Nurse Aide 1 Book
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Transcript of Nurse Aide 1 Book
North Carolina
NURSE AIDE
to testBEFORE JULY 1, 2012 click here
to test ON orAFTER JULY 1, 2012 click here
written (or oral) examination & skills evaluation
CANDIDATE HANDBOOK
PEARSON VUE
Stock #0734-00 6/11
nORTH CAROLInANURSe aide ICandidate Handbook
June 2011
QUICK REFEREnCE
TABLE OF COnTEnTS
SEARCH DOCUMEnT
QuiCk RefeReNCe
NACES Plus FouNdAtIoN, INC.North Carolina NNAAP®
7600 Burnet Road, Suite 440 Austin, TX 78757-1292
(888) 282-6904 Fax: 1 (866) 95 NACES
Hours of Operation 8:30 a.m. – 6:30 p.m. (Eastern Time Zone)
Call NACES Plus Foundation, Inc. to:• Obtain a Candidate Handbook• Obtain an Application for testing• Obtain registration information• Cancel and/or reschedule an examination• Arrange special examination requests
and services• Change your current address or name
before testing• Request an excused absence
PEARSoN VuE®North Carolina NNAAP®
PO Box 13785 Philadelphia, PA 19101-3785
(888) 204-6207Hours of Operation 8:00 a.m. – 5:00 p.m.
(Eastern Time Zone)
Call Pearson VUE to:• Ask questions about On-Line Registration• Obtain information regarding your Score Report• Request a duplicate Score Report • Obtain information regarding your examination
Go to Pearson VUE’s website (www.pearsonvue.com) to:
• Register On-Line• Download a Candidate Handbook• Download an Application • View Regional Test Site testing dates• Download a Nurse Aide Practice Written
Examination• View the Nurse Aide Program Overview• View Frequently Asked Questions• View a list of the Nurse Aide Registries (by State)• View Skills Listing
Refer any additional questions to:
NoRtH CARolINA dEPARtmENt oF HEAltH ANd HumAN SERVICES Center for Aide Regulation
and Education*2709 Mail Service Center Raleigh, NC 27699-2709
(919) 715-0562 (919) 855-3969
Hours of Operation 8:00 a.m. – 12:00 p.m. and 1:00 p.m. – 3:00 p.m.
(Eastern Time Zone, weekdays) The phone lines will be closed between 12 noon and 1 p.m.
*Please do not send application or fee for testing to this address
Pearson VUE and NACES do not discriminate on the basis of age, sex, race, creed, disabling condition, religion, national origin, or any other protected characteristics.
Copyright © 2011 Pearson Education, Inc., or its affiliates. All Rights Reserved.
NNAAP® Written Exam Content Outline and Practical Skills Listing Copyright © 2010 National Council of State Boards of Nursing, Inc. (NCSBN®). All rights reserved.
table Of CONteNts
Quick Reference........................... . inside.front.cover
Introduction......................................................... 1National Nurse Aide Assessment Program ............... 1Exam Overview ........................................................ 2
Eligibility....................................................................2Nurse Aide Trained Candidates................................ 3Community College Refresher
Course Candidates ................................................ 3Other NC Nurse Aide Trained Candidates .............. 3Challengers ............................................................... 3Student Nurse Candidates ........................................ 4North Carolina Nurse Aide I Registry Candidates .... 4
Application and Scheduling...............................4Filling Out an Application ....................................... 4Proper I.D. ................................................................ 4Exam Fees ................................................................. 6Exam Scheduling ...................................................... 6Authorization to Test Notice .................................... 7Testing Locations ...................................................... 7Special Exam Requests and Services ......................... 7Telecommunication Devices
for the Deaf (TDD) .............................................. 7
Cancellation and re-scheduling......................8Refunds .................................................................... 8Absence Policy .......................................................... 9Weather Emergencies ................................................ 9
Exam day................................................................. .10Checking In ............................................................. 10What to Bring ......................................................... 10Proper Identification ................................................ 10Security ................................................................... 11Testing Policies ....................................................... 12 Lateness ............................................................... 12 Electronic Devices ............................................... 12 Study Aids ........................................................... 12 Eating/Drinking/Smoking ................................... 12 Misconduct .......................................................... 12 Guests/Visitors ..................................................... 12
continued on next page
the Written (or oral) Exam..............................13Written Exam .......................................................... 13English or Spanish Oral Exam ................................ 13
Written (or oral) Exam Content outline..... .14
Sample Questions................................................. .15
self-assessment reading test....................... .16-19
the Skills Evaluation .................................................20What to Expect ...................................................... 20 Setting ................................................................ 20 Who Will Act As a Client? ................................. 20 Candidate Volunteer Requirements .................... 20 Candidate Dress Requirements ........................... 20The Tasks ................................................................ 21Recording a Measurement ...................................... 22Sample Recording Sheet for Measurement Skills .... 23 Tips for the Skills Evaluation .............................. 24
Skills listing .................................................... .25-40
Score Reporting................................................... .41Exam Results ........................................................... 41 Written (or Oral) Exam ....................................... 41 Skills Evaluation .................................................. 41Failing ..................................................................... 42Reading a Failing Score Report .............................. 42Sample of a Failing Score Report ............................ 43Passing .................................................................... 43Duplicate Score Report ........................................... 43
Grievance Process.................................................44Overview ................................................................ 44Process .................................................................... 44
the Registry............................................................ .45Initial Listing ........................................................... 45Change of Address or Name .................................... 45Listing Renewal ...................................................... 46
AppendixAppendix A: Request for Duplicate Score Report
or Handscored Answer Sheet Form
iNtROduCtiON
This handbook is designed for candidates seeking Nurse Aide I certi fi cation in North Carolina. It describes the process of applying for and taking the National Nurse Aide Assessment Program (NNAAP®) Examination.
The North Carolina Department of Health and Human Services (DHHS) has contracted with Pearson VUE, a nationally recognized leading provider of assessment services to regulatory agencies and national associations. Pearson VUE will administer, score, and report the results of the NNAAP® Examination for the North Carolina Nurse Aide I Registry. The Nurse Aide Competency Evaluation Service (NACES) will be working with Pearson VUE to schedule and administer the examination.
NAtIoNAl NuRSE AIdE ASSESSmENt PRoGRAm (NNAAP®)The Nursing Home Reform Act, adopted by Congress as part of the Omnibus Budget Reconciliation Act of 1987 (OBRA ’87), was designed to improve the quality of care in long-term health care facilities and to define training and evaluation standards for nurse aides who work in such facilities. Each state is responsible for following the terms of this federal law.
The National Nurse Aide Assessment Program (NNAAP®) is an examination program designed to determine minimal competency to become a certified nurse aide in your state. The NNAAP was developed by the National Council of State Boards of Nursing, Inc., (NCSBN) to meet the nurse aide evaluation requirement of federal and state laws and regulations. Pearson VUE is the authorized administrator of the NNAAP in your state.
The NNAAP Examination is an evaluation of nurse aide-related knowledge, skills, and abilities. The NNAAP Examination is made up of both a Written (or Oral) Examination and a Skills Evaluation. The purpose of the NNAAP Examination is to test that you understand and can safely perform the job of an entry-level nurse aide.
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ExAm oVERVIEWYou will be allowed to choose between a Written or Oral Examination. The Written Examination is available only in English; the Oral Examination is available in English or in Spanish. The two parts of the NNAAP Examination pro-cess, the Written (or English or Spanish Oral) Examination and the Skills Evaluation, will be administered on the same day. You must pass both parts to be certified and listed on the North Carolina Nurse Aide I Registry. The Written Examination consists of seventy (70) multiple-choice questions written in English. Sample examination questions are provided in this handbook.An Oral Examination available in English or in Spanish may be taken in place of the Written Examination. The Oral Examination consists of sixty (60) multiple-choice questions and ten (10) multiple-choice reading comprehension ques-tions provided on a cassette tape. You will be asked to listen to a cassette tape of the Oral Examination and follow along in the test booklet as the questions are read aloud on the tape. If you want to take the Oral Examination, you must request it when you submit your application. At the Skills Evaluation you will be asked to perform five (5) randomly selected nurse aide skills. You will be given thirty (30) minutes to complete the five (5) skills. You will be rated on these skills by a Nurse Aide Evaluator. You must successfully demonstrate all five (5) skills to pass the Skills Evaluation. A complete listing of the skills is shown on pages 25 to 40.See The Written (or Oral) Exam and The Skills Evaluation for more details about the NNAAP Examination.
eligibility
All candidates applying to take the NNAAP Examination in North Carolina MUST complete an Application for Registration by Competency Examination form using one of the eligibility routes listed on the following two (2) pages.
north carolina state-approved nurse aide I trained candidatesAll applicants who have successfully completed a North Carolina state-approved Nurse Aide I training program. Candidates must pass both portions within two (2) years from the completion date of a training program or within three (3) attempts, whichever comes first, in order to be placed on the North Carolina Nurse Aide I Registry.
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north carolina community college refresher course trained candidatesAll applicants who have completed a Nurse Aide I refresher course at a North Carolina Community College. Candidate must pass both portions within two (2) years from the completion date of a refresher course or within three (3) attempts, whichever comes first, in order to be placed on the North Carolina Nurse Aide I Registry.
other north carolina Nurse Aide Trained CandidatesAll applicants who have attended training in North Carolina for preparation for this exam at any program other than a North Carolina state-approved training program or Community College Refresher Course. Candidates must pass both portions of the exam within two (2) years from taking the first test or within three (3) attempts, whichever comes first, in order to be placed on the North Carolina Nurse Aide I Registry. Failure to do so will require train-ing at a North Carolina state-approved training program or Community College Refresher Course and retesting of both portions of the examination.If you return to school and have not completed testing or passed both portions of the examination, you must test (retest) BOTH portions of the examination.
challengersAll applicants who have completed nurse aide training out-side North Carolina, or are listed on another state’s Nurse Aide Registry (other than North Carolina), or EMT’s, or other health professionals, or those with NO nurse aide training. Candidates must pass both portions of the exam within two (2) years of taking the first test or three (3) attempts, whichever comes first, in order to be placed on the North Carolina Nurse Aide I Registry. Failure to do so will require training at a North Carolina state-approved train-ing program or Community College Refresher Course and retesting of both portions of the examination.If you return to school and have not completed testing or passed both portions of the examination, you must test (retest) BOTH portions of the examination.
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Eligibility routes continue on next page
north carolina state-approved student nurse training candidatesAll applicants who are currently enrolled in a North Carolina approved nursing education program preparing for registered or practical nurse licensure. Candidates must pass both portions within two (2) years from completion of the state-approved portion of the training program or within three (3) attempts, whichever comes first in order to be placed on the North Carolina Nurse Aide I Registry.
North Carolina Nurse Aide I Registry CandidatesAll applicants who are listed on the NC Nurse Aide I Registry and are not eligible to test under any other eligibil-ity routes or are unable to renew under required qualify-ing work experience. (Current registry listing is Active or Inactive.) Must pass both portions of the exam within two (2) years of taking the first test or three (3) attempts, which-ever comes first, in order to become/remain active on the North Carolina Nurse Aide I Registry.
appliCatiON aNd sCheduliNg
FIllING out AN APPlICAtIoN
Proper IdentificationCandidates are required to bring two (2) forms of current, not expired, official signature-bearing identification (one of which must be photo-bearing) to the test site. One form of identification must be a U.S. government-issued Social Security card, signed and non-laminated. Name and SSN must match what is on the application (for both on-line and paper registration).
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ON-LINE REGISTRATION(pRefeRRed MethOd) On-line registration is quick, convenient and an environ-mentally responsible way to register for your examination. This process will eliminate the transit time associated with mailing a paper application. Once your application is com-pleted, your information will be transmitted to NACES and the scheduling process can begin almost immediately. • Payment is in the form of a credit card or pre-paid credit
card (American Express, MasterCard or Visa). Fees are non-refundable and non-transferable once submitted.
• You can access the On-Line application through the PULSE Portal link www.pulseportal.com
• You must complete all required fields on your application before it will be submitted to NACES for your examina-tion scheduling. Please check www.pearsonvue.com for the link for required information.
Should you not have access to the internet, credit card or pre-paid credit card, you may still submit a paper application.
PAPER APPLICATION
NOTE: As of August 1, 2011, there is a $20 service fee for paper applications or failing score reports submit-ted to NACES. This information must be received by NACES twelve (12) business days before the examination date.
• You are responsible for completing the appropriate sections of the Examination Application. You may ask someone from your nurse aide training program or facility employer for assistance in completing the application.
• Payment must be in the form of a money order, cer-tified check, or company check made payable to “NACES”. The money order, certified check, or com-pany check must display your name so it can be applied to your examination. Company checks may pay for more than one candidate. Personal checks and cash will not be accepted. Fees are non-refundable and non-transferable once submitted to NACES.
• If you need help or have any questions about the application, please contact a NACES Customer Service Representative at (888) 282-6904.
• Mail your completed application and fee together in one envelope to:
NACES Plus Foundation, Inc. North Carolina NNAAP®
7600 Burnet Road, Suite 440 Austin, TX 78757-1292
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ExAm FEESThe fees listed below have been established for the NNAAP
Examination in North Carolina.
examination type fees
Written Examination & Skills Evaluation $101
Oral (English or Spanish) Examination & Skills Evaluation $101
Written Examination ONLY (re-test) $24
Oral (English or Spanish) Examination ONLY (re-test) $24
Skills Evaluation ONLY (re-test) $77Additional fee for any paper application or failing score report submitted to NACES on or after Aug. 1, 2011
$20
The first time you test, you must schedule bOTh the Written (or Oral) Examination
and the Skills Evaluation.
Under federal and North Carolina state laws, candidates employed as nurse aides in nursing homes that participate in Medicaid/Medicare programs are prohibited from paying their examination fees. Employers must pay the examination fee and any re-test fee for those candidates in their employ as nurse aides or candidates who have a written commitment or signed acceptance of employment on file in a Medicaid-certified nursing home. Candidates who become employed as a nurse aide by a Medicare/Medicaid skilled nursing facility within 12 months of suc-cessful completion of the competency evaluation may be reimbursed by the facility for training and competency testing costs. Therefore candidates should save all receipts to submit to the skilled nursing employer.
ExAm SCHEdulING Once NACES receives your application, required docu-ments, and fees, they will schedule you for testing. NACES will mail your Authorization to Test Notice (yellow postcard) to you at the address listed on your application within forty-eight (48) hours.
6
AutHoRIzAtIoN to tESt NotICEYour Authorization to Test Notice (yellow postcard) has important information about the examination. If you do not receive your notice within seven (7) business days, call NACES. NACES is NOT responsible for lost, misdirected, or delayed mail.
tEStING loCAtIoNSThe NNAAP Examination is given by NACES at Regional Test Sites.
The complete testing schedule, titled North Carolina Regional Test Sites &
Schedules, is available on the Pearson VUE website (www.pearsonvue.com) or at
https://www.ncnar.org, then click on the word Pearson VUE.
SPECIAl ExAm REQuEStS ANd SERVICESPearson VUE complies with the provisions of the Americans with Disabilities Act (42 U.S.C. § 12101 et seq.) and Title VII of the Civil Rights Act, as amended (42 U.S.C. § 2000e et seq.), in accommodating disabled candidates who need special arrangements to take the examination.
If you have a disability, you may ask for special arrangements for testing when you apply. All requests must be approved in advance. Be sure to:
• provide statement of diagnosed disability from your health care provider
• explain specific type of accomodation requested
Nurse Aide Evaluators administering the Written (or English or Spanish Oral) Examination and the Skills Evaluation will be prepared to meet the needs of nurse aide candidates who have approved accomodations.
tElECommuNICAtIoN dEVICES FoR tHE dEAF (tdd)Pearson VUE is equipped with Telecommunication Devices for the Deaf (TDD) to assist deaf and hearing-impaired candidates. TDD calling is available during all Pearson VUE hours through a special toll-free number, (866) 274-2777. This TDD phone option is for the express use of individuals equipped with compatible TDD machinery.
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CaNCellatiON aNd Re-sCheduliNg
If you are unable to attend your scheduled examination, you MUST notify NACES at least seven (7) business days before the examination date to re-schedule. Saturday and Sunday and national holidays are not considered busi-ness days.
If you provide at least seven (7) business days advance notice, you may re-schedule one (1) time, without pen-alty charges, and your fee may be transferred to your new examination date.
If you need to re-schedule an examination in less than seven (7) business days before the examination date, you must apply for an excused absence. (Please refer to the Absence Policy section in this handbook.)
If you do not call NACES at least seven (7) business days before your examination date to re-schedule, and do not show up for your scheduled examination, your fee will NOT be refunded and cannot be transferred to a new examination date. Also, you may not give your examina-tion date to another person.
REFuNdSOnce payment of exam fees is received, NO REFUNDS WILL bE ISSUED.
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AbSENCE PolICySince unexpected situations occur, NACES will consider excusing an absence from a scheduled examination.
Acceptable reasons for re-scheduling are as follows:• Illness of yourself or a member of your immediate
family• Death in the family• Disabling traffic accident• Court appearance or jury duty• Military duty• Weather emergency
Requests for excused absences must be made in writing and received within ten (10) business days following the scheduled examination. This request must include veri-fication of your absence from an appropriate source. For example, if you had jury duty, you must supply a copy of your court notice.
The decision of NACES to approve or deny the excused absence is final.
WEAtHER EmERGENCIESExaminations will be delayed or cancelled only in emergen-cies. If severe weather or a natural disaster makes the test cen-ter inaccessible or unsafe, the examination will be delayed or canceled. If the examination has been canceled, you will be re-scheduled for the next available examination at that site.
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exaM day
CHECkING INYou must arrive 30 minutes prior to your scheduled time for BOTH the written and skills examinations. If you are late for the written examination you will not be allowed to test and your fees will not be refunded. If you missed your written examination and are scheduled for a skills evalua-tion, please arrive 30 minutes prior to your scheduled time. Skills Evaluation test times are approximate.You will be required to check in for both the written and for the skills examinations. You will be required to present proper identification.
