Georgia Nurse Aide - Candidate Handbook

Georgia Nurse Aide

Written (or Oral) Examination & Skills Evaluation

Candidate

Handbook

J ul y 2024

It all starts here!

Reviewing this handbook is a big step toward your success.

Quick Reference . . . . . . . . . . . . . . . . . . . 4

Introduction . . . . . . . . . . . . . . . . . . . . . . . 6

National Nurse Aide Assessment Program . 6

Exam Overview . . . . . . . . . . . . . . . . . . 6

Eligibility. . . . . . . . . . . . . . . . . . . . . . . . . . 7

Eligibility by Examination . . . . . . . . . . . 7

Light Duty . . . . . . . . . . . . . . . . . . . . . . . 7

E1 - E6 . . . . . . . . . . . . . . . . . . . . . . . . . 7

Registration and Scheduling . . . . . . . . . . 8

Online Registration and Scheduling. . . 9

Here’s How it Works. . . . . . . . . . . . . . . 9

Exam Fees . . . . . . . . . . . . . . . . . . . . . . 9

Exam Scheduling . . . . . . . . . . . . . . . . 10

Accommodations . . . . . . . . . . . . . . . . 10

Testing Locations . . . . . . . . . . . . . . . . 10

Cancellation. . . . . . . . . . . . . . . . . . . . . . 11

Rescheduling . . . . . . . . . . . . . . . . . . . 11

Refunds . . . . . . . . . . . . . . . . . . . . . . . 11

Absence Policy. . . . . . . . . . . . . . . . . . 11

Weather Emergencies . . . . . . . . . . . . 11

Exam Day . . . . . . . . . . . . . . . . . . . . . . . 12

Taking your exam Online . . . . . . . 12-13

Taking your exam in person . . . . . 14-15

The Written (or Oral) Exam . . . . . . . . . . 15

Written Exam . . . . . . . . . . . . . . . . . . . 15

Oral Exam . . . . . . . . . . . . . . . . . . . . . 15

Self-Assessment Reading Test . . . . . 15

Written (or Oral) Exam . . . . . . . . . . . . . 16

Content Outline . . . . . . . . . . . . . . . . . 16

Sample Questions . . . . . . . . . . . . . . . . . 17

Self-Assessment Reading Test . . . . . . . 18

Part 1: Vocabulary . . . . . . . . . . . . . . . 18

Part 2: Comprehension . . . . . . . . . . . 19

The Skills Evaluation . . . . . . . . . . . . . . . 20

What to Expect. . . . . . . . . . . . . . . . . . 21

Setting. . . . . . . . . . . . . . . . . . . . . . . 21

Who Will Act as a Client? . . . . . . . . 21

Candidate Volunteer Requirements 21

The Tasks. . . . . . . . . . . . . . . . . . . . . . 21

Recording a Measurement. . . . . . . . . 22

Tips for the Skills Evaluation. . . . . . 22

Sample Recording Sheet

For Measurement Skills . . . . . . . . . . . 23

Skills Listing. . . . . . . . . . . . . . . . . . . 23-30

Exam Results . . . . . . . . . . . . . . . . . . . . 31

Score Reporting . . . . . . . . . . . . . . . . . 31

Duplicate Score Report . . . . . . . . . . . 31

Failing. . . . . . . . . . . . . . . . . . . . . . . . . 31

How to Read a Failing Score Report . 31

Passing. . . . . . . . . . . . . . . . . . . . . . . . 32

Grievance Process . . . . . . . . . . . . . . . . 32

The Registry . . . . . . . . . . . . . . . . . . . . . 33

Change of Address or Name . . . . . . . 33

Listing Renewal . . . . . . . . . . . . . . . . . 33

Renewal Notice . . . . . . . . . . . . . . . . . 33

Renewal Fee . . . . . . . . . . . . . . . . . . . 33

Table of Contents

Create or Log into your CNA365 account to:

• Change your current address and phone number.

• Submit Correction Form to update name, date of birth or social

security number before your exam has been scheduled.

• Obtain and submit an Examination Testing Application.

• Check Testing Application status.

• Find test sites and availability.

• Schedule, reschedule or cancel an examination.

• View exam details such as examination type, scheduled time,

date, and location.

• View Score report.

• Submit and review a Grievance application for completed

examination.

• Submit an excused absence application.

Contact Customer Service to:

• Problem occurs when creating CNA365 Account.

• Did not receive activation link.

• Problem occurs when applying an assigned voucher code.

• Testing Application Issue.

• Received an error message when scheduling examination.

• Score report not viewable in CNA365 after 24 hours.

• Call 888-204-6249

ALLIANT HEALTH SOLUTIONS

Nurse Aide Program

P.O. Box 105753 Atlanta, GA 30348

www.mmis.georgia.gov

(800) 414-4358 / (678) 527-3010 (Local)

Call for an application for eligibility routes E2, E3, E4, E5 or E6 (see p.3–6)

Hours of Operation 8:00 a.m. – 5:00 p.m. (Eastern Time Zone)

Quick Reference

CREDENTIA REGISTRATION AND

SCHEDULING SERVICES

1025 Greenwood Blvd.

Suite 401

Lake Mary, FL 32746

Hours of Operation

Mon. – Fri. 8:00 a.m. – 11:00 p.m.

Saturday: 8:00 a.m. - 5:00 p.m.

Sunday 10:00 a.m. - 4:00 p.m.

(Eastern Time Zone)

888-204-6249

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

NNAAP® Written Exam Content Outline and Practical Skills Listing

Introduction

Welcome and congratulations on your decision

to take the professional Nurse Aide’s test.

This handbook is designed for candidates who

want to be listed on the Georgia Nurse Aide

Registry. It tells you how to apply for and take

the National Nurse Aide Examination.

This handbook will answer many of your

questions about the test. Please take the time

to read it and keep it so you can refer to it

whenever you have a question about the test.

THE NATIONAL NURSE AIDE ASSESSMENT

PROGRAM (NNAAP®)

The National Nurse Aide Assessment Program (NNAAP®) was developed by the

National Council of State Boards of Nursing, Inc., The NNAAP Examination is an

evaluation of nurse aide-related knowledge, skills and abilities. Its purpose is

to determine if you understand and can safely perform the job of an entry-level

nurse aide.

ABOUT CREDENTIA

This handbook was created by Credentia in partnership with the Georgia

Department of Health. Credentia is a nationally recognized provider of testing

services to develop, score and report the results of the Georgia Nurse Aide

Registry test. Credentia also processes applications, schedules examinations and

administers the tests.

