Georgia CNA skills test

Hand hygiene

1. Address client by name and introduce self to client by name

2. Turns on water at sink

3. Wets hands and wrists thoroughly

4. Applies soap to hands

5. Lathers all surfaces of wrists, hands, and fingers producing friction for at least 20 seconds keeping hands lower than elbows and the fingertips down! don't miss

6. Cleans fingernails by rubbing fingertips against palms of the opposite hand

7. * Rinse all surfaces of wrists, hands, and fingers keeping hands lower than the elbows and the fingertips down

8. Uses clean dry paper towel/towels to dry all surfaces of hands, wrists, and fingers then disposes of paper towel/towels into waste container

9. Uses clean dry paper towel/towels to turn off faucet then disposes of paper towel/towels into waste container or uses knee/foot control to turn off faucet.

10. Does not touch inside of sink at any time.

Applies one knee-high stocking

1. Explains procedure speaking clearly, slowly, and directly maintaining face to face contact whenever possible

2. Privacy is provided with a curtain, screen or door

3. Client is in supine position (lying down in bed) while stocking is applied

4. Turns stocking inside-out at least to the heel

5. Places stocking over toes, foot, and heel

6. Pulls top of stocking over foot, heel, and leg

7. Moves foot and leg gently and naturally avoiding force and over-extension of limb and joints

8. Finishes procedure with no twists, or wrinkles and heel of stocking if present is over heel and opening in toe area (if present) is either over or under toe area

9. Signaling device is within reach and bed is in low position

10. After completing skill wash hands

Assists to ambulate using transfer belt

1. Explains procedure speaking clearly slowly and directly maintaining face to face contact whenever possible

2. Before assisting to stand client is wearing shoes

3. Before assisting to stand be is at a safe level

4. Before assisting to stand checks and or locks bed wheels

5. Before assisting to stand client is assisted to sitting position with feet flat on floor

6. Before assisting to stand applies transfer belt securely at the waist over clothing/gown

7. Before assisting to stand provides instructions to enable client to assist in standing including prearranged signal to alert client to begin standing

8. Stands facing client positioning self to ensure safety of candidate and client during transfer. Counts to 3 or other prearranged signal to alert client to begin standing

9. On signal gradually assists client to stand by grasping transfer belt on bother sides with an upward grasp (candidates hands are in upward position) and maintaining stability of clients legs

10. Walks slightly behind and to one side of client for a distance of ten feet while holding onto the belt

11. After ambulation assists client to bed and removes transfer belt

12. Signaling device is within reach and bed is in low position

13. After completing skill wash hands

Assists with use of bedpan

1. Explains procedure speaking clearly slowly and directly maintaining face to face contact whenever possible

2. Privacy is provided with a curtain, screen or door

3. Before placing bedpan lowers head of bed

4. Puts on clean gloves before handling bedpan

5. Places bedpan correctly under clients buttocks

6. Removes and disposes of gloves without contaminating self into waste container and washes hands.

7. After positioning client on bedpan and removing gloves, raises head of bed

8. Toilet tissue is within reach

9. Hand wipe is within reach and client is instructed to clean hands with hand wipe when finished

10. Signaling device is within reach and client is asked to signal when finished

11. Puts on clean gloves before removing bedpan

12. Head of bed is lowered before bedpan is removed

13. Avoids overexposure of client

14. Empties and rinses bedpan and pours rinse into toilet

15. After rinsing bedpan places bedpan in designated dirty supply area

16. After placing bedpan in designated dirty supply area removes and disposes of gloves without contaminating self into waste container and washes hands

17.Signaling device is within reach and bed is in low position

Cleans upper or lower denture

1. Puts on clean gloves before handling denture

2. Bottom of sink is lined and or sink is partially filled with water before denture is held over sink

3. Rinses denture in moderate temperature running water before brushing them

4. Applies toothpaste to toothbrush

5. Brushes surfaces of denture

6. Rinses surfaces of denture under moderate temperature running water

7. Before placing denture into cup rinses denture cup and lid

8. Places denture in denture cup with moderate temperature water/solution and places lid on cup

9. Rinses toothbrush and places in designated toothbrush basin/container

10. Maintains clean technique with placement of toothbrush and and denture

11. Sink liner is removed and disposed of appropriately and or sink is drained.

12. After rinsing equipment and disposing of sink liner removes and disposes of gloves without contaminating self into waste container and washes hands

Counts and records radial pulse

1. Explains procedure speaking clearly slowly and directly maintaining face to face contact whenever possible

2. Places fingertips on thumb side of clients wrist to locate radial pulse

3. Count beats for one full minute

4. Signaling device is within reach

5. Before recording washes hands

6. * After obtaining pulse by palpating in radial artery position records pulse rate within plus or minus 4 beats of evaluators reading

