Certified Nursing Assistant Examination (CNA) Basic Nursing Skills and Clinical Care Syllabus

Basic Nursing Skills and Clinical Care syllabus — full chapter and topic list

Expand any chapter to see its topics and sub-topics. This is the whole examinable outline for Basic Nursing Skills and Clinical Care in Certified Nursing Assistant Examination (CNA), not a summary of it.

1. 1

   Measuring and Recording Vital Signs

   6 topics

   • Body temperature
     • Oral, axillary, tympanic, and temporal routes
     • Normal ranges and reporting deviations
   • Pulse
     • Radial and apical pulse
     • Rate, rhythm, and force
   • Respirations
     • Counting rate and observing character
   • Blood pressure
     • Manual cuff and sphygmomanometer use
     • Systolic vs. diastolic and normal ranges
   • Pain assessment as the fifth vital sign
   • Height, weight, and intake/output measurement
2. 2

   Mobility, Positioning, and Transfers

   6 topics

   • Proper body alignment and positioning
     • Supine, prone, lateral, Fowler's, and Sims' positions
     • Use of pillows and positioning devices
   • Turning and repositioning schedules
     • Two-hour repositioning to prevent pressure
     • Logrolling technique
   • Safe transfer techniques
     • Bed to chair and wheelchair transfers
     • Use of gait/transfer belts
     • Mechanical and sit-to-stand lifts
   • Ambulation assistance
     • Assisting with walkers, canes, and crutches
     • Guarding against falls during walking
   • Range-of-motion (ROM) exercises
     • Active vs. passive ROM
     • Preventing contractures and deformities
   • Wheelchair safety and positioning
3. 3

   Skin Care and Pressure Injury Prevention

   4 topics

   • Skin observation and reporting
     • Color, temperature, and integrity changes
     • Recognizing early pressure injury (stage 1)
   • Pressure injury risk and prevention
     • Common pressure points and bony prominences
     • Repositioning, padding, and pressure-relieving devices
     • Keeping skin clean and dry
   • Edema and circulation monitoring
   • Care of casts, dressings, and existing wounds (CNA role)
4. 4

   Elimination Needs

   5 topics

   • Assisting with toileting
     • Bedpan, urinal, and bedside commode use
     • Perineal care after elimination
   • Urinary catheter care (CNA scope)
     • Indwelling catheter cleaning and securing
     • Emptying and measuring drainage bags
   • Bowel and bladder retraining
     • Establishing toileting schedules
     • Promoting continence
   • Specimen collection
     • Urine and stool specimens
     • Labeling and handling
   • Ostomy care basics
5. 5

   Comfort, Rest, and Therapeutic Measures

   4 topics

   • Promoting comfort and rest
     • Positioning for comfort
     • Reducing environmental disturbances
   • Sleep and rest needs
     • Factors affecting sleep
     • Supporting sleep routines
   • Heat and cold applications (CNA scope)
     • Safe application and skin monitoring
   • Pain recognition and non-medication comfort measures

Basic Nursing Skills and Clinical Care flashcards for Certified Nursing Assistant Examination (CNA)

25 of 51 cards from the Basic Nursing Skills and Clinical Care deck — real questions with worked answers.

1. What are the four standard sites for measuring body temperature, and which is considered the most accurate?

   Oral, rectal, axillary, and tympanic (ear). The rectal site is considered the most accurate, reflecting true core body temperature.

2. What is the normal oral body temperature range in Fahrenheit and Celsius?

   Normal oral temperature is about 97.6°F to 99.6°F (average 98.6°F), or roughly 36.5°C to 37.5°C (average 37°C).

3. How do rectal and axillary temperatures compare to an oral temperature reading?

   A rectal temperature is about 1°F (0.5°C) HIGHER than oral, and an axillary temperature is about 1°F (0.5°C) LOWER than oral.

4. What is a fever (pyrexia), and what general oral temperature defines it?

   Fever is an elevated body temperature above normal, generally an oral temperature of 100.4°F (38°C) or higher. The CNA should report it to the nurse.

5. Define pulse and name the most commonly used site for routine pulse measurement.

   Pulse is the beat of the heart felt at an artery as blood is pushed through it. The radial artery (thumb side of the wrist) is the most common site for routine measurement.

6. What is the normal resting pulse (heart rate) range for an adult, and what are tachycardia and bradycardia?

   Normal adult resting pulse is 60–100 beats per minute. Tachycardia is a rate over 100 bpm; bradycardia is a rate under 60 bpm.