EXAM OVERVIEW

There are two parts of the NNAAP Examination, the Written (or Oral) Examination

and the Skills Evaluation. You must pass both parts in order to be listed on the

Georgia Nurse Aide Registry.

THE WRITTEN EXAMINATION

The written part of your test is made of seventy (70) multiple-choice questions

written in English. Sample examination questions are provided in this handbook.

Please note: If you have difficulty reading English, you can take an Oral

Examination instead of the Written Examination.

The Oral Examination includes sixty (60) multiple-choice questions plus ten (10)

reading comprehension/word recognition questions. If you want to take the Oral

Examination, you must request it when you submit your registration form.

THE SKILLS EVALUATION

For the Skills portion of your test, you will be asked to perform five (5) randomly

selected nurse aide skills. You will be rated on these skills by a Nurse Evaluator.

You can also review The Written (or Oral) Exam and The Skills Evaluation for more

details about the NNAAP Examination.

VISIT resource center for additional info

https://credentia.com/about-us/

nurse-aide-resource-center

E-1

E-2

E-4

OUT-OF-STATE TRAINED NURSE AIDE (continued): Candidates

E-3 using out-of-state to test in Georgia may be granted three (3)

attempts for both the Written and Skills exam with one (1) year of

their training completion date.

OUT-OF-STATE TRAINED NURSE AIDE – LAPSED: Candidates

who received training at a state-approved training program in a state

other than Georgia with a lapsed/expired certification on another

state's nurse registry. To be considered eligible to test under this

Eligibility Route you must contact Alliant Health Solutions.

Candidates using out-of-state training to test in Georgia may be

granted three (3) attempts for both the Written and Skills exams

within one (1) year of their training completion date.

GEORGIA LAPSED OR EXPIRED REGISTRATION: Candidates

whose Georgia certification has lapsed or expired. If your

certification on the Georgia Nurse Aide Registry has been inactive or

expired (lapsed) for one (1) year or less, you may be eligible to test

under this Eligibility Route. To be considered eligible to test under

this Eligibility Route, you must contact Alliant Health Solutions. Once

you receive authorization to test, you will be granted three (3) exam

attempts for both the Written and Skills exams upon submitting an

application in CNA365.

RECIPROCITY CANDIDATES (Certified Nurse Aides applying to

obtain certification in GA using an active certification from another

state):

Candidates who have are ACTIVE and in good standing on another

state's registry, but who have not worked as a nurse aide in the past

two (2) years (24 months), listed in the other state as not eligible to

work in a Long Term Care facility or a Maryland CNA instead of

GNA. To be considered eligible to test under this Eligibility Route,

you must contact Alliant Health Solutions. Once you receive

authorization to test, you will be granted one (1) year from the date

of authorization and three (3) exam attempts for both the Written

and Skills exams upon submitting the application in CNA365.

Eligibility

This section explains:

• What you need to do to become a nurse aide in Georgia

• What you need to do before you can take the NNAAP test

ELIGIBILITY FOR EMPLOYMENT AS A NURSE

AIDE

All candidates applying to take the NNAAP Examination in Georgia

MUST complete an Application for Registration by Competency

Examination online at www.credentia.com/test-takers/ga.You must

pass both parts of the examination within a time period to be apart of

the GA Nurse Aide Registry

LIGHTDUTY

Candidates are prohibited from taking the Skills Evaluation if on limited

activity or light duty due to medical reasons. Candidates must be able to

complete required skills included in the Skills Evaluation. Candidates on

light duty can’t take the Skills Evaluation; however, they can take the

written/oral exam. Medical documentation stating return to full duty is

required to take the skills evaluation.

NEW NURSE AIDE CANDIDATES: NEW NURSE AIDE CANDIDATES:

Candidates who have completed a Georgia state-approved Nurse Aide

training program. Candidates have one (1) year following the completion of

a state-approved training program to pass both portions of the NNAAP

examination and are given three (3) test attempts for both Skills and

Written.

LPN/RN CANDIDATES: Applicants who are currently licensed in Georgia or

in another state w/in the U.S. To be considered eligible to test under this

Eligibility Route, you must contact Alliant Health Solutions. Once you receive

authorization to test from Alliant Health Solutions, you will be granted one

three (3) attempts for both the Written and Skills exams within one (1) year of

their training completion date.

OUT-OF-STATE TRAINED NURSE AIDE: Candidates who received

training at a state-approved training program in a state other than Georgia

and are not yet listed on another state’s registry. To be considered eligible

to test under this Eligibility Route you must contact Alliant Health Solutions.

E-5

E-6

E-3

Online Registration

and Scheduling

Online registration is the best way to register for your examination.

EXAM FEES

The fees listed below have been established for the National Nurse Aide

Assessment Program in Georgia:

To complete exam registration and scheduling for either or both the

Skills and Written exam(s), payment must be submitted through your

CNA365 account.

Under federal and Georgia laws, nursing homes are required to pay the

NNAAP fees for their nurse aide employees, including individuals

required to re-test.

Payment must be made in the form of a credit card, debit card single-

use card or electronic voucher. Vouchers can be purchased by the

training programs.

Fees are not refundable.

Note: Unexpired vouchers purchased before March 1, 2023, will be honored

HERE’S HOW IT WORKS:

After finishing a Georgia state-approved training course, you can

create an online account with Credentia’s CNA365 system. The

Credentia CNA365 system makes online registration quick and easy,

and much faster than mailing a paper application.

• To create a CNA365 account on the top of the Georgia nurse aide

website page at www.credentia.com/test-takers/ga, click the

“CNA365 Login” button and select “Sign-Up.”

• You can pay by credit card or pre-paid credit card (American

Express, MasterCard, Visa, ACH/ electronic check, or electronic

voucher). Fees are

non-refundable and non-transferable once you’ve paid.

• For exams at test center locations, you’ll need to make an online

reservation using a laptop. Using your phone or a tablet is not

recommended. You need

to make your reservation at least ten (10) calendar days before the

test date.

• For Written or Oral online exams, you can schedule an exam as

early as one day following registration, depending on when exam

availability.

• You’ll need to complete your online application in CNA365 but you

can ask someone from your nurse aide training program or facility

employer for help in completing the application. If you need help or

have

• All examinations, whether conducted in person as paper and

pencil or otherwise, necessitate the Proctor/Evaluator to utilize a

mobile device for scanning your identification and capturing a

photo. This data is securely saved within Credentia’ s software,

serving as a safeguard in case there arises any doubt regarding

the individual who was administered the exam.

