D&S Diversified Technologies LLP

Headmaster LLP

 

Massachusetts Nurse Aide Candidate Handbook

UPDATED: OCTOBER 2025

Translatable Version 6

 

 

Contact Information

Questions regarding: testing process • test scheduling • eligibility to test (888) 401-0462

 

Questions regarding: Nurse Aide Registry, obtaining information on official regulations and guidelines for nurse aides • obtaining information regarding approved training programs • updating your name, address • verification of current nurse aide certification • renewal, reciprocity, and equivalency information

(617) 753-8144

 

D&S Diversified Technologies (D&SDT), LLP- Headmaster, LLP

PO Box 6609

Helena, MT 59604

Email: massachusetts@hdmaster.com

Web Site: www.hdmaster.com

Phone: (888) 401-0462

Hours: Monday through Friday 8:00AM – 8:00PM, Eastern Standard Time (EST)

Massachusetts TMU© Webpage: mc.tmutest.com

 

Massachusetts Department of Health (DPH) Division of Health Care Facility Licensure and Certification – Nurse Aide Registry

67 Forest Street

Marlborough, MA 01752

Email: nars@mass.gov

Massachusetts Nurse Aide Web Site:

https://www.mass.gov/nurse-aide-registry-program

Phone: (617) 753-8144

Hours: Monday through Friday 8:00AM – 5:00PM, Eastern Standard Time (EST)

 

‌Introduction‌

Congress adopted the Nursing Home Reform Act in 1987 as part of the Omnibus Budget Reconciliation Act (OBRA ’87). This federal law was designed to improve the quality of care in long-term healthcare facilities and define training and evaluation standards for nursing aides who work in such facilities. Each state is responsible for following the terms of this federal law.

 

As defined in the OBRA regulations, a Nurse Aide Competency Evaluation program provides specific standards for nurse aide-related knowledge and skills. The purpose of this program is to ensure that candidates who are seeking to be nurse aides understand these standards and can competently and safely perform the job of an entry-level nurse aide.

 

This handbook describes the process of taking the nurse aide competency examination and is designed to help prepare candidates for testing. The examination has two parts: a multiple-choice knowledge test and a skill test. Candidates must pass both parts to be identified and listed on the Massachusetts Nurse Aide Registry.

 

The Massachusetts Department of Public Health (DPH) approved D&S Diversified Technologies, LLP (D&SDT)- Headmaster, LLP to provide tests and scoring services for nurse aide testing. For questions not answered in this handbook, please contact D&SDT-HEADMASTER at (888)401-0462 or go to D&SDT-HEADMASTER’s Massachusetts Nurse Aide (NA) webpage or at www.hdmaster.com and click on ‘Massachusetts CNA’. The information in this handbook will help you prepare for your examination.

 

‌Massachusetts Nurse Aide Registry Requirements‌

The Massachusetts Nurse Aide Registry (MANAR) lists the names of nurse aides who, through training, testing, and experience, meet federal and/or state requirements to work as nurse aides in Massachusetts. The Registry includes substantiated findings of nurse aide abuse, neglect, misappropriation of resident property, or exploitation involving a nurse aide at a Massachusetts Department of Public Health (DPH) regulated facility.

 

A nurse aide candidate, upon successful completion of training, passing both the knowledge and skills portions of the competency exam, and meeting federal and/or state requirements will be listed on the MANAR. Review the Nurse Aide Competency Exam section below to help prepare for the exam.

 

‌Registry Renewal‌

To maintain eligibility to work you must renew your eligibility every 24 months. To be eligible to renew, you must work for pay as a nurse aide performing nursing or nursing-related services at least eight (8) consecutive hours during the previous 24 months. Nurse aides with misconduct restrictions on the Registry are not eligible for renewal.

 

‌Registry Reciprocity‌

This information is for applicants who want to be entered on the MANAR through the Massachusetts Reciprocity/Out-of-State registry placement process.

 

‌Out-of-State Reciprocity Process‌

If you are a certified nurse aide and meet certain requirements, you may apply for reciprocity. In order to be eligible for Reciprocity, you must be a CNA:

·         Who is certified in another state

·         Whose certification is current and in good standing

·         Who has never been certified in Massachusetts

 

The Reciprocity application and additional information are available at the following link: Reciprocity Information

 

‌Waiver of the Certified Nurse Aide Training Requirement‌

Specific waiver provisions are available for applicants who can verify they meet the qualifications listed under 105 CMR 156.100 of the Nurse Aide Registry Laws and Regulations.

 

The application and information to request a Nurse Aide Training Waiver to take the Massachusetts Nurse Aide Competency Evaluation is available at the following link: Waiver Information and Application

 

‌Americans with Disabilities Act (ADA)‌

‌ADA Compliance‌

The Massachusetts Department of Public Health (DPH) and D&SDT-HEADMASTER provide reasonable accommodations for candidates with disabilities or limitations that may affect their ability to perform the nurse aide competency examination.  Accommodations are granted in accordance with the Americans with Disabilities Act (ADA). 

 

If you have a qualified disability or limitation, you may request special accommodations for the examination. D&SDT-Headmaster must approve accommodations in advance of examination. Complete the ADA Accommodation Request Application found on the Massachusetts CNA TMU© main page under ‘applications’ to be reviewed for accommodation.

 

ADA Accommodation Request Applications submitted without the required supporting documentation of a diagnosed disability will not be reviewed until the required documentation is provided.  D&SDT-HEADMASTER will email you if further documentation or information is required using the email in your TMU© account.

 

Please allow additional time for your request to be approved.  If you have questions regarding the ADA review process or specific required documentation, please call D&SDT-HEADMASTER at (888)401-0462.

 

‌The Massachusetts Nurse Aide Competency Exam‌

‌Alternate Testing Languages

The nurse aide certification exam's knowledge and skills components are offered in Chinese (traditional and simplified), Spanish (simplified), and English. During the exam registration process, candidates can indicate their intent to take the nurse aide exam in a language other than English.

 

IMPORTANT! You must proceed with the exam in the language you indicated during the exam registration. Once you have begun taking either exam (knowledge and skills) in Spanish or Chinese, you cannot switch languages (revert to English).

 

You can test in an alternate language (Spanish or Chinese) if:

• You have not begun the testing process.
• If you were a no-show for a test, the no-show does not count as an attempt.

 

• You have started testing but failed both the knowledge and the skills components.

 

You cannot test in an alternate language (Spanish or Chinese) if:

• You have started testing and passed either portion (knowledge or skill) of the exam. 
• For example, if you have passed the skill test but you have not passed the knowledge test – you cannot switch languages.  Or, if you have passed the knowledge exam but have not passed the skill test - you cannot switch languages.

 

You can only switch to an alternate language if you have passed one portion but have exhausted your testing attempts and completed a new training program.

 

Please call D&SDT-HEADMASTER’s alternate language line (855)263-6050 with any questions.

 

Payment Information‌

Knowledge Exam: -or- Knowledge Retake                                                                  $30.00

2^nd, 3^rd & 4^th Attempt(s) Retake

 

Audio Version of the Knowledge Exam: -or- Audio Knowledge Retake              $40.00

2nd, 3rd & 4th Attempt(s) Retake

 

Skill Test: -or- Skill Retake                                                                                                $70.00

2nd& 3rd Attempt(s) Retake

 

‌Complete your TMU© Account‌

Your initial registration information will be entered in D&SDT-HEADMASTER’s TestMaster Universe (TMU©) software. 

 

IMPORTANT:  Before you can test, you must sign in to your TMU© account at mc.tmutest.com using your secure Email or Username and Password and complete the missing demographic information prior to testing.  Failure to do so may result in you being turned away from testing.  You will be a no-show status for your event and forfeit your testing fees.

 

• Upon receiving your confirmation email from TMU© (check your junk/spam mail) that your account has been created, you need to sign in to your TMU© account, update your password, and complete your demographic information.  This must be done before scheduling a test event.

 

If you do not know your Email or Username and Password, enter your email address and click “Forgot Your Password?”  You will be asked to re-enter your email, and a ‘reset password link’ will be sent to your.  If you cannot sign in, contact D&SDT-HEADMASTER at (888)401-0462.

 

‌Scheduling a Massachusetts Nurse Aide Exam‌

Once your completed account is in the D&SDT-HEADMASTER TestMaster Universe© (TMU©) database and your testing fee has been paid ), you may schedule your exam date online at the Massachusetts TMU© webpage, mc.tmutest.com, using your Email or Username and Password. If you are unable to sign in with your email, or cannot schedule or reschedule your test date, please call D&SDT-HEADMASTER for assistance at (888)401-0462 during regular business hours, 8:00AM to 8:00PM EST, Monday through Friday, excluding Saturdays, Sundays, and holidays.

 

‌Self-Pay of Testing Fees in TMU©‌

Testing fees will need to be paid before you can schedule a test date. Once your training program has completed your training record with completion hours and date, you will receive an email and text message that you are eligible to schedule a test date. Some training programs pre-pay testing fees for their graduating students. Your program/instructor will inform you if this is the case. Before scheduling a test, verify with your instructor if the training program has already prepaid for your test.

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Securely processed Visa or MasterCard credit/debit card information is required when paying testing fees online.  Once your testing fees are paid, you will be eligible to choose a test site and date.

 

‌Test Confirmation Letter‌

Your test confirmation letter will provide you with important information regarding where you are scheduled to test (date, time, and address). It can be accessed at any time.

 

The body of the test confirmation letter will refer you to the candidate handbook, which gives you state-specific instructions on what time to arrive, ID requirements, dress code, etc.

 

It is important you read this letter!

 

Note: Failure to read the candidate handbook could result in No-Show status for your test event for not adhering to the policies of testing, etc.

 

Please see the ‘Remotely Proctored Knowledge Exam Option’ under the Knowledge/Audio Exam section if you are interested in taking your knowledge exam with a remote proctor from your home, etc.

 

Note: Candidates who self-schedule online, or those scheduled by their training programs, will receive their test confirmation at the time they are scheduled.

 

‌Check your TMU© Notifications‌

Remember to check your ‘notifications’ in your TMU© account for important notices regarding your selected test events and other information.

 

‌Time Frame for Testing from Training Program Completion‌

Training does not expire. If you fail the knowledge component four (4) times or the skills component three (3) times, you must complete another Massachusetts Department of Public Health (DPH) approved training program to be eligible to schedule testing.

 

Many training programs host and pre-schedule in-facility test dates for their graduating students. Your program/instructor will inform you if this is the case. Before scheduling a test, verify with your instructor if the training program has already scheduled your test. Regional test seats are open to all candidates. Regional test dates are posted on the Massachusetts CNA TMU© site at mc.tmutest.com.

 

‌Exam Check-In‌

You must arrive at your confirmed test site 20 minutes before your exam is scheduled to start.

·         Testing begins promptly at the start time noted.

·         You need to make sure you are at the event 20 minutes before the start time to allow time to get checked in with the RN Test Observer.

§  For example, if your test starts at 8:00AM, you must be at the test site for check-in by 7:40AM.

 

If you are not present at the test site 20 minutes before your test start time, you will not be admitted to the exam, you will be considered a NO SHOW, and any exam fees paid will NOT be refunded.

 

If you are scheduled for a remotely proctored knowledge exam, please see procedures/policies under ‘Remotely Proctored Knowledge Exam Option’ in the Knowledge/Audio Exam section.

 

‌Testing Attire‌

You must be in full clinical attire for all in-person test events (not required for remotely proctored knowledge testing), which consist of:

§  Clinical attire (scrubs [top and bottom] - as you would on the job) and closed-toed shoes.

§  Scrubs and shoes can be any color/design.

§  It is recommended that long hair be pulled back.

