Skills Test – Video Demonstrations

Skill 1 – Hand Hygiene (Washing Hands)

1. Greet the client by their name and introduce yourself.
2. Start by turning on the sink’s water.
3. Thoroughly dampen hands and wrists.
4. Dispense soap onto hands.
5. Rub soap over all surfaces of the wrists, hands, and fingers, creating a lather and using friction for at least 20 seconds; ensure hands remain below the elbows with fingertips pointed downward.
6. Clean under the fingernails by rubbing fingertips against the opposite palm.
7. Rinse all areas of the wrists, hands, and fingers, keeping hands lower than elbows with fingertips down.
8. Use a clean, dry paper towel to dry fingers, hands, and wrists from fingertips downward, then discard the towel in a waste bin.
9. Use a fresh paper towel to turn off the faucet, then discard it in the waste container.
10. Avoid touching the sink at any point.

Skill 2 – Applies a Single Knee-High Elastic Stocking

1. Clearly explains the procedure, speaking in a calm, slow manner and maintaining eye contact.
2. Ensures privacy by closing a curtain, screen, or door.
3. Positions the client lying flat on their back for stocking application.
4. Folds the stocking inside out down to the heel.
5. Fits the foot of the stocking over the toes, foot, and heel.
6. Gently pulls the stocking up over the foot, heel, and leg.
7. Handles the foot and leg carefully and smoothly, avoiding any pressure.
8. Completes the procedure with no twists or wrinkles, ensuring the heel section (if present) aligns with the client’s heel, and the toe area opening is positioned correctly; if using a mannequin, may state “stocking should be smooth and wrinkle-free.”
9. Places the call button within easy reach.
10. Washes hands.

Skill 3 – Aid in Walking with a Transfer Belt

1. Clearly explains the steps, speaking slowly and directly, while making eye contact.
2. Ensures privacy by closing a curtain, screen, or door.
3. Verifies that the client is wearing non-slip footwear before assisting with standing.
4. Adjusts the bed to a safe height before helping the client stand.
5. Ensures that the bed’s wheels are locked before assisting with standing.
6. Helps the client into a seated position with feet flat on the floor before standing.
7. Secures the transfer belt snugly around the client’s waist before standing.
8. Provides clear instructions and a prearranged cue to coordinate the standing process with the client.
9. Stands facing the client to ensure both parties’ safety during the transfer, counting to three to signal the client to stand.
10. On the agreed cue, gradually assists the client to stand, holding the transfer belt firmly on both sides and keeping the client’s legs stable by positioning knee to knee.
11. Walks slightly behind and to the side of the client for 10 feet, maintaining a hold on the belt.
12. Assists the client back to bed and removes the transfer belt.
13. Ensures the call button is within easy reach.
14. Washes hands.

Skill 4 – Measures and Documents Radial Pulse

1. Clearly explains the process, speaking calmly, at a slow pace, and maintaining eye contact.
2. Positions fingertips on the thumb side of the client’s wrist to find the radial pulse.
3. Counts the pulse beats for a full 60 seconds.
4. Ensures the call button is accessible to the client.
5. Washes hands before recording the measurement.
6. Records the pulse rate within a margin of 4 beats from the evaluator’s count.

Skill 5 – Helps Client Use a Bedpan

1. Clearly explains the procedure, speaking at a calm, slow pace, and maintaining eye contact.
2. Ensures privacy by closing a curtain, screen, or door.
3. Lowers the head of the bed before positioning the bedpan.
4. Puts on clean gloves prior to placing the bedpan under the client.
5. Correctly positions the bedpan under the client’s hips.
6. Safely removes and discards gloves in a waste container, then washes hands.
7. After positioning the client on the bedpan and removing gloves, raises the head of the bed.
8. Ensures toilet paper is within the client’s reach.
9. Keeps a hand wipe accessible to the client.
10. Ensures the call light is within reach and asks the client to signal once finished.
11. Puts on clean gloves before removing the bedpan.
12. Lowers the head of the bed before taking out the bedpan.
13. Makes sure the client remains covered, except during bedpan placement and removal.
14. Empties and rinses the bedpan, disposing of the rinse water in the toilet.
15. Places the bedpan in the designated area for soiled items.
16. Removes gloves safely without contamination, discards them in the waste container, and washes hands.
17. Ensures the call light is within reach and the bed is positioned low.

