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CNA FINAL REVIEW
The following items are things that have been missed in the past few years on
the CNA state test. Please look at and re-look up any you are not familiar with.
1. Communication - Sender and Receiver model
2. Feeding a person
3. Dressing a person partially affected by a stroke (affected vs unaffected side)
4. Denture care
5. Admitting a person and in house transfers
6. Body mechanic techniques
7. Reporting what abnormal changes, when and to who?
8. Assisting a blind person – ambulating and eating
9. Dying process
10. Role of a physician
11. Diabetic care – S & S of problems and what to report
12. Restraints
13. Flexion and extension/ Abduction and adduction/ rotation
14. G-tube (gastrostomy tube) and NG tubes- position for and safety concerns
15. Hand washing –how , when & why
16. Ambulation- cane placement and assistance with ambulating/ use of gait belts
17. Bathing and washing hair/hair care
18. Constipation vs. fecal impaction
19. Alzheimer’s – What it is and care & treatment for
20. Emphysema – What it is and care & treatment for
21. Edema – What it is and how to prevent and decrease
22. Maslow’s Hierarchy of Basic Needs
23. Incontinence and perineal care (male circumcised and uncircumcised & female)
24. Bladder and bowel training programs
25. Dysphagia – diet and feeding a person/ risk factors
26. Aging process- normal vs. disease process
27. Hearing aids- when removed and why not work
28. Pathogen and nonpathogens, contamination, & disinfected vs sterile
29. Responding to a person’s behavior appropriately
30. Specimen collections (sputum, urine, stool- how and what to do with it after you
collect it)
31. PPE and Universal precautions – what are they and who used for
32. Supplement feedings
33. Patient rights- what are they and how to protect them
34. Ethical issues
35. Fire safety – RACE & PASS
36. Care plans
37. Seizures –What are they & treatment for during and after
38. CHF – What is it & what diet do they have and care for the person
39. Back massage- when and how long
40. Sexuality for couples in LTC
41. Delusions vs hallucinations
42. Indwelling catheter and catheter care
43. Cardiac Arrest and MI
44. Multiple Sclerosis
45. I &O
CNA FINAL REVIEW
Essential behaviors to all cares:
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Medical Asepsis- practice used preventing the spread of microorganisms
Privacy- ALWAYS!!! Think of all the ways to provide for privacy.
Confidentiality- what you see as a CNA stays at work!
Abuse- report immediately to charge nurse, supervisor or administrator
Residents rights- respect, free from abuse, refuse treatment, informed
consent, phone and mail, etc…
Sexuality in Elderly- hygiene, grooming, self-esteem, privacy, respect.
Couples can share a room and bed.
OBRA- regulates CNA certification/skills; Minimum of 75 hours of class
OSHA- safety and health administration/ regulates work place safety factors
Medicaid- state and federal health insurance, disabled, low income
Medicare- Federal mandates for elderly (social security)
Systems (11) of the body (function and structure)
Changes of the 11 systems with aging KNOW what happens
Defense Mechanism in communication- uses to block unpleasant feelings
Restrictions for CNA- NO sterile procedures, cannot give medications,
cannot take orders from a MD, never insert objects in body openings, do
not supervise other CNA’s
Role of CNA-ADL’s, report changes, follow care plan, complete nurses
orders, respect patients rights
Side rails and call lights- Side rails up and call light in reach when
finished . Also leave water in reach.
Identify person- Wristband then ask name and check picture with name
Observe and Report- any abnormal or unusual immediately
Error in charting- line through, write error above and initial, in black ink
Charting/Documentation- Only in black ink, chart only after you do,
don’t chart for others, do not chart you opinion only chart objective
statements and actions, chart immediately and sign first initial, last name
and title of job
Hand washing- best prevention for spread of microorganisms. Do not
cross-contaminate, faucets are contaminated- use a clean paper towel
Alarms- Do not shut off or ignore, get nurse immediately
Communication- transferring of a message- Need someone to send the
message (sender) and someone to receive the message (receiver). Make
sure to clarify and restate to make sure you understand.
