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Excel Testing · Vermont Office of Professional Regulation

You don't have to read the book.

The Vermont LNA exam is not built from your textbook's chapter order — it's built from a published five-part content outline with fixed percentages. That outline tells you exactly which of Hartman's 24 chapters carry the test and which are background. This is that map, plus every step that fails you instantly on the skills exam.

Built from the official Nurse Aide Competency Test Guide (Excel Testing, 2023) and the chapter list of Hartman's Nursing Assistant Care: Long-Term Care, 6th ed.

60written questions
42correct to pass (70%)
90minutes, written
4skills, drawn at random
30minutes, all four skills
1bold step missed = fail

01

Four things that change how you study

Read these before you open the textbook again. Each one redirects effort away from something that isn't scored.

The skills exam is where people actually fail

The written test is 60 questions and you need 42 right — there's room to miss 18. The skills exam has no such cushion. Certain steps are marked in bold on the official checklist, and missing one of them is an immediate failure regardless of everything else you did. Four non-bold mistakes also fails you.

Most of the bold steps are not clinical knowledge. They're habits: gloves on before, gloves off after; brakes locked; side rail up; call bell left in reach. The full instant-fail list is below — it is the highest-value thing on this page.

Two different tests, two different jobs

Her class will quiz her on chapters in order, including material the state exam barely touches. The state exam follows a weighted outline. She has to survive both, but she should not give them equal effort — use the chapter triage to decide where a second pass is worth it.

Both exams happen the same day — and the door closes

Written and skills are administered on the same day, with verbal results before she leaves. Plan for a full six hours on site; if she's last in a group of eight to do skills, she finishes about five and a half hours after the start.

Arrive 15 minutes early. Once the exam room door closes, late candidates are not admitted — the guide says there are no exceptions.

Failing one half doesn't mean retaking both

If she fails only the written or only the skills portion, she retakes just that portion. There's a fee, and she can't retest until at least one day after. Worth knowing so a bad written test doesn't feel like the end of the road mid-day.

02

What the 60 questions are actually about

Excel Testing publishes the weighting. Two areas — Basic Nursing Skills and Personal Care — are 60% of the exam between them, or roughly 36 of the 60 questions.

Basic Nursing Skills30% · ~18 q Infection control · vital signs · positioning, moving, ambulation · admission procedures · data collection · reporting · disease process · abbreviations
Personal Care & Activities of Daily Living30% · ~18 q Resident's environment · skin care · bathing · grooming · dressing · oral care · nutrition · urinary and bowel elimination · restorative care and ROM · death and dying
Role of the Nursing Assistant23% · ~14 q Structure of the healthcare system · communication · resident rights and abuse · legal and ethical issues · personal and career care
Human Needs & Development10% · ~6 q Cultural needs · spiritual needs · emotional and mental health needs · the aging process
Safety7% · ~4 q Restraints · body mechanics · environmental safety · accident prevention · emergency care

Read the safety number carefully

Safety is only 7% of the written test — about four questions. That is not permission to skim it. Safety is graded continuously on the skills exam through the indirect observations, and several safety steps are instant-fail. Low written weight, maximum practical weight.

03

All 24 chapters, ranked by what they're worth

Mapping Hartman's chapters onto the Excel Testing outline. Tier 1 is where the exam lives; Tier 4 is real nursing content that the state exam barely asks about. If time runs out, it runs out from the bottom.

