CNA Skills Checklist: Complete List with Pass/Fail Criteria

This checklist covers every clinical skill tested across the three major CNA exam providers (Credentia/NNAAP, Prometric, and Headmaster). Use it to track your practice sessions. Mark each step as you perform it and note any steps you consistently miss. Print this page before each practice run.

Not every skill on this list is tested in every state. Most states test five skills per exam, with hand washing always included and the rest drawn randomly. The specific skills in your exam pool depend on your state's testing vendor. Check your state's candidate handbook for the exact list.

Each skill listed below links to the full step-by-step guide in our free CNA course. The pass/fail criteria shown here are based on standard evaluation guidelines. Some states have additional critical elements, so always check your specific testing provider for the complete checklist used on your exam.

To print: Use your browser's print function (Ctrl+P or Cmd+P). The checklist is formatted to print cleanly on standard letter paper.

Module 1: Infection Control and Safety

1. Hand Washing Always on exam

Hand washing is the only skill guaranteed to appear on every NNAAP skills exam. It is also evaluated implicitly throughout other skills, if you fail to wash your hands before or after a skill, you can receive a failing mark on that skill as well.

1. Turn on water and adjust to warm temperature
2. Wet hands under running water, keeping fingertips pointed down
3. Apply soap (at least a dime-sized amount)
4. Rub hands together, palms first, then back of each hand
5. Interlace fingers and scrub between them
6. Clean around and under fingernails
7. Scrub wrists and lower forearms
8. Continue scrubbing for at least 20 seconds total
9. Rinse hands under running water, fingertips pointing down
10. Dry hands with a clean paper towel from fingertips toward wrists
11. Use the paper towel to turn off the faucet
12. Discard paper towel without touching the trash can with clean hands

Key pass/fail criteria: Minimum 20 seconds of scrubbing. Paper towel used to turn off faucet. Fingertips pointing down during rinsing.

2. Personal Protective Equipment (PPE)

Tested as donning and doffing a full set of PPE: gown, gloves, mask, and eye protection. Order of application and removal is critical.

1. Perform hand hygiene before donning
2. Put on gown, tie at neck and waist
3. Put on mask or respirator, mold to nose
4. Put on eye protection (goggles or face shield)
5. Put on gloves last, pulling cuffs over gown sleeves
6. To doff: remove gloves first (peel and roll, touching only outside)
7. Perform hand hygiene
8. Remove eye protection from behind (do not touch front)
9. Remove gown, rolling inside out as you pull it off
10. Remove mask by touching ties or ear loops only
11. Perform hand hygiene after all PPE is removed

Key pass/fail criteria: Correct donning order (gown, mask, eye protection, gloves). Correct doffing order (gloves first, mask last). Hand hygiene before donning and after doffing.

3. Infection Control Principles

Infection control is evaluated throughout the skills exam, not as a standalone skill with a single checklist. You are expected to apply standard precautions during every other skill you perform.

• Wash hands before and after every resident contact
• Use clean gloves when contact with body fluids is possible
• Keep clean items separate from soiled items
• Dispose of soiled linen and supplies without shaking them (to avoid spreading pathogens)
• Never place soiled items on clean surfaces
• Follow transmission-based precautions if posted on the room door

Key pass/fail criteria: Consistent hand hygiene. No cross-contamination between clean and soiled items. Proper disposal of soiled materials.

Module 2: Vital Signs and Measurements

4. Manual Blood Pressure

1. Wash hands, identify resident, explain procedure
2. Position resident with arm at heart level, palm facing up, sleeve rolled up
3. Place cuff on bare arm, lower edge 1 inch above the antecubital space (inner elbow crease)
4. Locate brachial artery with fingertips
5. Place stethoscope over brachial artery
6. Close the valve on the bulb
7. Inflate cuff to approximately 180 mmHg (or 30 above expected systolic)
8. Slowly release valve at a rate of 2 mmHg per second
9. Note the reading when the first sound is heard (systolic)
10. Note the reading when the last sound is heard (diastolic)
11. Deflate cuff fully, remove it
12. Wash hands, record reading with date, time, and arm used
13. Report any abnormal values to the nurse

Key pass/fail criteria: Cuff placement 1 inch above antecubital space. Deflation rate of 2 mmHg/second. Recording both systolic and diastolic values. Reporting abnormals.

