New Jersey CNA cheat sheet

Hand hygiene: soap and water for at least 20 seconds covering palms, backs, between fingers, and wrists; an alcohol-based rub is acceptable only when hands are not visibly soiled.

Resting adult vital sign ranges: oral temperature 97.6–99.6°F, pulse 60–100 beats/min, respirations 12–20 breaths/min, blood pressure below 120/80 mmHg.

Pulse counting rule: count for 30 seconds and multiply by 2 when the rhythm is regular; count a full 60 seconds when the rhythm is irregular.

Temperature routes: a rectal reading runs about 1°F higher and an axillary reading about 1°F lower than an oral reading; record the route along with the value.

Reposition a dependent resident at least every 2 hours and check bony prominences for non-blanchable redness, which is a stage 1 pressure injury and is still reversible.

Range of motion: move each joint slowly only to the point of resistance and stop there; support the limb above and below the joint and never force a joint.

Urinary catheter care: keep the drainage bag below bladder level and off the floor, empty it when two-thirds full, and report output under 30 mL per hour.

Elastic stockings are applied in the morning before the resident gets out of bed and removed at least twice daily to inspect skin and circulation.

Aspiration precautions at meals: seat the resident upright at 90 degrees, tuck the chin slightly when swallowing, place food on the stronger side after a stroke, and stop feeding if coughing, gurgling, or food pocketing occurs.

Maslow order used to set priorities: physiological needs (oxygen, food, water, elimination) first, then safety, love and belonging, esteem, and self-actualization.

Kübler-Ross grief stages are denial, anger, bargaining, depression, and acceptance; a resident may move back and forth, so the current stage is accepted without correction.

Report at once any new behavior change - aggression, agitation, crying, confusion, or refusal to eat - because it often signals an unmet physical need such as pain, constipation, or infection.

Depression indicators include withdrawal from activities, changed appetite or sleep, hopeless statements, and loss of interest lasting two weeks or more.

Anxiety is observed rather than measured directly: pacing, restlessness, rapid speech, clenched fists, sweating, and a rising pulse or respiratory rate.

With an aphasic resident: ask yes/no questions, allow extra time for a response, use gestures and pictures, and never finish sentences or discuss the resident as if absent.

With a hearing-impaired resident: face the person, get attention before speaking, speak clearly at a slightly lower pitch, and cut background noise; shouting raises pitch and distorts sound.

A resident may refuse any task or treatment: honor the refusal, do not force care, notify the nurse, and document the refusal and the notification.

Dignity and privacy rule: knock and wait for permission before entering, close doors and curtains during care, and expose only the body part being cared for.

Scope of practice: the nursing assistant gives direct care and reports findings under RN or LPN supervision; assessment, client teaching, medication administration, and accepting verbal orders are outside the role.

Chain of command: nursing assistant, then charge nurse or LPN, then RN, then director of nursing, then administrator; concerns move up this line after the immediate supervisor.

Five rights of delegation: right task, right circumstance, right person, right direction and communication, right supervision; if any element is missing, question or decline the assignment.

Findings reported to the nurse immediately: any change in condition, abnormal vital signs, pain, falls or injuries, refusals of care, skin breakdown, and anything that looks like abuse or neglect.

Documentation standard: objective, factual, timely entries stating what was seen, heard, measured, and done, with time and signature; omit opinions and judgmental words.

Paper chart error correction: draw one line through the error so it stays readable, write 'error,' add initials and date, then chart the correct information; never erase or use correction fluid.

HIPAA rule: protected health information is shared only with staff involved in the resident's care; residents are never discussed in hallways, elevators, public areas, or on social media.

Suspected abuse or neglect is reported immediately to the charge nurse and per New Jersey and facility policy; the nursing assistant is a mandatory reporter and does not investigate.

An incident report records an unexpected event factually for facility risk management; it does not replace charting, and the incident report itself is not named in the resident's record.