Nurse

Aide Examination Exam Fee

Written

Examination Only $35

Oral

Examination Only

$35

Spanish

Examination Only

$35

Skills

Examination Only

$95

Competency

Evaluation

(Written

and Skills)

$130

Competency

Evaluation

(Oral

and Skills)

$130

This may include:

• Supporting documents from the professional who diagnosed the condition

• A description of past accommodations that you have received

Please visit www.credentia.com/accommodations full details on the

accommodations process and required supporting documentation.

TESTING LOCATIONS

In-Facility Testing (INF) - In facility testing is when your

state-approved Training Program Nurse Aide instructor has

made arranagments with Credentia to test at your training program

on a specific date.

Regional Test Sites (RTS) - Locations available for delivering the

NNAAP® written and skills exam and are open to the public. Please

view our website, https://credentia.com/test-takers/ga. Go to “Active

Regional Testing Sites” to view available sites.

SCHEDULING YOUR EXAM

Once you have completed your Profile (demographics) and

application, your Home Page will state: “Click here to schedule your

examinations.”

• Select PR (skills evaluation) first. Select the test site you want

to use and a calendar will appear with available test dates

highlighted.

• Select the date you want and repeat the process for the AW

(Written) or AO (Oral English).

• Proceed to checkout and select your form of payment. When

completed, you will receive a Confirmation Notice and Receipt of

Payment via email.

ACCOMMODATIONS

Credentia complies with the Americans with Disabilities Act and will

provide reasonable accommodations to anyone with a documented

disability who might need a little help in accessing the test.

Test accommodations may include things like:

• A separate testing room

• Extra testing time

• A Reader or Recorder, for individuals with mobility, hearing or

vision difficulties who cannot read or write on their own

Test accommodations will be considered on a case-by-case basis. If

you’re requesting accommodations because of a disability, you must

provide proof of your condition.

Cancellations

You can easily cancel or reschedule an exam online using your CNA365

account. Go to www.credentia.com/test-takers/ga and click on “How to

Cancel or Reschedule an Exam” in the Resources section of the webpage.

Remember: You need to cancel or reschedule your Online Written (or

Oral) examination at least 48 hours (2 days) before your scheduled test

time.

If you are unable to attend your test, you must call Credentia Customer

Service at least nine (9) business days before the test date to reschedule

(Saturday and Sunday and national holidays are not considered business

days). If you don’t call Credentia at least nine (9) business days before

your test date to reschedule, and do not show up for your scheduled test,

you will be responsible for the test fee. Your fee will not be refunded and

cannot be transferred to a new test date, and you may not give your test

date to another person.

• If you do notify Credentia in time, there is no penalty, and your fee may

be transferred to your new test date. If your employer paid your test

fee, you should tell them about missing the test or rescheduling. Let

them know how you have handled rescheduling and when you plan to

take the test again.

• If you do not report to the testing location on the day of your scheduled

test, you will be considered a “no-show” and you will not get your testing

fee back. An unexcused absence will not count as one of your 3

“opportunities” to pass the test.

RESCHEDULING

You can now use your CNA365 account to reschedule your exam. Go

to www.credentia.com/test-takers/ga and click on “How to Cancel or

Reschedule an Exam” in the Resources section of the webpage.

If you want to reschedule by phone, call 888-204-6249. You can

reschedule your exam one time and you must contact Credentia at

least nine (9) business days before your exam.

REFUNDS

Once payment of exam fees is received, NO REFUNDS WILL BE

ISSUED.

ABSENCE POLICY

Candidates who are late or absent from an exam may submit an

excused absence via CNA365 within 14 calendar days of the exam

date for the following reasons:

• Illness of yourself or a member of your household

• Death in the family

• Traffic accident or ticket

• Court appearance or jury duty

• Military duty

• Weather emergency

• Incarceration

Your request must include documentation or verification for the cause of

the absence. For example, if you are absent because of jury duty, you

must upload a copy of the court notice. In the case of illness, verification

from a medical provider must be included in your request. Please note,

a request takes approximately 3-5 business days to review. The

decision of Credentia to approve or deny the excused absence will be

final.

WEATHER EMERGENCIES

A test center/online examination will be delayed or cancelled only in

emergencies. If severe weather or a natural disaster makes the test site

inaccessible or unsafe, the examination will be delayed or cancelled. In

the event of an examination change due to a weather emergency,

candidates will be contacted with the information on file by phone and

email of cancellation.

Exam Day

TAKING YOUR EXAM

ONLINE

You can take your Written/Oral exam from home or work

through Credentia online proctoring. A live proctor (someone

who supervises the test) will securely monitor you through

the webcam on your workstation. Online exams also offer you

more scheduling flexibility than test center exams to fit with

your schedule.

Please visit www.credentia.com/online-exams for information

on what to expect and how to best prepare for your online

exam. We also recommend that you click on the “Policies &

Procedures” link on this webpage to review the exam rules and

procedures.

WHAT YOU’LL NEED

• The right computer – a desktop, laptop or Chromebook

with a single monitor (no smartphones or tablets).

Visit www.credentia.com/online-exams to view or

download system requirements.

• A private room – if you don’t have access to a private

room, check with your training program or local library for

availability.

• A mobile device – the proctor will need to see all around

your exam area with a 360-degree room scan. Please be

sure you have a smartphone or tablet (Apple or Android)

that can do this using our free app.

WHAT TO DO IN THE DAYS BEFORE YOUR ONLINE

EXAM:

• Run a system test – make sure to do the required system test and exam

simulation before exam day. Visit www.credentia.com/online-exams and

select the “Run System Test” button.

• Find your testing space – you need a quiet area in your home or office to

take your exam

• Get your ID ready – you are required to have two (2) forms of official ID

with a signature (One form of identification must be a U.S. government-

issued Social Security (SS) card, signed and not laminated.). A second

form of identification must be any of the items listed below and must be

photo-bearing:

• U.S. Government Issued Driver’s license

• State-issued identification card

• Passport

• Alien registration card

• Georgia- Issued Voter ID Card

• Georgia Temporary Driver’s License

• Signed Photo High School I.D. (for high school students)

• Signed Photo University I.D. (for university students)

• U.S. issued Photo Bearing Signed Military I.D.

• Certificate of Naturalization

The name on your identification must be the same as the name you used on

the application to register for the examination.