5. Electronic Blood Pressure

1. Wash hands, identify resident, explain procedure, provide privacy
2. Position resident with arm at heart level, palm up, upper arm exposed
3. Select the appropriate cuff size for the resident's arm
4. Locate brachial artery with fingertips
5. Apply cuff snugly with sensor arrow aligned over the brachial artery
6. Turn on the machine and verify it is functioning (select adult setting if applicable)
7. Press start. If cuff inflates above 200 mmHg, stop and move cuff to other arm
8. Wait for reading to appear on screen and cuff to fully deflate
9. Remove cuff, place call light within reach
10. Wash hands before recording
11. Record both systolic and diastolic pressures exactly as displayed on screen
12. Report any abnormal values to the nurse

Key pass/fail criteria: Correct cuff size selected. Sensor arrow over brachial artery. Reading recorded exactly as displayed (critical element). Machine verified functioning before use.

6. Counting Pulse and Respirations

1. Wash hands, identify resident, explain you are checking vital signs
2. Position resident comfortably with arm resting, palm down
3. Locate radial pulse at wrist (thumb side, below thumb)
4. Use two or three fingertips (not your thumb) to feel the pulse
5. Count beats for 60 seconds (or 30 seconds and multiply by 2)
6. Note rate, rhythm, and strength
7. Without telling the resident, begin counting respirations immediately after pulse
8. Count for 60 seconds (count each rise of the chest as one breath)
9. Note rate and any irregularities or abnormal sounds
10. Wash hands, record both readings with date and time
11. Report abnormal values to the nurse

Key pass/fail criteria: Fingertips (not thumb) for pulse. Count at least 30 seconds. Respirations counted without alerting the resident. Both readings recorded.

7. Weight Measurement

1. Wash hands, identify resident, explain procedure
2. Balance the scale to zero before the resident steps on
3. Assist resident to remove shoes and heavy outer clothing
4. Assist resident onto the scale, ensuring they hold the support bar if available
5. Ask resident to stand still with weight distributed evenly
6. Read the weight when the scale is balanced/stable
7. Assist resident off the scale safely
8. Assist resident to put shoes back on if needed
9. Wash hands, record weight with date and time
10. Report significant changes from previous weight to the nurse

Key pass/fail criteria: Scale balanced to zero before use. Resident safe on/off scale. Weight recorded accurately. Changes in weight reported.

8. Intake and Output (I&O)

1. Wash hands, identify resident, explain that you are measuring fluid intake/output
2. For intake: record all fluids consumed at each meal (water, juice, soup, ice cream, gelatin) in milliliters
3. Use standard measurement equivalents (1 cup = 240 mL, 1 oz = 30 mL)
4. For output: put on gloves before handling any urinary output
5. Pour urine from bedpan, urinal, or catheter bag into a graduated measuring container
6. Read the measurement at eye level
7. Note color, odor, and clarity of urine and report abnormalities
8. Dispose of urine properly
9. Clean and store the measuring container
10. Remove and dispose of gloves, wash hands
11. Record output in milliliters with date and time
12. Report output below 30 mL/hour or any significant changes to the nurse

Key pass/fail criteria: Gloves for all urine contact. Accurate measurement in mL. Reading at eye level. Recording and reporting.

Module 3: Personal Care

9. Oral Hygiene

1. Wash hands, put on gloves, identify resident, explain procedure
2. Position resident upright (at least 45 degrees) or on their side if they cannot sit up
3. Place towel across resident's chest
4. Wet toothbrush and apply a small amount of toothpaste
5. Brush all surfaces of teeth: outer, inner, and biting surfaces
6. Brush the tongue gently
7. Have resident rinse with water and spit into basin
8. Wipe the resident's mouth and remove the towel
9. Rinse and store toothbrush
10. Empty and clean the basin
11. Remove gloves, wash hands
12. Record procedure and report any abnormalities (bleeding gums, loose teeth, sores)

Key pass/fail criteria: Resident positioned upright to prevent aspiration. All tooth surfaces brushed. Mouth wiped clean. Supplies rinsed and stored.

10. Denture Care

1. Wash hands, put on gloves, identify resident, explain procedure
2. Ask resident to remove dentures or assist with removal
3. Place dentures in a labeled denture cup
4. Take dentures to the sink and place a washcloth or towel in the basin to cushion them
5. Hold dentures over the cushioned basin while brushing
6. Brush all surfaces with a denture brush and denture cleanser or mild soap (not toothpaste)
7. Rinse dentures thoroughly under cool running water (not hot, hot can warp dentures)
8. Assist resident with oral rinse while dentures are out
9. Return dentures to resident for reinsertion or store in labeled cup with cool water or cleanser
10. Clean and store supplies
11. Remove gloves, wash hands
12. Record and report any damage to dentures or sores in the mouth

Key pass/fail criteria: Towel or cloth in basin before brushing. Cool (not hot) water used for rinsing. All surfaces brushed. Dentures stored properly if not reinserted.

