningselftoensuresafetyofcandidateandclientduringtransfer.Countstothree(orsaysotherprearrangedsignal)toalertclienttobeginstanding

13 Onsignal,graduallyassistsclienttostandbygraspingtransferbeltonbothsideswithanupwardgrasp(candidateshandsareinupwardposition)andmaintainingstabilityofclient’slegs

14 Assistsclienttoturntostandinfrontofwheelchairwithbackofclient’slegsagainstwheelchair

15 Lowersclientintowheelchair16 Positionsclientwithhipstouchingbackofwheelchair

andtransferbeltisremoved17 Positionsfeetonfootrests18 Signalingdeviceiswithinreach19 Aftercompletingskill,washeshands

41

scoRe RepoRTing

ExAm RESultSThe Nurse Aide Evaluator may not answer questionsabout your Score Report. If you have questions aboutyour Score Report, or the content of the examination,callPearsonVUEat (888)204-6207.Results will not be given over the telephone.

Written (or english or spanish Oral) Exam

AfteryoufinishtheWritten(orEnglishorSpanishOral)Examination, the Nurse Aide Evaluator will fax youranswer sheet for scoring. Within approximately ten (10)minutes (from the time the answer sheetwas faxed), youwillreceiveanofficialScoreReport.TheScoreReportwillindicatewhetheryouhavepassedorfailedtheWritten(orEnglishorSpanishOral)Examination.

Skills Evaluation

TheNurseAideEvaluatorwillalsofaxyourSkillsEvaluationresultsforscoring.AftertheNurseAideEvaluatorevaluatesyourperformance,heor shewill fax theSkillsEvaluationanswer sheet for scoring. Within approximately ten (10)minutes(fromthetimetheanswersheetwasfaxed),youwillreceiveanofficialScoreReport.TheScoreReportwillindi-catewhetheryouhavepassedorfailedtheSkillsEvaluation.

Occasionally,dueto technicaldifficulties,ScoreReportsmaynotbereceivedatthetestcenteronthedayoftesting.IfthishappensyouranswersheetwillbemailedovernighttoPearsonVUEforhandscoring.YourScoreReportwillthenbemailedouttoyouwithin5-7businessdaysaftertesting. For questions regarding delayed Score Reports,pleasecontactPearsonVUEat(888)204-6207.

42

FAiliNGIf you fail the Written (or English or Spanish Oral)Examination or the Skills Evaluation, your Score Reportwillprovideyouwithinformationonhowtore-takeeitheror bothparts of the evaluation.Anew examination fee isrequired each time you re-take any part of the NNAAPExamination.Tore-takeeitherorbothparts,youmustsub-mityourofficialScoreReportandare-takefeetoNACES.

Stateandfederalregulationsallowyouthree(3)attemptstopassboththeSkillsEvaluationandtheWrittenExamination.Ifyoushouldfaileitherpartorbothpartsthree(3)times,within two (2) years, you will be required to successfullycompleteastate-approvedtrainingprogramandre-takebothparts.Seepage3"ELIGIBILITY"forroutespecificrulesandregulations. Youmust take and pass both theWritten (orOral)ExaminationandtheSkillsEvaluationtobeplacedontheNorthCarolinaNurseAideIRegistry.

Ifyoureturntoschoolandhavenotcompletedtestingorpassedbothportionsof theexamination,youmust test(retest)BOTHportionsoftheexamination.

hoW to REAd A FAiliNG SCoRE REPoRtIf you do not pass the Skills Evaluation, you willreceive a Failing Score Report. The score report willlist thefive (5) skills that youperformed and a score ofSatisfactory or Unsatisfactoryforeachskill.AnyskillwithanUnsatisfactory result is considered a failed skill. Youmust receive a Satisfactory result on all five (5) skills topasstheSkillsEvaluation.

Use your failing Score Report as an aid in studying tore-taketheSkillsEvaluation.Afailedskillwillshowthereason for the failure. Youmay not have performed thestepsofaskillcorrectly,oryoumayhaveforgottenastep,especiallyaCriticalElementStep.

ThefailingScoreReportwillliststepsthatweremissedorincorrect—lookfornumbersprinteddirectlyunderaskillmarkedUnsatisfactory.Alistofalltheskillsandthestepsneededforeachskillcanbefoundinthishandbook.Findthe skill you failed, and study the steps, especially stepslistedasUnsatisfactoryonthescorereport.

Intheexampleonthenextpage,acandidatereceivedaresultofUnsatisfactoryon the skillHand Hygiene.Thenumbers1,5,and10printedbelowtheskillrefertostepsthatwere

43

missedorperformedincorrectly.Tostudyforre-takingtheSkills Evaluation, this candidate should turn to the SkillsListinginthishandbook,lookfortheHandHygieneskill,andreviewallthesteps,especiallysteps1,5,and10.