7. Which pulse site is used for infants/young children and during CPR assessment, and which is checked for circulation in the lower legs?

   The apical pulse (heard with a stethoscope over the heart's apex) is used for infants and when the radial is irregular; the carotid is used during CPR/emergencies; the pedal (dorsalis pedis) pulse checks lower-leg circulation.

8. Besides rate, what two characteristics of the pulse should a CNA observe and report?

   The rhythm (regular vs. irregular) and the force/strength (strong, weak, bounding, or thready).

9. Define respiration and explain what counts as one respiration.

   Respiration is the act of breathing air in and out of the lungs. One respiration equals one inhalation (breathing in) plus one exhalation (breathing out).

10. What is the normal respiratory rate for an adult at rest?

    12 to 20 breaths per minute.

11. Why should a CNA count respirations without telling the patient, and how is this often done?

    Because people can consciously change their breathing if they know it is being counted, giving an inaccurate result. It is usually counted right after taking the pulse while still holding the wrist, so the patient is unaware.

12. Define the abnormal breathing terms: dyspnea, apnea, tachypnea, and bradypnea.

    Dyspnea = difficult/labored breathing; apnea = absence of breathing; tachypnea = abnormally rapid breathing; bradypnea = abnormally slow breathing.

13. What do the two numbers in a blood pressure reading (systolic and diastolic) represent?

    Systolic (top number) is the pressure in the arteries when the heart contracts/beats; diastolic (bottom number) is the pressure when the heart relaxes/rests between beats.

14. What is a normal adult blood pressure, and what readings define hypertension and hypotension?

    Normal is below 120/80 mmHg. Hypertension is generally 130/80 mmHg or higher (sustained); hypotension is a systolic below 90 mmHg.

15. List key rules for accurate blood pressure measurement (cuff size, arm position, what to avoid).

    Use a correctly sized cuff, place the arm supported at heart level, ensure the patient is seated and rested, and avoid the arm with an IV, dialysis shunt, or on the side of a mastectomy.

16. What is orthostatic (postural) hypotension and why is it a safety concern for CNAs?

    A sudden drop in blood pressure when a person stands up from lying or sitting, causing dizziness or fainting. It increases fall risk, so help residents change position slowly.

17. Why is pain called the 'fifth vital sign,' and what scale is commonly used to measure it?

    Because pain is routinely assessed along with temperature, pulse, respiration, and blood pressure as an indicator of patient status. It is commonly rated on a 0–10 numeric scale (0 = no pain, 10 = worst pain).

18. List objective (nonverbal) signs of pain a CNA should observe and report.

    Grimacing, moaning/crying, guarding or holding a body part, restlessness, sweating, increased pulse/blood pressure, grinding teeth, and changes in behavior or appetite.

19. When should height and weight be measured, and what should be standardized for accurate daily weights?

    Often on admission and at regular intervals. For accurate daily weights, weigh at the same time of day (usually morning before breakfast), using the same scale, with the resident wearing similar clothing and after voiding.

20. What is the purpose of measuring intake and output (I&O), and give examples of each.

    I&O measures fluid balance. Intake includes all liquids consumed (water, juice, soup, IV fluids); output includes urine, vomitus, diarrhea, and wound drainage. It is recorded in milliliters (mL/cc).

21. How many milliliters (mL) are in one ounce, and how do you convert ounces to mL for I&O?

    1 ounce = 30 mL. Multiply the number of ounces by 30 to get mL (e.g., 8 oz cup = 240 mL).

22. Describe proper body alignment (posture) for a person lying or standing.

    Body alignment is positioning the body so the spine is straight and body parts are in their natural position without strain, keeping the head, trunk, and limbs in line and well supported.

23. What is body mechanics, and name two key principles a CNA uses to prevent injury when lifting.

    Body mechanics is using the body efficiently to prevent injury. Key principles: bend at the knees/hips (not the back) and use the strong leg muscles, and keep the load close to your body with a wide base of support.

24. Define the supine, prone, lateral, and Fowler's positions.

    Supine = lying flat on the back; prone = lying on the abdomen/stomach; lateral = lying on the side; Fowler's = semi-sitting with head of bed raised 45–60 degrees.

25. How often should an immobile/bedbound resident be turned and repositioned, and why?

    At least every 2 hours. Frequent repositioning relieves pressure on the skin, promotes circulation, and prevents pressure injuries (bedsores) and contractures.

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