Table of Contents — Workplace English for Nursing Assistants

This introductory course gives adult English learners practical language and career preparation for healthcare settings. Learners build healthcare vocabulary and communication skills through realistic conversations, role-plays, case studies, and guided practice with topics such as infection control, safety, mobility, vital signs, personal care, nutrition, and dementia care. The course includes substantial workplace and foundational clinical content, but it does not replace a credit CNA training or certification program. Lessons were developed in consultation with healthcare professionals and reviewed for accuracy, workplace relevance, and accessibility.

🗣 Speaking PracticeThis course includes more than 130 speaking activities, (Chattybots). Scan the QR code to open the activities in the Neo English app, or phone.

Licensed under CC BY-NC 4.0 — free to use, share, and adapt.

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Unit	Learning objectives	Case Study Discussions	Speaking Flashcards	Dialogues	Roleplays	Check Your Knowledge	Paired Skill
1 Talking About the Body: Structures and Systems Web PDF	Name the levels of body organization, tissue types, muscle types, and major body systems. Explain a body-structure term in plain English. Ask what an unfamiliar word means and how it is spelled. Repeat back key information from a fast spoken update. Describe age-related changes using thinner, weaker, slower, fewer.	Grace Video: Grace — A Fall at Night Grace is 87 years old and lives alone. She eats only one small meal a day because she is not hungry. She takes medicine for her heart and her cholesterol. At night she wakes up often to use the bathroom, which is at the top of a flight of stairs. Last night the hallway was dark. On her way to the bathroom, Grace fell. She could not get up because of strong pain in her right hip. She waited on the floor until her son arrived in the morning. 5 case questions	The Building BlocksCell · Tissue · Organ · Organ system · Organism The Four Tissue TypesEpithelial · Connective · Muscle · Nervous The Three Muscle TypesSmooth · Cardiac · Skeletal · Smooth muscle · Cardiac muscle · Skeletal muscle The Integumentary SystemEpidermis · Dermis · Subcutaneous The Body SystemsMusculoskeletal · Respiratory · Cardiovascular · Nervous · Endocrine · Digestive · Urinary · Reproductive	Dialogue 1 — “What does peristalsis mean?” Dialogue 2 — A fast report: two words you don’t know	Role Play 1 — Unfamiliar words in an update Role Play 2 — A fast update	Quick Knowledge Check Why do older adults fall more easily? Name one body part that gets thinner with age, and one that gets weaker. Why can a normal dose of medicine become dangerous for an older client? Put in order, smallest to largest: organ, cell, organism, tissue, organ system. A group of the same cells is a ______. Two or more tissue types make an ______. Which tissue lines the stomach and lungs? Which tissue is blood? A client asks, “What is nervous tissue?” Answer in simple terms. Which muscle forms the heart? Which muscle do you control on purpose? Name the three layers of skin, outer to deep. Give two skin jobs.	Skill 1 Counting Respirations Applied Moved here from Unit 2. The unit names the respiratory system and teaches that aging makes the body slower; this turns one system’s work into a reportable number. CNA ESSENTIAL SKILLS — Count and Record Respirations (2:09)Measure and Record Respirations CNA Skill Prometric How to Measure and Record Respirations \| CNA Skills for Prometric Exam CNA Skill 7: Counts and Records Respirations