If you do not have proper identification, you will not be allowed to take the

test and your examination fee will not be refunded.

IMPORTANT: If you can’t take the test because of this, it still counts as one

of your 3 chances to take the exam because you were not prepared —

please have the correct forms of identification!

GO ONLINE to learn more about what to

expect before your

testing day and the day of testing

credentia.com/test-center-exams

WHAT TO DO ON YOUR ONLINE EXAM DAY

STEP 1: Prepare your testing space

• Quiet: no background noise and tell members of your

household you are taking your test.

• Well lit: proctors must be able to see you and your testing

space well.

• Privacy: no one else in the room.

• Remove prohibited items: clear workstation area to expedite

room scan.

• Restroom/Beverages: use restroom and prepare beverages

before exam.

STEP 2: Have your ID ready

Have your government-issued photo ID with you. (See list or

proper identification in section above.)

STEP 3: Prepare your computer

• Disconnect any additional monitors and close all other open

applications.

• Have your chargers (laptop, smart phone or tablet) plugged

in or nearby.

• Use a wired internet connection rather than WiFi, if possible.

• If using WiFi, we recommend at least 3Mbps and ask that

other people in your house do not use the internet during

your exam.

• Disconnect any VPNs or firewalls if you have them.

STEP 4: Download the ExamRoom 360 app

Download the ExamRoom 360 app to your smartphone or tablet and have

your CNA365 login credentials available (the username and password for

your Credentia CNA365 account). This app is required to complete a 360

degree room scan.

STEP 5: Check in for your exam

• You can begin to check in up to 30 minutes before your appointment. Your

onboarding agent will make sure everything is ready for your exam before

introducing your proctor (the test supervisor).

• How to check in: Go to www.credentia.com/test-takers/ga and click the

“CNA365 login” button. Once logged in, find your scheduled exam and

select the “Start Exam” button.

Exam Day

TAKING YOUR CENTER

EXAM IN PERSON

CHECKING IN

• You must arrive 30 minutes before your scheduled time for

BOTH the written examination and for the skills evaluation.

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 evaluation, please arrive 30 minutes prior to

your scheduled time. Skills Evaluation test times are

approximate.

PLEASE NOTE: You will be required to check in for both the

written examination and for the skills evaluation. You will be

required to present proper identification.

PROPER IDENTIFICATION

Get your ID ready – you are required to have two (2) forms of

official ID with a signature (One form of identification must be a

U.S. government-issued Social Security (SS) card, signed and not

laminated.). A second form of identification must be any of the

items listed below and must be photo-bearing:

• U.S. Government Issued Driver’s license

• State-issued identification card

• Passport

• Alien registration card

• Georgia- Issued Voter ID Card

• Georgia Temporary Driver’s License

• Signed Photo High School I.D. (for high school students)

• Signed Photo University I.D. (for university students)

• U.S. issued Photo Bearing Signed Military I.D.

• Certificate of Naturalization

The name on your identification must be the same as the name you

used on the application to register for the examination.

If you do not bring proper identification, you will not be allowed to test

and your examination fee will not be refunded. This absence will count

as one of your 3 opportunities to test because you were not prepared

with the correct forms of identification.

SECURITY AND CHEATING

If you give help to or receive help from anyone during the NNAAP

Examination, the examination will be stopped. The incident will be

reported to the Georgia Department of Health 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 copyrighted

by, the property of or licensed to Credentia. 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 material or information from the test site will be

prosecuted.

WHAT TO BRING

You MUST have the following items with you when you take

the NNAAP Examination:

• Two (2) forms of official (current, not expired), legible,

signature-bearing identification, one of which must be photo

identification

• Three (3) No. 2 pencils (sharpened)

• Eraser

• Analog watch with a sweeping seconds hand (not a digital

or Smartwatch)

No other materials will be allowed.

GO ONLINE to learn more about

what to expect before your testing

day and the day of testing

credentia.com/test-center-exams

TESTING POLICIES

The following policies are observed at each test site.

LATENESS

Plan to arrive thirty (30) minutes before the examination starts.

If you are late for your scheduled examination or do not bring

all your required materials, you will NOT be allowed to test and

your examination fee will NOT be returned.

ELECTRONIC DEVICES

Cellular phones, beepers, or any other electronic devices

are not permitted to be used and must be turned off during

testing, and there is no place for storage of personal

belongings at the test sites.

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 examination. Credentia 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 dismissed

from the examination and reported to the Department of

Health. Decisions regarding disciplinary measures are the

responsibility of that agency.

GUESTS/VISITORS

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

sites.

The Written (or Oral) Exam

WRITTEN EXAM

The Nurse 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 are left to finish. 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 15.

ORAL EXAM

The Oral Examination consists of sixty (60) multiple-choice questions and

ten (10) reading comprehension questions and is given on an MP3 player.

Each of the sixty (60) multiple-choice questions will be repeated two (2)

times, after which you mark your answer on an answer sheet. The reading

comprehension questions test your knowledge of and familiarity with common,

job-related words. Each of these words is repeated three (3) times. You have

two (2) hours to complete the entire Oral Examination. You must pass both the

multiple-choice and reading comprehension sections in order to pass the Oral

Examination.

SELF-ASSESSMENT READING TEST

A self-assessment reading test, found on page 16 of this handbook, will help

you decide if you should take the Oral Examination.

The 2024 National Nurse Aide

Assessment Program (NNAAP®)

Written (Oral) Examination Content

Outline

The revised content outline is based on the findings from

the 2019–2020 Job Analysis and Knowledge, Skill, and

Ability Study of Nurse Aides published by the National

Council of State Boards of Nursing (NCSBN) in 2023. The

examination content outline will be effective April 2024.

The NNAAP written examination is comprised of 70

multiple-choice items; 10 of these items are pretest (non-

scored) items on which statistical information will be

collected. The NNAAP oral examination is comprised of 60

multiple-choice items and 10 reading comprehension

(word recognition) items.

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 prevention 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

Sample Questions

The following questions are samples of the kinds of questions that

you will find on the Written Examination. Check your answers to these

questions in the box below.

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

1. B 2. B

Correct Answers

3. B 4. C

5. B 6. A

Self-Assessment

Reading Test

The two (2)-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 determine 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 17.

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 consider taking the Oral Examination.