 

Other testing attire requirements:

§  You may bring a standard watch with a second hand.

§  No smartwatches, fitness monitors, or Bluetooth-connected devices are allowed.

 

Note: You will not be admitted for testing if you are not wearing scrubs attire and the appropriate shoes. You will be considered a NO SHOW. You will forfeit your testing fees and have to pay for another exam date.

 

‌Identification‌

You must bring your United States (US) government-issued, non-expired, *signature-bearing photo identification. 

 

Only original ID cards are accepted. Photocopies, images, faxes, emails, screenshots, and electronic or digitally stored forms of identification (for example, Apple or Google Wallet) will not be accepted.

 

Examples of the forms of signed, non-expired photo IDs that are acceptable are: 

 

·                     State (non-expired from any state is acceptable) or other United States government-issued Driver’s License

§  You may use the original letter with photo, expiration date, and signature issued from the Department of Motor Vehicles (DMV) that you receive when you apply for or renew your driver’s license while waiting to receive your new license.

• State-issued Identification Card (non-expired from any state is acceptable)

• Signed US Passport (Foreign Passports and Passport Cards are not acceptable)

§  Exception: A signed foreign passport with a US VISA attached is acceptable (the VISA does not have a signature).

• Permanent Resident Card (Green Card or Alien Registration Card)/Employment Authorization Card issued by the U.S. Citizenship and Immigration Services (USCIS) (now accepted without a signature or fingerprint IF ISSUED from January 30, 2023, to present day.  If issued before January 1, 2023, may contain a fingerprint in place of a signature)
• Tribal Identification Card (a signed photo ID with an expiration date (not expired) issued by a federally recognized Tribal Nation/Indian Tribe)

• US Military Identification Card (accepted without a signature or fingerprint, but will have a bar code or may contain a fingerprint in place of a signature)

 

 

 

 

 

EXCEPTION FOR HIGH SCHOOL STUDENTS ONLY:  If you do not have a current, official US (United States of America) Government-issued photo-bearing identification card, you must provide your current year high school identification card with a photo and a secondary form of identification as listed below. Approved secondary forms of identification for high school students only:

 

®     Social Security card – hard copy

®     Birth certificate - certified

®     Credit/Debit Card - signed and not expired

®     Health Insurance card

®     Hunting License

 

The FIRST and LAST names listed on your ID presented to the RN Test Observer during check-in at your test event must match the FIRST and LAST names entered in the Massachusetts CNA TMU© database by your training program. You may call D&SDT-HEADMASTER at (888)401-0462 during regular business hours, 8:00AM to 8:00PM ET, Monday through Friday, excluding holidays, to confirm that your name of record matches your acceptable ID, or sign in to your TMU© account mc.tmutest.com using your Email or Username and Password, to check or change your demographic information.  See more information under Demographic Updates / Changes / Corrections.

 

Note:

·         You will not be admitted for testing if you do not bring proper/valid identification.

·         Be sure your US government-issued, *signed, non-expired photo-bearing form of identification is not expired and is signed.

·         Check to ensure that the FIRST and LAST printed names on your form of identification match your current name of record in your TMU© account.

·         A driver’s license or state-issued ID card with a hole punched in it is NOT VALID and will not be accepted as an acceptable form of ID.

 

• In the cases where names do not match or your IDs are not proper/valid or have a hole punched in them, this is considered a NO-SHOW STATUS, and you will have to reschedule and pay for another test and date.

 

You will be required to re-present your photo ID when you enter the knowledge test room and the skills lab (if testing on-site). Please keep your photo ID with you throughout the exam day.

Demographic Updates / Changes / Corrections

The name on your US government-issued identification must match the name entered in the Massachusetts TMU©.  If your legal name has changed, or you have an address change or date of birth correction, please complete the DEMOGRAPHIC CHANGE/CORRECTION REQUEST FORM and upload your name change documentation (official name change documentation such as a marriage certification, divorce decree, or other legal State document that shows the name change, along with your ID or driver’s license with your updated name on it).  The form is under ‘Applications’ on the Massachusetts CNA TMU© main web page (before you log in to your account), or click on this link: https://mc.tmutest.com/apply/6.

 

‌Instructions for the Knowledge Exam, Remotely Proctored Knowledge Exam, and Skill Tests‌

Test instructions for the knowledge and skills exams will be provided in written format in the waiting area when you check in for your test. If you are taking a remotely proctored knowledge exam, the Remotely Proctored Knowledge Exam Instructions can be found in your TMU© account under the Downloads tab.

 

The Knowledge, Remotely Proctored Knowledge, and Skill Exam Instructions are also available under the ‘DOWNLOADS’ tab in your TMU© account.

 

These instructions detail the process and what you can expect during your exam. Please read the instructions before taking the knowledge exam or skills test. The instructions will be left in the waiting area during testing for you to refer to throughout your time at the test site. The RN Test Observer and Knowledge Test Proctor will ask you questions about the instructions you read when you enter the testing rooms.

 

‌Testing Policies‌

The following policies are observed at each test site:

·         Make sure you have signed in to your TMU© account at mc.tmutest.com well before your test date to update your password and complete your demographic information.  Refer to this handbook's Complete Your TMU© Account section for instructions and information. 

§  If you have not signed in and completed/updated your TMU© account when you arrive for your test, you may not be admitted to the exam, and any exam fees paid will NOT be refunded.

·         In the worst-case scenario, plan to be at the test site for up to five (5) hours (if taking both components on-site).

·         You must arrive at your confirmed test site 20 minutes before your exam is scheduled to start.  (For example:  if your test start time is 8:00AM – you must be at the test site at 7:40AM.)  If you are not present at the test site 20 minutes before your test start time, you will not be admitted to the exam, you will be considered a NO SHOW, and any exam fees paid will NOT be refunded.

§  If you are scheduled into a remotely proctored knowledge exam, please see procedures/policies under Remotely Proctored Knowledge Exam Option in the Knowledge/Audio Exam section.           

• If you do not bring valid and appropriate ID (US government-issued, non-expired, *signed photo ID, you will not be admitted to the exam, and any exam fees paid will NOT be refunded.

§  If the FIRST and LAST names listed on your ID presented to the RN Test Observer during check-in at your test event do not match the FIRST and LAST names that were entered in the Massachusetts Nurse Aide TMU© database, you will not be admitted to the exam and any exam fees paid will NOT be refunded.

• If you do not wear full clinical attire and shoes with long hair pulled back and conform to all testing policies for both the knowledge and skills portion of the exam, you will not be admitted to the exam, considered a No-Show status and any exam fees paid will NOT be refunded.
• If you do not show up for your exam day, or are considered a NO-SHOW STATUS (see details in this handbook’s No-Show Status section) for any reason, any test fees paid will NOT be refunded. You must repay your testing fees online in your TMU© account using your Email or Username and Password to schedule another exam date. 
• ELECTRONIC DEVICES AND PERSONAL ITEMS: Cell phones, smartwatches, fitness monitors, electronic recording devices, Bluetooth-connected devices, and personal items (such as water bottles, purses, briefcases, large bags, study materials, extra books, or papers) are not permitted to be on or near you in either testing room. The testing team will inform you of the designated area to place your personal items and electronic devices, and you will collect these items when you complete your test(s).

§  All electronic devices must be turned off, including smartwatches, fitness monitors, and Bluetooth-connected devices, which must be removed from your wrist or body.

§  If you are scheduled into a remotely proctored knowledge exam, please see procedures/policies under Remotely Proctored Knowledge Exam Option in the Knowledge/Audio Exam section.

• Anyone caught using any electronic recording device during either component (knowledge or skills) of the exam will be dismissed from the exam and testing room(s), your test will be scored as a failed attempt, you will forfeit all testing fees, and you will be reported to your training program and the Massachusetts Department of Public Health (DPH). You may, however, use personal devices during your free time in the waiting area.
• Behavioral misconduct or unlawful acts by test candidates are strictly prohibited at any stage of the competency evaluation. Such actions may result in dismissal from the test site, denial of testing privileges, and reporting to your training program and the Massachusetts Department of Public Health (DPH).  Please see this handbook’s Security section for detailed information.
• You may not remove any notes or other materials from the testing room.
• You are not allowed to leave the testing room (knowledge test room or skills lab) once the exam has begun for any reason.  If you do leave during your test event, you will not be allowed back into the testing room to finish your exam.
• You are prohibited from eating, drinking, or smoking (e-cigarettes or vaping) during the exam.
• You may use personal devices during your free time in the waiting area.
• You are encouraged to bring a jacket, snack, drink, or study material during your free time in the waiting area.

·        No visitors, guests, pets (including companion and emotional support animals), or children are allowed.

§  Service animals (a dog that has been individually trained to perform specific tasks for people with disabilities) are allowed. We encourage you to contact D&SDT-HEADMASTER at (888) 401-0462, or via email massachusetts@hdmaster.com once you schedule a test date so that we can notify the testing team.

§  If you show up at your event with guests, pets (including companion or emotional support animals), or children of any age, you will not be allowed to test and will forfeit all testing fees paid.

• TRANSLATION DICTIONARIES: Published foreign word-for-word translation dictionaries are allowed. Dictionaries with definitions or handwriting/notes will not be allowed.  You must show your published word-for-word translation dictionary to the test observer/proctor during check-in (on-site or remotely proctored) at your test event. Using a translator, language translators that are not pre-approved, and electronic dictionaries are not allowed.  
• You may not test if you are ill (sick).  Call D&SDT-HEADMASTER at (888)401-0462 immediately to reschedule (see the note below). 

§  You may not test if you have any physical limitation (excluding pre-arranged ADAs) that would prevent you from performing your duties as a nurse aide. (Examples: cast, arm/leg braces, crutches, etc.).  Call D&SDT-HEADMASTER at (888)401-0462 immediately to reschedule if you are on doctor's orders (see the note below).   

NOTE:  Please see this handbook's Rescheduling Policy and No-Show Exceptions sections. 

®    Reschedules will not be granted less than one (1) full business day before a scheduled test date.

• Test sites, RN Test Observers, Knowledge Test Proctors, and Actors are not responsible for the candidate's personal belongings at the test site.
• Please review this Massachusetts CNA Candidate Handbook before your test day for any testing and/or policy updates.

·         The Candidate Handbook can also be accessed within your TMU© account under your ‘Downloads’ tab.

 

‌Security‌

Behavioral misconduct or unlawful acts by test candidates are strictly prohibited at any stage of the competency evaluation. Such actions may result in dismissal from the test site, denial of testing privileges, and reporting to your training program and the Massachusetts Department of Public Health (DPH).

 

You will be asked to leave the test site, your test will be stopped and scored as a failed attempt, and you will forfeit any testing fees if you, which may include, but are not limited to, the following circumstances:

§  Are caught cheating

§  Refuse to follow directions

§  Use abusive language or threaten others

§  Disrupt the examination environment

§  Are visibly impaired

§  Engage in unprofessional or aggressive behavior

§  Attempt to remove test material, take notes, or copy information

§  Give or receive unauthorized help during testing, including using electronic devices (e.g., cell phones, smartwatches) or navigating to other browsers during your exam

 

A report of your behavior will be sent to your training program and DPH, and you are subject to legal prosecution to the fullest extent of the law. You may not be allowed to retest for at least six months and may need DPH permission to be eligible to test again.

 

‌Rescheduling Policy

All candidates may reschedule for a new test date up until one (1) business day preceding the scheduled test day, excluding Saturdays, Sundays, and holidays.

 

If you must reschedule your exam date, please do so as soon as possible. You may reschedule an exam date by signing in to your TMU© account at http://mc.tmutest.com using your Email or Username and Password.