Counts and records respirations

1. Explains procedure for testing purposes speaking clearly, slowly, and directly maintaining face to face contact whenever possible

2. Counts respirations for one full minute

3, signaling device is within reach

4. Washes hands

5. Records respiration rate within plus or minus 2 breaths of evaluators reading

Donning and removing PPE gown and gloves

1. Picks up gown and unfolds

2. Facing the back opening of the gown places arms through each sleeve

3. Fastens the neck opening

4. Secures gown at waist making sure that back of clothing is covered by gown as much as possible

5. Puts on gloves

6. Cuffs of gloves overlap cuffs of gown

7. Before removing gown with one gloved hand grasps the other glove at the palm remove glove

8. Slips fingers from ungloved hand underneath cuff of remaining glove at wrist and removes glove turning it inside out as it is removed

9. Disposes of gloves into designated waste container without contaminating self

10. After removing gloves unfastens gown at neck and waist

11. After removing gloves removes removes gown without touching outside of gown

12. While removing gown holds gown away from body without touching the floor, turns gown inward and keeps it inside out

13. Disposes of gown in designated container without contaminating self

14. After completing skill washes hands

Dresses client with affected weak right arm

1. Explains procedure speaking clearly slowly and directly maintaining face to face contact whenever possible

2. Privacy is provided with a curtain screen or door

3. Asks which shirt he/she would like to wear and dresses him/her in shirt of choice

4. While avoiding overexposure of client removes gown from the unaffected side and disposes of gown into soiled linen container

5. Assists to put the right (affected/weak) arm through the right sleeve of the shirt before placing garment on left (unaffected) arm

6. While putting on shirt moves body gently and naturally avoiding force and over extension of limbs and joints

7. Finishes with clothing in place

8. Signaling device is within reach and bed is in low position

9. After completing skill washes hands

Feeds client who cannot feed self

1. Explains procedure speaking clearly slowly and directly maintaining face to face contact whenever possible

2. Before feeding looks at name card on tray and asks client to state name

3. Before feeding client client is in an upright sitting position 75-90 degrees

4. Places tray where the food can be easily seen by client

5. Candidate cleans clients hands with hand wipe before beginning feeding

6. Candidate sits facing client during feeding

7. Tells client what foods are on tray and asks what client would like to eat first

8. Using spoon offers client one bite of each type of food on tray telling client the content of each spoonful

9. Offers beverage at least once during meal

10. Candidate asks client if they are ready for next bite of food or sip of beverage

11. At end of meal candidate cleans client's mouth and hands with wipes

12. Removes food tray and places tray in designated dirty supply area

13. Signaling device is left within reach

14. After completing skill washes hands

Gives modified bed bath (face and one arm hand and underarm)

1. Explains procedure speaking clearly slowly and directly maintaining face to face contact whenever possible

2. Privacy is provided with a curtain, screen or door

3. Removes gown and places in soiled linen container

4. Before washing checks water temperature for safety and comfort and asks client to verify comfort of water

5. Puts on clean gloves before washing client

6. Beginning with eyes, washes eyes with wet washcloth (no soap) using a different area of the washcloth for each stroke washing inner aspect to outer aspect then proceeds to wash face

7. Dries face with towel

8. Exposes one arm and places towel underneath arm

9. Applies soap to wet washcloth

10. Washes arm, hand and underarm keeping rest of body covered

11. Rinses and dries arm, hand, and underarm

12. Moves body gently and naturaly avoiding force and over-extension of limbs and joints

13. Puts clean gown on client

14. Empties, rinses and dries basin

15. After rinsing and drying basin, places basin in designated dirty supply area

16. Disposes of linen into soiled linen container

17. Avoids contact between candidate clothing and used linens

18. After placing basin in designated dirty supply area and disposing of used linen, removes and disposes of gloves without contaminating self into waste container and washes hands

19. Signaling device is within reach and bed is in low position

Measures and records blood pressure

1. Explains procedure speaking clearly slowly and directly maintaining face to face contact whenever possible

2. Before using stethoscope wipes bell/diaphragm and earpieces of stethoscope with alcohol

3. Clients arm is positioned with palm up and upper arm is exposed

4. Feels for brachial artery on inner aspect of arm at bend of elbow

5. Places blood pressure cuff snugly on clients upper arm with sensor/arrow over brachial artery site

6. Earpieces of stethoscope are in ears and bell diaphragm is over brachial artery site

7. Candidate inflates cuff between 160-180 mm Hg. If beat is heard immediately upon cuff deflation completely deflate cuff. Re-inflate cuff to no more than 200 mm of mercury

8. Deflates cuff slowly and notes the first sound (systolic reading) and last sound (diastolic reading) (If rounding needed measurements are rounded up to the nearest 2 mm of mercury