2 Describing Symptoms and Conditions Web PDF	Tell the difference between a sign and a symptom. Decode medical words using common prefixes and suffixes. Describe symptoms of the skin, bones, heart, brain, and mood. Turn a long, vague complaint into a short factual report. Report what you saw and heard without naming a diagnosis.	Mr. Osei Video: Mr. Osei — A Sudden Change You visit Mr. Osei once a week to help him bathe. Today he is still in bed, which is unusual. He smiles at you, but the smile looks crooked — one side of his face is drooping. When you help him sit up, his left arm is very weak. When you ask how he feels, his words are slurred and he seems confused. A few minutes ago he was fine. 5 case questions	First: Sign vs. SymptomSwollen ankles · "My chest hurts." · Heavy sweating · "I feel dizzy." The Decoder: prefixes and suffixesdys- · a- / an- · -pnea · -phagia · -uria · hemi- · -plegia Everyday Symptom WordsDyspnea · Orthopnea · Dysphagia · Diaphoresis · Nocturia · Edema · Aspiration Skin, Bone & MusclePressure injury · Stasis ulcer · Fomite · Atrophy · Contracture · Kyphosis Heart & BrainArrhythmia (dysrhythmia) · Angina · CVA (stroke) · Hemiplegia · Aphasia Mind & ConfusionHallucination · Delusion · Delirium · Dementia · Mental illness HIV & CancerHIV · AIDS · Cancer · Metastasis · Benign tumor · Malignant tumor Recognize and Report NOW — 3 Emergencies	Dialogue 1 — "I just don't feel right today." Dialogue 2 — A long story, a short report	Role Play 1 — "I don't feel good" Role Play 2 — The long story	Check Your Knowledge A client says "I feel sick to my stomach." Sign or symptom? You see a new red rash. Sign or symptom? A client says only "It hurts." Write two questions you would ask. _______________________________________________________________________________ _______________________________________________________________________________ What does "dysphagia" mean? Which two parts build it? "Hemi-" + "-plegia" = ? Which side of the body? Which sore comes from pressure? Which comes from poor blood flow? Name two fomites in a client's room. Mrs. L was clear yesterday and confused today. Delirium or dementia? A client believes she is in a hotel. Hallucination or delusion? Which two FAST letters match a drooping face and a weak arm? Rewrite "It's clear she's having a heart attack" as an action conclusion.	Skill 2 Hand Hygiene (Handwashing) Applied Done before and after every other skill, and before and after every look at a client — which is what this unit is for. Unit 3 pairs with putting on and taking off gloves and teaches how to teach this procedure; here the student performs it. CNA Essential Skills — Hand Hygiene: Washing Hands Properly (4:03)Proper Handwashing Technique \| CNA Skills for Prometric Exam (2025)Handwashing CNA Skill Prometric Credentia CNA Skill 1: Hand Hygiene (Handwashing)
3 The Language of Hygiene and Infection Control Web PDF	Name the four kinds of germs and the links in the chain of infection. Use vocabulary for hand hygiene and protective equipment. Read common medical abbreviations on signs and notes. Give step-by-step instructions using first, next, then, finally. Confirm a fast PPE or precaution order by repeating it back.	Mr. Reyes Video: Mr. Reyes — A New Infection Mr. Reyes has been in the hospital getting IV antibiotics for pneumonia. He was improving, but today he has a fever and loose, watery stools. The nurse places him on contact precautions with strict handwashing. By evening, tests confirm he has a C. diff infection. This afternoon, he needs to go to another floor for a chest X-ray. 5 case questions	Four Kinds of GermsBacteria · Virus · Fungus · Protozoa The Chain of InfectionInfectious agent · Reservoir · Portal of exit · Mode of transmission · Portal of entry · Susceptible host Preventing InfectionInfection control · Primary prevention · Immunity · Antibody · Hand hygiene Personal Protective EquipmentGloves · Gown · Mask · Goggles / face shield The Three PrecautionsAirborne · Droplet · Contact Skill: Reading Medical AbbreviationsPPE · N95 · MRSA · VRE · C. diff · MDRO · CDC	Dialogue 1 — Teaching handwashing to a new worker Dialogue 2 — A fast PPE order	Role Play 1 — Teach the glove procedure Role Play 2 — The rushed order	Check Your Knowledge Which germ causes athlete's foot? Which germ spreads most easily person to person? How many links must be broken to stop an infection? Handwashing breaks which link? Covering a wound breaks which link? Put in order: rinse • add soap • wet hands • dry • scrub 20 seconds. Name the three times you MUST use soap and water. A new worker says "Yes, I understand." What is a better way to check? You finish washing a client and remove your gloves. What do you do next? Why are gloves not allowed in the dining room? A client has TB. Which precaution and which mask? A client has MRSA in a wound. Which precaution and which PPE? You cared for a client with C. diff. Sanitizer or soap and water?	Skill 3 Donning PPE Direct This unit’s own vocabulary — gown, mask, gloves, goggles — as a procedure. CNA Essential Skills — Donning and Removing PPE (Gown & Gloves) (4:30)channel search — no direct linkPPE Training Video: Donning and Doffing PPE Nursing Skill CNA Skill 8: Donning and removing PPE (gown and gloves)Credentia CNA Skill 8: Donning and Removing PPE (Gown and Gloves)
4 Safety English: Warnings, Hazards, and Emergencies Web PDF	Choose between urgent warning language and calm hazard reporting. Use vocabulary for safe client moving, hazards, exposure, chemicals, and fire safety. Say what the acronyms RACE and PASS stand for. Ask what an unfamiliar emergency code means and repeat instructions back. Report an incident: what happened, when, and who you told.	Daniela Video: Daniela — A Transfer Done Alone Daniela is a healthcare worker on the evening shift at a nursing home. Tonight it is hard to find a coworker to help. A client's care plan says "two-person assist," but Daniela tries to move the client from the wheelchair to the toilet alone. During the move, the client becomes unsteady and falls. Daniela tries to stop the fall and hurts her back. The client now complains of hip pain. 5 case questions	Moving Clients Without InjuryErgonomics · Body mechanics · Gait belt · Pivot disc · Mechanical lift Protecting Yourself: Exposure & ChemicalsBlood-borne pathogens · Sharps box · SDS (Safety Data Sheet) · Hepatitis B vaccine · Incident report Fire Safety: RACE & PASS Other Emergencies & Staying SafeEmergency codes · Run, Hide, Fight · EAP (Employee Assistance Plan) · Workplace violence	Dialogue 1 — Two kinds of warning in one hallway Dialogue 2 — A code you don't know	Role Play 1 — The cluttered hallway Role Play 2 — A new chemical	Check Your Knowledge Which muscles do you lift with? Which do you never lift with? The care plan says "two-person assist" and no one is free. What do you do? A client starts to slide during a transfer. What exactly do you say? A visitor is about to step in a puddle. Which kind of warning? You notice a frayed cord behind a bed. Which kind of warning? Rewrite "I'm so sorry, would you mind moving?" for a falling IV pole. Put the four exposure steps in order. Where do used needles go? What does an SDS tell you? You see smoke in the kitchen. What is your FIRST action? Where do you aim the extinguisher? What does the C in RACE mean? What are the three choices in an active-shooter event? Why do facilities use color codes instead of plain words?	Skill 4 Moving Client Bed→Wheelchair, One Assist Direct “Moving Clients Without Injury” word set, in procedure form. CNA ESSENTIAL SKILLS — Transfer from Bed to Wheelchair Using Transfer Belt (4:32)Transfer from Bed to Wheelchair CNA Skill Prometric How to Transfer a Resident from Bed to Wheelchair \| CNA Skills for Prometric Exam CNA Skills: Transfer From Bed to Wheelchair using a Gait Belt
