Certified Nursing Assistant Examination (CNA) Safety, Infection Control, and Emergency Care Syllabus

If a resident starts to fall while you are assisting them, what should you do?

Do NOT try to stop the fall. Ease the resident to the floor by widening your stance, bending your knees, and supporting/lowering them gently against your body to protect their head, then call for help. Trying to catch them can injure you both.

What is a physical restraint, and what must legally be in place before one is used?

Any device, material, or equipment that restricts a person's freedom of movement or access to their own body. It requires a doctor's written order specifying the type and duration, must be the last resort, and used only to protect the resident—never for staff convenience or discipline.

How often must a restrained resident be checked and released, and for how long?

Check the resident at least every 15 minutes; remove the restraint at least every 2 hours for at least 10 minutes to reposition, provide range of motion, toileting, food/fluids, and skin/circulation care.

Name three alternatives to using restraints.

Bed/chair alarms, frequent toileting and observation rounds, lowering the bed and using floor mats, providing diversional activities/companionship, and meeting needs promptly (e.g., pain, hunger, toileting).

List three safety rules for caring for a resident receiving oxygen therapy.

1) No smoking, open flames, or sparks near oxygen (post 'Oxygen in Use' signs), 2) Avoid flammable/oil-based products (petroleum jelly, aerosol sprays) near the resident, 3) Check that tubing is not kinked and that flow rate matches the order (CNAs do not change flow rate).

Why is oxygen a fire hazard even though it does not burn itself?

Oxygen supports and accelerates combustion (it is an oxidizer). It makes fires start more easily and burn hotter and faster, so all ignition sources and flammable materials must be kept away.

What is the recommended safe maximum hot water temperature to prevent scalds in a healthcare setting?

Generally about 105-110 F (around 41-43 C) for bathing. Always test water temperature before use and check it on your inner wrist or with a thermometer to prevent burns/scalds.

List three ways to prevent burns when serving food/beverages or providing care.

1) Test temperature of food, drinks, and bathwater before giving them, 2) Keep hot liquids away from the edge of tables/trays and out of reach, 3) Pour hot liquids away from the resident; warn the resident that items are hot.

What are three measures to prevent poisoning in a care setting?

1) Store chemicals/cleaners in locked areas in their original labeled containers, 2) Keep medications secured and never leave them at the bedside, 3) Know how to access Safety Data Sheets (SDS) and the Poison Control number (1-800-222-1222).

What is the first step in responding to any emergency?

Assess the scene for safety (make sure it is safe for you and the victim), then check the victim's responsiveness, and call for help/activate the emergency response system (911 or facility code) before beginning care.

What is the universal sign of choking, and how do you tell a mild from a severe airway obstruction?

The universal sign is clutching the throat with one or both hands. Mild/partial obstruction: the person can cough forcefully, speak, or breathe—encourage coughing. Severe/complete: cannot cough, speak, or breathe (silent, possibly bluish)—act immediately.

How do you respond to a conscious adult with a complete airway obstruction (choking)?

Perform abdominal thrusts (Heimlich maneuver): stand behind, make a fist with thumb side just above the navel and below the breastbone, grasp with the other hand, and give quick inward and upward thrusts until the object is expelled or the person becomes unconscious.

How is the response to choking modified for a pregnant or obese (large) adult?

Use chest thrusts instead of abdominal thrusts—place the fist on the center of the breastbone (sternum) and give quick inward thrusts, because the abdomen cannot be safely compressed.

What should you do if a choking adult becomes unconscious?

Lower them gently to the floor, call for help/activate EMS, and begin CPR. Each time you open the airway to give breaths, look in the mouth and remove any visible object (do not perform blind finger sweeps).

What are the warning signs of a heart attack (myocardial infarction)?

Chest pain/pressure (may radiate to arm, jaw, neck, or back), shortness of breath, sweating (diaphoresis), nausea, dizziness, and a feeling of impending doom. Women may have atypical signs like fatigue or indigestion. Activate EMS immediately.

What are common signs of respiratory distress in a resident?

Shortness of breath (dyspnea), rapid or labored breathing, gasping, use of accessory muscles, wheezing, bluish lips/nail beds (cyanosis), restlessness/anxiety, and inability to speak in full sentences. Stay with the resident and call for help.

