CNA Practice Questions and Answers (NNAAP Written Exam)

Answer: D. Remove gloves, wash hands well, and report the exposure to the nurse

Grader’s note

Blood on skin is an exposure: wash with soap and water right away and report it to the nurse so follow-up can start quickly. "Clean the hands with alcohol hand rub and put on new gloves" is wrong because alcohol rub does not remove blood, which needs soap and water. "Wash hands well, finish care, and tell the nurse at break time" is wrong because exposures must be reported promptly, not hours later. "Finish the entire current task first, then wash hands afterward" is wrong because finishing the task first leaves blood on the skin longer.

Source: NNAAP Content Outline — Basic Nursing Skills: Infection Control (35%)

Answer: D. Support above and below the joint, move slowly, stop with pain

Grader’s note

Range-of-motion exercise supports the limb above and below the joint, moves it slowly and smoothly, and stops at pain or resistance. "Hold the limb at the joint and move it through its range quickly" is wrong because holding the joint itself and moving fast can injure it. "Keep moving through mild pain so the stiff joint loosens up" is wrong because pain is the signal to stop and report, not to push on. "Repeat each movement until the resident says she feels tired" is wrong because the care plan sets the number of repetitions, not fatigue.

Source: NNAAP Content Outline — Basic Nursing Skills: Technical Procedures (35%)

Answer: C. Count a full minute and report the irregular rhythm to the nurse

Grader’s note

An irregular pulse must be counted for a full 60 seconds, because a short count multiplied up misses skipped or extra beats, and the change is reported to the nurse. "Count the irregular pulse 15 seconds and multiply the rate by 4" is wrong because a 15-second count cannot capture an irregular rhythm. "Recount for 30 seconds, double it, and chart the higher rate" is wrong because a 30-second count has the same problem. "Chart the rate now and mention the rhythm on the next round" is wrong because a new irregular rhythm should be reported promptly.

Source: NNAAP Content Outline — Basic Nursing Skills: Technical Procedures (35%)

Answer: B. Apply them smooth and wrinkle-free; check the skin beneath

Grader’s note

Anti-embolism stockings go on smooth and wrinkle-free, usually before the resident gets up, and the skin under them is checked. "Apply them after she has walked, when the legs feel warm" is wrong because the legs swell once she is up. "Roll the stocking tops down tightly below the knee line" is wrong because a rolled top acts like a tight band. "Keep the stockings on for days without removing them" is wrong because the stockings are removed regularly to check the skin.

Source: NNAAP Content Outline — Basic Nursing Skills: Technical Procedures (35%)

Answer: C. Measure it as output, note its look, and report to the nurse

Grader’s note

Vomitus counts as output, so it is measured, its color and look noted, and the event reported to the nurse. "Clean it up and record nothing, since it was not urine" is wrong because all fluid lost by vomiting counts as output. "Guess a round number for the amount instead of measuring" is wrong because a guess is not an accurate record. "Add it to the urine total and record one output amount" is wrong because each kind of output is recorded separately.

Source: NNAAP Content Outline — Basic Nursing Skills: Data Collection and Reporting (35%)

Answer: D. Perform hand hygiene and notify the nurse immediately

Grader’s note

"Perform hand hygiene and notify the nurse immediately" is right: inserting an indwelling catheter is a sterile, invasive procedure outside the nursing assistant's scope, so the assistant cleans her hands and gets the nurse. "Document that the catheter was inserted and continue care" is wrong because charting a procedure that was never done is falsification. "Ask a coworker to watch while she tries it herself" is wrong because having a coworker watch does not make an out-of-scope task allowed. "Attempt the procedure using the supply kit on the cart" is wrong because having the supplies on hand does not give the assistant permission to do it.

