CNA skills test: the 22 skills and how you are scored

The CNA skills test is a practical evaluation, not a written one. You perform 3 to 5 randomly selected skills on a live person or a simulated client while an evaluator scores each step against a checklist. Missing a critical step fails the skill, even if everything else was perfect.

The skills most often evaluated

• Hand hygiene
• Measuring radial pulse
• Measuring respirations
• Measuring blood pressure
• Measuring temperature
• Measuring weight
• Bed bath
• Mouth care
• Denture care
• Perineal care
• Bedpan
• Dressing a client with weakness
• Feeding a client
• Foot care
• Position on side
• Range of motion
• Transfer bed to wheelchair
• Ambulate with gait belt
• Catheter care
• Donning and removing PPE
• Post-mortem care
• Specimen collection

How scoring works

Each skill has a list of steps. Some are critical: if you miss one, the whole skill fails. The rest are scored, but a missed non-critical step can still cost you. The evaluator is not judging whether you are good at your job. They are watching whether you follow the sequence safely and whether you protect the client's dignity and privacy.

The five mistakes that fail people

1. Forgetting hand hygiene. Before and after every skill. It is the cheapest point on the test and the most commonly missed.
2. Not providing privacy. Door closed or curtain drawn, and the client covered. Evaluators mark it every time.
3. Moving a client who has fallen. Stay, call for help, do not lift.
4. Forcing a joint during range of motion. Stop at pain and report.
5. Talking instead of doing. You can explain what you are doing, but the steps have to be performed. Narrating a step you did not do earns nothing.

How to practise without a partner

Say the steps out loud in order, with your hands moving, on a pillow or a chair. The goal is to build the sequence into muscle memory, not to memorise a list. Then have someone read the checklist while you perform it once, cold, without looking at your notes. That single rehearsal exposes the step you always skip.

What the skills test does not cover

It does not test clinical judgement, medication, or diagnosis. It tests safe, respectful, repeatable care. That is good news: it is the most trainable part of the whole certification.

Questions people also ask

How many skills do I perform?

Usually 3 to 5, randomly selected from the state list.

Can I fail one skill and still pass?

In most states, failing a critical step on any selected skill fails the skills portion. Check your state's rules.

Do I need a real client?

Most states use a trained actor or a classmate. Follow the instructions on your authorization to test.