5 Talking About Falls Web PDF	Use vocabulary for fall risk, hazards, and mobility equipment. Explain what to do before, during, and after a fall. Say no politely with a refusal, a reason, and an alternative. Ask a busy coworker for help. Give a factual account of a fall: what happened, what you did, who you told.	Rosa Video: Rosa — A Night on the Floor Rosa is 84 and lives at home. She is the main caregiver for her husband, who has dementia. One night, on her way to the bathroom, Rosa tripped on a throw rug and fell. She could not get up, and her husband could not help her. Rosa stayed on the floor until her son visited the next day. She broke her hip and her wrist. After three nights in the hospital, she was moved to a nursing home for rehabilitation. 4 case questions	Key WordsAmbulatory · Gait · Orthostatic hypotension · Immobility	Dialogue 1 — A client who says no Dialogue 2 — Reporting the fall	Role Play 1 — Nobody is free Role Play 2 — “I don’t need help”	Check Your Knowledge Why can a fall lead to death, even when the fall itself is not serious? Why does fear of falling make the next fall more likely? A two-person client seems weak today. May you use a lift? May you go alone? Ask a busy coworker for two minutes of help. Name three fall-prevention strategies you can do yourself. A client on bed rest wants to walk to the toilet. What do you do? Why must you never hold a falling client upright? Where should the wheelchair be when you walk a client? What do you protect as the client goes down? Why do you keep the client on the floor?	Skill 5 Ambulating With Gait Belt Applied Safe ambulation is the direct antidote to the falls this unit covers. CNA ESSENTIAL SKILLS — Assist to Ambulate Using a Transfer Belt Ambulate with a Gait Belt CNA Skill Prometric How to Ambulate a Resident Using a Gait Belt \| CNA Skills for Prometric Exam CNA Skill 3: Assists to Ambulate Using Transfer Belt
6 Difficult Conversations: Refusing and Disagreeing Web PDF	Use key vocabulary for restraints, alternatives, and dignity. Refuse in four parts: refuse, reason, alternative, refer. Explain what counts as a restraint and why restraints are a last resort. Disagree with someone respectfully. Suggest an alternative with “How about…?” and “What if we…?”	Mr. Novak Video: Mr. Novak — Aggression During Care Mr. Novak has dementia. When you help him to the bathroom or try to bathe him, he becomes very aggressive — he spits, pinches, and shouts. Tonight, while you were getting him ready for bed, he hit you in the face. 4 case questions	Key WordsRestraint · Physical restraint · Chemical restraint · Environmental restraint	Dialogue 1 — "Just tie her in the chair" Dialogue 2 — Disagreeing with a coworker	Role Play 1 — "Put the belt on her" Role Play 2 — The experienced coworker	Check Your Knowledge Say the one test question from memory. A client's wheelchair is parked facing a wall so she cannot turn it. Restraint? Name the three types of restraint. What do you secure a restraint to? What must you never secure it to? The nurse has a doctor's order and asks you to apply wrist restraints. What do you do? When is a side rail NOT a restraint? What two things are needed before a side rail is used for positioning? Why are side rails especially dangerous? Name the four parts of a good refusal. Which refusal phrases must you never use with a family member? A daughter asks you to raise both side rails. Say your whole answer out loud. Why is indirect disagreement stronger at work than direct disagreement? A coworker says "A tray isn't a restraint." Write a polite disagreement. Which disagreeing phrases are only for friends, never for work?	— No paired skill Structural pairing removed — the skill had no content link and carried no spoken language.
