What Skills Are Tested on the Texas CNA Skills Exam?

Understanding the Texas CNA Skills Exam

The Texas CNA skills exam tests your ability to perform basic nursing tasks safely and correctly. You'll be asked to complete five randomly selected skills in front of a nurse evaluator. One of these will always be handwashing. The other four come from a list of 20 possible skills.

This practical exam is the second part of your Texas certification. You must pass both the written test and the skills exam to become a certified nursing assistant in Texas.

The Five Skills You'll Perform

During your exam, you'll perform exactly five skills. The state testing agency randomly selects which skills you'll demonstrate. Here's what to expect:

• Skill 1: Always handwashing
• Skills 2-5: Four additional skills chosen randomly from the approved list

You have about 30 minutes to complete all five skills. The evaluator watches you perform each one and marks whether you did it correctly.

Mandatory Skill: Handwashing

Every candidate must demonstrate proper handwashing. This skill appears on every test because it's the foundation of infection control in healthcare.

You'll need to show that you can:

• Turn on the water and adjust the temperature
• Wet your hands completely
• Apply soap and create lather
• Scrub for at least 20 seconds
• Clean under your fingernails
• Rinse with fingers pointed down
• Dry with a paper towel
• Turn off the faucet using the paper towel

Most students practice this skill until they can do it perfectly without thinking about the steps.

Complete List of Testable Skills

The Texas Department of Aging and Disability Services maintains the official list of skills that may appear on your exam. Here are all 20 skills you should be prepared to demonstrate:

Clinical Skills List

1. Ambulate the resident using a transfer/gait belt 

2. Assist resident needing to use a bedpan 

3. Change bed linen while the resident remains in bed 

4. Change resident’s position to a supported side-lying position 

5. Dress a resident who has a weak arm

6. Empty contents of resident’s urinary drainage bag, and measure and record urine output on an Intake and Output (I&O) form 

7. Feed a resident who is sitting in a chair 

8. Measure and record a resident’s radial pulse 

9.  Measure and record a resident’s respirations

10. Provide catheter care to a female resident who has an indwelling urinary catheter 

11. Provide foot care to a resident who is sitting in a chair 

12. Provide mouth care to a resident who has a denture 

13. Provide mouth care to a resident who has teeth 

14. Provide perineal care to a female resident who is incontinent of urine 

15. Provide resident hand and nail care 

16 Provide resident a partial bed bath and back rub

17. Provide resident with passive range of motion (ROM) exercises to one elbow and wrist 

18. Provide resident with passive range of motion (ROM) exercises to one shoulder 

19. Provide resident with passive range of motion (ROM) exercises to one hip, knee, and ankle 

20. Transfer the resident from the bed into a wheelchair using a pivot technique and a transfer/gait belt

What Evaluators Look For

The nurse evaluator uses a detailed checklist for each skill. They mark whether you complete each required step correctly. Here's what matters most:

Safety First

Any action that could harm the patient results in an automatic failure for that skill. This includes:

• Failing to lock wheelchair brakes before transfers
• Not identifying the patient before providing care
• Forgetting to raise bed rails when required
• Positioning a patient in a way that could cause injury

Infection Control

You must demonstrate proper infection control practices. This means:

• Washing hands before and after patient contact
• Wearing gloves when appropriate
• Keeping clean and dirty items separated
• Disposing of waste properly

Privacy and Dignity

Treating the patient (or mannequin) with respect is essential. You should:

• Knock before entering the room
• Explain what you're doing
• Close curtains or doors for privacy
• Cover the patient appropriately
• Speak respectfully throughout

Following Proper Steps

Each skill has specific steps that must be done in order. Missing critical steps can result in failure. 

How the Testing Process Works

When you arrive for your skills exam, here's what happens:

Check-in: You'll show your ID and testing authorization. The testing center will verify your identity.

Random selection: A computer randomly generates your five skills. You'll receive a printout showing which skills you'll perform.

Preparation time: You get a few minutes to review your skills and gather any needed supplies.

Testing: You perform each skill one at a time while the evaluator observes and marks their checklist.

Completion: After finishing all five skills, you'll leave the testing area. Results are typically available within a few days.

Pass or Fail: Understanding the Scoring

You must pass at least four out of five skills to pass the practical exam. If you fail handwashing, you automatically fail the entire exam because it's mandatory.

If you don't pass, you can retake the exam. You'll need to:

• Pay another testing fee
• Schedule a new test date
• Practice the skills you struggled with
• Return to complete the full five-skill exam again

Most students who fail do so because of nervousness, not lack of knowledge. Practice and preparation are the keys to passing on your first attempt.

How to Prepare for the Skills Test

Practice Every Skill

Don't just focus on the skills you think are easy. Practice all 20 skills until you can perform each one correctly without looking at notes.

Use the Exact Steps

Your training program will teach you the specific steps required for the Texas exam. Follow these exactly. Different states may have slightly different requirements.

Practice with a Partner

Have someone watch you perform skills and use a checklist to mark what you do correctly. This simulates the actual test environment.

Time Yourself

Get comfortable completing skills within the time limit. Practice working efficiently without rushing.

Focus on Your Weak Areas

If you struggle with a particular skill, spend extra time on it. The random selection means any skill could appear on your test.

Stay Calm

Anxiety causes more failures than lack of knowledge. Take deep breaths, read each skill card carefully, and trust your training.

Common Mistakes to Avoid

Students often fail because of these preventable errors:

• Rushing: Going too fast leads to skipped steps
• Not reading the card: Each skill card has specific instructions
• Forgetting safety: Always lock brakes, identify patients, and maintain proper body mechanics
• Poor communication: Tell the "patient" what you're doing at each step
• Skipping handwashing: Wash your hands before and after patient contact in every skill

What Happens After You Pass

Once you pass both the written knowledge test and the skills exam, Texas will add your name to the state registry. This makes you officially certified to work as a CNA in Texas.

You can then:

• Apply for CNA positions at hospitals, nursing homes, and other facilities
• Start working immediately
• Begin earning your CNA salary
• Continue your education in nursing if you choose

Get Expert Training for Your CNA Skills Test

At CNA Training Institute in Sugar Land, we prepare you thoroughly for the Texas skills exam. Our hands-on clinical training covers all 20 testable skills. You'll practice in our state-accredited facility with experienced instructors who know exactly what evaluators look for.

We're the only state-accredited exam center in Fort Bend County, so many of our students take their certification exam right where they trained. This familiarity helps reduce test-day anxiety.

Our 3-week program includes 100 hours of training split between classroom instruction and clinical practice. You'll practice each skill repeatedly until you feel confident. We also provide test-taking strategies and help you manage exam stress.

Ready to start your CNA training? Call us at (346) 633-4628 or visit cnatraininginstitute.org to register for our next class. Our experienced team will guide you from the first day of class all the way through passing your state certification exam.