CNA Exam Clinical Skills Test Study Guide

CNA Exam Clinical Skills Test Study Guide

Practice Skills test: taking someones pulse procedure


Welcome to the CNA Exam Cram’s first ever-free CNA Skills Set Study Guide.  As one of the top authoritative sites on becoming a CNA, we heard your requests and got our team of previous CNAs and CNA proctors to devise the best Skills Set Study Guide out there.  It is our firm belief that this study guide is all you will need to pass the Skills Set portion and become a CNA in no time.nurse-taking-pulse

The goal of this CNA Study Guide is to give you the necessary information and recommendations to be able to pass the CNA Clinical Skills Test (CST).  Although it is jammed packed with information on this portion of the test, it is not designed to help with the written portion of the test.  If you are interested in more information on taking the CNA written test, then we recommend you try out of free CNA practice Test.  The nursing assistant’s practice exam can be accessed here.

This study guide will start by discussing the basics of the CST and then provide proven methods in which you can prepare for the test. Furthermore, we have included a list of each possible practical performance that you could be tested on. Each link will include a full discussion on the skill, the procedures on how to adequately perform each skill.

In some cases, we will also include stories and recommendations that proctors have said they witnessed or have experienced when grading a potential CNA.  Find out exactly what they think about the process and what you can do to help improve your chances of passing the CNA Skills Set exam.

Hopefully, after reading our guide and practicing the procedures, you will be more than ready to pass the CST with flying colors. If after reading this, and taking the test, you feel as though there is something we can do to improve our free Study Guide, please contact us. This guide is meant to help future CNAs, free of cost.

What is the Clinical Skills Test or CST

The Clinical Skills Test (CST) is the practical portion of the CNA test that validates a potential CNA’s ability to perform the duties and responsibilities of a nursing assistant. This portion of the test has the highest failure rate and is therefore considered the hardest part of becoming a CNA.

Each state has different requirements, however, in most cases the test will be administered by a Registered Nurse who will give you between 35-45 minutes to perform at least 5 critical CNA skill sets. They will grade you on your overall knowledge, ability to follow the procedures and your overall demeanor while performing your duties. The list of possible tasks varies but in most cases you are looking at over 30 critical skills in which they can challenge you on.

How to Prepare for the CNA Clinical Skills Test

Since you could be tested on over 30 critical skills, it is important that you memorize and understand each and everyone. However, the mistake that most people make is that their preparations just stop there.  They never follow up their knowledge with other important aspects of the test, which we will discuss below:

What do you Need?  PRACTICE!

Because this portion of the exam is a practical portion, your grade is dependent on your performance and not your knowledge. Therefore, it is imperative that you not only memorize the steps, but practice doing them too.  Notice that the word “practical” is another form of “practice.”

According to Jackie Swanson, a CNA of 25 years and a prior proctor of the exam, you can tell who has practiced and who hasn’t.

“There are two types of CST Test Takers: those that have practiced and those that only know the steps. When we grade a CNA we can instantly tell which one is which. Those that have practiced performing the steps are usually more confident and can therefore place more attention on the patient then just moving through the steps. The ones who didn’t practice, act like robots and in most cases second-guess themselves. I’m sure you can guess which one fails the most.”

The best thing you can do is to get extra time in the labs or as an intern. However, for most, this isn’t an option. The other “best method” is to ask a friend to act as a patient and go through the steps as if the proctor is standing right there and is watching you.

Don’t Skip the Small Stuff, they Burn the Most!

CNA Critical Skills hand washingThe biggest mistake that our previous proctors witness is that most potential CNAs spend all their time working on the hard practical performances like Making an Occupied Bed or Using a Gait-Transfer Belt Correctly but skip working on the simple ones like Washing Your Hands or Measuring Blood Pressure.

No matter how well you perform your practical performances, if you don’t wash your hands properly or dispose of waste properly, throughout your required practical exam, then you will fail.  If you don’t believe us, check out any CNA forum and most of time, you will see other CNAs complaining about how they failed the small stuff and never the big ones.

Jessica Myers, a CNA of 5 years, had this to say about her first experience with the skills test:

“I remember the first time I took the practical test.  I was so nervous that when I went to wash my hands, I forgot to count how long I was washing and ended it too soon.  I couldn’t believe I failed for that.  I had a wait a month later to retake it.  I was so depressed!  I had spent so much time on the other portions, that I hadn’t engrained that procedure in my mind.”

So, don’t spend all your time on the longer skills sets and neglect the smaller ones.  They are just as important…. if not more.

Remember Your Other Roles

The CST isn’t just about going through the steps, but remembering your responsibilities as a CNA.  As you practice going through your skills performance, you need to remember all of your patient’s needs and rights.  It is important to do this while you practice other sets because come test time, you will be nervous and without practice, you may find that you quickly turn into a procedure robot.qualities of a CNA

To do this, you need to perform your CST as if the dummy or actor is a real patient:

    • Talk to them.
    • Inform them of what you will be doing.
    • Be kind and sweet.
    • Always check the room for any hazards or waste.
    • Be courteous and treat them with respect.
    • Be vigilant in monitoring what they are doing at all times of the procedure.

