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CNA basic nursing skills practice test: infection control, safety, vitals, reporting

Basic Nursing Skills is the biggest slice of the written test: 35% of the 60 scored items in the 2024 NNAAP outline, about 21 questions. They come from infection control, safety and emergencies, hands-on procedures like vital signs, and deciding what to record versus what to report.

The map

What the Basic Nursing Skills area covers

The questions test what a nurse aide does on a long-term-care unit, at entry level. At 35% of the scored items in the 2024 NNAAP outline, this area outweighs Activities of Daily Living (22%). Prometric and Headmaster/D&S use similar outlines with their own weights.

The four subtopics
SubtopicWhat the questions askWhat the best answer usually does
Infection controlHand hygiene, gloves, PPE, isolation types, linen, sharpsBreaks the chain of infection: gloves for body fluids, not for a back rub
Safety and emergenciesFalls, fire, choking, seizures, oxygen, restraints, body mechanicsMakes the resident safe first, then calls the nurse
Technical proceduresVital signs, weight, intake and output, specimens, catheter care, range of motionFollows the steps and stays inside the aide's role
Data collection and reportingObserving, objective vs subjective, chartingRecords a normal finding, reports a change

Weights from the 2024 NNAAP written outline. Your vendor's candidate handbook has the outline for your state's test.

Hygiene, feeding and toileting live next door in Activities of Daily Living; the full outline is in the CNA study guide.

Try it first

12 basic nursing skills practice questions

Start cold: answer each card before reading the sections below, and the rationale opens on the card. These are original practice questions written in the style of the NNAAP and Prometric written tests, not questions from a real exam.

Card 1 of 12

Basic Nursing Skills

When using a fire extinguisher, the nurse aide should aim the nozzle at:

Pick an answer. The rationale flips up right here, on the back of the card.

0 right · 0 missed · 12 to go

Fits a 20-minute break

Twelve cards fit a meal break. Sit down, phone face down, water instead of a second coffee, and stop when the break ends. For all nine areas mixed, use the practice deck.

Subtopic 1

Infection control: what the questions ask

Hand hygiene is the most tested infection-control action, and the answer whenever a question asks how to stop germs moving between residents. Alcohol rub is the default. Soap and water wins when hands are visibly soiled, after the restroom, before eating, and for C. difficile or norovirus, which alcohol does not reliably kill.

Hand washing steps the test expects

  • Lather for at least 20 seconds
  • Fingertips pointing down so water runs off the hands
  • Turn the faucet off with a clean paper towel, not your bare hand
Gloves go on by exact indication
Gloves neededGloves not needed
Peri-care, bedpans and urinalsFeeding a resident
Emptying a drainage bagA back rub on intact skin
Oral or denture careRange-of-motion exercises
Broken skin or any body fluidTransfers with a gait belt

Gloves never replace hand hygiene: clean your hands before putting them on and after taking them off, and change them when you move from a dirty area to a clean one.

Isolation types
PrecautionWhat you wearExamples the test uses
StandardPPE as the task requiresEvery resident, every time
ContactGown and glovesC. diff, MRSA, scabies
DropletMaskInfluenza, pertussis
AirborneN95, negative-pressure roomTuberculosis, measles, chickenpox
  1. On

    Gown, mask, goggles or face shield, gloves last.

  2. Off

    Gloves first, then goggles, then the gown rolled dirty side in, then the mask. The gown comes off before you leave the room.

  3. Then

    Hand hygiene, even if the gloves looked clean.

The linen trap

Clean linen that touches the floor is dirty. So is unused clean linen you carried into a room; it does not go back on the cart. Hold linen away from your uniform and never shake it. Sharps go in the puncture-resistant container, never recapped.

Subtopic 2

Safety and emergencies: make the resident safe, then get help

Safety questions follow one rule: protect the resident first, then call the nurse. Safety sits above rights, scope and comfort in the order behind every keyed answer, so when two options both sound helpful, pick the one that removes the danger soonest.

Emergencies the written test likes
SituationFirst move the test rewardsTempting wrong move
Resident found on the floorStay and call for the nurseLifting them back to bed yourself
Resident starts to fall while walkingEase them to the floor, protecting the headHolding them upright
Fire in a roomRemove the resident (RACE: Remove, Alarm, Contain, Extinguish)Fighting the fire first
SeizureProtect the head, time it, side-lying afterwardsHolding them down or putting anything in the mouth
Conscious adult choking, cannot speakAbdominal thrustsOffering water
Sudden shortness of breath in bedAfter calling for help, raise the head of the bedRaising the feet

Extinguishers follow PASS: Pull, Aim at the base, Squeeze, Sweep. Some first-aid courses now alternate back blows with abdominal thrusts, so a back-blow option is not automatically wrong.

Restraints and side rails

A restraint is a last resort: a doctor's order, the least restrictive option, frequent checks and release on the care-plan schedule, never for convenience. The quick-release tie goes on the movable bed frame, not the side rail. Side rails that stop a resident from getting out of bed count as a restraint under federal resident-rights rules, a favorite trap.