WHAt to bRINGYou must have the following items with you when you take the examination:• Two (2) forms of proper identification• Three (3) No. 2 pencils (sharpened)• Eraser• Watch with a second hand
No other materials will be allowed.
PRoPER IdENtIFICAtIoNCandidates are required to bring two (2) forms of current, not expired, official signature-bearing identification (one of which must be photo-bearing) to the test site. One form of identification must be a U.S. government-issued Social Security card, signed and non-laminated. Nurse Aide I applicants who are in the armed services may use their current U.S. Military I.D. in place of a Social Security (SS) card. The test taker’s SS number must be on the I.D. if used. Sponsor or Dependent Military I.D.s are NOT accept-ed in place of SS card, but can be used as a second I.D. (one with photo) when presented with a valid SS card.
The second form must be any of those listed below. Photocopies of identification will NOT be accepted.Original signature bearing SS cards are required to test in NC. If you have scheduled your exam and have misplaced your SS card 7 business days prior to your exam, call NACES to reschedule. If there are extenuating circumstances such as fire or theft and your exam is scheduled in less than 7 business days from the time of the incident, you may apply for an excused absence. Refer to page 7, Cancellation and Rescheduling in
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the NC Nurse Aide I Handbook. Documentation substan-tiating the event must be provided. NACES’s decision to approve or deny a credit request will be final.
Proper.photo.identification.includes.one.of.the.following:
• Current, non-expired driver’s license (Candidates who do not have their new license by exam day MUST bring their expired driver's license AND the 20 day temporary permit)
• U.S. government-issued Military I.D. (if not used in lieu of social security card)
• State-issued identification card• Passport (US or foreign, current, non-expired)• Alien registration card
The name on your identification must be the same as the name you used on the application to register for the exami-nation. If your name has changed you must:
• Contact NACES if you are NOT on the North Carolina Nurse Aide I Registy
• If you ARE on the North Carolina Nurse Aide I Registry, contact NACES AND the Registry
You must do this at least seven (7) business days prior to your scheduled exam. Be prepared to provide official gov-ernment documentation of the name change.If you do not bring proper identification, you will not be allowed to test and your examination fee will not be refunded.
SECuRIty ANd CHEAtINGIf you give help to or receive help from anyone during the examination, the examination will be stopped. The incident will be reported to the North Carolina Division of Health Service Regulation (DHSR) for review, and your examination will not be scored (see Testing Policies).
Please note that all examination questions, each form of the examination, and all other examination materials are copy-righted by, the property of, or licensed by Pearson VUE. Consequently, any distribution of the examination content or materials through any form of reproduction, or through oral or written communication, is strictly prohibited and punishable by law. Anyone who removes or tries to remove examination materials or information from the test site will be prosecuted.
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tEStING PolICIESThe following policies are observed at each test center.
Lateness
You must arrive thirty (30) minutes before the examina-tion starts. If you are late for your scheduled examination, or do not bring all of your required materials, you will NOT be allowed to test and your examination fee will NOT be returned. If you are late for the Written (or Oral) Examination, but arrive on time for the Skills Evaluation, you will be allowed to take the Skills Evaluation.
If you are late for your Skills Evaluation or do not bring all your required materials, you will NOT be allowed to test and you will be required to re-apply and pay another examination fee (see Cancellation for more details).
Electronic Devices
Cellular phones, beepers, or any other electronic devices are not permitted to be used and must be turned off during testing. There is no place for storage of personal belongings at the test center.
Study Aids
You are not permitted to take personal belongings such as briefcases, large bags, study materials, extra books, or papers into the examination room. Any such materials brought into the examination room will be collected and returned to you when you have completed the examina-tion. Pearson VUE is not responsible for lost or misplaced items.
Eating/Drinking/Smoking
You are not permitted to eat, drink, or smoke during the examination.
Misconduct
If you are discovered causing a disturbance of any kind or engaging in any kind of misconduct, you will be dis-missed from the examination and the incident will be reported to the North Carolina Division of Health Service Regulation.
Guests/Visitors
No guests, visitors, pets, or children are allowed at the test center.
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the WRitteN (OR ORal) exaM
WRIttEN ExAmThe Nurse Aide Evaluator will hand out materials and give instructions for taking the Written Examination. The Written Examination has seventy (70) multiple-choice questions. You will have two (2) hours to complete the Written Examination. You will be told when fifteen (15) minutes remain. Fill in only one (1) oval on the answer sheet for each question. Markings in the test booklet will NOT be accepted as answers. Your answers must appear on the separate answer sheet. Sample questions for the Written Examination are located on page 14.
ENGlISH oR SPANISH oRAl ExAmAn Oral Examination may be taken in place of the Written Examination. The Oral Examination may be taken in English or in Spanish. You must request an English or Spanish Oral Examination when filling out your application. The Oral Examination is provided on a cassette tape. A cassette player and earphones are provided at the test center. You will be asked to listen to a tape of the Oral Examination and follow along in the test booklet as the questions are read aloud on the tape. The Oral Examination consists of two (2) parts, and you must pass both parts to pass the Oral Examination. The first part of the Oral Examination has sixty (60) multiple-choice questions. Each of these questions is read twice. As each question is read, you will be asked to choose the correct answer and mark it on your answer sheet. The second part of the Oral Examination has ten (10) multiple-choice questions. These questions test your abil-ity to speak a minimum amount of English by recogniz-ing common words used by nurse aides in long-term care facilities. Each word is read three (3) times. You are asked to match the word you hear on the tape to the written word in the test booklet. As you find the match, mark your answer on the answer sheet.The Oral Examination takes two (2) hours to complete. You will be told when fifteen (15) minutes remain. Fill in only one (1) oval on the answer sheet for each question. You may write in the test booklet, but markings in the test booklet will NOT be accepted as answers. Your answers must appear on the separate answer sheet.
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2011 WRitteN (OR ORal) exaM CONteNt OutliNe
The revised 2011 NNAAP® Examination Content Outline is based on the findings from the 2009 Job Analysis of Nurse Aides published by NCSBN in spring 2010. The examination content outline will go into effect January 2011.
The NNAAP written examination is comprised of 70 multiple-choice items; 10 are pretest items (non-scored) on which statistical information will be collected. The NNAAP oral examination is comprised of 60 multiple-choice items and 10 reading comprehension (word recog-nition) items. The candidate is allowed to choose between a written and an oral examination. # of % of questions I. Physical Care Skills the exam in the exam
A. Activities of Daily Living ........ 14% ............8 1. Hygiene 2. Dressing and Grooming 3. Nutrition and Hydration 4. Elimination 5. Rest/Sleep/Comfort B. Basic Nursing Skills .................39% ............ 24 1. Infection Control 2. Safety/Emergency 3. Therapeutic/Technical Procedures 4. Data Collection and Reporting C. Restorative Skills ...................... 7% .............4 1. Prevention 2. Self Care/Independence
II. Psychosocial Care Skills A. Emotional and Mental Health Needs ..............11% .............6
B. Spiritual and Cultural Needs ....2% ..............2
III. Role of the Nurse Aide A. Communication ....................... 8% .............5
B. Client Rights ........................... 7% .............4
C. Legal and Ethical Behavior ...... 3% .............2
D. Member of the Health Care Team ................... 9% .............5
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saMple QuestiONs
The following questions are samples of the kinds of ques-tions that you will find on the Written Examination. Check your answers to these questions in the box below.
1. The client's call light should always be placed:(A) on the bed(B) within the client's reach(C) on the client's right side(D) over the side rail
2. Which of the following items is used in the pre-vention and treatment of bedsores or pressure sores?(A) rubber sheet(B) air mattress(C) emesis basin(D) restraint
3. When caring for a dying client, the nurse aide should:(A) keep the client's room dark and quiet(B) allow client to express his feelings(C) change the subject if client talks about death(D) contact the client's minister, priest or rabbi
4. What does the abbreviation ADL mean?(A) Ad Lib(B) As Doctor Likes(C) Activities of Daily Living(D) After Daylight
5. After giving a client a back rub, the nurse aide should always note:(A) the last time the client had a back rub(B) any change in the client's skin(C) client's weight(D) amount of lotion used
6. how should the nurse aide communicate with a client who has a hearing loss?(A) face the client when speaking(B) repeat the statement(C) shout so that the client can hear(D) use a high-pitched voice
Correct Answers
1. B 2. B 3. B 4. C 5. B 6. A
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self-assessMeNt ReadiNg test
The two-part Self-Assessment Reading Test that appears below will help you decide if you should consider taking the Oral Examination instead of the Written Examination. To complete the reading test, follow the instructions provided below and select the answer to each question. When you have completed the reading test, you will be able to deter-mine the number of questions you answered correctly.
PARt 1: VoCAbulARy
1. Circle the best answer to each question.
2. When you have finished, check your answers using the answer key on page 18.
3. Count up the number of correct answers.
4. If your score is less than 17, you may have difficulty reading the Written Examination and should con-sider taking the Oral Examination.
1. You go to a doctor when you _____.(A) feel sleepy (D) need money(B) need socks (E) need clothes(C) feel sick
2. A person who flies an airplane is its _____.(A) pilot (D) surgeon(B) steward (E) director(C) mother
3. You use a _____ to write.(A) bow (D) carpenter(B) calculator (E) needle(C) pencil
4. To ExIT a room means to _____ it.(A) enter (D) read(B) leave (E) interrupt(C) forget
5. A wedding is a joyous _____.(A) focus (D) occasion(B) vehicle (E) civilization(C) balloon
6. To REqUIRE something means to _____ it.(A) need (D) understand(B) have (E) hear(C) forget go to next page
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7. You _____ something to find its length.(A) slice(B) lock(C) measure(D) force(E) tape
8. Soup is served in a _____.(A) plate(B) bowl(C) fork(D) chair(E) closet
9. To accompany someone means to _____.(A) disagree with him(B) work for him(C) go with him(D) speak to him(E) choose him
10. A nursing home resident receives _____ from the staff.(A) quality(B) fame(C) interruption(D) care(E) work
11. Medicine is used to _____ pain.(A) widen(B) conjure(C) enliven(D) increase(E) relieve
12. To DRENCh the flowers means to ____ them.(A) steam(B) drink(C) touch(D) soak(E) anger
13. A bicycle is a means of _____.(A) nourishment(B) transportation(C) prediction(D) collision(E) walking
14. When someone speaks in a whisper, it may be difficult to _____.(A) deceive(B) understand(C) frighten(D) estimate(E) regulate go to next page
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self-assessMeNt ReadiNg test
PARt 2: ComPREHENSIoNIn this part of the reading test you will be provided with a series of brief paragraphs. You are to read each paragraph and then answer the questions that appear after the paragraph.
There are many different kinds of fish. All fish live in water. They use their tails and fins to swim.
15. Fish live in _____.(A) cups(B) houses(C) air(D) water(E) fountains
16. Fish use their _____ to swim.(A) tails(B) heads(C) gills(D) lungs(E) floats
Maria grew up on a farm. She loved the work on the farm. She knew when all of the crops had to be planted. She would like a job on a farm or in a flower garden.
17. Maria has had experience as a _____.(A) guide(B) farmer(C) driver(D) nurse(E) teacher
18. She would like to work in _____.(A) an office(B) a library(C) a garden(D) a hospital(E) a supermarket
19. As a child Maria lived _____.(A) in the city(B) in an apartment(C) on a farm(D) in a large house(E) on the beach go to next page
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Carolyn has a good job. She is a nurse in a large hos-pital. Every day she can help many people. She enjoys this very much. She also makes a good salary. Each month she can pay her bills and save some money.
20. Carolyn works in a _____.(A) hospital(B) doctor’s office(C) garage(D) school(E) library
21. One of the things Carolyn enjoys is _____.(A) working in an office(B) helping people(C) reading books(D) working late hours(E) driving a car
22. With her salary she can pay her bills and _____.(A) buy furniture(B) give to charity(C) save money(D) buy new clothes(E) pay for college
This completes the Self-Assessment Reading Test.
Answers
1. C 7. C 13. B 19. C
2. A 8. B 14. B 20. A
3. C 9. C 15. D 21. B
4. B 10. D 16. A 22. C
5. D 11. E 17. B
6. A 12. D 18. C
If your score is less than 17, you may have difficulty reading the Written Examination and should consider taking the Oral Examination in place of the Written Examination.
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the skills evaluatiON
WHAt to ExPECt
Setting
The Skills Evaluation is set up to resemble an actual care-giving situation. The Skills Evaluation area will look similar to your work setting. It will have all the equipment neces-sary to perform the assigned skills. The Skills Evaluation will be administered by a Nurse Aide Evaluator. Before your skills evaluation begins, the evaluator will show you where equipment is located and answer questions about operating the equipment.Please arrive 30 minutes early. Test times are approxi-mate. Please plan to spend the day.
Who Will Act as a Client?
The part of the “client” will be played by a candidate who volunteers to act as a weakened elderly person. While you perform the skills, speak to the candidate volunteer as you would speak to an actual client in a nurse aide work setting. You are encouraged to speak to the candidate volunteer not only because it is part of quality care, but also because it will help you to relax as you perform the skills.
Candidate Volunteer Requirements
You will need to act as a candidate volunteer for another candidate’s Skills Evaluation and play the role of a nursing home patient (client). The evaluator will give you verbal instructions that will describe how you should act in per-forming the role of the client.
Candidate dress Requirements
You must wear flat, slip-on, non-skid shoes, a loose-fitting top with short sleeves that can be rolled up to the shoulder or tank top, and loose fitting pants that can be rolled up. You will be required to put a gown on over your clothing. In no case may candidates remove clothing down to undergar-ments.
Prior to beginning the exam, you should inform the evalu-ator of any food or latex allergy or sensitivity to skin soaps or lotion. Any limitations to range of motion must also be communicated to the evaluator prior to the start of the skills examination.
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For infection control purposes, you should not come to the test site with open areas/sores on the skin. Candidates with any open areas or sores on their skin should reschedule their skills test to a later date after their skin fully heals.
tHE tASkSThe NNAAP Skills List contains all of the skills that you may be asked to demonstrate during the Skills Evaluation. Each skill represents a task that you will be asked to per-form in your job and has been broken down into a series of steps.
See pages 25-40 for the complete skills listing.
A step that is highlighted in bold type is called a Critical Element Step. Critical Element Steps are important steps that must be performed correctly in order for you to pass the skill. If you leave out a Critical Element Step or do not perform a Critical Element Step properly, you will not pass the skill. However, if you perform only the Critical Element Step correctly in a skill, you do not automati-cally pass that skill. You must also correctly demonstrate enough steps to meet the passing standard (or cut score) for each skill.
Before your Skills Evaluation begins, the Nurse Aide Evaluator will give you an instruction card that will list the five (5) skills selected for you to perform. Hand-washing will always be one of the skills to be performed. The remaining four (4) skills are randomly chosen from the complete set of skills listings on pages 25 to 40 of this handbook. You are strongly encouraged to perform the skills in the order they are listed on the instruction card. If you make a mistake, say so, and you will be instructed to tell the evaluator which step(s) is to be corrected and then to perform the step(s). You will not have to redo the entire skill, just the steps you wish to correct. There are, however, some exceptions to this rule. If you fail to put on gloves or take them off when it is required to do so and the evaluator reminds you to do so, for infection control purposes, then you will not receive credit for attempting to correct this step. If you wish to correct an order-dependent step (a step stating that an action should be performed before or after another step) and you fail to say when the corrected step should be performed, you will not receive credit for the correction.
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Once you begin a new skill, you may not go back to correct a previous skill. The Nurse Aide Evaluator will not answer questions during the Skills Evaluation and will not tell you whether you performed a skill correctly. You may not receive help from anyone during the Skills Evaluation. If you do have any questions, please ask them before the Skills Evaluation begins.One (1) of the four (4) randomly-selected skills will include a measurement skill (see the section below, Recording A Measurement, for more information regarding measure-ment skills).
You will be asked to decontaminate your hands (with hand sanitizer) before proceeding from skills performed on a live client to skills that are not. This is for infection control purposes and will not effect the result of your evaluation.
When you have completed your skills evaluation, the evaluator will direct you to wash your hands. Although this will not affect your examination results, for the pur-poses of infection control, you must wash your hands.
You must successfully complete all five (5) skills to pass the Skills Evaluation. You will have thirty (30) minutes to demonstrate all five (5) skills.
RECoRdING A mEASuREmENtThe NNAAP Skills Evaluation requires every candidate to perform one measurement skill, such as blood pressure, radial pulse, respirations, urine output, or weight. You will be given a special form, called a Recording Sheet for Measurement Skills, to write down, or record, the measure-ment. For example, if performing the Measures and Records Blood Pressure skill, you will write the complete systolic and diastolic pressures of your blood pressure reading in a box labeled Candidate Results.
On the following page is a copy of the recording sheet that will be used during the skills exam. The candidate must record his/her results in the Candidate Results box on this sheet. This sheet will be used to record the results of the following measurement skills:
• Measures and Records Blood Pressure• Measures and Records Weight of
Ambulatory Client• Measures and Records Urinary Output• Counts and Records Radial Pulse• Counts and Records Respirations
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Date
Test Site ID
CANDIDATE NAME
CANDIDATE ID
EVALUATOR NAME
EVALUATOR ID
SKILL TESTEDEvaluator must check one box next to the skill being tested.
� Blood Pressure � Respirations
� Oral Temperature � Urine Output
� Radial Pulse � Weight
RECORDING SHEET FOR MEASUREMENT SKILLS
TM
CANDIDATE EVALUATORRESULTS RESULTS
Copyright © 2005 Promissor, Inc. All Rights Reserved. Stock# 0699-02 6/05
SAMPLE
Tips for the Skills Evaluation
• You will be expected to perform the skills as you would in a nursing home setting. When water is required, you must use running water. All candidates will be required to perform the Washes Hands skill. The evaluator will inform you after you have washed your hands for the first time that you should just tell him or her when you would wash your hands during your performance of the rest of the skills, rather than actually washing them for each skill. For all steps other than hand-washing, you must actually perform the skill in order to receive credit. You may not simply tell the evaluator what you would do for simulating a step. For example, you may not simply tell the evalua-tor that you would wash the client. You must actually demonstrate washing the client. You may not simply tell the evaluator that you would feed the client. You must actually demonstrate feeding the client.
