California NURSE ASSISTANT€¦ · If you have not completed a CNA training program but you have...

California

NURSE ASSISTANTwritten (or oral) examination & skills evaluation

CANDIDATE HANDBOOKAugust 2013

PEARSON VUE

Quick RefeRence

Regional centeRs

Northern RegionRegional Testing Center

Mission College 3000 Mission College Blvd MS #19

Santa Clara CA 95054 (408) 855-5203 (408) 855-5216

Fax: (408) 855-5213http://missioncollege.org/depts/HWI/regional_testing.html

Northern Region covers the area from the Oregon border to Kern County, CA

Southern RegionRegional Testing Center

Golden West College 15744 Golden West Street

Forum I, Room 112A Huntington Beach, CA 92647

(714) 895-8708 Fax: (714) 895-8994

www.regionaltestingcenter.orgSouthern Region covers the area from

Oxnard, CA to the Mexican border

Hours of Operation Monday through Friday 8:00 a.m. - 4:00 p.m. (Pacific Time Zone)

Call the appropriate Regional Center to:• Obtainregistrationinformation• Canceland/orrescheduleanexamination• Arrangespecialexaminationrequestsandservices• Changeyourcurrentaddressornamebefore testing• Requestanexcusedabsence

Go to Regional Testing Center's website to:• ObtainNursingAssistantTrainingandAssessment

Program(NATAP)applications• Locateexaminationdatesandlocations

Northern Region’s website: http://missioncollege.org/depts/HWI/regional_testing.html

Southern Region’s website: www.regionaltestingcenter.org

PeaRSoN VUe® California NNAAP®

POBox13785 Philadelphia,PA19101-3785

(800) 475-8290Hours of Operation 8:00 a.m. – 5:00 p.m.

(Eastern Time Zone)

Call Pearson VUE to:• ObtaininformationregardingyourScoreReport• Changeyourcurrentaddressornameafter testing• RequestaduplicateScoreReport

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

• DownloadaCandidateHandbook• ViewRegionalTestSitetestingdates• DownloadaNursingAssistantPracticeWritten

ExaminationandSkillsCheckList• DownloadanApplication

CalifoRNia Department of Public Health

(CDPH)(916) 327-2445

Web:http://www.cdph.ca.govHours of Operation 8:00 a.m. – 5:00 p.m.

(Pacific Time Zone)

Call CDPH to:• Obtaininformationregardingrequirementsfor

initial licensing• Changeyourcurrentaddressornameafter testing• Obtaininformationregardingreciprocity• Obtainadditionalinformation

For applications and licensing requirements, go to:http://www.cdph.ca.gov/pubsforms/Pages/

CNAHHAProgram.aspx

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

Copyright©2012PearsonEducation,Inc.,oritsaffiliate(s). [email protected]

NNAAP®WrittenExamContentOutlineandPracticalSkillsListing Copyright©2010-2012NationalCouncilofStateBoardsofNursing,Inc.(NCSBN®).Allrightsreserved.

table of contents

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

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

eligibility .................................................................. 3

application and Scheduling ............................. 3FillingOutanApplication....................................... 3Exam Fees................................................................. 4Exam Scheduling...................................................... 4TestingLocations...................................................... 5Accommodations...................................................... 5

Cancellation and re-scheduling .................... 6Refunds.................................................................... 6AbsencePolicy.......................................................... 6Weather Emergencies................................................ 7

exam Day .................................................................. 7CheckingIn.............................................................. 7What to Bring.......................................................... 8ProperIdentification................................................. 8SecurityandCheating.............................................. 9TestingPolicies......................................................... 9 Lateness................................................................ 9 ElectronicDevices................................................ 9 StudyAids............................................................ 9 Eating/Drinking/Smoking................................... 10 Misconduct.......................................................... 10 Guests/Visitors..................................................... 10

The Written (or oral) exam ............................ 10Written Exam.......................................................... 10OralExam............................................................... 11

Written (or oral) exam Content outline ................................................. 12

Sample Questions ................................................ 13

self-assessment reading test ...................... 14-17continued on next page

The Skills evaluation ........................................ 18

WhattoExpect...................................................... 18 Setting................................................................ 18 Who Will Act as a Client?.................................. 18CandidateVolunteerRequirements......................... 18TheTasks................................................................ 19Recording a Measurement...................................... 20SampleRecordingSheetforMeasurementSkills..... 21 TipsfortheSkillsEvaluation.............................. 22

Skills listing .................................................... 23-38

Score Reporting .................................................. 39

Exam Results........................................................... 39 Written(orOral)Exam....................................... 39 SkillsEvaluation.................................................. 39Failing...................................................................... 39HowtoReadaFailingScoreReport...................... 40SampleofaFailingScoreReport............................ 40Passing..................................................................... 41DuplicateScoreReport............................................ 41

grievance process ............................................... 42

Overview................................................................ 42Process.................................................................... 42

The Registry ........................................................... 42

ChangeofAddressorName................................... 42Re-certification....................................................... 43LapsedCertification............................................... 43CertificationbyReciprocity................................... 43

california nurse assistant frequently asked questions ................. 44-47

appendix

Appendix A:RequestforDuplicateScoreReport orHandscoredAnswerSheetForm

Appendix B: ChangeofAddressorNameForm

intRoduction

This handbook is designed for candidates seeking nurseassistantcertificationinCalifornia.Itdescribestheprocess of applying for and taking the National Nurse AideAssessmentProgram(NNAAP®)Examination.

The Chancellor’s Office of the California CommunityColleges System (COCCC) has contracted with Pearson VUE, a nationally recognized leading providerof assessment services to regulatory agencies and nation-al associations. Pearson VUE will develop, score, andreport the results of the NNAAP® Examination for theCaliforniaNursing Assistant Registry.TheCOCCO hasalso designated selected colleges within the CommunityCollege System to serve as Regional Test CoordinationCenters (Regional Centers) to manage the administration of the examination. The Regional Centers are respon-sible for managing the candidate application process aswell as for contracting with evaluators to administer theexamination.Moreover, theRegionalCenters are respon-sibleforschedulingtestingdates,managingtestsites,andcoordinating the activities of nurse assistant candidates, PearsonVUE,andthestateofCalifornia.

NaTioNal NURSe aSSiSTaNT aSSeSSmeNT PRogRam (NNaaP®)TheNursingHomeReformAct,adoptedbyCongressaspartoftheOmnibusBudgetReconciliationActof1987(OBRA’87),wasdesignedtoimprovethequalityofcarein long-termhealth care facilities and todefine trainingandevaluationstandardsfornurseassistantswhoworkinsuchfacilities.Eachstate isresponsible for followingthetermsofthisfederallaw.The National Nurse Assistant Assessment Program(NNAAP®) is an examination programdesigned to deter-mine minimal competency to become a certified nurseassistant in your state. The NNAAP was developed bythe National Council of State Boards of Nursing, Inc.,(NCSBN) to meet the nurse assistant evaluation require-mentoffederalandstatelawsandregulations.PearsonVUEistheauthorizedadministratoroftheNNAAPinyourstate.TheNNAAPExaminationisanevaluationofnurseassis-tant-relatedknowledge,skills,andabilities.TheNNAAPExamination is made up of both a Written (or Oral)

1

Continued next page

ExaminationandaSkillsEvaluation.ThepurposeoftheNNAAPExaminationistotestthatyouunderstandandcansafelyperformthejobofanentry-levelnurseassistant.

exam oVeRVieWThetwopartsof theNNAAPExamination process, theWritten (orOral)Examinationand theSkillsEvaluation,willbeadministeredonthesameday.Youmustpassbothparts inorder tobecertifiedand listedon theCaliforniaNursingAssistantRegistry.YoumustpassboththeWritten(or Oral) Examination and the Skills Evaluation withintwo(2)yearsaftercoursecompletionandCDPHapprovalin order to obtain your nurse assistant certification inCalifornia.