11. Foot Care

1. Wash hands, put on gloves, identify resident, explain procedure
2. Fill basin with warm water and test temperature on inner wrist
3. Position resident in chair with feet able to reach basin
4. Soak feet for 5 to 10 minutes (if ordered)
5. Wash each foot thoroughly, including between toes
6. Rinse feet well
7. Dry each foot completely, paying close attention to the areas between toes
8. Apply lotion to the tops and bottoms of feet if ordered (do not apply between toes)
9. Inspect feet for redness, swelling, open sores, or skin breakdown, report any findings
10. Put clean socks and footwear on the resident
11. Empty, clean, and store the basin
12. Remove gloves, wash hands
13. Record and report any skin abnormalities

Key pass/fail criteria: Water temperature tested before soaking. Feet dried thoroughly between toes. Lotion not applied between toes. Skin inspected and abnormalities reported.

12. Hand and Nail Care

1. Wash hands, identify resident, explain procedure, provide privacy
2. Fill basin with warm water, test temperature, confirm with resident
3. Soak one hand for 3 to 5 minutes
4. Remove hand and dry thoroughly, including between fingers
5. Clean under each fingernail with an orangewood stick
6. Clean or wipe the stick between each nail
7. File nails in one direction with an emery board (do not use clippers unless authorized)
8. Warm lotion in your hands, apply from fingertips toward wrist
9. Remove excess lotion so hands are not slippery
10. Repeat on the other hand (change water if cooled)
11. Clean up basin and supplies
12. Wash hands, record procedure, report any nail abnormalities

Key pass/fail criteria: Orangewood stick cleaned between nails. Nails filed in one direction. Lotion warmed before applying. Excess lotion removed. No clippers unless care plan authorizes.

13. Bed Bath

1. Wash hands, identify resident, explain procedure, close curtains/door for privacy
2. Fill basin with warm water and test temperature
3. Raise bed to working height, lower far side rail
4. Cover resident with a bath blanket, remove gown under blanket
5. Wash and dry face (eyes first, inner corner to outer), then ears and neck
6. Expose and wash far arm, then near arm
7. Wash chest and abdomen, keeping rest of body covered
8. Change water if it becomes cool or soapy
9. Wash far leg, then near leg (wash from distal to proximal, ankle to hip)
10. Assist resident to turn to side, wash back and buttocks
11. Perform perineal care last (separate wash basin if available)
12. Dress resident in clean gown, raise side rail, lower bed
13. Remove gloves, wash hands
14. Record procedure and report any skin changes

Key pass/fail criteria: Privacy maintained throughout. Water changed when needed. Wash progresses from clean areas to soiled areas. Perineal care performed last.

Module 4: Mobility and Patient Handling

14. Positioning a Patient in Bed

1. Wash hands, identify resident, explain procedure
2. Raise bed to working height, lower side rail on working side
3. For lateral position: cross resident's near arm over chest, cross near leg over far leg
4. Roll resident toward you or away from you using a draw sheet or rolling technique
5. Maintain proper body alignment: head, spine, and hips in line
6. Place pillow behind the back for support
7. Place pillow between knees to align hips
8. Ensure resident's top arm is supported (pillow in front)
9. Ensure resident's ear is not folded
10. Raise side rail, lower bed, ensure call light is within reach
11. Wash hands, record position change and time

Key pass/fail criteria: Proper body alignment maintained. Bony prominences protected with pillows. Resident comfortable and repositioned at least every 2 hours per care plan.

15. Assisting to Ambulate Using a Transfer Belt

1. Wash hands, identify resident, explain procedure
2. Assist resident to sit at edge of bed, allow a moment to regain balance
3. Put appropriate footwear on resident
4. Apply transfer belt snugly around resident's waist over clothing (not bare skin)
5. Check that two fingers fit between belt and resident (snug but not too tight)
6. Stand to the resident's weaker side
7. Grasp transfer belt from below with an underhand grip
8. Assist resident to stand, moving with them rather than pulling
9. Walk slightly behind and to the weaker side, maintaining belt grip
10. If resident begins to fall: do not try to hold them up. Guide them to the floor in a controlled manner, bending your knees.
11. At the end of ambulation, reverse the process to return resident to sitting
12. Remove transfer belt after resident is safely seated
13. Wash hands, record distance and tolerance

Key pass/fail criteria: Belt applied over clothing, snug with two-finger check. Underhand grip on belt. CNA positioned on weaker side. Safe fall response if needed.