Personal Protective Equipment- Don (to put on)the gown then mask
and gloves (opposite to remove) Remember to remove gown rolling away
from you and that the outside is contaminated, inside is clean
24. Maslow’s Hierarchy- Philosophy of life and meeting peoples basic needs.
First need is physical needs then safety and security, love and belonging,
self-esteem and self-actualization. (looks like pyramid)
25. Sharps Containers and Biohazard labels – All needles and material that
contains a great amount of blood or body fluids must be placed in
receptacles for sharps or a red bag. Biohazard labels mean extreme
caution, body fluid contamination.
26. Care Plan – Plan of what care will be given to the patient. Found at the
nurse station on a binder or chart. May be with the Kardex. Needs to be
followed.
27. Policy Book –Outline rules that govern the facility. Found at nurse station.
28. MSDS- Measures for exposure to hazardous material and what to do if
exposed
29. Characteristics of a CNA- Dependable, sensitive, mature, positive
attitude……
30. Ethical Code- Moral rules, the code of behavior you follow as a
professional
31. Incident Form- filled out when an accident occurs (like a fall or accident
ect…). Chart what you saw and did. Give to risk manager
32. Pre Procedure Guidelines- Used in every procedure/skill – KNOW ALL
33. Post Procedure Guidelines- Used in every procedure/skill – KNOW ALL
34. Kardex-Place to find patient information and orders. CNA does not change
or alter. Not a permanent part of chart. Used to see plan of care for
patient.
35. Resident’s Bill of Rights- Set of guidelines residents and patients have
for their treatment and stay at a facility. Included are: Free from abuse,
privacy, freedom to make choices, right to information, to refuse treatment,
right to participate, right to personal possessions, freedom from restraints,
right to quality of life.
36. Prioritize care- Determine what must be done immediately for safety of
patient. If patient would like to finish or do something first let them of the
care is not an immediate need.
37. HIPAA- Privacy and confidentiality at ALL times for all people.
Basic Skills
1. Radial Pulse- thumb side of wrist 1 min or 30 sec x 2
Apical Pulse- heart; listen 1 full min (listen with a stethoscope)
2. Respiration’s- don’t let them know /1 min or 30 sec x 2/ Inhale and exhale
counts as one breath.
3. Abnormal TRP and BP- Report immediately and record/ Abnormal for
range or for the persons normal
4. Abdominal thrusts- back blows than hands in middle abdomen, above navel,
quick upward thrusts, only given when person can not speak, breath or cough, get
permission prior to starting
5. Weight- same time, same scale, same clothing, arms at their side, urinate
first, report gain or loss of 5 lbs (reason is to assess nutritional status)
6. Height: Supine- Person in flat, body extended, no pillow. Mark sheet at the top
the head and bottom of HEEL. Measure the distance between the marks on the
sheet, not over the body. Standing – Stand on scale, facing away from
measurement bar. Balance at center with arms to the side. Measuring bar is
placed on top of the head not the hair.
7. Cold or Warm Compress- place a cover between skin and compress,
check after 5 minutes, leave on for no more than 20 minutes.
8. Restraint knot- quick release, only tie to bed frame or immovable part
9. Position Foley- over leg, hang on bed frame, no kinks, and never place on
the floor, must be down to gravity and below bladder or will go back in
bladder and cause infection and spasms
10. Temperatures: Oral glass TEMP- 3-5 minutes (Ask if they have eaten or
had a drink or smoked in 15 minutes)
Rectal glass TEMP- 2-3 minutes
Axillary glass TEMP- 5-10 minutes
11. Prevent pressure sores (DQ’s)- turn q 2 hr, protect pressure points,
proper body alignment, lotion to pressure points, keep skin dry and intact,
keep sheets dry and wrinkle free, use sheepskin or eggcrate mattress pads
12. Enema administration- Left Sims or side-lying, lubricated, 12 inches
above rectum, drape or cover for privacy
13. Indwelling Catheter- (Left in place) never DC without order or
disconnect, check for no leaks, no pulling on peri area, good peri care at
least BID, bag below bladder, position on frame not hang on side rails
14. Signs of DQ’s- early see red and tender than progress to blisters,
tissue exposes, drainage. Report ASAP and reposition person
15. Restraint Rules- consent from the pt or family, not for convenience, snug
not tight, release q2h and skin checked, not interfering with normal
functions of the body, offer ADL’s frequently, check on person q 15 minutes
16. Systolic- contraction/top # BP
Diastolic- relaxation/bottom # BP
17. Normal VS Measurements- P- 60-100 Oral TEMP- 97-99
Rectal or Tympanic 98-100 Axillary 96-98 R- 10- 20 SBP- 90-135
DBP- 60-85 Blood Sugar- 80-120
18. BP placement- 1 inch above antecubital. Max inflation- 180 mm Hg
Stethoscope placement- not under cuff/place on brachial artery (medial part
of the forearm). You will not hear any sounds until you begin to deflate cuff.