7 Emergency English: Speaking Under Pressure Web PDF	Use vocabulary for choking, fainting, seizures, bleeding, and burns. Switch between polite English and short emergency English. Give the essential facts in an emergency phone call. Follow short spoken emergency commands. Describe an emergency afterward, in order.	Damaris Video: Damaris — Coughing at Dinner You work in an assisted-living facility. During dinner, your client Damaris begins coughing hard. She stands and walks quickly toward her room. As you follow, her cough grows weaker. She shakes her head "no" to your help. Then you notice she has turned red and you hear a high-pitched wheeze. 5 case questions	Choking: Airway ObstructionFBAO · Partial (mild) · Complete (severe) Heart & FaintingCardiac arrest · Syncope · Dangling SeizuresSeizure · Aura · Status epilepticus Bleeding & ShockHemorrhage · Cardiogenic shock · Anaphylactic shock · Hypovolemic shock BurnsSuperficial · Partial-thickness · Full-thickness	Dialogue 1 — Choking in the dining room Dialogue 2 — On the phone with the dispatcher	Role Play 1 — Choking at breakfast Role Play 2 — The noisy phone call	Check Your Knowledge The dispatcher says something you cannot hear. What exactly do you say? Rewrite "Excuse me, I'm so sorry, could you possibly repeat that?" for an emergency. When is the long polite form the right choice? A client is coughing hard and can still speak. What do you do? The client walks away from you. What do you do? Name the two skin-colour changes of a complete obstruction. Once CPR is started, when may you stop? Name three warning signs that a client is about to faint. What does dangling prevent? Say the two NEVERS from memory. How long must a seizure last before you activate EMS? Why do you note the start and end time? The dressing soaks through with blood. What do you do? Which artery do you press for a bleeding arm? For a bleeding leg? For shock, do you raise the head or the feet?	Skill 7 Counting Heart Rate—Radial Pulse Applied First hands-on assessment step in a cardiac or fainting emergency. CNA Essential Skills — Count and Record Radial Pulse (2:35)Measure and Record Radial Pulse CNA Skill Prometric 2025 CNA Skills Measure and Record Pulse CNA Skill 6: Counts and Records Radial Pulse
8 Person-Centered Conversation Web PDF	Use vocabulary for physical, emotional, social, and spiritual well-being. Explain Maslow’s hierarchy in plain English. Make small talk and tell safe topics from taboo ones. Recognize elderspeak and speak to an adult as an adult. Describe how someone seems when they cannot speak.	Gene Video: Gene — Waiting Near Nursing Station You work in a long-term care facility. Gene has dementia and does not talk to staff or other clients. Gene sits near the nurses’ station, waiting for their partner to visit. You notice Gene looks upset. When you ask if something is wrong, Gene just shakes their head and looks away. 5 case questions	Core WordsHolistic care · Quality of life · Homeostasis · Esteem · Self-actualization · Nonpharmacological pain management Maslow’s Hierarchy of Needs1. Physiological · 2. Safety · 3. Love & belonging · 4. Esteem · 5. Self-actualization Quality of Life: Four AreasEmotional health · Physical comfort · Spiritual wellness · Social activity	Dialogue 1 — Two minutes and a photograph Dialogue 2 — Reporting what you noticed	Role Play 1 — Two minutes Role Play 2 — Correcting elderspeak	Check Your Knowledge Say the five levels in order, bottom to top. A client joins the after-lunch card game. Which level? Write one sentence that offers a client a real choice. Name three safe topics and three taboo topics. A client starts telling you who she voted for. What do you do? Write one opening question about a photo on a client’s wall. What is elderspeak? Give two examples. What do you call a new client on the first day? Rewrite: “Are we ready for our nap, sweetie?” Name the four areas of quality of life. Give three signs a nonverbal client may be in pain. A client stops joining activities. Who do you tell, and what do you say?	— No paired skill Structural pairing removed — the skill had no content link and carried no spoken language.