Tier 1Know these cold Roughly two-thirds of the written exam, and every skill she'll be asked to perform.
  • 05Infection Prevention and ControlThe single most tested idea on both halves. Standard Precautions, chain of infection, PPE order, handwashing. Gloves and hand hygiene are instant-fail steps.
  • 13Personal Care SkillsBathing, grooming, dressing, oral care, skin. Feeds the 30% Personal Care block and at least six testable skills.
  • 14Basic Nursing SkillsVital signs, measurement, data collection. Memorize normal ranges and what gets reported.
  • 10Positioning, Transfers, and AmbulationTransfers, gait belts, body mechanics, positions. Bed-to-wheelchair transfer is a testable skill with an instant-fail step.
  • 15Nutrition and HydrationFeeding, diets, intake and output, ounce-to-cc conversion. Two skills come straight out of this chapter.
  • 16Urinary EliminationCatheter care and output measurement — three instant-fail steps live here.
  • 21Rehabilitation and Restorative CareRange of motion. She needs abduction, adduction, flexion, extension, dorsiflexion and plantar flexion by name, and she must work the correct side.
  • 03Legal and Ethical IssuesResident rights, abuse types, mandated reporting. The densest single chapter in the 23% Role block.
Tier 2Solid single pass Named directly in the outline. Read once properly; review the key terms.
  • 17Bowel EliminationNamed in the outline alongside urinary. Bedpan and commode are testable skills.
  • 04Communication and DiversityServes both the Role block and the Human Needs block. Also covers reporting and abbreviations.
  • 06Safety and Body MechanicsRestraints, falls, accident prevention. Low written weight, but graded all day long on the skills exam.
  • 12The Resident's UnitListed first under Personal Care. Bed making is a testable skill with two instant-fail steps.
  • 02The Nursing Assistant and the Care TeamScope of practice, delegation, chain of command, reporting vs. recording.
  • 08Human Needs and Human DevelopmentMost of the 10% Human Needs block: cultural, spiritual, and emotional needs plus the aging process.
  • 23Dying, Death, and HospiceExplicitly named under Personal Care. Know the five stages of grief and the signs of approaching death.
  • 11Admitting, Transferring, and DischargingAdmission procedures are called out by name in the Basic Nursing Skills block. Height and weight are testable skills.
Tier 3Skim for key terms Covered indirectly. Read the objectives, key terms, and Guidelines boxes; skip the narrative.
  • 18Common Chronic and Acute ConditionsCovers "disease process." Large chapter, few questions — learn what each condition means for care, not its pathology.
  • 19Confusion, Dementia, and Alzheimer DiseaseNot named in the outline, but reachable through mental health needs and disease process. Her class will test this heavily, and it's most of the actual job. Don't skip — just don't over-invest for the state exam.
  • 01Understanding Healthcare Settings"Structure of the healthcare system." Know what OBRA and a survey are; the rest is context.
  • 24Caring for Your Career and Yourself"Personal and career care." Short, easy points — stress, time management, professionalism.
  • 20Mental Health and Mental Health DisordersFeeds "emotional and mental health needs." Focus on defense mechanisms and depression.
  • 07Emergency Care and Disaster PreparationInside the 7% Safety block. Know what to do first for a fall, choking, and bleeding.
Tier 4Lowest priority Cut these first when the night gets short.
  • 09The Healthy Human BodyAnatomy background. Useful for understanding, rarely asked directly. Learn body-system names and skip the detail.
  • 22Special Care SkillsOxygen, IVs, ostomies and similar. Not named anywhere in the outline — this is the safest chapter to leave for last.

How firm is this ranking?

Tiers 1 and 2 are pinned to outline items named word-for-word by Excel Testing. Tiers 3 and 4 are my judgment about where broader phrases like "disease process" and "emotional and mental health needs" land. Treat Tier 4 as deprioritized, never as skipped — and if her instructor says a chapter matters, the instructor wins.

04

How to take a chapter in 25 minutes

Hartman chapters are built to be mined, not read. Every one is organized under numbered learning objectives, with bolded key terms, gray Guidelines boxes, and numbered Procedure boxes. The prose between those elements is mostly explanation of them.

  1. Read the chapter-opening objectives first. They are the chapter's own summary of what matters — and they're what the instructor's lesson plans are built around.
  2. Go straight to the Guidelines boxes and Procedure boxes. This is where exam questions and every skills-test step come from. If she reads nothing else in a chapter, she reads these.
  3. Collect the bolded key terms. Definitions are cheap points on both her class quizzes and the state exam. Say each one out loud in a sentence.
  4. Do the chapter review questions. Answering questions builds recall; re-reading builds only recognition. This is the single biggest upgrade available to her, and it's the step people skip when they're behind.
  5. Only then, read the narrative — and only for whatever from the four steps above didn't make sense.