1. You go to a doctor when you .

(A) feel sleepy

(B) need socks

(C)feel sick

(D)need money

(E) need clothes

2. A person who flies an airplane is its .

(A) pilot

(B) steward

(C)mother

(D)surgeon

(E) director

3. You use a to write.

(A) bow

(B) calculator

(C)pencil

(D)carpenter

(E) needle

4. To exit a room means to it.

(A) enter

(B) leave

(C)forget

(D)read

(E) interrupt

5. A wedding is a joyous .

(A) focus

(B) vehicle

(C)balloon

(D)occasion

(E) civilization

6. To require something means to it.

(A) need

(B) have

(C)forget

(D)understand

(E) hear

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

(D) estimate

(E) regulate

Answers

C 7. C 13. B 19.

A 8. B 14. B 20.

C 9. C 15. D 21.

10. D

11. E

16. A

17. B

22.

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.

(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

Carolyn has a good job. She is a nurse in a

large hospital. 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.

PART 2: COMPREHENSION

In 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

GO ONLINE for a Quick Guide on how to

get your exam score results in CNA365

credentia.com/test-takers/ga

The Skills Evaluation

WHAT TO EXPECT

SETTINGS

The Skills Evaluation is set up to look like an actual care-giving situation.

The Skills Evaluation area will look like your work setting. It will have

all the equipment needed to perform the assigned skills. The Skills

Evaluation will be given by a Nurse Aide Evaluator. Before your Skills

Evaluation begins, the evaluator will show you where equipment is and

answer questions about using the equipment. Please arrive 30 minutes

early. Please plan to spend the day. See pages 23-30 for the complete

skills listing.

WHO WILL ACT AS A CLIENT

The part of the “client” will be played by a candidate who will act like an

elderly person. While you perform the skills, speak to the client as you

would speak to an actual client in a nurse aide work setting. It’s good

to speak to the client not only because it is part of quality care, but also

because it will help you to relax as you perform the skills.

Please note, you cannot get help from anyone during the Skills

Evaluation, and you must speak to the client in English so that the

evaluator can understand and correctly score the evaluation. If either one

of you gives help or receives help during the test or you and the client are

talking in a language other than English, the test will be stopped.

CANDIDATE VOLUNTEER REQUIREMENTS

You will need to act as a candidate volunteer for another nurse aide’s

Skills Evaluation and play the role of a nursing home patient (client).

You will get instructions on how you should act in your role as the

client. 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 have to put a gown on

over your clothing. In no case should anyone remove clothing down to

undergarments.

Before starting the test, you should tell the evaluator about any food or

latex allergy or sensitivity to skin soaps or lotion. If you have trouble with

any range of motion, you should tell the evaluator before you start.

You should not come to the test site with open sores on the skin.

Candidates with any open sores on their skin should reschedule their

skills test to a later date.

THE TASKS

The NNAAP Skills List shows all of the skills that you may be asked to

do during the Skills Evaluation. The skills have been broken down into

steps.

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 correctly, you

will not pass the skill. However, if you perform only the Critical Element

Step correctly, you do not automatically pass that skill. You must also

correctly perform 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 skills listings

on pages 23 to 30 of this handbook. You should 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

want to correct. There are some exceptions to this rule. If you don’t

put on gloves or take them off when required, and the evaluator

reminds you to do that, then you will not get credit for trying to

correct this step.

• If you want to correct a step that must be done in order — a step

that has to be performed before or after another step — and you

forget to say when the corrected step should be performed, you will

not get credit for the correction.

• Once you begin a new skill, you can’t go back to correct the skill

that came before it.

• 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 on measurement skills).

• You must successfully complete five (5) out of the five (5) skills

in the skill form to pass the Skills Evaluation. You will have 30

minutes to demonstrate all 5 skills. When 25 minutes have

elapsed the Nurse Aide Evaluator will tell you that you have 5

minutes left.

• When you have finished your Skills Evaluation, the evaluator will

tell you to wash your hands. This will not affect your score, but you

must wash your hands as a hygiene measure.

RECORDING A MEASUREMENT

For your Skills Evaluation, you must 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 the measurement. 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. You must record your 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

Tips for the Skills Evaluation

• You will be expected to perform the skills just like you would in

a nursing home setting. When water is required, you must use

running water. You will be required to perform the Hand Hygiene

skill.

• For your skills evaluation, you don’t have to wash your hands for

each skill. You can just tell the evaluator “Now I would wash my

hands.” You don’t have to wash them each time, as long as you

tell the evaluator when you would wash them if this were a real

situation.

• For all steps other than hand-washing, you must actually perform

the skill in order to get credit. You can’t tell the evaluator what you

would do for simulating a step. You have to actually do the step.

• 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 23 of this handbook. It’s

best for you to become familiar with the Recording Sheet before

your scheduled test date.

• You must know how to use 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 (like

a 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.

Skills Listing

The 23 skills that follow are arranged in alphabetical order, except for the Hand

Hygiene (Hand Washing) skill. Hand Hygiene is listed first as a reminder of the

importance of performing 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.

SKILL 1 — HAND HYGIENE (HAND WASHING)

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 20 (twenty) seconds, keeping hands lower than the elbows and the

fingertips down

6 Cleans fingernails by rubbing fingertips against palms of the opposite hand

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

elbows and the fingertips down

8 Uses clean, dry paper towel/towels to dry all surfaces of fingers, hands and wrists

starting at fingertips then disposes of paper towel/towels into waste container

9 Uses clean, dry paper towel/towels to turn off faucet then disposes of paper towel/

towels into waste container or uses knee/foot control to turn off faucet

10 Does not touch inside of sink at any time

SKILL 2 — 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, at least to the heel

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

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; if using a mannequin, candidate may state

stocking needs to be wrinkle-free

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

10 After completing skill, wash hands

SKILL 3 — ASSISTS TO AMBULATE USING

TRANSFER BELT

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 assisting to stand, client is wearing non-skid shoes/

footwear

4 Before assisting to stand, bed is at a safe level

5 Before assisting to stand, checks and/or locks bed wheels

6 Before assisting to stand, client is assisted to sitting position with

feet flat on the floor

7 Before assisting to stand, applies transfer belt securely at the waist over

clothing/gown

8 Before assisting to stand, provides instructions to enable client to assist

in standing including prearranged signal to alert client to begin standing

9 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

10 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 by standing knee to

knee or toe to toe with client

11 Walks slightly behind and to one side of client for a distance of ten (10)

feet, while holding onto the belt

12 Assists client to bed and removes transfer belt

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

14 After completing skill, wash hands

SKILL 4 — 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 placing bedpan under client

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 lowered before bedpan is removed