 

·         Example: If you are scheduled to take your exam on a Friday, you would need to reschedule by close of business the Wednesday before your scheduled exam. D&SDT-HEADMASTER’s regular business hours are 8:00AM to 8:00PM EST, Monday through Friday, excluding holidays.

 

The scheduled test date is on a:	Reschedule before 8:00PM EST the previous:
Monday	The previous Thursday
Tuesday	The previous Friday
Wednesday	The previous Monday
Thursday	The previous Tuesday
Friday	The previous Wednesday
Saturday	The previous Thursday
Sunday	The previous Thursday

 

Note: Reschedules will not be granted less than one full business day before a scheduled test date.

 

‌Refund of Testing Fees Paid‌

Requesting a refund of testing fees paid is different than rescheduling a test date. Requesting a refund means that you are not interested in taking the Massachusetts nurse aide certification exam at all.

Scheduled in a Test Event

1)      If you are scheduled for a test event, you must request a refund of the testing fees paid by filling out and submitting the Refund Request Form on D&SDT-HEADMASTER’s main webpage at www.hdmaster.com at least one (1) full business day before your scheduled test event (excluding Saturdays, Sundays, and holidays). No phone calls will be accepted.

§  Example:  If you are scheduled to take your exam on a Saturday, Sunday, or Monday, you would need to request a refund by the close of business the Thursday before your scheduled exam.  D&SDT-HEADMASTER is open until 8:00PM Eastern time, Monday through Friday, excluding holidays.

 

2)      Refund requests made in the required time frame qualify for a full refund of any testing fees paid minus a $35 refund processing fee. 

3)      Refund requests must be made within thirty (30) days of paying testing fees with D&SDT. Requests for refunds made after 30 days will not be issued.

Not Scheduled in a Test Event

1)      Refund requests must be made within thirty (30) days of paying testing fees with D&SDT. Requests for refunds made after 30 days will not be issued.

2)      To request a refund of testing fees paid, you must fill out and submit the Refund Request Form on D&SDT-HEADMASTER’s main webpage at www.hdmaster.com. No phone calls will be accepted.

3)      Refund requests made in the required time frame qualify for a full refund of any testing fees paid minus a $35 refund processing fee.

 

‌Unforeseen Circumstances Policy‌

If an exam date is canceled due to an unforeseen circumstance, D&SDT-HEADMASTER staff will make every effort to contact you using the contact information (email, text message, phone call) we have on file in your TMU© account to reschedule you, for no charge, to a mutually agreed upon new test date. Therefore, you must keep your contact information up to date in case we need to contact you. (*See examples below for reasons we may not be able to contact you that you are responsible for.)

 

If D&SDT-HEADMASTER is unable to reach you via phone or email with the information in your TMU© account (*see examples below) due to inclement weather or an unforeseen circumstance for a test event you are scheduled for, you will be removed from the test event, and D&SDT-HEADMASTER will not reschedule you until we hear back from you.

 

NOTE: The *examples listed below are your responsibility to check and/or keep updated.

·         If D&SDT-HEADMASTER leaves you a message or emails you at the phone number or email in your TMU© account and:

§  you do not call us back in a timely manner

§  your phone number is disconnected/your voice mailbox is full

§  you do not check your messages in a timely manner

§  you do not check your email or reply to our email in a timely manner

§  your email is invalid or you are unable to access your email for any reason

 

See more information under No-Show Exceptions.

 

 

 

No-Show Status

If you are scheduled for your exam and do not show up without notifying D&SDT-HEADMASTER at least one (1) full business day before your scheduled testing event, excluding Saturdays, Sundays, and holidays, OR if you are turned away for lack of proper identification, not arriving at the test site 20 minutes before the test start time, or any other reason to deem you ineligible to test, you will be considered a NO-SHOW STATUS.  You will forfeit all fees paid and must sign in to your TMU© account to repay or submit a new testing fee to schedule yourself into a new test event.

 

These fees partially offset D&SDT-HEADMASTER’s costs incurred for services requested and resulting work that is performed. If a reschedule or refund request is not done or received before the one (1) full business day preceding a scheduled test event, excluding Saturdays, Sundays, and holidays (see examples under Rescheduling Policy and Refund of Testing Fees Paid), a NO-SHOW status will exist. You will forfeit your testing fees and must repay the full testing fee to secure a new test event.

No-Show Exceptions

Exceptions to the No-Show status exist; if you are a No-Show for any test component for any of the following reasons, a free reschedule will be authorized to the remitter of record, providing the required documentation is received within the appropriate time frames outlined below:

 

• Car breakdown or accident: D&SDT-HEADMASTER must be contacted within one business day via phone call, fax, or email. A tow bill, police report, or other appropriate documentation showing your name and the provider of service name must be submitted within three (3) business days of the exam date. If we do not receive proof within three business days, you will have to pay as though you were a no-show.

 

• Weather or road condition-related issue:  D&SDT-HEADMASTER must be contacted within one business day via phone call, fax, or email.  A road report, weather report, or other appropriate documentation must be submitted within three (3) business days of the exam date. If we do not receive proof within three business days, you will have to pay as though you were a no-show.

 

• Medical emergency or illness: D&SDT-HEADMASTER must be contacted within one business day via phone, fax, or email. A doctor’s note showing your name and the provider of service name (or be on the provider’s letterhead) must be submitted within three (3) business days of the missed exam date. If we do not receive proof within three business days, you will have to pay as though you were a no-show.

 

• Death in the family: D&SDT-HEADMASTER must be contacted within one business day via phone call, fax, or email.  An obituary showing your name and the provider of service name for immediate family must be submitted within seven (7) business days from a missed exam date. If we do not receive proof within seven business days, you will have to pay as though you were a no-show.  (Immediate family includes the parent, grand and great-grandparent, sibling, children, spouse, or significant other.)

 

• Remotely proctored testing issues: D&SDT-HEADMASTER must be contacted within one business day via phone, fax, or email. Appropriate documentation showing your name and the provider of service name must be submitted within three (3) business days of the exam date. If we do not receive proof within three business days, you will have to pay as though you were a no-show.

·   Internet outage or issue: Documentation showing your name and the provider of service name from the Internet provider showing outage date and times.

·   Computer or cell phone issue: If the computer or cell phone fails to work for any reason, documentation showing your name and the provider of service name from a computer repair technician/shop or other appropriate documentation.

‌Candidate Feedback – Exit Survey‌

Candidates are provided the opportunity to complete an exit survey via a link when checking their test results in their TMU© account. The survey is confidential and will not affect the outcome of any test. You are encouraged to complete the survey questions with honest feedback regarding the examination process to help improve the testing process.

 

‌Test Results‌

After you have completed both the Knowledge and Skill Test components of the competency exam, your test results will be officially scored and double-checked by D&SDT-HEADMASTER scoring teams.  Official test results will be available by signing in to your TMU© account after 8:00PM (ET) the business day after your test event. D&SDT-HEADMASTER cannot release test results over the phone.

 

When you pass your exam, you may be certified and listed on the Massachusetts Nurse Aide Registry ONLY AFTER you have met all Massachusetts Department of Public Health (DPH) requirements. One of those requirements includes passing the Massachusetts nurse aide examination's knowledge and skill test components.

 

Note: D&SDT-HEADMASTER does not send postal mail test results letters.

 

‌Test Attempts‌

You have four (4) attempts to pass the knowledge portion and three (3) attempts to pass the skill test portion of the exam. If you fail four attempts on the knowledge component or three attempts on the skills component, you must complete a new Massachusetts Department of Public Health (DPH) approved training program to become eligible to further attempt the Massachusetts CNA examinations.

 

NOTE: Federal and State regulations allow healthcare facilities to employ students for up to 120 days from the day employment and training is offered in an approved facility-based nurse aide training and competency evaluation program. However, if you fail four (4) attempts on the knowledge portion or three (3) attempts on the skills portion of the state competency exam, the facility is no longer allowed to employ you to perform nurse aide duties.

 

‌Retaking the Nurse Aide Exam‌

If you fail the knowledge and/or skill portion of the examination, when you want to apply for a retest, you will need to repay the portion you failed before you can schedule a new exam date.

 

You can schedule a test or re-test online by signing in to your TMU© account with your Email or Username and Password at mc.tmutest.com.  (See instructions with screenshots under Schedule / Reschedule a Test Event.)  You will need to pay with a Visa or MasterCard credit/debit card before you can schedule.

 

If you need assistance scheduling your re-test, please call D&SDT-HEADMASTER at (888)401-0462 during regular business hours, 8:00AM to 8:00PM ET, Monday through Friday, excluding holidays. We can assist you in scheduling a test or re-test date as long as your fees have been paid first.

 

‌Test Review Requests‌

You may request a review of your test results or dispute any other testing condition.  The purpose of this review process is to ensure fairness and accuracy in the evaluation of your test.

 

*PLEASE READ BEFORE FILLING OUT THE TEST REVIEW REQUEST:  Please call D&SDT-HEADMASTER at (888)401-0462 during regular business hours, Monday through Friday, 8:00AM to 8:00PM ET, excluding Saturdays, Sundays, and holidays, and discuss the test outcome you are questioning before committing to sending the $25 test review request deposit fee.  Once you have further details about the scoring of your test, you will often understand the scoring process and learn how to better prepare yourself for subsequent exam attempts.  If, after discussion with D&SDT-HEADMASTER staff, you still have a concern with your testing process that affected the outcome of your exam, you may submit a Test Review Request.

 

There is a $25 non-refundable test review deposit fee.  To request a review, complete the Test Review Request and Payment  Application, available on the Massachusetts CNA TMU© main page (before you log in to your account) at mc.tmutest.com. Test Review Requests must be received within three (3) business days from the official scoring of your test (excluding Saturdays, Sundays, and holidays).  Late requests will be denied and will not be considered. 

 

Since one qualification for certification as a nurse aide in Massachusetts is demonstrated by examination of minimum nurse aide knowledge and skills, the likely outcome of your review will determine who pays for any re-tests granted.   If, after investigation, the review finding is in your favor, you will be refunded the $25 test review deposit.  If the finding of the review is not in your favor, the $25 test review deposit will stand, and the fee is non-refundable.

 

D&SDT-HEADMASTER will review your detailed recollection, your knowledge test markings, and any skill task measurements you recorded at the time of your test, in addition to reviewing markings, notations, and measurements recorded by the RN Test Observer at the time of your test.  We will interview the RN Test Observer, Actor, or Knowledge Test Proctor about the facts detailed in your dispute documentation. D&SDT-HEADMASTER will re-check the scoring of your test and may contact you and/or the RN Test Observer, Actor and/or Knowledge Test Proctor, and other candidates who were on-site at your test event for any additional information about the test event.

 

D&SDT-HEADMASTER cannot review test results or reviews with the candidate’s instructor/training program. After a candidate reaches the age of 18, D&SDT-HEADMASTER will only discuss test results or test reviews with the candidate. D&SDT-HEADMASTER will not review test results or reviews with family members or anyone else on behalf of the candidate once the candidate is 18. D&SDT-HEADMASTER will complete your review request within ten business days of receiving your timely review request and will email the review results to your email address and the Massachusetts Department of Public Health (DPH).

 

‌The Knowledge/Audio Exam‌

Knowledge Exam Content

The Knowledge Exam consists of 60 multiple-choice questions. Questions are selected from subject areas based on the Massachusetts Department of Public Health (DPH) approved Massachusetts test plan and include questions from all the required categories as defined in the federal regulations. The subject areas are as follows on the next page.