The rule that saves the most time

Reading a chapter twice is worth less than reading it once and being quizzed on it. If she has 50 minutes for a chapter, spend 25 mining it and 25 being tested — by the book's review questions, by the practice set below, or by someone reading terms aloud to her. Ask her to explain a Guidelines box to you without looking. Where she stalls is exactly what to restudy.

Ask the instructor for two things

The Hartman package includes an instructor's guide with chapter exams, a final exam, and chapter reviews, plus skills videos that the publisher provides to adopting programs and their students at no extra charge. Both are already paid for. A student who asks for the practice exams and the video login usually gets them — and watching a skill performed correctly is worth more than reading it three times.

05

Twelve evenings

This assumes the class moves roughly in chapter order, which Hartman-based programs usually do. Match it to her actual syllabus — the sequence matters less than the rule underneath it: every evening ends with a skill drilled out loud, not just a chapter read.

EVE 01Chapters 1–3 · Rights and abuse Skip most of Ch 1. Spend the night on Ch 3 — resident rights, the types of abuse, and who a mandated reporter is. This is the densest chapter in the 23% Role block.
EVE 02Chapters 4–5 · Infection control Ch 5 is the highest-value chapter in the book. Standard Precautions, the chain of infection, PPE order on and off. Drill: handwashing. Time it — ten seconds of vigorous scrubbing is longer than it feels.
EVE 03Chapters 6–7 · Safety and emergencies Restraints, falls, body mechanics, what to do first in an emergency. Drill: gloves on and off until it's automatic — gloves appear as an instant-fail step in four separate skills.
EVE 04Chapters 8–9 · Human needs, body systems Lighter night. Read Ch 8 properly; skim Ch 9 for body-system names only. Use the spare hour to re-drill infection control.
EVE 05Chapters 10–12 · Transfers and the unit Drill: bed-to-wheelchair transfer and the occupied bed. Three instant-fail steps live in these two skills, and all three are about brakes and side rails.
EVE 06Chapter 13 · Personal care The biggest Tier 1 chapter, and the source of six testable skills. Drill: mouth and denture care, nail care, dressing a weak side. Weak arm into the sleeve first — every time.
EVE 07Chapter 14 · Vital signs Memorize the normal ranges and the exam's accuracy tolerances tonight. Drill: radial pulse, respirations, blood pressure, weight. Practice on you — she needs a real person and a real watch.
EVE 08Chapter 15 · Nutrition and hydration Learn the diets and the ounce-to-cc conversion cold. Drill: feeding a dependent resident — upright at 45 degrees is the instant-fail step.
EVE 09Chapters 16–17 · Elimination Catheters and bowel care. Drill: emptying a drainage bag, the bedpan, perineal care. The drainage bag skill alone carries three instant-fail steps — more than any other skill on the test.
EVE 10Chapter 21 · Range of motion pulled forward Ch 21 sits late in the book but it's Tier 1, so do it here rather than in the last-night scramble. Learn the six movement words by doing them on your own arm and leg. Drill: both ROM skills.
EVE 11Chapters 18–20, 22–24 · Sweep One pass, objectives and key terms only. Dementia care (Ch 19) gets the most of this night because her class will test it hardest. Ch 22 gets the least.
EVE 12Review only — no new reading The instant-fail list, the memorize sheet, and the practice questions. Then walk through all four skills of a mock test out loud, start to finish, including knocking on the door and leaving the call bell.

If she's already behind

Don't try to catch up chapter by chapter — the backlog only grows. Jump to tonight's chapter with the class, and use the tier list to backfill: reclaim missed Tier 1 chapters first, let Tier 4 go entirely. A student who knows chapters 3, 5, 10, 13, 14, 15, 16 and 21 well and has never opened chapter 22 is in far better shape than one who has skimmed all 24 evenly.

06

The skills exam

Four skills, drawn at random, 30 minutes total, performed one-on-one with an evaluator while another candidate plays the resident. She must actually perform each skill, not talk through it. If she makes a mistake, she can tell the evaluator and redo the step — so a fumble is recoverable, but only if she says something.

How the scoring works

Every skill has a checklist. Steps printed in bold are critical: miss one and it's an immediate failure, no matter how well the rest went. Everything else counts as a skills error, and four errors fails the exam.