19. Occupied bed-making- keep person covered, don’t roll onto bare
mattress, one side at a time, bed at appropriate height, get help as needed,
roll dirty linen under pt and place clean lined tight on the bed.
20. Measurement: 1 ounce=30 cc or ml (always chart in ml)
21. CPR- Adult-2 breaths and 30 compressions - 5 cycles
Child/Infant- 2 breathe to 30 compressions – 5 cycles
22. Position of NC- prongs down in nose, tubing around ears, and check for
DQ’s over cheek and behind ears
23. Moist heat- penetrates deeper/ dilates/promotes healing
Cold pack- constricts blood vessels/ decreases swelling
24. Normal UOP- 1500 ml a day 30cc/ hr minimum
25. Feeding- pt choice, small amounts, alternative foods. Spoon 1/3rd full.
26. Transferring a patient- use gait belt, non skid- footwear move to strong
side, get assistance, check restrictions for the person before you transfer
In House Transfer- When patient going from one area in a facility to
another
27. Admit, Discharge, & Transfer- Orient, VS, ht & wt, meet their needs,
orient to their room(call light, TV, ect…)
28. ADL’s – Activities of Daily Living (Bathing, eat, activity, hygiene etc..)
29. Alters VS- meds, food, activity, time of day, stress, sleep, disease
30. Application of a bandage- start farthest area from heart and work up
31. Traction- Immobilize fractures, Never remove weights, keep weights off
ground, proper body alignment, check for restrictions in movement, get help
in moving and providing care, cannot remove the device ever!
32. Hemorrhage care- Direct pressure and cover- Never a tourniquet
33. Oral Intake- Best for body functions 2000- 2500cc/day
34. Clean catch UA- Clean peri area prior, start then stop midstream
35. When VS are done- As ordered and when change in condition. You do not
have to have an order to get a set of VS. Report change in VS immediately.
36. Universal/Standard Precautions- Use with ALL people! Wash hands
before and after, if it is wet and it is not yours wear gloves, gown and mask
when needed.
37. Specimen Collection- Universal precautions & collect as ordered. Take to
lab immediately, place in biohazard bag. If it cannot go to lab immediately
put in specimen fridge.
Sputum specimen- from the throat/lungs. Collect first thing in am.
38. Telephone Etiquette- Answer by second ring, state who you are if in a
health care facility. Place on hold for no more than 30 seconds, never set
receiver down on desk, take a message and give to person immediately.
39. Cleaning up a Spill- Immediately with spill kit. Contain it and protect the
patients. Follow MSDS manual. Call for assistance.
40. Dressing Changes- Sterile procedures you may only assist with. Do not
reach across/over a sterile field. One inch border is not sterile; Dressing
goes into biohazard container.
41. O2 therapy- Cannot increase or decrease the O2 setting. Can set O2 at
proper level. Very flammable. Never use around flames/smoking. Patient
should always keep O2 on unless care plan states otherwise. O2 tank need
to be secure. Good oral and nasal care- O2 will dry out mucus membranes
42. Repositioning – Keep person in normal body alignment. If in a chair do
not lift under the arms. Lift person as an entire unit, do not drag.
Restorative/Rehabilitation Care
1. Anti-Embolism (TED) hose- apply to prevent blood clots, when not on
have pt should be in bed with feet elevated. Put on correctly with heel
marker. Toe opening is per manufacture. Application should be in bed with
feet elevated
2 Passive ROM - you do for them Active ROM- they do it themselves
Do a set of 3 per joint.