9 Describing Skin Changes and Speaking Up Web PDF	Use vocabulary for describing skin appearance and changes. Report a skin observation: location, size, color, and change. Correct a fact without criticizing the person. Decline a request politely and offer to involve someone else. Ask a coworker to take another look at something you have seen.	Carol Video: Carol — A Sore That Was Missed Carol is 91, has diabetes and dementia, and is incontinent of urine and feces. While bathing Carol today, you notice a red area on their bottom that does not go away when pressed. You ask if it hurts; Carol says no. After the bath, you use a gait belt and a second assistant to help Carol into the wheelchair. At breakfast, Carol says they only want to eat desserts. 6 case questions	How Skin Breaks DownShear · Friction · Maceration · Microclimate · Immobility Pressure-Injury WordsBony prominence · Eschar · Debridement The Four Stages (by depth)Stage 1 · Stage 2 · Stage 3 · Stage 4	Dialogue 1 — "It's only a rash" Dialogue 2 — The daughter with the ointment	Role Play 1 — "That's just a bruise" Role Play 2 — Nothing changed	Check Your Knowledge Which force happens when a client slides down the bed? What is the number-one cause of pressure injuries? Say the 30-degree rule in your own words — both halves. Which stage is red, closed skin that does not blanch? Which stages are OPEN skin? You find an open area. Name the four things you do — and the one thing you must not do. How often do you reposition in bed? In a wheelchair? How do you check that the heels are really floated? Which food do you offer first to a client at risk?	Skill 9 Providing Foot Care Applied Feet are a classic site for the skin breakdown this unit teaches you to flag. CNA ESSENTIAL SKILLS — Foot Care (6:37)Provide Foot Care CNA Skill Prometric How to Provide Foot Care \| CNA Skills for Prometric Exam CNA Skill 16: Provides Foot Care on One Foot
10 Team Talk: Coordinating and Confirming Web PDF	Understand vocabulary for body positions, equipment, and transfers. Give one clear team instruction and count off a shared action. Check that a listener understood you. Choose checking phrases that suit coworkers or clients. Stop a move safely when the team or client is not ready.	Yvonne Video: Yvonne — A Transfer That Went Wrong Yvonne is a bariatric client with a stage-3 pressure injury on their sacrum. They are expected to be out of bed at meal times. Their care plan says to transfer them with a two-person assist, a gait belt, and a walker. 5 case questions	The Three ToolsGait belt · Trapeze · Friction/shearing prevention device The Six Patient PositionsSupine · Side-lying · Fowler's · Prone · Sims's · Tripod The Transfer LadderIndependent · Stand-by assist (SBA) · One assist · Two assist · Sit-to-stand · Mechanical lift	Dialogue 1 — "What are we doing on three?" Dialogue 2 — Halfway up	Role Play 1 — The client who says yes Role Play 2 — A stranger on the team	Check Your Knowledge Which position eases breathing? Which is used for an enema, and on which side? Which Fowler's position causes the most shearing? Where does the pillow go so the heels float — and where must it NOT go? How many staff for a log roll? For a bed-to-stretcher move? When may ONE healthcare worker move a client up in bed? Where must the head of the bed be before you boost someone up? Which comprehension-check phrases should you NOT use with a client? Why? Instead of "Did you hear me?", what is a better question before a transfer?	Skill 10 Side-Lying (Lateral) Position Direct One of the unit’s six named bed positions. CNA Essential Skills — Position Client on Side (4:01)Change Position to Supported Side Lying CNA Skill Prometric How to Change Position to Supported Side-Lying \| CNA Skills for Prometric Exam CNA Skill 14: Positions on Side Updated
11 The Language of Encouragement Web PDF	Use vocabulary for movement, exercise, and assistive devices. Soften advice with “you could,” “you might try,” and “why don’t we.” Agree first, then make a suggestion. Offer a choice instead of a command. Recognize a real no and respond to it.	