The instant-fail steps below are marked as bold in the official Excel Testing guide. Because they're what she cannot afford to miss, they're pulled to the top of every skill card.

The nine things graded on every single skill

These "indirect observations" are scored on all four skills, so a single sloppy habit can cost points four times over. Four of the nine are instant-fail.

Indirect observations — apply to all four skills
Instant fail
  • Leave the call bell within reach before leaving
  • Follow infection control practices throughout
  • Complete every assigned task
  • Maintain safety at all times
  • Knock on the door before entering
  • Provide privacy — close the door, pull the curtain
  • Check the resident's ID
  • Introduce yourself
  • Explain the procedure to the resident before doing it

Build it into a reflex. Knock, introduce, check ID, explain, privacy — then the skill — then call bell in reach. Same opening and closing every time, for every skill, in every practice run. This is free marks she can bank before she touches a single piece of equipment.

Every skill on the list

Excel Testing notes this list "is not all-inclusive," so treat it as the core, not the ceiling. Tick each one as she drills it out loud.

Progress 0 / 22 drilled
Handwashing
Instant fail
  • Rub hands vigorously for at least 10 seconds
  • Finish the task without recontaminating your hands
  • Wet hands and apply soap
  • Rinse well with fingers pointed down
  • Dry hands completely

Recontamination is the trap. Turning off the tap with a bare hand, or touching the sink or her uniform after drying, undoes the whole skill. Use a clean paper towel on the faucet, and keep fingertips lower than wrists so dirty water runs off, not back up her arms.

Denture care and mouth care
Instant fail
  • Gloves on before care, gloves off after
  • Carry dentures in a lined basin
  • Line the sink with a washcloth or paper towels
  • Brush every surface of the dentures
  • Store clean dentures in a denture cup with water
  • Give mouth care with a toothette, cleaning all areas of the mouth
  • Offer the resident a chance to rinse

Line the sink first. Both the basin lining and the sink lining exist for one reason — dentures are expensive and they shatter on porcelain. Evaluators watch for it.

Dressing a resident with a weak side
Instant fail
  • Dress the weak side first
  • Support the affected arm while dressing
  • Handle the body gently

Weak goes in first, strong comes out first. Clothing on: affected limb leads. Clothing off: strong limb leads. The reason is range of motion — the strong limb can stretch and twist to meet the garment; the weak one can't, so it gets the easy end of the job both times.

Emptying a catheter drainage bag
Instant fail — three of them, the most of any skill
  • Gloves on before care, gloves off after
  • Keep the drainage bag below the level of the bladder
  • Measure and record output within 25 cc of the evaluator
  • Set the graduate on a clean paper towel, below the bag
  • Drain the bag without letting the drain spout touch the graduate
  • Clean the drain with an alcohol prep pad after draining

Below the bladder, always. Raise the bag above bladder level even briefly and urine flows back toward the resident, which is how catheter infections start. Read the graduate at eye level on a flat surface — not in her hand — or the 25 cc tolerance will get her.

Range of motion — hip, knee, ankle
Instant fail
  • Perform ROM on the correct side
  • Hip: abduction and adduction
  • Knee: flexion and extension
  • Ankle: dorsiflexion and plantar flexion
  • Support the joint above and below while moving it

Check the card twice. The instant-fail step here isn't the movement, it's the side — and the side is written on her skills card. Read it, say it out loud, then start. Never push a joint past the point of resistance or pain.

Range of motion — shoulder, elbow, wrist, fingers
Instant fail
  • Handle the body gently
  • Perform ROM on the correct side
  • Flexion and extension of the shoulder, elbow, wrist and fingers
  • Support the joint while moving it

Gentleness is scored here, not just assumed. Slow and supported beats fast and complete. Cradle the limb — one hand above the joint, one below — and move within the resident's comfort.

Assisting with a bedpan
Instant fail
  • Gloves on before care, gloves off after
  • Position the resident comfortably on the bedpan
  • Raise the head of the bed
  • Offer toilet tissue, or state that you would clean the resident
  • Dispose of contents properly, or state how you would

"Or state" is a gift — use it out loud. Two steps let her narrate instead of perform. She only gets credit if the evaluator hears her say it, so she should say it clearly and deliberately, not mumble it.