TheWrittenExaminationconsistsofseventy(70)multiple-choice questions written in English. Sample examinationquestionsareprovidedinthishandbook.

AnOralExaminationmaybetakeninplaceoftheWrittenExamination if you have difficulty reading English. TheOral Examination consists of sixty (60) multiple-choicequestionsandten(10)multiple-choicereadingcomprehen-sionquestionsprovidedonacassettetape.YouwillbeaskedtolistentoacassettetapeoftheOralExaminationandfol-lowalonginthetestbookletasthequestionsarereadaloudonthetape.IfyouwanttotaketheOralExamination,youmustrequestitwhenyousubmityourapplication.

At the Skills Evaluation you will be asked to performfive(5)randomlyselectednurseassistant skills.Youwillbe given twenty-five (25) minutes to complete the five(5) skills.Youwillbe ratedon these skillsbyaNursingAssistant Evaluator. You must successfully demonstratefive(5)skillsinordertopasstheSkillsEvaluation.Acom-pletelistingoftheskillsisshownonpages23to38.

See The Written (or Oral) Exam and The Skills Evaluation formoredetailsabouttheNNAAPExamination.

2

eligibility

AllstudentnurseassistantcandidatesapplyingtotaketheNNAAP Examination in Californiamust have success-fullycompletedaDepartmentofPublicHealth-approvednurseassistanttrainingprogram.Youareallowedtwo(2)yearsfromyourtrainingprogramcompletiondatetopassthenursingassistantexamination.IfyoudonotpasstheNNAAPExaminationwithinatwo-yearperiod,youwillberequiredtore-trainbeforeyouwillbeallowedtotaketheexaminationagain.

IfyouhavenotcompletedaCNAtrainingprogrambutyouhavehadothertraining,pleasecontacttheCaliforniaDepartmentofPublicHealthat(916)327-2445todeter-mineyoureligibility.

application and scheduling

filliNg oUT aN aPPliCaTioNYoumay get theNNAAP registration application fromthePearsonVUEorRegionalTestingCenter’sweb site.NOTE:IfyouareapprovedbyCaliforniaDepartmentofPublicHealth(CDPH),pleasesendcopyofapprovallet-ter(932form)andregistrationapplicationtotheregionaltestingcenter.• You are responsible for completing the registration

application.

• Ifyouneedhelporhaveanyquestionsabouttheappli-cation,pleasecontacttheappropriateRegionalCenter.You may also contact your nursing assistant trainingprogramforassistancewiththeapplication.

• All required documentation (applications, fee in theformofcashiercheckormoneyorder)mustbereceivedten(10)businessdaysbeforetheexaminationdate.

• Mailbothcompletedapplicationsandappropriatefeestogether in one envelope to the appropriate RegionalCenter (see Quick Referenceforaddress).

3

exam feeSThe fees listed below have been established for theNNAAP ExaminationinCalifornia.

exam feeS

Written Examination & SkillsEvaluation both $90

OralExamination& SkillsEvaluation both $105

Written Examination oNly re-test $35

OralExaminationoNly re-test $50

SkillsEvaluationoNly re-test $55

The first time you test, you must schedule both the Written (or Oral) Examination and the Skills Evaluation.

Payment must be made in the form of a money order, cashier’s check, or company check made payable to the college that is associated with the appropriate Regional Center.Evenifitisfromyouremployer,themoneyorder,certifiedcheck,orcompanycheckmustdisplayyournameso it canbeapplied toyourexamination. Ifyouarenotcurrentlyemployedinanursinghome,youmaypaythefee yourself. Company checks may pay for more thanone candidate. Personal checks and cash will not be accepted. Fees are non-refundable and non-transferableoncesubmittedtoRegionalCenterbecausetheycovertheadministrativecostsofregistrationandtesting.

exam SCheDUliNg Once the Regional Center receives your applications,requireddocuments,andfees,theywillscheduleyoufortesting.Youwillnotbescheduledtotestuntilallrequiredmaterialsarereceived.

4

TeSTiNg loCaTioNSThe NNAAP Examination is given by COCCC at Regional Test Sites. Check the Pearson VUE websiteat www.pearsonvue.com for the testing locations, titled California Test Sites.

Current schedule of examination dates and locations for for the Northern region are available at: www.missioncollege.org/depts/HWI/regional_testing.html and for the Southern Region at: www.regionaltestingcenter.org

aCCommoDaTioNSPearsonVUEandCOCCCcomplieswiththeprovisionsof theAmericanswithDisabilitiesAct as amended.Thepurposeofaccommodationsistoprovidecandidateswithfullaccesstothetest.Accommodationsarenotaguaran-teeofimprovedperformanceortestcompletion.PearsonVUE provides reasonable and appropriate accommoda-tions to individuals with documented disabilities whodemonstrateaneedforaccommodations.

Ifyouhaveadisability,youmustaskforspecialarrange-ments for testingwhen you apply. All requestsmust beapproved in advance by COCCC. Be sure to explainthe specific type of help you need and enclose proof ofthe need (diagnosed disability) from your health careprovider.NursingAssistantEvaluatorsadministeringtheWritten(orOral)ExaminationandtheSkillsEvaluationwillbepreparedtomeettheneedsofnurseassistantcan-didateswhohavedisablingconditions.

5

cancellation and Re-scheduling

If you are unable to attend your scheduled examination,you MUST call the regional test coordination center at least two (2) business daysbeforetheexaminationdatetore-schedule(SaturdayandSundayandnationalholidaysarenotconsideredbusinessdays).Ifyoudonotcalltheregion-al test site at least two (2) business daysinadvanceofyourexaminationdatetore-scheduleyouwillberequiredtopayanadditionalfeeof$25forthewrittenandanadditional$25fortheskillsevaluationatthetimeofyourrescheduledtest and your fee will NoT be refunded and cannot betransferred toanewexaminationdate.Youmaynotgiveyourexaminationdatetoanotherperson.

Ifyounotify theRegionalCenterwithinat48hoursofyour examinationdate there is nopenalty and your feemaybetransferredtoyournewexaminationdateforthefirsttimeonly. Allsubsequentcancellationsorabsenceswillautomaticallybechargedthe$25reschedulingfeeperexam.Ifyouremployerpaidforyourexaminationfee,youshouldtellthemaboutmissingtheexamination.Letthemknowhowyouhavehandledre-schedulingandwhenyouplantore-test.

RefUNDSOncepaymentofexamfeesisreceived,No REFUNDS WIll BE ISSUED.

abSeNCe PoliCyIfyouappliedtotakethetestandpaidtherequiredfeebut did not show up to take the test, yourmoney willNoTberefunded. There are no refunds of examina-tion fees. Sinceunexpected situations sometimesoccur,the Regional Center will consider excusing an absencefromascheduledexaminationincertainsituations.