• After you have introduced yourself to the client for the first time, it is not necessary for you to introduce yourself each time you begin a new skill.
• To receive full credit for a measurement skill, you must accurately make the required measurement and then write that measurement on the Recording Sheet for Measurement Skills. The evaluator will provide the Recording Sheet to you at the test site. A sample of the Recording Sheet is shown on page 22 of this hand-book. You are encouraged to become familiar with the Recording Sheet before your scheduled test date.
• You must know how to operate both a standing and a non-digital bathroom scale and must know how to set both types of scales to zero.
• You may not bring any of your own equipment to the test site (e.g. transfer/gait belt).
• It is important for you to place the call signal within the client’s reach whenever you leave the client.
• Where the word “client” appears, it refers to the person receiving care.
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skills listiNg
The 24 skills that follow are arranged in alphabetical order, except for the Washes Hands skill. Washes Hands is listed first as a reminder of the importance of perform-ing this skill before all other skills. The numbered lines below each skill are the steps needed to perform that skill. Critical Element Steps are in bold type.
Washes haNds 1 Address client by name and introduces self to client
by name 2 Turns on water at sink 3 Wets hands and wrists thoroughly 4 Applies soap to hands 5 Lathers all surfaces of wrists, hands, and fingers,
producing friction for at least 15 (fifteen) seconds 6 Cleans fingernails by rubbing fingertips against palms
of the opposite hand 7 After lathering for at least 15 seconds, rinses all
surfaces of wrists, hands, and fingers keeping hands lower than the elbows and the fingertips down
8 Uses clean, dry paper towel to dry all surfaces of hands, wrists, and fingers then disposes of paper towel into waste container
9 Uses clean, dry paper towel to turn off faucet then disposes of paper towel into waste container or uses knee/foot control to turn off faucet
10 Does not touch inside of sink at any time
applies ONe kNee-high elastiC stOCkiNg 1 Explains procedure, speaking clearly, slowly,
and directly, maintaining face-to-face contact whenever possible
2 Privacy is provided with a curtain, screen, or door 3 Client is in supine position (lying down in bed) while
stocking is applied 4 Turns stocking inside-out 5 Places foot of stocking over toes, foot, and heel 6 Pulls top of stocking over foot, heel, and leg 7 Moves foot and leg gently and naturally, avoiding
force and over-extension of limb and joints
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Skill continues
8 Finishes procedure with no twists or wrinkles and heel of stocking (if present) is over heel and opening in toe area (if present) is either over or under toe area (Evaluator: If stocking toe is completely open, or if client has large foot, it is okay if toes go through opening)
9 Signaling device is within reach and bed is in low position
10 Washes hands
assists tO aMbulate usiNg tRaNsfeR belt 1 Explains procedure, speaking clearly, slowly, and
directly, maintaining face-to-face contact whenever possible
2 before assisting to stand, candidate ensures client is wearing shoes
3 Before assisting to stand, bed is at a safe level 4 Before assisting to stand, checks and/or locks bed
wheels 5 Before assisting to stand, client is assisted to sitting
position with feet flat on the floor 6 Before assisting to stand, applies transfer belt securely
over clothing/gown 7 Before assisting to stand, provides instructions
to enable client to assist in standing including prearranged signal to alert client to begin standing
8 Stands facing client positioning self to ensure safety of candidate and client during transfer. Counts to three (or says other prearranged signal) to alert client to begin standing
9 On signal, gradually assists client to stand by grasping transfer belt on both sides with an upward grasp (candidate’s hands are in upward position), and maintaining stability of client’s legs
10 Walks slightly behind and to one side of client for a distance of ten (10) feet, while holding onto the belt
11 After ambulation, assists client to bed and removes transfer belt
12 Signaling device is within reach and bed is in low position
13 Washes hands
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assists With use Of bedpaN 1 Explains procedure speaking clearly, slowly, and directly,
maintaining face-to-face contact whenever possible 2 Privacy is provided with a curtain, screen, or door 3 Before placing bedpan, lowers head of bed 4 Puts on clean gloves before handling bedpan 5 Places bedpan correctly under client’s buttocks 6 Removes and disposes of gloves (without contaminating
self ) into waste container and washes hands 7 After positioning client on bedpan and removing
gloves, raises head of bed 8 Toilet tissue is within reach 9 Hand wipe is within reach and client is instructed to
clean hands with hand wipe when finished 10 Signaling device within reach and client is asked to
signal when finished 11 Puts on clean gloves before removing bedpan 12 Head of bed is flat before bedpan is removed 13 Avoids overexposure of client 14 Removes, empties, and rinses bedpan and pours rinse
into toilet 15 After rinsing bedpan, places bedpan in designated
dirty supply area 16 After placing bedpan in designated dirty supply area,
removes and disposes of gloves (without contaminating self ) into waste container and washes hands
17 Signaling device is within reach and bed is in low position
CleaNs uppeR OR lOWeR deNtuRe 1 Puts on clean gloves before handling dentures 2 Sink is lined and/or sink is partially filled with water
before denture is held over sink 3 Rinses denture in tepid/moderate temperature
running water before brushing them 4 Applies toothpaste to toothbrush 5 Brushes surfaces of denture 6 Rinses surfaces of denture under tepid/moderate
temperature running water 7 Before placing denture into cup, rinses denture cup
and lid 8 Places denture in denture cup with tepid/moderate
temperature water and places lid on cup 9 Rinses toothbrush and places in designated toothbrush
basin/container
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Skill continues
10 Maintains clean technique with placement of toothbrush and denture
11 Sink liner is removed and disposed of appropriately and/or sink is drained
12 After rinsing equipment and disposing of sink liner, removes and disposes of gloves (without contaminating self ) into waste container and washes hands
COuNts aNd ReCORds Radial pulse* 1 Explains procedure, speaking clearly, slowly, and
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 Washes hands 6 After obtaining pulse by palpating in radial artery
position, records pulse rate within plus or minus 4 beats of evaluator’s reading
* Count for one full minute.
COuNts aNd ReCORds RespiRatiONs* 1 Explains procedure (for testing purposes), speaking
clearly, slowly, and directly, maintaining face-to-face contact whenever possible
2 Counts respirations for one full minute 3 Signaling device is within reach 4 Washes hands 5 Records respiration rate within plus or minus 2
breaths of evaluator’s reading * Count for one full minute. For testing purposes you
may explain to the client that you will be counting the respirations.
dONNiNg aNd ReMOviNg ppe (gOWN aNd glOves) 1 Picks up gown and unfolds 2 Facing the back opening of the gown places arms
through each sleeve 3 Fastens the neck opening 4 Secures gown at waist making sure that back of
clothing is covered by gown (as much as possible) 5 Puts on gloves 6 Cuffs of gloves overlap cuffs of gown
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Skill continues
7 With one gloved hand, grasps the other glove at the palm, pulls glove off
8 Slips fingers from ungloved hand underneath cuff of remaining glove at wrist, and removes glove turning it inside out as it is removed
9 Disposes of gloves into designated waste container without contaminating self
10 After removing gloves, unfastens gown at neck and waist
11 Removes gown without touching outside of gown 12 While removing gown, holds gown away from body,
turns gown inward and keeps it inside out 13 Disposes of gown in designated container without
contaminating self 14 Washes hands
dResses ClieNt With affeCted (Weak) Right aRM 1 Explains procedure, speaking clearly, slowly, and
directly, maintaining face-to-face contact whenever possible
2 Privacy is provided with a curtain, screen, or door 3 Asks which top he/she would like to wear and dresses
him/her in top of choice 4 While avoiding overexposure of client, removes gown
from the unaffected side first, then removes gown from the affected side
5 Assists to put the right (affected/weak) arm through the right sleeve of the top before placing garment on left (unaffected) arm
6 While putting on items, moves body gently and naturally, avoiding force and over-extension of limbs and joints
7 Finishes with clothing in place 8 Disposes of gown into soiled linen container 9 Signaling device is within reach and bed is in low
position 10 Washes hands
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feeds ClieNt WhO CaNNOt feed self 1 Explains procedure to client, speaking clearly,
slowly, and directly, maintaining face-to-face contact whenever possible
2 Before feeding, candidate picks up name card from tray and asks client to state name
3 before feeding client, client is in an upright sitting position (45-90 degrees)
4 Places tray where it can be easily seen by client 5 Client’s hands are cleaned with hand wipe before
beginning feeding 6 Candidate sits facing client during feeding 7 Tells client what foods are on tray and asks what client
would like to eat first 8 Using spoon, offers client one bite of each type of food
on tray, telling client the content of each spoonful 9 Offers beverage at least once during meal 10 Makes sure client’s mouth is empty before offering
next bite of food or sip of beverage 11 At end of meal, client’s mouth is wiped and hands are
cleaned with hand wipe 12 Removes food tray and places tray in designated dirty
supply area 13 Signaling device is within client’s reach 14 Washes hands
gives MOdified bed bath (faCe aNd ONe aRM, haNd aNd uNdeRaRM) 1 Explains procedure, speaking clearly, slowly, and
directly, maintaining face-to-face contact whenever possible
2 Privacy is provided with a curtain, screen, or door 3 Removes gown while keeping client covered 4 Before washing, checks water temperature for safety
and comfort and asks client to verify comfort of water 5 Puts on clean gloves before washing client 6 Beginning with eyes, washes eyes with wet washcloth
(no soap), using a different area of the washcloth for each eye, washing inner aspect to outer aspect then proceeds to wash face
7 Dries face with towel 8 Exposes one arm and places towel underneath arm 9 Applies soap to wet washcloth
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Skill continues
10 Washes arm, hand, and underarm, keeping rest of body covered
11 Rinses and dries arm, hand, and underarm 12 Moves body gently and naturally, avoiding force and
over-extension of limbs and joints 13 Puts clean gown on client 14 Empties, rinses, and dries basin 15 After rinsing basin, places basin in designated dirty
supply area 16 Disposes of used gown and linen into soiled linen
container 17 Avoids contact between candidate clothing and used
linens 18 After placing basin in designated dirty supply area,
and disposing of used linen, removes and disposes of gloves (without contaminating self ) into waste container and washes hands
19 Signaling device is within reach and bed is in low position
Makes aN OCCupied bed (ClieNt dOes NOt Need assistaNCe tO tuRN) 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 Lowers head of bed before moving client 4 Client is covered while linens are changed 5 Loosens top linen from the end of the bed 6 Raises side rail on side to which client will move and
client moves toward raised side rail 7 Loosens bottom used linen on working side and
moves bottom used linen toward center of bed 8 Places and tucks in clean bottom linen or fitted
bottom sheet on working side and tucks under client 9 Before going to other side, client moves back onto
clean bottom linen 10 Raises side rail then goes to other side of bed 11 Removes used bottom linen 12 Pulls and tucks in clean bottom linen, finishing with
bottom sheet free of wrinkles 13 Client is covered with clean top sheet and bath
blanket/used top sheet has been removed 14 Changes pillowcase
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Skill continues
15 Linen is centered and tucked at foot of bed 16 Avoids contact between candidate’s clothing and used
linen 17 Disposes of used linen into soiled linen container and
avoids putting linen on floor 18 Signaling device is within reach and bed is in low
position 19 Washes hands
MeasuRes aNd ReCORds 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 does one of the following: a. Inflates cuff between 160 mm Hg to 180 mm Hg. (If beat heard immediately upon cuff deflation, completely deflate cuff.) Re-inflate cuff to no more than 200 mm Hg. OR b. Inflates cuff 30 mm Hg beyond where radial or brachial pulse was last heard or felt
8 Deflates cuff slowly and notes the first sound (systolic reading), and last sound (diastolic reading) (If rounding needed, measurements are rounded UP to the nearest 2 mm of mercury)
9 Removes cuff 10 Signaling device is within reach 11 Washes hands 12 After obtaining reading using bP cuff and
stethoscope, records both systolic and diastolic pressures each within plus or minus 8 mm of evaluator’s reading
* This is a one-step blood pressure procedure. However, if a candidate correctly performs a two-step blood pressure procedure that includes step 7b, the candidate will not be penalized and will be given credit for step 7.
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MeasuRes aNd ReCORds uRiNaRy Output 1 Puts on clean gloves before handling bedpan 2 Pours the contents of the bedpan into measuring
container without spilling or splashing urine outside of container
3 Measures the amount of urine at eye level with container on flat surface
4 After measuring urine, empties contents of measuring container into the toilet
5 Rinses measuring container and pours rinse into toilet 6 Rinses bedpan and pours rinse into toilet 7 After rinsing equipment, and before recording
output, removes and disposes of gloves (without contaminating self ) into waste container and washes hands
8 Records contents of container within plus or minus 25 ml/cc of evaluator’s reading
MeasuRes aNd ReCORds Weight Of aMbulatORy ClieNt 1 Explains procedure, speaking clearly, slowly, and
directly, maintaining face-to-face contact whenever possible
2 Candidate ensures client has shoes on before walking to scale
3 Sets scale to zero before weighing client 4 While client steps onto scale, candidate stands next to
scale and assists client, if needed, onto center of scale, then determines client’s weight
5 While client steps off scale, candidate stands next to scale and assists client, if needed, off scale before recording weight
6 Records weight based on indicator on scale. Weight is within plus or minus 2 lbs of evaluator’s reading (If weight recorded in kg weight is within plus or minus 0.9 kg of evaluator’s reading)
7 Washes hands
peRfORMs passive RaNge Of MOtiON (pROM) fOR ONe kNee aNd ONe aNkle 1 Explains procedure, speaking clearly, slowly, and
directly, maintaining face-to-face contact whenever possible
2 Privacy is provided with a curtain, screen, or door 3 Instructs client to inform nurse aide if pain is
experienced during exercise
33Skill continues
4 Supports leg at knee and ankle while performing range of motion for knee
5 Bends the knee and then returns leg to client’s normal position (extension/flexion) (AT LEAST 3 TIMES unless pain is verbalized)
6 Supports foot and ankle close to the bed while performing range of motion for ankle
7 Pushes/pulls foot toward head (dorsiflexion), and pushes/pulls foot down, toes point down (plantar flexion) (AT LEAST 3 TIMES unless pain is verbalized)
8 While supporting the limb, moves joints gently, slowly, and smoothly through the range of motion, discontinuing exercise if client verbalizes pain
9 Signaling device is within reach and bed is in low position
10 Washes hands
peRfORMs 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 nurse aide if pain is
experienced during exercise 4 Supports client’s arm at elbow and wrist while
performing range of motion for shoulder 5 Raises client’s straightened arm from side position
upward toward head to ear level and returns arm down to side of body (extension/flexion) (AT LEAST 3 TIMES unless pain is verbalized)
6 Moves client’s straightened arm away from the side of body to shoulder level and returns to side of body (abduction/adduction) (AT LEAST 3 TIMES unless pain is verbalized)
7 While supporting the limb, moves joint gently, slowly, and smoothly through the range of motion, discontinuing exercise if client verbalizes pain
8 Signaling device is within reach and bed is in low position
9 Washes hands
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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 Slowly rolls onto side as one unit toward raised side
rail 6 Places or adjusts pillow under head for support 7 Client is positioned so that client is not lying on arm 8 Supports top arm with supportive device 9 Places supportive device behind client’s back 10 Places supportive device between legs with top knee
flexed; knee and ankle supported 11 Signaling device is within reach and bed is in low
position 12 Washes hands
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 before
washing 6 Exposes area surrounding catheter while avoiding
overexposure of client 7 Applies soap to wet washcloth 8 While holding catheter near meatus without
tugging, cleans at least four inches of catheter nearest meatus, moving in only one direction, away from meatus, using a clean area of the cloth for each stroke
9 While holding catheter near meatus without tugging, rinses at least four inches of catheter nearest meatus, moving only in one direction, away from meatus, using a clean area of the cloth for each stroke
10 While holding catheter near meatus without tugging, dries four inches of catheter moving away from meatus
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Skill continues
11 Empties, rinses, and dries basin 12 After rinsing basin, places basin in designated dirty
supply area 13 Disposes of used linen into soiled linen container and
disposes of linen protector appropriately 14 Avoids contact between candidate clothing and used
linen 15 After disposing of used linen and cleaning
equipment, removes and disposes of gloves (without contaminating self ) into waste container and washes hands
16 Signaling device is within reach and bed is in low position
pROvides fiNgeRNail CaRe ON ONe haNd 1 Explains procedure, speaking clearly, slowly, and
directly, maintaining face-to-face contact whenever possible
2 Before immersing fingernails, checks water temperature for safety and comfort and asks client to verify comfort of water
3 Basin is in a comfortable position for client 4 Puts on clean gloves before cleaning fingernails 5 Fingernails are immersed in basin of water 6 Cleans under each fingernail with orangewood stick 7 Wipes orangewood stick on towel after each nail 8 Dries fingernail area 9 Candidate feels each nail and files as needed 10 Disposes of orangewood stick and emery board into
waste container (for testing purposes) 11 Empties, rinses, and dries basin 12 After rinsing basin, places basin in designated dirty
supply area 13 Disposes of used linen into soiled linen container 14 After cleaning nails and equipment, and disposing of
used linen, removes and disposes of gloves (without contaminating self ) into waste container and washes hands
15 Signaling device is within reach
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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 11 Applies lotion to top and bottom of foot, removing
excess (if any) with a towel 12 Supports foot and ankle during procedure 13 Empties, rinses, and dries basin 14 After rinsing basin, places basin in designated dirty
supply area 15 Disposes of used linen into soiled linen container 16 After cleaning foot and equipment, and disposing of
used linen, removes and disposes of gloves (without contaminating self ) into waste container and washes hands
17 Signaling device is within reach
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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 (45-90 degrees) 4 Puts on clean gloves before cleaning mouth 5 Places clothing protector across chest before providing
mouth care 6 Moistens toothbrush 7 Applies toothpaste to toothbrush 8 Cleans mouth (including tongue and surfaces of
teeth) using gentle motions 9 Maintains clean technique with placement of
toothbrush 10 Holds emesis basin to chin while client rinses mouth 11 Wipes mouth and removes clothing protector 12 Empties, rinses, and dries basin 13 Places used toothbrush in basin 14 After rinsing basin, places basin in designated dirty
supply area 15 Disposes of clothing protector appropriately 16 After placing basin in designated dirty supply area,
and disposing of used linen, removes and disposes of gloves (without contaminating self ) into waste container and washes hands
17 Signaling device is within reach and bed is in low position
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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 before
washing 6 Exposes perineal area while avoiding overexposure of
client 7 Applies soap to wet washcloth 8 Washes genital area, moving from front to back,
while using a clean area of the washcloth for each stroke
9 Using clean washcloth, rinses soap from genital area, moving from front to back, while using a clean area of the washcloth for each stroke
10 Dries genital area moving from front to back with towel
11 After washing genital area, turns to side, then washes and rinses rectal area moving from front to back using a clean area of washcloth for each stroke. Dries with towel
12 Repositions client 13 Empties, rinses, and dries basin 14 After rinsing basin, places basin in designated dirty
supply area 15 Disposes of used linen into soiled linen container and
disposes of linen protector appropriately 16 Avoids contact between candidate clothing and used
linen 17 After disposing of used linen, and placing used
equipment in designated dirty supply area, removes and disposes of gloves (without contaminating self ) into waste container and washes hands
18 Signaling device is within reach and bed is in low position
39
40
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
along side of bed, at head of bed, and facing the foot of the bed
4 Before assisting to stand, footrests are folded up or removed
5 Before assisting to stand, bed is at a safe level 6 before assisting to stand, locks wheels on
wheelchair 7 Before assisting to stand, checks and/or locks bed
wheels 8 Before assisting to stand, client is assisted to a sitting
position with feet flat on the floor 9 Before assisting to stand, candidate ensures client is
wearing shoes 10 Before assisting to stand, applies transfer belt securely
over clothing/gown 11 Before assisting to stand, provides instructions to
enable client to assist in transfer including prearranged signal to alert when to begin standing
12 Stands facing client positioning self to ensure safety of candidate and client during transfer. Counts to three (or says other prearranged signal) to alert client to begin standing
13 On signal, gradually assists client to stand by grasping transfer belt on both sides with an upward grasp (candidates hands are in upward position) and maintaining stability of client’s legs
14 Assists client to turn to stand in front of wheelchair with back of client’s legs against wheelchair
15 Lowers client into wheelchair 16 Positions client with hips touching back of wheelchair
and transfer belt is removed 17 Positions feet on footrests 18 Signaling device is within reach 19 Washes hands
41
sCORe RepORtiNg
ExAm RESultSThe Nurse Aide Evaluator may not answer questions about your Score Report. If you have questions about your Score Report, or the content of the examination, call Pearson VUE at (888) 204-6207. Results will not be given over the telephone.
