Massachusetts Nurse Aide Candidate Handbook
D&SDT-HEADMASTER’s regular business hours are 8:00AM to 8:00PM ET, Monday through Friday, excluding holidays.  Please call D&SDT-Headmaster’s alternate language line (855)263-6050 with any questions.
	
	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. This program aims to ensure that candidates 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 nurse aide competency examination process 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 get in touch with 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.

Upon successful completion of training, passing both the knowledge and skills portions of the competency exam, and meeting federal and/or state requirements, a nurse aide candidate will be listed on the MANAR.  Review the Nurse Aide Competency Exam section 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.  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 examination. D&SDT-Headmaster must approve accommodations in advance of examination. Complete the ADA Accommodation Request Application found on the Massachusetts Nurse Aide 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) and Spanish (simplified), in addition to English. Candidates can indicate their intent to take the NA exam in a language other than English during the exam registration process. 

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

Please call D&SDT-Headmaster’s alternate language line (855)263-6050 with any questions.
	Payment Information
$30.00 – Knowledge exam or retake 
$40.00 – Audio version of the knowledge exam
$70.00 – Skill Test
	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 the Massachusetts CNA TMU© mc.tmutest.com using your secure Email or Username and Password and complete your demographic information.

It is highly recommended that when you receive your confirmation email from TMU© (check your junk/spam mail) that your account has been created, you sign in to your TMU© account, update your password, and complete your demographic information.

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 email. If you cannot sign in, contact D&SDT-HEADMASTER at (888)401-0462.

	Schedule 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, please call D&SDT-HEADMASTER for assistance at (888)401-0462 during regular business hours, 8:00AM to 8:00PM ET, Monday through Friday, excluding Saturdays, Sundays, and holidays.

To schedule or reschedule your test date, sign in to the Massachusetts TMU© webpage at mc.tmutest.com with your Email or Username and Password.  If you are unable to schedule/reschedule online, please call D&SDT-HEADMASTER at (888)401-0462 for assistance.
	Self-Pay of Testing Fees in TMU©
Testing fees must 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 can 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. 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 that will give you state-specific instructions on what time to arrive, ID requirements, dress code, etc.
	
	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.

St. Paul, MN

St. Paul, MN

Please see the ‘Remotely Proctored Knowledge Exam Option’ under the Knowledge/Audio Exam section if you want to take your knowledge exam with a remote proctor from your home, etc.  If you have any questions regarding your test scheduling, call D&SDT-HEADMASTER at (888)401-0462, Monday through Friday, excluding holidays, 8:00AM to 8:00PM ET.

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/View 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 4 times or the skills component 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 TMU© site at mc.tmutest.com.

If you have any questions regarding your test scheduling, call D&SDT-HEADMASTER at (888)401-0462 during regular business hours, 8:00AM to 8:00PM ET, Monday through Friday, excluding holidays.
	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 status, 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 status.  You will forfeit your testing fees and must pay for another exam date.
	Identification
You must bring your 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)
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 a 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 exactly match the FIRST and LAST names that were entered in the Massachusetts Nurse Aide 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.

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 for your skills exam. 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 Nurse Aide 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 Test
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.

These instructions detail the process and what you can expect during your exam. Please read the instructions before entering the knowledge exam room or skills lab. 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 questions about the instructions you read when entering the testing rooms.

The Knowledge, Remotely Proctored Knowledge, and Skill Exam Instructions are also available under the ‘DOWNLOADS’ tab in your TMU© account.  
	Testing Policies
The following policies are observed at each test site:
Make sure you have signed in to your TMU© account at http://mc.tmutest.com 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 scrubs with appropriate shoes to your in-person test event (not required for remotely proctored knowledge test events) and conform to all testing policies, you will not be admitted to the exam, and any exam fees paid will NOT be refunded.
If you are a NO SHOW status for your exam day, any test fees paid will NOT be refunded.  
ELECTRONIC DEVICES AND PERSONAL ITEMS: Cell phones, smart watches, 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.
You are encouraged to bring a jacket, snack, drink, or study material to have while waiting to test.
Foreign language paper word-for-word translation dictionaries are allowed and must be shown to the RN Test Observer at check-in (for both a remotely proctored knowledge test and an on-site test event) and to the Knowledge Test Proctor when you enter the knowledge test room (on-site test event).  If there is any writing or definitions, the translation dictionary will not be permitted to be used during testing. Using language translators that are not pre-approved and electronic dictionaries are not allowed.   
You may not remove any notes or other materials from the testing room.
You are not permitted to eat, drink, or smoke (e-cigarettes or vape) during the exam.
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.
If you are discovered causing a disturbance of any kind, engaging in any misconduct, are visibly impaired, or trying to take any notes or testing materials from the testing room, you will be dismissed from the exam, your test will be scored as a failed attempt, you will forfeit all testing fees paid, and you will be reported to your training program and the Massachusetts Department of Public Health (DPH).
Test sites, RN Test Observers, Knowledge Test Proctors, and Actors are not responsible for the candidate's personal belongings at the test site. 
No visitors, guests, pets (including companion animals), or children are allowed.
  
