Free CNA Basic Nursing Skills Practice Test 2026

    Imagine walking into your patient’s room. You’re not just checking boxes on a list; you’re the frontline of their comfort, their safety, and their recovery. Whether it’s taking a vital sign that catches a dangerous change or helping someone stand up for the first time in days, Basic Nursing Skills are the heartbeat of the CNA role.

    This isn’t just a small part of your exam—it’s the biggest part. Mastering these skills isn’t just about passing a test; it’s about becoming the kind of caregiver residents trust and facilities rely on.

    In this comprehensive guide, we will break down the 35-40% of your exam dedicated to these physical care tasks. From hygiene hacks to mobility mastery, we’ve got the strategies you need to succeed.

    💡 Quick Stat: Basic Nursing Skills typically accounts for 24-28 questions out of a standard 70-question exam. That makes it the single most heavily tested category!


    Understanding Basic Nursing Skills: Your Exam Blueprint

    Basic Nursing Skills encompasses the fundamental “hands-on” care you provide daily. This domain bridges the gap between medical knowledge and practical caregiving, covering everything from Activities of Daily Living (ADLs) like bathing to critical physiological monitoring like vital signs.

    Understanding the weight of this section is crucial for your study strategy. If you ace this section, you are well on your way to passing.

    Exam Weight Visualization – Topic Position

    pie showData title Basic Nursing Skills on the CNA Exam
    "Basic Nursing Skills" : 38
    "Other Exam Topics" : 62

    This chart shows that nearly two-fifths of your success hinges on these core tasks. Practically, this means you cannot afford to “sort of” know how to take a blood pressure or give a bed bath. You must know these procedures inside and out.

    Topic Structure Visualization – Subtopics

    flowchart TD
        MAIN["🎯 Basic Nursing Skills<br/><small>(38% of Exam)</small>"]
    
        MAIN --> ST1["📌 Hygiene & Grooming<br/><small>High Frequency</small>"]
        MAIN --> ST2["📌 Vital Signs & Monitoring<br/><small>High Frequency</small>"]
        MAIN --> ST3["📌 Mobility & Transfers<br/><small>High Frequency</small>"]
        MAIN --> ST4["📋 Nutrition & Hydration<br/><small>Medium Frequency</small>"]
        MAIN --> ST5["📋 Elimination & Toileting<br/><small>Medium Frequency</small>"]
        MAIN --> ST6["📄 Restorative Care<br/><small>Low Frequency</small>"]
    
        style MAIN fill:#1976D2,color:#fff,stroke:#1565C0
        style ST1 fill:#c8e6c9,stroke:#4CAF50
        style ST2 fill:#c8e6c9,stroke:#4CAF50
        style ST3 fill:#c8e6c9,stroke:#4CAF50
        style ST4 fill:#fff3e0,stroke:#FF9800
        style ST5 fill:#fff3e0,stroke:#FF9800
        style ST6 fill:#f5f5f5,stroke:#9e9e9e

    Notice that three subtopics—Hygiene, Vital Signs, and Mobility—are flagged as High Frequency. These are your “money makers.” Focus your energy here first, as they are guaranteed to appear multiple times on both the written and skills exams.

    📋 Study Strategy: Prioritize the green nodes. If you are short on time, master Vital Signs and Body Mechanics before worrying about Restorative Care or prosthetics.

    More Basic Nursing Skill Practice Tests

    Test NameNumber of Questions
    Basic Nursing skill Practice Test – Part 160
    Basic Nursing skill Practice Test – Part 260
    Basic Nursing skill Practice Test – Part 360
    Basic Nursing skill Practice Test – Part 460
    Basic Nursing skill Practice Test – Part 560

    High-Yield Cheat Sheet: Basic Nursing Skills at a Glance

    Before we dive into the deep details, let’s look at the big picture. This cheat sheet organizes the massive amount of information into digestible pillars.

    mindmap
      root((Basic Nursing Skills))
        Hygiene & Care
          Clean to Dirty
          Oral Care
          Skin Integrity
          Perineal Care
        Vital Signs
          BP (120/80)
          Pulse (60-100)
          Resp (12-20)
          Temp (98.6°F)
        Mobility
          Body Mechanics
          Gait Belt
          Transfers
          Positioning
        Nutrition
          Swallowing Safety
          I&O Recording
          Fluid Balance
        Elimination
          Specimen Collection
          Catheter Care
          Bedpan Use

    Quick Reference Summary

    Hygiene & Personal Care

    This pillar focuses on maintaining skin integrity, cleanliness, and grooming. The golden rule is moving from the cleanest areas (face) to the dirtiest (perineum/anus) to prevent infection. Exam questions often test the order of washing or specific safety steps for unconscious residents during oral care.