Skill 6 – Measures and Documents Respiratory Rate

1. Clearly explains the procedure, speaking at a slow, calm pace, and maintaining eye contact.
2. Measures the respiratory rate for a full 60 seconds.
3. Ensures the call light is within the client’s reach.
4. Washes hands before documenting the findings.
5. Records the respiratory rate within a margin of 2 breaths of the evaluator’s count.

Skill 7 – Cleans Both Upper and Lower Dentures

1. Puts on clean gloves before handling the dentures.
2. Lines the bottom of the sink and/or fills it with water before holding the dentures over it.
3. Rinses the dentures with lukewarm running water before brushing.
4. Applies denture paste to the toothbrush.
5. Brushes all surfaces of the dentures thoroughly.
6. Rinses the dentures under lukewarm running water to remove any toothpaste.
7. Rinses the denture cup and its lid.
8. Places the dentures in the cup filled with lukewarm water or a cleaning solution and secures the lid.
9. Rinses the toothbrush and stores it in the designated container.
10. Ensures clean technique when handling the toothbrush and dentures.
11. Removes and disposes of the sink liner properly and/or drains the sink.
12. Safely removes gloves without contamination, discards them in the waste container, and washes hands.

Skill 8 – Measures and Documents Urine Output

1. Wears clean gloves before handling the bedpan.
2. Carefully pours the bedpan contents into the measuring container, avoiding spills or splashes.
3. Rinses the bedpan and disposes of the rinse water in the toilet.
4. Measures the urine at eye level, placing the container on a flat surface. (If the measurement is between two lines, round up to the nearest 25 ml.)
5. After measuring, empties the contents of the measuring container into the toilet.
6. Rinses the measuring container and pours the rinse water into the toilet.
7. Before documenting the output, removes and discards gloves safely in a waste container and washes hands.
8. Records the urine volume within 25 ml/cc of the evaluator’s measurement.

Skill 9 – Putting On and Taking Off Personal Protective Equipment (Gown and Gloves)

1. Picks up the gown and unfolds it.
2. With the back opening facing you, inserts your arms into each sleeve.
3. Fastens the neck opening of the gown securely.
4. Ties the gown at the waist, ensuring the back of your clothing is fully covered (as much as possible).
5. Puts on gloves.
6. Ensures the cuffs of the gloves overlap the gown cuffs.
7. Before removing the gown, uses one gloved hand to grasp the palm of the other glove and removes it.
8. Slips the fingers of the ungloved hand underneath the cuff of the remaining glove at the wrist and removes it, turning it inside out during removal.
9. Disposes of the gloves in the designated waste container, ensuring no contamination occurs.
10. After removing the gloves, unfastens the gown at both the waist and neck.
11. Removes the gown without touching its outside surface.
12. While removing the gown, holds it away from the body, ensuring it doesn’t touch the floor, turns it inward, and keeps it inside out.
13. Disposes of the gown in the appropriate container without contaminating yourself.
14. Washes hands thoroughly after completing the procedure.

