Task Lists and Tips

1. Practice good personal hygiene
2. Maintain good personal health
3. Exhibit acceptable behavior
4. Work cooperatively with others
5. Maintain confidentiality
6. Observe the Resident's Rights
7. Identify and report abuse or neglect to appropriate person
8. Use plan of care to meet resident's needs
9. Communicate with resident, family, and staff
10. Assist resident in use of intercom/call system/telephone
11. Report observations/information to appropriate personnel
12. Recognize health problems related to the aging process
13. Recognize needs of the resident with cognitive impairment
14. Assist with providing recreational activities for the resident
15. Assist with giving postmortem care
16. Follow standard precautions & bloodborne pathogens standard
17. Hand hygiene
18. Provide for environmental safety
19. Adjust bed and side rails
20. Assist with application of protective devices
21. Report unsafe conditions to appropriate person
22. Assist with care of resident with oxygen
23. Follow fire and disaster plan
24. Assist resident who has fallen
25. Assist resident who has fainted
26. Assist resident who is having a seizure
27. Clear the obstructed airway - the conscious adult
28. Using elevation, direct pressure, and pressure points to control bleeding
29. Serve meals and collect trays
30. Recognize diet modifications/restrictions
31. Check food tray against diet list
32. Feed or assist resident in eating
33. Administer after meal care
34. Record and report intake and output
35. Give bed bath
36. Assisting with the partial bath
37. Assist resident with tub bath
38. Assist resident with shower
39. Make unoccupied (closed) bed
40. Make occupied bed
41. Perform or assist in performing oral hygiene for the conscious/unconscious resident
42. Assist with or shave resident
43. Give backrub
44. Give perineal care
45. Shampoo/groom hair
46. Give nail care
47. Assist resident with dressing and undressing
48. provide urinary catheter care
49. Provide care for the urinary incontinent resident - to include incontinence briefs
50. Provide care for the bowel incontinent resident
51. Assist resident in bladder retraining
52. Assist resident in bowel retraining
53. Assist resident in using bedpan/urinal
54. Assist with enema administration
55. Collect routine/clean catch urine specimen
56. Collect stool specimen
57. Collect sputum specimen
58. Use good body mechanics
59. Perform or assist with range of motion exercises
60. Turn and position the resident in bed
61. Transfer the resident to and from bed/chair
62. Use a mechanical lift to transfer resident
63. Apply and use gait belt
64. Assist resident with standing/walking
65. Assist resident in using cane/walker
66. Transport resident by wheelchair
67. Move resident between stretcher and bed
68. Assist with admission, in-house transfer, and discharge of resident
69. Measure and record resident temperature by using oral, auxiliary, rectal and lympanic routes using non-mercury glass/electronic thermometer
70. Measure and record radial pulse
71. Measure and record respiration
72. Measure and record blood pressure
73. Measure and record resident height/weight
74. Assist in prevention of pressure/circulatory ulcers
75. Apply elastic stockings
76. Donning and Doffing Personal Protective Equipment

There are a number of skills that may help you improve your ability to take a test. Here are some tips that are strongly recommended:

• Get a good night’s rest before the test.
• Be familiar with the test directions. If anything in the directions is not clear, ask the test administrator to clarify. You will have a few minutes to ask questions before the test begins.
• Think through each question. Read each question word for word. Consider all of the answer choices. Do not choose the first answer that seems reasonable. Read and evaluate all choices to find the best answer to the question. Give careful consideration before going on to the next question, but do not spend too much time on any one question.
• When selecting the best answer to a question, do not re ad too much into the questions. The questions are written to be clear and straightforward. They are not intended to be tricky or misleading.
• If, after considering all answer choices, the correct answer is not clear, eliminate the choices you know are incorrect and choose from the remaining answers. You may want to review the questions after you have completed the rest of the test.
• Always guess even if you cannot eliminate any of the possible responses. Every question will be scored right or wrong. Your test score is based on the number of questions answered correctly. You do not lose points for incorrect answers, so you will not be penalized for guessing.
• After you have finished the test, review your answers. If possible, check all responses. Do not be afraid to change your answer. However, before changing your answer, consider the reason for your original answer.