Acceptable reasons for re-scheduling are as follows:• Illnessofyourselforamemberofyourimmediate

family• Deathinthefamily• Disablingtrafficaccident• Courtappearanceorjuryduty• Militaryduty• Weatheremergency

6

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

ThedecisionoftheRegionalCenterwillbefinalregardingwhetheranabsenceisexcusedandwhetheryoumustpaytheexaminationfeeifyouareabsent.

WeaTheR emeRgeNCieSExaminations will be delayed or cancelled only in emer-gencies. If severeweather or a natural disastermakes thetestcenter inaccessibleorunsafe, theexaminationwillbedelayedorcancelled.Iftheexaminationhasbeencancelled,youwillbere-scheduledforthenextavailableexaminationatthatsite.

exam day

CheCkiNg iNYoumustarrive15minutespriortoyourscheduledtimefor BOTH the written examination and for the skillsevaluation. If you are late for the written examinationyouwillnotbeallowedtotestandyourfeeswillnotberefunded.Ifyoumissedyourwrittenexaminationandarescheduledforaskillsevaluation,pleasearrive15minutespriortoyourscheduledtime.SkillsEvaluationtesttimesareapproximate.You will be required to check in for both the writtenexamination and for the skills evaluation. You will berequiredtopresentproperidentification.

7

WhaT To bRiNgYoumust have the following items with you when youtaketheexamination:• Two(2)formsofcurrent(notexpired)signatureidentifi-

cation:onemustbegovernment-issuedphotoidentifica-tion,andtheothermustbeyouroriginalSocialSecuritycard.SeeProper Identificationbelow.

• Two(2)No.2pencils(sharpened)• Eraser• YouroriginalSocialSecuritycard• Onegovernment-issuedlegalphotoidentificationcard

thatincludesyoursignature• ApplicationforNurseAssistantCertification(HS283B)

orCDPHApprovalLetter• Watchwithasecondhand• Non-skid footwear. Dress professionally, uniform

preferred.• Optional Item: Translation Dictionary (Translations

only,nodefinitions)No other materials will be allowed.

YouMUSThavetheaboveitemswithyouonthedayoftesting.Ifyoudonotbringtheaboveitemswithyouonthedayoftesting,youwillNoTbeallowedtotestandyourexaminationfeewillNoTbereturned.You may bring a paper English translation dictionarywhichwillbecheckedfornotationsandanyothersecurityissues.Noelectronicdevicesofanykindarepermitted.

PRoPeR iDeNTifiCaTioNYou are required to bring your original Social Securitycard and one form of legal photo identification thatincludesyoursignaturewhenreportingtotaketheexami-nation. This is a mandatory requirement issued by theCaliforniaDepartmentofPublicHealth(effective January 2002).PhotocopiesofidentificationwillNoTbeaccept-ed.Examplesofproperidentificationinclude:

• Driver’slicense• DMVIdentificationcard• Passport• Alienregistrationcard

Thenameonbothformsofyouridentificationmustbethesameasthenameyouusedontheapplicationtoregisterfortheexamination.If you do not bring proper identification, you will not be allowed to test and your examination fee will not be refunded.

8

SeCURiTy aND CheaTiNgIf you give help to or receive help from anyone duringthe examination, the examination will be stopped. TheincidentwillbereportedtotheCaliforniaDepartmentofPublicHealth for review, and your examinationwill bescoredasanautomaticfailure.Pleasenotethatallexaminationquestions,eachformoftheexamination,andallotherexaminationmaterialsarecopy-righted by, the property of, or licensed toPearsonVUE.Consequently,anydistributionoftheexaminationcontentormaterialsthroughanyformofreproduction,orthroughoral orwritten communication, is strictly prohibited andpunishablebylaw.Anyone who removes or tries to remove examination materials or information from the test site will be prosecuted.

TeSTiNg PoliCieSThefollowingpoliciesareobservedateachtestcenter.

LatenessPlantoarriveaboutfifteen(15)minutesbeforetheexami-nation starts. If youare late for your scheduled examina-tion, or do not bring all of your requiredmaterials, youwillNoTbeallowedtotestandyourexaminationfeewillNoTbereturned.IfyouarelatefortheWritten(orOral)Examination,butarriveontimefortheSkillsEvaluation,youwillbeallowedtotaketheSkillsEvaluation.IfyouarelateforyourSkillsEvaluationordonotbringallyourrequiredmaterials,youwillNoTbeallowedtotestandyouwillberequiredtore-applyandpayanotherexaminationfee(seeCancellationformoredetails).

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

Study AidsYou are not permitted to take personal belongings suchasbriefcases, largebags, studymaterials, extrabooks,orpapers into the examination room. Any such materialsbroughtintotheexaminationroomwillbecollectedandreturned toyouwhenyouhavecompleted theexamina-tion.PearsonVUEisnotresponsibleforlostormisplaceditems.

9

Eating/Drinking/Smoking

Youarenotpermittedtoeat,drink,orsmokeduringtheexamination.

Misconduct

If you are discovered causing a disturbance of any kindor engaging in any kind of misconduct, you will bedismissed from the examination and the incident willbe reported to the appropriateRegionalTestingCenter.Decisionsregardingdisciplinarymeasuresaretherespon-sibilityofthisagency.

Guests/Visitors

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

the WRitten (oR oRal) exam

WRiTTeN examTheNursingAssistantEvaluatorwill handoutmaterialsandgiveinstructionsfortakingtheWrittenExamination.TheWrittenExaminationhasseventy(70)multiple-choicequestions. You will have two (2) hours to complete theWrittenExamination.Youwillbe toldwhenfifteen (15)minutesremaininordertofinish.Fillinonlyone(1)boxontheanswersheetforeachquestion.MarkingsinthetestbookletwillNoT be accepted as answers.Your answersmust appear on the separate answer sheet. Sample ques-tionsfortheWrittenExaminationarelocatedonpage13.

10

oRal examAnOralExaminationmaybetakeninplaceoftheWrittenExamination if youhavedifficulty readingEnglish.YoumustrequestanOralExaminationwhenfillingoutyourapplication.TheOralExaminationisprovidedonacas-settetape.Acassetteplayerandearphonesareprovidedatthetestcenter.YouwillbeaskedtolistentoatapeoftheOralExaminationandfollowalonginthetestbookletasthequestionsarereadaloudonthetape.

The Oral Examination consist of two (2) parts, andyou must pass both parts in order to pass the OralExamination.ThefirstpartoftheOralExaminationhassixty (60)multiple-choicequestions.Eachof theseques-tionsisreadtwice.Aseachquestionisread,youwillbeasked tochoose thecorrectanswerandmark itonyouranswersheet.

The second part of the Oral Examination has ten (10)multiple-choicequestions.Thesequestionstestyourabil-itytospeakaminimumamountofEnglishbyrecognizingcommonwordsusedasanurseassistantinlong-termcarefacilities.Eachwordisreadthree(3)times.Youareaskedtomatch theword you hear on the tape to thewrittenwordinthetestbooklet.Asyoufindthematch,youmarkyouranswerontheanswersheet.

TheOralExamination takes two (2)hours to complete.You will be told when fifteen (15) minutes remain inorder to finish. Fill in only one (1) box on the answersheetforeachquestion.Youmaywriteinthetestbooklet,butmarkings in the testbookletwillNoT be acceptedas answers. Your answers must appear on the separateanswersheet.