    Vital Signs & Monitoring

    This is the objective assessment of health. You need to know normal ranges by heart and exactly when to report abnormalities. Accuracy is key—remember that irregular pulses must be counted for a full 60 seconds, not just 15 or 30.

    Mobility, Positioning & Transfers

    This covers safely moving residents to prevent contractures and maintain circulation. Safety is the theme here: locking wheels, using gait belts, and using your own body mechanics correctly (bend knees, straight back) to protect yourself and the resident.

    Nutrition & Hydration

    Assisting residents with intake to meet nutritional needs. The main testing points are choking prevention (placing food on the strong side of the mouth) and accurately measuring Intake and Output (I&O). Remember: 30ml equals 1 ounce.

    Elimination & Specimen Collection

    Assisting with bowel and bladder needs. Infection control is massive here. Key points include keeping catheter bags below bladder level to prevent backflow and following specific protocols for collecting “clean catch” urine or stool samples.


    How Basic Nursing Skills Connects to Other Exam Topics

    The CNA exam is not a collection of isolated facts; it is a web of connected responsibilities. Understanding how Basic Nursing Skills links to other domains will help you answer complex scenario questions.

    flowchart TD
        subgraph CORE["Basic Nursing Skills"]
            A["Hygiene Care"]
            B["Vital Signs"]
            C["Mobility/Transfers"]
        end
    
        subgraph RELATED["Connected Topics"]
            D["Infection Control"]
            E["Safety/ Emergencies"]
            F["Communication"]
            G["Role/ Responsibility"]
        end
    
        A -->|"Handwashing before care"| D
        B -->|"Reporting abnormal data"| G
        C -->|"Body mechanics prevents injury"| E
        A -->|"Explaining procedure"| F
        C -->|"Using gait belt"| E
    
        style CORE fill:#e3f2fd,stroke:#1976D2
        style RELATED fill:#f5f5f5,stroke:#757575

    Why These Connections Matter

    • Safety First: Mobility questions are often actually Safety questions. They test if you know to lock wheelchair wheels (a safety step) before moving a resident.
    • Infection Control: You cannot perform a hygiene or catheter care skill without applying Standard Precautions. Handwashing is the bridge between these topics.
    • Communication: The exam will often ask, “What do you do before taking a blood pressure?” The answer is introducing yourself and explaining the procedure—a Communication skill applied to a Nursing Skill.

    🎯 Exam Tip: When you see a question about Basic Nursing Skills, ask yourself: “Is there also a safety or infection control step hidden here?”


    What to Prioritize: High-Yield vs. Supporting Details

    Not all facts are created equal. To study efficiently, you need to treat high-yield concepts differently than background details.

    quadrantChart
        title Study Priority Matrix
        x-axis "Low Complexity" --> "High Complexity"
        y-axis "Low Yield" --> "High Yield"
        quadrant-1 "Master These"
        quadrant-2 "Know Well"
        quadrant-3 "Basic Awareness"
        quadrant-4 "Review If Time"
        "Normal Vitals Ranges": [0.25, 0.85]
        "Body Mechanics": [0.35, 0.90]
        "Clean to Dirty Order": [0.2, 0.95]
        "Gait Belt Use": [0.3, 0.9]
        "Choking Safety": [0.25, 0.85]
        "Positioning Names": [0.5, 0.6]
        "Specimen Collection": [0.75, 0.5]
        "ROM Exercises": [0.6, 0.4]
        "Cast Care": [0.7, 0.3]
        "Prosthetic Care": [0.65, 0.25]