Skill 10 – Dresses Client Using the Affected (Weaker) Right Arm

1. Clearly explains the procedure, speaking at a slow, calm pace, and maintaining eye contact when possible.
2. Ensures privacy by closing a curtain, screen, or door.
3. Asks the client which shirt they would like to wear and helps them put it on.
4. Prevents overexposure by keeping the client’s chest covered.
5. Removes the gown starting from the left (unaffected) side, then takes it off the right (affected/weak) side.
6. Disposes of the gown in the soiled linen container before dressing the client.
7. Assists the client in placing the right (affected/weak) arm through the shirt’s right sleeve first, then dresses the left (unaffected) arm.
8. While dressing, moves the client’s body smoothly and gently, avoiding force or excessive stretching of limbs and joints.
9. Ensures the clothing is properly positioned and adjusted.
10. Makes sure the call light is within reach and the bed is in a low position.
11. Washes hands after completing the procedure.

Skill 11 – Assists with Feeding a Client Unable to Feed Themselves

1. Clearly explains the procedure, speaking at a calm and slow pace, while maintaining eye contact when possible.
2. Before feeding, checks the name card on the tray and asks the client to confirm their name.
3. Ensures the client is seated in an upright position (between 75-90 degrees) before starting.
4. Places the tray where the client can easily see the food.
5. Cleans the client’s hands before beginning the feeding process.
6. Sits facing the client in a chair during the meal.
7. Describes the foods and beverages on the tray to the client.
8. Asks the client which food they would like to eat first.
9. Using a spoon, offers the client a bite of each food item on the tray, describing each item as it is offered.
10. Offers a drink at least once during the meal.
11. Asks the client if they are ready for the next bite or sip.
12. Cleans the client’s mouth and hands at the end of the meal.
13. Removes the food tray from the area.
14. Leaves the client in an upright position with the call light within reach.
15. Washes hands after completing the procedure.

Skill 12 – Administers a Partial Bed Bath (Face, One Arm, Hand, and Underarm)

1. Clearly explains the procedure, speaking slowly and directly while maintaining eye contact whenever possible.
2. Ensures privacy by using a curtain, screen, or door.
3. Removes the gown, placing it directly in the soiled linen container, while ensuring the client’s chest and lower body remain covered.
4. Checks the water temperature for comfort and safety, asking the client to confirm it is suitable.
5. Puts on clean gloves before beginning the washing process.
6. Starts with the eyes, using a wet washcloth without soap, and cleans the eyes from inner to outer corner, using a clean area of the washcloth for each stroke, then proceeds to wash the face.
7. Dries the face using a dry cloth towel placed under the client’s arm.
8. Exposes one arm and places a cloth towel underneath it.
9. Applies soap to the wet washcloth.
10. Washes the client’s fingers, including fingernails, hand, arm, and underarm, ensuring the rest of the body is covered.
11. Rinses and dries the fingers, hand, arm, and underarm.
12. Moves the client’s body gently, avoiding any force or overextension of limbs and joints.
13. Puts a clean gown on the client.
14. Empties, rinses, and dries the basin.
15. Places the basin in the designated area for dirty supplies.
16. Disposes of used linens in the soiled linen container.
17. Avoids contact between the candidate’s clothing and used linens.
18. Removes and safely disposes of gloves without contamination, then washes hands.
19. Ensures the call light is within reach and the bed is in a low position.

Skill 13 – Measures and Documents Blood Pressure Using an Electronic Device

1. Clearly explains the procedure, speaking at a calm and deliberate pace while maintaining eye contact when possible.
2. Ensures privacy by using a curtain, screen, or door.
3. Instructs the client to assume a comfortable position, either lying down or sitting.
4. Positions the client’s arm at heart level with the palm facing up and the upper arm exposed.
5. Selects the correct cuff size for the client.
6. Locates the brachial artery on the inner side of the arm, at the elbow crease.
7. Places the blood pressure cuff snugly on the client’s upper arm, ensuring the sensor/arrow is aligned with the brachial artery.
8. Powers on the machine and checks that it’s working properly, selecting the correct setting for the client (e.g., adult, child, or infant) if needed.
9. Presses the start button. If the cuff inflates to over 200 mm Hg, stops the machine and switches to the other arm.
10. Waits for the blood pressure reading to appear on the screen and for the cuff to deflate before removing it.
11. Ensures the call light is within reach of the client.
12. Washes hands before recording the results.
13. Records the systolic and diastolic readings exactly as displayed on the digital screen.

