Certified Nursing Assistant Examination (CNA) Personal Care and Activities of Daily Living (ADLs) Syllabus

How should mouth care be given to an unconscious resident, and in what position?

Position the resident on their side (lateral) with the head turned to the side, use only a small amount of fluid with swabs, and keep suction or a basin ready. Side-lying positioning prevents aspiration of fluids into the lungs.

How are dentures cleaned and stored safely?

Clean them over a basin or sink lined with a towel/water to prevent breakage if dropped, use cool or lukewarm (not hot) water, and store them in a labeled container with cool water or denture solution when not worn.

Why must hot water never be used to clean or soak dentures?

Hot water can warp the denture material, changing the shape so the dentures no longer fit properly.

How should shaving be done with a safety razor, and what direction?

Soften the skin first, shave in the direction of hair growth using short strokes while holding the skin taut, then rinse and dry. Shaving with the grain reduces nicks and irritation.

Which residents should NOT be shaved with a regular safety razor, and what is the alternative?

Residents on anticoagulants (blood thinners) or with bleeding disorders should be shaved with an electric razor to reduce the risk of cuts and bleeding.

What is the safe practice for cutting fingernails and toenails as a nursing assistant?

File nails to shape and smooth them; never cut a resident's nails unless permitted by facility policy. Nail trimming for diabetic or vascular residents is usually done only by a nurse or podiatrist.

Why must extra caution be used when caring for the nails and feet of a diabetic resident?

Diabetics often have poor circulation and reduced sensation (neuropathy), so small cuts or injuries heal slowly and can lead to serious infection, ulcers, or amputation.

When dressing a resident with a weak (affected) side, which arm goes into the sleeve first?

Dress the weak/affected side first and undress it last. This reduces strain and discomfort on the affected limb.

When undressing a resident with one weak side, which side is removed first?

Undress the strong (unaffected) side first, then the weak side. Memory aid: 'strong side first to undress, weak side first to dress.'

List three principles of proper foot care for at-risk residents.

Wash and dry feet daily (especially between the toes), inspect for cuts/redness/blisters/swelling, keep skin moisturized but not between the toes, and ensure clean dry socks and well-fitting shoes.

Why should lotion not be applied between the toes?

Moisture trapped between the toes promotes fungal growth and skin maceration/breakdown, increasing infection risk.

What are the foot inspection findings on a diabetic resident that must be reported immediately?

Any cut, sore, blister, ingrown nail, redness, swelling, drainage, color change (pale/blue/black), or coolness of the foot, because these can signal poor circulation or infection.

What are the five basic food groups in the USDA MyPlate guide?

Fruits, vegetables, grains, protein, and dairy.

What are the six essential nutrients the body needs?

Carbohydrates, proteins, fats (lipids), vitamins, minerals, and water.

What is the main function of protein in the diet?

Tissue growth and repair; building and maintaining muscles, organs, and the immune system. Protein is especially important for wound healing.

What nutrient is the body's primary source of energy?

Carbohydrates.

What is a mechanical soft diet, and who needs it?

A diet of foods that are chopped, ground, mashed, or pureed so they are easy to chew and swallow. It is used for residents with chewing difficulty, dental problems, or mild swallowing issues.

What is dysphagia, and what diet modification helps manage it?

Dysphagia is difficulty swallowing. It is managed with thickened liquids and modified-texture foods (mechanical soft or pureed) to reduce the risk of choking and aspiration.

What is a clear liquid diet?

A diet of liquids you can see through, such as water, broth, clear juices (apple), gelatin, and tea. It is used short-term, often before/after procedures or for GI upset.

What is the best position for a resident during meals and feeding to prevent aspiration?

Sitting upright (Fowler's position) at 90 degrees, or as upright as possible, and remaining upright for at least 30 minutes after eating.

List three safety practices when feeding a resident.

Offer small bites, alternate solids and liquids, allow time to chew and swallow each bite, check the mouth is empty before the next bite, and never rush or feed a sleepy/reclined resident.

How should you check that fluids are an appropriate temperature before feeding?

Test hot foods/liquids before serving (e.g., a small amount on your wrist) and avoid serving food too hot, which can burn the resident's mouth.

What is the approximate recommended daily fluid intake for most adults?

About 1,500 to 2,000 mL (roughly 6 to 8 eight-ounce glasses, about 2 liters) per day, unless restricted by a doctor's order.

How many milliliters are in one ounce, used for measuring intake and output?

1 ounce equals 30 mL. (Example: an 8-ounce glass = 240 mL.)

What is fluid balance, and what are the two opposite imbalances?

Fluid balance is when fluid intake equals fluid output. Too little fluid causes dehydration; too much fluid retention causes edema (fluid overload).

List three signs of dehydration a nursing assistant should watch for and report.

Dark/concentrated urine with low output, dry mouth and skin, poor skin turgor (skin 'tents'), sunken eyes, confusion, weakness, weight loss, and complaints of thirst.

What is the difference between NPO and a 'force fluids' (encourage fluids) order?

NPO (nil per os) means nothing by mouth — no food or fluids. 'Force/encourage fluids' means actively offer extra fluids throughout the day to increase intake.

What is the difference between an occupied and an unoccupied bed?

An occupied bed is made while the resident remains in it (for those on bed rest who cannot get up); an unoccupied bed is made while empty.

What is the key infection-control rule for handling clean and soiled linens?

Hold all linens away from your body/uniform, never shake them (shaking spreads microorganisms into the air), carry clean and dirty linen separately, and place soiled linen directly into the hamper, never on the floor.

In what order do you carry and gather linens to maintain cleanliness?

Gather linens in the order of use and place them on a clean surface; carry clean linen away from your body and never return unused linen from one resident's room to the linen cart (it is considered contaminated).

List three elements of maintaining a safe, comfortable resident unit.

Keep the call light within reach, keep the bed in low position with wheels locked, keep the area free of clutter and spills, ensure good lighting and comfortable temperature, and keep personal items within the resident's reach.

Why should personal care equipment be cleaned and organized after each use?

To prevent the spread of infection, ensure supplies are ready for the next use, keep each resident's items separate (no sharing of personal items like razors or toothbrushes), and maintain an uncluttered, safe environment.