Written (or english or spanish Oral) Exam
After you finish the Written (or English or Spanish Oral) Examination, the Nurse Aide Evaluator will fax your answer sheet for scoring. Within approximately ten (10) minutes (from the time the answer sheet was faxed), you will receive an official Score Report. The Score Report will indicate whether you have passed or failed the Written (or English or Spanish Oral) Examination.
Skills Evaluation
The Nurse Aide Evaluator will also fax your Skills Evaluation results for scoring. After the Nurse Aide Evaluator evaluates your performance, he or she will fax the Skills Evaluation answer sheet for scoring. Within approximately ten (10) minutes (from the time the answer sheet was faxed), you will receive an official Score Report. The Score Report will indi-cate whether you have passed or failed the Skills Evaluation.
Occasionally, due to technical difficulties, Score Reports may not be received at the test center on the day of testing. If this happens your answer sheet will be mailed overnight to Pearson VUE for handscoring. Your Score Report will then be mailed out to you within 5-7 business days after testing. For questions regarding delayed Score Reports, please contact Pearson VUE at (888) 204-6207.
42
FAIlINGIf you fail the Written (or English or Spanish Oral) Examination or the Skills Evaluation, your Score Report will provide you with information on how to re-take either or both parts of the evaluation. A new examination fee is required each time you re-take any part of the NNAAP Examination. To re-take either or both parts, you must sub-mit your official Score Report and a re-take fee to NACES.
State and federal regulations allow you three (3) attempts to pass both the Skills Evaluation and the Written Examination. If you should fail either part or both parts three (3) times, within two (2) years, you will be required to successfully complete a state-approved training program and re-take both parts. See page 3 "ELIGIBILITY" for route specific rules and regulations. You must take and pass both the Written (or Oral) Examination and the Skills Evaluation to be placed on the North Carolina Nurse Aide I Registry.
If you return to school and have not completed testing or passed both portions of the examination, you must test (retest) BOTH portions of the examination.
HoW to REAd A FAIlING SCoRE REPoRtIf you do not pass the Skills Evaluation, you will receive a Failing Score Report. The score report will list the five (5) skills that you performed and a score of Satisfactory or Unsatisfactory for each skill. Any skill with an Unsatisfactory result is considered a failed skill. You must receive a Satisfactory result on all five (5) skills to pass the Skills Evaluation.
Use your failing Score Report as an aid in studying to re-take the Skills Evaluation. A failed skill will show the reason for the failure. You may not have performed the steps of a skill correctly, or you may have forgotten a step, especially a Critical Element Step.
The failing Score Report will list steps that were missed or incorrect—look for numbers printed directly under a skill marked Unsatisfactory. A list of all the skills and the steps needed for each skill can be found in this handbook. Find the skill you failed, and study the steps, especially steps listed as Unsatisfactory on the score report.
In the example on the next page, a candidate received a result of Unsatisfactory on the skill Washes Hands. The numbers 1, 5, and 10 printed below the skill refer to steps that were
43
missed or performed incorrectly. To study for re-taking the Skills Evaluation, this candidate should turn to the Skills Listing in this handbook, look for the Washes Hands skill, and review all the steps, especially steps 1, 5, and 10.
North Carolina NNAAP® Examination Results
Exam: Skills Result: Fail
Skills Performance:
Washes Hands 1, 5, 10
Unsatisfactory
Provides Fingernail Care On One Hand
Satisfactory
Measures and Records Blood Pressure
Satisfactory
Puts One Knee-High Elastic Stocking on Client
Satisfactory
Measures and Records Weight of Ambulatory Client
Satisfactory
A sample of a Failing Score Report
PASSINGOnce you have passed bOTh the Written (or English or Spanish Oral) Examination and the Skills Evaluation, your name will be submitted to the North Carolina Nurse Aide I Registry. You may view your name on the Registry by going to www.ncnar.org. If you have any questions regarding your listing on the Registry you may contact the North Carolina Division of Health Service Regulation, Monday through Friday from 9:00 a.m. to 3:00 p.m. (EST) at (919) 855-3969 or (919) 715-0562.
duPlICAtE SCoRE REPoRtIf you lose your Score Report or need a duplicate Score Report, or would like a handscoring of your Written (or Oral) Examination or Skills Evaluation, complete the Request for Duplicate Score Report or Handscored Answer Sheet Form and mail it to Pearson VUE (see Appendix A).
44
NuRse aide testiNg gRievaNCe pROCess
oVERVIEWEach candidate has a right to file a grievance to complain or contest the results of their Nurse Aide Exam. The NACES Plus Foundation, Inc. (NACES) will follow-up on each grievance within thirty (30) days of receipt of the candidate grievance letter.
No grievance will be investigated if it is not received in writing by the NACES Plus Foundation, Inc.
PRoCESSAll grievances must be in writing. The candidate must provide as much detail as possible in a grievance letter and forward it to the NACES Plus Foundation, Inc. within 30 days of their exam date.
After receipt of the grievance letter, the appropriate RN Associate Program Director will investigate the complaint.
Once the investigation is complete, the RN Associate Program Director will draft a letter back to the candidate informing him/her of the outcome of the investigation. If an error was made by the evaluator, NACES, or Pearson VUE, the candidate will be allowed to retest at no additional cost.
45
the RegistRy
INItIAl lIStINGYou must pass both the written and skills portions of the NNAAP competency evaluation to be listed on the Nurse Aide I Registry. Once on the registry, your listing will remain current for 24 months from the month you passed both parts of the NNAAP exam. A letter advising you of your initial listing will be mailed to the address you provided on your exam application. You will not receive any other form or notice. Address corrections can be made at the exam site. Please check the letter for accuracy of your listing information and notify the registry if there are any errors.
CHANGE oF AddRESS oR NAmEThe North Carolina Nurse Aide I Registry must be kept informed of your current address and name.
There is no charge for changing your name or address on the registry. You may notify the registry of a name or address change by using the Name/Address Change Reporting Form on the Nurse Aide I Registry website (www.ncnar.org). Alternately, you may call the Nurse Aide I Registry at (919) 715-0562 or (919) 855-3969 to change your mailing address on the registry.
If your name changes at any time after you are placed on the registry, you must send written notification of this change to the registry. Please remember, however, that if you changed your name, you MUST provide official documentation along with your notification. Written docu-mentation must include 1) a COPY of your signed social security card with the new name on it, AND 2) a COPY of a court-issued marriage certificate, divorce decree, or other legal document that demonstrates the name change. Your notification must include your previous name, current name, mailing address, phone number, and Social Security number. All documents provided to the registry in sup-port of your name change MUST be official and legal documents. Any documents provided may be subject to verification with the issuing source.
Failure to inform the registry of an address or name change may jeopardize your listing status.
lIStING RENEWAlNurse aides on the North Carolina Nurse Aide I Registry must renew their registry listing to remain eligible for employment as a nurse aide. To be eligible for renewal based on employment, you must work for pay, performing nursing-related services (as a nurse aide or medication aide), under RN supervision, for at least eight (8) hours every twenty-four (24) months. This employment must be documented and reported to the Nurse Aide I Registry prior to each listing expiration date. A new competency examination is required if you do not work in a qualifying position for a 24-month period or more.
• Failure to inform the registry of an address or name change may jeopardize your listing status.
• It is your responsibility to renew. Current renewal procedures can be found at https://www.ncnar.org.
• There is no fee for re-listing on the North Carolina Nurse Aide I Registry.
For more information regarding Nurse Aide I list-ings and policies go to https://www.ncnar.org. Additional information is available to nurse aides and nurse aide candidates at the Frequently Asked Questions (FAQ) link.
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North Carolina
NURSE AIDEwritten (or oral) examination & skills evaluation
CANDIDATE HANDBOOKJuly 2012
PEARSON VUE
Quick RefeRence
NACES Plus FouNdAtioN, iNC.North Carolina NNAAP®
7600 Burnet Road, Suite 440 Austin, TX 78757-1292
(888) 282-6904 Fax: 1 (866) 95 NACES
Hours of Operation 8:30 a.m. – 6:30 p.m. (Eastern Time Zone)
Call NACES Plus Foundation, Inc. to:• ObtainaCandidateHandbook• ObtainanApplicationfortesting• Obtainregistrationinformation• Canceland/orrescheduleanexamination• Arrangespecialexaminationrequests
andservices• Changeyourcurrentaddressorname
beforetesting• Requestanexcusedabsence
PEARSoN VuE® North Carolina NNAAP®
POBox13785 Philadelphia,PA19101-3785
(888) 204-6207Hours of Operation 8:00 a.m. – 5:00 p.m.
(Eastern Time Zone)
Call Pearson VUE to:• AskquestionsaboutOn-LineRegistration• ObtaininformationregardingyourScoreReport• RequestaduplicateScoreReport• Obtaininformationregardingyourexamination
Go to Pearson VUE’s website (www.pearsonvue.com) to:
• RegisterOn-Line• DownloadaCandidateHandbook• DownloadanApplication• ViewRegionalTestSitetestingdates• DownloadaNurseAidePracticeWritten
Examination• ViewtheNurseAideProgramOverview• ViewFrequentlyAskedQuestions• ViewalistoftheNurseAideRegistries(byState)• ViewSkillsListing
Refer any additional questions to:
NoRth CARoliNA dEPARtmENt oF hEAlth ANd humAN SERViCES Center for Aide Regulation
and Education*2709MailServiceCenter Raleigh,NC27699-2709
(919) 715-0562 (919)855-3969
Hours of Operation 8:00 a.m. – 12:00 p.m. and 1:00 p.m. – 3:00 p.m.
(Eastern Time Zone, weekdays) The phone lines will be closed between 12 noon and 1 p.m.
*Please do not send application or fee for testing to this address
PearsonVUEandNACESdonotdiscriminateonthebasisofage,sex,race,creed, disablingcondition,religion,nationalorigin,oranyotherprotectedcharacteristics.
Copyright©2012PearsonEducation,Inc.,oritsaffiliates.AllRightsReserved.
NNAAP®WrittenExamContentOutlineandPracticalSkillsListing Copyright©2011NationalCouncilofStateBoardsofNursing,Inc.(NCSBN®).Allrightsreserved.
Table of conTenTs
Quick Reference .......................... inside front cover
introduction ....................................................... 1NationalNurseAideAssessmentProgram............... 1ExamOverview........................................................ 2
Eligibility .................................................................. 2Nurse Aide Trained Candidates................................ 3CommunityCollegeRefresher
Course Candidates................................................ 3OtherNCNurseAideTrainedCandidates.............. 3Challengers............................................................... 3Student Nurse Candidates........................................ 4NorthCarolinaNurseAideIRegistryCandidates.... 4
Application and Scheduling ............................. 4FillingOutanApplication....................................... 4ProperI.D................................................................. 4ExamFees................................................................. 6ExamScheduling...................................................... 6AuthorizationtoTestNotice.................................... 7TestingLocations...................................................... 7SpecialExamRequestsandServices......................... 7TelecommunicationDevices
fortheDeaf(TDD).............................................. 7
Cancellation and re-scheduling .................... 8Refunds.................................................................... 8AbsencePolicy.......................................................... 9WeatherEmergencies................................................ 9
Exam day ................................................................ 10CheckingIn............................................................. 10WhattoBring......................................................... 10ProperIdentification................................................ 10Security................................................................... 11TestingPolicies....................................................... 12 Lateness............................................................... 12 ElectronicDevices............................................... 12 StudyAids........................................................... 12 Eating/Drinking/Smoking................................... 12 Misconduct.......................................................... 12 Guests/Visitors..................................................... 12
continued on next page
the Written (or oral) Exam ............................ 13WrittenExam..........................................................13EnglishorSpanishOralExam................................13
Written (or oral) Exam Content outline .... 14
Sample Questions ................................................ 15
self-assessment reading test ...................... 16-19
the Skills Evaluation .................................................20WhattoExpect...................................................... 20 Setting................................................................ 20 WhoWillActAsaClient?................................. 20 CandidateVolunteerRequirements.................... 20 CandidateDressRequirements........................... 20TheTasks................................................................ 21RecordingaMeasurement...................................... 22SampleRecordingSheetforMeasurementSkills.... 23 TipsfortheSkillsEvaluation.............................. 24
Skills listing ................................................... 25-40
Score Reporting .................................................. 41ExamResults........................................................... 41 Written(orOral)Exam....................................... 41 SkillsEvaluation.................................................. 41Failing..................................................................... 42ReadingaFailingScoreReport.............................. 42SampleofaFailingScoreReport............................ 43Passing.................................................................... 43DuplicateScoreReport........................................... 43
Grievance Process ............................................... 44Overview................................................................ 44Process.................................................................... 44
the Registry ........................................................... 45InitialListing........................................................... 45ChangeofAddressorName.................................... 45ListingRenewal...................................................... 46
AppendixAppendix A:RequestforDuplicateScoreReport
orHandscoredAnswerSheetForm
inTRoducTion
Thishandbook isdesigned forcandidates seekingNurseAide I certification in North Carolina. It describes theprocessofapplyingforandtakingtheNationalNurseAideAssessmentProgram(NNAAP®)Examination.
TheNorthCarolinaDepartmentofHealthandHumanServices (DHHS) has contracted with Pearson VUE,a nationally recognized leading provider of assessmentservices to regulatory agencies andnational associations.PearsonVUEwilladminister,score,andreporttheresultsof the NNAAP® Examination for the North CarolinaNurse Aide I Registry. The Nurse Aide CompetencyEvaluationService(NACES)willbeworkingwithPearsonVUEtoscheduleandadministertheexamination.
NAtioNAl NuRSE AidE ASSESSmENt PRoGRAm (NNAAP®)TheNursingHomeReformAct,adoptedbyCongressaspartoftheOmnibusBudgetReconciliationActof1987(OBRA’87),wasdesignedtoimprovethequalityofcarein long-termhealth care facilities and todefine trainingandevaluationstandardsfornurseaideswhoworkinsuchfacilities.Eachstateisresponsibleforfollowingthetermsofthisfederallaw.
TheNationalNurseAideAssessmentProgram(NNAAP®)isanexaminationprogramdesignedtodetermineminimalcompetencytobecomeacertifiednurseaideinyourstate.TheNNAAPwasdevelopedby the NationalCouncilofStateBoardsofNursing,Inc.,(NCSBN)tomeetthenurseaide evaluation requirementof federal and state laws andregulations.PearsonVUE is the authorized administratoroftheNNAAPinyourstate.
The NNAAP Examination is an evaluation of nurseaide-relatedknowledge,skills,andabilities.TheNNAAPExamination is made up of both a Written (or Oral)ExaminationandaSkillsEvaluation.ThepurposeoftheNNAAPExaminationistotestthatyouunderstandandcansafelyperformthejobofanentry-levelnurseaide.