Although the above things are only minor, the missed points can add up.  We have heard of an occasion or two, where the proctor had the actor do something during a procedure so as to test the potential CNA’s response.  So be careful and remember all of your responsibilities, not just the procedure.

CNA Exam Cram’s Guide to the CST

In most cases, you will enter a room and will have either a person or a dummy play your patient. The proctor will then ask you to perform a specific task. Before you start, you should do the following things:

      • 1. Ensure you understand the task and ask questions before starting.
      • 2. Verify that you have all the equipment you will need. If you don’t see it in the room, then ask the proctor about it.

When instructed by a proctor, you must perform the following tasks, even if you already did them in the previous step.CNA nurse

      • 1. Announce to your patient/dummy that you are there, address them by their name and inform them of what you will be doing. Ask them if they have any questions and whether or not they are okay with the procedure that this time.
      • 2. Ensure you wash your hands thoroughly.
      • 3. Verify that you have all the appropriate equipment setup and ready for use.

Once you have accomplished the above things, then you are prepared for the CST performance. Although our list is not complete, it is pretty extensive. We highly recommend that you memorize our steps or your own, and then practice them on a friend.

Once you have finished the skills procedure, make sure that you always perform the following:

      • 1. Inform the patient that you are finished and ask them if everything is okay.
      • 2. Ensure they are in a comfortable position and are safe. Also check to make sure your equipment has been properly stowed and that the overall sanitation of the room is adequate and acceptable.
      • 3. Wash your hands.

Final Tips and Recommendations

You are not expected to be perfect, but there are things that you can do when you make a mistake. The following are tips that prior Proctors have given us to share with you:

      • 1. If you make a mistake, don’t try to cover it up. The proctor probably saw you anyways. What you should do is announce to the proctor that you made the mistake and tell them what you would do differently. This tells the proctor that you know you made a mistake and that you know the right answer. You might lose a point or two, but not as much as if you just skip through it and never acknowledge you were wrong.
      • 2. Never forget that you are being graded on your performance. This means that you need to communicate with your dummy/actor and perform all duties of a CNA, not just the task at hand.  You can find out more about these responsibilities here.
      • 3. You are able to make mistakes and still pass. Just do not violate any sanitation rules or safety requirements. If you violate either of these two, you will automatically fail.  Like we discussed earlier, this could be from a very simple procedure of washing your hands or not properly disposing of something.

Top Supplemental Resources

This study guide should be sufficient to help you pass the test. But if you need additional information or preparation tips, you should check the below resources.

      • CNA Exam Cram Practice Test: Our very own, professional made practice test will help you to test your knowledge and help you to gauge your level of understanding. As close to the real test as you can get.
      • 4 Your CNA Exam Videos: Access a list of professionally made videos showing you each step. Although many of these are in our own articles listed above.
      • CNA Exam Cram Study Guide: This is not our book and it’s an absolute coincident that we have the same domain as them. However, their book has the most extensive list of practical skills that you could be tested on and provides flashcards to use. Absolutely worth every penny.


Practice makes perfect, so don’t forget to actually take the time and practice running through each of the steps above. You can’t just memorize the steps and pass.  You need to practice all facets of the performance. A CNA proctor can tell who has practiced and who has not.


CNA Exam Clinical Skills Test Study Guide by


  1. I failed my skills exam three times, I don’t know if I have to start all over, what should I do. Need your help, thank you very much

  2. From my understanding sarai. If you fail 3 times you have to re-take the part you failed you have time wait for awhile. Call your local board of nursing for accurate information. I hope this helps. Best wishes!

  3. I’m beyond pissed I need so badly to pass this exam and become a cna so I can make a better future for me and my son . I can’t even provide a roof over our head so passing both parts is crucial to me being able to get a can job. I know I passed the written but I do not know if I passed the skills which is what I’ve been stressing about the most . I’m just hoping and praying I passed both I was So nervous I spent too much time trying to make sure I did all skills I didn’t have time for the last one . I hope they’ll excuse that and give me the benefit of the doubt.

  4. I failed my test in November. And I keep putting off to retake. But I need to. I’m just to nervous. And I get very STRESSED before any test. And I cant think straight. Please help me if you have any advice

  5. I am trying to find the requirements to take the State exam. I pass the written exam but was unable to pass the skills. Where am I find an on-line class that will meet the requirements to take the State Exam.
    Thank you

  6. Dear CNA Exam Cram, Thank you so much for this great web site. As an instructor for the CNA certification classes at Monterey Peninsula Community College- I am thrilled to see this information and I will pass it on to my students who will be taking their exams after the course concludes in mid May. Best of luck to all of you!
    Carolyn Washington
    The Learning Oasis
    CNA Course
    Monterey Peninsula Community College

  7. Hi, my CNA cert has expired because i’ve been working as a medical assistant, im eligible to restest to bring it active again. It’s been quite a few years since I first tested, haven’t worked as CNA for 4-5 yrs I’ve put it off and now I need to do it by August or I’ll have to take the class again, so i’m wondering how many clinical skills are you tested on, and does anyone know of a refresher class in the bay area , san jose area. Any information would be great thanks!!