Skill 14 – Weighs and Documents the Weight of an Ambulatory Client

1. Clearly explains the procedure, speaking in a slow, direct manner while maintaining eye contact whenever possible.
2. Ensures the client is wearing non-slip footwear before walking to the scale.
3. Sets the scale to zero before the client steps on.
4. Instructs the client to step onto the center of the scale and records their weight.
5. Asks the client to step off the scale after weighing.
6. Washes hands before documenting the weight.
7. Records the weight shown on the scale, ensuring it is within 2 lbs. of the evaluator’s reading (or within 0.9 kg if the weight is measured in kilograms).

Skill 15 – Administers Modified Passive Range of Motion Exercises to One Knee and Ankle

1. Clearly explains the procedure, speaking in a calm, deliberate manner while maintaining eye contact whenever possible.
2. Ensures privacy by using a curtain, screen, or door.
3. Positions the client in a supine position in bed and asks the client to notify the candidate if any pain is felt during the exercise.
4. While supporting the leg at both the knee and ankle, gently bends the knee and then returns the leg to its original position (flexion and extension), performing the movement at least three times, unless the client reports pain. The joints are moved slowly, smoothly, and carefully, stopping if the client indicates pain.
5. While supporting the foot and ankle close to the bed, gently pulls the foot toward the head (dorsiflexion) and then pushes or pulls the foot downward, with the toes pointing down (plantar flexion), performing the movements at least three times, unless the client reports pain. The joint is moved gently, slowly, and smoothly through its range of motion, stopping if pain is expressed.
6. Ensures the call light is within reach and the bed is lowered to a safe position.
7. Washes hands after completing the skill.

Skill 16 – Administers Modified Passive Range of Motion Exercises for One Shoulder

1. Clearly explains the procedure in a calm, slow, and direct manner, maintaining eye contact whenever possible.
2. Ensures privacy by using a curtain, screen, or door.
3. Instructs the client to notify the candidate if any pain is felt during the exercise.
4. While supporting the arm at both the elbow and wrist, gently raises the client’s straightened arm from the side to head level (flexion), then lowers it back to the side of the body (extension), repeating the motion at least three times unless pain is reported. The joint is moved smoothly, slowly, and gently, stopping if the client experiences pain.
5. While supporting the arm at both the elbow and wrist, moves the client’s straightened arm away from the body to shoulder level (abduction) and then returns it to the side of the body (adduction), repeating the motion at least three times unless pain is reported. The joint is moved slowly, smoothly, and gently through the range of motion, discontinuing if pain is verbalized.
6. Ensures the call light is within reach and the bed is in a lowered position.
7. Washes hands after completing the procedure.

Skill 17 – Assists in Positioning Client onto Their Side

1. Clearly explains the procedure in a slow, direct manner, maintaining eye contact whenever possible.
2. Ensures privacy by using a curtain, screen, or door.
3. Lowers the head of the bed before turning the client.
4. Raises the side rail on the side toward which the client will be turned.
5. Assists the client in gently rolling onto their side toward the raised side rail.
6. Positions or adjusts a pillow under the client’s head for proper support.
7. Repositions the client’s arm and shoulder to avoid pressure on the arm.
8. Supports the top arm with a supportive device.
9. Places a supportive device behind the client’s back for stability.
10. Positions a supportive device between the client’s legs, with the top knee flexed, ensuring support for the knee and ankle.
11. Ensures the call light is within reach and the bed is lowered.
12. Washes hands after completing the procedure.