 

‌Subject Areas‌

2 Questions in Aging Process and Restorative Care                           4 Questions in Infection Control        

8 Questions in Basic Nursing Skills                                                      4 Questions in Mental Health

3 Questions in Care Impaired                                                             4 Questions in Personal Care 

5 Questions in Communication                                                          6 Questions in Resident Rights          

2 Questions in Data Collection                                                           9 Questions in Role and Responsibility           

7 Questions in Disease Process                                                           6 Questions in Safety

 

Knowledge Exam Information

You will be required to re-present your ID when you enter the knowledge test room and the skills lab for your skills exam. Please keep your ID with you throughout the exam day. 

 

The Knowledge Test Proctor will hand out materials and give instructions for taking the Knowledge Exam. You will have sixty (60) minutes to complete the 60 multiple-choice question Knowledge Exam.  You will be told when fifteen (15) minutes remain.  You may not ask questions about the content of the Knowledge Exam (such as “What does this question mean?”).

 

You must have a score of 76% or better to pass the knowledge portion of the exam.

 

All test sites in Massachusetts utilize electronic TMU© testing using Internet-connected computers. The Knowledge test portion of your exam will be displayed on a computer screen for you to read and key/tap or click on your answers. 

 

NOTE:  You will need your TMU© Username or Email and Password to sign in to your knowledge exam.  Please see the information under Complete Your TMU© Account to sign in to your TMU© account.

 

§  The Knowledge Test Proctor will provide you with a code at the test event to start your exam.

 

SCRATCH PAPER AND BASIC CALCULATOR:

If needed, you may do math calculations on the scratch paper provided by the KTP.  If you need a calculator, please quietly alert the Knowledge Test Proctor; one will be provided.

 

§  Any scratch paper and provided calculator must be left with the KTP when testing is done.

 

FOREIGN LANGUAGE WORD-FOR-WORD TRANSLATION DICTIONARIES:

The knowledge and the audio version of the knowledge exam are in English.

§  Foreign language word-for-word translation dictionaries are allowed.

·         You must show the RN Test Observer and KTP the dictionary during check-in.

·         Translators, non-approved language translators, electronic dictionaries, or dictionaries that contain writing or definitions are not allowed.

 

When you leave the testing room, you must leave all test materials in it. Anyone who takes or tries to take materials, notes, or information from the room is subject to prosecution and will be reported to the Massachusetts Department of Health (MDH).

 

Knowledge Exam Audio Version

An audio (oral) version of the knowledge test is available.  However, you must request an Audio version of the Knowledge Exam before you submit your testing fee payment. There is an additional fee of $10 (the total for the Audio version of the Knowledge Exam is $40.00) for an Audio version of the Knowledge Exam.

 

·         The questions are read neutrally to you and can be heard through wired headphones or earbuds plugged into the computer provided by the KTP (or you may bring your own, but they must be shown to the RN Test Proctor and KTP at check-in).  Bluetooth-connected devices are not allowed. The audio control buttons will be displayed on the computer screen, enabling you to play, rewind, or pause questions as needed.

 

‌

Selecting an Audio Version of the Knowledge Exam‌

To select the Audio version of the knowledge exam, under your PROFILE, check the ‘Enable Audio Testing’ to receive an Audio version of the Knowledge Exam.

at the bottom of the screen to save.

The questions are read to you neutrally and can be heard through wired headphones or earbuds plugged into the computer. Bluetooth-connected devices are not allowed. When taking an electronic Audio exam, the audio control buttons will be displayed on the computer screen, enabling you to play, rewind, or pause questions as needed.

Remotely Proctored Knowledge Exam Option

You can retake the knowledge exam with a remote proctor from your home, etc.  If you have a previously approved ADA, please call D&SDT-HEADMASTER at (888)401-0462 before scheduling a remotely proctored retake to ensure your accommodations can be provided.

Remotely Proctored Knowledge Exam Candidate Requirements

Candidates must have:

·         An updated version of Google Chrome as your Internet browser.

§  TMU© does not support Internet Explorer.

·         A reliable Internet (Wi-Fi) connection.

·         A personal computer/tablet/laptop to log into TMU© to access the knowledge exam.

·         Your Email or Username and Password to take the remotely proctored TMU© Knowledge exam.  The remote Proctor will give you a ‘code’ to start your test.

·         A smartphone to access the ‘video conferencing app’ (for example, Zoom, etc.) that you must download. 

§  You will receive an email and notifications (in your TMU© account) with information about the ‘video conferencing app’ (for example, Zoom, etc.) you must download before test day.

§  The night before your scheduled remotely proctored knowledge exam, you will be emailed, along with a notification (in your TMU© account), a reminder with the password-protected link to join the test event.

·         During your test, your smartphone must be positioned so that the remote Proctor can clearly see you, your keyboard, mouse (if used), and the entire screen of your computer/tablet/laptop.

·         You may not use a video filter, such as a background or blurring your screen.

·         IMPORTANT NOTE: On testing day, you will not be allowed to receive any assistance with your setup from anyone in your environment (room/area). 

• You must be alone (by yourself during the entire time while testing) in a quiet, isolated, secured room/area free of distractions, interruptions, and any other people, children, or pets.

·         Along with showing the remote Proctor your surroundings/entire room during check-in, the remote Proctor may also ask you to show your room/entire surroundings at any time during your test.

• If you have selected the Audio version of the knowledge exam, you will provide your own wired headphones/earbuds (Bluetooth-connected devices are not allowed) to plug into the computer. 

§  The questions are neutrally read to you and will be heard through wired headphones or earbuds plugged into the computer. 

§  When taking an Audio exam, the audio control buttons will be displayed on the computer screen, enabling you to play, rewind, or pause questions as needed.

• Failure to adhere to any of these remote testing conditions will require the remote Proctor to stop your test, which will be scored as a failed attempt.

Schedule a Remotely Proctored Knowledge Exam

You will need to sign in to your TMU© account using your Username or Email and Password and follow the instructions to Schedule / Reschedule a Test Event.  Please ensure you have met the Remotely Proctored Knowledge Exam Candidate Requirements above before scheduling a remotely proctored knowledge exam.

·         The test site location for a remotely proctored knowledge exam will be ‘Remotely Proctored Test’.

·         Once scheduled, a test confirmation will be sent via email and/or text. A notification will be generated in your TMU© account for you to view (see the Test Confirmation Letter and the Check your TMU© Notifications sections for information.)

·         Instructions and the link to download the ‘video conferencing app’ (for example, Zoom, etc.), including the meeting ID and Password for the remotely proctored knowledge event you are scheduled for, will be emailed to you and in your notifications.

• Remember, for this information, check your ‘NOTIFICATIONS’ under your profile pic in your TMU© account. Please refer to the Check your TMU© Notifications section.

 

Please call D&SDT-HEADMASTER at (888)401-0462 if you have any questions or concerns or need assistance scheduling a remotely proctored knowledge exam.

Remotely Proctored Knowledge Exam Instructions

It is important that you read the Remotely Proctored Knowledge Exam Instructions before signing in to your remotely proctored knowledge exam. 

Remotely Proctored Knowledge Exam Check-In

You must be signed in to the remotely proctored exam link (for example, Zoom, etc., waiting room) for the check-in process with the remote test proctor 20 minutes before the start time listed on your test confirmation.  If you are not signed into the remotely proctored exam waiting room prior (20 minutes) to the time listed on your test confirmation, you will not be allowed to test, considered a no-show status, forfeit your testing fees paid, and have to pay for another test date.

·         You must show your mandatory forms of identification to the remote Proctor at check-in before starting your remotely proctored knowledge exam.  Please see the Identification section for specifics.

• You must be alone (by yourself during the entire time while testing) in a quiet, isolated, secured room/area free of distractions, interruptions, and any other people, children, or pets.

·         You must show your surroundings/entire room to the remote Proctor during check-in before starting your remotely proctored knowledge exam.

§  Along with showing the remote Proctor your surroundings/entire room during check-in, the remote Proctor may also ask you to show your room/entire surroundings at any time during your test.

·         Then, you must position your smartphone so the remote Proctor can clearly see you, your keyboard, mouse (if used), and the entire screen of your computer/tablet/laptop.

§  You may not use a video filter, such as a background or blurring your screen.

·         NOTE: On testing day, you will not be allowed to receive any assistance with your setup from anyone in your environment (room/area).

·         Failure to adhere to any of these remote testing conditions will require the remote Proctor to stop your test, which will be scored as a failed attempt.

 

Remotely Proctored Knowledge Exam Policies

All Testing Policies and Security measures are followed during the remotely proctored knowledge exam. Please refer to those sections for information.

·         On testing day, you will not be allowed to receive any assistance with your setup from anyone in your environment (room/area).  If someone else is in the room with you, the remote Proctor will remove you from the meeting, and you will be considered a no-show status.  You will forfeit any testing fees paid and must repay to schedule a new test.

 

• You must be alone (by yourself during the entire time while testing) in a quiet, isolated, secured room/area free of distractions, interruptions, and any other people, children, or pets.

 

·         Along with showing the remote Proctor your surroundings/entire room during check-in, the remote Proctor may also ask you to show your room/entire surroundings at any time during your test.

 

·         During your test, your smartphone must be positioned so that the remote Proctor can clearly see you, your keyboard, mouse (if used), and the entire screen of your computer/tablet/laptop.

§  You may not use a video filter, such as a background or blurring your screen.

 

·         The ‘video conferencing app’ (for example, Zoom, etc.) link must be maintained during the entire knowledge exam.

 

 

§  If the ‘video conferencing app’ (for example, Zoom, etc.) connection is lost, you must immediately reconnect, or you will be disconnected from the test event by the remote Proctor, and your test will be scored as a failed attempt.

 

·         Your device must not be muted during testing so that the remote Proctor can hear if there are any distractions or other interruptions during your test.  REMEMBER:  You need to test in an isolated, secured/room area that is distraction and interruption-free, just like you would if you were sitting in the knowledge test room at a test site.

 

·         If the remote Proctor has any inclination that you are cheating or not following instructions, your test will be ended and scored as a failed attempt.

 

 

·         Please see the information on remotely proctored testing issues under the No-Show Exceptions section.

 

·         If needed, you may do math calculations on scratch paper or with a basic calculator. Before starting your exam, you will be asked to show both sides of the scratch paper and the basic calculator to the remote Proctor.

 

§ At the end of your exam, you will be asked to show both sides of the scratch paper and the calculator to the remote Proctor again. You will then be told you must tear up the scratch paper in view of the remote Proctor and to mute your phone before tearing up the scratch paper.

 

·      Published foreign language word-for-word translation dictionaries are allowed.

 

§ You will need to show the remote Proctor the dictionary during check-in. 

§ Electronic, non-approved language translators or dictionaries that contain writing or definitions are not allowed.

 

·      If you have requested an AUDIO version of the Knowledge Exam, you will need to have wired headphones/earbuds (Bluetooth-connected devices are not allowed) that plug into the computer.

 

Failure to adhere to any of these remote testing conditions/policies will require the remote Proctor to stop your test, which will be scored as a failed attempt.

 

 

‌Self-Assessment Reading Comprehension Exam‌

The following passages and corresponding questions will assess your reading comprehension required for the knowledge portion of the state competency evaluation. If you miss more than three (3) questions, you should consider utilizing the audio option for the knowledge exam.

 

PASSAGE 1

Paul and Ben are twins. They are identical in features but opposite in personality. Paul likes to wear dark

colors. Ben likes to wear bright colors. Paul likes to read quietly. Ben likes to attend football games with friends.

