Check out some of our blog posts! You will find informative articles, testing tips, test registration information and skills instruction!

Testing Tip: Dentures in a Cup?

CNAs are not generally required to take a patient’s dentures out or put them in. This is a safety measure for both the CNA and the patient. Why? Because trying to “pop” dentures from the lower jaw (where they will be held in place by denture paste) causes the CNA to place downward pressure on the lower jaw, which can possibly dislocate the jaw. Patients may also accidentally bite down on the CNAs fingers. Because of these risks, this action should be avoided. If the patient is unable to put their own dentures in or remove their own dentures, their food can be pureed to make it easier to eat without chewing. The nurse and doctor will make this determination, but they will rely on input regarding the patient’s abilities from the other staff members. It is important that you monitor your patients for difficulties in placing and removing their own dentures. For this reason, the scenario for the exam will have the patient sitting in a chair at the side of the bed with their dentures already removed and stored in a cup that the patient will be holding (or may have set on the overbed table). After cleaning the dentures, you will store them in clean water in the denture cup for patient use as they wish. style=”display:inline-block;width:300px;height:250px” data-ad-client=”ca-pub-0507141994722999″ data-ad-slot=”2891204660″>... read more

Testing Tip: Raise the Bed?

Hospital beds are great! They can be adjusted higher to make it easier for you to do your skills…less bending equals less stress on your back! And you are more than welcome to raise a bed to a comfortable working height if you wish. BUT… IT IS AN AUTOMATIC FAIL IF YOU DO NOT LOWER THE BED AT THE END OF THE SKILL! Why? Well, when you go to bed, your bed stays right where it always is. Home beds don’t move up and down. That means when you wake up, the floor will be right where you left it. Very predictable. But if someone came along during the night and moved that floor about a foot lower than you expect it to be, you can imagine the consequences. Patients in a hospital bed don’t expect the floor to move either. When they try to get out of bed, they may fall and become injured if the floor is not where they left it. And because they are further away from the floor, the fall is further and the injuries much more serious. So, if you raise a bed to a comfortable working height, you MUST lower it back to the lowest position at the end of the skill for safety. But, you don’t HAVE to raise the bed in the first place! Since the majority of our patients in healthcare will not have adjustable beds (think: home care, assisted living, low-income nursing homes, convalescent centers, etc.), in most states it isn’t a requirement of the test to raise the bed, since they are not present in every setting. Since... read more

Testing Tip: Close the Privacy Curtain For All Skills…Except One!

Providing privacy for skills is an essential component of patient care. It may not always make sense to you to close the privacy curtain for certain skills, but it must be done! I often hear questions like, “If we are walking a patient, why are we closing the curtain first?” The answer is…because privacy is important! This simply must be a routine part of patient care – with no judgment required on your part. Otherwise, care is not performed consistently as some CNAs provide privacy for one skill while others do not. So, the rule remains…provide privacy…always.  Except for one skill! Which skill does not require privacy? Feeding a patient. Why? Because eating is a social event and when you isolate a patient by closing a privacy curtain, you may inadvertently cause them to eat less! Most people gather in groups to eat. They will have conversations and interact with others. If someone is alone, they will often turn to TV or a book for their socialization needs. But there is still some social connection that must be present to stimulate the appetite. By closing the privacy curtain, the patient will remain isolated and not eat as well! So, provide privacy for all skills except feeding by closing the privacy curtain. This shows respect and an understanding of the patient’s need to feel secure and retain their dignity as we assist them with their physical needs.  ... read more

Testing Tip: Basins are “NO SOAP ZONES”

When preparing for bathing a patient, do not add soap to the water in the basin. By adding soap to this water, you lose the ability to use it for rinsing. Place the soap on the washcloth instead. This allows you to wash the appropriate area without affecting your rinse water. In addition, do not place soapy washcloths into the water after use; set used washcloths off to the side. This ensures that all the basin has held is clean water, which simplifies your cleaning process after patient use. Most facilities will use lather-free or “no-rinse” spray cleansers. This type of cleanser will not produce suds. It is still a good idea to rinse any cleaning agent off of the patient’s skin to avoid skin irritations.  ... read more

Testing Tip: Let the Patient Check the Water!

For all washing skills (hand and nail care, foot care, partial bed bath, peri-care, catheter care), you will go fill a basin with water to bring it to the bedside. You will check the water temperature with the inside of your wrist before filling the basin: it should feel warm, not hot and not cold – just warm. But just because YOU think it feels good, doesn’t mean the patient will agree! Why? I’m glad you asked! As people age, they begin to lose the protective layer of fat beneath their skin. This layer of fat also provides insulation. Without this insulation, an older person will perceive temperatures much differently than you do.  Think of it like this: if you go outside in the middle of winter with long pants, boots, mittens and a coat on, the temperature won’t feel quite so bad. Sure, it will be cold, but it’s not unbearable – because you have protective layers on that hold in your body heat and block out the cold. But what if you just had on shorts and a tank top and you were outside in the middle of winter? It is going to feel really, really cold – because you have nothing to hold in your heat and block out the cold.  This is what happens as we age…we begin to lose our protective layers. So cold is going to feel really, really cold. And hot water may feel really, really hot. Since you still have your layers, there is no way for you to understand how the patient is going to feel about a certain temperature... read more

Testing Tip: Use an alcohol pad to count respiration!

Testing Tip: Respirations are easier to count if you place an alcohol pad on the patient’s abdomen. Why? Your eye is drawn to motion with contrasting colors. Since the alcohol pad packet is often colored differently than the patient’s clothing or sheets, it makes the small motions of breathing much more visible to the observer. This is not a necessary step, and is generally used during learning activities, but there is no rule that says you cannot use this tip during the CNA exam! Since it makes it easier to see, and is not prohibited, why not give yourself every advantage? An alcohol pad is small, lightweight, disposable and has a medical reputation. Patients often will assume you will be using it for a task later so they usually won’t even ask why you are putting it on their abdomen. Give it a try! Have someone lie down on a flat surface and observe their abdomen moving up and down. Then place an alcohol pad (or small slip of paper) on the volunteer’s abdomen and see how much easier it becomes! This technique should be viewed like training wheels on a bike: useful while learning, but the student should progress beyond their use during regular clinical practice. However, this technique can be helpful when trying to view respirations on shallow breathers, those with apnea, near end of life, or other situations where the patient’s respirations may be difficult to visualize.  ... read more