Skill 18 – Performs and Records Manual Blood Pressure Measurement

1. Clearly explains the procedure, speaking slowly and directly while maintaining eye contact whenever possible.
2. Before using the stethoscope, disinfects the bell/diaphragm and earpieces with alcohol.
3. Positions the client’s arm with the palm facing up and ensures the upper arm is exposed.
4. Locates the brachial artery on the inner aspect of the arm, at the elbow bend.
5. Securely places the blood pressure cuff around the client’s upper arm, aligning the sensor/arrow over the brachial artery.
6. Ensures earpieces of the stethoscope are properly fitted, with the bell/diaphragm positioned over the brachial artery.
7. Inflates the cuff to a range of 160–180 mm Hg. If a pulse is heard immediately upon deflation, completely deflate the cuff and re-inflate it to no more than 200 mm Hg.
8. Slowly releases air from the cuff, noting the first sound (systolic) and the last sound (diastolic). If rounding is necessary, round the measurement to the nearest 2 mm of mercury.
9. Removes the cuff.
10. Ensures the call light is within the client’s reach.
11. Washes hands before recording the results.
12. Records both the systolic and diastolic pressures, ensuring the measurements are within 8 mm of mercury of the evaluator’s reading.

Skill 19 – Administers Catheter Care for Women

1. Clearly and slowly explains the procedure, ensuring face-to-face communication whenever possible.
2. Ensures privacy by using a curtain, screen, or door.
3. Checks the water temperature for comfort and safety before washing, asking the client to confirm the water’s comfort level.
4. Wears clean gloves before beginning the washing process.
5. Places a linen protector beneath the perineal area, including the buttocks, before washing.
6. Exposes only the area around the catheter, ensuring privacy by covering the client from the hips to the knees.
7. Lathers soap onto a wet washcloth.
8. Gently holds the catheter at the meatus without pulling, and cleans at least four inches of catheter away from the meatus using a clean part of the washcloth with each stroke.
9. Holds the catheter at the meatus without tugging, rinsing at least four inches of the catheter away from the meatus with a clean washcloth, using a new area for each stroke.
10. While securing the catheter at the meatus, dries at least four inches of catheter, moving away from the meatus with a dry cloth or towel.
11. Empties, rinses, and dries the basin.
12. Places the basin in the designated area for soiled supplies.
13. Disposes of used linen in the appropriate soiled linen container and discards the linen protector properly.
14. Ensures that there is no contact between the candidate’s clothing and the used linen.
15. Removes and discards gloves without contamination, places them in the waste container, and washes hands thoroughly.
16. Ensures the call light is within the client’s reach, and the bed is in the lowest position.

Skill 20 – Administers Foot Care to a Single Foot

1. Clearly and slowly explains the procedure, maintaining direct face-to-face communication whenever possible.
2. Ensures privacy with the use of a curtain, screen, or door.
3. Verifies the water temperature for safety and comfort before washing, asking the client to confirm the water’s comfort level.
4. Positions the basin comfortably for the client, ensuring a protective barrier underneath.
5. Puts on clean gloves before beginning the foot care process.
6. Places the client’s bare foot into the water.
7. Lathers soap onto a wet washcloth.
8. Lifts the foot out of the water and thoroughly washes it, including between the toes.
9. Rinses the foot, ensuring to clean between the toes.
10. Dries the foot, including between the toes, using a dry towel or washcloth.
11. Applies lotion to the top and bottom of the foot, avoiding the toes, and removes excess lotion with a towel or washcloth.
12. Provides support to the foot and ankle throughout the procedure.
13. Empties, rinses, and dries the basin.
14. Places the basin in the designated area for soiled supplies.
15. Disposes of used linens into the soiled linen container.
16. Removes and disposes of gloves without contamination, placing them in the waste container, and washes hands thoroughly.
17. Ensures the call light is within the client’s reach.