    Priority Table

    PriorityConceptsStudy Approach
    🔴 Must KnowNormal Vitals Ranges, Body Mechanics, Reporting Abnormals, Clean-to-Dirty Hygiene, Transfer Safety (lock wheels), Choking Prevention, I&O Measurement.Master completely. Memorize numbers. Drill steps until automatic.
    🟡 Should KnowPurpose of Positions (Fowler’s vs. Trendelenburg), Specimen Collection steps, Active vs. Passive ROM, Bed Making principles, Foot Care (drying toes).Understand well. Know why we do it, not just how.
    🟢 Good to KnowCast Care observations, Prosthetic application, Ostomy basics, Hair care specifics.Review basics. Don’t spend hours here unless you have the “Must Knows” down.
    AwarenessBlood Glucose Monitoring (scope varies by state), Oxygen therapy (observation only).Skim if time permits. Know your specific state’s rules.

    Strategic Insight: If you are struggling to remember the difference between Sims’ and Lateral position, don’t panic. That’s “Should Know.” But if you don’t know that a BP of 180/120 requires immediate reporting, you are in trouble. Prioritize the red zone.


    Essential Knowledge: Basic Nursing Skills Deep Dive

    1. Hygiene & Personal Care

    Hygiene is about more than looking good; it is about preserving skin integrity (preventing bedsores) and dignity. The exam tests your ability to do this safely and respectfully.

    Key Concepts:
    The overarching principle of hygiene is Clean to Dirty. You always start with the face (eyes outer to inner) and neck, move down to the arms, chest, and legs, and finish with the perineal area and anus. This prevents spreading bacteria from the anal area to the eyes or mouth.

    Exam Focus:

    • Perineal Care: Wipe from front to back (urethra to anus) to prevent UTIs.
    • Oral Care: For unconscious residents, place them on their side to prevent choking/aspiration. Never put fingers in the mouth if the resident has a seizure risk or is clenching teeth.
    • Temperature of Water: Always test water temperature against your inner wrist (where skin is most sensitive) before washing the resident.

    💡 Memory Tip: Use the P.R.E.P. acronym before every bath:

    • Privacy (Close curtains).
    • Respect (Cover with a bath blanket).
    • Explain (Tell them what you are doing).
    • Position (Comfortable and safe).

    2. Measuring & Recording Vital Signs

    Vital signs are the only objective data you collect. They tell the story of what is happening inside the body.

    Key Concepts:
    You must know the equipment (stethoscope, sphygmomanometer, thermometer) and the sites. Accuracy is critical; a small error can lead to wrong medical treatment.

    Comparison Table: Vitals – Normal Adult Ranges

    Vital SignNormal RangeEquipment UsedImmediate Report Thresholds (General)
    Temperature98.6°F (37°C)Oral, Rectal, Axillary (electronic or glass)> 100°F (38°C) or < 95°F (35°C)
    Pulse60 – 100 bpmStethoscope (apical) or fingers (radial)< 60 or > 120, or irregular
    Respirations12 – 20 bpmWatch chest rise/fall, hand on wrist< 10 or > 24, or difficulty breathing
    Blood Pressure120/80 mmHgStethoscope + BP cuff (sphygmomanometer)> 160 systolic or > 100 diastolic (varies)

    Exam Focus:

    • Irregular Pulse: If a pulse feels irregular, you must count for a full 60 seconds. Do not multiply a 15-second count by 4.
    • BP Technique: Do not take BP over clothing. The arm should be at heart level. Pump cuff up about 20-30 mmHg past where the pulse disappears.
    • Documentation: If you don’t document it, legally, you didn’t do it.

    💡 Memory Tip: “98.6 is the fix, Pulse 60-100 picks the mix, BP 120/80 feels great, Resp 12-20 is the pace.”

    3. Mobility, Positioning & Transfers

    This is the most physically demanding part of the job and carries the highest risk of injury for both you and the resident. The exam focuses heavily on safety protocols.

    Key Concepts:
    Body mechanics involves using the strong muscles of your legs and keeping your back straight. Transfers require planning—locking wheels, adjusting bed height, and using assistive devices.