3. Bed positioning when moving- flat, height at a comfortable position, and
side rails down, wheels locked
4. Log Roll- move person as a unit, use a draw sheet, get help as needed
5. Sims/Semi prone- half on stomach
Prone- stomach
Fowlers- sitting (HOB 45-90)
Lateral- side
Supine- back/dorsal
Semi-Fowlers –Knees bent 15 degrees, HOB at 30
High-Fowlers – Sitting at a 90 degree angle
6. Assisting Ambulation- stand to the weak side & slightly behind, gait belt
7. Falling- lower to floor, protect head, check for injuries, Do not stop fall
8. Position for a vomiting person- on side/risk for aspiration
9. Position difficulty breathing- sitting up or the most comfortable position
10. Walkers- pick up and move 6-8 inches in front of person
11. Canes- place on strong side, non-skid shoes, grip level with hip
12. Fall Prevention-answer call lights quickly, use non-skid shoes, side rails,
proper lighting, and safety checks
13. Reality Orientation- call person by name, set schedule, do not tease,
frequent reminders, stay calm and patient
14. Confusion – Be patient, orient as needed, safety concern all the time, allow
for as much choice as possible, respect, and keep a routine
15. Dysphagia- Difficulty swallowing, risk for aspiration. Assist with correct
diet orders (Pureed or thickened fluids) and swallowing techniques
16. Cast Care- Check color, sensation and circulation at distal end. Report
changes immediately. Do not get wet, Weight bearing as ordered
17. Traction- Keep weights free-hanging not on floor, do not remove weights,
good body alignment, position as directed. Good skin care.
18. Wheelchair safety- Front wheels forward position, wheels locked.
19. Bladder and Bowel Training – Used with incontinence to retrain the
bowel or bladder to have a routine. Set a plan of how often to take person
to BR even if they do not have the urge to go.
20. Total Hip- (Hip prosthesis) – Pillows (abductor wedge) used between knees
when turning. Follow any restrictions for bending or crossing legs and
weight bearing.
21. Rehabilitation Equipment – Use to assist pt to be as independent as
possible. Grabber, button helpers. Weighted silverware, plate rims, handled
cups.
22. Hearing Aids- Amplify sound. Check and make sure turned on and battery
works. Clean only as instructed, never submerge in water or get wet.
Remove before shower in their room.
23. Partially affected- A person who has had a stroke and has lost part of
mobility on one side of the body. This is the affected or weak side.
24. Amputation- removal of a body part. Should do ROM on amputated
limbs. Encourage as much independence as possible.
25. Prosthetics- Artificial limbs and body parts used following an amputation.
Make sure they are used as ordered.
26. Gait Belts- Used to assist in transferring and ambulating. Placed over
clothing, under breast tissue, snug with buckle to the side.
Personal Care and Hygiene
1. Soiled Linen- change immediately, never place on floor, place in linen bag,
must be covered with lid or towel
2. Denture Care- wear gloves, place padding in the sink, use warm water to
clean and store, never carry around unless in a container
3. Unconscious Oral Care- Position on the side to prevent aspiration, use
swabs instead of toothbrush and toothpaste, do every 2 hours
4. Back Rub- long firm buttocks to neck and circular shoulders do QD,
promotes circulation and comfort, check skin for reddened areas and report
immediately. Do for 3-5 minutes. Offer at HS to promote comfort and help
with restlessness.
5. Dress- Weak side first
Undress- strong side first
6. Shaving- wear gloves, apply warm cloth prior, direction on hair growth
7. Bed Bath- Expose on the area being cleaned, rinse after washing, wash
clean to dirty, (face, axillary, chest, legs, back, peri area, buttocks)
8. Meal Position- high Fowler in bed, WC or chair. Prevents aspiration.
9. Sitz bath- rectum, peri area soaks .
10. Bedpan position- HOB up, knees bent, sitting position, and privacy, leave
call light in reach. Check on person after 5 minutes.