1.      Paul can be classified as an

a.      omnivert

b.      extrovert

c.      introvert

d.      ambivert

 

2.      Ben can be classified as an

a.      omnivert

b.      extrovert

c.      introvert

d.      ambivert

 

3.      Paul and Ben have identical

a.      noses

b.      shoes

c.      earrings

d.      tattoos

 

PASSAGE 2

Amy is from Montana and lives in an apartment with her parents and her brother Nick. Tomorrow, she is flying to Oregon. Amy is bringing three books of three different colors with her. Nick doesn’t understand why she needs three books. The yellow one is a Spanish-English dictionary. The red one is a tourist guide to Oregon. The blue one is about horses, which Amy feels is the most important.

 

Amy will not need her United States of America passport because she won’t be leaving the country.

 

4.      Amy is from

a.      Wisconsin

b.      Montana

c.      Oregon

d.      Wyoming

 

5.      Amy resides in a(n)

a.      house

b.      farm

c.      condo

d.      apartment

 

 

 

6.      Amy lives in

a.      Canada

b.      America

c.      Mexico

d.      Peru

 

7.      Amy lives with her

a.      aunt

b.      grandmother

c.      father

d.      sister

 

8.      Amy’s brother’s name is

a.      Nick

b.      Loren

c.      Chad

d.      Jared

 

9.      Tomorrow she is going to

a.      Montana

b.      Canada

c.      Wisconsin

d.      Oregon

 

10.  The type of book that is yellow is a(n)

a.      dictionary

b.      animal interest

c.      tourist

d.      guidebook

 

11.  Amy believes the book that is the most important is the color

a.      red

b.      black

c.      yellow

d.      blue

 

PASSAGE 3

Katherine did not like being called by her full name. She preferred to be called Katie. Katherine’s mother wanted her to understand why she was given that legal name. Her mother shared a story about a strong-willed woman who overcame adversities, and her name was Katherine. Katherine then embraced her given name.

 

12.  Katherine is a

a.      last name

b.      middle name

c.      legal name

d.      nickname

 

13.  The purpose of Katherine’s mother sharing the story with Katherine is to

a.      entertain

b.      persuade

c.      inform

d.      describe

 

 

 

 

‌Knowledge Practice Exam‌

D&SDT-HEADMASTER offers a free knowledge test question of the day and a ten-question online static practice test available on our website at www.hdmaster.com.  Candidates may purchase complete practice tests randomly generated based on the state test plan. A mastery learning method is used, and each practice test will be unique.  This means candidates must get the question they are attempting correct before they move on to the next question. A first-attempt percentage score and vocabulary feedback are supplied upon completion of the practice test. A list of vocabulary words to study is provided at the end of each test. Single or group purchase plans are available.

 

NOTE: Make sure you select MASSACHUSETTS from the drop-down list.

 

The following is a sample of the kinds of questions that you will find on the Knowledge/Audio exam:

 

‌

The Manual Demonstration Skill Test‌

·         The purpose of the Skill Test is to evaluate your performance when demonstrating DPH-approved nurse aide skill tasks. You will find a complete list of skill tasks in this handbook.

 

·         You will be asked to re-present your ID that you showed the RN Test Observer at check-in.

 

·         Be sure you understand all instructions you read while in the waiting area before you begin your skill task demonstrations.  You may not ask questions once the Skill Test begins and the timer starts.  Once the Skill Test begins, the RN Test Observer may not answer questions.

 

·         Each of your randomly selected three (3) or four (4) tasks will have scenarios associated with them.  The scenarios will be read to you by the RN Test Observer immediately before you are asked to do each task.

 

·         You will be allowed forty (40) minutes to complete your three or four tasks.

§  Two timers will be set when you begin your skill test.  The first timer will sound when 15 minutes remain, and the second timer will sound when all 40 minutes have elapsed.

 

·         Listen carefully to all instructions given by the RN Test Observer. You may request to have any of the scenarios repeated at any time during your Skill Test up until you run out of time or tell the RN Test Observer that you are finished with your skill task demonstrations.

 

·         You must correctly perform all critical steps (in bold font) and 80% of all non-key steps on each task assigned to pass the Skill Test.   

 

·         If you believe you made a mistake while performing a task, tell the RN Test Observer you would like to make a correction.  You will need to correctly demonstrate the step or steps on the task you believe you performed incorrectly to receive credit for the correction.

 

·         You may repeat or correct any step or steps on any task you believe you have performed incorrectly at any time during your allotted 40 minutes or until you tell the RN Test Observer you are finished with the Skill Test.

 

·         The skill task steps are not order dependent unless the words BEFORE or AFTER are used in a step.

 

·         When you finish each task, verbally tell the RN Test Observer you are finished and move to the designated “relaxation area.” When the RN Test Observer and actor have set up and are ready for your next skill task demonstration, the RN Test Observer will read the scenario for your next task.

 

·         All steps must actually be demonstrated.  Steps that are only verbalized WILL NOT COUNT.

 

‌Skill Test Recording Form‌

If your skill test includes a skill task that requires recording a count or measurement, the RN test observer will provide a recording form that you will be asked to sign during the equipment/supplies demonstration.

 

‌Skill Test Tasks‌

You will be assigned one of the following mandatory tasks with embedded hand washing using soap and water as your first task:

§ Assist a Resident with the use of a Bedpan, Measure, and Record Urine Output with Hand Washing

§ Catheter Care for a Female Resident with Hand Washing [demonstrated on a manikin]

§ Don [put on] a Gown and Gloves, Empty a Urinary Drainage Bag, Measure and Record Urine Output, and Doff [remove] the Gown and Gloves with Hand Washing

§ Perineal Care for a Female Resident with Hand Washing [demonstrated on a manikin]

 

Note:  Hand washing with soap and water is embedded in each of the mandatory tasks and must be demonstrated at the end of each mandatory task.

 

You will also receive an additional two (2) or three (3) randomly selected tasks from the Skill Task listing below.  These selected tasks will make up your personalized and unique skill test.  Each skill test randomly assigned by the TMU© skill test assignment algorithm will be comparable in overall difficulty.

‌Skill Tasks Listing‌

To receive credit, you must actually perform and demonstrate every step during your skill test demonstration.

 

The steps listed for each task are required for a nurse aide candidate to successfully demonstrate minimum proficiency in the skill task for the RN Test Observer.  The steps will be performed on a live resident actor for all but two tasks; the catheter care for a female and the perineal care for a female will be performed on a manikin.  You will be scored only on the steps listed. 

 

You must score 80% or better on each task without missing any critical steps (the bolded steps) to pass the skill component of your competency evaluation. 

 

If you fail the Skill Test, there will always be one of the first mandatory tasks to start each Skill Test.  You will receive one of the tasks you failed (if you failed more than one task, the computer will randomly draw which task you failed to retest on), and one or two other tasks are randomly chosen so that every Skill Test is comparable in difficulty and an average length of time to complete.  The RN Test Observer will observe your demonstrations of your skill tasks and record what they see you do.  D&SDT-HEADMASTER scoring teams will officially score and double-check your test.

 

‌

APPLY AN ANTI-EMBOLIC (COMPRESSION) STOCKING TO ONE LEG‌

1. Perform hand hygiene.
1. Cover all surfaces of your hands with hand sanitizer.
2. Rub your hands together until they are completely dry.
2. Explain the procedure to the resident.
3. Raise bed height.
4. Provide for the resident’s privacy.
5. Provide for the resident's privacy by only exposing one leg.
6. Roll, gather, or turn the stocking down inside out to at least the heel.
7. Place the foot of the stocking over the resident's toes, foot, and heel.
8. Roll -or- pull the top of the stocking over the resident’s foot, heel, and up the leg.
9. Check toes for possible pressure from the stocking.
10. Adjust stocking as needed.
11. Leave the resident with a stocking that is smooth/wrinkle-free.
12. Lower bed.
13. Place the call light or signaling device within easy reach of the resident.
14. Maintain respectful, courteous interpersonal interactions at all times.
15. Perform hand hygiene.
1. Cover all surfaces of your hands with hand sanitizer.

b.      Rub your hands together until they are completely dry.

 

‌ASSIST RESIDENT TO AMBULATE USING A GAIT BELT‌

1.      Perform hand hygiene.

a.      Cover all surfaces of your hands with hand sanitizer.

b.      Rub your hands together until they are completely dry.

2.      Explain the procedure to the resident.

3.      Obtain a gait belt for the resident.

4.      Assist the resident in putting on non-skid shoes/footwear.

5.      Adjust the bed height to ensure that the resident’s feet are flat on the floor when sitting on the edge of the bed.

6.      Lock bed brakes to ensure the resident's safety.

7.      Lock wheelchair brakes to ensure the resident’s safety.

8.      Bring the resident to a sitting position.

9.      Place a gait belt around the resident’s waist to stabilize the trunk.

10.  Tighten the gait belt.

11.  Check the gait belt for tightness by slipping fingers between the gait belt and the resident.

12.  Face the resident.

13.  Grasp the gait belt on both sides with an upward grasp.

14.  Bring the resident to a standing position.

15.  Stabilize the resident.

16.  Ambulate the resident at least ten (10) steps to the wheelchair.

17.  Assist the resident in pivoting/turning and sitting the resident in the wheelchair in a controlled manner that ensures safety.

18.  Use proper body mechanics at all times.

19.  Remove gait belt.

20.  Place the call light or signaling device within easy reach of the resident.

21.  Maintain respectful, courteous interpersonal interactions at all times.

22.  Perform hand hygiene.

a.      Cover all surfaces of your hands with hand sanitizer.

b.      Rub your hands together until they are completely dry.

 

ASSIST RESIDENT WITH THE USE OF A BEDPAN, MEASURE AND RECORD URINE OUTPUT WITH HAND WASHING

(One of the possible first mandatory tasks.)

‌-EMBEDDED HAND WASHING ADDED-‌

1.      Perform hand hygiene.

a.      Cover all surfaces of your hands with hand sanitizer.

b.      Rub your hands together until they are completely dry.

2.      Explain the procedure to the resident.

3.      Provide for the resident’s privacy.

4.      Put on gloves.

5.      Position the resident on the bedpan/fracture pan safely and correctly. (The pan is not upside down, is centered, etc.)

6.      Raise the head of the bed to a comfortable level.

7.      Leave tissue within reach of the resident.

8.      Leave the call light or signaling device within reach of the resident.

9.      Step behind the privacy curtain to provide privacy for the resident.

10.  When the RN Test Observer indicates the candidate returns. 

11.  Lower the head of the bed.

12.  Gently remove the bedpan/fracture pan.

13.  Hold the bedpan for the RN Test Observer while an unknown quantity of liquid is poured into the bedpan.

14.  Place the graduate on a designated level flat surface.

15.  Pour bedpan/fracture pan contents into the graduate.

16.  With the graduate at eye level, measure output.

17.  Empty the equipment into the designated toilet/commode. 

18.  Rinse equipment used and empty rinse water into the designated toilet/commode.

19.  Return equipment to storage.

20.  Wash/assist the resident in washing and drying hands with soap and water.

21.  Place soiled linen in the designated laundry hamper.

22.  Remove gloves, turning them inside out as they are removed, and dispose in a trash container.

23.  Record output on the previously signed recording form.

24.  The candidate's recorded measurement is within 25mLs of the RN Test Observer's reading.                                                                                                                                     

25.  Place the call light or signaling device within easy reach of the resident.

26.  Maintain respectful, courteous interpersonal interactions at all times.

27.  Turn on the water.

28.  Wet hands and wrists thoroughly.

29.  Apply soap to hands.

30.  Rub hands together using friction with soap.

31.  Scrub/wash hands together with soap for at least twenty (20) seconds.

32.  Scrub/wash with interlaced fingers pointing downward with soap.

33.  Wash all surfaces of your hands with soap.

34.  Wash wrists with soap.

35.  Clean fingernails by rubbing fingertips against the palm of the opposite hand.

36.  Rinse fingers, hands, and wrists thoroughly under running water with fingers pointed downward.

37.  Starting at the fingertips, dry fingers, hands, and wrists with a clean paper towel(s).

38.  Discard paper towel(s) in a trash container as used.

39.  Turn off the faucet with a clean, dry paper towel and discard it in a trash container as used, or use the elbow or knee/foot control to turn off the faucet.

