Free CNA Skills Course: Step-by-Step Guides for Every CNA Skill

This free course covers every clinical skill you need as a CNA, no matter which state you are in or which testing provider your state uses. Each lesson walks you through the exact procedure step by step, explains what the evaluator is looking for on exam day, and lists the most common mistakes that cause students to fail.

The course covers every clinical skill tested across the three major CNA exam providers (Credentia/NNAAP, Prometric, and Headmaster) plus key training fundamentals like body mechanics. Not every skill is tested in every state, but every skill in this course is one you will use in clinical practice. Whether you are preparing for your certification exam or reviewing procedures on the job, start with Module 1 and work through in order, or jump directly to any skill you need.

US states use one of three testing vendors for the CNA skills exam: Credentia (administers the NNAAP exam in most states), Prometric (used in Florida, New York, and others), or Headmaster/D&S Diversified (used in Ohio, Arizona, and others). The core clinical skills are the same across all three. The differences are in which specific skills appear on your exam, exact checklist wording, and minor procedural details. Check your state's candidate handbook for the specific skills and checklist used on your exam.

What Is the NNAAP Skills Exam?

The NNAAP (National Nurse Aide Assessment Program) skills exam is the clinical portion of the CNA certification test administered in most US states. During the exam, you are asked to perform five skills in front of a trained evaluator. You must complete each skill correctly and within the time allowed. One of those five skills is always hand washing — that is not random. The other four are drawn randomly from the list of tested skills.

The evaluator uses a standardized checklist. They mark each step as performed or not performed. There is no partial credit — either you did the step or you did not. Certain steps, such as identifying the resident before any procedure, are considered critical elements in some states. Failing a critical element means failing the skill even if all other steps were performed correctly. Always check your specific state's testing provider for their critical element list.

The skills test typically takes 25 to 35 minutes. You do not need to memorize the steps in isolation — you need to be able to perform them fluidly while being observed. That is why practicing with a physical checklist is more effective than reading the steps passively. Every skill page in this course includes a printable checklist designed for that purpose.

How to Use This Course

Work through the modules in order if you are starting from scratch. Each lesson builds on concepts from earlier lessons — infection control principles from Module 1 apply to every hands-on skill that follows. If you are reviewing before your exam, use the CNA skills checklist to identify which skills need more practice, then revisit those individual lessons.

After working through the written steps on each page, practice the skill physically. If you are in a training program, use the classroom mannequin. If you are self-studying, practice on a willing family member or use a bed at home. Reading the steps is preparation for practice. Practice is what builds the muscle memory the exam requires.

Module 1: Infection Control and Safety

Infection control is the foundation of every clinical skill. The steps in this module apply to every patient interaction you will have as a CNA. Evaluators watch for lapses in infection control throughout the skills exam, not just during skills where it is the primary focus.

• Hand Washing: Always on the exam. The single most important skill to master.
• Personal Protective Equipment (PPE): Donning and doffing gowns, gloves, masks, and eye protection in the correct order.
• Infection Control Principles: Standard precautions, transmission-based precautions, and how they apply to every skill.

Module 2: Vital Signs and Measurements

Vital sign measurement is one of the most frequently tested skill categories. Blood pressure and pulse/respiration appear on many students' exams. Accuracy matters — you will be evaluated not just on technique but on whether your documented reading is within an acceptable range.

• Manual Blood Pressure: Sphygmomanometer and stethoscope technique, step by step.
• Electronic Blood Pressure: Digital monitor setup, cuff selection, and recording the reading exactly as displayed.
• Counting Pulse and Respirations: Radial pulse technique and respiration counting without alerting the resident.
• Weight Measurement: Standing scale and chair scale procedures with safety steps.
• Intake and Output (I&O): How to measure, record, and report fluid intake and urinary output accurately.

Module 3: Personal Care

Personal care skills appear frequently on the NNAAP exam. Bed bath in particular is one of the most commonly tested skills. The evaluator is watching for proper technique, privacy maintenance, and infection control throughout.

• Oral Hygiene: Mouth care for an alert, cooperative resident using a toothbrush.
• Denture Care: Removing, cleaning, and reinserting dentures safely.
• Foot Care: Soaking, washing, drying, and inspecting feet with proper safety precautions.
• Hand and Nail Care: Soaking, cleaning under nails, filing, and lotion application.
• Bed Bath: Complete bed bath procedure for a resident who cannot get up, including privacy and infection control.

Module 4: Mobility and Patient Handling

Mobility skills make up a large portion of the skills pool across all exam providers. Bed to wheelchair transfer, ambulation with a transfer belt, and range of motion exercises all appear regularly. These skills also carry the highest injury risk for both the CNA and the resident, so proper technique is critical in clinical practice as well as on the exam.

• Body Mechanics and Safe Lifting: Principles for protecting your back during every patient handling task.
• Positioning a Patient in Bed: Supine, lateral (side-lying), Fowler's, and Sims' positions with proper alignment and support.
• Assisting to Ambulate Using a Transfer Belt: Walking a resident safely using a gait belt, including how to respond if they start to fall.
• Bed to Wheelchair Transfer: Step-by-step transfer using a transfer belt, including wheelchair positioning and locking.
• Range of Motion Exercises: Passive ROM for all major joint groups including shoulder, elbow, wrist, hip, knee, and ankle.
• Dressing a Resident with a Weak Arm: The correct sequence for dressing and undressing when one side is weaker.
• Applying One Knee-High Elastic Stocking: Proper technique for applying a compression stocking with safety checks.

Module 5: Daily Care

Daily care skills cover the routine procedures CNAs perform every shift. Occupied bed making and catheter care are among the most tested skills in this module. Perineal care requires particular attention to direction of cleaning and maintaining dignity throughout the procedure.

• Making an Occupied Bed: Complete linen change for a resident who remains in bed, rolled to each side.
• Making an Unoccupied Bed: Standard bed-making procedure for an empty bed, including mitered corners.
• Feeding Assistance: Positioning, food identification, pacing, and safety for a resident who needs help eating.
• Toileting Assistance and Bedpan Use: Placing and removing a bedpan and urinal, including contents measurement and recording.
• Catheter Care: Perineal cleaning around an indwelling urinary catheter and drainage bag inspection.
• Perineal Care: Cleaning the perineal area for a female and male resident with proper technique and direction.

Module 6: Written Exam Topics

The two topics below are not clinical skills. They will not appear on your skills test. They are tested on the written portion of the CNA exam and are included here to give the course a complete picture of what CNAs are expected to know.

• Resident Rights: OBRA-mandated rights, privacy, dignity, and HIPAA basics for the written exam.
• Communication and Documentation: Reporting to the nurse, objective versus subjective observations, and accurate charting.

Supporting Resources

• CNA Skills Checklist: All NNAAP skills in a single printable checklist with pass/fail criteria. Use this to track your practice sessions.
• Free CNA Practice Test: Six 30-question practice tests covering all written exam topics. Test your knowledge after working through the course.
• Free CNA Classes Near You: Looking for a program to enroll in? Find free and low-cost CNA training options by state.
• CNA Programs by State: Compare CNA training programs, costs, and requirements across all 50 states.

Ready to test what you have learned? Take the free CNA practice test →