Texas Nurse Aide Course Notes

Highest-weight written domain (24%). Think OBSERVE → PROTECT → REPORT. The aide notices changes, keeps the resident safe, summons the nurse/emergency help when needed, and reports objective facts; the aide does not diagnose or independently change treatment. The Texas Written Test is 60 multiple-choice questions in 90 minutes. The separate Clinical Skills test scores five skills: Handwashing, Indirect Care, and three assigned skills; all five must be passed.

• Waiting to finish a task before reporting an urgent change.

• For every scenario ask: Is there an immediate threat to life or safety?

Second-highest written domain (22%). Most questions reward prevention: remove or report hazards, use Standard Precautions, protect mobility and skin, and follow the resident-specific care plan. Safety devices do not replace observation. Restraints are not a convenience or punishment and should never be improvised by the aide.

• Assuming gloves are required for every resident interaction.

• Choose prevention over reaction when both are offered.

This 20% domain is the 'scope + rights + communication' section. The aide provides assigned care, observes, records, reports, and protects rights. The aide does not independently assess, diagnose, prescribe, administer unauthorized treatments, or rewrite the care plan. When in doubt, choose the answer that respects the resident, stays within scope, follows the care plan, and communicates the concern.

• Confusing observing with nursing assessment.

• If an answer requires assessment, diagnosis, prescribing, or changing treatment, it is usually beyond the aide role.

This 20% domain is about helping residents do as much as safely possible for themselves. Do not take over a task the resident can perform. Protect skin and mobility, support nutrition/hydration and elimination, use assistive devices as directed, and report new changes. Independence + dignity + safety is the core pattern.

• Doing the whole task for a resident who can safely participate.

• Choose 'assist' over 'take over' whenever the resident can safely participate.

Lowest-weight written domain (14%), but highly scenario-based. Adapt—not abandon—person-centered care when health changes. Use simple calm communication, protect safety, validate emotions, preserve dignity, and report new or worsening physical/psychological changes. Near end of life, comfort and resident wishes remain central.

• Arguing with a confused resident to prove facts.

• Confusion: calm voice, simple explanation, safety, redirection, report change.