    Comparison Table: Transfer Types

    Transfer TypeResident CapabilityEquipment NeededSafety Checks
    Stand-PivotCan bear weight, has good trunk controlGait belt, wheelchairLock wheels, place feet apart, pivot on strong leg.
    Mechanical (Hoyer) LiftCannot bear weight or assistHoyer lift, sling, 2 CNAs (usually)Check sling hooks, ensure base is open and locked.
    Assistive (Walker)Weak but can bear weight and walkWalkerEnsure rubber tips are intact, check height.

    Exam Focus:

    • Gait Belt: Place it snugly over the resident’s clothing, not over skin, and around the waist.
    • Range of Motion (ROM): Move joints smoothly to the point of resistance, never pain. Support the joint above and below.
    • Positioning: Use pillows to support bony prominences and prevent pressure ulcers.

    4. Nutrition & Hydration

    You are the gatekeeper of your resident’s intake. Dehydration is a common and dangerous issue in facilities.

    Key Concepts:
    Feeding a resident is a slow, respectful process. It involves checking for swallowing difficulties (dysphagia) to prevent aspiration pneumonia.

    Exam Focus:

    • Swallowing Safety: Check the mouth for “pocketing” food (storing it in the cheek). Place food on the strong side of the mouth (the unaffected side for stroke survivors).
    • Fluid Restrictions: If a resident is on fluid restriction, do not give them extra water just because they ask. Offer ice chips or a damp cloth instead.
    • I&O: Record everything. If a resident drinks half an 8-ounce cup, record 120ml (or 4 oz).

    5. Elimination & Specimen Collection

    This area requires strict infection control.

    Key Concepts:
    Normal elimination patterns vary, but sudden changes (constipation, diarrhea) must be reported. When handling specimens, you must ensure the sample is clean and not contaminated.

    Exam Focus:

    • Catheter Care: Keep the bag below the level of the bladder (never on the bed or lap) to prevent backflow and infection. Secure the tubing to the thigh to prevent pulling.
    • Specimens: For a “clean catch” urine, the resident cleans the perineal area and urinates a small amount into the toilet before catching the mid-stream sample in the cup.

    Common Pitfalls & How to Avoid Them

    Even good students fall for these traps. Let’s expose them so you can avoid them.

    ⚠️ Pitfall #1: The “Fresh Breath” Trap
    THE TRAP: Students think brushing teeth is just about cosmetic appearance or removing food.
    THE REALITY: Oral care is primarily infection control to prevent pneumonia (aspiration of bacteria).
    💡 QUICK FIX: Remember: “Oral care prevents pneumonia.”

    ⚠️ Pitfall #2: The “Quick Check” Vitals
    THE TRAP: Counting the pulse for only 15 seconds without multiplying by 4, or counting an irregular pulse for only 15 seconds.
    THE REALITY: An irregular pulse must be counted for a full 60 seconds for accuracy.
    💡 QUICK FIX: If it’s irregular, “One minute is the limit.”

    ⚠️ Pitfall #3: The “Higher is Better” Bed
    THE TRAP: Raising the bed to a height comfortable for the CNA without considering the resident’s safety, and leaving it high when you leave.
    THE REALITY: The bed should be at the lowest position (locked) when leaving the room to prevent falls.
    💡 QUICK FIX: “Lowest when leaving, elbow when receiving.”

    ⚠️ Pitfall #4: Confusing “Weak Side” vs “Strong Side”
    THE TRAP: Approaching a resident or placing food on their weak side (e.g., the side affected by a stroke).
    THE REALITY: Always approach from the strong side (unaffected side) and place food/utensils on the strong side.
    💡 QUICK FIX: “Serve the strong, support the weak.”

    ⚠️ Pitfall #5: The “Water Temperature” Guess
    THE TRAP: Assuming water is warm enough based on touch or just looking at the steam.
    THE REALITY: Always check water temperature with a bath thermometer (usually 105-110°F) or against your inner wrist. Never ask the resident to test it for you.
    💡 QUICK FIX: “Test on the wrist, avoid the risk.”

