CNA Practice Exams: 25 Written Competency Questions & Clinical Rationales
Test your readiness for the National Nurse Aide Assessment Program (Credentia NNAAP), Headmaster D&SDT, and Prometric written exams with 25 high-yield questions modeled on actual state testing blueprints. Click any question below to reveal the correct answer and clinical rationale, or use the "Expand All Rationales" button to study in review mode.
CNA Written Exam Domain Breakdown
PPE donning/doffing sequence, C. diff contact precautions, BP/pulse/respiration rules, and I&O conversion.
Dysphagia aspiration prevention, catheter/peri-care, gait-belt transfers, PROM, and pressure injury prevention.
Sundowning redirection, emergency response (falls, seizures, fire), OBRA rights, HIPAA, and CNA scope.
Domain 1: Infection Control, Vital Signs & Clinical Measurements (Questions 1–8)
A) Face mask or N95 respirator | B) Goggles or face shield | C) Gloves | D) Isolation gown
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Correct Answer: C (Gloves). Under CDC infection control guidelines, gloves are the most heavily contaminated piece of PPE and are always removed first (glove-to-glove, skin-to-skin), followed by goggles/face shield, gown, and mask/respirator last. Remember the alphabetical order for removal: Gloves → Goggles → Gown → Mask (and reverse for donning: Gown → Mask → Goggles → Gloves).
A) Rub hands with 70% alcohol-based hand sanitizer until dry | B) Wash hands thoroughly with soap and running warm water for at least 20 seconds | C) Wipe hands with a quaternary ammonium disinfectant wipe | D) Double-glove and sanitize the outer gloves
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Correct Answer: B (Wash hands with soap and running water for at least 20 seconds). Alcohol-based hand rubs do not kill hardy C. diff bacterial spores. Mechanical friction with soap and running water is required to physically rinse spores from the skin.
A) Count for 15 seconds and multiply by 4 | B) Count for 30 seconds and multiply by 2 | C) Count for a full 60 seconds and report the irregular rhythm to the charge nurse immediately | D) Document the previous shift's pulse rate
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Correct Answer: C (Count for a full 60 seconds and report to the nurse). Any irregular pulse must be counted for one full minute for accuracy and reported immediately so the RN can auscultate an apical pulse with a stethoscope.
A) Use the left arm since the mastectomy was 2 years ago | B) Use the right arm above the AV fistula | C) Notify the nurse and measure blood pressure on the lower extremity (thigh/popliteal or ankle) as directed | D) Inflate the cuff to only 120 mmHg on the left arm
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Correct Answer: C. Blood pressure cuffs (and venipuncture) are strictly contraindicated on an arm on the side of a mastectomy (risk of lymphedema) and on an arm with a dialysis AV fistula/shunt, IV infusion, or cast. Use an approved lower-extremity site per nursing direction.
A) 300 mL | B) 420 mL | C) 540 mL | D) 280 mL
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Correct Answer: B (420 mL). Add only liquids (including foods that melt at room temperature like ice cream, gelatin, popsicles, and broth; solid toast is recorded as a % of meal consumed, not mL): 6 oz juice + 4 oz coffee + 4 oz milk (half of 8 oz) = 14 oz total. Multiply 14 oz × 30 mL/oz = 420 mL.
A) Oral temperature of 98.4°F (36.9°C) | B) Radial pulse of 76 beats per minute | C) Respiratory rate of 28 breaths per minute (tachypnea) | D) Blood pressure of 116/74 mmHg
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Correct Answer: C (Respiratory rate of 28 breaths/min). Normal adult resting respirations are 12 to 20 breaths per minute. Any rate below 12 (bradypnea) or above 20–24 (tachypnea) indicates potential respiratory distress, hypoxia, or infection and must be reported immediately.
A) 2 minutes | B) 5 minutes | C) 15 to 20 minutes | D) 60 minutes
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Correct Answer: C (15 to 20 minutes). Hot or cold liquids, smoking, or chewing gum alter oral mucosal temperature for 15 to 20 minutes. Either wait 15–20 minutes or take a tympanic, temporal artery, or axillary temperature.
A) Standard surgical ear-loop mask | B) Fit-tested N95 particulate respirator (or PAPR) | C) Plastic face shield only | D) Gown and gloves only
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Correct Answer: B (Fit-tested N95 respirator). Airborne pathogens (MTV: Measles, Tuberculosis, Varicella/Chickenpox/Disseminated Shingles) remain suspended in droplet nuclei and require a fit-tested N95 respirator and a closed negative-pressure room door.