13 Ensures client is covered except when placing and removing bedpan

14 Empties and rinses bedpan and pours rinse into toilet

15 Places bedpan in designated dirty supply area

16 Removes and disposes of gloves (without contaminating self) into waste

container and washes hands

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

SKILL 5 — CLEANS UPPER OR LOWER DENTURE

1 Puts on clean gloves before handling denture

2 Bottom of sink is lined and/or sink is partially filled with water before

denture is held over sink

3 Rinses denture in moderate temperature running water before brushing

them

4 Applies denture toothpaste to toothbrush

5 Brushes all surfaces of denture

6 Rinses all surfaces of denture under moderate temperature running

water

7 Rinses denture cup and lid

8 Places denture in denture cup with moderate temperature water/solution

and places lid on cup

9 Rinses toothbrush and places in designated toothbrush basin/container

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 Removes and disposes of gloves (without contaminating self) into waste

container and washes hands

SKILL 6 — COUNTS AND RECORDS RADIAL

PULSE

1 Explains procedure, speaking clearly, slowly and directly, maintaining

face-to-face contact whenever possible

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 Before recording, washes hands

6 Records pulse rate within plus or minus 4 beats of evaluator’s

reading

SKILL 7 — 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 Before recording, washes hands

5 Records respiration rate within plus or minus 2 breaths of

evaluator’s reading

SKILL 8 — 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

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 Disposes of gloves into designated waste container without

contaminating self

10 After removing gloves, unfastens gown at waist and neck

11 After removing gloves, removes gown without touching outside of gown

12 While removing gown, holds gown away from body without touching the

floor, turns gown inward and keeps it inside out

13 Disposes of gown in designated container without contaminating self

14 After completing skill, washes hands

SKILL 9 — DRESSES CLIENT WITH AFFECTED

(WEAK) RIGHT ARM

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 Asks which shirt he/she would like to wear and dresses him/her in shirt of

choice

4 Avoids overexposure of client by ensuring client’s chest is covered

5 Removes gown from the left (unaffected) side first, then removes gown

from the right (affected/weak) side

6 Before dressing client, disposes of gown into soiled linen container

7 Assists to put the right (affected/weak) arm through the right sleeve

of the shirt before placing garment on left (unaffected) arm

8 While putting on shirt, moves body gently and naturally, avoiding force

and over-extension of limbs and joints

9 Finishes with clothing in place

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

11 After completing skill, washes hands

SKILL 10 — 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, looks at name card on tray and asks client to state name

3 Before feeding client, client is in an upright sitting position (75-90

degrees)

4 Places tray where the food can be easily seen by client

5 Candidate cleans client’s hands before beginning feeding

6 Candidate sits in a chair facing client during feeding

7 Tells client what foods and beverage are on tray

8 Asks client what he/she would like to eat first

9 Using spoon, offers client one bite of each type of food on tray, telling

client the content of each spoonful

10 Offers beverage at least once during meal

11 Candidate asks client if they are ready for next bite of food or sip of

beverage

12 At end of meal, candidate cleans client’s mouth and hands

13 Removes food tray

14 Leaves client in upright sitting position (75-90 degrees) with signaling

device within client’s reach

15 After completing skill, washes hands

SKILL 11 — GIVES MODIFIED BED BATH (FACE

AND ONE ARM, HAND AND UNDERARM)

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 Removes gown and places directly in soiled linen container while

ensuring client’s chest and lower body is 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 stroke, washing

inner aspect to outer aspect then proceeds to wash face

7 Dries face with dry cloth towel/washcloth

8 Exposes one arm and places cloth towel underneath arm

9 Applies soap to wet washcloth

10 Washes fingers (including fingernails), hand, arm and underarm keeping

rest of body covered

11 Rinses and dries fingers, hand, arm 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 Places basin in designated dirty supply area

16 Disposes of linen into soiled linen container

17 Avoids contact between candidate clothing and used linens

18 Removes and disposes of gloves (without contaminating self) into waste

container and washes hands

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

SKILL 12* — MEASURES AND RECORDS

ELECTRONIC BLOOD PRESSURE

*STATE SPECIFIC (EVALUATOR: DO NOT SUBSTITUTE THIS SKILL

FOR SKILL 23 ‘MANUAL BLOOD PRESSURE’)

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 Has client assume a comfortable lying or sitting position

4 Client’s arm is positioned at level of heart with palm up and upper arm

is exposed

5 Selects appropriate cuff size

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

7 Places blood pressure cuff snugly on client’s upper arm and sensor/

arrow is over the brachial artery site

8 Turns on the machine and ensures device is functioning. If the machine

has different settings for infants, children and adults, selects the

appropriate setting.

9 Pushes start button. If cuff inflates to more than 200 mm Hg then stops

machine and uses cuff on client’s other arm.

10 Waits until the blood pressure reading appears on the screen and for

the cuff to deflate, then removes the cuff

11 Signaling device is within reach

12 Before recording, washes hands

13 After obtaining reading using BP cuff, records both systolic and

diastolic pressures exactly as displayed on the digital screen

SKILL 13 — 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 Rinses bedpan and pours rinse into toilet

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

(if between measurement lines, round up to nearest 25 ml/cc)

5 After measuring urine, empties contents of measuring container into

toilet

6 Rinses measuring container and pours rinse into toilet

7 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

SKILL 14 — MEASURES AND RECORDS WEIGHT

OF AMBULATORY CLIENT

1 Explains procedure, speaking clearly, slowly and directly, maintaining

face-to-face contact whenever possible

2 Client has non-skid shoes/footwear on before walking to scale

3 Before client steps on scale, candidate sets scale to zero

4 Asks client to step on center of scale and obtains client’s weight

5 Asks client to step off scale

6 Before recording, washes hands

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).

SKILL

NOT

TESTED

SKILL 15 — PERFORMS MODIFIED PASSIVE

RANGE OF MOTION (PROM) FOR ONE KNEE AND

ONE ANKLE

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 Ensures that client is supine in bed and instructs client to inform

candidate if pain is experienced during exercise

4 While supporting the leg at knee and ankle, bends the knee and

then returns leg to client’s normal position (flexion/extension) (AT

LEAST 3 TIMES unless pain is verbalized). Moves joints gently,

slowly and smoothly through the range of motion, discontinuing

exercise if client verbalizes pain.

5 While supporting the foot and ankle close to the bed, pushes/pulls

foot toward head (dorsiflexion), and pushes/pulls foot down, toes

point down (plantar flexion) (AT LEAST 3 TIMES unless pain is

verbalized). Moves joints gently, slowly and smoothly through the

range of motion, discontinuing exercise if client verbalizes pain.