    🎯 Remember: The exam answers are based on ideal care, not shortcuts. Never skip the safety check to save time in a test question.


    How This Topic Is Tested: Question Patterns

    Recognizing the pattern of the question is half the battle.

    📋 Pattern #1: The “Order of Operations”
    WHAT IT LOOKS LIKE: A question asking for the correct sequence of steps in a procedure, such as washing hands or transferring a resident.
    EXAMPLE STEM:
    “When preparing to bathe a resident, which of the following is the correct order of actions?”
    SIGNAL WORDS: “First,” “Next,” “Then,” “Finally,” “Initial,” “Prior to.”
    YOUR STRATEGY:

    1. Identify the goal of the procedure (e.g., infection prevention for handwashing).
    2. Look for the logical starting point (e.g., identifying the resident).
    3. Check safety steps (locking wheels, raising bed).
    4. Eliminate answers that skip safety or privacy.
      ⚠️ TRAP TO AVOID: Options that look correct technically but skip the “identify the resident” or “check water temp” safety steps.

    📋 Pattern #2: The “Vital Sign Interpretation”
    WHAT IT LOOKS LIKE: A scenario providing a set of vital signs, asking what the CNA should do next.
    EXAMPLE STEM:
    “A resident has a blood pressure reading of 180/110. The previous reading was 120/80. What is the CNA’s best action?”
    SIGNAL WORDS: “Action,” “Report,” “Re-check,” “Assessment data,” “Normal range.”
    YOUR STRATEGY:

    1. Analyze the numbers against normal ranges.
    2. Look for change or severity.
    3. If out of range or significantly changed, the answer is almost always “Report to the nurse immediately.”
    4. Do not choose “Wait and see” or “Re-check in an hour” if the value is critical.
      ⚠️ TRAP TO AVOID: Trying to treat the symptom (e.g., offering a drink for high BP) instead of reporting it.

    📋 Pattern #3: The “Scope of Practice” Safety Check
    WHAT IT LOOKS LIKE: A question asking if the CNA can perform a specific task related to basic skills.
    EXAMPLE STEM:
    “The nurse asks the CNA to irrigate a resident’s wound. Can the CNA perform this task?”
    SIGNAL WORDS: “Can the CNA,” “Outside the scope,” “Delegate,” “Responsibility.”
    YOUR STRATEGY:

    1. Recall the “Nurse vs. CNA” division.
    2. Anything sterile/invasive is usually RN.
    3. Anything maintenance/hygiene/observation is CNA.
    4. If unsure, err on the side of “I cannot do this; I must report it to the nurse.”
      ⚠️ TRAP TO AVOID: Confusing “doing” a task (RN) with “observing/reporting” findings from a task (CNA).

    🎯 Pattern Recognition Tip: If a question asks “What is the nurse’s responsibility?” vs “What is the CNA’s responsibility?”, stop and think. The CNA collects data; the Nurse evaluates it.


    Key Terms You Must Know

    Vocabulary questions can be tricky because they often hinge on a single word. Here are the heavy hitters.

    TermDefinitionExam Tip
    Body MechanicsUsing the body efficiently to prevent injury to self and resident.Critical for safety questions; think “bend knees, straight back.”
    DysphagiaDifficulty swallowing.High risk for choking/aspiration. Requires diet modification (thickened liquids).
    EdemaSwelling caused by excess fluid in tissues.Indicates circulatory or kidney issues; usually checked by pressing a finger into the skin.
    HypertensionHigh blood pressure.Vital sign abnormality that requires immediate reporting.
    OrthopneaDifficulty breathing when lying flat.Requires positioning in Fowler’s/Semi-Fowler’s (sitting up) to breathe easier.
    Perineal CareCleaning the genital and anal area.Infection control hub; specific “clean to dirty” technique (front to back).
    ContractureShortening of muscles/tendons due to lack of movement.Key reason for doing ROM exercises and positioning regularly.
    Fowler’s PositionSitting up, head of bed 45-60 degrees.Standard position for eating and breathing.
    AphasiaInability to understand or produce speech.Communication barrier requiring alternative strategies (pointing, nodding).
    Intake & Output (I&O)Measurement of fluids entering and leaving the body.Key indicator of kidney function and hydration. 1 oz = 30 ml.

