CNA state exam question

by Magplad Magplad (New) New

A friend of mine (who is also taking the test with me) and I have basically confused ourselves. We found out through the grapevine that one of the skills for the state exam this month is Blood Pressure. The book says you need to be within 6mm of the evaluators reading.

Example: Evaluator got 114/82 , student got 110/78

Our question is....does the top number need to be within 6mm and also the bottom number need to be within 6mm? Or is it the difference (114-110=4, 82-78=4; 4+4=8) between the top and the difference between the bottom added together?


classicdame, MSN, EdD

Specializes in Hospital Education Coordinator. 2 Articles; 7,255 Posts

this is a question for your instructor as the faculty are the ones who made up the rule. Probably both numbers have to be within 6mm/Hg, not a combo. Just guessing there. You need to confirm with instructor. Always a good idea to ask questions to learn what is expected of you. Good luck.



7 Posts

I asked the instructor but I think we all confused her with the question because she just kept responding "it needs to be within 6mm". So no clarity from her whatsoever, lol!


jb2u, ASN, RN

Specializes in ICU, ER, Hemodialysis. Has 5 years experience. 1 Article; 862 Posts

Of course only your instructor can really answer what he/she wants. However, when I had my was just the top/bottom had to be with in 4-6mm NOT a combination of the two. The fact is two people CAN hear the BP differently, but the difference should not be way off...ex: you hear 120/74, instructor hears 150/80.

When it comes to BPs, the trick is to listen carefully, and be confident in your abilities. I know some people will get a high reading and second guess themselves, but if you HEARD it then you HEARD it. Now if you didn't hear it or are having trouble hearing it...let someone know. Say, "hey, I can't hear the bp on room 444, can you check it for me?" Some people have really faint BPs!!

Good luck,



jb2u, ASN, RN

Specializes in ICU, ER, Hemodialysis. Has 5 years experience. 1 Article; 862 Posts

If Promissor is the same company that will adminster the test in your state, I'm not sure what state you are from (I know that they administer the test in many states, then this is what their handbook states...Handbook.pdf


1 Explains procedure to client, speaking clearly,

slowly, and directly, maintaining face-to-face contact

whenever possible

2 Before using stethoscope, wipes diaphragm and

earpieces of stethoscope with alcohol

3 Exposes client's upper arm and positions arm with

palm up

4 Locates brachial pulse with fingertips

5 Places blood pressure cuff snugly on client's upper

arm, with sensor placed over artery

6 Places earpieces of stethoscope in ears

7 Places diaphragm over brachial artery

8 Candidate does one of the following;

a. Inflates cuff quickly between 160 mm Hg to 180

mm Hg. (If the beat is heard immediately upon

deflation of the cuff, completely deflate the cuff.

Then re-inflate cuff to no more than 200 mm Hg.)


b. Inflates the cuff 30 mm Hg beyond where radial or

brachial pulse last heard or felt

9 Deflates cuff slowly and removes

10 Signaling device is within client's reach

11 Washes hands

12 Records both systolic and diastolic pressures each

within plus or minus 4 mm of evaluator's reading

Note that step 12 is in bold..which means it MUST be done in order to pass. Now it says that EACH must be within that would be sys. within 4mm and then the dia. must be within 4mm, NOT combined. Like I said, just be confident and I am sure you will do fine. Do not guess. Better to repeat BP than to make up a BP. If Promissor is not administering your test, try to find out from the list of registries in my signature from YOUR state what they want. On their website, there may be a handbook for the test like on my states site, South Carolina.



Specializes in ICU. Has 5 years experience. 225 Posts

I pulled BP as one of my skills for the CNA test. (They had all the skills in a bowl, and we pulled a skill out at each of three stations.)

We had a 4 mm leeway on the systolic and 4 mm leeway on the diastolic.

Now, keep in mind that I was using two hands to hold onto the equipment and the test administrator didn't have to hold onto anything... so she put the earpieces tightly in her ears so she could hear accurately. But my hands were busy so my earpieces were pretty loose in my ears. So it makes sense that she heard the sounds for the systolic earlier that I did - she had 4 mm higher than my reading.

Also, we were all so nervous when we took the test. The girl who acted as my patient must have been all of 5'0" and maybe 110 pounds - but she was very nervous so her BP was about 140/90. Much higher for her than normal. It's something to keep in mind if you've been practicing BPs on each other.



Has 7 years experience. 8 Posts

Taking blood pressures are tricky and can take a bit to get comfortable with. On my exam I think I was most nervous about blood pressure not because I wasn't confident - but I was worried about the "instructor factor." That I could do everything right and for some reason still wouldn't make my 4mm buffer. Most instructors are not out to get you but there are a few that really stick to their guns and I understand why. Good study habits is the key to passing.

Good luck Test Takers!

:) Suzanne

Edited by Silverdragon102
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