Service animals with an approved ADA accommodation in place are allowed.
You may not test if you are ill (sick).  Call D&SDT-Headmaster at (800)393-8664 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:  Reschedules will not be granted less than one (1) full business day before a scheduled test date.
Please review this Massachusetts NA 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
If you refuse to follow directions, are caught cheating, use abusive language, are visibly impaired, or disrupt the examination environment, your test will be stopped and scored as a failed attempt. You will be dismissed from the testing room and forfeit any testing fees paid. A report of your behavior will be given to your training program and the Massachusetts Department of Public Health (DPH). You will not be allowed to retest for a minimum period of six (6) months.

If you remove or try to remove test material or take notes or information from the test site, you will be reported to your training program and DPH and are subject to prosecution to the full extent of the law. Your test will be scored as a failed attempt, and you will forfeit any testing fees that have been paid.  You will not be allowed to retest for a minimum period of six (6) months. You may need to obtain permission from DPH to be eligible to test again.

If you give or receive help from anyone during testing (which also includes the use of any electronic recording devices such as cell phones, smart watches, or navigating to other browsers/sites during an electronic exam, etc.), your test will be stopped, you will be dismissed from the testing room and your test will be scored as a failed attempt. You will forfeit any testing fees paid.  You will be reported to your training program and DPH and you may need to obtain permission from DPH to be eligible to test again.
	Reschedules
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 the close of business on Wednesday before your scheduled exam.  D&SDT-HEADMASTER’s regular business hours are 8:00AM to 8:00PM ET, Monday through Friday, excluding holidays. 

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
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 Fillable 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.

Refund requests made in the required time frame qualify for a full refund of any testing fees paid minus a $35 refund processing fee.  
Refund requests must be made within thirty (30) days of payment of original testing fees with D&SDT-HEADMASTER.  Any requests for refunds made beyond 30 days of the original payment of testing fees with D&SDT-HEADMASTER will not be issued.
	Not Scheduled in a Test Event
Refund requests must be made within thirty (30) days of original payment of testing fees with D&SDT-HEADMASTER.  Any requests for refunds made beyond 30 days of the original payment of testing fees with D&SDT-HEADMASTER will not be issued.
To request a refund for testing fees paid, you must fill out and submit the Refund Request Fillable Form on D&SDT-HEADMASTER’s main webpage at www.hdmaster.com. No phone calls will be accepted. 
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 current in case we need to contact you. (*See examples below for reasons we may not be able to contact you for which you are responsible.)
 
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 Reschedules and Refunds 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 Test 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 7:00PM (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 Massachusetts NA 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 http://mc.tmutest.com.   You will need to pay with a Visa or Master Card 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.

*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 NA 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.   The purpose of this review process is to ensure fairness and accuracy in the evaluation of your test. 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
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 Test. You will have 60 minutes to complete the 60-question Knowledge Test.  You will be told when fifteen (15) minutes remain.  You may not ask questions about the content of the Knowledge Test (such as “What does this question mean?”). The Knowledge Test Proctor will have scratch paper and a basic calculator available during your knowledge exam.

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.  The Knowledge Test Proctor will provide you with a code at the test event to start your test.  
Please see the information under ‘Complete Your TMU© Account’ to sign in to your TMU© account.

An audio (oral) version of the knowledge exam is available.  However, you must request an Audio version of the Knowledge Exam before you submit your testing fee payment. (See instructions below for requesting an audio version of the knowledge exam.)

Foreign language paper word-for-word translation dictionaries are allowed and must be shown to the RN Test Observer at check-in (for both a remotely proctored knowledge test and an on-site test event) and to the Knowledge Test Proctor when you enter the knowledge test room (on-site test event).  If there is any writing or definitions, the translation dictionary will not be permitted to be used during the test. 