    Red Flag Answers: What’s Almost Always Wrong

    Use these red flags to quickly eliminate wrong answers on multiple-choice questions.

    🚩 Red FlagExampleWhy It’s Wrong
    Task Abandonment“Ignore the call light and finish your current task.”Safety is always priority; call lights must be answered.
    Diagnosis“The resident appears to have a urinary tract infection.”CNAs observe; RNs/NPs diagnose. Never give a medical diagnosis.
    Unsafe Adjustment“Adjust the oxygen flow rate to 4L/min.”Adjusting medical equipment orders is outside CNA scope.
    Invalidating“Tell the resident the pain is just in their head.”Pain is what the resident says it is. Never dismiss a report of pain.
    Unsafe Fluid“Encourage the resident to drink as much water as possible right now.”If on fluid restriction, this violates orders.
    Incorrect Hygiene“Start washing the resident’s perineal area first.”Always wash cleanest (face) to dirtiest (perineum).
    Delayed Reporting“Wait until the end of your shift to report the low blood pressure.”Critical changes must be reported immediately.

    Practice Application: If you see two answers that seem okay, look for a red flag in one of them. The one without the red flag is usually correct.


    Myth-Busters: Common Misconceptions

    Let’s clear up some confusion that might be holding you back.

    Myth #1: “If a resident refuses a bath, you should just try again later when they are less tired.”
    THE TRUTH: While timing matters, you should first try to find out why they are refusing (fear, cold, modesty) and address the concern. Rescheduling without investigation might lead to hygiene issues.
    📝 EXAM IMPACT: Choosing “skip the bath” instead of “investigate the cause and encourage” leads to wrong answers.

    Myth #2: “Taking a rectal temperature is the standard way to get the most accurate reading.”
    THE TRUTH: While accurate, rectal temperatures are invasive. For an alert adult, oral is preferred; axillary is the safest/most common CNA method. Rectal is usually reserved for specific situations.
    📝 EXAM IMPACT: Selecting rectal as the routine first choice for an alert, stable adult is incorrect.

    Myth #3: “You should use lotion on every resident’s back every time you give a bed bath.”
    THE TRUTH: Lotion should only be applied to dry, intact skin. You should never apply lotion over broken skin, rashes, or red areas without a specific order (it traps bacteria).
    📝 EXAM IMPACT: Choosing “apply lotion” without checking skin integrity first is a common error.

    Myth #4: “If a resident’s blood pressure is high, you should have them lie down and relax immediately.”
    THE TRUTH: While relaxation is good, the CNA’s primary and immediate action is to report the finding to the nurse. Treatments are ordered by the nurse.
    📝 EXAM IMPACT: Choosing a nursing intervention (treatment) over the CNA role (reporting) is a scope of practice error.

    Myth #5: “It’s okay to help a resident eat faster if you are in a hurry.”
    THE TRUTH: Never rush a resident. Rushing increases the risk of choking and aspiration.
    📝 EXAM IMPACT: Selecting an answer that suggests hurrying or feeding quickly is automatically wrong.

    💡 Bottom Line: Always stick to the “ideal” standard of care. The exam does not reward shortcuts, even if they seem practical in the real world.


    Apply Your Knowledge: Practice Scenarios

    Let’s put your knowledge to the test with some realistic scenarios.

    Scenario #1: The Vital Sign Change
    Situation: You measure your resident’s blood pressure at 9:00 AM. It is 110/70. At 1:00 PM, it reads 180/110. The resident says they feel fine.

    Think About:

    • Is this within normal range?
    • Did the resident’s condition change significantly?
    • What is your role vs. the nurse’s role?

    Key Principle: Reporting significant changes. A sudden spike of 70 points in the systolic number is critical.

    See Application:

    • Wrong: Re-check it in 20 minutes to see if it goes down.
    • Wrong: Ask the resident if they are stressed because the BP machine is probably wrong.
    • Correct: Report the reading to the nurse immediately.

    Scenario #2: The Weak Side Feeding
    Situation: Mr. Jones had a stroke and has weakness on his right side. You are about to feed him lunch.