Facilities and test candidates are encouraged to schedule the test so they do not work 12 hours prior to the competency evaluation.

Example questions:

1. A specimen colleged by having the resident cough up a substance from the lungs and bronchial tubes is called

1. saliva
2. mucus
3. sputum
4. spit

2. You see bruises on a resident's face. You should notify

1. a state agency responsible for abuse
2. the charge nurse
3. the family
4. the physician

Recording Responses

Each question will have an associated series of bubbles marked with with the letter that corresponds to the answer choice for the question.

You should be sure to fully fill in the bubble corresponding to your answer. Bubbles with only partial fill, Xs or checks in the bubble will not be counted.

The skills demonstration aspect of the examination must consist of a minimum performance of five randomly selected skills

The following skills will be used for test purposes. At least 70% of the steps must be performed correctly in each skill. Some of the steps within a skill are considered critical and must be performed at 100% accuracy. An asterisk (*) identifies the critical steps.

A critical step is defined as a step within a task that relates to physical safety of the resident or nurse aide or medical asepsis (infection control).

Sequencing of steps will not be considered critical unless it becomes a physical safety or medical asepsis violation as defined above.

The skills test is not designed to teach. The skills test is designed to measure competency. No help will be given.

All test candidates are expected to complete the skills in a timely manner. At the evaluator’s discretion, you may be given a 5-minute warning to finish the current skill.

Evaluator interactions are very limited. You may ask your evaluators questions, but the evaluator may or may not be able to answer you.

Candidates frequently stop demonstrating skills to review the steps in their mind but the evaluators cannot read your mind or your intent at this time. You may want to verbalize those steps out loud to ensure the evaluator understands your actions. Make sure you are demonstrating each step. The same applies if you are quiet because you are finished. Please let the evaluator verbally know that you are finished with each skill.

For clarification of procedures, test candidates are encouraged to refer to the procedure checklist in your workbook.

Promoting Safety and Comfort: Bed Rails - page 156 of the approved text Safety

You raise the bed to give care. Follow these safety measures to prevent the person from falling:

• For a person who uses bed rails – Always raise the far bed rail if you are working alone. Raise both bed rails if you need to leave the bedside for any reason.
• For the person who does not use bed rails – Ask a co-worker to help you. The co-worker stands on the far side of the bed. This protects the person from falling.
• Never leave the person alone when the bed is raised.
• Always lower the bed to its lowest position when you are finished giving care.

Comfort

The person has to reach over raised bed rails to access items on the bedside stand and overbed table. Such items include the water pitcher and cup, tissues, phone, and TV and light controls. Adjust the overbed table so it is within the person’s reach. Ask if the person wants other items nearby. Place them on the overbed table too. Always make sure needed items, including the signal light, are within the person’s reach.

For the purpose of testing, the resident’s care plan indicates side rails are not to be used. Side rails will be raised when the bed is raised. Side rails will be lowered when the bed is lowered.

42 C.F.R 483.13(a) provides that “the resident has the right to be free from any physical or chemical restraints imposed for discipline or convenience, and not required to treat the resident’s medical symptom.” Centers for Medicare & Medicaid Services (CMS) defines “physical restraints” in the State Operations Manual (SOM), Appendix PP as, “any manual method or physical or mechanical device, material, or equipment attached or adjacent to the resident’s body that the individual cannot remove easily which restricts movement or normal access to one’s body.”

You will be expected to perform the skills as you would in a nursing home setting. When water is required, water may be used. All candidates will be required to perform the Hand Hygiene skill. The evaluator will inform you after you have performed hand hygiene for the first time that you should tell him or her when you would perform hand hygiene during your performance of the rest of the skills rather than actually washing them for each skill. No other steps will give you credit for simply verbalizing to the evaluator what you would do, or for simulating the step, unless noted in this study guide next to that particular step within a skill. To receive credit for all other steps, you must actually demonstrate the step.

The test will consist of five of the 28 skills.