  8. Great Article. article ! I learned a lot from the points ! Does someone know if I can get a template a form form to work with ?

  9. I am testing out..I was a CNA in the past..I forget if on the measurements portion of the skills test when you sign you name are you signing ex: J. Doe, CNA???? I forget…seeing that you arent certified yet. I wasnt sure if you sign that or J. Doe, NA??? Does anyone have this answer? To the other people looking for information on skill videos you can find any of them on type in 2016 CNA skills add the state your in or not. basically all skills should be the same. for sample writtten exams us can go to CNAClasses4u., Union CNA free exam. Or just type in free CNA classes.

  10. does anyone know if the written test is hard or are they both the same? please help im a week away from taking my state test and im scared that i might fail…

    • The written test is easy. Think safety and remember it’s all about the residents. I passed my written the 1st try. But study study study. They have practice tests online, that will help you. It helped me

  11. I want to take state Bord exam but i have problem to speak how can explain each producer that is my problem guys.

  12. Hi I failed my skills test 3 times . I sent a grievance because it wasn’t fear I did everything right . How can they know when they review my test if the proctor have the power over me.

  13. The test is more nerve wrecking than anything else and then u font get a grade its just pass or fail. U can almost tell when u do something wrong by evaluators mood and how it swings. I passed yesterday but left a towel under clients head but caught it b4 I finished that skill. Geez!

  14. I finished my CNA class this past November, 2016. The class was totally hidious, due to lack of organization with all parties involved. However, my class tested at Walters State Community College in Morristown, Tn., at the end of November. The entire class, with the exception of 2 ladies failed either the written exam or skills exam but, in most cases failed only the skills portion. I was able to talk to each of them immediately after completion of the exam. Every one of them said, they felt really good about the skills exam but, there naturally were a few that expressed concern with the written. After talking with several other classes, we began to learn our class wasnt the only class that had failed the skills portion of the exam. There were numerous ladies from different areas that had the same experience. The test results came back and, these ladies were right about failing the skills. But, every single lady i spoke with said basically the samethng about this scenario! Most of these ladies were saying “i know i did this/that,” but she failed me! Fortunately, all these ladies were able to test again UNDER THE SUPERVISION OF A DIFFERENT PROCTOR, and every single one passed! Due to personal reasons, I was unable to test at that time. So, I tested this past march 2017. As it turned out, I had the exact same proctor as my classmates and all the other ladies from surrounding areas. I was certified in 2001 but, went to obtain my bachelors degree allowing my licenses to expire. But, I had 12 years of experience at that time and have since gained 6 more years of experience. This left me feeling pretty confident about the skills but not the written exam. While taking the written exam, I was almost scared because it seemed just too easy to be true! There were only two questions that raised a red flag so, I had time to review my test 3 times! I walked out feeling confident I had passed the written portion with a fairly high grade. However, I only passed the written with a mere 79%! Close to failing! Failed my skills because, the procter noted, I didn’t was the dependent residents hands with soap/water prior to feeding. BUT, I DID THAT!!! I clearly recall getting the washcloths, and performing the procedure. As I was about to walk out, I turned to the proctor and said, should I go home and cry now or can I breath a such of relief? Her exact reply was, “you can go home and relax because I saw nothing that would cause you to fail.” Can you imagine the fury I felt after hearing her assure me I could relax that she had saw nothing that would fail me?!! I did contact the testing services and, after they had already had lots and lots of complaints about this proctor, they informed that I could pay $33.00 and contest my results. WHAT, I’m paying that much money for it to be my word against the proctors plus another $66.00 to retake my skills at some point and time. It would have been like fighting a loosing battle! So, not only do I feel this proctor has some sort of problem but, I feel 100% certain that my test had been tampered! I was the only person in the room with the proctors sister administering my written exam. Please accept my apilogizy for the long response but, please try and understand my frustration and you be the judge. What’s your opinion?

  15. Hi everyone! I passed my written test, didn’t pass my skills test. Are the teacher there supposed to be rude? funny part is I did all the step to wash your hands. They failed me, I told the examiner, why did you guys fail me if i did all the steps, her responds was that I didn’t wet my hands before starting the hand skills. The first thing I did, was wet my hands. I informed the examiner I did do that step first, the lady that was going over the skills test wasn’t the person that watch me do the skills, she didn’t have answer for me, I Brushed it off. taking the skill test in three weeks. Wish me luck

  16. I took can class about 1 and a half years ago did not pass last exam so failed course is there a sort less costly class to re learn my skills and can I still take certificate test when I’m ready

  17. i took the cna course two years ago and never examined because i was JUST that nervous but i recently took the course in april, i went to take my state test i passed my written and failed the skills, i knew i was going to fail because i was nervous as SHIT. i go back on the 31st of this month to retake it and i pray to GOD UP ABOVE that he allows me to pass so that i can move on with my education.