9. Removes cuff

10. Signaling device is within reach

11. Before recording, washes hands

12. After obtaining reading using BP cuff and stethoscope records both systolic and diastolic pressures each within plus or minus 9 mm of evaluators reading

Measures and records urinary output

1. Puts on clean gloves before handling bedpan

2. Pours the contents of bedpan into measuring container without spilling or splashing urine outside of container

3. Measures the amount of urine at eye level with container on flat surface

4. After measuring urine empties contents of measuring container into toilet

5. Rinses measuring container and pours rinse into toilet

6. Rinses bedpan and pours rinse into toilet

7. After rinsing equipment and before recording output removes and disposes of gloves without contaminating self into waste container and washes hands

8. Records contents of container within plus or minus 25 ml/cc of evaluators reading

Measures and records weight of ambulatory client

1. Explains procedure speaking clearly slowly and directly maintaining face to face contact whenever possible

2. Client has shoes on before walking to scale

3. Before client steps on scale candidate sets scale to zero then obtains clients weight

4. While client steps onto scale candidate stands next to scale and assists client if needed onto center of scale

5. While client steps off scale candidate stands next to scale and assists client if needed off scale before recording weight

6. Before recording washes hands

7. Records weight based on indicator on scale. Weight is within plus or minus 2 lbs of evaluators reading. If weight is in kg within .9 kg of evaluators reading

Performs modified passive range of motion (PROM) for one knee and one ankle

1. Explains procedure speaking clearly slowly and directly maintaining face to face contact whenever possible

2. Privacy is provided with a curtain, screen, or door

3. Instructs client to inform candidate if pain is experienced during exercise

4. Supports leg at knee and ankle while performing range of motion for knee

5. Bends the knee and then returns leg to clients normal position (extension/flexion) at least 3 times unless pain is verbalized

6. Supports foot and ankle close to bed while performing range of motion for ankle

7. Pushes/pulls foot toward head (dorsiflexion) and pushes/pulls foot down, toes point down (plantar flexion) at least 3 times unless pain is verbalized

8. While supporting the limb moves joints gently slowly, and smoothly through the range of motion discontinuing exercise if client verbalizes pain

9. Signaling device is within reach and bed is in low position

10. After completing skill washes hands

Performs modified passive range of motion (PROM) for one shoulder

1. Explains procedure speaking clearly slowly and directly maintaining face to face contact whenever possible

2. Privacy is provided with a curtain, screen, or door

3. Instructs client to inform candidate if pain experienced during exercise

4. Supports clients upper and lower arm while performing range of motion for shoulder

5. Raises client's straightened arm from side position upward toward head to ear level and returns arm down to side of body (flexion/extension) (AT LEAST 3 TIMES) unless pain is verbalized. Supporting the limb moves joint gently, slowly, and smoothly through the range of motion discontinuing exercise if client verbalizes pain

6. Moves client's straightened arm away from the side of body to shoulder level and returns to side of body (abduction/adduction) (AT LEAST 3 TIMES) unless pain is verbalized. Supporting the limb moves joint gently, slowly, and smoothly through the range of motion discontinuing exercise if client verbalizes pain.

7. Signaling device is within reach and bed is in low position

8. After completing skill washes hands

Positions on side

1. Explains procedure speaking clearly slowly and directly maintaining face to face contact whenever possible

2. Privacy is provided with a curtain, screen or door

3. Before turning, lowers head of bed

4. Raises side rail on side to which body will be turned

5. Slowly rolls onto side as one unit toward raised side rail

6. Places or adjusts pillow under head for support

7. Candidate positions client so that client is not lying on arm

8. Supports top arm with supportive device

9. Places supportive device behind clients back

10. Places supportive device between legs with top knee flexed; knee and ankle supported

11. Signaling device is within reach and bed is in low position

12. After completing skill washes hands

Provides catheter care for female

1. Explains procedure speaking clearly slowly and directly maintaining face to face contact whenever possible

2. Privacy is provided with a curtain, screen, or door

3. Before washing, checks water temperature for safety and comfort and asks client to verify comfort of water

4. Puts on clean gloves before washing

5. Places linen protector under perineal area before washing

6. Exposes area surrounding catheter while avoiding overexposure of client

7. Applies soap to wet washcloth

8. While holding catheter at meatus without tugging cleans at least four inches of catheter from meatus moving in only one direction (ie away from meatus) using a clean area of cloth for each stroke

9. While holding catheter at meatus without tugging rinses at least four inches of catheter from meatus moving only in one direction away from meatus using a clean area of the cloth for each stroke

10. While holding catheter at meatus without tugging dries at least four inches of catheter moving away from meatus

11. Empties, rinses and dries basin

12. After rinsing and drying basin places basin in designated dirty supply area

13. Disposes of used linen into soiled linen into soiled linen container and disposes of linen protector appropriately

14. Avoids contact between candidate clothing and used linen

15. After disposing of used linen and cleaning equipment removes and disposes of gloves (without contaminating self) into waste container and washes hands