Trudy Video: Trudy — Angry About the Gait Belt Trudy is recovering from a stroke and is working to regain strength and function on their right side. You need to help them walk to the dining room. When you put the gait belt around their waist, they get angry — they don't like it. While walking, Trudy becomes weak and nearly falls, so you sit them back in the wheelchair and wheel them to the dining room. 6 case questions	Movement & ExerciseADLs (Activities of Daily Living) · IADLs (Instrumental ADLs) · Active range of motion (AROM) · Passive range of motion (PROM)	Dialogue 1 — "Not today" Dialogue 2 — Hearing the real answer	Role Play 1 — "I'm too tired" Role Play 2 — The polite no	Check Your Knowledge Who moves the joint in AROM? In PROM? What is the opposite of flexion? Of abduction? A client says the exercise hurts. What do you do? Which hand holds the cane? Which side do you stand on? What must a client NOT pull up on to stand? A one-assist client seems very weak today. What are you allowed to do? Why do you agree with the client BEFORE suggesting anything? Rewrite "You should walk to the dining room" as a soft suggestion with a choice. A client says "I'll think about it." What does that mean, and what do you do?	Skill 11 Range-of-Motion Exercises Direct The unit’s own AROM/PROM vocabulary. CNA Essential Skills — Passive Range of Motion (PROM) for One Shoulder (3:12)CNA Essential Skills — Passive Range of Motion (PROM) for One Knee and One Ankle (3:12)How to Perform Range of Motion for Shoulder \| CNA Skills for Prometric Exam How to Perform Range of Motion for Hip, Knee, and Ankle \| CNA Skills for Prometric Exam CNA Skill 13: PROM for One Knee and One Ankle
12 Numbers at Work: Saying and Hearing Measurements Web PDF	Use vocabulary for the five vital signs. Build words with hyper-, hypo-, brady-, and tachy-. Say numbers clearly and confirm them digit by digit. Report a set of measurements in a consistent order. Ask for clarification when a number is unclear.	Herman Video: Herman — Emergency Vital Signs You work in an assisted-living facility. While walking with Herman, they pass out and fall. You call 911 and take vital signs to report to the emergency team: temperature 99.9°F (axillary), pulse 108, respirations 14, blood pressure 190/98. 3 case questions	Medical Root Words (Word-Building)Bradycardia · Tachycardia · Bradypnea · Tachypnea · Hypertension · Hypotension Measuring AccuratelyOral (98.6°) · Axillary (97.6°) · Rectal (99.6°) · Tympanic (97.6°) · Temporal artery (99.6°) · NCIT (99.6°) Blood PressureHypertensive CRISIS	Dialogue 1 — Sixty or sixteen? Dialogue 2 — Reporting a full set	Role Play 1 — The impossible reading Role Play 2 — The noisy handover	Check Your Knowledge Say all five normal ranges from memory. A temperature of 100.4°F — normal or fever? You get an abnormal reading. Name the two things you do, in order. Build the word: slow + breathing = ? Fast + heart = ? Which is high blood pressure — hyper- or hypo-tension? A pulse of 52. Normal? What is the word? Which temperature route is best for a client with dementia? Which is never used? How long do you count a pulse? What if you lose it? Why do you not tell a client you are counting their breathing? Say "15" and "50" the safe way. Say this out loud: BP 180/120, pulse 60, temp 99.9 axillary.	Skill 12 Taking Blood Pressure Direct The unit’s own “Hypertensive Crisis” content. CNA Essential Skills — Measure and Record Blood Pressure (4:56)Blood Pressure Measurement: How to Check Blood Pressure Manually Manual Blood Pressure: Explanation, Demonstration, and Practice Measure and Record Blood Pressure — CNA skill video — AAMT
13 Explaining Personal Care with Dignity Web PDF	Use vocabulary for bathing, hygiene, and personal care. Explain what will happen before you begin, in plain words. Read gestures and expressions as answers. Respond calmly to an inappropriate comment. Offer alternatives when someone is reluctant.	Ida Video: Ida — Distress During Bathing Ida lives in your long-term care facility. For the last few days they have felt unwell with a urinary tract infection, and their dementia symptoms are more pronounced. You are assigned to help Ida bathe this morning. Normally Ida enjoys a bath, but when you try to take them into the tub room, they begin screaming and crying. 6 case questions	The Two Key TermsPeri-care · Paraphimosis Bed Baths — Partial vs. CompletePartial bed bath · Complete bed bath	Dialogue 1 — Before you touch Dialogue 2 — The answer she didn't say	Role Play 1 — First bath Role Play 2 — The unspoken no	Check Your Knowledge Rewrite "I am going to perform peri-care" in plain words. Which phrase in this bank is too sharp for a client, and why? Name three things you WATCH for when a client cannot tell you they are frightened. What exactly do you say to a client who makes a sexual remark? Name the three things you must NOT do. Do you report it if you handled it well? Why?	Skill 13 Giving a Partial Bed Bath Direct Replaces Perineal Care (Female). Matches the unit’s Bed Baths — Partial vs. Complete section; peri-care is the last step of the procedure. First skill in the book to carry spoken language — the worker names each body part before washing it. Skill videos still need re-sourcing; the unit now carries a topic video (UCLA, Refusal to Bathe).