Source: NNAAP Content Outline — Basic Nursing Skills: Technical Procedures (35%)

Answer: A. Lock the wheelchair brakes and move the footrests aside

Grader’s note

"Lock the wheelchair brakes and move the footrests aside" is correct: locked brakes keep the chair from rolling, and moving the footrests aside keeps the resident's feet from catching on them. "Apply the bed's side rails and raise the head of the bed" is wrong because raising the side rails puts a barrier between the resident and the chair. "Ask another resident to help steady the wheelchair" is wrong because another resident is not trained and could be hurt. "Take off the resident's shoes and socks first" is wrong because the resident should wear non-skid footwear during a transfer, not go barefoot.

Source: NNAAP Content Outline — Basic Nursing Skills: Safety/Prevention/Emergency (35%)

Answer: A. Wipe front to back, using a clean area of the cloth each time

Grader’s note

Perineal care wipes from front to back, from the cleanest area toward the dirtiest, using a clean part of the washcloth for each stroke. "Wipe from back to front to clean the whole area more fully" is wrong because back-to-front wiping carries stool bacteria toward the urethra. "Keep using the same area of the washcloth for the entire cleaning" is wrong because reusing the same area spreads germs. "Clean the outer area only, without separating the labia" is wrong because the labia are separated so the inner folds are cleaned too.

Source: NNAAP Content Outline — Activities of Daily Living: Hygiene/Dressing/Grooming (22%)

Answer: C. Support the knee with pillows and avoid pressing on it

Grader’s note

A painful, swollen joint is supported with pillows and handled gently, and the pain and swelling are reported. "Keep the knee bent over a pillow roll for long periods" is wrong because a knee kept bent can tighten into a contracture. "Put a heating pad on the knee before moving it" is wrong because heat needs an order and can worsen swelling. "Massage the swollen joint firmly until the swelling fades" is wrong because firm massage of a swollen joint can cause harm.

Source: NNAAP Content Outline — Activities of Daily Living: Rest/Sleep/Comfort (22%)

Answer: B. Turn the head to the side and clean gently with moist swabs

Grader’s note

For an unconscious resident, the head is turned to the side so fluid drains out, and the mouth is cleaned gently with moist swabs. "Lay the resident flat and pour in cups of rinse water" is wrong because pouring fluid into the mouth can cause choking. "Sit her upright and give her a small cup to rinse with" is wrong because an unconscious resident cannot rinse or spit. "Wait until she wakes up, since she cannot swallow now" is wrong because an unconscious mouth dries out and needs frequent care.

Source: NNAAP Content Outline — Activities of Daily Living: Hygiene/Dressing/Grooming (22%)

Answer: D. Offer small bites slowly, pausing so the resident can swallow

Grader’s note

Small bites offered slowly, with pauses to chew and swallow and sips between bites, make feeding safe. "Give large spoonfuls so she tires less during the meal" is wrong because large bites raise the risk of choking. "Stand over the resident while feeding to finish the tray fast" is wrong because standing over her rushes her; the assistant sits at eye level. "Offer drinks only after all of the food has been eaten" is wrong because sips between bites help her swallow.

Source: NNAAP Content Outline — Activities of Daily Living: Nutrition/Hydration (22%)

Answer: C. Face first, then body from cleanest to dirtiest areas

Grader’s note

"Face first, then body from cleanest to dirtiest areas" is correct: the face is washed first with clean water, then the body from cleaner areas toward dirtier ones, so germs are not spread upward. "Feet first, then work upward toward the head" is wrong because starting at the feet carries germs from a less clean area to the face. "Body first, then the face and hands at the end" is wrong because washing the face last uses water already used on the body. "Perineal area first, then face and hands last" is wrong because the perineal area is washed near the end, never before the face.