11

WRitten (oR oRal) exam content outline

The currentNNAAP® Examination ContentOutline 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

12

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) air mattress(C) emesisbasin(D) restraint

3. When caring for a dying client, the nursing assistant 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 nursing assistant should always note:(A) thelasttimetheclienthadabackrub(B) anychangeintheclient'sskin(C) client'sweight(D) amountoflotionused

6. How should the nursing assistant communicate with a client who has a hearing loss?(A) facetheclientwhenspeaking(B) repeatthestatement(C) shout so that the client can hear(D) useahigh-pitchedvoice

Correct Answers

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

13

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,checkyouranswersusingtheanswerkeyonpage17.

3. Countupthenumberofcorrectanswers.

4. Ifyourscoreislessthan17,youmayhavedifficultyreading the Written Examination and should con-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

14

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) 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

15

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) a garden(D) ahospital(E) asupermarket

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

16

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) driving a car

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.

17

the skills evaluation

WhaT To exPeCT

Setting

TheSkillsEvaluationissetuptoresembleanactualcare-givingsituation.TheSkillsEvaluationareawilllooksimilartoyourworksetting.Itwillhavealltheequipmentneces-sary to perform the assigned skills.The Skills EvaluationwillbeadministeredbyaNurseAssistantEvaluator.Beforeyour skills evaluationbegins, theevaluatorwill showyouwhere equipment is located and answer questions aboutoperatingtheequipment.

Who Will Act as a Client?

Thepartofthe“client”willbeplayedbyacandidatewhovolunteerstoactasaweakenedelderlyperson.Whileyouperformtheskills,speaktothecandidatevolunteerasyouwould speak to an actual client in anurse assistantworksetting.Youareencouragedtospeaktothecandidatevol-unteernotonlybecauseit ispartofqualitycare,butalsobecauseitwillhelpyoutorelaxasyouperformtheskills.

CaNDiDaTe VolUNTeeR ReQUiRemeNTSYouwillneedtoactasacandidatevolunteerforanothernurse assistant’s Skills Evaluation and play the role of anursinghomepatient(client).Theevaluatorwillgiveyouverbalinstructionsthatwilldescribehowyoushouldactinperformingtheroleoftheclient.

You must wear flat, slip-on, non-skid shoes; a loose-fitting topwith short sleeves thatcanbe rolledup to theshoulder,or tank top; and loosefittingpants that canberolledup.Youwillberequiredtoputagownonoveryourclothing.Innocasemaycandidatesremoveclothingdowntoundergarments.

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

18

Forinfectioncontrolpurposes,youshouldnotcometothetestsitewithopenareas/soresontheskin.Candidateswithanyopenareasorsoresontheirskinshouldrescheduletheirskillstesttoalaterdateaftertheirskinfullyheals.

The TaSkSTheNNAAPSkillsListcontainsalloftheskillsthatyoumaybeaskedtodemonstrateduringtheSkillsEvaluation.Eachskillrepresentsataskthatyouwillbeaskedtoper-forminyourjobandhasbeenbrokendownintoaseriesofsteps.

See pages 23-38 for the complete skills listing.

Astepthatishighlightedinbold type is called a Critical 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 AssistantEvaluatorwillgiveyouaninstructioncardthatwilllistthefive(5)skillsselectedforyoutoperform.Hand-washingwillalwaysbeoneoftheskillstobeperformed.Theremainingfour(4)skillsarerandomlychosenfromthecompletesetofskillslistingsonpages23to38ofthishandbook.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)andyoufailtosaywhen the corrected step should be performed, you will not receivecreditforthecorrection.

19

Onceyoubeginanewskill,youmaynotgobacktocor-rect a previous skill.TheNurseAssistantEvaluatorwillnot answer questions during the Skills Evaluation andwillnottellyouwhetheryouperformedaskillcorrectly.Youmaynot receivehelp fromanyoneduring theSkillsEvaluation.Ifyoudohaveanyquestions,pleaseaskthembeforetheSkillsEvaluationbegins.One(1)ofthefour(4)randomly-selectedskillswillincludea measurement skill (see the section below, Recording A Measurement, for more information regarding measure-mentskills).

You must successfully complete five (5) out of the five (5) skills in the skill form to pass the Skills Evaluation. Youwillhavetwenty-five(25)minutestodemonstrateallfive(5)skills.

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

ReCoRDiNg a meaSURemeNTTheNNAAPSkillsEvaluationrequireseverycandidatetoperformatleastonemeasurementskill,suchasbloodpres-sure,radialpulse,respirations,urineoutput,orweight.Youwillbegivena special form,calledaRecordingSheet forMeasurementSkills,towritedown,orrecord, the measure-ment.Forexample,ifperformingtheMeasures and Records Blood Pressureskill,youwillwritethecompletesystolicanddiastolicpressuresofyourbloodpressurereadinginaboxlabeledCandidateResults.

Onthefollowingpageisacopyoftherecordingsheetthatwillbeusedduringtheskillsexam.Thecandidatemustrecordhis/herresultsintheCandidateResultsboxonthissheet.Thissheetwillbeusedtorecordtheresultsofthefollowingmeasurementskills:

• MeasuresandRecordsBloodPressure• MeasuresandRecordsWeightof

AmbulatoryClient• MeasuresandRecordsUrinaryOutput• CountsandRecordsRadialPulse• CountsandRecordsRespirations

20

21

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 shownonpage21of this hand-book.YouareencouragedtobecomefamiliarwiththeRecordingSheetbeforeyourscheduledtestdate.

• Youmustknowhowtooperatebothastandingandanon-digitalbathroomscaleandmustknowhowtosetbothtypesofscalestozero.

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

• Itisimportantforyoutoplacethecallsignalwithintheclient’sreachwheneveryouleavetheclient.

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

22

skills listing

The 22 skills that follow are arranged in alphabeticalorder,exceptfortheHand Hygiene (Hand Washing)skill.HandHygiene is listedfirstasa reminderof the impor-tanceofperformingthis skillbeforeallother skills.Thenumbered lines below 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

23

Skill continues

7 Movesfootandleggentlyandnaturally,avoidingforceandover-extensionoflimbandjoints

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

9 Signalingdeviceiswithinreachandbedisinlowposition

10 Aftercompletingskill,washhands

assists to ambulate using tRansfeR belt 1 Explainsprocedure,speakingclearly,slowly,and


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

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

position with feet flat on the floor 6 Beforeassistingtostand,appliestransferbeltsecurely

atthewaistoverclothing/gown 7 Beforeassistingtostand,providesinstructionstoenable

clienttoassistinstandingincludingprearrangedsignaltoalertclienttobeginstanding

8 Standsfacingclientpositioningselftoensuresafetyofcandidateandclientduringtransfer.Countstothree(orsaysotherprearrangedsignal)toalertclienttobeginstanding