14 Mealtime English: Diets, Preferences, and Complaints Web PDF	Understand vocabulary for diets, fluids, and appetite. Describe a plate using the clock face. Assist a client to eat safely, at their own speed. Handle a complaint in five steps. Apologize for a problem without blaming anyone.	Mrs. Okafor Video: Mrs. Okafor — The Tray She Pushed Away Mrs. Okafor is 86 and had a stroke six weeks ago. She is on a mechanical-ground diet with nectar-thick liquids. For the last four days she has eaten very little and pushes her tray away, saying "It's horrible, take it away." She has lost three pounds. Today her daughter arrives and says, loudly, "She's wasting away in here and nobody is feeding her." 6 case questions	Therapeutic DietsRegular · DASH · Diabetic · Low-cholesterol · Mechanical / ground (easy-to-chew) · Thickened liquids · NPO (nothing by mouth) Fluids, Intake & Dehydration Feeding a Client Safely	Dialogue 1 — "It's stone cold" Dialogue 2 — "It's disgusting"	Role Play 1 — The same complaint every night Role Play 2 — "I'm not eating that"	Check Your Knowledge What must happen before a post-surgery client can start clear liquids? In what units do you record intake? Name three foods that count as fluid. How much fluid should most adults have per day? Name four signs of dehydration. How do you test the temperature of food? What must you never do? How full should the spoon be? What do you alternate?	Skill 14 Feeding a Dependent Client Direct Feeding is exactly what this unit is about. CNA Essential Skills — Feeding the Client (4:59)How to Feed a Resident Sitting in a Chair \| CNA Skills for Prometric Exam CNA Skill 9: Feeds Client Who Cannot Feed Self Feed a Resident in a Chair CNA Skill
15 Communicating with People Living with Memory Loss Web PDF	Use vocabulary for memory loss and confusion. Tell dementia from other cognitive and mental health conditions. Acknowledge a feeling instead of arguing about a fact. Break an instruction into single small steps. Describe a behavior objectively when reporting it.	Olga Video: Olga — The First Night Mr. Tran, 80, has moderate dementia. It is early evening ( sundowning ). He is frightened and shouting that there is a dog under his bed, trying to bite him. You must validate his reality, resolve it, and redirect him to something calming. 9 case questions	Behavior Is Communication Warning Signs, Diagnosis, and StagesMild · Moderate · Severe · Memory deficit · Impaired communication · Loss of ADLs · Mood/behavior changes · Restlessness / agitation · Aggression · Sundowning · Sexual inappropriateness · Hallucinations / delusions Other Cognitive and Mental Health DisabilitiesIntellectual disability · Mental illness Managing Challenging BehaviorsReminiscence · Activity · Sensory stimulation · Validation · won't open their mouth / poor appetite · won't open wide / bites the spoon · pockets (packs) food in cheeks · is aggressive at meals	Dialogue 1 — The Frightened Client (Mrs. Alvarez) Dialogue 2 — Resisting Toileting (Mr. Bianchi)	Role Play 1 — Seeing Something That Isn't There Role Play 2 — The Client Who Says No	Check Your Knowledge Which memory is lost first — short-term or long-term? Name three behaviors you may see in the moderate stage. A client is hitting you. What is the FIRST thing you check? A client sees snakes that are not there. What do you do — argue or validate?	Skill 15 Oral Care (Natural Teeth) Direct The skill itself names dementia in its own steps. CNA Essential Skills — Mouth Care (4:30)Perform Mouth Care with Teeth CNA Skill Prometric How to Provide Mouth Care to a Resident with Teeth \| CNA Skills for Prometric Exam CNA Skill 17: Provides Mouth Care