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

7 After completing skill, washes hands

SKILL 16 — PERFORMS MODIFIED PASSIVE

RANGE OF MOTION (PROM) FOR ONE

SHOULDER

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 Instructs client to inform candidate if pain experienced during exercise

4 While supporting arm at the elbow and at the wrist, 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). Moves joint gently,

slowly and smoothly through the range of motion, discontinuing

exercise if client verbalizes pain.

5 While supporting arm at the elbow and at the wrist, 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). Moves joint gently, slowly and smoothly

through the range of motion, discontinuing exercise if client

verbalizes pain.

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

7 After completing skill, washes hands

SKILL 17 — POSITIONS ON SIDE

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 turning, lowers head of bed

4 Raises side rail on side to which body will be turned

5 Candidate assists client to slowly roll onto side toward raised side rail

6 Places or adjusts pillow under head for support

7 Candidate repositions arm and shoulder 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 position

12 After completing skill, washes hands

SKILL 18 — PROVIDES CATHETER CARE FOR

FEMALE

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 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 including buttocks before

washing

6 Exposes area surrounding catheter (only exposing client between hip

and knee)

7 Applies soap to wet washcloth

8 While holding catheter at meatus without tugging, cleans at least

four inches of catheter from meatus, moving in only one direction,

away from meatus, using a clean area of the washcloth for each

stroke

9 While holding catheter at meatus without tugging, using a clean

washcloth, rinses at least four inches of catheter from meatus,

moving only in one direction, away from meatus, using a clean

area of the washcloth for each stroke

10 While holding catheter at meatus without tugging, dries at least four

inches of catheter moving away from meatus using a dry cloth towel/

washcloth

11 Empties, rinses and dries basin

12 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 Removes and disposes of gloves (without contaminating self) into

waste container and washes hands

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

SKILL 19 — PROVIDES FOOT CARE ON ONE

FOOT

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 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) with dry cloth towel/washcloth

11 Applies lotion to top and bottom of foot (excluding between the toes)

removing excess with a towel/washcloth

12 Supports foot and ankle during procedure

13 Empties, rinses and dries basin

14 Places basin in designated dirty supply area

15 Disposes of used linen into soiled linen container

16 Removes and disposes of gloves (without contaminating self) into waste

container and washes hands

17 Signaling device is within reach

SKILL 20 — PROVIDES MOUTH CARE

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 providing mouth care, client is in upright sitting position (75-90

degrees)

4 Puts on clean gloves before cleaning mouth

5 Places cloth towel across chest before providing mouth care

6 Secures cup of water and moistens toothbrush

7 Before cleaning mouth, applies toothpaste to moistened toothbrush

8 Cleans mouth (including tongue and all surfaces of teeth), using

gentle motions

9 Maintains clean technique with placement of toothbrush

10 Candidate holds emesis basin to chin while client rinses mouth

11 Candidate wipes mouth and removes clothing protector

12 Disposes of used linen into soiled linen container

13 Rinses toothbrush and empties, rinses and dries basin

14 Removes and disposes of gloves (without contaminating self) into waste

container and washes hands

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

SKILL 21 — PROVIDES PERINEAL CARE

(Peri-Care) for Female

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 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 including buttocks before

washing

6 Exposes perineal area (only exposing between hips and knees)

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 dry cloth towel/

washcloth

11 After washing genital area, turns to side, then washes rectal area moving

from front to back using a clean area of washcloth for each stroke.

12 Using clean washcloth, rinses soap from rectal area, moving from front to

back, while using a clean area of the washcloth for each stroke

13 Dries rectal area moving from front to back with dry cloth towel/washcloth

14 Repositions client

15 Empties, rinses and dries basin

16 Places basin in designated dirty supply area

17 Disposes of used linen into soiled linen container and disposes of linen

protector appropriately

18 Avoids contact between candidate clothing and used linen

19 Removes and disposes of gloves (without contaminating self) into waste

container and washes hands

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

SKILL 22 — TRANSFERS FROM BED TO

WHEELCHAIR USING TRANSFER BELT

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 assisting to stand, wheelchair is positioned alongside of bed,

at head of bed facing foot or foot of bed facing head

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

5 Before assisting to stand, locks wheels on wheelchair

6 Before assisting to stand, bed is at a safe level

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, client is wearing shoes

10 Before assisting to stand, applies transfer belt securely at the waist

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 by

standing knee to knee or toe to toe with the client

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

While a formal nurse aide “scope of practice”

does not exist, these skills addressed as part

of the NATCEP program constitute the range

of acceptable duties that may be assigned to a

nurse aide and that a nurse aide will be deemed

competent to perform. Duties inherent to another

professional scope of practice, such as those

associated with a Licensed Practical Nurse or

Registered Nurse, are deemed inappropriate for

a nurse aide to perform.

SKILL 23* — MEASURES AND RECORDS MANUAL

BLOOD PRESSURE

*STATE SPECIFIC (EVALUATOR: DO NOT SUBSTITUTE THIS SKILL FOR

SKILL 12 ‘ELECTRONIC BLOOD PRESSURE’)

1 Explains procedure, speaking clearly, slowly and directly, maintaining face-to-

face contact whenever possible

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 inflates cuff between 160mm Hg to 180 mm Hg. If beat heard

immediately upon cuff deflation, completely deflate cuff. Reinflate cuff to no

more than 200 mm Hg.

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 Before recording, 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 readings

Exam Results

Credentia will give you your official test results (your score report) within a

few hours after a testing event is completed for the day. Score reports are

listed as Pass or Fail only, there is no numeric score included. Score

reports are available Online to print or download.

To see your Score Report, please log into your CNA365 account by going

to https://credentia.com/test-takers/ga. The Skills Exam Score Report lists

the topics that were failed for each skill. The Written Exam Score Report

shows which sections were failed but does not provide a breakdown of

which questions or topics were missed. For additional information on how

to access your exam results, click here https://credentia.com/storage/

scores/Exam-Score-Results-QRG-v1.0.pdf.

SCORE REPORTING

Credentia will give you your official test results (your score report) within a

few hours after a testing event is completed for the day. Score reports are

available online to print or download.

To see your score report, please log into your account at

https://i7.integral7.com/pana

If it has been more than 24 hours and you are unable to view your score

report in the portal, please contact customer service at 800-457-6752.

Test results will not be given over the telephone nor can they be sent by

Credentia to your employer.