Positioning a resident on their side
Instant fail
  • Actually get the resident onto their side
  • Handle the body gently
  • Pillow behind the back for support, and one between the knees
  • Body in proper alignment
  • Resident left comfortable

Both pillows. Behind the back and between the knees — the second one is the commonly forgotten step, and it's what keeps the top leg from pressing on the bottom one.

Radial pulse for one minute
Instant fail
  • Record a result within 4 beats of the evaluator's count
  • Locate the radial pulse
  • Count for one full minute

Never count with your thumb. Your thumb has its own pulse and she'll end up counting her own. Two or three fingertips on the thumb side of the wrist, and count the whole minute — no counting for 30 seconds and doubling.

Counting respirations for one minute
Instant fail
  • Record a result within 2 breaths of the evaluator's count
  • Count for one full minute

Don't announce it. People change their breathing the moment they know it's being watched. The standard trick: keep her fingers on the wrist as though still taking the pulse, and count the rise and fall of the chest. One rise plus one fall equals one respiration — counting each half is the classic way to land double the real number and blow a 2-breath tolerance.

Blood pressure (electronic cuff)
Instant fail
  • Record both the systolic and diastolic readings exactly as the display shows them
  • Correct cuff size, snug on the upper arm, arrow over the brachial artery
  • Press start and inflate up to 200 mm Hg — never above 200
  • Wait for the reading and for the cuff to deflate, then remove it

This is the machine, not the stethoscope. Vermont tests blood pressure on an electronic device, so there's no listening involved — the graded skill is cuff placement, staying under 200, and transcribing the number correctly. Write down what the screen says, not what she expects it to say.

Measuring and recording weight
Instant fail
  • Document within 2 pounds of the evaluator
  • Balance the scale at zero before the resident steps on
  • Assist the resident onto the scale
  • Obtain the weight

Zero it first, and be seen doing it. Balancing after the fact doesn't count. Steady the resident on and off — a scale is a small platform and this is a fall risk the evaluator is watching.

Calculating fluid intake in cc
Instant fail
  • Document within 60 cc of the evaluator
  • Measure accurately and convert ounces to cc

One ounce is 30 cc. That single number carries the whole skill and shows up on the written test too. Multiply total ounces by 30 — 8 oz is 240 cc, 4 oz is 120 cc. A 60 cc tolerance is exactly two ounces of slack, so the arithmetic has to be right.

Transferring from bed to wheelchair
Instant fail
  • Lock the wheelchair brakes
  • Position the wheelchair at the head or foot of the bed
  • Assist the resident to a sitting position
  • Place a gait belt around the waist
  • Put shoes or footwear on the resident
  • Assist them to stand, pivot, and sit in the chair

Brakes before anything else moves. This is the most famous instant-fail step on any nurse aide exam and it's still the one people lose on. Lock them the moment the chair is in place. Shoes go on before standing — bare or stockinged feet on a hard floor is a fall.

Changing a soaker pad with the resident in bed
Instant fail
  • Raise the side rail on the side opposite where you're working
  • Gloves on before, gloves off after
  • Gather the soaker pad
  • Raise the bed to working height
  • Help the resident roll toward the raised side rail
  • Roll the soiled pad inward, toward the centre of the bed
  • Place the clean pad under the resident by rolling it
  • Raise the side rail nearest you
  • Help the resident roll the other way and remove the dirty linen
  • Pull the clean pad through and smooth it

The rail goes up before the resident rolls. She's about to turn someone toward the far edge of a raised bed. Rail first, every time — and soiled linen always gets rolled dirty-side inward so nothing touches her uniform.

Making an occupied bed
Instant fail — both are side rails
  • Raise the side rail opposite your working side
  • Raise the second side rail before turning the resident back
  • Gather linen; rest clean linen on the back of a chair or the foot of the bed
  • Provide privacy
  • Raise the bed to working height
  • Keep the resident covered throughout
  • Help them roll toward the raised rail
  • Roll soiled linen inward to the centre of the bed
  • Place the clean bottom sheet along the centre
  • Roll the resident to the other side; remove the soiled linen
  • Pull the clean linen through and smooth it
  • Put linen in the hamper

Same rhythm as the soaker pad. Learn them together — rail up, roll away, dirty in, clean down, second rail up, roll back, strip, smooth. Keeping the resident covered is dignity, and it's scored.

