Challenging CNA exam..help please?

[BossBadger]

I am challenging the CNA exam in Florida soon, and I'm beginning to worry that I am in way over my head and won't pass the test. I am fairly confident about the written portion (though I may eat my words) but have some questions about portions of the clinical skills section..any help would be appreciated.

1.Changing an occupied bed: Do I leave the top sheet over the patient the whole time in order to keep them covered, and change only the bottom sheet first? Then remove the top sheet and replace it with a new one? Do I need to assist the resident to lay on his/her side, and how do I best do this? What's the best way to replace the pillowcase?

2.Changing resident to side-lying position: What is the best thing to use behind the patient's back..a pillow rolled in half, towel, blanket? Will there be padding or something available to put between the person's knees, ankles, and under their arm?

For both 2 and 3, what is the correct way to align and turn the patient?

The other problem I am having is where to put all of the stuff needed to do the skill. For example, when giving a partial bed bath/doing perineal or foot care. I know you need a basin of water, two washcloths, soap, towel, etc. Where do you set everything? Do you sit on the edge of the bed or stand when performing the bath? Where do you sit for foot care? Where do you put the soapy washcloth while you are using the rinsing cloth?

I apologize for all the questions. I am trying to get in as much practice as possible before the test but I want to make sure I'm practicing correctly!

As for the written exam, I didn't miss any questions on the practice exam, but I'm a bit concerned that there may be things that aren't on the practice test that aren't 'common sense' (meaning something they only teach you in a care setting or a class).

Thanks so much for any help!

[FLNA]

I am in the same boat as you. I am challenging the exam, scheduled for 09/04/09. I am taking my test at Casel Healthcare in Melbourne Florida. There aren't any preceptor programs in my area, and no one offers a clinical skills review class close by. The closet I found was Tampa (2 hours ) and Orlando (about 1 hour away). I have the clinical skills checklist from Prometric, but like you said, nothing is better than hands on training. What part of Florida are you in?

[FLNA]

P.S. I spent 15 hours a day in Hospice house with my grandmother this summer (where she passed away) and I watched the CNA's carefully everyday and assisted them with position change every 2 hours. They used pillows (2)behind grams back, tucked or rolled them under her back, put a pillow between her knees and ankles, one pillow used for a "huggie" and one pillow to support her neck/head.

[Student4Now]

Hi there- I can tell you what we were taught and what is in my book- although Im not sure that is how they will have you do it. Also, youtube.com has vids of skills you might be interested it- its how I learned to create a sterile field. I really needed the visual. You would take any blankets off of the pt, leave their sheet.Put a bath blanket on top of their top sheet and then remove it. They should have the bath blanket on the entire time until it is time to put on a clean top sheet. For pillowcase changing, grasp the closed end and turn it inside out over hand . Now grasp one end of pillow with hand in the case and smooth out wrinkles , making sure pillowcase corners fit with pillow corners. In the real world if a pt needs turned, you just make sure the rail is up on the side they will be turning to, and kind of support them while they turn (if they are able.) If they are unable to turn on their own,use the drawsheet to gently pull them to the side of the bed opposite to the side you want them to turn to.Turn them toward you using with one hand on shoulder and the other on their hip As for #2- you will usually use pillows for behind their back, knees and under arms.Some residents will have the padded booties for ankles but most do not and you can use pillows there also. When doing a bed bath, put your supplies on the bedside table. Raise the bed to waist level (dont forget to lower it when you are finished) and stand up when you are doing the bed bath or perineal care. For foot care, the pt should be in a chair. This info came from my FON book- Good luck!

[FLNA]

Thank you so very much. This is helpful information. I appreciate you taking the time to answer in such detail.

[BossBadger]

Thanks for your help!

One more question..what exactly is a 'bath blanket'? Is it commonly one of the available items during the test? If one isn't available, do I leave the regular blanket over the patient while removing the sheet?

I'm going to my mother's tomorrow to watch some videos of the skills (I'm on dialup so I can't load them). Hopefully that'll help.

Good luck, NewCna! Here's the link to the videos (I found it elsewhere on this forum so I assume it's okay to post...)

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

[Student4Now]

Yes, bath blankets should be commonly available anywhere. They are smaller than a blanket and less heavythan a blanket, but heavier than a sheet. If one isnt available (and there really should be), I might just grab a clean sheet to use instead.

[zoffy1231]

I am currently an LPN student in my 2nd semester and I plan on challenging the test soon even though I wouldn't necesarilly have to to get a job. A classmate challenged the test already and passed the written, but failed the clinical. They do things differently than what we have been taught. She failed Blood Pressure! We are taught to feel for the pulse before pumping and then pump 2 more times when we do not feel a pulse anymore at teh radial site...apparently for CNA's you have to listen to the brachial for the entire thing! Stupid if you ask me, you can get false sounds this way! Also, NEVER trust what you see an actual health care person do in the field...9 times out of 10 they are using shortcuts they learned along the way! In my experience in the clinical setting, no one does things by the book in the field, even us! We do things much differently than what we are required to do them for our boards and even class exams!!! You really should at least take a clinical class. I am still going to challenge it regardless,Ii will just try again if I fail but I am sure I won't. Written exam for nurses is basically common sense...it kind of scares me that they let just anyone challenge the CNA, especially since CNA play a major role in patient ADL care!

[zoffy1231]

Yes, bath blankets should be commonly available anywhere. They are smaller than a blanket and less heavythan a blanket, but heavier than a sheet. If one isnt available (and there really should be), I might just grab a clean sheet to use instead.

In my experience they are usually not readily available! I have been in several LTC and SNF and hospitals and have NEVER seen these!

[FLNA]

True, it is a scary thought that we can challenge the exam, although I am personaly grateful that we have that option. I wouldn't be able to afford it any other way. As far as the Blood Pressure portion of the clinical exam, you are correct. I stopped by Casel where I will be taking my exam next month and the owner was kind enough to give me a tip. She said "make sure you check the pulse at the brachial, or they will fail you". She said you won't be able to hear it, but they just want to see that you know about the brachial pulse.

[Student4Now]

In my experience they are usually not readily available! I have been in several LTC and SNF and hospitals and have NEVER seen these!

Really? That stinks! I have never been anywhere that they didnt have them.

[displacedfloridian]

Where are you scheduled to test? I just took the test today (passed) in Ocala.....it was a little easier than I thought, my nerves were still in high-gear that's for sure.