1
ExAm oVERViEWYouwill be allowed to choose between aWritten orOralExamination.TheWrittenExaminationisavailableonlyinEnglish;theOralExaminationisavailableinEnglishorinSpanish.The twopartsof theNNAAPExaminationpro-cess,theWritten(orEnglishorSpanishOral)ExaminationandtheSkillsEvaluation,willbeadministeredonthesameday.YoumustpassbothpartstobecertifiedandlistedontheNorthCarolinaNurseAideIRegistry.TheWrittenExaminationconsistsofseventy(70)multiple-choice questions written in English. Sample examinationquestionsareprovidedinthishandbook.An Oral Examination available in English or in SpanishmaybetakeninplaceoftheWrittenExamination.TheOralExaminationconsistsofsixty(60)multiple-choicequestionsand ten (10) multiple-choice reading comprehension ques-tionsprovidedonacassettetape.YouwillbeaskedtolistentoacassettetapeoftheOralExaminationandfollowalongin the test booklet as the questions are read aloud on thetape.If you want to take the Oral Examination, you must request it when you submit your application. AttheSkillsEvaluationyouwillbeaskedtoperformfive(5)randomlyselectednurseaideskills.Youwillbegiventhirty(30)minutestocompletethefive(5)skills.Youwillbe rated on these skills by aNurseAideEvaluator. Youmustsuccessfullydemonstrateallfive(5)skillstopasstheSkillsEvaluation.Acompletelistingoftheskillsisshownonpages25to40.See The Written (or Oral) Exam and The Skills Evaluation formoredetailsabouttheNNAAPExamination.
eligibiliTy
AllcandidatesapplyingtotaketheNNAAPExaminationin North Carolina MUST complete an Application for Registration by Competency Examinationformusingoneoftheeligibilityrouteslistedonthefollowingtwo(2)pages.
north carolina state-approved nurse aide I trained candidatesAll applicants who have successfully completed a NorthCarolina state-approved Nurse Aide I training program.Candidatesmustpassbothportionswithintwo(2)yearsfromthecompletiondateofatrainingprogramorwithinthree (3) attempts,whichever comes first, in order to beplacedontheNorthCarolinaNurseAideIRegistry.
2
north carolina community college refresher course trained candidatesAll applicants who have completed a Nurse Aide Irefreshercourseat aNorthCarolinaCommunityCollege.Candidatemust pass both portionswithin two (2) yearsfromthecompletiondateof a refresher courseorwithinthree (3) attempts,whichever comes first, in order to beplacedontheNorthCarolinaNurseAideIRegistry.
other north carolina Nurse Aide Trained CandidatesAll applicants who have attended training in NorthCarolinaforpreparationforthisexamatanyprogramotherthanaNorthCarolinastate-approvedtrainingprogramorCommunity College Refresher Course. Candidates mustpassbothportionsoftheexamwithintwo(2)yearsfromtakingthefirsttestorwithinthree(3)attempts,whichevercomesfirst, inorder tobeplacedon theNorthCarolinaNurseAideIRegistry.Failuretodosowillrequiretrain-ing at aNorthCarolina state-approved training programorCommunityCollegeRefresherCourseandretestingofbothportionsoftheexamination.Ifyoureturntoschoolandhavenotcompletedtestingorpassedbothportionsof theexamination,youmust test(retest)BOTHportionsoftheexamination.
challengersAllapplicantswhohavecompletednurseaidetrainingout-sideNorthCarolina,orare listedonanother state’sNurseAide Registry (other thanNorthCarolina), or EMT’s, orother health professionals, or those with NO nurse aidetraining.Candidates mustpassbothportionsof the examwithin two (2) years of taking the first test or three (3)attempts,whichevercomesfirst,inordertobeplacedontheNorthCarolinaNurseAideIRegistry.FailuretodosowillrequiretrainingataNorthCarolinastate-approvedtrain-ing program or Community College Refresher Courseandretestingofbothportionsoftheexamination.Ifyoureturntoschoolandhavenotcompletedtestingorpassedbothportionsof theexamination,youmust test(retest)BOTHportionsoftheexamination.
3
Eligibility routes continue on next page
north carolina state-approved student nurse training candidatesAllapplicantswhoarecurrentlyenrolledinaNorthCarolinaapprovednursingeducationprogrampreparingforregisteredor practical nurse licensure. Candidates must pass bothportionswithintwo(2)yearsfromcompletionofthestate-approvedportionofthetrainingprogramorwithinthree(3)attempts,whichevercomesfirstinordertobeplacedontheNorthCarolinaNurseAideIRegistry.
North Carolina Nurse Aide I Registry CandidatesAll applicants who are listed on the NC Nurse Aide IRegistryandarenoteligibletotestunderanyothereligibil-ityroutes or are unable to renew under required qualify-ing work experience. (Current registry listing isActiveorInactive.)Mustpassbothportionsoftheexamwithintwo(2)yearsoftakingthefirsttestorthree(3)attempts,which-ever comes first, in order to become/remain active on theNorthCarolinaNurseAideIRegistry.
applicaTion and scheduling
FilliNG out AN APPliCAtioN
Proper IdentificationCandidatesarerequiredtobringtwo(2)formsofcurrent, not expired, official signature-bearing identification (oneofwhichmustbephoto-bearing)tothetestsite.OneformofidentificationmustbeaU.S.government-issuedSocialSecuritycard,signedandnon-laminated.Name and SSN must match what is on the application (for both on-line and paper registration).
4
ON-LINE REGISTRATION(pRefeRRed MeThod) On-line registration is quick, convenient and an environ-mentally responsibleway to register for your examination.Thisprocesswilleliminatethetransittimeassociatedwithmailingapaperapplication.Onceyourapplicationiscom-pleted,yourinformationwillbetransmittedtoNACESandtheschedulingprocesscanbeginalmostimmediately.• Paymentisintheformofacreditcardorpre-paidcredit
card(AmericanExpress,MasterCardorVisa).Feesarenon-refundableandnon-transferableoncesubmitted.
• You can access the On-Line application through thePULSEPortallinkwww.pulseportal.com
• YoumustcompleteallrequiredfieldsonyourapplicationbeforeitwillbesubmittedtoNACESforyourexamina-tionscheduling.Pleasecheckwww.pearsonvue.comforthelinkforrequiredinformation.
Should younot have access to the internet, credit card orpre-paidcreditcard,youmaystillsubmitapaperapplication.
PAPER APPLICATION
NOTE: As of August 1, 2011, there is a $20 service fee for paper applications or failing score reports submit-ted to NACES. This information must be received by NACES twelve (12) business days before the examination date.
• Youareresponsibleforcompletingtheappropriatesectionsof the Examination Application. You may ask someonefromyournurseaidetrainingprogramorfacilityemployerforassistanceincompletingtheapplication.
• Paymentmustbe in the formofamoney order, cer-tified check, or company check made payable to “NACES”. Themoneyorder,certifiedcheck,orcom-panycheckmustdisplayyournamesoitcanbeappliedto your examination. Company checks may pay formore than one candidate.Personal checks and cash will not be accepted. Fees are non-refundable and non-transferable once submitted to NACES.
• If you need help or have any questions about theapplication,pleasecontactaNACESCustomerServiceRepresentativeat(888)282-6904.
• Mailyourcompletedapplicationandfeetogether in one envelope to:
NACES Plus Foundation, Inc. NorthCarolinaNNAAP®
7600 Burnet Road, Suite 440 Austin, TX 78757-1292
5
ExAm FEESThefeeslistedbelowhavebeenestablishedfortheNNAAP
ExaminationinNorthCarolina.
examination type fees
WrittenExamination&SkillsEvaluation $101
Oral(EnglishorSpanish)Examination&SkillsEvaluation $101
WrittenExaminationONLY (re-test) $24
Oral(EnglishorSpanish)ExaminationONLY (re-test) $24
SkillsEvaluationONLY (re-test) $77Additional fee for any paper application or failing score report submitted to NACES on or after Aug. 1, 2011
$20
The first time you test, you must schedule bOTh the Written (or Oral) Examination
and the Skills Evaluation.
UnderfederalandNorthCarolinastatelaws,candidatesemployedasnurseaidesinnursinghomesthatparticipatein Medicaid/Medicare programs are prohibited frompaying their examination fees. Employers must pay theexamination fee and any re-test fee for those candidatesin their employasnurse aidesor candidateswhohaveawrittencommitmentorsignedacceptanceofemploymentonfileinaMedicaid-certifiednursinghome.Candidateswho become employed as a nurse aide by a Medicare/Medicaidskillednursingfacilitywithin12monthsofsuc-cessful completion of the competency evaluationmay bereimbursed by the facility for training and competencytestingcosts.Thereforecandidates shouldsaveall receiptstosubmittotheskillednursingemployer.
ExAm SChEduliNG OnceNACES receives your application, required docu-ments, and fees, they will schedule you for testing.NACES will mail your Authorization to Test Notice (yellow postcard) to you at the address listed on yourapplicationwithinforty-eight(48)hours.
6
AuthoRizAtioN to tESt NotiCEYour Authorization to Test Notice (yellow postcard) has important information about the examination. If you do not receive your notice within seven (7) business days, call NACES. NACES is NOT responsible for lost, misdirected, or delayed mail.
tEStiNG loCAtioNSTheNNAAPExaminationisgivenbyNACESatRegionalTestSites.
The complete testing schedule, titled North Carolina Regional Test Sites &
Schedules, is available on the Pearson VUE website (www.pearsonvue.com) or at
https://www.ncnar.org, then click on the word Pearson VUE.
SPECiAl ExAm REQuEStS ANd SERViCESPearsonVUEcomplieswiththeprovisionsoftheAmericanswithDisabilitiesAct(42U.S.C.§12101et seq.)andTitleVIIof theCivilRightsAct, as amended (42U.S.C.§2000e et seq.),inaccommodatingdisabledcandidateswhoneedspecialarrangementstotaketheexamination.
If you have a disability, you may ask for special arrangements for testing when you apply.Allrequestsmustbeapprovedinadvance.Besureto:
•providestatementofdiagnoseddisabilityfromyourhealthcareprovider
•explainspecifictypeofaccomodationrequested
Nurse Aide Evaluators administering the Written (orEnglish or Spanish Oral) Examination and the SkillsEvaluationwill be prepared tomeet the needs of nurseaidecandidateswhohaveapprovedaccomodations.
tElECommuNiCAtioN dEViCES FoR thE dEAF (tdd)PearsonVUEisequippedwithTelecommunicationDevicesfor the Deaf (TDD) to assist deaf and hearing-impairedcandidates.TDDcallingisavailableduringallPearsonVUEhours through a special toll-free number, (866) 274-2777.ThisTDDphoneoptionisfortheexpressuseofindividualsequippedwithcompatibleTDDmachinery.
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cancellaTion and Re-scheduling
Ifyouareunabletoattendyourscheduledexamination,you MUST notifyNACES at least seven (7) business daysbeforetheexaminationdatetore-schedule.SaturdayandSundayandnationalholidaysarenotconsideredbusi-nessdays.
If you provide at least seven (7) business days advancenotice, you may re-schedule one (1) time, without pen-altycharges,andyourfeemaybetransferredtoyournewexaminationdate.
If you need to re-schedule an examination in less thanseven(7)businessdaysbeforetheexaminationdate,youmust apply for an excused absence. (Please refer to theAbsence Policy sectioninthishandbook.)
IfyoudonotcallNACESatleastseven(7)businessdaysbeforeyourexaminationdatetore-schedule,anddonotshow up for your scheduled examination, your fee willNOT be refunded and cannot be transferred to a newexaminationdate.Also,youmaynotgiveyourexamina-tiondatetoanotherperson.
REFuNdSOncepaymentofexamfeesisreceived,NO REFUNDS WILL bE ISSUED.
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AbSENCE PoliCySinceunexpectedsituationsoccur,NACESwillconsiderexcusinganabsencefromascheduledexamination.
Acceptable reasons for re-scheduling are as follows:• Illnessofyourselforamemberofyour immediate
family• Deathinthefamily• Disablingtrafficaccident• Courtappearanceorjuryduty• Militaryduty• Weatheremergency
Requests for excused absencesmust bemade inwritingandreceivedwithin ten (10) business daysfollowingthescheduled examination. This request must include veri-ficationofyourabsence fromanappropriate source.Forexample,ifyouhadjuryduty,youmustsupplyacopyofyourcourtnotice.
ThedecisionofNACES toapproveordeny the excusedabsenceisfinal.
WEAthER EmERGENCiESExaminationswillbedelayedorcancelledonlyinemergen-cies.Ifsevereweatheroranaturaldisastermakesthetestcen-terinaccessibleorunsafe,theexaminationwillbedelayedorcanceled.Iftheexaminationhasbeencanceled,youwillbere-scheduledforthenextavailableexaminationatthatsite.
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exaM day
ChECkiNG iNYoumustarrive30minutespriortoyourscheduledtimeforBOTHthewrittenandskillsexaminations.Ifyouarelateforthewrittenexaminationyouwillnotbeallowedtotestandyourfeeswillnotberefunded.Ifyoumissedyourwrittenexaminationandarescheduledforaskillsevalua-tion,pleasearrive30minutespriortoyourscheduledtime.SkillsEvaluationtesttimesareapproximate.Youwillberequiredtocheckinforboththewrittenandfortheskillsexaminations.Youwillberequiredtopresentproperidentification.
WhAt to bRiNGYoumust have the following items with you when youtaketheexamination:• Two(2)formsofproperidentification• Three(3)No.2pencils(sharpened)• Eraser• Watchwithasecondhand
No other materials will be allowed.
PRoPER idENtiFiCAtioNCandidatesarerequiredtobringtwo(2)formsofcurrent, not expired, official signature-bearing identification (oneofwhichmustbephoto-bearing)tothetestsite.OneformofidentificationmustbeaU.S.government-issuedSocialSecuritycard,signedandnon-laminated.NurseAideIapplicantswhoareinthearmedservicesmayusetheircurrentU.S.MilitaryI.D.inplaceofaSocialSecurity(SS)card.Thetesttaker’sSSnumbermustbeontheI.D.ifused.SponsororDependentMilitaryI.D.sareNOTaccept-edinplaceofSScard,butcanbeusedasasecondI.D.(onewithphoto)whenpresentedwithavalidSScard.
The second form must be any of those listed below.PhotocopiesofidentificationwillNOTbeaccepted.OriginalsignaturebearingSScardsarerequiredtotestinNC.If youhave scheduledyour examandhavemisplacedyourSScard7businessdayspriortoyourexam,callNACEStoreschedule.Ifthereareextenuatingcircumstancessuchasfireortheftandyourexamisscheduledinlessthan7businessdaysfromthetimeoftheincident,youmayapplyforanexcusedabsence.Refertopage7,CancellationandReschedulingin
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theNCNurseAideIHandbook.Documentationsubstan-tiating the event must be provided. NACES’s decision toapproveordenyacreditrequestwillbefinal.
Proper photo identification includes one of the following:
• Current, non-expired driver’s license (Candidateswho do not have their new license by exam dayMUSTbringtheirexpireddriver'slicenseANDthe20daytemporarypermit)
• U.S.government-issuedMilitaryI.D.(ifnotusedinlieuofsocialsecuritycard)
• State-issuedidentificationcard• Passport(USorforeign,current,non-expired)• Alienregistrationcard
The name on your identificationmustbethesameasthenameyouusedontheapplicationtoregisterfortheexami-nation.Ifyournamehaschanged,youmust:
•ContactNACES(ifyouappliedbymail/paperappli-cation)orPearsonVUE(ifyouappliedonline),and
•IfyouWEREpreviouslylistedontheNorthCarolinaNurseAideIRegistry,alsocontacttheRegistry.
Youmust contactNACES/PearsonVUE at least seven (7)businessdayspriortoyourscheduledexam,andtheRegistryatleast(9)businessdayspriortotheexam.Bepreparedtopro-videofficialgovernmentdocumentationofthenamechange.If you do not bring proper identification to the exam, you will not be allowed to test and your examination fee will not be refunded.
SECuRity ANd ChEAtiNGIf you give help to or receive help from anyone during theexamination, theexaminationwillbe stopped.The incidentwill be reported to theNorthCarolinaDivision ofHealthServiceRegulation(DHSR)forreview,andyourexaminationwillnotbescored(seeTesting Policies).
Pleasenotethatallexaminationquestions,eachformoftheexamination, andallother examinationmaterials are copy-righted by, the property of, or licensed by Pearson VUE.Consequently, any distribution of the examination contentormaterials throughany formof reproduction,or throughoral or written communication, is strictly prohibited andpunishablebylaw.Anyone who removes or tries to remove examination materials or information from the test site will be prosecuted.
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tEStiNG PoliCiESThefollowingpoliciesareobservedateachtestcenter.
Lateness
Youmust arrive thirty (30)minutes before the examina-tionstarts.Ifyouarelateforyourscheduledexamination,or do not bring all of your required materials, you willNOT be allowed to test and your examination fee willNOTbereturned.IfyouarelatefortheWritten(orOral)Examination,butarriveontimefortheSkillsEvaluation,youwillbeallowedtotaketheSkillsEvaluation.
IfyouarelateforyourSkillsEvaluationordonotbringallyourrequiredmaterials,youwillNOTbeallowedtotestandyouwillberequiredtore-applyandpayanotherexaminationfee(seeCancellationformoredetails).
Electronic Devices
Cellularphones,beepers,oranyotherelectronicdevicesare not permitted to be used and must be turned offduring testing.There is no place for storage of personalbelongingsatthetestcenter.
Study Aids
You are not permitted to take personal belongings suchas briefcases, large bags, studymaterials, extra books, orpapers into the examination room. Any such materialsbrought intotheexaminationroomwillbecollectedandreturned to youwhen you have completed the examina-tion.PearsonVUEisnotresponsibleforlostormisplaceditems.