Skill 21 – Administers Oral Hygiene

1. Describes each step of the procedure, speaking clearly, slowly, and directly, while keeping eye contact whenever possible.
2. Ensures privacy by using a curtain, screen, or door.
3. Positions the client upright (75-90 degrees) before beginning mouth care.
4. Wears clean gloves prior to starting mouth cleaning.
5. Drapes a cloth towel across the client’s chest before starting.
6. Prepares by securing a cup of water and wetting the toothbrush.
7. Applies toothpaste to the moistened toothbrush before cleaning.
8. Cleans the client’s mouth (including tongue and all tooth surfaces) with gentle movements.
9. Maintains a clean technique when placing the toothbrush down.
10. Holds the emesis basin under the client’s chin as they rinse.
11. Wipes the client’s mouth and removes the protective cloth.
12. Disposes of used linens in the soiled linen container.
13. Rinses the toothbrush, then empties, rinses, and dries the basin.
14. Removes gloves carefully to avoid self-contamination, disposes of them in the waste container, and washes hands.
15. Ensures the call light is within reach and the bed is in a low position.

Skills 22 – Provides Perineal Hygiene Care for a Female

1. Describes the steps of the procedure clearly, slowly, and directly, keeping eye contact whenever possible.
2. Ensures privacy by using a curtain, screen, or door.
3. Checks water temperature for safety and comfort before beginning, and asks the client to confirm that it feels comfortable.
4. Wears clean gloves before starting to wash the perineal area.
5. Places a protective pad or linen protector under the perineal area and buttocks before washing.
6. Uncovers the perineal area, exposing only the area between the hips and knees.
7. Applies soap to a wet washcloth.
8. Cleans the genital area by moving from front to back, using a new part of the washcloth with each stroke.
9. Using a clean washcloth, rinses the soap from the genital area from front to back, using a fresh part of the cloth for each pass.
10. Dries the genital area from front to back with a dry towel or washcloth.
11. After washing the genital area, turns the client to their side and cleans the rectal area from front to back, using a clean area of the washcloth for each stroke.
12. Rinses soap from the rectal area with a clean washcloth, moving from front to back and using a fresh part of the washcloth for each stroke.
13. Dries the rectal area from front to back with a dry towel or washcloth.
14. Repositions the client comfortably.
15. Empties, rinses, and dries the basin.
16. Places the basin in the designated area for used supplies.
17. Disposes of used linens in the soiled linen container and discards the linen protector properly.
18. Avoids letting personal clothing come into contact with used linens.
19. Removes gloves without self-contamination, disposes of them in the waste container, and washes hands.
20. Ensures the call light is within reach and that the bed is in a low position.

Skill 23 – Assists with Moving from Bed to Wheelchair Using a Transfer Belt

1. Clearly and slowly explains the steps of the procedure, speaking directly and maintaining eye contact whenever possible.
2. Ensures privacy by using a curtain, screen, or door.
3. Before assisting the client to stand, places the wheelchair next to the bed, with its head facing the foot of the bed or vice versa.
4. Ensures footrests are either folded up or removed before helping the client to stand.
5. Locks the wheelchair wheels securely before assisting the client to stand.
6. Adjusts the bed to a safe height before assisting the client to stand.
7. Checks and secures the bed wheels before helping the client to stand.
8. Assists the client to sit up on the edge of the bed, ensuring their feet are flat on the floor.
9. Verifies that the client is wearing shoes before helping them stand.
10. Applies the transfer belt securely around the client’s waist, over their clothing or gown.
11. Provides instructions to the client on how to assist with the transfer, including a prearranged cue to indicate when to start standing.
12. Faces the client to ensure the safety of both during the transfer, counting to three (or using another agreed-upon cue) to signal the client to start standing.
13. Assists the client to stand gradually on cue, holding the transfer belt firmly with an upward grip on both sides and maintaining stability with the client’s legs against the wheelchair.
14. Gently lowers the client into the wheelchair.
15. Positions the client so their back is touching the wheelchair and removes the transfer belt.
16. Places the client’s feet on the footrests.
17. Ensures the call light is within reach.
18. Washes hands after completing the procedure.