Source: NNAAP Content Outline — Activities of Daily Living: Hygiene, Dressing and Grooming (22%)

Answer: B. Snug the gait belt at the waist; walk behind and to the side, holding it

Grader’s note

A gait belt is snug at the waist over clothing, and the assistant walks slightly behind and on the weaker side, holding the belt. "Pull the unsteady resident forward by both arms while walking them along" is wrong because pulling the arms can dislocate a shoulder. "Walk ahead of the unsteady resident without holding on for support" is wrong because walking ahead gives no support if she falls. "Hold her hand and walk on her strong side without a belt" is wrong because a hand gives a poor grip and the assistant stands on the weak side.

Source: NNAAP Content Outline — Self Care/Independence (7%)

Answer: C. On her right side, close to the bed

Grader’s note

The wheelchair goes on the resident's strong side, close to the bed and at a slight angle, so she can lead and pivot with her stronger leg. "At the foot of the bed, facing away from her" is wrong because the chair must be beside her to pivot into it. "On her left side, right next to the bed" is wrong because the left is her weak side. "Facing the bed directly, touching the mattress edge" is wrong because a chair facing the bed leaves no room to pivot.

Source: NNAAP Written Examination Content Outline — Physical Care Skills: Self Care/Independence

Answer: B. Handle it gently, check stump skin, and report redness

Grader’s note

A prosthesis is handled gently and stored safely, and the stump is checked for redness or sores, which are reported. "Soak the socket in hot water after each use" is wrong because hot water can damage the socket. "Put it on even if the stump is red, so therapy is not missed" is wrong because red or broken skin needs the nurse's check before the leg goes on. "Rub lotion on the stump right before putting the leg on" is wrong because lotion under the socket softens the skin and makes the fit slip.

Source: NNAAP Content Outline — Self Care/Independence (7%)

Answer: A. Stand close, use a gait belt, and allow the resident to attempt the transfer

Grader’s note

"Stand close, use a gait belt, and allow the resident to attempt the transfer" is correct: with a gait belt on and the assistant close by, she can try the transfer while help is ready if she wobbles. "Tell the resident she is not ready and lift her into the chair" is wrong because lifting her takes away the practice she needs. "Lock the wheelchair and watch from the doorway" is wrong because a doorway is too far away to catch an unsteady resident. "Wait until physical therapy is present before any attempt" is wrong because the assistant can safely supervise a transfer the care plan allows.

Source: NNAAP Content Outline — Physical Care Skills: Self Care/Independence (7%)

Answer: C. Calmly redirect to a familiar task and offer two simple choices

Grader’s note

A confused resident's belief is real to him, so arguing or correcting raises distress; staying calm, redirecting and offering simple choices works better. "Explain clearly that nobody has taken any of his things" is wrong because correcting him tends to start an argument. "Agree that his things were stolen and promise to call the police" is wrong because agreeing and promising police action feeds the fear and makes a false promise. "Tell him that accusing staff of stealing is upsetting them" is wrong because scolding him adds shame and agitation.

Source: NNAAP Content Outline — Emotional and Mental Health Needs (8%)

Answer: D. Step back for safety, stay calm, and report to the nurse

Grader’s note

When a resident becomes combative the assistant steps back out of reach, stays calm, keeps her safe and reports to the nurse. "Hold her wrists firmly until she stops hitting you" is wrong because holding her can injure her and is a restraint. "Tell her hitting staff is not allowed and finish the bath quickly" is wrong because rushing the task increases agitation. "Leave her alone in the tub and hurry to get the nurse" is wrong because a resident must never be left alone in a tub, where she could fall or slip under the water.

Source: NNAAP Content Outline — Emotional and Mental Health Needs (8%)

Answer: B. Keep routines steady, lighting warm, and redirect calmly

Grader’s note

Sundowning eases with steady routines, good lighting, a calm setting and gentle redirection. "Correct her about the time and place each time she asks" is wrong because repeated correcting frustrates and agitates her. "Schedule her bath and busy activities for late afternoon" is wrong because busy tasks late in the day add to the overload. "Keep her room dark early in the evening so she settles" is wrong because shadows and darkness increase confusion and fear.