Domain 2: Personal Care, ADLs, Transfers & Restorative Mobility (Questions 9–17)
A) Flat (Supine, 0 degrees) | B) Semi-Fowler's to Fowler's (30 to 45 degrees minimum) | C) Trendelenburg position | D) Sims' left lateral position
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Correct Answer: B (30 to 45 degrees minimum). Keeping the head of the bed elevated at least 30 to 45 degrees during tube feedings (and for 30 to 60 minutes after intermittent bolus feedings) prevents gastric formula from refluxing into the airway.
A) Put sleeve on strong (left) arm first; take off weak (right) arm first | B) Put sleeve on weak (right) arm first; take off strong (left) arm first | C) Pull both arms through simultaneously
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Correct Answer: B (Dress weak arm first; undress strong arm first). Dressing the weak/affected arm first (and undressing the strong/unaffected arm first) allows the garment more slack and prevents painful shoulder subluxation on the weak side.
A) Hold cane in weak (left) hand; move strong leg with cane | B) Hold cane in strong (right) hand; move cane forward, then step with weak (left) leg, followed by strong (right) leg | C) Hold cane in either hand
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Correct Answer: B (Strong hand holds the cane). Use the acronym COAL (Cane Opposite Affected Leg): the resident holds the cane on the strong/unaffected side so weight is distributed evenly across a wide base of support when the weak leg steps forward.
A) Hung on the movable upper side rail at waist level | B) Placed flat on the floor next to the bed | C) Hung below the level of the bladder/hips on the non-movable bed frame (or wheelchair frame below the seat) | D) Placed on the resident's abdomen during transport
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Correct Answer: C (Below bladder level on the non-movable bed frame). Gravity prevents contaminated urine in the tubing/bag from refluxing back into the bladder (which causes CAUTI). Hanging the bag on a movable side rail can tear the balloon out of the urethra when the rail is lowered, and touching the floor contaminates the drainage spout.
A) Vigorously massage the reddened sacrum with lotion to restore blood flow | B) Place the resident directly on their back on a rubber ring cushion | C) Offload pressure immediately by positioning the resident on their side at a 30-degree angle with pillows and report the finding to the nurse | D) Apply a heating pad
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Correct Answer: C. Never massage a reddened bony prominence—fragile capillaries underneath are already damaged and rubbing shears the tissue further. Offload pressure immediately and alert the RN.
A) Position head flat on back and pour mouthwash from a cup | B) Turn the resident's head to the side (lateral position) and use a lightly moistened padded sponge swab (Toothette) with very little liquid | C) Sit the resident at 90 degrees and use a standard hard toothbrush with water | D) Skip oral care until the resident wakes up
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Correct Answer: B (Turn head to the side and use a moistened sponge swab). Unconscious residents lack a gag/swallowing reflex; turning the head laterally allows any trace moisture to drain out of the corner of the mouth rather than pooling in the pharynx and causing aspiration pneumonia. Never put your fingers between an unconscious resident's teeth.
A) Right after the resident walks back from lunch | B) In the morning before the resident gets out of bed (or after legs have been elevated in bed for 15–30 minutes) | C) Only at bedtime | D) Immediately after a hot shower while legs are dangling
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Correct Answer: B (In the morning before getting out of bed while leg veins are least distended). Dependent edema increases once legs hang down; applying TED hose smoothly (with zero wrinkles or rolled tops) while supine prevents venous pooling and DVT.
A) Wash the entire hearing aid under warm running water | B) Check that the battery is inserted correctly/charged, the power switch is ON, the earmold is seated snugly in the ear canal, and the tubing is free of earwax (cerumen) | C) Turn the volume all the way to maximum before inserting it | D) Soak the hearing aid in alcohol
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Correct Answer: B. Never submerge a hearing aid in water or cleaning solution. Turn the hearing aid off and remove the battery when stored at night, and insert it with the volume turned low before adjusting upward.
A) Stand the resident up quickly to get them into the wheelchair | B) Assist the resident to lie back down safely on the bed, stay with them, check vital signs, and notify the nurse | C) Leave the resident sitting on the edge of the bed while you walk to the nurse's station | D) Give the resident a hot bath
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Correct Answer: B (Lay the resident back down safely and stay with them). Dizziness upon sitting up is a classic sign of orthostatic hypotension (a sudden drop in blood pressure). Never attempt to stand a dizzy resident or leave them unattended on the edge of the bed.
