CNA WOCC(C) Exam cheat sheet

The CNA WOCC(C) exam tests entry-level nursing assistant competence; the certification content area covers resident rights, safety, infection control, personal care, nutrition and hydration, elimination, mobility and positioning, observation and reporting, and psychosocial care.

Scope of practice: a nursing assistant performs delegated tasks under licensed nurse supervision; assessment, care planning, teaching, and invasive procedures remain with the licensed nurse.

Resident rights include dignity, privacy, self-determination, freedom from restraint and abuse, access to personal belongings, and the right to refuse care; refusal must be reported, not overridden.

Abuse categories: physical, emotional or verbal, sexual, financial, neglect, and involuntary seclusion; mandatory reporting applies to any witnessed or suspected incident.

Standard precautions apply to every resident regardless of diagnosis: hand hygiene before and after contact, gloves for body fluids, and eye or mask protection when splashing is likely.

Hand hygiene with soap and water is required when hands are visibly soiled or after contact with spore-forming organisms such as Clostridioides difficile; alcohol-based rub is acceptable otherwise.

Vital sign normal adult ranges: temperature about 36.1 to 37.8 C oral, pulse 60 to 100 beats per minute, respirations 12 to 20 per minute, blood pressure below 120/80 mmHg, oxygen saturation 95 to 100 percent.

Pain is the fifth vital sign; report location, quality, intensity on a 0 to 10 scale, timing, and what relieves or worsens it.

Reportable changes include sudden confusion, new shortness of breath, chest pain, fever, bleeding, inability to urinate, falls, skin breakdown, and refusal of food, fluids, or medications.

Body mechanics: keep the load close, bend at the knees and hips rather than the waist, keep feet shoulder-width apart, and pivot the feet instead of twisting the spine.

Before any transfer, verify the resident's weight-bearing status and the prescribed level of assistance; a gait belt is used for residents who can bear weight and are able to stand.

Sequence for repositioning: raise the bed to working height, lower the near side rail, lock the bed wheels, explain the move, position the draw sheet, then lower the bed and raise the rail afterward.

A dependent resident is repositioned at least every 2 hours; check skin over bony prominences (sacrum, heels, hips, elbows, ears) at each turn.

Pressure injury staging: stage 1 is intact skin with non-blanchable redness; stage 2 is partial-thickness loss with a shallow open wound or blister; stage 3 extends to subcutaneous tissue; stage 4 reaches muscle, bone, or tendon.

Fall prevention: bed in lowest position, wheels locked, call light within reach, non-skid footwear, adequate lighting, and frequent toileting rounds for residents with urgency.

When a resident falls, do not move or lift them; check responsiveness and injury, call for the nurse, and stay with the resident until help arrives.

Intake and output: record all oral fluids, tube feedings, and intravenous fluids as intake; urine, vomit, wound drainage, and liquid stool as output; report output below 30 mL per hour or a sudden drop.

Fluid needs are roughly 1500 to 2000 mL daily for most adults unless restricted; thickened liquids are used only when a swallowing disorder is identified by the care team.

Chain of infection: infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, susceptible host; hand hygiene breaks the transmission link.

Contact precautions require gown and gloves and dedicated equipment; droplet precautions require a mask within about 1 meter; airborne precautions require an N95 or equivalent respirator and a negative-pressure room.

Do not share razors, toothbrushes, or other personal items; clean shared equipment between residents; bag soiled linen at the point of use and never place it on the floor.

Dysphagia precautions: upright at 90 degrees, chin tucked, small bites, no talking while eating, remain upright 30 minutes after the meal, and report coughing or a wet voice.

Aspiration signs include coughing during eating, choking, a gurgling or wet voice, and new fever; stop feeding and notify the nurse immediately.

Diabetic diet principles: consistent carbohydrate portions, no concentrated sweets, meals on schedule; report a resident who is sweating, shaky, or confused as possible hypoglycemia.

Dehydration signs: dry mucous membranes, poor skin turgor, dark concentrated urine, confusion, and low urine output; encourage preferred fluids within any restriction.

Psychosocial care: use active listening, address the resident by the preferred name, allow choices, respect cultural and religious practices, and support family involvement.

Confusion and dementia care: maintain routines, use short simple sentences, redirect rather than argue, and validate feelings rather than correcting facts.

Confidentiality: discuss resident information only with the care team and only in a private setting; never in hallways, elevators, or on social media.