Source: NNAAP Content Outline — Emotional and Mental Health Needs (8%)

Answer: A. Note the warning signs and report them to the nurse promptly

Grader’s note

Withdrawal, poor appetite and hopeless talk are warning signs of depression or suicide risk, so they are reported to the nurse promptly. "Tell her she has a lot to live for and change the subject" is wrong because it dismisses her feelings and nothing is reported. "Give her some space and check in again next shift" is wrong because waiting a shift delays help. "Promise to keep the hopeless statements completely secret" is wrong because warning signs can never be kept secret.

Source: NNAAP Content Outline — Emotional and Mental Health Needs (8%)

Answer: A. Ask about food practices and work with the nurse to honor them

Grader’s note

Residents have the right to have their religious and cultural food practices honored, so the assistant asks about them and works with the nurse and dietary staff. "Tell her to pick around the forbidden foods on her tray" is wrong because leaving forbidden foods on the tray does not respect her practice. "Ask her family to bring all her meals in from home" is wrong because the facility must meet her needs. "Serve the menu meal, since only the dietitian can change it" is wrong because the request should be passed on so the diet can be changed.

Source: NNAAP Content Outline — Spiritual and Cultural Needs (2%)

Answer: C. Provide privacy, allow the rituals, and cooperate with the family

Grader’s note

Respecting cultural and spiritual practices at the end of life means giving privacy and cooperating with the family's rituals. "Allow the rituals but only during the normal visiting hours" is wrong because dying residents' families should not be held to routine visiting hours. "Ask the family to wait until after the resident has died" is wrong because many rituals are meant for before death. "Allow the rituals only if the facility chaplain is present" is wrong because the family's own practices do not need a chaplain's approval.

Source: NNAAP Content Outline — Spiritual and Cultural Needs (2%)

Answer: C. Ask preferences respectfully and adapt care within the plan

Grader’s note

Respecting culture means asking the resident about her preferences, explaining care before touching her, and adapting care within the plan. "Explain that touch is needed for care and carry on as usual" is wrong because it ignores her preferences. "Ask her family to persuade her to accept touch" is wrong because she has the right to her own customs. "Avoid touching her, even if it means skipping care" is wrong because needed care is adapted, not skipped, and refusals are reported.

Source: NNAAP Content Outline — Spiritual and Cultural Needs (2%)

Answer: A. Tell the nurse so the visit can be arranged soon

Grader’s note

Residents have the right to practice their faith, and the nurse or social services can contact clergy, so the assistant passes the request on promptly. Telling her to pray alone dismisses a spiritual need she has clearly stated. The resident, not her family, decides whether she wants a visit. Reading from the aide's own religious text puts the assistant's beliefs in place of the resident's and does not meet her request.

Source: NNAAP Written Examination Content Outline — Psychosocial Care Skills: Spiritual and Cultural Needs

Answer: C. Decline to share information and refer the visitor to the nurse

Grader’s note

Health information is private under HIPAA, so the assistant shares nothing and refers the visitor to the nurse. "Give only general news, such as how she is feeling today" is wrong because even general updates are private health information. "Share the details if the visitor says they are family" is wrong because a visitor's claim to be family does not give them a right to information. "Post about the resident's care on social media without using names" is wrong because residents can be identified from posts even without names.

Source: NNAAP Content Outline — Client Rights (8%)

Answer: D. Keep the resident draped, exposing only the area washed

Grader’s note

Dignity during a bed bath means closing the door and curtain, keeping the resident covered with a bath blanket, and uncovering only the part being washed. "Close the door but leave the privacy curtain pulled open" is wrong because an open curtain lets others see in. "Remove the gown fully at the start so it stays dry" is wrong because removing the gown leaves the body exposed during the whole bath. "Cover only the private areas and leave the rest uncovered" is wrong because the rest of the body should stay covered for warmth and privacy.