If needed, you may do math calculations on 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/or provided calculator must be left with the KTP when done testing.
	Audio Version of the Knowledge Exam
The questions are neutrally read to you and can be heard through wired headphones or earbuds plugged into the computer. Bluetooth-connected devices are not allowed. When taking an Audio version of the Knowledge exam, the audio control buttons are displayed on the computer screen, enabling you to play, rewind, or pause questions as needed.
	Remotely Proctored Knowledge Exam Option
You will have the option to take the knowledge exam remotely from your home, etc.  
	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 provide you with a ‘code’ to start your test.
A smartphone to access the ‘video conferencing app’ (for example, Zoom, etc.) that you must download.  
An email will be emailed to you and in your notifications (in your TMU© account) with information about the ‘video conferencing app’ (for example, Zoom, etc.) you will need to 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.
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.
	Scheduling a Remotely Proctored Knowledge Exam
You will need to sign in to your TMU© account using your Username or Email and Password. 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.
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 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. 
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
During the remotely proctored knowledge exam, all ‘Testing Policies’ and ‘Security’ measures are followed. 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.

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.

	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                               
8 Questions in Basic Nursing Skills                                                     
3 Questions in Care Impaired                                                             
5 Questions in Communication                                                                    
2 Questions in Data Collection                                                                      
7 Questions in Disease Process                                                          
4 Questions in Infection Control
4 Questions in Mental Health
4 Questions in Personal Care
6 Questions in Resident Rights
9 Questions in Role and Responsibility
6 Questions in Safety

	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 the state of Montana.  Amy lives in an apartment with her parents and her brother, Nick.  Tomorrow, Amy is flying to the state of Oregon.  Amy is bringing three books of 3 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 most important book 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

Answers:   1. C | 2. B | 3. A | 4. B | 5. D | 6. B | 7. C | 8. A | 9. D | 10. A | 11. D | 12. C | 13. C

	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. 

	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. After fifteen (15) minutes have elapsed, you will be alerted when 15 minutes remain.

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.
	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 Resident with the use of a Bedpan, Measure, and Record Urine Output with Hand Washing
Catheter Care for a Female with Hand Washing [demonstrated on a manikin]
Donn [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 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.

Note:  The skill task steps included in this handbook are offered as guidelines to help prepare candidates for the Massachusetts nurse aide skill test, and the steps included herein are not intended to be used to provide complete care that would be all-inclusive of best care practiced in an actual work setting.
Apply an Anti-Embolic (compression) Stocking to One Leg
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.	Raise bed height.
4.	Provide for resident’s privacy.
5.	Provide for 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 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.
a.	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 resident's safety.
7.	Lock wheelchair brakes to ensure 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 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 resident in pivoting/turning and sitting 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 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 equipment used 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 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 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 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 – Clean 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 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.