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

10 Walksslightlybehindandtoonesideofclientforadistanceoften(10)feet,whileholdingontothebelt

11 Afterambulation,assistsclienttobedandremovestransferbelt


13 Aftercompletingskill,washhands

24

assists With use of bedpan 1 Explainsprocedurespeakingclearly,slowly,and


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

contaminatingself )intowastecontainerandwasheshands

7 Afterpositioningclientonbedpanandremovinggloves,raisesheadofbed

8 Toilettissueiswithinreach 9 Handwipeiswithinreachandclientisinstructedto

cleanhandswithhandwipewhenfinished10 Signalingdevicewithinreachandclientisaskedto

signalwhenfinished11 Putsoncleanglovesbeforeremovingbedpan12 Headofbedisloweredbeforebedpanisremoved13 Avoidsoverexposureofclient14 Emptiesandrinsesbedpanandpoursrinseintotoilet15 Afterrinsingbedpan,placesbedpanindesignated

dirtysupplyarea16 Afterplacingbedpanindesignateddirtysupply

area,removesanddisposesofgloves(withoutcontaminatingself )intowastecontainerandwasheshands


cleans uppeR oR loWeR dentuRe 1 Putsoncleanglovesbeforehandlingdenture 2 Bottomofsinkislinedand/orsinkispartiallyfilled

withwaterbeforedentureisheldoversink 3 Rinsesdentureinmoderatetemperaturerunning

waterbeforebrushingthem 4 Appliestoothpastetotoothbrush 5 Brushessurfacesofdenture 6 Rinsessurfacesofdentureundermoderate

temperaturerunningwater 7 Beforeplacingdentureintocup,rinsesdenturecup

and lid

25Skill continues

8 Placesdentureindenturecupwithmoderatetemperaturewater/solutionandplaceslidoncup

9 Rinsestoothbrushandplacesindesignatedtoothbrushbasin/container

10 Maintainscleantechniquewithplacementoftoothbrushanddenture

11 Sinklinerisremovedanddisposedofappropriatelyand/orsinkisdrained

12 Afterrinsingequipmentanddisposingofsinkliner,removesanddisposesofgloves(withoutcontaminatingself )intowastecontainerandwasheshands

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


2 Placesfingertipsonthumbsideofclient’swristtolocateradialpulse

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

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

counts and RecoRds RespiRations 1 Explainsprocedure(fortestingpurposes),speakingclearly,

slowly,anddirectly,maintainingface-to-facecontactwheneverpossible

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

breaths of evaluator’s reading

26

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

through each sleeve 3 Fastenstheneckopening 4 Securesgownatwaistmakingsurethatbackofclothing

iscoveredbygown(asmuchaspossible) 5 Puts on gloves 6 Cuffsofglovesoverlapcuffsofgown 7 Before removing gown, with one gloved hand,

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

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

9 Disposesofglovesintodesignatedwastecontainerwithoutcontaminatingself

10 Afterremovinggloves,unfastensgownatneckandwaist

11 Afterremovinggloves,removesgownwithouttouchingoutsideofgown

12 Whileremovinggown,holdsgownawayfrombodywithouttouchingthefloor,turnsgowninwardandkeepsit inside out

13 Disposesofgownindesignatedcontainerwithoutcontaminatingself

14 Aftercompletingskill,washeshands

dResses client With affected (Weak) Right aRm 1 Explainsprocedure,speakingclearly,slowly,and


2 Privacyisprovidedwithacurtain,screen,ordoor 3 Askswhichshirthe/shewouldliketowearanddresses

him/herinshirtofchoice 4 Whileavoidingoverexposureofclient,removesgown

fromtheunaffectedsidefirst,thenremovesgownfromtheaffectedsideanddisposesofgownintosoiledlinen container

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

27

Skill 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,looksatnamecardontrayandasksclient to state name

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

28

gives modified bed bath (face and one aRm, hand and undeRaRm) 1 Explainsprocedure,speakingclearly,slowly,and


2 Privacyisprovidedwithacurtain,screen,ordoor 3 Removesgownandplacesinsoiledlinencontainer,

whileavoidingoverexposureoftheclient 4 Beforewashing,checkswatertemperatureforsafety

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

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

7 Driesfacewithtowel 8 Exposesonearmandplacestowelunderneatharm 9 Appliessoaptowetwashcloth10 Washesarm,hand,andunderarmkeepingrestofbody

covered 11 Rinses and dries arm, hand, and underarm12 Movesbodygentlyandnaturally,avoidingforceand

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

designateddirtysupplyarea16 Disposesoflinenintosoiledlinencontainer17 Avoidscontactbetweencandidateclothingandused

linens 18 Afterplacingbasinindesignateddirtysupplyarea,and

disposingofusedlinen,removesanddisposesofgloves(withoutcontaminatingself )intowastecontainerandwasheshands


29

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


2 Beforeusingstethoscope,wipesbell/diaphragmandearpiecesofstethoscopewithalcohol

3 Client’sarmispositionedwithpalmupandupperarmisexposed

4 Feelsforbrachialarteryoninneraspectofarm,atbendofelbow

5 Placesbloodpressurecuffsnuglyonclient’supperarm,withsensor/arrowoverbrachialarterysite

6 Earpiecesofstethoscopeareinearsandbell/diaphragmisoverbrachialarterysite

7 Candidateinflatescuffbetween160mmHgto180mmHg.Ifbeatheardimmediatelyuponcuffdeflation,completelydeflatecuff.Re-inflatecufftonomore than 200 mm Hg

8 Deflatescuffslowlyandnotesthefirstsound(systolicreading), and lastsound(diastolicreading)(Ifrounding needed, measurements are rounded UP 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

30

measuRes and RecoRds uRinaRy output 1 Putsoncleanglovesbeforehandlingbedpan 2 Poursthecontentsofthebedpanintomeasuring

containerwithoutspillingorsplashingurineoutsideofcontainer

3 Measurestheamountofurineateyelevelwithcontaineronflatsurface

4 Aftermeasuringurine,emptiescontentsofmeasuringcontainer into toilet

5 Rinsesmeasuringcontainerandpoursrinseintotoilet 6 Rinsesbedpanandpoursrinseintotoilet 7 Afterrinsingequipment,andbeforerecording

output,removesanddisposesofgloves(withoutcontaminatingself )intowastecontainerandwasheshands

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

measuRes and RecoRds Weight of ambulatoRy client 1 Explainsprocedure,speakingclearly,slowly,and


2 Clienthasshoesonbeforewalkingtoscale 3 Beforeclientstepsonscale,candidatesetsscaletozero

thenobtainsclient’sweight 4 Whileclientstepsontoscale,candidatestandsnextto

scaleandassistsclient,ifneeded,ontocenterofscale 5 Whileclientstepsoffscale,candidatestandsnext

toscaleandassistsclient,ifneeded,offscalebeforerecordingweight

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

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

31

peRfoRms modified passive Range of motion (pRom) foR one knee and one ankle 1 Explainsprocedure,speakingclearly,slowly,and


2 Privacyisprovidedwithacurtain,screen,ordoor 3 Instructsclienttoinformcandidateifpainis

experiencedduringexercise 4 Supportslegatkneeandanklewhileperformingrange

ofmotionforknee 5 Bendsthekneeandthenreturnslegtoclient’snormal

position(extension/flexion)(ATLEAST3TIMESunlesspainisverbalized)

6 Supportsfootandankleclosetothebedwhileperformingrangeofmotionforankle

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

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



32

peRfoRms modified passive Range of motion (pRom) foR one shouldeR 1 Explainsprocedure,speakingclearly,slowly,anddirectly,

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

experiencedduringexercise 4 Supportsclient’supperandlowerarmwhile

performingrangeofmotionforshoulder 5 Raises client’s straightened arm from side position