Putting an elastic stocking on a leg
Instant fail
  • Leave the stocking with no twists and no wrinkles
  • Hold the heel of the stocking and gather the rest of it
  • Support the foot at the heel
  • Slip the front over the toes, foot and heel
  • Pull it snugly and evenly up the leg

Smooth it, then check it again. A wrinkle in a compression stocking is a pressure point on skin that's already fragile, which is why it's the critical step. Gather the stocking down to the heel first — trying to drag it up inch by inch is how twists happen.

Nail care
Instant fail
  • Gloves on before, gloves off after
  • Soak the nails
  • Clean under each nail
  • File and smooth each nail

Each nail, individually. The checklist says "each" twice. Work finger by finger visibly rather than doing a fast general pass. Nursing assistants file — they don't cut — and never for a resident with diabetes unless a nurse says so.

Modified bed bath — face, one arm, one hand

No instant-fail steps — but four ordinary errors still fails the exam

  • Cover the resident with a blanket or sheet
  • Fill the basin with warm water
  • Wash and dry the face without soap
  • Expose the arm and lay a towel underneath it
  • Wash the arm and hand with soap and water
  • Rinse and dry the area
  • Put soiled linen in the appropriate place

No soap on the face. That's the step people miss, and it's the one that separates candidates who learned the procedure from candidates who improvised a wash. Rinse and dry are separate scored steps — don't skip straight from washing to the towel.

Donning and doffing an isolation gown and gloves
Instant fail
  • Roll the gown with the soiled side inward, never letting it touch your uniform
  • Put arms through each sleeve
  • Gown snug at the neck and tied at the waist, covering the uniform
  • Gloves on, overlapping the gown's cuffs at the wrist
  • Remove gloves before removing the gown
  • Pull each sleeve off by grasping the shoulder from the inside, turning the gown inside out
  • Dispose of gown and gloves in the correct container

Dirty side in, always. Gown goes on first and comes off last; gloves go on last and come off first. Everything about doffing is turning contamination inward — inside out, rolled up, never brushing her clothes.

Feeding a dependent resident
Instant fail
  • Position the resident upright at least 45 degrees
  • Check the diet card and say out loud that this is the right tray for this resident
  • Place a towel or clothing protector on the chest
  • Wash and dry the resident's hands
  • Sit down and face the resident while feeding
  • Small, bite-sized amounts, with time to chew and swallow
  • Offer fluids frequently
  • Leave the resident clean and dispose of dirty linen

Upright, and sit down. Feeding someone reclined risks aspiration, which is why the angle is the critical step. Sitting rather than standing over them is scored too — it's a dignity step, and it slows her to the resident's pace. Say the diet-card check aloud or it won't be credited.

Seven more the guide says to know

Listed without checklists as skills she should still be ready for: height, backrub, perineal care, commode, bathing, temperature, and semi-Fowler's position. Since the published list isn't all-inclusive, the safe assumption is that any procedure box in the textbook is fair game. Perineal care is the one to rehearse hardest — front to back, clean to dirty, gloves throughout.

07

The memorize sheet

Everything on this page that is pure recall, in one place. If she reviews nothing else on the last night, she reviews this and the instant-fail steps.

Vital signs — adult normal ranges

MeasurementNormal rangeTell the nurse when
Temperature, oral97.6–99.6 °FOutside the range, or a change from the resident's usual
Temperature, rectal98.6–100.6 °FRuns about a degree higher than oral
Temperature, axillary96.6–98.6 °FRuns about a degree lower than oral
Pulse60–100 bpmUnder 60 or over 100; also if weak or irregular
Respirations12–20 / minUnder 12 or over 20; also if laboured or noisy
Blood pressure90/60 – 119/79At or above 140/90, or below 90/60

The nursing assistant measures and reports. She never diagnoses, never interprets, and never decides a reading is fine because the resident feels well.