Eating/Drinking/Smoking
Youarenotpermittedtoeat,drink,orsmokeduringtheexamination.
Misconduct
If you are discovered causing a disturbance of any kindorengaging inanykindofmisconduct,youwillbedis-missed from the examination and the incident will bereportedtotheNorthCarolinaDivisionofHealthServiceRegulation.
Guests/Visitors
No guests, visitors, pets, or children are allowed at the test center.
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The WRiTTen (oR oRal) exaM
WRittEN ExAmThe Nurse Aide Evaluator will hand out materials andgiveinstructionsfortakingtheWrittenExamination.TheWritten Examination has seventy (70) multiple-choicequestions. You will have two (2) hours to complete theWrittenExamination.Youwillbe toldwhenfifteen (15)minutes remain. Fill in only one (1) oval on the answersheetforeachquestion.MarkingsinthetestbookletwillNOTbeacceptedasanswers.Youranswersmustappearon the separate answer sheet. Sample questions for theWrittenExaminationarelocatedonpage14.
ENGliSh oR SPANiSh oRAl ExAmAn Oral Examination may be taken in place of theWritten Examination. The Oral Examination may betaken in English or in Spanish. You must request anEnglish or Spanish Oral Examination when filling outyourapplication.TheOralExaminationisprovidedonacassettetape.Acassetteplayerandearphonesareprovidedatthetestcenter.YouwillbeaskedtolistentoatapeoftheOralExaminationandfollowalonginthetestbookletasthequestionsarereadaloudonthetape.TheOralExaminationconsistsoftwo(2)parts,andyoumustpassbothpartstopasstheOralExamination.ThefirstpartoftheOralExaminationhassixty(60)multiple-choice questions. Each of these questions is read twice.Aseachquestionisread,youwillbeaskedtochoosethecorrectanswerandmarkitonyouranswersheet.The second part of the Oral Examination has ten (10)multiple-choicequestions.Thesequestionstestyourabil-itytospeakaminimumamountofEnglishbyrecogniz-ingcommonwordsusedbynurseaidesinlong-termcarefacilities.Eachwordisreadthree(3)times.Youareaskedtomatch theword you hear on the tape to thewrittenwordinthetestbooklet.Asyoufindthematch,markyouranswerontheanswersheet.TheOralExamination takes two (2)hours to complete.Youwillbetoldwhenfifteen(15)minutesremain.Fillinonlyone (1)ovalon theanswer sheet foreachquestion.Youmaywriteinthetestbooklet,butmarkingsinthetestbookletwillNOTbeacceptedasanswers.Youranswersmustappearontheseparateanswersheet.
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WRiTTen (oR oRal) exaM conTenT ouTline
The currentNNAAP® ExaminationContentOutline isbasedonthefindingsfromthe2009 Job Analysis of Nurse AidespublishedbyNCSBNinspring2010.
The NNAAP written examination is comprised of 70multiple-choice items; 10 are pretest items (non-scored)on which statistical information will be collected. TheNNAAP oral examination is comprised of 60multiple-choiceitemsand10readingcomprehension(wordrecog-nition)items.Thecandidateisallowedtochoosebetweenawrittenandanoralexamination. # of % of questions I. Physical Care Skills the exam in the exam
A.ActivitiesofDailyLiving........ 14% ............8 1.Hygiene 2.DressingandGrooming 3.NutritionandHydration 4.Elimination 5.Rest/Sleep/Comfort B.BasicNursingSkills.................39%............ 24 1. InfectionControl 2.Safety/Emergency 3.Therapeutic/TechnicalProcedures 4.DataCollectionandReporting C.RestorativeSkills...................... 7%.............4 1.Prevention 2.SelfCare/Independence
II. Psychosocial Care Skills A.Emotionaland MentalHealthNeeds..............11%.............6
B.SpiritualandCulturalNeeds....2%..............2
III. Role of the Nurse Aide A.Communication....................... 8%.............5
B.ClientRights........................... 7%.............4
C.LegalandEthicalBehavior...... 3%.............2
D.Memberofthe HealthCareTeam................... 9%.............5
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saMple QuesTions
Thefollowingquestionsaresamplesofthekindsofques-tions that you will find on the Written Examination.Checkyouranswerstothesequestionsintheboxbelow.
1. The client's call light should always be placed:(A) onthebed(B) withintheclient'sreach(C) ontheclient'srightside(D) overthesiderail
2. Which of the following items is used in the pre-vention and treatment of bedsores or pressure sores?(A) rubbersheet(B) airmattress(C) emesisbasin(D) restraint
3. When caring for a dying client, the nurse aide should:(A) keeptheclient'sroomdarkandquiet(B) allowclienttoexpresshisfeelings(C) changethesubjectifclienttalksaboutdeath(D) contacttheclient'sminister,priestorrabbi
4. What does the abbreviation ADL mean?(A) AdLib(B) AsDoctorLikes(C) ActivitiesofDailyLiving(D) AfterDaylight
5. After giving a client a back rub, the nurse aide should always note:(A) thelasttimetheclienthadabackrub(B) anychangeintheclient'sskin(C) client'sweight(D) amountoflotionused
6. how should the nurse aide communicate with a client who has a hearing loss?(A) facetheclientwhenspeaking(B) repeatthestatement(C) shoutsothattheclientcanhear(D) useahigh-pitchedvoice
Correct Answers
1.B2.B3.B4.C5.B6.A
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self-assessMenT Reading TesT
The two-part Self-Assessment Reading Test that appearsbelowwill help youdecide if you should consider takingtheOralExaminationinsteadoftheWrittenExamination.Tocomplete thereadingtest, followthe instructionspro-videdbelowandselecttheanswertoeachquestion.Whenyou have completed the reading test, youwill be able todeterminethenumberofquestionsyouansweredcorrectly.
PARt 1: VoCAbulARy
1. Circlethebestanswertoeachquestion.
2. Whenyouhavefinished,checkyouranswersusingtheanswerkeyonpage18.
3. Countupthenumberofcorrectanswers.
4. Ifyourscoreislessthan17,youmayhavedifficultyreadingtheWrittenExaminationandshouldcon-sidertakingtheOralExamination.
1. You go to a doctor when you _____.(A) feelsleepy (D) needmoney(B) needsocks (E) needclothes(C) feelsick
2. A person who flies an airplane is its _____.(A) pilot (D) surgeon(B) steward (E) director(C) mother
3. You use a _____ to write.(A) bow (D) carpenter(B) calculator (E) needle(C) pencil
4. To ExIT a room means to _____ it.(A) enter (D) read(B) leave (E) interrupt(C) forget
5. A wedding is a joyous _____.(A) focus (D) occasion(B) vehicle (E) civilization(C) balloon
6. To REqUIRE something means to _____ it.(A) need (D) understand(B) have (E) hear(C) forget go to next page
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7. You _____ something to find its length.(A) slice(B) lock(C) measure(D) force(E) tape
8. Soup is served in a _____.(A) plate(B) bowl(C) fork(D) chair(E) closet
9. To accompany someone means to _____.(A) disagreewithhim(B) workforhim(C) gowithhim(D) speaktohim(E) choosehim
10. A nursing home resident receives _____ from the staff.(A) quality(B) fame(C) interruption(D) care(E) work
11. Medicine is used to _____ pain.(A) widen(B) conjure(C) enliven(D) increase(E) relieve
12. To DRENCh the flowers means to ____ them.(A) steam(B) drink(C) touch(D) soak(E) anger
13. A bicycle is a means of _____.(A) nourishment(B) transportation(C) prediction(D) collision(E) walking
14. When someone speaks in a whisper, it may be difficult to _____.(A) deceive(B) understand(C) frighten(D) estimate(E) regulate go to next page
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self-assessMenT Reading TesT
PARt 2: ComPREhENSioNInthispartofthereadingtestyouwillbeprovidedwithaseriesofbriefparagraphs.Youaretoreadeachparagraphandthenanswerthequestionsthatappearaftertheparagraph.
Therearemanydifferentkindsoffish.Allfishliveinwater.Theyusetheirtailsandfinstoswim.
15. Fish live in _____.(A) cups(B) houses(C) air(D) water(E) fountains
16. Fish use their _____ to swim.(A) tails(B) heads(C) gills(D) lungs(E) floats
Mariagrewupona farm.She lovedtheworkonthe farm.Sheknewwhen all of the cropshad tobeplanted.Shewouldlikeajobonafarmorinaflowergarden.
17. Maria has had experience as a _____.(A) guide(B) farmer(C) driver(D) nurse(E) teacher
18. She would like to work in _____.(A) anoffice(B) alibrary(C) agarden(D) ahospital(E) asupermarket
19. As a child Maria lived _____.(A) inthecity(B) inanapartment(C) onafarm(D) inalargehouse(E) onthebeach go to next page
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Carolynhasagoodjob.Sheisanurseinalargehos-pital.Everydayshecanhelpmanypeople.Sheenjoysthisverymuch.Shealsomakesagood salary.Eachmonthshecanpayherbillsandsavesomemoney.
20. Carolyn works in a _____.(A) hospital(B) doctor’soffice(C) garage(D) school(E) library
21. One of the things Carolyn enjoys is _____.(A) workinginanoffice(B) helpingpeople(C) readingbooks(D) workinglatehours(E) drivingacar
22. With her salary she can pay her bills and _____.(A) buyfurniture(B) givetocharity(C) savemoney(D) buynewclothes(E) payforcollege
This completes the Self-Assessment Reading Test.
Answers
1.C 7.C 13.B 19.C
2.A 8.B 14.B 20.A
3.C 9.C 15.D 21.B
4.B 10.D 16.A 22.C
5.D 11.E 17.B
6.A 12.D 18.C
If your score is less than 17, you may have difficulty reading the Written Examination and should consider taking the Oral Examination in place of the Written Examination.
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The skills evaluaTion
WhAt to ExPECt
Setting
TheSkillsEvaluationissetuptoresembleanactualcare-givingsituation.TheSkillsEvaluationareawilllooksimilartoyourworksetting.Itwillhavealltheequipmentneces-sary to perform the assigned skills.The Skills Evaluationwill be administered by a Nurse Aide Evaluator. Beforeyour skills evaluationbegins, theevaluatorwill showyouwhere equipment is located and answer questions aboutoperatingtheequipment.Please arrive 30 minutes early. Test times are approxi-mate. Please plan to spend the day.
Who Will Act as a Client?
Thepartofthe“client”willbeplayedbyacandidatewhovolunteerstoactasaweakenedelderlyperson.Whileyouperformtheskills,speaktothecandidatevolunteerasyouwouldspeaktoanactualclientinanurseaideworksetting.Youareencouragedtospeaktothecandidatevolunteernotonlybecauseitispartofqualitycare,butalsobecauseitwillhelpyoutorelaxasyouperformtheskills.
Candidate Volunteer Requirements
Youwillneedtoactasacandidatevolunteerforanothercandidate’sSkillsEvaluationandplaytheroleofanursinghomepatient (client).The evaluatorwill give you verbalinstructionsthatwilldescribehowyoushouldactinper-formingtheroleoftheclient.
Candidate dress Requirements
You must wear flat, slip-on, non-skid shoes,aloose-fittingtopwithshortsleevesthatcanberolleduptotheshoulderor tank top, and loosefittingpants that canbe rolledup.Youwillberequiredtoputagownonoveryourclothing.Innocasemaycandidatesremoveclothingdowntoundergar-ments.
Priortobeginningtheexam,youshouldinformtheevalu-atorofanyfoodorlatexallergyorsensitivitytoskinsoapsor lotion.Any limitations to range ofmotionmust alsobecommunicatedtotheevaluatorpriortothestartoftheskillsexamination.
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Forinfectioncontrolpurposes,youshouldnotcometothetestsitewithopenareas/soresontheskin.Candidateswithanyopenareasorsoresontheirskinshouldrescheduletheirskillstesttoalaterdateaftertheirskinfullyheals.
thE tASkSTheNNAAPSkillsListcontainsalloftheskillsthatyoumaybeaskedtodemonstrateduringtheSkillsEvaluation.Eachskillrepresentsataskthatyouwillbeaskedtoper-forminyourjobandhasbeenbrokendownintoaseriesofsteps.
See pages 25-40 for the complete skills listing.
Astepthatishighlightedinbold typeiscalledaCritical Element Step.CriticalElementStepsareimportantstepsthatmustbeperformedcorrectlyinorderforyoutopassthe skill. If you leave out aCriticalElement Step or donotperformaCriticalElementStepproperly,youwillnotpass theskill.However, ifyouperformonlytheCriticalElement Step correctly in a skill, you do not automati-callypassthatskill.Youmustalsocorrectlydemonstrateenough steps tomeet the passing standard (or cut score) foreachskill.
Before your Skills Evaluation begins, the Nurse AideEvaluatorwillgiveyouaninstructioncardthatwilllistthefive(5)skillsselectedforyoutoperform.Hand-washingwillalwaysbeoneoftheskillstobeperformed.Theremainingfour(4)skillsarerandomlychosenfromthecompletesetofskillslistingsonpages25to40ofthishandbook.Youarestronglyencouragedtoperformtheskillsintheordertheyarelistedontheinstructioncard.Ifyoumakeamistake,sayso,andyouwillbeinstructedto tell the evaluatorwhich step(s) is tobe correctedandthentoperformthestep(s).Youwillnothavetoredotheentireskill, just thestepsyouwishtocorrect.Thereare,however, some exceptions to this rule. If you fail toputonglovesortakethemoffwhenitisrequiredtodosoandthe evaluator reminds you to do so, for infection controlpurposes,thenyouwillnotreceivecreditforattemptingtocorrectthisstep.Ifyouwishtocorrectanorder-dependentstep (a step stating that an action should be performedbefore or afteranotherstep)andyoufailtosaywhenthecorrected step should be performed, you will not receivecreditforthecorrection.
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Once you begin a new skill, you may not go back tocorrect a previous skill. The Nurse Aide Evaluator willnot answer questions during the Skills Evaluation andwillnottellyouwhetheryouperformedaskillcorrectly.Youmaynot receivehelp fromanyoneduring theSkillsEvaluation.Ifyoudohaveanyquestions,pleaseaskthembeforetheSkillsEvaluationbegins.At least one (1) of the four (4) randomly-selected skillswill include a measurement skill (see the section below,Recording A Measurement,formoreinformationregardingmeasurementskills).
Youwillbeaskedtodecontaminateyourhands(withhandsanitizer)beforeproceedingfromskillsperformedonaliveclient to skills that are not. This is for infection controlpurposesandwillnoteffecttheresultofyourevaluation.
When you have completed your skills evaluation, the evaluator will direct you to wash your hands. Although this will not affect your examination results, for the pur-poses of infection control, you must wash your hands.
You must successfully complete all five (5) skills to pass the Skills Evaluation. You will have thirty (30) minutes todemonstrateallfive(5)skills.
RECoRdiNG A mEASuREmENtTheNNAAPSkillsEvaluationrequireseverycandidatetoperformatleastonemeasurementskill,suchasbloodpres-sure,radialpulse,respirations,urineoutput,orweight.Youwillbegivena special form,calledaRecordingSheet forMeasurementSkills,towritedown,orrecord,themeasure-ment.Forexample,ifperformingtheMeasures and Records Blood Pressureskill,youwillwritethecompletesystolicanddiastolicpressuresofyourbloodpressurereadinginaboxlabeledCandidateResults.
Onthefollowingpageisacopyoftherecordingsheetthatwillbeusedduringtheskillsexam.Thecandidatemustrecordhis/herresultsintheCandidateResultsboxonthissheet.Thissheetwillbeusedtorecordtheresultsofthefollowingmeasurementskills:
• MeasuresandRecordsBloodPressure• MeasuresandRecordsWeightof
AmbulatoryClient• MeasuresandRecordsUrinaryOutput• CountsandRecordsRadialPulse• CountsandRecordsRespirations
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23
Date
Test Site ID
CANDIDATE NAME
CANDIDATE ID
EVALUATOR NAME
EVALUATOR ID
SKILL TESTEDEvaluator must check one box next to the skill being tested.
� Blood Pressure � Respirations
� Oral Temperature � Urine Output
� Radial Pulse � Weight
RECORDING SHEET FOR MEASUREMENT SKILLS
TM
CANDIDATE EVALUATORRESULTS RESULTS
Copyright © 2005 Promissor, Inc. All Rights Reserved. Stock# 0699-02 6/05
SAMPLE
Tips for the Skills Evaluation
• You will be expected to perform the skills as youwould in a nursing home setting. When water isrequired,youmustuserunningwater.Allcandidateswill be required to perform theHand Hygiene skill.Theevaluatorwillinformyouafteryouhavewashedyourhandsforthefirsttimethatyoushouldjusttellhimorherwhenyouwouldwashyourhandsduringyourperformanceoftherestoftheskills,ratherthanactually washing them for each skill. For all stepsotherthanhand-washing,youmustactuallyperformtheskillinordertoreceivecredit.Youmaynotsimplytelltheevaluatorwhatyouwoulddoforsimulatingastep.Forexample,youmaynotsimplytelltheevalua-torthatyouwouldwashtheclient.Youmustactuallydemonstratewashingtheclient.Youmaynotsimplytelltheevaluatorthatyouwouldfeedtheclient.Youmustactuallydemonstratefeedingtheclient.
• Afteryouhaveintroducedyourselftotheclientforthefirsttime,itisnotnecessaryforyoutointroduceyourselfeachtimeyoubeginanewskill.
• To receive full credit for a measurement skill, youmustaccuratelymaketherequiredmeasurementandthenwrite thatmeasurementon theRecording Sheet for Measurement Skills.TheevaluatorwillprovidetheRecordingSheettoyouatthetestsite.AsampleoftheRecordingSheet is shownonpage22of thishand-book.YouareencouragedtobecomefamiliarwiththeRecordingSheetbeforeyourscheduledtestdate.
• Youmustknowhowtooperatebothastandingandanon-digitalbathroomscaleandmustknowhowtosetbothtypesofscalestozero.