North Carolina NNAAP® Examination Results

Exam: Skills Result: Fail

Skills Performance:

Hand Hygiene 1, 5, 10

Unsatisfactory

Provides Fingernail Care On One Hand

Satisfactory

Measures and Records Blood Pressure

Satisfactory

Puts One Knee-High Elastic Stocking on Client

Satisfactory

Measures and Records Weight of Ambulatory Client

Satisfactory

A sample of a Failing Score Report

PASSiNGOnce you have passed bOTh the Written (or Englishor SpanishOral) Examination and the Skills Evaluation,yournamewillbesubmittedtotheNorthCarolinaNurseAideIRegistry.YoumayviewyournameontheRegistryby going to www.ncnar.org. If you have any questionsregardingyourlistingontheRegistryyoumaycontactthe North Carolina Division of Health Service Regulation,Monday through Friday from 9:00 a.m. to 3:00 p.m.(EST) at (919) 855-3969 or (919) 715-0562.

duPliCAtE SCoRE REPoRtIf you lose your Score Report or need a duplicate ScoreReport, orwould like a handscoring of yourWritten (orOral) Examination or Skills Evaluation, complete theRequest for Duplicate Score Report or Handscored Answer Sheet FormandmailittoPearsonVUE(seeAppendix A).

44

nuRse aide TesTing gRievance pRocess

oVERViEWEachcandidatehasarighttofileagrievancetocomplainor contest the results of their Nurse Aide Exam. TheNACES Plus Foundation, Inc. (NACES)will follow-uponeachgrievancewithinthirty(30)daysofreceiptofthecandidategrievanceletter.

Nogrievancewill be investigated if it isnot received inwritingbytheNACESPlusFoundation,Inc.

PRoCESSAll grievances must be in writing. The candidate mustprovide as much detail as possible in a grievance letterandforwardittotheNACESPlusFoundation,Inc.witha copyof the failed score reportwithin30daysof theirexamdate.

After receiptof the grievance letter, the appropriateRNAssociateProgramDirectorwillinvestigatethecomplaint.Once the investigation is complete, the RN AssociateProgramDirectorwilldraftaletterbacktothecandidateinforming him/her of the outcome of the investigation. If an error was made by the evaluator, NACES, or PearsonVUE, thecandidatewillbeallowed to retest atnoadditionalcost.

45

The RegisTRy

iNitiAl liStiNGYou must pass both the written and skills portions ofthe NNAAP competency evaluation to be listed on theNurseAide IRegistry.Once on the registry, your listingwill remain current for 24months from themonth youpassedbothpartsoftheNNAAPexam.Aletteradvisingyouofyourinitiallistingwillbemailedtotheaddressyouprovided on your exam application.Youwill not receiveanyotherformornotice.Addresscorrectionscanbemadeattheexamsite.Please check the letter for accuracy of your listing information and notify the registry if there are any errors.

ChANGE oF AddRESS oR NAmEThe North Carolina Nurse Aide I Registry must be kept informed of your current address and name.

There is no charge for changing your name or addresson the registry. You may notify the registry of a nameor address change by using the Name/Address ChangeReporting Form on the Nurse Aide I Registry website(www.ncnar.org). Alternately, you may call the Nurse AideIRegistryat (919)715-0562or(919)855-3969tochangeyourmailingaddressontheregistry.

Ifyournamechangesatanytimeafteryouareplacedonthe registry, you must send written notification of thischange to the registry. Please remember, however, thatif you changed your name, you MUST provide officialdocumentationalongwithyournotification.Writtendocu-mentationmust include1)aCOPYofyour signed socialsecuritycardwiththenewnameonit,AND2)aCOPYof a court-issued marriage certificate, divorce decree, orotherlegaldocumentthatdemonstratesthenamechange.Yournotificationmustincludeyourpreviousname,currentname,mailingaddress,phonenumber,andSocialSecuritynumber.All documents provided to the registry in sup-port of your name change MUST be official and legaldocuments.Any documents providedmay be subject toverificationwiththeissuingsource.

Failure to inform the registry of an address or name change may jeopardize your listing status.

liStiNG RENEWAlNurse aides on the North Carolina Nurse Aide I Registry must renew their registry listing to remain eligible for employment as a nurse aide.Tobeeligiblefor renewal based on employment, youmustwork forpay,performingnursing-relatedservices(asanurseaideormedicationaide),underRNsupervision,forat leasteight (8) hours every twenty-four (24) months. Thisemploymentmustbedocumented and reported to theNurse Aide I Registry prior to each listing expirationdate.Anewcompetencyexaminationisrequiredifyoudonotwork inaqualifyingposition fora24-monthperiodormore.

• Failure to inform the registry of an address or name change may jeopardize your listing status.

•It is your responsibility to renew. Current renewalprocedurescanbefoundathttps://www.ncnar.org.

•Thereisno fee forre-listingontheNorthCarolinaNurseAideIRegistry.

FormoreinformationregardingNurseAideIlist-ings and policies go to https://www.ncnar.org.AdditionalinformationisavailabletonurseaidesandnurseaidecandidatesattheFrequentlyAskedQuestions(FAQ)link.

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