Source: NNAAP Content Outline — Client Rights (8%)

Answer: A. Knock, state her name, and wait for permission to enter

Grader’s note

Respecting privacy means knocking, giving her name and waiting for permission before entering. "Knock and walk straight in to save the resident effort" is wrong because knocking without waiting gives no chance to answer. "Knock only if the door is closed; walk in if it is open" is wrong because an open door does not give permission to enter. "Open the door, step inside, then say who she is" is wrong because she should be invited in before stepping inside.

Source: NNAAP Content Outline — Client Rights (8%)

Answer: C. Explain each step simply first and respect any refusal

Grader’s note

Residents have the right to know what care they will get, so each step is explained simply beforehand and a refusal is respected and reported. "Explain the procedure only if the resident asks about it" is wrong because explaining is the assistant's duty, not the resident's to ask for. "Explain using complex medical terms the resident cannot follow" is wrong because medical terms she cannot follow do not inform her. "Explain the bath, then carry on even if she says no" is wrong because continuing after a refusal violates her rights.

Source: NNAAP Content Outline — Client Rights (8%)

Answer: B. Report observed facts plus vital signs and symptoms, without diagnosing

Grader’s note

A good report gives facts the assistant observed, including vital signs and symptoms, without making a diagnosis. "Tell the nurse the resident definitely has the flu based on today's symptoms" is wrong because diagnosing is outside the assistant's role. "Report only the symptoms that the resident complains about" is wrong because objective signs, such as a high temperature or a change in skin color, matter as much as complaints. "Say the resident just does not look good today and leave the report there" is wrong because a vague impression gives the nurse nothing to act on.

Source: NNAAP Content Outline — Communication (7%)

Answer: D. Use short simple sentences, one step at a time, unhurried

Grader’s note

A cognitively impaired resident understands best with short, simple sentences, one step at a time, in a calm voice. "Give all of the steps at once so she knows the plan" is wrong because several steps at once are hard to follow. "Speak loudly and quickly to keep her attention" is wrong because loud, fast speech confuses and upsets. "Ask open questions such as 'What would you like today?'" is wrong because open questions are harder to answer than a simple choice between two things.

Source: NNAAP Content Outline — Communication (7%)

Answer: B. The resident's vital signs, complaints, and any changes from baseline

Grader’s note

"The resident's vital signs, complaints, and any changes from baseline" is correct: vital signs, complaints, and changes from the resident's usual condition are the facts the next shift needs to give safe care. "A summary of the assistant's personal feelings about the resident" is wrong because personal feelings about a resident are not part of a clinical report. "Details of conversations the assistant had with other staff" is wrong because side conversations with staff are not resident data. "A description of the resident's family members and visitors" is wrong because a description of visitors does not tell the next shift anything about the resident's condition.

Source: NNAAP Content Outline — Communication (7%)

Answer: B. Resident refused morning care and appeared agitated

Grader’s note

"Resident refused morning care and appeared agitated" is correct: a refusal is a fact, and agitation describes observed behavior, so the entry reports what happened. "Resident was in good spirits today" is wrong because good spirits is a vague opinion. "Resident is a very pleasant person who cooperates" is wrong because calling her pleasant is a judgment, not an observation. "Resident probably has pain but is not saying anything" is wrong because probably is a guess, not something the assistant saw.

Source: NNAAP Content Outline — Role of the Nurse Aide: Communication (7%)

Answer: D. Giving a resident a dose of prescription medication

Grader’s note

Giving prescription medication is a licensed nurse's task, so it falls outside the nursing assistant's scope. "Giving a bed bath and feeding a resident breakfast" is within scope because bathing and feeding are core daily-living care. "Measuring vital signs and reporting changes to the nurse" is within scope because aides measure vital signs and report changes to the nurse. "Helping a resident walk down the hall with a gait belt" is within scope because aides routinely help residents walk using a gait belt.