40.  Do not re-contaminate hands at any time during the hand washing procedure. (For example, do not touch the sides of the sink during the procedure or crumple up the paper towel used to turn off the faucet with both hands before discarding it.)

 

CATHETER CARE FOR A FEMALE RESIDENT WITH HAND WASHING

(One of the possible first mandatory tasks.)

‌-EMBEDDED HAND WASHING ADDED- [DEMONSTRATED ON A MANIKIN]‌

1.      Perform hand hygiene.

   a.  Cover all surfaces of your hands with hand sanitizer.

   b.  Rub your hands together until they are completely dry.

2.      Explain the procedure to the resident.

3.      Provide for the resident’s privacy.

4.      Fill a basin with comfortably warm water.

5.      Put on gloves.

6.      Expose the area surrounding the catheter, only exposing the lower half of the resident’s body.

7.      Hold the catheter where it exits the urethra with one hand.

8.      While holding the catheter, clean at least 3-4 inches down the drainage tube.

9.      Clean with at least two strokes only away from the urethra.

10.  Use a clean portion of the washcloth for each stroke.

11.  While holding the catheter, rinse at least 3-4 inches down the drainage tube.

12.  Rinse using strokes only away from the urethra.

13.  Rinse using a clean portion of the washcloth for each stroke.

14.  Pat dry.

15.  Do not allow the tube to be tugged/pulled at any time during the procedure.

16.  Replace the top cover over the resident.

17.  Place soiled linen in the designated laundry.

18.  Empty, rinse, dry, and return equipment to storage.

19.  Remove gloves, turn them inside out as they are removed, and dispose in a trash container.

20.  Place the call light or signaling device within easy reach of the resident.

21.  Maintain respectful, courteous interpersonal interactions at all times.

22.  Turn on the water.

23.  Wet hands and wrists thoroughly.

24.  Apply soap to hands.

25.  Rub hands together using friction with soap.

26.  Scrub/wash hands together with soap for at least twenty (20) seconds.

27.  Scrub/wash with interlaced fingers pointing downward with soap.

28.  Wash all surfaces of your hands with soap.

29.  Wash wrists with soap.

30.  Clean fingernails by rubbing fingertips against the palm of the opposite hand.

31.  Rinse fingers, hands, and wrists thoroughly under running water with fingers pointed downward.

32.  Starting at the fingertips, dry fingers, hands, and wrists with a clean paper towel(s).

33.  Discard paper towel(s) in a trash container as used.

34.  Turn off the faucet with a clean, dry paper towel and discard it in a trash container as used, or use the elbow or knee/foot control to turn off the faucet.

35.  Do not re-contaminate hands at any time during the hand washing procedure. (For example, do not touch the sides of the sink during the procedure or crumple up the paper towel used to turn off the faucet with both hands before discarding it.)

 

DENTURE CARE – CLEANING UPPER OR LOWER DENTURE

-WITHOUT MOUTH CARE – Only one plate is used for testing

1.      Perform hand hygiene.

a.      Cover all surfaces of your hands with hand sanitizer.

b.      Rub your hands together until they are completely dry.

2.      Explain the procedure to the resident.

3.      Line the bottom of the sink with a protective lining that will help prevent damage to the denture. (Towels, washcloths, or paper towels are all acceptable.)

4.      Put on gloves. 

5.      Apply denture cleanser (paste) to denture brush (or toothbrush).

6.      Remove the denture from the cup.

7.      Handle the denture carefully to avoid damage.

8.      Rinse the denture under cool running.

9.      Thoroughly brush the inner surfaces of an upper or lower denture.

10.  Thoroughly brush the outer surfaces of an upper or lower denture.

11.  Thoroughly brush the denture chewing surfaces of an upper or lower denture.

12.  Rinse all surfaces of the denture under cool running water.

13.  Rinse the denture cup and lid.

14.  Place the denture in the rinsed cup.

15.  Add cool, clean water to the denture cup and replace the lid on the denture cup.

16.  Rinse equipment.

17.  Return equipment to storage.

18.  Discard the sink protective lining in an appropriate container.

19.  Remove gloves, turn them inside out as they are removed, and dispose in a trash container.

20.  Perform hand hygiene.

a.      Cover all surfaces of your hands with hand sanitizer.

b.      Rub your hands together until they are completely dry.

21.  Place the call light or signaling device within easy reach of the resident.

22.  Maintain respectful, courteous interpersonal interactions at all times.

 

DON [PUT ON] A GOWN AND GLOVES, EMPTY A URINARY DRAINAGE BAG, MEASURE AND RECORD URINE OUTPUT, AND DOFF [REMOVE] THE GOWN AND GLOVES WITH HAND WASHING

(One of the possible first mandatory tasks.)

‌-EMBEDDED HAND WASHING ADDED-‌

1.      Perform hand hygiene.

a.      Cover all surfaces of your hands with hand sanitizer.

b.      Rub your hands together until they are completely dry.

2.      Unfold the gown.

3.      Face the back opening of the gown.

4.      Place arms through each sleeve.

5.      Secure the neck opening.

6.      Secure the gown at the waist, ensuring the back flaps cover the clothing as completely as possible.

7.      Put on gloves.

8.      Ensure the cuffs of the gloves overlap the cuffs of the gown.

9.      Explain the procedure to the resident.

10.  Provide for the resident’s privacy.

11.  Place a barrier on the floor under the drainage bag.

12.  Place the graduate on the previously placed barrier.

13.  Open the drain to allow the urine to flow into the graduate until the bag is completely empty.

14.  Avoid touching the graduate with the tip of the tubing.

15.  Close the drain.

16.  Wipe the drain with an alcohol wipe AFTER emptying the drainage bag.

17.  Place the graduate on a level, flat surface.

18.  With the graduate at eye level, measure output.

19.  Empty the graduate into the designated toilet/commode.

20.  Rinse equipment, emptying rinse water into the designated toilet/commode.

21.  Return equipment to storage.

22.  Record the output on the previously signed recording form.

23.  The candidate's recorded measurement is within 25mLs of the RN Test Observer's measurement.

24.  Place the call light or signaling device within easy reach of the resident.

25.  Maintain respectful, courteous interpersonal interactions at all times.

26.  Remove gloves before removing the gown OR, with gloves on, pull/pop the gown off by pulling on the front of the gown.

27.  Remove gloves by turning them inside out and folding one glove inside the other, or pull/pop the gown from the neck, always keeping gloved hands on the outside (contaminated) portion of the gown.

28.  Do not touch the outside of the gloves with your bare hand at any time, OR work gown down the arms from the neck and roll the gown inside out as it is removed.

29.  Dispose of the gloves in the appropriate container without contaminating yourself, OR peel them off, keeping them inside out and rolling up inside the gown.

30.  Unfasten the gown at the waist with bare hands if not using an alternate removal method.

31.  Unfasten the gown at the neck with bare hands if not using an alternate removal method.

32.  Remove the gown by folding/rolling the soiled area to the soiled area with either removal method.

33.  The candidate’s bare hands never touch the soiled surface of the gown.

34.  With either method of removal, dispose of the gown in an appropriate container without contaminating yourself.

35.  Turn on the water.

36.  Wet hands and wrists thoroughly.

37.  Apply soap to hands.

38.  Rub hands together using friction with soap.

39.  Scrub/wash hands together with soap for at least twenty (20) seconds.

40.  Scrub/wash with interlaced fingers pointing downward with soap.

41.  Wash all surfaces of hands with soap.

42.  Wash wrists with soap.

43.  Clean fingernails by rubbing fingertips against the palm of the opposite hand.

44.  Rinse fingers, hands, and wrists thoroughly under running water with fingers pointed downward.

45.  Starting at the fingertips, dry fingers, hands, and wrists with a clean paper towel(s).

46.  Discard paper towel(s) in a trash container as used.

47.  Turn off the faucet with a clean, dry paper towel and discard it in a trash container as used, or use the elbow or knee/foot control to turn off the faucet.

48.  Do not re-contaminate hands at any time during the hand washing procedure. (For example, do not touch the sides of the sink during the procedure or crumple up the paper towel used to turn off the faucet with both hands before discarding it.)

 

DRESS A RESIDENT WITH AN AFFECTED (WEAK) SIDE

-OVERSIZED SHIRT, PANTS AND SOCKS-

1.      Perform hand hygiene.

a.      Cover all surfaces of your hands with hand sanitizer.

b.      Rub your hands together until they are completely dry.

2.      Explain the procedure to the resident.

3.      Provide for the resident’s privacy.

4.      Raise bed height.

5.      Keep the resident covered while removing the gown.

6.      Remove the gown from the unaffected side first.

7.      Place the soiled gown in the designated laundry hamper.

8.      Dress the resident in a button-up shirt. Insert your hand through the shirt sleeve and grasp the resident's hand.

9.      When dressing the resident in a button-up shirt, always dress from the affected (weak) side first.

10.  Assist the resident to raise their buttocks or turn the resident from side to side and draw the pants over the buttocks and up to the resident's waist.

11.  Put on the resident's socks. Draw the socks up the resident's foot until they are smooth.

12.  Leave the resident comfortably/properly dressed (pants pulled up to the waist front and back and shirt completely buttoned).

13.  Lower bed.

14.  Place the call light or signaling device within easy reach of the resident.

15.  Maintain respectful, courteous interpersonal interactions at all times.

16.  Perform hand hygiene.

a.      Cover all surfaces of your hands with hand sanitizer.

b.      Rub your hands together until they are completely dry.

 

FEED A DEPENDENT RESIDENT

-WITH THE RESIDENT IN THE BED-

1.      Perform hand hygiene.

a.      Cover all surfaces of your hands with hand sanitizer.           

b.      Rub your hands together until they are completely dry.

2.      Explain the procedure to the resident.

3.      Ask the resident to state the name and verify that the name matches the name on the diet card.

4.      Position the resident in an upright, sitting position at least 75-90 degrees BEFORE feeding.

5.      Protect clothing from soiling using a napkin, clothing protector, or towel.

6.      Provide hand hygiene for the resident BEFORE feeding. (Candidate may use a disposable wipe and dispose of it in a trash can, or wash the resident’s hands with soap and a wet washcloth, or they may rub hand sanitizer over all surfaces of the resident’s hands until dry.)

7.      Ensure the resident's hands are dry BEFORE feeding. (If a wet washcloth with soap was used, the candidate must dry the resident’s hands. The hands must be dry if a disposable wipe or hand sanitizer is used.)

8.      Place soiled linen in the designated laundry hamper or dispose of disposable wipes in the trash container if used.

9.      Sit in a chair, facing the resident, while feeding the resident.

10.  Describe the food and fluid being offered to the resident.

11.  Offer each fluid frequently.

12.  Offer small amounts of food at a reasonable rate.

13.  Allow resident time to chew and swallow.

14.  Wipe the resident's hands and mouth AFTER feeding the resident.

15.  Remove the clothing protector and place it in the designated laundry hamper.  If a napkin is used, dispose of it in a trash container.

16.  Leave the resident sitting upright in bed with the head of the bed set up to at least 45 degrees.

17.  Record intake as a percentage of total solid food eaten on the previously signed recording form.

18.  The candidate's calculation must be within 25 percentage points of the RN Test Observer’s.

19.  Record estimated intake as the sum of total fluid consumed in mLs on the previously signed recording form.

20.  The candidate's calculation must be within 60mLs of the RN Test Observer's calculation.

21.  Place the call light or signaling device within easy reach of the resident.

22.  Maintain respectful, courteous interpersonal interactions at all times.

23.  Perform hand hygiene.

a.      Cover all surfaces of your hands with hand sanitizer.

b.      Rub your hands together until they are completely dry.