• Youmay not bringanyofyourownequipmenttothetestsite(e.g.transfer/gaitbelt).
• Itisimportantforyoutoplacethecallsignalwithintheclient’sreachwheneveryouleavetheclient.
• Where the word “client” appears, it refers to the person receiving care.
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skills lisTing
The 24 skills that follow are arranged in alphabeticalorder,exceptfortheHand Hygiene (Hand Washing)skill.HandHygiene is listedfirstasa reminderof the impor-tanceofperformingthis skillbeforeallother skills.Thenumbered linesbelow each skill are the stepsneeded toperformthatskill.CriticalElementStepsareinboldtype.
hand hygiene (hand Washing) 1 Addressclientbynameandintroducesselftoclientby
name 2 Turnsonwateratsink 3 Wetshandsandwriststhoroughly 4 Appliessoaptohands 5 Lathers all surfaces of wrists, hands, and fingers
producing friction, for at least 20 (twenty) seconds, keeping hands lower than the elbows and the fingertips down
6 Cleansfingernailsbyrubbingfingertipsagainstpalmsoftheoppositehand
7 Rinse all surfaces of wrists, hands, and fingers, keeping hands lower than the elbows and the fingertips down
8 Usesclean,drypapertowel/towelstodryallsurfacesofhands,wrists,andfingersthendisposesofpapertowel/towelsintowastecontainer
9 Usesclean,drypapertowel/towelstoturnofffaucetthendisposesofpapertowel/towelsintowastecontainerorusesknee/footcontroltoturnofffaucet
10 Doesnottouchinsideofsinkatanytime
applies one knee-high elasTic sTocking 1 Explainsprocedure,speakingclearly,slowly,and
directly,maintainingface-to-facecontactwheneverpossible
2 Privacyisprovidedwithacurtain,screen,ordoor 3 Clientisinsupineposition(lyingdowninbed)while
stockingisapplied 4 Turnsstockinginside-out,atleasttotheheel 5 Placesfootofstockingovertoes,foot,andheel 6 Pullstopofstockingoverfoot,heel,andleg
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Skill continues
7 Movesfootandleggentlyandnaturally,avoidingforceandover-extensionoflimbandjoints
8 Finishes procedure with no twists or wrinkles and heel of stocking, if present, is over heel and opening in toe area (if present) is either over or under toe area
9 Signalingdeviceiswithinreachandbedisinlowposition
10 Aftercompletingskill,washhands
assisTs To aMbulaTe using TRansfeR belT 1 Explainsprocedure,speakingclearly,slowly,and
directly,maintainingface-to-facecontactwheneverpossible
2 before assisting to stand, client is wearing shoes 3 Beforeassistingtostand,bedisatasafelevel 4 Beforeassistingtostand,checksand/orlocksbed
wheels 5 before assisting to stand, client is assisted to sitting
position with feet flat on the floor 6 Beforeassistingtostand,appliestransferbeltsecurely
atthewaistoverclothing/gown 7 Beforeassistingtostand,providesinstructionstoenable
clienttoassistinstandingincludingprearrangedsignaltoalertclienttobeginstanding
8 Standsfacingclientpositioningselftoensuresafetyofcandidateandclientduringtransfer.Countstothree(orsaysotherprearrangedsignal)toalertclienttobeginstanding
9 Onsignal,graduallyassistsclienttostandbygraspingtransferbeltonbothsideswithanupwardgrasp(candidate’shandsareinupwardposition),andmaintainingstabilityofclient’slegs
10 Walksslightlybehindandtoonesideofclientforadistanceoften(10)feet,whileholdingontothebelt
11 Afterambulation,assistsclienttobedandremovestransferbelt
12 Signalingdeviceiswithinreachandbedisinlowposition
13 Aftercompletingskill,washhands
26
assisTs WiTh use of bedpan 1 Explainsprocedurespeakingclearly,slowly,and
directly,maintainingface-to-facecontactwheneverpossible
2 Privacyisprovidedwithacurtain,screen,ordoor 3 Beforeplacingbedpan,lowersheadofbed 4 Putsoncleanglovesbeforehandlingbedpan 5 Places bedpan correctly under client’s buttocks 6 Removesanddisposesofgloves(without
contaminatingself )intowastecontainerandwasheshands
7 Afterpositioningclientonbedpanandremovinggloves,raisesheadofbed
8 Toilettissueiswithinreach 9 Handwipeiswithinreachandclientisinstructedto
cleanhandswithhandwipewhenfinished10 Signalingdevicewithinreachandclientisaskedto
signalwhenfinished11 Putsoncleanglovesbeforeremovingbedpan12 Headofbedisloweredbeforebedpanisremoved13 Avoidsoverexposureofclient14 Emptiesandrinsesbedpanandpoursrinseintotoilet15 Afterrinsingbedpan,placesbedpanindesignated
dirtysupplyarea16 Afterplacingbedpanindesignateddirtysupply
area,removesanddisposesofgloves(withoutcontaminatingself )intowastecontainerandwasheshands
17 Signalingdeviceiswithinreachandbedisinlowposition
cleans uppeR oR loWeR denTuRe 1 Putsoncleanglovesbeforehandlingdenture 2 Bottomofsinkislinedand/orsinkispartiallyfilled
withwaterbeforedentureisheldoversink 3 Rinsesdentureinmoderatetemperaturerunning
waterbeforebrushingthem 4 Appliestoothpastetotoothbrush 5 Brushessurfacesofdenture 6 Rinsessurfacesofdentureundermoderate
temperaturerunningwater 7 Beforeplacingdentureintocup,rinsesdenturecup
andlid
27
Skill continues
8 Placesdentureindenturecupwithmoderatetemperaturewater/solutionandplaceslidoncup
9 Rinsestoothbrushandplacesindesignatedtoothbrushbasin/container
10 Maintainscleantechniquewithplacementoftoothbrushanddenture
11 Sinklinerisremovedanddisposedofappropriatelyand/orsinkisdrained
12 Afterrinsingequipmentanddisposingofsinkliner,removesanddisposesofgloves(withoutcontaminatingself )intowastecontainerandwasheshands
counTs and RecoRds Radial pulse 1 Explainsprocedure,speakingclearly,slowly,and
directly,maintainingface-to-facecontactwheneverpossible
2 Placesfingertipsonthumbsideofclient’swristtolocateradialpulse
3 Countbeatsforonefullminute 4 Signalingdeviceiswithinreach 5 Beforerecording,washeshands 6 After obtaining pulse by palpating in radial artery
position, records pulse rate within plus or minus 4 beats of evaluator’s reading
counTs and RecoRds RespiRaTions 1 Explainsprocedure(fortestingpurposes),speakingclearly,
slowly,anddirectly,maintainingface-to-facecontactwheneverpossible
2 Countsrespirationsforonefullminute 3 Signalingdeviceiswithinreach 4 Washeshands 5 Records respiration rate within plus or minus 2
breaths of evaluator’s reading
28
donning and ReMoving ppe (goWn and gloves) 1 Picksupgownandunfolds 2 Facingthebackopeningofthegownplacesarms
througheachsleeve 3 Fastenstheneckopening 4 Securesgownatwaistmakingsurethatbackofclothing
iscoveredbygown(asmuchaspossible) 5 Putsongloves 6 Cuffsofglovesoverlapcuffsofgown 7 before removing gown, with one gloved hand,
grasps the other glove at the palm, remove glove 8 Slips fingers from ungloved hand underneath cuff of
remaining glove at wrist, and removes glove turning it inside out as it is removed
9 Disposesofglovesintodesignatedwastecontainerwithoutcontaminatingself
10 Afterremovinggloves,unfastensgownatneckandwaist
11 Afterremovinggloves,removesgownwithouttouchingoutsideofgown
12 Whileremovinggown,holdsgownawayfrombodywithouttouchingthefloor,turnsgowninwardandkeepsit inside out
13 Disposesofgownindesignatedcontainerwithoutcontaminatingself
14 Aftercompletingskill,washeshands
dResses clienT WiTh affecTed (Weak) RighT aRM 1 Explainsprocedure,speakingclearly,slowly,and
directly,maintainingface-to-facecontactwheneverpossible
2 Privacyisprovidedwithacurtain,screen,ordoor 3 Askswhichshirthe/shewouldliketowearanddresses
him/herinshirtofchoice 4 Whileavoidingoverexposureofclient,removesgown
fromtheunaffectedsidefirst,thenremovesgownfromtheaffectedsideanddisposesofgownintosoiledlinencontainer
5 Assists to put the right (affected/weak) arm through the right sleeve of the shirt before placing garment on left (unaffected) arm
6 Whileputtingonshirt,movesbodygentlyandnaturally,avoidingforceandover-extensionoflimbsandjoints
29Skill continues
7 Finisheswithclothinginplace 8 Signalingdeviceiswithinreachandbedisinlow
position 9 Aftercompletingskill,washeshands
feeds clienT Who cannoT feed self 1 Explainsproceduretoclient,speakingclearly,
slowly,anddirectly,maintainingface-to-facecontactwheneverpossible
2 Beforefeeding,looksatnamecardontrayandasksclienttostatename
3 before feeding client, client is in an upright sitting position (75-90 degrees)
4 Placestraywherethefoodcanbeeasilyseenbyclient 5 Candidatecleansclient’shandswithhandwipebefore
beginningfeeding 6 Candidatesitsfacingclientduringfeeding 7 Tellsclientwhatfoodsareontrayandaskswhatclient
wouldliketoeatfirst 8 Usingspoon,offersclientonebiteofeachtypeoffood
ontray,tellingclientthecontentofeachspoonful 9 Offersbeverageatleastonceduringmeal10 Candidateasksclientiftheyarereadyfornextbiteof
foodorsipofbeverage11 Atendofmeal,candidatecleansclient’smouthand
handswithwipes12 Removesfoodtrayandplacestrayindesignateddirty
supplyarea13 Signalingdeviceiswithinclient’sreach14 Aftercompletingskill,washeshands
30
gives Modified bed baTh (face and one aRM, hand and undeRaRM) 1 Explainsprocedure,speakingclearly,slowly,and
directly,maintainingface-to-facecontactwheneverpossible
2 Privacyisprovidedwithacurtain,screen,ordoor 3 Removesgownandplacesinsoiledlinencontainer,
whileavoidingoverexposureoftheclient 4 Beforewashing,checkswatertemperatureforsafety
andcomfortandasksclienttoverifycomfortofwater 5 Putsoncleanglovesbeforewashingclient 6 beginning with eyes, washes eyes with wet washcloth
(no soap), using a different area of the washcloth for each stroke, washing inner aspect to outer aspect then proceeds to wash face
7 Driesfacewithtowel 8 Exposesonearmandplacestowelunderneatharm 9 Appliessoaptowetwashcloth10 Washesarm,hand,andunderarmkeepingrestofbody
covered11 Rinsesanddriesarm,hand,andunderarm12 Movesbodygentlyandnaturally,avoidingforceand
over-extensionoflimbsandjoints13 Putscleangownonclient14 Empties,rinses,anddriesbasin15 Afterrinsinganddryingbasin,placesbasinin
designateddirtysupplyarea16 Disposesoflinenintosoiledlinencontainer17 Avoidscontactbetweencandidateclothingandused
linens18 Afterplacingbasinindesignateddirtysupplyarea,
anddisposingofusedlinen,removesanddisposesofgloves(withoutcontaminatingself )intowastecontainerandwasheshands
19 Signalingdeviceiswithinreachandbedisinlowposition
31
MeasuRes and RecoRds blood pRessuRe 1 Explainsprocedure,speakingclearly,slowly,and
directly,maintainingface-to-facecontactwheneverpossible
2 Beforeusingstethoscope,wipesbell/diaphragmandearpiecesofstethoscopewithalcohol
3 Client’sarmispositionedwithpalmupandupperarmisexposed
4 Feelsforbrachialarteryoninneraspectofarm,atbendofelbow
5 Placesbloodpressurecuffsnuglyonclient’supperarm,withsensor/arrowoverbrachialarterysite
6 Earpiecesofstethoscopeareinearsandbell/diaphragmisoverbrachialarterysite
7 Candidateinflatescuffbetween160mmHgto180mmHg.Ifbeatheardimmediatelyuponcuffdeflation,completelydeflatecuff.Re-inflatecufftonomorethan200mmHg
8 Deflatescuffslowlyandnotesthefirstsound(systolicreading),andlastsound(diastolicreading)(Ifroundingneeded,measurementsareroundedUP to thenearest2mmofmercury)
9 Removescuff10 Signalingdeviceiswithinreach11 Beforerecording,washeshands 12 After obtaining reading using bP cuff and
stethoscope, records both systolic and diastolic pressures each within plus or minus 8 mm of evaluator’s reading
32
MeasuRes and RecoRds uRinaRy ouTpuT 1 Putsoncleanglovesbeforehandlingbedpan 2 Poursthecontentsofthebedpanintomeasuring
containerwithoutspillingorsplashingurineoutsideofcontainer
3 Measurestheamountofurineateyelevelwithcontaineronflatsurface
4 Aftermeasuringurine,emptiescontentsofmeasuringcontainerintotoilet
5 Rinsesmeasuringcontainerandpoursrinseintotoilet 6 Rinsesbedpanandpoursrinseintotoilet 7 Afterrinsingequipment,andbeforerecording
output,removesanddisposesofgloves(withoutcontaminatingself )intowastecontainerandwasheshands
8 Records contents of container within plus or minus 25 ml/cc of evaluator’s reading
MeasuRes and RecoRds WeighT of aMbulaToRy clienT 1 Explainsprocedure,speakingclearly,slowly,and
directly,maintainingface-to-facecontactwheneverpossible
2 Clienthasshoesonbeforewalkingtoscale 3 Beforeclientstepsonscale,candidatesetsscaletozero
thenobtainsclient’sweight 4 Whileclientstepsontoscale,candidatestandsnextto
scaleandassistsclient,ifneeded,ontocenterofscale 5 Whileclientstepsoffscale,candidatestandsnext
toscaleandassistsclient,ifneeded,offscalebeforerecordingweight
6 Beforerecording,washeshands 7 Records weight based on indicator on scale. Weight
is within plus or minus 2 lbs of evaluator’s reading (If weight recorded in kg weight is within plus or minus 0.9 kg of evaluator’s reading)
33
peRfoRMs Modified passive Range of MoTion (pRoM) foR one knee and one ankle 1 Explainsprocedure,speakingclearly,slowly,and
directly,maintainingface-to-facecontactwheneverpossible
2 Privacyisprovidedwithacurtain,screen,ordoor 3 Instructsclienttoinformcandidateifpainis
experiencedduringexercise 4 Supportslegatkneeandanklewhileperformingrange
ofmotionforknee 5 Bendsthekneeandthenreturnslegtoclient’snormal
position(extension/flexion)(ATLEAST3TIMESunlesspainisverbalized)
6 Supportsfootandankleclosetothebedwhileperformingrangeofmotionforankle
7 Pushes/pullsfoottowardhead(dorsiflexion),andpushes/pullsfootdown,toespointdown(plantarflexion)(ATLEAST3TIMESunlesspainisverbalized)
8 While supporting the limb, moves joints gently, slowly, and smoothly through the range of motion, discontinuing exercise if client verbalizes pain
9 Signalingdeviceiswithinreachandbedisinlowposition
10 Aftercompletingskill,washeshands
34
peRfoRMs Modified passive Range of MoTion (pRoM) foR one shouldeR 1 Explainsprocedure,speakingclearly,slowly,anddirectly,
maintainingface-to-facecontactwheneverpossible 2 Privacyisprovidedwithacurtain,screen,ordoor 3 Instructsclienttoinformcandidateifpain
experiencedduringexercise 4 Supportsclient’supperandlowerarmwhile
performingrangeofmotionforshoulder 5 Raises client’s straightened arm from side position
upward toward head to ear level and returns arm down to side of body (flexion/extension) (AT LEAST 3 TIMES unless pain is verbalized). Supporting the limb, moves joint gently, slowly, and smoothly through the range of motion, discontinuing exercise if client verbalizes pain
6 Moves client’s straightened arm away from the side of body to shoulder level and returns to side of body (abduction/adduction) (AT LEAST 3 TIMES unless pain is verbalized). Supporting the limb, moves joint gently, slowly, and smoothly through the range of motion, discontinuing exercise if client verbalizes pain
7 Signalingdeviceiswithinreachandbedisinlowposition
8 Aftercompletingskill,washeshands
posiTions on side 1 Explainsprocedure,speakingclearly,slowly,and
directly,maintainingface-to-facecontactwheneverpossible
2 Privacyisprovidedwithacurtain,screen,ordoor 3 Beforeturning,lowersheadofbed 4 Raisessiderailonsidetowhichbodywillbeturned 5 Slowlyrollsontosideasoneunittowardraisedside
rail 6 Placesoradjustspillowunderheadforsupport 7 Candidatepositionsclientsothatclientisnotlying
onarm 8 Supportstoparmwithsupportivedevice 9 Placessupportivedevicebehindclient’sback10 Placessupportivedevicebetweenlegswithtopknee
flexed;kneeandanklesupported11 Signalingdeviceiswithinreachandbedisinlow
position12 Aftercompletingskill,washeshands
35
pRovides caTheTeR caRe foR feMale 1 Explainsprocedure,speakingclearly,slowly,and
directly,maintainingface-to-facecontactwheneverpossible
2 Privacyisprovidedwithacurtain,screen,ordoor 3 Beforewashing,checkswatertemperatureforsafety
andcomfortandasksclienttoverifycomfortofwater 4 Putsoncleanglovesbeforewashing 5 Placeslinenprotectorunderperinealareabefore
washing 6 Exposesareasurroundingcatheterwhileavoiding
overexposureofclient 7 Appliessoaptowetwashcloth 8 While holding catheter at meatus without tugging,
cleans at least four inches of catheter from meatus, moving in only one direction (i.e., away from meatus) using a clean area of the cloth for each stroke
9 While holding catheter at meatus without tugging, rinses at least four inches of catheter from meatus, moving only in one direction, away from meatus, using a clean area of the cloth for each stroke
10 Whileholdingcatheteratmeatuswithouttugging,driesatleastfourinchesofcathetermovingawayfrommeatus
11 Empties,rinses,anddriesbasin12 Afterrinsinganddryingbasin,placesbasinin
designateddirtysupplyarea13 Disposesofusedlinenintosoiledlinencontainerand