IF YOU RECEIVE A FAILING SCORE

• If you fail the Written (or Oral) Examination or the Skills Evaluation,

your Score Report will tell you how to retake either or both parts.

• If you fail either part of the NNAAP Examination three (3) times, you

will need to complete another training program and retake BOTH

parts of the NNAAP Examination, not just the part that was failed.

• In addition, if you were scheduled to take the exam 3 times and did

not become licensed — either as a result of failing the exam or

absence(s) — you will need to retrain.

• If you have used all three (3) allotted attempts for the Skills and/or

Written exams, you are required to reenroll into a nurse aide training

program course before you can reapply as an E1-New Nurse Aide. A

full list of training programs can be found on your state's webpage.

Visit www.credentia.com and select your state from the top-right of

the screen.

See Registration and Scheduling for more details.

HOW TO READ A FAILING SCORE REPORT

If you don’t pass the Skills Evaluation, you’ll get 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 need a Satisfactory

result on all five (5) skills in order to pass the Skills Evaluation.

IMPORTANT: Use your Failing Score Report to help you study for when

you retake the Skills Evaluation. A failed skill will show the reason for the

failure, and you can use this information to make sure you do this the skill

correctly when you retake it. Find the skill you failed, and study the steps,

especially steps listed as Unsatisfactory on the score report.

In the example below, a candidate got an Unsatisfactory on the skill Hand

Hygiene. The numbers 1, 5 and 10 printed below the skill refer to steps

that were missed or performed incorrectly. To study for retaking the Skills

Evaluation, you should turn to the Skills Listing in this handbook, look for

the Hand Hygiene skill, and review all the steps, especially steps 1, 5 and

10.

GEORGIA NNAAP® EXAMINATION RESULTS

Exam: Skills Result: Fail

Skills

Performance:

Hand

Hygiene

5, 10

Unsatisfactory

Provides

Mouth Care Satisfactory

Written

Examination only Satisfactory

Measures

and Records Blood Pressure Satisfactory

Puts

One Knee-High

Elastic

Stocking on Client

Satisfactory

Assists

Client to Ambulate using

transfer

belt

Satisfactory

A sample of a Failing Score Report

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 documentation 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

support 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. A correct address is required for you

to receive notification for renewal.

If there is a change of name or address, it is the sole responsibility of the

CNA to report this change. You must send written notification within ten

(10) business days of this change to the Registry. Please notify Alliant

Health Solutions as soon as possible if you are not able to make

this change within ten (10) business days.

LISTING RENEWAL

Nurse aides on the Georgia Nurse Aide 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, for at least eight (8) hours

every twenty-four (24) consecutive months under the supervision of

a nurse. This employment must be documented and reported to the

Nurse Aide Registry prior to each listing expiration date. The listing

expiration date is twenty-four (24) months from either the date of your

last successful competency examination or last recertification date,

whichever is more recent. A new state-approved nurse aide training

course and/or competency examination is required if you do not work in

a qualifying position for a twenty-four (24)

Failure to inform the Registry of an address or name change may

jeopardize your listing status. A correct address is required for you to

receive notification for renewal.

Grievance Process

If you disagree with your score, you can file what’s called a “grievance,”

an explanation or reason for why you think your score was not correct

or fair.

• All grievances must be in writing and submitted through the online

system. You must provide as much detail as possible. The

grievance must be submitted within 30 days of your exam date.

After we receive your grievance form, your complaint will be

investigated. Once the investigation is complete, Credentia will

contact you to tell you whether or not your grievance was accepted.

If the grievance is accepted, you’ll be allowed to retest at no

additional cost.

• For details on how to submit a grievance, visit www.credentia.com/

test-takers/ga and click on “Grievances” in the Resources section of

the webpage. You will receive a response within 30 days of

Credentia receiving your form.

The Registry

CHANGE OF ADDRESS OR NAME

The Georgia Nurse Aide 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

Address or Name Change Reporting Form on the Nurse Aide Registry

website (www.mmis.georgia.gov) and click the Nurse Aide tab).

Alternately, you may call the Nurse Aide Registry at (800) 414-4358

or locally at (678) 527-3010 to change your mailing address on the

Registry.

Continued on next page.

RENEWAL NOTICE

RENEWAL NOTICE Approximately sixty (60) days before the expiration of

your Registry listing, the Registry will send a Renewal Application to the

mailing address listed for you on the Registry. It is your responsibility to

renew by the expiration date, even if you do not receive the Renewal

Application from the Registry. If you do not receive a Renewal Application,

or you misplace it, a Nurse Aide Renewal Application (hardcopy or online

digital entry) is available on the Registry web site www.mmis.georgia.gov

(click the Nurse Aide/Medication Aide tab). When you receive your

Renewal Application, please sign/date and complete Section A or B. You

will need to submit a copy of your proof of employment within the renewal

period. Private Duty requires additional documentation and proof of work

history under a licensed nurse. Please review the private duty

requirements on the registry web portal. Please contact the registry at

(800) 414-4358 or locally at (678) 527-3010 for all renewal questions.

RENEWAL FEE

There is no fee for re-listing on the Georgia Nurse Aide Registry

certification. For more information about re-activating a lapsed Nurse Aide

Registry listing, please call the Georgia Nurse Aide Registry at

(800) 414-4358 or locally at (678) 527-3010.

PETITION FOR REMOVAL OF FINDING OF NEGLECT:

An individual whose nurse aide certification has been revoked due to a

finding of Neglect may have that Neglect removed if they have fulfilled the

provisions set forth by the Social Security Act cited below:

The Social Security Act 1319(g) (1) (D) and 1919(g) (D); includes a

provision to address the removal of a neglect finding on a nurse aide from

the Nurse Aide Registry in limited circumstances. The law requires that

when there is a finding of neglect against an aide, the nurse aide may

petition the state to have his or her name removed from the registry. If the

state determines that the employment and personal history of the nurse

aide does not reflect a pattern of abusive behavior or neglect; and the

neglect involved in the finding was a singular occurrence. The law requires

that a determination on a petition for removal cannot be made prior to the

expiration of a one-year period beginning on the date which the finding

against the nurse aide was added to the Nurse Aide Registry. You may

send your petition to C.N.A. Abuse Registrar, 2 Peachtree Street, 31-447,

Atlanta, GA 30303. Once granted, you will then need to contact Alliant

Health Solutions for guidelines to update your certified nurse aide

certification.

Notes:

(04/23)HB-GA