 

‌FOOT CARE - ONE FOOT‌

1. Perform hand hygiene.
1. Cover all surfaces of your hands with hand sanitizer.
2. Rub your hands together until they are completely dry.
2. Explain the procedure to the resident.
3. Fill a basin with comfortably warm water.
4. Remove a sock from the resident’s (right/left) foot.  (The scenario read to you will specify right or left.)
5. Immerse the resident’s foot in warm water.

a.      Verbalize the 5 to 20 minutes of soaking time after you begin soaking the foot.                  

b.      Once the 5 to 20-minute soaking time is verbalized, the RN Test Observer acknowledges the stated time and says, “You may continue with your demonstration now.”

6. Use water and a soapy washcloth.
7. Wash entire foot.
8. Wash between toes.
9. Rinse entire foot.
10. Rinse between toes.
11. Dry foot thoroughly.
12. Dry thoroughly between toes.
13. Apply lotion to the top and bottom of the foot.
14. Avoid getting lotion between the resident’s toes.
15. If any excess lotion is on the foot, wipe with a towel/washcloth.
16. Replace the sock on the resident’s foot.
17. Empty, rinse, dry, and return equipment to storage.
18. Place soiled linens in the designated laundry hamper.
19. Perform hand hygiene.
1. Cover all surfaces of your hands with hand sanitizer.
2. Rub your hands together until they are completely dry
20. Place the call light or signaling device within easy reach of the resident.
21. Maintain respectful, courteous interpersonal interactions at all times.

 

‌MAKE AN OCCUPIED BED‌

1. Perform hand hygiene.
1. Cover all surfaces of your hands with hand sanitizer.
2. Rub your hands together until they are completely dry.
2. Explain the procedure to the resident.
3. Gather linen and transport linen away from the body without touching the uniform.
4. Place linen over the back of the chair, drape it over the foot of the bed, or place it on the overbed table.
5. Provide for the resident’s privacy.
6. Raise bed height.
7. The resident is to remain covered at all times.
8. Assist the resident in rolling onto the side.
9. Roll or fan-fold soiled linen, soiled side inside, to the center of the bed.
10. Place a clean bottom sheet on the mattress.
11. Secure two fitted corners.
12. Roll or fan-fold clean linen against the resident’s back.
13. Assist the resident in rolling onto the side over the clean bottom linen.
14. Remove soiled linen without shaking.
15. Avoid placing soiled linen on the overbed table, chair, or floor.
16. Avoid touching soiled linen on your uniform.
17. Place soiled linen in the designated laundry hamper.
18. Pull through and smooth out the clean bottom linen, leaving it tight and wrinkle-free.
19. Secure the other two fitted corners.
20. Place the resident on their back.
21. Ensure that the resident never touches the bare mattress at any time during the demonstration.
22. Place clean top linen over the covered resident.
23. Place a clean blanket or bedspread over the covered resident.
24. Remove soiled linen, keeping the resident unexposed at all times.
25. Place soiled linen in the designated laundry hamper.
26. Tuck in clean top linen, blanket, or bedspread at the foot of the bed while providing room for the resident’s feet to move.
27. Apply a clean pillowcase with zippers and/or tags to the inside.
28. Gently lift the resident's head while replacing the pillow.
29. Leave the bed neatly and completely made.
30. Lower bed.
31. Place the call light or signaling device within easy reach of the resident.
32. Maintain respectful, courteous interpersonal interactions at all times.
33. Perform hand hygiene.
1. Cover all surfaces of your hands with hand sanitizer.

b.      Rub your hands together until they are completely dry.

 

‌MODIFIED BED BATH- FACE AND ONE ARM, HAND AND UNDERARM‌

1.      Perform hand hygiene.

a.      Cover all surfaces of your hands with hand sanitizer.

b.      Rub your hands together until they are completely dry.

2.      Explain the procedure to the resident.

3.      Provide for the resident’s privacy.

4.      Raise bed height.

5.      Cover the resident with a bath blanket.

6.      Remove the remaining top covers.  Fold to the bottom of the bed or place aside.

7.      Remove the resident's gown without exposing the resident and place the soiled gown in the designated laundry hamper.

8.      Fill a basin with comfortably warm water.

9.      Beginning with the eyes, wash the eyes WITHOUT SOAP using a clean portion of the washcloth for each stroke, washing from the inner aspect to the outer aspect.

10.  Wash the resident’s face WITHOUT SOAP.

11.  Pat dry face.

12.  Place a towel under the resident’s arm, exposing one arm.

13.  Wash the resident’s arm with soap.

14.  Wash the resident’s hand with soap.

15.  Wash the resident’s underarm with soap.

16.  Rinse arm.

17.  Rinse hand.

18.  Rinse underarm.

19.  Pat dry arm.

20.  Pat dry hand.

21.  Pat dry underarm.

22.  Assist the resident in putting on a clean gown.

23.  Empty, rinse, dry, and return equipment to storage.

24.  Place soiled linen in the designated laundry hamper.

25.  Lower bed.

26.  Perform hand hygiene.

a.      Cover all surfaces of your hands with hand sanitizer.

b.      Rub your hands together until they are completely dry.

27.  Place the call light or signaling device within easy reach of the resident.

28.  Maintain respectful, courteous interpersonal interactions at all times.

 

‌MOUTH CARE—BRUSH A RESIDENT’S TEETH‌

1. Perform hand hygiene.
1. Cover all surfaces of your hands with hand sanitizer.
2. Rub your hands together until they are completely dry.
2. Explain the procedure to the resident.
3. Provide for the resident’s privacy.
4. Drape the resident's chest with a towel to prevent soiling.
5. Put on gloves BEFORE cleaning the resident’s mouth.
6. Wet the toothbrush and apply a small amount of toothpaste.
7. Gently brush the inner surfaces of the resident’s upper and lower teeth.
8. Gently brush the outer surfaces of the resident’s upper and lower teeth.
9. Gently brush the chewing surfaces of the resident’s upper and lower teeth.
10. Gently brush the resident's tongue.
11. Assist the resident in rinsing the mouth.
12. Wipe the resident's mouth.
13. Remove soiled linen.
14. Place soiled linen in the designated laundry hamper.
15. Empty container.  (The container may be an emesis basin or a disposable cup.)
16. Rinse the emesis basin, if used, or discard disposable items in the trash can.
17. Dry emesis basin, if used.
18. Rinse the toothbrush.
19. Return equipment to storage.
20. Remove gloves, turning them inside out as they are removed, and dispose in a trash container.
21. Perform hand hygiene.
1. Cover all surfaces of your hands with hand sanitizer.
2. Rub your hands together until they are completely dry.
22. Place the call light or signaling device within easy reach of the resident.

23.  Maintain respectful, courteous interpersonal interactions at all times.

 

‌NAIL CARE - ONE HAND‌

1.      Perform hand hygiene.

a.      Cover all surfaces of your hands with hand sanitizer.

b.      Rub your hands together until they are completely dry.

2.      Explain the procedure to the resident.

3.      Fill a basin with warm water.

4.      Immerse left/right-hand nails in warm water.  (The scenario read to you will specify right or left.)

a.      Verbalize the ‘at least 5 minutes’ soaking time after you begin soaking the nails.

b.      Once the ‘at least 5 minutes’ of soaking time is verbalized, the RN Test Observer acknowledges the stated time and says, “You may continue with your demonstration now.”

5.      Dry hand thoroughly.

6.      Specifically dry between the fingers.

7.      Gently clean under the resident’s nails with an orange stick.

8.      Gently push the resident’s cuticles back with a towel or washcloth.

9.      File each fingernail.

10.  Empty, rinse, dry, and return equipment to storage.

11.  Place soiled linen in the designated laundry hamper.

12.  Place the call light or signaling device within easy reach of the resident.

13.  Maintain respectful, courteous interpersonal interactions at all times.

14.  Perform hand hygiene.

a.      Cover all surfaces of hands with hand sanitizer.

b.      Rub hands together until hands are completely dry.

 

‌PASSIVE RANGE OF MOTION EXERCISES FOR ONE HIP AND ONE KNEE‌

1.      Perform hand hygiene.

a.      Cover all surfaces of your hands with hand sanitizer.

b.      Rub your hands together until they are completely dry.

2.      Explain the procedure to the resident.

3.      Provide for the resident’s privacy.

4.      Raise bed height.

5.      Position the resident supine (bed flat).

6.      Correctly support joints at all times by placing one hand under the resident’s knee and the other hand under the resident’s ankle.

7.      Gently move the resident’s entire leg away from the body.

a.      Abduction

8.      Gently return the resident’s leg toward the body.

a.      Adduction

9.      Gently complete abduction and adduction of the hip at least three times.

10.  Continue correctly supporting joints at all times by placing one hand under the resident’s knee and the other hand under the resident’s ankle.

11.  Gently bend the resident’s knee and hip toward the resident’s trunk.

a.      Flexion of the hip and knee at the same time.

12.  Gently straighten the resident’s knee and hip.

a.      Extension of the hip and knee at the same time.

13.  Gently complete flexion and extension of the knee and hip at least three times.

14.  Do not force any joint beyond the point of free movement.

15.  The candidate must ask at least once during the PROM exercise if there is/was any discomfort/pain.

16.  Lower bed.

17.  Place the call light or signaling device within easy reach of the resident.

18.  Maintain respectful, courteous interpersonal interactions at all times.

19.  Perform hand hygiene.

a.      Cover all surfaces of your hands with hand sanitizer.

a.      Rub your hands together until they are completely dry.

 

PASSIVE RANGE OF MOTION EXERCISES FOR ONE SHOULDER

1. Perform hand hygiene.
1. Cover all surfaces of your hands with hand sanitizer.
2. Rub your hands together until they are completely dry.
2. Explain the procedure to the resident.
3. Provide for the resident’s privacy.
4. Raise bed height.
5. Position the resident supine (bed flat).
6. Correctly support joints at all times by placing one hand under the resident’s elbow or upper arm and the other hand under the resident’s wrist.
7. Gently raise the resident's straightened arm up and over the resident's head to ear level.
1. Flexion

 

8. Gently bring the resident's arm back down to the side of the resident's body. 
1. Extension
9. Gently complete flexion and extension of the shoulder at least three times.
10. Continue correctly supporting shoulder joints by placing one hand under the resident’s elbow or upper arm and the other hand under the resident’s wrist.
11. Gently move the resident's entire arm away from the side of the resident’s body to shoulder level.
1. Abduction
12. Gently return the resident’s arm to the side of the resident's body.
1. Adduction
13. Gently complete abduction and adduction of the shoulder at least three times.
14. Do not force any joint beyond the point of free movement.
15. The candidate must ask at least once during the PROM exercise if there is/was any discomfort/pain.
16. Lower bed.
17. Place the call light or signaling device within easy reach of the resident.
18. Maintain respectful, courteous interpersonal interactions at all times.
19. Perform hand hygiene.
1. Cover all surfaces of your hands with hand sanitizer.

b.      Rub your hands together until they are completely dry.

 

PERINEAL CARE FOR A FEMALE RESIDENT WITH HAND WASHING

(One of the possible first mandatory tasks.)

‌-EMBEDDED HAND WASHING ADDED- [DEMONSTRATED ON A MANIKIN]‌

1.      Perform hand hygiene.

a.      Cover all surfaces of your hands with hand sanitizer.

b.      Rub your hands together until they are completely dry.