What are the recognized signs and symptoms of a stroke (CVA), summarized by the acronym FAST?

F = Face drooping, A = Arm weakness, S = Speech difficulty/slurred, T = Time to call 911. Other signs: sudden confusion, vision loss, severe headache, dizziness, or numbness on one side.

How do you control external bleeding from a wound?

Apply firm, direct pressure over the wound with a clean cloth/gloved hand, add more layers without removing soaked ones, elevate the body part if no fracture is suspected, and call for help. Wear gloves (standard precautions).

What is shock, and what are its common signs and symptoms?

Shock is inadequate blood flow/oxygen to body tissues. Signs: pale, cool, clammy/moist skin; rapid weak pulse; rapid shallow breathing; low blood pressure; thirst; restlessness/confusion. It is life-threatening—call for emergency help.

How should you position a person showing signs of shock (no spinal injury suspected)?

Lay the person flat on their back and keep them warm and calm; control any bleeding. Do not give food or fluids. Activate EMS. (Legs may be raised about 12 inches only if no head, neck, back, or leg injury is suspected.)

What should a CNA do FIRST and during a seizure?

Stay with the resident, lower them to the floor/protect the head, move furniture away, loosen tight clothing, turn them on their side (if possible) to keep the airway clear, and time the seizure. Do NOT restrain them or put anything in their mouth.

How do you care for a resident who has fainted (syncope)?

If you sense it coming, help them sit or lie down to prevent injury. Once down, keep them lying flat, loosen tight clothing, and if no injury is suspected, you may elevate the legs about 12 inches. Keep them lying down until fully recovered and report it.

How do you provide first aid for a minor (superficial/first-degree) burn?

Cool the burn with cool (not ice-cold) running water for several minutes, remove jewelry/tight items, and cover loosely with a clean, dry, non-stick dressing. Do not apply butter, ointments, or ice. Report and document the burn.

What is the difference between a first-, second-, and third-degree burn?

First-degree: affects only the outer skin (epidermis)—red, painful, dry (like sunburn). Second-degree: epidermis and dermis—red, blistered, very painful. Third-degree: full thickness through all skin layers—may look white/charred and be painless due to nerve damage.

What are the signs of hypoglycemia (low blood sugar / insulin reaction)?

Rapid onset: shakiness/trembling, sweating, pallor, hunger, rapid pulse, dizziness, confusion/irritability, weakness, and possible loss of consciousness. It is an emergency—give a fast-acting sugar if the person is conscious and able to swallow, and report immediately.

What are the signs of hyperglycemia (high blood sugar) and diabetic ketoacidosis?

Slow onset: increased thirst, frequent urination, hunger, dry warm flushed skin, fruity/sweet (acetone) breath, deep/rapid breathing, drowsiness, nausea, and possible coma. Report immediately—it is a medical emergency.

Compare the onset and skin findings of hypoglycemia versus hyperglycemia.

Hypoglycemia: rapid/sudden onset with cool, pale, moist (sweaty) skin. Hyperglycemia: gradual/slow onset with warm, dry, flushed skin and fruity breath. (Memory aid: 'cold and clammy, need some candy; hot and dry, sugar high.')

What does the fire-safety acronym RACE stand for?

R = Rescue anyone in immediate danger, A = Alarm (activate the fire alarm/call for help), C = Confine the fire (close doors and windows), E = Extinguish the fire if small/safe, or Evacuate.

What does the fire-extinguisher acronym PASS stand for?

P = Pull the pin, A = Aim the nozzle at the base of the fire, S = Squeeze the handle, S = Sweep from side to side at the base of the fire.

During a facility evacuation, who is evacuated first and how is resident accountability ensured?

Move residents in immediate danger first, generally ambulatory residents first, then those needing assistance/non-ambulatory. Account for every resident and staff member using the resident roster/census at the designated assembly point, and follow the facility's evacuation plan.

What are the basic principles of good body mechanics for staff safety when lifting?

Keep a wide base of support (feet shoulder-width apart), bend at the knees/hips (not the waist), keep the load close to your body, lift with your leg muscles, keep your back straight, and avoid twisting—pivot your feet instead. Push or roll rather than lift when possible.