Source: NNAAP Content Outline — Member of the Health Care Team (6%)

Answer: C. Help a resident walk to the dining room with a gait belt

Grader’s note

Walking a resident to the dining room is a routine task within aide training, so the assistant can accept it. "Assess the resident and write the nursing care plan alone" is wrong because assessment and care planning are nursing responsibilities. "Change the sterile dressing on the resident's surgical wound" is wrong because sterile dressing changes belong to licensed nurses. "Take a telephone order for medication from the on-call physician" is wrong because only licensed staff may take physician orders by telephone.

Source: NNAAP Content Outline — Member of the Health Care Team (6%)

Answer: D. Tell the nurse about the lack of training and ask for direction

Grader’s note

"Tell the nurse about the lack of training and ask for direction" is correct: the assistant tells the nurse she has not been trained and asks how to proceed, so the task is done safely. "Ask a fellow CNA to do the task instead without informing the nurse" is wrong because the nurse is left not knowing who did the task. "Try the task while the nurse is busy elsewhere" is wrong because trying an untrained task behind the nurse's back can hurt the resident. "Refuse all tasks from the nurse for the rest of the shift" is wrong because refusing everything for the shift abandons residents.

Source: NNAAP Content Outline — Member of the Health Care Team (6%)

Answer: C. Share concerns with the nurse while following the current plan

Grader’s note

"Share concerns with the nurse while following the current plan" is correct: the assistant raises the concern with the nurse but follows the current plan until it is changed. "Document the disagreement in the resident's chart personally" is wrong because the chart records care and observations, not staff disagreements. "Refuse to follow the new care plan until it is changed back" is wrong because refusing to follow the plan can leave the resident without ordered care. "Talk about the disagreement with family members during their visit" is wrong because airing staff disagreements to the family is unprofessional.

Source: NNAAP Content Outline — Member of the Health Care Team (6%)

Answer: B. Discussing resident details only with the care team in private

Grader’s note

Resident information is shared only with the care team that needs it, and only in a private place. "Discussing a resident's care with coworkers in the break room" is wrong because a break room is public and others can overhear. "Sharing health details with the resident's roommate's family" is wrong because the roommate's family has no right to the information. "Telling a resident's close friend how her surgery went" is wrong because friends receive information only if the resident permits it.

Source: NNAAP Content Outline — Legal and Ethical Behavior (5%)

Answer: B. Draw one line through it, write the fix, and initial it

Grader’s note

A chart is a legal record, so the error is crossed out with a single line that leaves the original readable, then the correct entry is written and initialed and dated per facility policy. Correction fluid hides what was first written, which looks like tampering. Erasing also destroys the original entry and makes the record unreliable. Tearing out and recopying a page removes part of the legal record and is never allowed.

Source: NNAAP Written Examination Content Outline — Role of the Nurse Aide: Legal and Ethical Behavior

Answer: A. A resident left soiled for hours with the call light ignored

Grader’s note

Neglect is failing to give needed care, such as leaving a resident soiled for hours while the call light goes unanswered. "A resident who refused lunch, with the refusal reported" is wrong because respecting and reporting a refusal is correct care. "A resident who waited five minutes for help at shift change" is wrong because a short wait is not a failure to give care. "A resident resting in bed on a day she chose to stay in" is wrong because staying in bed by choice is her right.

Source: NNAAP Content Outline — Legal and Ethical Behavior (5%)

Answer: C. Refuse, keep the resident safe, and tell the nurse

Grader’s note

Tying a resident to a chair is a restraint, and restraints may be used only with a doctor's order and as the care plan directs, so the assistant refuses, stays with the resident, and alerts the nurse. A loosely tied sheet is still a restraint applied without an order. Restraining her only until she sleeps is still unlawful and can cause injury. Hourly checks do not make an unordered restraint acceptable, and a sheet is not an approved device.

Source: NNAAP Written Examination Content Outline — Role of the Nurse Aide: Legal and Ethical Behavior