2.      Explain the procedure to the resident.

3.      Provide for the resident’s privacy.

4.      Fill a basin with comfortably warm water.

5.      Raise bed height.

6.      Put on gloves.

7.      Turn the resident or raise hips and place a waterproof pad under the resident’s buttocks.

8.      Expose the perineal area only. 

9.      Separate labia. (It is helpful if you verbalize separating the labia as you demonstrate separating the labia.)

10.  Use water and a soapy washcloth (peri-wash and no-rinse soaps are not allowed).

11.  Clean one side of the labia from front to back.

12.  Use a clean portion of the washcloth and clean the other side of the labia from front to back.

13.  Use a clean portion of the washcloth, and clean the vaginal area from front to back.

14.  Use a clean washcloth and rinse from one side of the labia from front to back.

15.  Use a clean portion of the washcloth and rinse the other side of the labia from front to back.

16.  Use a clean portion of the washcloth and rinse the vaginal area from front to back.

17.  Pat dry.

18.  Assist the resident (manikin) in turning sideways away from the candidate toward the center of the bed.

19.  Use a clean washcloth with water and soap (peri-wash and no-rinse soaps are not allowed).

20.  Wash from the vagina to the rectal area.                                        

21.  Use a clean portion of the washcloth with any stroke.

22.  Use a clean washcloth and rinse the rectal area from front to back.

23.  Use a clean portion of the washcloth with any stroke.

24.  Pat dry.

25.  Safely remove the waterproof pad from under the resident’s buttocks.

26.  Position the resident on their back.

27.  Place soiled linen in the designated laundry hamper.

28.  Empty, rinse, dry, and return equipment to storage.

29.  Remove gloves, turn them inside out as they are removed, and dispose in a trash container.

30.  Lower bed.

31.  Place the call light or signaling device within easy reach of the resident.

32.  Maintain respectful, courteous interpersonal interactions at all times.

33.  Turn on the water.

34.  Wet hands and wrists thoroughly.

35.  Apply soap to hands.

36.  Rub hands together using friction with soap.

37.  Scrub/wash hands together with soap for at least twenty (20) seconds.

38.  Scrub/wash with interlaced fingers pointing downward with soap.

39.  Wash all surfaces of your hands with soap.

40.  Wash wrists with soap.

41.  Clean fingernails by rubbing fingertips against the palm of the opposite hand.

42.  Rinse fingers, hands, and wrists thoroughly under running water with fingers pointed downward.

43.  Starting at the fingertips, dry fingers, hands, and wrists with a clean paper towel(s).

44.  Discard paper towel(s) in a trash container as used.

45.  Turn off the faucet with a clean, dry paper towel and discard the paper towel in a trash container as used, or use elbow or knee/foot control to turn off the faucet.

46.  Do not re-contaminate hands at any time during the hand washing procedure. (For example, do not touch the sides of the sink during the procedure or crumple up the paper towel used to turn off the faucet with both hands before discarding it.)

 

‌POSITION A DEPENDENT RESIDENT IN BED ON THEIR SIDE‌

1.      Perform hand hygiene.

a.      Cover all surfaces of your hands with hand sanitizer.

b.      Rub your hands together until they are completely dry.

2.      Explain the procedure to the resident.

3.      Provide for the resident’s privacy.

4.      Position the bed flat.

5.      Raise bed height.

6.      Direct the RN Test Observer to stand on the side of the bed opposite the working side or raise the side rail opposite the working side of the bed to provide safety.

7.      From the working side of the bed – gently move the resident's upper body toward self.

8.      From the working side of the bed – gently move the resident's hips toward self.

9.      From the working side of the bed – gently move the resident's legs toward self.

10.  Gently assist/turn the resident to slowly roll onto the correct side that the RN Test Observer read to the candidate in the scenario at the start of the task.

11.  Place or adjust the pillow under the resident’s head for support. 

12.  Reposition the resident’s arm and shoulder so that the resident is not lying on the arm.

13.  Place the support device under the resident's upside arm.

14.  Place the support device behind the resident’s back.

15.  Place the support device between the resident’s knees.

16.  Lower bed.

17.  Place the call light or signaling device within easy reach of the resident.

18.  Maintain respectful, courteous interpersonal interactions at all times.

19.  Perform hand hygiene.

a.      Cover all surfaces of your hands with hand sanitizer.

b.      Rub your hands together until they are completely dry.

 

‌TRANSFER RESIDENT FROM THEIR BED TO A WHEELCHAIR USING A GAIT BELT‌

1. Perform hand hygiene.
1. Cover all surfaces of your hands with hand sanitizer.
2. Rub your hands together until they are completely dry.
2. Explain the procedure to the resident.
3. Provide for the resident’s privacy.
4. Obtain a gait belt for the resident.
5. Assist the resident in putting on non-skid shoes/footwear.
6. Adjust the bed height to ensure that the resident’s feet are flat on the floor when the resident is sitting on the edge of the bed.
7. Lock bed brakes to ensure the resident's safety.
8. Lock wheelchair brakes to ensure the resident’s safety.
9. Bring the resident to a sitting position.
10. Place a gait belt around the resident’s waist to stabilize the trunk.
11. Tighten gait belt.
12. Check the gait belt for tightness by slipping fingers between the gait belt and the resident.
13. Position the wheelchair arm/wheel touching the side of the bed.
14. Face the resident.
15. Grasp the gait belt on both sides with an upward grasp.
16. Bring the resident to a standing position.
17. Assist the resident to pivot in a controlled manner that ensures safety.
18. Lower the resident into the wheelchair in a controlled manner that ensures safety.
19. Remove gait belt.
20. Place the call light or signaling device within easy reach of the resident.
21. Maintain respectful, courteous interpersonal interactions at all times.
22. Perform hand hygiene.
1. Cover all surfaces of your hands with hand sanitizer.

b.      Rub your hands together until they are completely dry.

 

VITAL SIGNS – COUNT AND RECORD RESIDENT’S RADIAL PULSE AND RESPIRATION

-PULSE AND RESPIRATIONS COMBINED-

1. Perform hand hygiene.
1. Cover all surfaces of your hands with hand sanitizer.
2. Rub your hands together until they are completely dry.
2. Explain the procedure to the resident.
3. Locate the resident’s radial pulse by placing fingertips on the thumb side of the resident's wrist.
4. Count the resident’s radial pulse for one full minute.
1. Tell the RN Test Observer when you start counting and tell them when you stop counting.
5. Record the resident’s radial pulse rate reading on the previously signed recording form.
6. The candidate’s recorded radial pulse rate is within eight (8) beats of the RN Test Observer's recorded rate.
7. Count the resident’s respiration for one full minute.
1. Tell the RN Test Observer when you start counting and tell them when you stop counting.
8. Record the resident’s respiration reading on the previously signed recording form.
9. The candidate’s recorded respiratory rate is within four (4) breaths of the RN Test Observer's recorded rate.
10. Place the call light or signaling device within easy reach of the resident.
11. Maintain respectful, courteous interpersonal interactions at all times.
12. Perform hand hygiene.
1. Cover all surfaces of your hands with hand sanitizer.

b.      Rub your hands together until they are completely dry.

 

 

 

‌Knowledge Exam Vocabulary List‌

abandonment

abdominal thrust

abductor wedge

abnormal vital signs

abuse

accidents

activities

acute

adaptive

ADL

admission

admitting resident

affected side

aging process

agitation

Alzheimer's

ambulation

angina

anterior

anxiety

aphasia

arthritis

aspiration

assault

assistive device

atrophy

basic needs

bathing

bed cradle

bed making

bedrest

behavior

behavioral care plan

beliefs

biohazard

bleeding

blindness

blood pressure

body alignment

body fluid

body language

body mechanics

body temperature

bone loss

bowel program

brain stem

breathing

burnout

call light

cancer

cardiac arrest

cardiovascular system

care impaired

care plan

care planning

cataract

catheter

chain of command

charge nurse

choking

chronic

circulation

circulatory system

cleaning

clear liquid diet

clergy

cognitive impaired

cold pack

colostomy

colostomy care

coma

combative resident

communicable

communication

conduct

confidentiality

confused resident

congestive heart failure

constipation

contracture

converting measures

COPD

coughing excessively

cultural

culture

CVA

dangling

de-escalation

death and dying

dehydration

delegation

dementia

denture care

dentures

dependability

developmental disability

diabetes

diastolic

diet

dietitian

digestion

dirty linen

discharging resident

disease

disease process

disoriented

disposing of contaminated materials

disrespect

dizziness

DNR

documentation

domestic abuse

dressing

dry skin

dying

dyspnea

dysuria

edema

elastic/compression (anti-embolic) stocking

elimination

emesis basin

emotional abuse

emotional needs

emotional support

empathy

essential behaviors

ethics

falls

fasting

feces

feeding

fire

fire safety

first aid

flatus

Foley catheter

foot drop

fractures (broken bones)

fraud

frayed cord

gait belt

gastric feedings

gastrostomy tube

geriatrics

gestures

grieving process

hand tremors

hand washing

health-care team

hearing aid

hearing impaired

hearing loss

heart muscle

Heimlich maneuver

helping residents

hemiplegia

HIPAA

HIV

hormones

hospice

hyperglycemia

hypertension

hyperventilation

immobility

impaired

in-house transfer

in-service programs

incontinence

indwelling catheter

infection

infection control

initial observations

insomnia

intake

intake and output (I&O)

interpersonal skills

invasion of privacy

isolation

isolation precautions

IV care

job description

lactose intolerance

lift/draw sheet

log rolling

loose teeth

male perineal care

masturbation

measuring height

measuring temperature

mechanical lift

medical record

medications

memory loss

mental health

microorganism

military time

mistakes

mobility

mouth care

moving

Multiple Sclerosis

muscle spasms

musculoskeletal

nail care

nasal cannula

neglect

non-contagious disease

NPO

nurse aide's role

nutrition

objective

objective data

occupied bed

ombudsman

oral care

oral hygiene

oral temperature

orientation

oriented

orthostatic hypotension

osteoporosis

ostomy bag

output

overbed table

oxygen

oxygen use

palliative care

paralysis

paranoia

Parkinson's

patience

perineal care

personal care

personal items

personal protective equipment (PPE)

pet therapy

physical needs

physician's authority

plaque

plate rim

positioning

precautions

pressure ulcer/injury

preventing falls

privacy

prostate gland

prosthesis

psychological needs

psychosocial

pulse

quadriplegia

quality of life

radial

range of motion

reality orientation

rectal

regulation

rehabilitation

renewal

reporting

reposition

resident abuse

resident belongings

resident independence

resident right

resident treatment

resident trust

Resident's Bill of Rights

resident's chart

resident's families

resident's room

residents

respectful treatment

respiration

respiratory symptoms

respiratory system

responding to resident's behavior

responsibility

restorative care

restraint

resuscitation

rights

risk factor

safety

safety procedures

sanitizer

scale

secretions

seizure

self-esteem

sexual abuse

sexual needs

sharing information

sharps container

shaving

skin observation

smoking

social needs

soiled linen

specimen

spiritual/religious needs

standard precautions

stethoscope

stress

stroke

subjective data

sundowning

supplemental feedings (snacks, Ensure, Boost, etc.)

suprapubic

survey

swelling

tachycardia

telephone etiquette

temperature

terminal illness

terminology

thickened liquids

tips

toenails

toileting schedule

transfer belt

transfers

transporting food

transporting linens

tubing

tympanic

tympanic temperature

unaffected

unconscious

unsteady

urethral

urinary catheter bag

urinary system

urinary tract

urination

validation therapy

vision change

vital signs

vocabulary

vomitus

walker

water faucets

weakness

weighing

weight

wheelchair safety