Accuracy tolerances on the skills exam

Every one of these is an instant-fail step. Her number has to land inside the evaluator's number by this much.

Radial pulse
± 4 beats
Respirations
± 2 breaths
Urine output
± 25 cc
Fluid intake
± 60 cc
Weight
± 2 pounds

Conversions

1 ounce
= 30 cc (mL)
1 cup / glass
= 8 oz = 240 cc
1 pint
= 16 oz = 480 cc
1 quart
= 32 oz = 960 cc
1 kilogram
= 2.2 pounds
1 inch
= 2.54 cm

Positions

Supine
flat on the back
Prone
on the stomach
Lateral
on the side
Sims'
left side, upper knee bent
Semi-Fowler's
head up 30–45°
Fowler's
head up 45–60°
High Fowler's
head up 60–90°
Reposition every
2 hours minimum

Range-of-motion words

Abduction
away from the body
Adduction
toward the body (adds to it)
Flexion
bending a joint
Extension
straightening a joint
Dorsiflexion
toes pulled up
Plantar flexion
toes pointed down

Abbreviations the outline names directly

Abbr.MeaningAbbr.Meaning
BIDtwice a dayNPOnothing by mouth
TIDthree times a dayI&Ointake and output
QIDfour times a dayADLactivities of daily living
prnas neededROMrange of motion
acbefore mealsHOBhead of bed
pcafter mealsBMbowel movement
qeveryBRPbathroom privileges
q2hevery 2 hoursVSvital signs
SOBshortness of breathWNLwithin normal limits
CVAstrokeDNRdo not resuscitate
HTNhigh blood pressureUTIurinary tract infection
DMdiabetes mellitusPPEpersonal protective equipment

Resident rights and abuse — the 23% block

Rights guaranteed under OBRA

To be informed and to help plan their own care · to refuse treatment · privacy and confidentiality · dignity and respect · to be free from abuse, neglect and restraint · to voice grievances without retaliation · to manage their own money · to have visitors · security of their possessions · to be told about services and charges.

Forms of abuse she must be able to name

Physical · psychological or verbal · sexual · financial · neglect · involuntary seclusion. Tying a resident into a chair without an order is physical abuse and false imprisonment, not a safety measure.

A nursing assistant is a mandated reporter. Suspected abuse goes to the nurse immediately — she does not investigate it, confirm it, or wait to be sure.

Infection control — the most tested idea in the book

Rules that answer a lot of questions

08

Study tools

This page is the thing you read and look things up in. The doing — questions, flashcards, trainer reps, skill scripts — lives in six small apps built for this class.

The question bank

Every practice question written for this course, sorted into sets of ten. You answer one question per screen, tap an option, and it tells you immediately whether you were right and why — then a score card after each ten.

It also has a timed 60-question exam built to the real blueprint, a blood pressure pack, a My misses set that follows you until you have each one right twice, and per-domain accuracy bars so you can see which area is weakest.

Open the question sets →

The whole toolkit

09

Test day

Everything here comes from the official candidate guide. Most of it is the kind of thing that only matters once — on the morning it goes wrong.

Two of these will end the day before it starts

Two forms of ID. One must be an unexpired photo ID — driver's licence, passport, or government-issued card. The second can be a social security card, credit card, or vehicle registration. No proper ID means no test.

The name on the IDs must match the name on the application. If she has recently married or divorced, she needs to bring the marriage certificate or divorce decree.

Pack the night before

How the day runs

The one worth saying out loud to her

The resident is played by another candidate — someone just as nervous, sitting in the same room. Treating that person exactly as she would treat a real resident is not a formality; courtesy, privacy and communication are all separately scored. The candidate who talks the person through what she is doing is quietly banking marks the silent one never sees.

Confirm two things with the program before test day

This page is built from the 2023 edition of the Excel Testing guide, which is the version currently posted. Exam vendors change tolerances and skill lists between revisions, so before test day it's worth confirming with the coordinator at Central Vermont Home Health & Hospice that the current skills list still matches, and that the criminal background check is filed — passing both exams with a pending check yields a provisional licence rather than a full one.

Excel Testing can be reached at 844-516-0600.

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