	Donn [Put On] a Gown and gloves, Empty a Urinary Drainage Bag, Measure and Record Urine Output, and Doff [Remove] 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 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 the gloves off, keeping them inside out and rolled 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 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 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 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.
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 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.
a.	Cover all surfaces of your hands with hand sanitizer.
b.	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.
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.	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 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 to 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 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 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.
a.	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 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 eyes, wash eyes WITHOUT SOAP using a clean portion of the washcloth for each stroke, washing 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.
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 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.
a.	Cover all surfaces of your hands with hand sanitizer.
b.	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 your hands with hand sanitizer.
b.	Rub your hands together until they 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 resident’s privacy.
4.	Raise bed height.
5.	Position 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 hip and knee at the same time.
12.	Gently straighten the resident’s knee and hip.
a.	Extension of 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.
b.	Rub your hands together until they are completely dry.
	Passive Range of Motion Exercises for one Shoulder 
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 resident’s privacy.
4.	Raise bed height.
5.	Position 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. 
a.	Flexion
8.	Gently bring the resident's arm back down to the side of the resident's body.  
a.	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. 
a.	Abduction
12.	Gently return the resident’s arm to the side of the resident's body. 
a.	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.
a.	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 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 labia as you demonstrate separating 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.
a.	RN Test Observer may help hold the manikin on their side ONLY after the candidate has turned the manikin.   
19.	Use a clean washcloth with water and soap (peri-wash and no-rinse soaps are not allowed).
20.	Wash from vagina to 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 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 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 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.
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 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 resident's safety.
8.	Lock wheelchair brakes to ensure 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.
a.	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.
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.	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.
a.	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.
a.	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.
a.	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	
absorption	
abuse	
accidents	
activities	
acute	
adaptive	
ADL	
admission	
admitting resident	
affected side	
aging process	
agitation	
Alzheimer's	
ambulation	
angina	
anterior	
anti-embolic (compression) stocking	
anxiety	
aphasia	
arthritis	
aspiration	
assault	
assistive device	
atrophy	
authorized duty	
basic needs	
bath water temperature	
bathing	
bed cradle	
bed height	
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	
catheter care	
cc's in an ounce	
central nervous system	
chain of command	
charge nurse	
choking	
chronic	
circulation	
circulatory system	
cleaning	
clear liquid diet	
clergy	
cold pack	
colostomy	
colostomy care	
coma	
combative resident	
communicable	
communication	
conduct	
confidentiality	
conflict	
confused resident	
congestive heart failure	
constipation	
contracture	
converting measures	
COPD	
coughing excessively	
CPR	
cultural	
culture	
CVA	
dangling	
de-escalation	
death and dying	
deeper tissue	
dehydration	
delegation	
demanding resident	
dementia	
denture care	
dentures	
dependability	
developmental disability	
diabetes	
diastolic	
diet	
dietitian	
digestion	
dirty linen	
discharging resident	
disease	
disease process	
disinfection	
disoriented	
disposing of contaminated materials	
disrespect	
dizziness	
DNR	
documentation	
domestic abuse	
dressing	
dry skin	
dying	
dyspnea	
dysuria	
edema	
elastic (compression) stockings	
elimination	
emesis	
emesis basin	
emotional abuse	
emotional needs	
emotional stress	
emotional support	
empathy	
essential behaviors	
ethics	
eyeglasses	
falls	
fasting	
feces	
feeding	
fire	
fire safety	
first aid	
flatus	
Foley catheter	
foot care	
foot drop	
fractures (broken bones)	
fraud	
frayed cord	
gait belt	
gastric feedings	
gastrostomy tube	
geriatrics	
gestures	
gifts	
gloves	
grieving process	
group settings	
hair care	
hand care	
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	
jaundice	
job description	
lactose intolerance	
lift/draw sheet	
linen (sheets, towels, etc.)	
log rolling	
loose teeth	
male perineal care	
masturbation	
measuring height	
measuring temperature	
mechanical lift	
medical record	
medications	
memory loss	
mental health	
mentally impaired	
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	
passive	
patience	
perineal care	
personal care	
personal items	
personal protective equipment (PPE)	
personal values	
pet therapy	
phone etiquette	
physical needs	
physical therapist	
physician's authority	
plaque	
plate rim	
positioning	
precautions	
pressure ulcer/injury	
preventing falls	
privacy	
pronation	
prostate gland	
prosthesis	
prosthesis	
psychological needs	
psychosocial	
pulse	
quadriplegia	
quality of life	
RACE (acronym)	
radial	
range of motion	
reality orientation	
rectal	
regulation	
rehabilitation	
religious service	
reminiscing	
renewal	
reporting	
reposition	
resident abuse	
resident belongings	
resident independence	
resident pictures	
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	
rotation	
safety	
safety procedures	
sanitizer	
scale	
secretions	
seizure	
self-esteem	
sexual abuse	
sexual harassment	
sexual needs	
shampoo tray	
sharing information	
sharps container	
shaving	
skin observation	
smoking	
social needs	
social worker	
soiled linen	
specimen	
spiritual/religious needs	
standard precautions	
stealing	
stethoscope	
stress	
stroke	
subjective	
subjective data	
sundowning	
supplemental feedings (snacks, Ensure, Boost, etc.)	
suprapubic	
survey	
swelling	
tachycardia	
telephone etiquette	
temperature	
tendons	
terminal illness	
terminology	
thickened liquids	
threatening resident	
tips	
toenails	
toileting schedule	
transfer belt	
transfers	
transporting food	
transporting linens	
tub bath	
tubing	
twice daily	
tympanic	
tympanic temperature	
unaffected	
unconscious	
unsteady	
urethral	
urinary catheter bag	
urinary system	
urinary tract	
urination	
validation therapy	
vision change	
vital signs	
vocabulary	
vomitus	
walker	
wandering resident	
water faucets	
weakness	
weighing	
weight	
well-being	
wheelchair safety	
withdrawn resident