11. Nail care- trimming, shaping cuticles, dryness treatment, NEVER CUT
TOENAILS, tell patient you will report the need to the nurse.
12. Pericare (Perineal)- given when needed to the private area, do front to
back, clean to dirty, wear gloves and drape the person
13. Lotion- keep skin form being dry, does not heal skin or abrasions
14. HS snacks- Everyone offered & receives if awake and wants one; must give
To patients with diabetes to help maintain blood sugar through night
15. Fecal Impaction- liquid oozing of stool from prolonged constipation, need
digital stimulation and medications, prevention is the best way to deal with
impactions, report changes in bowel habits – change from persons normal
16. Types of Diets:
Regular-All foods
Soft- easy to chew
Full liquid- liquid at room temp
Clear liquid- no residue/ can see through
Dysphagia/ Pureed- blended; thickened
Bland- non irritating
NA res triction- salt reduced/heart and kidney pts
Diabetic- CHO, fat and protein regulated for insulin
17. Temperature of water – Bathing temperature 95-105 F
18. Enema- Position in left Sims, assist nurse as needed, get bedpan or
commode, BR as soon as called, provide good peri care
19. Tub Bath- Maintain safety consideration. Do not leave in longer than 20
minutes.
20. Supplements - Given in addition to meals. Make sure to report and
record what the patient ate or drank. Assists with malnutrition, healing and
weight gain.
21. Feeding Tubes- Must be sitting up during and after feedings to prevent
aspiration. Will need good oral care every 2 hours because they are
normally NPO.
G-Tube=Gastrostomy tube, surgically placed in stomach
NG tube= Nasogastric, placed through the nose and goes to stomach
22. Hair Care- Wash only if instructed. Honor the person preference and
style. Make sure it is appropriate- maintain persons dignity. Never cut or
trim. Wash at least weekly.
Diseases & Vocabulary
1. Chronic- long term
Acute- short term
Terminal - Dying
2. Geriatrics/Gerintology- elderly
Rehabilitation/Restorative care- return to highest level possible
3. Hearing Difficulty- speak clear, slow, distinct, to their face (do not yell)
4. Blind Care- 12 hr clock, don’t rearrange, and walk slightly in front
5. Diabetes- sugar checked in blood and urine as directed by MD, have trouble
with insulin and maintaining blood sugar, pancreas is the problem, need
excellent foot care- NEVER trim toenails
6. Alzheimer’s unit- decrease stimulation to assist with confusion, may not
recognize dangerous situations, fall and have poor balance, set a routine and
be patient
7. Seizures- protect from injury, don’t place anything in the mouth, watch for
cessation of breathing, and assist with hygiene and first aid after- notify
nurse immediately
8. Benign Cancer- localized and small
Malignant Cancer- fast & spreads
Metastasize- spreading
9. Side effects from cancer treatment- kill’s normal cells, hair loss, skin
and mouth are sore, nausea, grief and depression
10. Parkinson’s- trembling and shaking, safety concern, assist them
11. Stroke side effects- hemiparalysis, dysphasia, speaking difficulty, need
assistance with ADL’s. Dress weak side first, Undress strong first
12. Sign- observed (objective) Symptom- what the person feels (subjective)
13. S&S of Diabetes- weakness, confused, trembling, headache, dizzy,
polydypsia, polyuria, flushed, moist skin, nausea, vomiting, poor circulation,
nerve damage, MI and strokes, blindness, renal failure
14. Atrophy- decrease size or wasting
Contracture- shortening muscle
15. Last sense to lose- Hearing!! Treat coma and dying pt’s the same as
others. Remember respect to the person.
16. Multiple Sclerosis- Not a congenital birth disorder, gradual loss of muscle
functioning, no cure.
17. Shock- compromises circulation, do not move, keep warm, lay down, NPO,
and report to nurse ASAP!!
18. Environment for infection- warm, dark and moist
19. Normal Flora- microbes that live in a certain location
20. CHF- congestive heart failure, will have edema, use Ted hose with
ambulation. Diet will be low in salt. Will be on O2.
