Measuring Respirations
Measuring the respiratory rate accurately requires observing the rise and fall of the chest without alerting the resident, as awareness changes breathing patterns.
1Step-by-Step Procedure
- 1
Wash hands.
- 2
Identify the resident and explain that you are continuing to monitor vital signs (do not announce you are counting breaths).
- 3
Keep your fingers on the resident's wrist as if still counting the pulse — this prevents the resident from becoming aware and altering their breathing pattern.
- 4
Observe the rise and fall of the chest; one complete rise-and-fall cycle equals one respiration.
- 5
Count respirations for a full 60 seconds.
- 6
Note the rate, depth (shallow, normal, or deep), and rhythm (regular or irregular).
- 7
Also note any abnormal sounds such as wheezing, gurgling, or stridor.
- 8
Lower the resident's arm and ensure comfort.
- 9
Wash hands.
- 10
Record the respiratory rate, depth, rhythm, and any abnormal sounds immediately.
- 11
Report abnormal findings to the nurse right away.
What the Examiner Is Watching For
- ✓
Fingers remain on the wrist to avoid alerting the resident.
- ✓
One full chest rise-and-fall is counted as one respiration.
- ✓
Respirations are counted for a full 60 seconds.
- ✓
Rate, depth, and rhythm are all assessed and recorded.
Common Mistakes That Cause Failure
- ⚠
Announcing you are counting respirations — this makes people breathe differently.
- ⚠
Counting each chest movement (up and down) as a separate respiration instead of a cycle.
- ⚠
Counting for only 30 seconds and doubling.
- ⚠
Not noting the depth and rhythm, only the rate.
- ⚠
Forgetting to report abnormal sounds like wheezing.
Tips for Exam Day
- →
Keep your fingers on the wrist — it looks like you are still counting the pulse.
- →
One rise + one fall = one breath. Count complete cycles.
- →
Normal adult respiratory rate is 12–20 breaths per minute.
- →
Immediately after counting the pulse is the ideal time — transition smoothly.
Also prep for the written exam
The written NNAAP exam tests the same knowledge behind these clinical skills — use the study guides to reinforce the concepts in multiple-choice format.
Browse All 6 Study Guides →Recommended Study Books
Top-rated CNA prep books to pass both the written and skills tests.
CNA Study Guide 2026-2027
Mometrix Test Prep — 3 full-length practice tests with detailed explanations.
CNA Study Guide 2024-2025
Ascencia Test Prep — 7 practice tests covering all NNAAP content areas.
CNA Exam Cram
Whitenton & Walker — Focused prep — ideal for last-minute review.
As an Amazon Associate we earn from qualifying purchases.
Also practice the written exam
Free practice questions with instant feedback and explanations.
Take a Practice Test →