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

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



positions on side 1 Explainsprocedure,speakingclearly,slowly,and


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

rail 6 Placesoradjustspillowunderheadforsupport 7 Candidatepositionsclientsothatclientisnotlying

on arm 8 Supportstoparmwithsupportivedevice 9 Placessupportivedevicebehindclient’sback10 Placessupportivedevicebetweenlegswithtopknee

flexed;kneeandanklesupported11 Signalingdeviceiswithinreachandbedisinlow

position12 Aftercompletingskill,washeshands

33

pRovides catheteR caRe foR female 1 Explainsprocedure,speakingclearly,slowly,and


2 Privacyisprovidedwithacurtain,screen,ordoor 3 Beforewashing,checkswatertemperatureforsafety

andcomfortandasksclienttoverifycomfortofwater 4 Putsoncleanglovesbeforewashing 5 Placeslinenprotectorunderperinealareabefore

washing 6 Exposesareasurroundingcatheterwhileavoiding

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

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

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

10 Whileholdingcatheteratmeatuswithouttugging,driesatleastfourinchesofcathetermovingawayfrommeatus

11 Empties,rinses,anddriesbasin12 Afterrinsinganddryingbasin,placesbasinin

designateddirtysupplyarea13 Disposesofusedlinenintosoiledlinencontainerand

disposesoflinenprotectorappropriately14 Avoidscontactbetweencandidateclothingandused

linen 15 Afterdisposingofusedlinenandcleaning

equipment,removesanddisposesofgloves(withoutcontaminatingself )intowastecontainerandwasheshands


34

SKILL NOT

TESTED

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



andcomfortandasksclienttoverifycomfortofwater 4 Basinisinacomfortablepositionforclientandon

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

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

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

designateddirtysupplyarea15 Disposesofusedlinenintosoiledlinencontainer16 Aftercleaningfootandequipment,anddisposingof

usedlinen,removesanddisposesofgloves(withoutcontaminatingself )intowastecontainerandwasheshands

17 Signalingdeviceiswithinreach

35

pRovides mouth caRe 1 Explainsprocedure,speakingclearly,slowly,and


2 Privacyisprovidedwithacurtain,screen,ordoor 3 Beforeprovidingmouthcare,clientisinupright

sittingposition(75-90degrees) 4 Putsoncleanglovesbeforecleaningmouth 5 Placesclothingprotectoracrosschestbeforeproviding

mouth care 6 Securescupofwaterandmoistenstoothbrush 7 Beforecleaningmouth,appliestoothpasteto

moistenedtoothbrush 8 Cleans mouth (including tongue and surfaces of

teeth), using gentle motions 9 Maintainscleantechniquewithplacementof

toothbrush10 Candidateholdsemesisbasintochinwhileclient

rinses mouth 11 Candidatewipesmouthandremovesclothing

protector12 Afterrinsingtoothbrush,empty,rinseanddrythe

basinandplaceusedtoothbrushindesignatedbasin/container

13 Placesbasinandtoothbrushindesignateddirtysupplyarea

14 Disposesofusedlinenintosoiledlinencontainer15 Afterplacingbasinandtoothbrushindesignateddirty

supplyarea,anddisposingofusedlinen,removesanddisposesofgloves(withoutcontaminatingself )intowastecontainerandwasheshands


36

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



andcomfortandasksclienttoverifycomfortofwater 4 Putsoncleanglovesbeforewashingperinealarea 5 Placespad/linenprotectorunderperinealareabefore

washing 6 Exposesperinealareawhileavoidingoverexposureof

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

while using a clean area of the washcloth for each stroke

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

10 Driesgenitalareamovingfromfronttobackwithtowel

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

12 Repositionsclient13 Empties,rinses,anddriesbasin14 Afterrinsinganddryingbasin,placesbasinin

designateddirtysupplyarea15 Disposesofusedlinenintosoiledlinencontainerand

disposesoflinenprotectorappropriately16 Avoidscontactbetweencandidateclothingandused

linen 17 Afterdisposingofusedlinen,andplacingused

equipmentindesignateddirtysupplyarea,removesanddisposesofgloves(withoutcontaminatingself )intowastecontainerandwasheshands


37

38

tRansfeRs fRom bed to WheelchaiR using tRansfeR belt 1 Explainsprocedure,speakingclearly,slowly,and


2 Privacyisprovidedwithacurtain,screen,ordoor 3 Beforeassistingtostand,wheelchairispositioned

alongsideofbed,atheadofbedfacingfootorfootofbedfacinghead

4 Beforeassistingtostand,footrestsarefoldeduporremoved

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

wheelchair 7 Beforeassistingtostand,checksand/orlocksbed

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

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

atthewaistoverclothing/gown11 Beforeassistingtostand,providesinstructionsto

enableclienttoassistintransferincludingprearrangedsignaltoalertwhentobeginstanding

12 Standsfacingclientpositioningselftoensuresafetyofcandidateandclientduringtransfer.Countstothree(orsaysotherprearrangedsignal)toalertclienttobeginstanding

13 Onsignal,graduallyassistsclienttostandbygraspingtransferbeltonbothsideswithanupwardgrasp(candidateshandsareinupwardposition)andmaintainingstabilityofclient’slegs

14 Assistsclienttoturntostandinfrontofwheelchairwithbackofclient’slegsagainstwheelchair

15 Lowersclientintowheelchair16 Positionsclientwithhipstouchingbackofwheelchair

andtransferbeltisremoved17 Positionsfeetonfootrests18 Signalingdeviceiswithinreach19 Aftercompletingskill, washes hands

39

scoRe RepoRting

exam ReSUlTSThe Nursing Assistant Evaluator may not answer ques-tions about your Score Report. If you have questionsaboutyourScoreReport,orthecontentoftheexamina-tion,callPearsonVUEat (800)475-8290.Results will not be given over the phone.

Written (or Oral) ExamAfteryoufinish theWritten (orOral)Examination, theNursing Assistant Evaluator will fax your answer sheetforscoring.AnofficialScoreReportwillbefaxedtotheevaluator. The Score Report will indicate whether youhavepassedorfailedtheWritten(orOral)Examination.

Skills Evaluation After theNursingAssistantEvaluator evaluates yourperfor-mance,heorshewillfaxtheSkillsEvaluationanswersheetforscoring.AnofficialScoreReportwillbefaxedtotheevaluator.The ScoreReportwill indicatewhether you have passed orfailedtheSkillsEvaluation.Occasionally,duetotechnicaldifficulties,ScoreReportsmaynotbereceivedatthetestcenteronthedayoftesting.IfthishappensyouranswersheetwillbemailedovernighttoPearsonVUEforhandscoring.YourScoreReportwillthenbemailedouttoyouwithin5-7businessdaysaftertesting. For questions regarding delayed Score Reports,pleasecontactPearsonVUEat(800)475-8290.

failiNgIfyoufailtheWritten(orOral)ExaminationortheSkillsEvaluation, your Score Report will provide you withinformationonhowtore-takeeitherorbothparts.Anewexaminationfeeisrequiredeachtimeyoure-takeanypartof the NNAAP Examination. To re-take either or bothparts,youmustsubmityourofficialScoreReportandare-takefeetotheappropriateRegionalCenter(seeExam Fees).Stateandfederalregulationsallowyouthree(3)attemptstopassboththeSkillsEvaluationandtheWritten(orOral)Examination. Ifyoushould fail eitherpartorbothpartsthree(3)times,youwillberequiredtosuccessfullycom-pletea state-approvedtrainingprogramandre-takebothparts.YoumusttakeandpassboththeWritten(orOral)ExaminationandtheSkillsEvaluationwithintwenty-four(24)monthsofyournursingassistanttraininginordertobeplacedontheCaliforniaNursingAssistantRegistry.