16. Bed to Wheelchair Transfer

1. Wash hands, identify resident, explain procedure
2. Position wheelchair at a 45-degree angle to the bed on the resident's stronger side
3. Lock both wheelchair wheels
4. Raise foot rests out of the way
5. Assist resident to sit at edge of bed, pause for balance
6. Put appropriate footwear on resident
7. Apply transfer belt snugly around waist
8. Stand facing resident, feet shoulder-width apart, bend knees
9. Grasp transfer belt from below with underhand grip
10. Instruct resident to push up from bed and stand on count of three
11. Pivot resident toward wheelchair (pivot on stronger leg)
12. Lower resident into wheelchair by bending your knees
13. Position resident's feet on foot rests
14. Ensure resident is positioned comfortably and call light is within reach
15. Remove transfer belt if not part of the resident's care plan
16. Wash hands, record transfer and tolerance

Key pass/fail criteria: Wheelchair at 45 degrees, wheels locked, foot rests up before transfer. Transfer belt used correctly. Bending knees (not back) throughout. Resident pivoted toward stronger side.

17. Range of Motion Exercises

1. Wash hands, identify resident, explain procedure
2. For passive ROM: support the joint above and below with your hands
3. Move each joint slowly and smoothly through its full range of motion
4. Stop immediately if the resident reports pain
5. Do not force a joint beyond its comfortable range
6. Shoulder: abduction/adduction, flexion/extension, internal/external rotation, circumduction
7. Elbow: flexion/extension, pronation/supination
8. Wrist: flexion/extension, radial/ulnar deviation
9. Hip: flexion/extension, abduction/adduction
10. Knee: flexion/extension
11. Ankle: dorsiflexion/plantar flexion, inversion/eversion
12. Perform exercises on each side per care plan (typically 3–5 repetitions per joint)
13. Wash hands, record exercises performed and any pain or resistance noted
14. Report changes in range or resident reports of pain to the nurse

Key pass/fail criteria: Joint supported above and below. No forcing beyond comfortable range. Exercises stopped at first report of pain. All specified joints completed.

18. Dressing a Resident with a Weak Arm

1. Wash hands, identify resident, explain procedure, provide privacy
2. Gather clean clothing
3. When putting clothes ON: dress the weak/affected arm or leg FIRST
4. Guide the weak arm into the sleeve gently, supporting the joint
5. Pull the garment over the resident's back
6. Guide the strong arm into the other sleeve
7. Adjust the garment for comfort and alignment
8. When taking clothes OFF: undress the strong/unaffected arm or leg FIRST
9. Remove the garment from the strong side first, then gently remove from the weak side
10. Assist with pants, socks, and footwear following the same principle
11. Ensure resident is comfortable and dressed appropriately
12. Wash hands, record procedure

Key pass/fail criteria: Weak side dressed FIRST, undressed LAST. No pulling or forcing the weak limb. Resident's dignity maintained throughout.

19. Applying One Knee-High Elastic Stocking

1. Wash hands, identify resident, explain procedure
2. Assist resident to lie flat or in semi-recumbent position (stockings are applied before getting up)
3. Inspect the leg for any skin breakdown, redness, or swelling and report abnormalities before applying
4. Turn the stocking inside out down to the heel pocket
5. Slide the stocking over the toes and foot
6. Position the heel pocket at the resident's heel
7. Pull the stocking up the leg smoothly, turning it right-side out as you go
8. Ensure the stocking is smooth with no wrinkles or folds
9. Check that the stocking ends at or below the knee (for knee-high style)
10. Check that toes are not restricted
11. Ask resident to report any discomfort, numbness, or tingling after application
12. Wash hands, record application and note condition of the skin

Key pass/fail criteria: Stocking applied before resident stands. Heel correctly positioned. No wrinkles after application. Skin inspected before application.