disposesoflinenprotectorappropriately14 Avoidscontactbetweencandidateclothingandused
linen15 Afterdisposingofusedlinenandcleaning
equipment,removesanddisposesofgloves(withoutcontaminatingself )intowastecontainerandwasheshands
16 Signalingdeviceiswithinreachandbedisinlowposition
36
pRovides fooT caRe on one fooT 1 Explainsprocedure,speakingclearly,slowly,and
directly,maintainingface-to-facecontactwheneverpossible
2 Privacyisprovidedwithacurtain,screen,ordoor 3 Beforewashing,checkswatertemperatureforsafety
andcomfortandasksclienttoverifycomfortofwater 4 Basinisinacomfortablepositionforclientandon
protectivebarrier 5 Putsoncleanglovesbeforewashingfoot 6 Client’sbarefootisplacedintothewater 7 Appliessoaptowetwashcloth 8 Liftsfootfromwaterandwashesfoot(including
betweenthetoes) 9 Footisrinsed(includingbetweenthetoes)10 Driesfoot(includingbetweenthetoes)11 Applieslotiontotopandbottomoffoot,removing
excess(ifany)withatowel12 Supportsfootandankleduringprocedure13 Empties,rinses,anddriesbasin14 Afterrinsinganddryingbasin,placesbasinin
designateddirtysupplyarea15 Disposesofusedlinenintosoiledlinencontainer16 Aftercleaningfootandequipment,anddisposingof
usedlinen,removesanddisposesofgloves(withoutcontaminatingself )intowastecontainerandwasheshands
17 Signalingdeviceiswithinreach
37
pRovides MouTh caRe 1 Explainsprocedure,speakingclearly,slowly,and
directly,maintainingface-to-facecontactwheneverpossible
2 Privacyisprovidedwithacurtain,screen,ordoor 3 Beforeprovidingmouthcare,clientisinupright
sittingposition(75-90degrees) 4 Putsoncleanglovesbeforecleaningmouth 5 Placesclothingprotectoracrosschestbeforeproviding
mouthcare 6 Securescupofwaterandmoistenstoothbrush 7 Beforecleaningmouth,appliestoothpasteto
moistenedtoothbrush 8 Cleans mouth (including tongue and surfaces of
teeth), using gentle motions 9 Maintainscleantechniquewithplacementof
toothbrush10 Candidateholdsemesisbasintochinwhileclient
rinsesmouth11 Candidatewipesmouthandremovesclothing
protector12 Afterrinsingtoothbrush,empty,rinseanddrythe
basinandplaceusedtoothbrushindesignatedbasin/container
13 Placesbasinandtoothbrushindesignateddirtysupplyarea
14 Disposesofusedlinenintosoiledlinencontainer15 Afterplacingbasinandtoothbrushindesignateddirty
supplyarea,anddisposingofusedlinen,removesanddisposesofgloves(withoutcontaminatingself )intowastecontainerandwasheshands
16 Signalingdeviceiswithinreachandbedisinlowposition
38
pRovides peRineal caRe (peRi-caRe) foR feMale 1 Explainsprocedure,speakingclearly,slowly,and
directly,maintainingface-to-facecontactwheneverpossible
2 Privacyisprovidedwithacurtain,screen,ordoor 3 Beforewashing,checkswatertemperatureforsafety
andcomfortandasksclienttoverifycomfortofwater 4 Putsoncleanglovesbeforewashingperinealarea 5 Placespad/linenprotectorunderperinealareabefore
washing 6 Exposesperinealareawhileavoidingoverexposureof
client 7 Appliessoaptowetwashcloth 8 Washes genital area, moving from front to back,
while using a clean area of the washcloth for each stroke
9 Using clean washcloth, rinses soap from genital area, moving from front to back, while using a clean area of the washcloth for each stroke
10 Driesgenitalareamovingfromfronttobackwithtowel
11 After washing genital area, turns to side, then washes and rinses rectal area moving from front to back using a clean area of washcloth for each stroke. Dries with towel
12 Repositionsclient13 Empties,rinses,anddriesbasin14 Afterrinsinganddryingbasin,placesbasinin
designateddirtysupplyarea15 Disposesofusedlinenintosoiledlinencontainerand
disposesoflinenprotectorappropriately16 Avoidscontactbetweencandidateclothingandused
linen17 Afterdisposingofusedlinen,andplacingused
equipmentindesignateddirtysupplyarea,removesanddisposesofgloves(withoutcontaminatingself )intowastecontainerandwasheshands
18 Signalingdeviceiswithinreachandbedisinlowposition
39
40
TRansfeRs fRoM bed To WheelchaiR using TRansfeR belT 1 Explainsprocedure,speakingclearly,slowly,and
directly,maintainingface-to-facecontactwheneverpossible
2 Privacyisprovidedwithacurtain,screen,ordoor 3 Beforeassistingtostand,wheelchairispositioned
alongsideofbed,atheadofbedfacingfootorfootofbedfacinghead
4 Beforeassistingtostand,footrestsarefoldeduporremoved
5 Beforeassistingtostand,bedisatasafelevel 6 before assisting to stand, locks wheels on
wheelchair 7 Beforeassistingtostand,checksand/orlocksbed
wheels 8 before assisting to stand, client is assisted to a
sitting position with feet flat on the floor 9 Beforeassistingtostand,clientiswearingshoes10 Beforeassistingtostand,appliestransferbeltsecurely
atthewaistoverclothing/gown11 Beforeassistingtostand,providesinstructionsto
enableclienttoassistintransferincludingprearrangedsignaltoalertwhentobeginstanding
12 Standsfacingclientpositioningselftoensuresafetyofcandidateandclientduringtransfer.Countstothree(orsaysotherprearrangedsignal)toalertclienttobeginstanding
13 Onsignal,graduallyassistsclienttostandbygraspingtransferbeltonbothsideswithanupwardgrasp(candidateshandsareinupwardposition)andmaintainingstabilityofclient’slegs
14 Assistsclienttoturntostandinfrontofwheelchairwithbackofclient’slegsagainstwheelchair
15 Lowersclientintowheelchair16 Positionsclientwithhipstouchingbackofwheelchair
andtransferbeltisremoved17 Positionsfeetonfootrests18 Signalingdeviceiswithinreach19 Aftercompletingskill,washeshands
41
scoRe RepoRTing
ExAm RESultSThe Nurse Aide Evaluator may not answer questionsabout your Score Report. If you have questions aboutyour Score Report, or the content of the examination,callPearsonVUEat (888)204-6207.Results will not be given over the telephone.
Written (or english or spanish Oral) Exam
AfteryoufinishtheWritten(orEnglishorSpanishOral)Examination, the Nurse Aide Evaluator will fax youranswer sheet for scoring. Within approximately ten (10)minutes (from the time the answer sheetwas faxed), youwillreceiveanofficialScoreReport.TheScoreReportwillindicatewhetheryouhavepassedorfailedtheWritten(orEnglishorSpanishOral)Examination.
Skills Evaluation
TheNurseAideEvaluatorwillalsofaxyourSkillsEvaluationresultsforscoring.AftertheNurseAideEvaluatorevaluatesyourperformance,heor shewill fax theSkillsEvaluationanswer sheet for scoring. Within approximately ten (10)minutes(fromthetimetheanswersheetwasfaxed),youwillreceiveanofficialScoreReport.TheScoreReportwillindi-catewhetheryouhavepassedorfailedtheSkillsEvaluation.
Occasionally,dueto technicaldifficulties,ScoreReportsmaynotbereceivedatthetestcenteronthedayoftesting.IfthishappensyouranswersheetwillbemailedovernighttoPearsonVUEforhandscoring.YourScoreReportwillthenbemailedouttoyouwithin5-7businessdaysaftertesting. For questions regarding delayed Score Reports,pleasecontactPearsonVUEat(888)204-6207.
42
FAiliNGIf you fail the Written (or English or Spanish Oral)Examination or the Skills Evaluation, your Score Reportwillprovideyouwithinformationonhowtore-takeeitheror bothparts of the evaluation.Anew examination fee isrequired each time you re-take any part of the NNAAPExamination.Tore-takeeitherorbothparts,youmustsub-mityourofficialScoreReportandare-takefeetoNACES.
Stateandfederalregulationsallowyouthree(3)attemptstopassboththeSkillsEvaluationandtheWrittenExamination.Ifyoushouldfaileitherpartorbothpartsthree(3)times,within two (2) years, you will be required to successfullycompleteastate-approvedtrainingprogramandre-takebothparts.Seepage3"ELIGIBILITY"forroutespecificrulesandregulations. Youmust take and pass both theWritten (orOral)ExaminationandtheSkillsEvaluationtobeplacedontheNorthCarolinaNurseAideIRegistry.
Ifyoureturntoschoolandhavenotcompletedtestingorpassedbothportionsof theexamination,youmust test(retest)BOTHportionsoftheexamination.
hoW to REAd A FAiliNG SCoRE REPoRtIf you do not pass the Skills Evaluation, you willreceive a Failing Score Report. The score report willlist thefive (5) skills that youperformed and a score ofSatisfactory or Unsatisfactoryforeachskill.AnyskillwithanUnsatisfactory result is considered a failed skill. Youmust receive a Satisfactory result on all five (5) skills topasstheSkillsEvaluation.
Use your failing Score Report as an aid in studying tore-taketheSkillsEvaluation.Afailedskillwillshowthereason for the failure. Youmay not have performed thestepsofaskillcorrectly,oryoumayhaveforgottenastep,especiallyaCriticalElementStep.
ThefailingScoreReportwillliststepsthatweremissedorincorrect—lookfornumbersprinteddirectlyunderaskillmarkedUnsatisfactory.Alistofalltheskillsandthestepsneededforeachskillcanbefoundinthishandbook.Findthe skill you failed, and study the steps, especially stepslistedasUnsatisfactoryonthescorereport.
Intheexampleonthenextpage,acandidatereceivedaresultofUnsatisfactoryon the skillHand Hygiene.Thenumbers1,5,and10printedbelowtheskillrefertostepsthatwere
43
missedorperformedincorrectly.Tostudyforre-takingtheSkills Evaluation, this candidate should turn to the SkillsListinginthishandbook,lookfortheHandHygieneskill,andreviewallthesteps,especiallysteps1,5,and10.
North Carolina NNAAP® Examination Results
Exam: Skills Result: Fail
Skills Performance:
Hand Hygiene 1, 5, 10
Unsatisfactory
Provides Fingernail Care On One Hand
Satisfactory
Measures and Records Blood Pressure
Satisfactory
Puts One Knee-High Elastic Stocking on Client
Satisfactory
Measures and Records Weight of Ambulatory Client
Satisfactory
A sample of a Failing Score Report
PASSiNGOnce you have passed bOTh the Written (or Englishor SpanishOral) Examination and the Skills Evaluation,yournamewillbesubmittedtotheNorthCarolinaNurseAideIRegistry.YoumayviewyournameontheRegistryby going to www.ncnar.org. If you have any questionsregardingyourlistingontheRegistryyoumaycontactthe North Carolina Division of Health Service Regulation,Monday through Friday from 9:00 a.m. to 3:00 p.m.(EST) at (919) 855-3969 or (919) 715-0562.
duPliCAtE SCoRE REPoRtIf you lose your Score Report or need a duplicate ScoreReport, orwould like a handscoring of yourWritten (orOral) Examination or Skills Evaluation, complete theRequest for Duplicate Score Report or Handscored Answer Sheet FormandmailittoPearsonVUE(seeAppendix A).
44
nuRse aide TesTing gRievance pRocess
oVERViEWEachcandidatehasarighttofileagrievancetocomplainor contest the results of their Nurse Aide Exam. TheNACES Plus Foundation, Inc. (NACES)will follow-uponeachgrievancewithinthirty(30)daysofreceiptofthecandidategrievanceletter.
Nogrievancewill be investigated if it isnot received inwritingbytheNACESPlusFoundation,Inc.
PRoCESSAll grievances must be in writing. The candidate mustprovide as much detail as possible in a grievance letterandforwardittotheNACESPlusFoundation,Inc.witha copyof the failed score reportwithin30daysof theirexamdate.
After receiptof the grievance letter, the appropriateRNAssociateProgramDirectorwillinvestigatethecomplaint.Once the investigation is complete, the RN AssociateProgramDirectorwilldraftaletterbacktothecandidateinforming him/her of the outcome of the investigation. If an error was made by the evaluator, NACES, or PearsonVUE, thecandidatewillbeallowed to retest atnoadditionalcost.
45
The RegisTRy
iNitiAl liStiNGYou must pass both the written and skills portions ofthe NNAAP competency evaluation to be listed on theNurseAide IRegistry.Once on the registry, your listingwill remain current for 24months from themonth youpassedbothpartsoftheNNAAPexam.Aletteradvisingyouofyourinitiallistingwillbemailedtotheaddressyouprovided on your exam application.Youwill not receiveanyotherformornotice.Addresscorrectionscanbemadeattheexamsite.Please check the letter for accuracy of your listing information and notify the registry if there are any errors.
ChANGE oF AddRESS oR NAmEThe North Carolina Nurse Aide I Registry must be kept informed of your current address and name.
There is no charge for changing your name or addresson the registry. You may notify the registry of a nameor address change by using the Name/Address ChangeReporting Form on the Nurse Aide I Registry website(www.ncnar.org). Alternately, you may call the Nurse AideIRegistryat (919)715-0562or(919)855-3969tochangeyourmailingaddressontheregistry.
Ifyournamechangesatanytimeafteryouareplacedonthe registry, you must send written notification of thischange to the registry. Please remember, however, thatif you changed your name, you MUST provide officialdocumentationalongwithyournotification.Writtendocu-mentationmust include1)aCOPYofyour signed socialsecuritycardwiththenewnameonit,AND2)aCOPYof a court-issued marriage certificate, divorce decree, orotherlegaldocumentthatdemonstratesthenamechange.Yournotificationmustincludeyourpreviousname,currentname,mailingaddress,phonenumber,andSocialSecuritynumber.All documents provided to the registry in sup-port of your name change MUST be official and legaldocuments.Any documents providedmay be subject toverificationwiththeissuingsource.
Failure to inform the registry of an address or name change may jeopardize your listing status.
liStiNG RENEWAlNurse aides on the North Carolina Nurse Aide I Registry must renew their registry listing to remain eligible for employment as a nurse aide.Tobeeligiblefor renewal based on employment, youmustwork forpay,performingnursing-relatedservices(asanurseaideormedicationaide),underRNsupervision,forat leasteight (8) hours every twenty-four (24) months. Thisemploymentmustbedocumented and reported to theNurse Aide I Registry prior to each listing expirationdate.Anewcompetencyexaminationisrequiredifyoudonotwork inaqualifyingposition fora24-monthperiodormore.
• Failure to inform the registry of an address or name change may jeopardize your listing status.
•It is your responsibility to renew. Current renewalprocedurescanbefoundathttps://www.ncnar.org.
•Thereisno fee forre-listingontheNorthCarolinaNurseAideIRegistry.
FormoreinformationregardingNurseAideIlist-ings and policies go to https://www.ncnar.org.AdditionalinformationisavailabletonurseaidesandnurseaidecandidatesattheFrequentlyAskedQuestions(FAQ)link.
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ord
erm
ade
paya
ble
to“
Pear
son
VU
EPr
oces
sing
Cen
ter”
. D
o no
tsen
dca
sh.W
rite
the
Pear
son
VU
Eid
entif
icat
ion
num
berf
ound
on
your
Sco
reR
epor
tory
ourS
ocia
lSec
urity
nu
mbe
ron
your
pay
men
t.
se
nd
To
: N
orth
Car
olin
aD
uplic
ate
Scor
eRe
port
/Han
dsco
reR
eque
st
Pe
arso
n V
UE
Proc
essi
ng C
ente
r
PO
Box
822
749
Ph
ilade
lphi
a,P
A1
9182
-274
5
plea
se c
oM
pleT
e bo
Th s
ides
of
This
fo
RM
aM
ou
nT
enc
lose
d:
$___
____
____
____
____
_
Nor
th C
arol
ina
Nur
se A
ide
Req
ues
t fo
r d
upl
icat
e Sc
ore
Rep
ort
or
ha
nd
sco
red
An
swer
Sh
eet
Appendix a
Please c
om
plete the fo
llow
ing
for
m w
ith yo
ur c
urren
t na
me a
nd
ad
dress. A
ll info
rm
atio
n m
ust be c
om
plete an
d
ac
cu
ra
te to en
sure pro
per proc
essing
.
Nam
e ________________________________________________________________________________________________________________
Street ________________________________________________________________________________________________________________
City ______________________________________________________________________
State ____________Zip_______________________
Tel.(______)_______________________PearsonVU
EIdentificationNum
berorSocialSecurityNum
ber________________________________
if the a
bov
e info
rm
atio
n w
as d
ifferent a
t the tim
e you
were tested
, please in
dic
ate o
rigin
al in
for
ma
tion
.
Nam
e ________________________________________________________________________________________________________________
Street ________________________________________________________________________________________________________________
City ______________________________________________________________________
State ____________Zip_______________________
Tel.(______)______________________________________
I hereby authorize Pearson VU
Etosend tomeattheaddress above aduplicate copy ofm
yScore Report orthehandscored results ofm
yWritten (orO
ral) Exam
ination orSkills Evaluation.
Your Signature _____________________________________________________________________Date ______________________________
please c
oM
pleTe boTh
sides o
f This fo
RM