40

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 inordertopasstheSkillsEvaluation.

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

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

Intheexampleonthenextpage,acandidatereceivedaresultofUnsatisfactoryon the skillHand Hygiene.Thenumbers1,5,and10printedbelowtheskillrefertostepsthatweremissedorperformedincorrectly.Tostudyforre-takingtheSkills Evaluation, this candidate should turn to the SkillsListinginthishandbook,lookfortheHandHygieneskill,andreviewallthesteps,especiallysteps1,5,and10.

California NNAAP® Examination Results

Exam: Skills Result: Fail

Skills Performance:

Hand Hygiene Unsatisfactory 1, 5, 10

Assists Client With Satisfactory Use of Bedpan

Measures and Records Satisfactory Blood Pressure

Puts One Knee-High Satisfactory Elastic Stocking on Client

Measures and Records Satisfactory Weight of Ambulatory Client

Sample of a Failing Score Report

41

PaSSiNgOnce you have passed both the Written (or Oral)Examination and the Skills Evaluation, your name willbe placed on the California Nursing Assistant Registry.Approximately3–4(threetofour)weeksfromthedayonwhichyousuccessfullycompletebothpartsoftheNNAAPExamination, the CA Department of PublicHealth willmail yourNurse assistantCertificate to you. If you havenotreceivedyourNurseAssistantCertificatewithin6(six)weeksaftertesting,contacttheCDPHat(916)327-2445.your Nurse assistant Certificate is valid for twenty-four (24) months from the date it was issued.

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).

42

gRievance pRocess

oVeRVieWEachcandidatehasarighttofileagrievancetocomplainorcontesttheresultsoftheirNurseAideExam.TheRegionalTesting Center will follow up on each grievance withinthirty(30)daysofreceiptofthecandidategrievanceletter.

Nogrievancewill be investigated if it isnot received inwritingbytheRegionalTestingCenter.

PRoCeSSAll grievances must be in writing. The candidate mustprovideasmuchdetailaspossibleinagrievanceletterandforward it totheRegionalTestingCenterwithin30daysoftheirexamdate.

After receiptof thegrievance letter, the appropriateRNAssociate Program Director will investigate the com-plaint.TheRNAssociateProgramDirectorwillleadtheinvestigationintothecomplaint.

Once the investigation is complete, the RN AssociateProgramDirectorwill draft a letterback to the candidateinforminghim/heroftheoutcomeoftheinvestigation.Ifanerrorwasmadebytheevaluator,CDPH,orPearsonVUE,thecandidatewillbeallowedtoretestatnoadditionalcost.

A copy of the original grievance letter along with theresultsoftheinvestigationwillbeforwardedtotheappro-priateagencyandtoPearsonVUE.

the RegistRy

ChaNge of aDDReSS oR NameThe California Department of Public Health must be kept informed of your current address and name so that you can receive notification of certification renewal on the Registry. Failure to informtheCDPHofanaddresschangemayjeopardizeyourcertificationstatus.

IfyouraddressornamechangesatanytimeafteryouareplacedontheRegistry,youmustsendwrittennotificationofthischangetotheCDPH.UsetheChange of Address or Name Formfoundinthebackofthishandbook.

Name changes MUST be accompanied by official docu-mentationsuchasanotarizedcopyofamarriagecertificate,divorcedecree,orotherofficialdocument.Yournotificationmust include your previous name, current name,mailingaddress,phonenumber,andSocialSecuritynumber.

Re-CeRTifiCaTioNNursing assistants on the California Nursing Assistant Registry must renew their certification through the California Department of Public Health in order to stay active. You must have worked for pay as a nurseassistant performing nursing-related services for at leasteight (8) consecutive hours during the twenty-four (24)months prior to your certification expiration date, andyoumustsubmitevidenceofforty-eight(48)hoursofin-servicetrainingorcontinuingeducation.ContacttheCADepartmentofPublicHealthat(916)327-2445formoreinformation.

laPSeD CeRTifiCaTioNUnderfederalrequirements,certificationasanurseassis-tant becomes invalid after a lapse of twenty-four (24)consecutivemonths ormore in the performance of paidnursing-relatedservices.Itiscriticaltomaintainapersonalfileofyourpastworkhistorythatcanbevalidatedbyyourprospectiveemployer.

CeRTifiCaTioN by ReCiPRoCiTyReciprocity is a process bywhich a certified nurse assis-tant from another state may qualify for certification inCalifornia.Youareeligibleforreciprocityifyouareanurseassistant in a state other than California in accordancewith the competency evaluation requirements of OBRA’87,andifyouarecurrentlylistedontheotherstate’sreg-istryasactiveandingoodstanding.

Contact the CDPH for additional information aboutapplying for placement onto the California NursingAssistantRegistryviareciprocity.

44

CalifoRNia NURSe aSSiSTaNTfReQUeNTly aSkeD QUeSTioNS

quESTiOn AnSWEr

HowdoIbecomeaCNA?

•Youmustsuccessfullycompleteastate-approvednurseaidetrainingprogramandpassboththewrittenandskillsportionsoftheNNAAPexamination.•Ifyouhavenotcompleteda CNAtrainingprogrambutyouhave had other training, contact the CaliforniaDepartmentofPublicHealth at 916-327-2445 to determineyoureligibility.•YoumustpassboththewrittenandskillsportionsoftheNNAAPexamination.

MayIPerformtheDutiesofaNurseAssistant BeforeIAmCertified?

•Ifyouarecurrentlyattendinganapprovedtrainingprograminanursinghome,youhave120daysinwhichtocompletethetrainingandbecomecertified.Duringthatperiod,astudentmaynotperformanydutyforwhichtheyhavenotbeentrainedandcheckedbytheinstructor.•Ifyouarenotenrolledinanapprovedfacilitytrainingcourse,youmaynotperformanynurseaidedutiesuntilyoubecomecertified.

HowDoI Arrange forSpecialAccommo-dations?

•Specialrequestsmustbesubmit-tedandapprovedpriortotesting.Documentationfromyourphysicianorotherqualifyingprofessionalmustbeincludedwiththerequest.PleaserefertotheSpecialExamRequestsandServicessectionofthecandidatehandbookfordetails.

45


quESTiOn AnSWEr

HowdoIdecidewhichexamtotake?

•Initially,boththeWrittenandSkillsexamsmustbescheduledtogether.•AnOralExaminationinEnglishmaybesubstitutedfortheWrittenexaminationifyouhavedifficultyreadingEnglish.Itcontainsten(10) readingcomprehensionquestionsinwhichyoumustidentifyjob-relatedwords.

Is there a time limitinwhichImustpassbothexams?

•Youareallowedthree(3)attemptswithintwo(2)yearsaftersuccess-fullycompletingatrainingprogramtopassbothpartsoftheNNAAPExamination,tobeeligibleforplace-mentontheNurseAideRegistry.IfyoudonotpasstheNNAAPExaminationwithinatwo-year period,youwillberequiredto re-trainbeforeyouwillbeallowed totaketheexaminationagain.

Can I register foranexamorcheckmyscores online?