Module 5: Daily Care

20. Feeding Assistance

1. Wash hands, identify resident, explain procedure
2. Check diet order and tray for correct resident name and diet type
3. Assist resident to wash hands before eating
4. Position resident upright (90 degrees if possible) for eating
5. Position yourself at the resident's eye level (sit down if they are seated)
6. Identify each food and ask preferences for order
7. Offer small bites (teaspoon-sized) from the tip of the spoon
8. Allow adequate time to chew and swallow between bites
9. Offer fluids between bites
10. Watch for signs of difficulty swallowing (coughing, gurgling, pocketing food in cheek)
11. Stop feeding and notify nurse if swallowing difficulty is observed
12. Record percentage of meal consumed and fluid intake
13. Wash hands after the meal

Key pass/fail criteria: Resident upright at 90 degrees. Small bites at appropriate pace. Signs of swallowing difficulty recognized and reported. Intake recorded.

21. Toileting Assistance and Bedpan Use

1. Wash hands, put on gloves, identify resident, explain procedure, provide privacy
2. Raise bed to working height, lower side rail
3. Ask resident to bend knees and lift hips (or log-roll if unable)
4. Slide the bedpan under the resident so the wider flat end is positioned at the buttocks
5. Raise the head of the bed to about 30–45 degrees to facilitate voiding/defecation
6. Place toilet tissue and call light within reach
7. Provide privacy and allow time (stay nearby)
8. Return when called, lower bed, ask resident to lift hips to remove bedpan
9. Cover the bedpan and take to bathroom for measurement and disposal
10. Perform perineal care after use
11. Assist resident to wash hands
12. Empty, clean, and store the bedpan
13. Remove gloves, wash hands
14. Record output and report abnormalities

Key pass/fail criteria: Privacy provided. Bedpan positioned correctly. Perineal care performed after use. Output measured and recorded.

22. Catheter Care

1. Wash hands, put on gloves, identify resident, explain procedure, provide privacy
2. Position resident appropriately (female: supine; male: supine)
3. Expose perineal area while keeping the rest of the body covered
4. Inspect catheter tube for kinks, and drainage bag for correct position (below bladder)
5. Inspect urine in the bag for color, clarity, and amount, note any abnormalities
6. For females: using a clean washcloth, wipe from the urethral meatus (where catheter exits) downward toward the rectum with a single stroke
7. Clean at least 4 inches of catheter tubing from the insertion site outward
8. For males: hold the penis upright and clean from the urethral meatus outward in a circular motion
9. Clean at least 4 inches of catheter tubing
10. Ensure catheter is secured to the inner thigh to prevent tension on the urethra
11. Ensure drainage bag is hanging below bladder level at all times
12. Remove gloves, wash hands
13. Record procedure and report any unusual urine characteristics to the nurse

Key pass/fail criteria: Cleaning direction correct (urethral meatus outward). At least 4 inches of tubing cleaned. Drainage bag positioned below bladder. Catheter secured to inner thigh.

23. Perineal Care

1. Wash hands, put on gloves, identify resident, explain procedure, provide privacy
2. Fill basin with warm water and test temperature
3. Cover resident with bath blanket, remove clothing
4. For female residents:
5. Separate the labia with one hand
6. With a washcloth, clean from the pubic area down toward the rectum using a single stroke per area of cloth
7. Use a clean section of cloth for each stroke, never wipe back to front
8. Clean the inner and outer labia folds
9. Rinse thoroughly in the same front-to-back direction
10. Dry thoroughly
11. For male residents:
12. Retract the foreskin if uncircumcised
13. Clean the tip of the penis in a circular motion from the urethral meatus outward
14. Clean the shaft of the penis from tip toward the body
15. Replace the foreskin after cleaning
16. Clean the scrotum and perineal area
17. Dry thoroughly
18. Remove gloves, wash hands, record procedure

Key pass/fail criteria: Front-to-back direction for females. Clean area of cloth used per stroke. Foreskin replaced for uncircumcised males. Thorough drying. Privacy maintained.

Module 6: Written Exam Topics

The following two topics are tested on the written exam, not the skills test. They do not have a step-by-step checklist format. Review the full lesson pages for written exam preparation.

24. Resident Rights

• The right to be informed about their care and to participate in care planning
• The right to refuse treatment
• The right to privacy and confidentiality (including HIPAA)
• The right to be treated with dignity and respect
• The right to make personal choices (what to wear, when to wake up, etc.)
• The right to be free from abuse and restraints
• The right to voice grievances without retaliation
• The right to family and visitor access

25. Communication and Documentation

• Report changes in resident condition to the nurse promptly
• Use objective language in documentation (what you observed, not what you think it means)
• Use the 24-hour clock (military time) in documentation
• Never document care before it is given
• Correct errors with a single line (do not use correction fluid)
• Use approved abbreviations only
• Maintain resident confidentiality, do not discuss resident information in public areas