    Think About:

    • Which side of his mouth is affected?
    • Where should you place the food?
    • Where should you stand?

    Key Principle: Utilizing the strong side for safety and autonomy.

    See Application:

    • Wrong: Place food on his right side to encourage him to use it.
    • Wrong: Stand on his right side so you can see him eat.
    • Correct: Place food in his mouth on the left (strong) side and approach from the left.

    Scenario #3: The Transfer
    Situation: You need to move Mrs. Lee from the bed to a wheelchair. She can bear weight but is unsteady.

    Think About:

    • What equipment do you need?
    • What safety checks must happen before she moves?

    Key Principle: Transfer safety mechanics.

    See Application:

    • Wrong: Grab her under her armpits to lift her out of bed.
    • Wrong: Lower the bed to the lowest setting before transferring (too hard on your back).
    • Correct: Raise bed to waist level, lock wheelchair wheels, apply gait belt, and ask her to pivot.

    Frequently Asked Questions

    Q: How do I count respirations without the resident knowing?

    To get an accurate reading, residents often alter their breathing if they know you are counting. Keep your hand on the pulse site (wrist) as if you are still checking their pulse. Watch the chest rise and fall. One rise and one fall = one respiration. Count for a full 60 seconds if the rhythm is irregular.

    Q: What exactly is the “clean to dirty” rule in hygiene?

    Start with the face (cleanest area), specifically eyes (outer to inner). Move to neck, arms, chest, and abdomen. Then wash legs. Wash the perineal area (genitals) and anal area (dirtiest) last. Use a separate washcloth for the perineal area or change washcloths midway to avoid spreading fecal bacteria.

    Q: What if I can’t hear the blood pressure with the stethoscope?

    Don’t panic. Do not pump the cuff up again immediately; wait 1-2 minutes. Reposition the cuff or the stethoscope slightly. Check that the equipment is working and the stethoscope is in your ears correctly. If you still can’t get it, ask a colleague to verify or report it to the nurse.

    Q: How do I record Intake and Output (I&O) if the resident vomits?

    Estimate the volume of emesis (vomit) as best you can (e.g., “250 ml emesis”). Record it as “output.” You must also describe the appearance (color, consistency) in your notes. Report it to the nurse immediately, as large amounts of vomiting can lead to dehydration.

    Q: Why is a gait belt necessary for transfers?

    A gait belt provides a secure handhold for the CNA. It prevents you from grabbing the resident’s arm or clothing, which can cause shoulder injury or dislocation. It allows you to guide the resident’s center of gravity safely during a pivot or transfer.

    Q: Can I use hot water bottles or heating pads for a resident’s comfort?

    Generally, NO. These are high burn risks, especially for elderly residents with thin skin, poor circulation, or diabetes (who may not feel the burn). Use warm blankets instead. If a heating pad is specifically ordered by a doctor, never apply it directly to the skin; always use a cover and check the skin frequently.


    Because this topic is so broad (38% of the exam!), a generic study plan won’t cut it. You need a targeted approach.

    Phase 1: Build Foundation (2.5 Hours)

    Focus Areas:

    • Vital Signs (Normal Ranges, Equipment).
    • Hygiene (Clean to Dirty sequence).
    • Terminology (Dysphagia, Edema, etc.).

    Activities:

    • Create flashcards for the normal ranges of BP, Pulse, Resp, and Temp. Drill these until you can say them in your sleep.
    • Practice “The Order of Washing” on a doll or pillow: Face -> Arms -> Chest -> Legs -> Back -> Perineum.
    • Write out the definitions for the vocabulary list from this guide.

    Phase 2: Deepen Understanding (3.5 Hours)

    Focus Areas:

    • Mobility & Body Mechanics.
    • Transfer Safety (Gait belt, Hoyer lift).
    • Choking Prevention & Nutrition.

    Activities:

    • Visual Mapping: Draw a human body and label all the positions (Fowler’s, Supine, Prone, Sims’, Trendelenburg). Note what each position is used for.
    • Error Spotting: Watch YouTube videos of “CNA Skills” and press pause every 10 seconds. Ask yourself: “Did they lock the wheels?” “Did they check the water temp?”
    • Focus on the why: Why don’t we lift under the arms? (Injury risk). Why do we place food on the strong side? (Choking risk).