"Restrain to prevent falls"

Be suspicious of any option that says a restraint keeps the resident safe. Restraints raise the risk of pressure injuries and of falls from climbing over. Alternatives come first: scheduled toileting, a low bed, more frequent checks.

Before you walk away from any bed

  • Bed in its lowest position, wheels locked
  • Call light within the resident's reach
  • Non-skid footwear on if they will get up

Body mechanics: lift with your legs, feet apart, load close to your body, and get a coworker when unsure. The gait belt goes on the resident's waist. Around oxygen there is no open flame, and you never change the flow rate; report problems to the nurse.

Subtopic 3

Vital signs and procedures: principles, not trivia

Vital-sign questions test technique and context more than memorized cutoffs. Learn a few anchors, the correct way to measure, and the habit of asking what the resident was doing when the reading was taken.

MeasurementAnchorWhat the question is really testing
TemperatureAbout 98.6°F (37°C) average; 100.4°F (38°C) is a feverRectal is most accurate, axillary least; wait after a hot or cold drink before an oral reading
PulseAdult 60–100 a minuteRadial is routine; count a full minute
RespirationsThe adult range your course taughtCount without the resident knowing, so the breathing stays natural
Blood pressureNormal is under 120/80Right cuff size, arm at heart level, never on the side of a mastectomy, dialysis fistula or IV
Pulse oximetry95% or higher is normalRecord normal, report low. The aide never adjusts oxygen

Why some numbers are missing

Textbooks disagree on a few cutoffs: the low end of normal respirations, temperature ranges by route, exact head-of-bed degrees. Good test items avoid hinging on those edges, so use the range your training program taught.

Expect simple intake arithmetic: 1 ounce = 30 mL, so an 8-ounce cup is 240 mL, and anything liquid at room temperature counts, gelatin and ice cream included. Daily weights: same time, same scale, similar clothing.

  • Catheter care: clean from the opening outward, bag below the bladder and off the floor, never disconnect. Bag nearly empty? Check the tubing for kinks first.
  • Specimens: label at the bedside; keep stool free of urine and tissue; sputum is coughed from deep in the chest, not saliva.
  • Warm and cold packs: check the skin underneath often; report redness or numbness.
  • Range of motion: support the joint, move slowly, stop at pain or resistance and report it.

Scope questions are free points

If the nurse asks you to insert a catheter, give medication or adjust an IV, the keyed answer is to explain that it is outside the aide's role. Your job is to observe, measure and report.

Subtopic 4

Data collection and reporting: record it or report it?

A normal finding is recorded; a change or an abnormal finding is reported to the nurse right away. Answering "tell the nurse" by reflex costs points. A resident at 96% on the oximeter, chatting comfortably, does not need the nurse paged; the reading goes in the chart.

Record or report?
FindingYour moveWhy
Normal reading at restRecordNothing changed
Fast breathing at restReportThe same rate right after a walk may be expected; context decides
Redness over a hip or heel that does not fadeReport; do not rub itFirst sign of a pressure injury; the nurse assesses
Red streaks in the stoolDon't flush; reportThe nurse needs to see it
Chest pain, drooping face, slurred speechReport immediatelyPossible heart attack or stroke
Shaky, sweaty, suddenly confusedReport immediatelySigns of low blood sugar

Objective data is what you see or measure: a pulse of 88, a bruise on the left forearm. Subjective data is what the resident says, charted in their words. An option like "the resident is being difficult" is an opinion, not a fact.

Charting rules the test checks

  • Facts, not opinions
  • Never chart care before you give it
  • Fix an error with a single line, initials and date; no correction fluid
  • 24-hour clock: 8 p.m. is 2000

Where this area meets the skills test

Much of this area returns on the hands-on part, in front of an evaluator: hand hygiene, call light in reach, bed lowered, a measurement recorded correctly. Which skills you draw depends on your state and vendor; the CNA skills test guide covers the skill families and the steps checked in every one.

Pack for the physical part

Scrubs or whatever your handbook names, closed-toe non-skid shoes, hair tied back, short nails. Check whether your handbook wants a watch with a second hand for counting a pulse.

Basic nursing skills questions people ask

What skills do CNAs need?

For the exam, two kinds. The written test covers nine areas, with Basic Nursing Skills the largest: infection control, safety, vital signs and reporting. The skills test has you perform a few randomly drawn skills in front of an evaluator; the list depends on your state and vendor.

What is the most important thing a CNA does to prevent infection?

Hand hygiene, before and after every resident contact and every pair of gloves. Alcohol rub unless your hands are visibly dirty; soap and water for C. difficile or norovirus.

How many basic nursing skills questions are on the CNA test?

On the NNAAP written test, 35% of the 60 scored items, about 21. Prometric and Headmaster/D&S weight their outlines a little differently; check your vendor's candidate handbook.

Are these real CNA exam questions?

No. They are original practice questions written in the style of the NNAAP and Prometric written tests. For a timed run across every area, try the timed mock.