21. Hypoglycemia- low blood sugar. For treatment check with nurse,
treatment is not always to give sugar, will depend on the blood sugar
22. Edema- swelling in tissues, weigh daily to check amount of loss or gain,
report a change in 5 pounds. Ted hose can assist in decreasing swelling.
23. Stages of grief/dying- anger, denial, bargaining, depression and
acceptance. Not always in order. Treat each person individually.
24. Nutrients: CHO- Carbs, give energy
Fat- store energy/insulate
Proteins- build and repair tissue
25. Isolation- all items brought in to room are considered contaminated,
remove garbage through double red bags, use appropriate protective
equipment
Repiratory: Airborne/Droplet
Reverse: Protect person from you
Contact: Wound/body fluids
Enteric: Bowel (stool)
26. Nursing team- RN. LPN and CNA’s working together
27. RACE- Rescue, alarm, contain, extinguish (Fire Safety)
28. Universal Precautions- Used for ALL people and all circumstances
29. Trendelenberg- HOB down, feet up
Reverse- opposite
30. Living Will- document written by person to describe what life saving
measures they want used
31. Bedfast/Bedrest- Patient to stay in bed for all ADL’s.
32. Bedcradle- used to keep bed linens off lower extremities
33. Footboard- used at the end of the bed to prevent foot drop
34. Aspiration- To take food or fluids into the lungs. Often a problem with
dysphagia.
35. Emphysema- Respiratory condition where the lung, alveoli enlarge and
lungs are less elastic. Trouble breathing when lying flat- sit up and will use
O2 at low amounts. Do not adjust O2 to higher rates.
36. Artery- blood vessel going away from heart
37. Vein- blood vessel that goes toward the heart
38. Assault- threat or attempt to touch without consent
39. Battery- unauthorized touching of a person’s body
40. Nosocomial- acquired after admission to a health care facility
41. Renewal of certification – Every 2 years, must work at least 200 hours
42. REVIEW ALL MEDTERM AND ABBREVIATIONS!!!
ac- before meals
c- with
pc- after meals
p- after
s- without
a- before
q- every
h- hour
bid- twice a day
DQ- pressure sore
tid- three times a day
I & O- Intake and output
qid- four times a day
NPO- nothing by mouth
qd- once a day
po- by mouth
VS- Vital signs
x- times
43. Evacuation Plan – Follow with any emergency, facility specific, help
ambulatory patients first. Manuals at nursing desk.
44. AIDS- Medical asepsis for body fluids, meet psychological needs, will have
low immune systems so protect against you, provide good skin care.
Spread by HIV (virus). Same precautions as other patients.
39. Ambulate- Walking, use a gait-belt if patient unsteady. Place over the
clothing, snug and under breast tissue. Check Kardex for orders
40. Sundowning- Confusion as the day progresses and night approaches
41. Asepsis- Without pathogens (disease causing agent)
42. Microbs/Microorganisms- See under a microscope. Types are bacteria,
virus, protozoa, fungal, rickettsiae
43. Disinfect- Some pathogens destroyed
44. Sterilize-All disease producing germs destroyed. Steam or autoclave.
45. Huntington’s Disease-Hereditary disorder. Extreme body movements.
Bizarre dance motions. Maintain patient’s safety.
46. Depression- Common in elderly, they have had many losses. It is often
overlooked and we need to pay attention to symptoms of it (lack of interest,
poor grooming, with drawl from people or interests, decreased appetite) and
report it.
47. Tendon – Connect a muscle to a bone
48. Dementia (Alzheimer) –Loss of cognitive functioning caused by changes
in the brain. NOT a normal part of aging, it is a disease. Alzheimer is
gradual in onset and assistance needs to be given as safety becomes an
issue.
49. Incontinence- Inability to control the pass of urine or feces. Treatment
can include bowel and bladder training. Some types have to do with
urgency, so answer call lights quickly and anticipate when they will need to
use the bathroom. Provide good peri-care.
50. Hallucinations- Seeing or hearing something that is not real
Delusion- A false belief
51. Objective- Information that is seen, heard, felt or smelled; A sign.
Subjective – What a person tells you; A symptom
52. Arthritis- Joint inflammation. Assist as needed, may have pain with
movement.
53. Pathogen- disease causing microorganism