•Registrationmustbedonebymail.•STATEISSUESCNALICENSE•Ifyoupassedbothpartsoftheexamination,yournamewillbeplacedontheCaliforniaNursingAssistantRegistry.•Resultscannotbeviewedonline.

WhatformofpaymentdoyouacceptandmayItakeittothetest site?

•Allpayments(moneyorder,cashier’scheck,orcompanycheckmadepayabletotheRegionalTestingCenterandmailedto appropriateRegionalCenter. NOformofpaymentwillbe acceptedatthetestsite.

46


quESTiOn AnSWEr

What is the next test date?

•TestdatesatRegionalTestSitesarelistedonthePearsonVUEweb-site (www.pearsonvue.com), or RegionalTestingCenter's (http://missioncollege.org/depts/HWI/regional_testing.html) or Southern Region (www.regionaltestingcenter.org).

HowlongwillittakemetofindoutifIpassedorfailed?

•AftertheNursingAssistantEvaluatorevaluatesyourperfor-mance,heorshewillfaxtheanswersheetforscoring.AnofficialScoreReportwillbefaxedtotheevalua-tor.TheScoreReportwillindicatewhetheryouhavepassedorfailed.Ifthesiteexperiencestechnical difficultieswithfaxinganswersheets,theywillbesentto PearsonVUEforhandscoringandresultswillbemailedwithin5-7businessdaysaftertesting.

the RegistRy

HowdoIverifyifI’m on the NurseAideRegistry?

•ContacttheCaliforniaCertificationUnitat(916)327-2445

HowdoIchangemynameand/oraddress?

•CompletetheforminthebackofthehandbookandmailitwithappropriatedocumentationtoPearsonVUE.

47


quESTiOn AnSWEr

Howlongwillmynameremain on the registry?

•OnceontheNurseAideRegistry,yourcertificationwillremaincurrentfortwenty-four(24)monthsfromthedateyoupassedbothpartsoftheNNAAPexam.Youmusthaveworkedforpayasanurseassistantperformingnursingrelatedservicesforatleasteight(8)consecutivehoursduringthetwenty-four(24months)priortoyourcertificationexpirationdate,andyoumustsubmitevidenceof48hoursofin-servicetrainingorcontinuingeducation.ContacttheCADepartmentofPublicHealthat(916)327-2445foradditionalinformation.ARenewalNoticewillbesenttoyoufour(4)monthspriortoyourexpirationdate.

Mycertifica-tionexpired.HowdoIrenewitorbecomecerti-fiedagain?

•Ifyourcertificationexpired,youwillberequiredtore-testatanCaliforniaDepartmentofPublicHealth-approvedtrainingprogram.

I’m moving toorfromanotherstate.MayIper-formnurseaide duties in that state?

•IfyouaremovingTOCalifornia,pleasecontacttheCaliforniaDepartmentofPublicHealthforstaterequirements.•IfyouaremovingFROMCalifornia,youshouldcontacttheBoardofNursingorDepartmentofHealthforthatstate,toobtainstaterequirements.

d

iRec

tio

ns:

Yo

um

ayu

seth

isfo

rmto

requ

estP

ears

onV

UE

tose

nda

dup

licat

eco

pyo

fyou

rSco

reR

epor

tort

ore

ques

tah

and-

scor

eof

you

rWrit

ten

(orO

ral)

Exam

inat

ion

orS

kills

Eva

luat

ion

answ

ersh

eet.

Plea

sep

rinto

rtyp

e

alli

nfor

mat

ion

onth

ere

vers

esid

eof

this

form

and

incl

ude

corr

ectf

ees,

ory

ourr

eque

stw

illb

ere

turn

ed.

Che

ckth

ese

rvic

ere

ques

ted:

■ D

uplic

ate

Scor

e R

epor

t

■ H

ands

core

fe

e:

$15

each

.Ple

ase

encl

ose

ace

rtifi

edc

heck

orm

oney

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

: C

alifo

rnia

Dup

licat

eSc

ore

Repo

rt/H

ands

core

Req

uest

Pear

son

VU

E Pr

oces

sing

Cen

ter

POB

ox1

3785

Phila

delp

hia,

PA

191

01-3

785

plea

se c

om

plet

e bo

th s

ides

of

this

fo

Rm

am

ou

nt

enc

lose

d:

$___

____

____

____

____

_

Cal

iforn

iaN

ursi

ng A

ssis

tant

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 th

e abo

ve in

for

ma

tion

wa

s differen

t at th

e time yo

u w

ere tested, plea

se ind

ica

te orig

ina

l info

rm

atio

n.

Nam

e________________________________________________________________________________________________________________

Street________________________________________________________________________________________________________________

City______________________________________________________________________

State____________Zip_______________________

Tel.(______)___________________________________

IherebyauthorizePearsonVU

Etosendtomeattheaddressaboveaduplicatecopyofm

yScoreReportorthehandscoredresultsofm

yWritten(orO

ral)Exam

inationorSkillsEvaluation.

Your Signature _____________________________________________________________________Date______________________________

please c

om

plete both

sides o

f this fo

Rm

d

iRec

tio

ns:

U

seth

isfo

rmto

info

rmth

eR

egist

ryo

fyou

rcha

nge

ofa

ddre

sso

rnam

e.P

leas

ep

rinto

rtyp

eal

l

in

form

atio

non

the

reve

rse

side

ofth

isfo

rm.B

esu

reto

pro

vide

all

info

rmat

ion,

ory

ourr

eque

st

cann

otb

efil

led.

Forn

ame

chan

gesy

oum

usta

lsop

rovi

dew

ritte

ndo

cum

enta

tion

ofy

ourn

ame

chan

ge.S

eeb

ack

of

this

form

ford

etai

ls.

se

nd

to

:C

alifo

rnia

Nur

sing

Ass

istan

tReg

istry

C

alif

orni

a D

epar

tmen

t of P

ublic

Hea

lth

Aide

and

Tec

hnic

ian

Cer

tific

atio

n Se

ctio

n 16

15C

apito

lAve

nue,

MS-

3301

P.

O.B

ox9

9741

6 Sa

cram

ento

, CA

958

99-7

416

plea

se c

om

plet

e o

theR

sid

e o

f th

is f

oR

m

C

alifo

rnia

N

ursi

ng A

ssis

tant

Ch

an

ge

of

ad

dre

ss o

r N

am

e

AppEnDix b

Print yo

ur n

ew n

am

e an

d a

dd

ress below

.

Nam

e____________________________________________________________________________________________________________

Street____________________________________________________________________________________________________________

City_______________________________________________________________State______________

Zip_______________________

Tel.(__________)___________________________________

Please prin

t you

r old

na

me a

nd

ad

dress belo

w.

Nam

e____________________________________________________________________________________________________________

Street____________________________________________________________________________________________________________

City_______________________________________________________________State______________

Zip_______________________

SocialSecurityNum

ber____________________________NursingA

ssistantCertificationN

umber__________________________

you

r Sign

atu

re _________________________________________________________________Date__________________________

No

Te: A copy of an official document (m

arriage certificate or other court order) verifying your name change m

ust accompany this request if you are notifying the

California N

ursing Assistant Registry of a change in name.

change

Stoc

k #

0705

-00

8/

13

Date post:	17-Jun-2020
Category:	Documents
Upload:	others
View:	0 times
Download:	0 times

California NURSE ASSISTANT€¦ · If you have not completed a CNA training program but you have...

Documents