    Phase 3: Apply & Test (2.5 Hours)

    Focus Areas:

    • Scenario-based questions.
    • Recognizing “Red Flag” answers.
    • Scope of Practice boundaries.

    Activities:

    • Take practice quizzes specifically on “Basic Nursing Skills.”
    • For every question you get wrong, identify the pattern (e.g., “I missed this because I didn’t report to the nurse”).
    • Review the “Common Pitfalls” and “Red Flag” sections of this guide daily during this phase.

    Phase 4: Review & Reinforce (1.5 Hours)

    Focus Areas:

    • High-yield quick review.
    • Self-assessment.

    Activities:

    • Teach a friend or family member how to take a blood pressure (using the cuff and stethoscope) or how to move a patient safely using body mechanics. Teaching is the best way to learn.
    • Final mental run-through of the P.R.E.P. and C.L.E.A.N. mnemonics.

    ✅ You’re Ready When You Can:

    • [ ] List the normal ranges for Temperature, Pulse, Respiration, and Blood Pressure without looking.
    • [ ] Explain the difference between “clean” and “sterile” technique in the context of a urine specimen.
    • [ ] Draw a diagram of where a gait belt is placed on a resident.
    • [ ] State the “clean to dirty” washing order perfectly.
    • [ ] Identify the correct course of action if a resident has a BP of 180/100 (Report vs. Re-check).
    • [ ] Explain why a catheter bag must be kept below bladder level.

    🎯 Study Tip: Spend the most time on Vitals and Mobility. These are the hardest skills to fake your way through and the most dangerous if done wrong.


    Skills Test Connection

    While this guide focuses on the written exam, Basic Nursing Skills are the core of the Clinical Skills Evaluation.

    SkillWritten Exam ConnectionCritical Success Factor
    HandwashingSafety/Infection Control questions20 seconds friction; turn off faucet with paper towel.
    Blood PressureVital signs interpretationDon’t cuff over clothing; pump 20-30mmHg past pulse disappearance.
    Denture CarePersonal HygieneStore dentures in a labeled cup (never in a tissue). Clean over basin with water.
    BedpanElimination“Wipe front to back.” Perineal care after removal. Check skin for redness.
    Transfer (Bed to Chair)Mobility/Body MechanicsLock wheels, raise bed, place gait belt, ask resident to pivot.
    FeedingNutrition/SwallowingCheck for swallowing difficulty. Never rush. Place food in strong side.
    Range of MotionRestorative CareMove joints smoothly to point of resistance, not pain. Support the joint.

    Study Integration: When you practice the physical skill, quiz yourself on the written concepts. For example, while practicing the transfer, ask yourself, “What position should the bed be in for my back safety?” (Hip level).


    Wrapping Up: Your Basic Nursing Skills Action Plan

    Basic Nursing Skills is the engine of the CNA exam. It is a large, varied, and critical section. By focusing on the high-yield pillars—Hygiene, Vitals, and Mobility—and understanding the “why” behind safety protocols, you will be prepared for even the trickiest questions.

    Remember to use the Mnemonics (P.R.E.P., C.L.E.A.N.), watch out for the Red Flags, and always prioritize Reporting over treating.

    You have the knowledge. Now, go practice those ranges and perfect that body mechanics. You’ve got this!

    🌟 Final Thought: The CNA exam doesn’t just test what you know; it tests if you can care safely. Stick to the standards, keep the resident safe, and the answers will follow.

    More Practice Tests

    CNA Practice Test
    Basic Nursing Skills (you are here)
    Basic Restorative Skills
    Personal Care Skills
    Activities of Daily Living

    Infection Control
    Safety & Emergency Procedures
    Communication Skills
    Member of a Healthcare Team
    Emotional & Mental Health Needs

    Priorities and Priority Setting
    Data Collection and Reporting
    Care of Cognitively Impaired Residents
    End of Life Care
    Patient Rights