16. Signaling device is within reach and bed is in low position

Provides foot care on one foot

1. Explains procedure speaking clearly slowly and directly maintaining face to face contact whenever possible

2. Privacy is provided with a curtain, screen, or door

3. Before washing checks water temperature for safety and comfort and asks client to verify comfort of water

4. Basin is in a comfortable position for client and on protective barrier

5. Puts on clean gloves before washing foot

6. Clients bare foot is placed into the water

7. Applies soap to wet washcloth

8. Lifts foot from water and washes foot (including between the toes)

9. Foot is rinsed including between the toes

10. Dries foot including between the toes

11. Applies lotion to top and bottom of foot removing excess if any with a towel

12. Supports foot and ankle during procedure

13. Empties, rinses, and dries basin

14. After rinsing and drying basin places basin in designated dirty supply area

15. Disposes of used linen into soiled linen container

16. After cleaning foot and equipment and disposing of used linen removes and disposes of gloves (without contaminating self) into waste container and washes hands

17. Signaling device is within reach

Provides mouth care

1. Explains procedure speaking clearly slowly and directly maintaining face to face contact whenever possible

2. Privacy is provided with a curtain, screen, or door

3. Before providing mouth care client is in an upright sitting position 75-90 degrees

4. Puts on clean gloves before cleaning mouth

5. Places clothing protector across chest before providing mouth care

6. Secures cup of water and moistens toothbrush

7. Before cleaning mouth applies toothpaste to moistened toothbrush

8. Cleans mouth including tongue and surfaces of teeth using gentle motions

9. Maintains clean technique with placement of toothbrush

10. Candidate holds emesis basin to chin while client rinses mouth

11. Candidate wipes mouth and removes clothing protector

12. After rinsing toothbrush empty, rinse, and dry the basin and place used toothbrush in designated basin/container

13. Places basin and toothbrush in designated dirty supply area

14. Disposes of used linen into soiled linen container

15. After placing basin and toothbrush in designated dirty supply area and disposing of used linen removes and disposes of gloves (without contaminating self) into waste container and washes hands

16. Signaling device within reach and bed is in low position

Provides perineal care (peri-care) for female

1. Explains procedure speaking clearly slowly and directly maintaining face to face contact whenever possible

2. Privacy is provided with a curtain, screen, or door

3. Before washing checks temperature for safety and comfort and asks client to verify comfort of water

4. Puts on clean gloves before washing perineal area

5. Places pad/linen protector under perineal area before washing

6. Exposes perineal area while avoiding overexposure of client

7. Applies soap to wet washcloth

8. Washes genital area moving from front to back while using a clean area of the washcloth for each stroke

9. Using clean washcloth rinses soap from genital area moving from front to back while using a clean area of washcloth for each stroke

10. Dries genital ara moving from front to back with towel

11. After washing genital area turns on side then washes and rinses rectal area moving from front to back using a clean area of washcloth for each stroke. Dries with towel

12. Repositions client

13. Empties, rinses and dries basin

14. After rinsing and drying basin places basin in designated dirty supply area

15. Disposes of used linen into soiled linen container, and disposes of linen protector appropriately

16. Avoids contact between candidate clothing, and and used linen

17. After disposing of used linen and placing used equipment in designated dirty supply area removes and disposes of gloves (without contaminating self) into waste container and washes hands

18. Signaling device is within reach and bed is in low position

Transferring from bed to wheelchair using transfer belt

1. Explains procedure speaking clearly slowly and directly maintaining face to face contact whenever possible

2. Privacy is provided with a curtain, screen, or door

3. Before assisting to stand wheelchair is positioned along side of bed at head of bed facing foot or foot of bed facing head

4. Before assisting to stand footrests are folded up or removed

5. Before assisting to stand bed is at a safe level

6. Before assisting to stand locks wheels on wheelchair

7. Before assisting to stand checks and or locks bed wheels

8. Before assisting to stand client is assisted to a standing position with feet flat on the floor

9. Before assisting to stand client is wearing shoes

10. Before assisting to stand applies transfer belt securely at the waist over clothing /gown

11. Before assisting to stand provides instructions to enable client to assist in transfer including prearranged signal to alert when to begin standing

12. Stands facing client positioning self to ensure safety of candidate and client during transfer. Counts to three or other prearranged signal to alert client to begin standing

13. On signal gradually assists client to stand by graping transfer belt on both sides with an upward grasp (candidates hands are in upward position) and maintaining stability of clients legs

14. Assists client to turn to stand in front of wheelchair with back of clients legs against wheelchair

15. Lowers client into wheelchair

16. Positions client with hips touching back of wheelchair and transfer belt is removed

17. Positions feet on footrests

18. Signaling device is within reach

19. After completing skill washes hands