Domain 3: Dementia Care, Emergency Response, Resident Rights & Scope (Questions 18–25)
A) Place a padded tongue blade or spoon in the resident's mouth to prevent biting the tongue | B) Hold the resident's arms and legs down firmly to stop the jerking | C) Protect the resident's head, loosen tight clothing around the neck, turn onto the side (recovery position) if possible, note the start time, and call the nurse | D) Transfer the resident to a wheelchair
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Correct Answer: C. Never restrain a seizing patient or put any object into their mouth (causes broken teeth and airway obstruction). Pad the head, clear nearby hazards, turn to the lateral position to keep the airway clear of saliva/emesis, time the seizure, and summon the nurse.
A) "Your children are 50 years old now, Mrs. Davis; you live in a nursing home." | B) Lock the resident in her room until dinner | C) Validate her feelings and redirect calmly: "You are such a caring mother, Mrs. Davis. Walk with me down the hall and tell me about your children while we get a warm snack." | D) Ignore her and continue charting
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Correct Answer: C (Validation therapy and gentle redirection). In moderate-to-severe dementia, harsh reality orientation ("your parents/children are gone") triggers acute grief and combativeness. Validate the emotion behind the statement and redirect to a safe, calming activity.
A) Check every 4 hours; release once per 12-hour shift | B) Check at least every 15 minutes for circulation/safety, and release at least every 2 hours for 10 minutes of ROM, repositioning, and toileting | C) Tie the restraint using a square knot to the movable side rail | D) CNAs can apply restraints anytime a patient wanders without a doctor's order
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Correct Answer: B (Check every 15 minutes; release every 2 hours). Restraints require a specific physician order, must always be tied with a quick-release knot to the non-movable bed frame (never the side rail), checked every 15 minutes for cyanosis/numbness, and released at least every 2 hours.
A) Extinguish the fire with a water bucket | B) Open the bedroom window to let smoke out | C) Rescue / Remove the resident (and any roommates) from immediate danger to a safe zone | D) Gather the resident's clothing and valuables
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Correct Answer: C (Rescue/Remove residents in immediate danger first). RACE stands for: Rescue/Remove residents in danger → Activate the fire alarm/call 911 → Confine/Contain the fire by closing doors → Extinguish (using PASS: Pull pin, Aim at base, Squeeze handle, Sweep side to side) or Evacuate.
A) Tell the coworker quietly since they also work at the hospital | B) Show the coworker Mr. Miller's chart at the nurse's station | C) Politely decline to confirm or discuss any patient information, as only staff directly involved in a patient's care may access their Protected Health Information (PHI) | D) Text the coworker after work
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Correct Answer: C. Under federal HIPAA law, Protected Health Information (PHI) is strictly restricted to healthcare personnel on a "need-to-know" basis who are directly providing care to that patient, and must never be discussed in public elevators, cafeterias, or social media.
A) Keep it secret if the resident asks you not to tell anyone | B) Confront the night-shift coworker directly in the breakroom | C) Ensure the resident is safe and report the observation and statement immediately to the supervising RN / Director of Nursing / Administrator per mandatory reporting law | D) Wait until next week to see if it happens again
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Correct Answer: C. Certified Nursing Assistants are legally mandated reporters under federal OBRA and state adult protective services laws. Suspected physical, verbal, emotional, sexual, or financial abuse—or neglect—must be reported immediately up the chain of command.
A) Staff may open and screen a resident's mail before handing it to them | B) The right to send and receive unopened mail, make private phone calls, participate in resident council meetings, and refuse medical treatment | C) Married couples residing in the same facility are prohibited from sharing a room | D) Facilities may confiscate personal clothing if a resident complains
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Correct Answer: B. OBRA guarantees every resident the right to privacy in communications (unopened mail and private telephone access), the right to share a room with a consenting spouse, the right to be free from chemical or physical restraints, and the right to voice grievances without retaliation.
A) Remove dentures and leave the mouth and eyelids wide open | B) Treat the body with complete respect and privacy, bathe gently, place a single pillow under the head and shoulders (elevating head slightly to prevent facial discoloration), close eyelids gently, insert dentures if facility policy allows, and place clean linens | C) Throw away all personal jewelry and family photos in the room | D) Perform post-mortem care in front of the roommate with the curtain open
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Correct Answer: B. Post-mortem care must be completed promptly (before rigor mortis sets in 2 to 4 hours after death) while wearing gloves and maintaining full privacy and dignity, positioning the body in supine alignment with a pillow under the head so the family can say goodbye peacefully.