Help with cna skills test--have questions

In my test vitals were done with the patient (a fellow candidate) lying down. During the test they made everyone wash their hands once, properly, and then they have you verbalize it for every skill.

No one did foot care and they do not include it on our state's test. You learn it in the classroom but they don't want people having to bare their feet for other candidates during the exam.

For the other things...
Gather equipment
Knock
Await an answer
Enter
Close door behind you
Introduce yourself
Perform hand hygiene
Explain procedure
Check patient ID

Think about it...if you were a patient wouldn't you rather someone had cleaned their hands before they touch you? Even if it is just a wrist band.

In reality you should be able to perform foot care on someone who is actually in a bed or sitting.

Again, get the official candidates handbook. Beware youtube videos unless your instructor has actually approved them. Your course should provide you with approved videos to watch. Also, you can try the link below. Some of them are a bit dated. Once you have the official candidate handbook you will be able to use it as you look at the videos.

http://deptets.fvtc.edu/nursing/index.htm

One thing that i disagree with above, you want to wash your hands BEFORE you gather supplies, otherwise you are contaminating clean supplies with your unwashed hands. So wash hands, gather supplies, knock, and so on.....

We were taught to wash hands right before you touch your patient. Greet, introduce, close curtain, and gather supplies and get them ready (fill basin with water etc..) then wash hands and go directly to your patient. We take the skills exam this Saturday and someone from another class before us who passed his exam the first time told us that also. He also said that the examiner at his test told them to wash hands one time and from then on tell them that you washed your hands. We were told that the BP is taken in bed with the patient sittin up at a 60-90 degree angle.

For my test I was unlucky and was the first person to be called. I had Weight of ambulatory resident, mouth care of a dependent resident, and ambulation. I was so nervous I failed the weight, but since I passed communication, handwashing, and the other two skills she passed me. My proctor wouldn't let me finish a single skill before she told me move on. Some of the other girls I tested with failed because they weren't concerned with patient safety. Our test was done on the actual patients in a ltc facility so it made you really think about privacy and safety. If your not doing it on real people just remember Safety and Privacy and you should do fine.

We had the "patient" lying down for hand and foot washing. We had to wash our hands first thing before touching anything, but maybe that was because the handwashing was in the bathroom. So it probably depends on the facility. Hope that helps! Don't stress out about it too much it's really not that bad. Good luck!

The basics are the same no matter how the client is positioned. So you do the knock, wash, intro/explain, gather supplies, curtain, lock wheels if they're in bed. If your skill is foot care, chances are they'll be in a chair (that's how we were instructed) but if they're in bed, you will have to assist them to a sitting position. With vitals, it's more likely they'll be in bed. Doesn't matter. This is where you have to think "what would i do in the real world". If you have BP, raise the head of the bed. If you have radial pulse, it's unnecessary. If you have respirations/pulse, again, leave them supine. If you have tympanic temperature, it's easier if they're semi Fowlers. If your examiner gives you a scenario where the client must be positioned a certain way, you go with that. Otherwise, take charge and do whatever vitals you get in a way that makes it easiest for you. If you get weight with ambulation just DON'T FORGET to zero out the scale before and after the skill. If you are lucky, like me, and get fluid intake, you just get three containers with pee-colored liquid. Do your best estimate of how much liquid is missing and make sure you record everything on paper. Especially do it before you forget what the numbers were and before moving on to another skill. Oh yeah, and don't forget to give the call button.

Order of the basic steps isn't critical as long as you remember to do them all. If Headmaster is your testing authority, the only skill with steps required to be in a set order is female perineal care.

In our state we didn't have to check wristbands. That depends on your testing authority. We were told who the patient was before the skill, and all we had to do was greet them by that name. Don't get too wrapped up in the order of steps. Remember the basics of privacy, safety, dignity and universal precautions and just do the skill without skipping the critical steps or forgetting to wash your hands and glove. You won't be docked for washing too much. I think it's a good idea to wash anytime you remove gloves, even if it's only a simulated wash.

If you KNOW the skill, your knowledge will kick in and you'll do fine with that boost of adrenaline. I know it sounds ridiculous now, but try to have fun with it. If you feel goofy, joke a little. Your BP will go down, and you'll feel a lot better.