How close does my blood pressure reading have to be on the skills test?

Your reading is compared with the evaluator's, and it must fall within the tolerance printed in your candidate handbook. See our guide on blood pressure tolerance.

Which sound is the systolic pressure?

The first clear tapping sound as the cuff deflates is the systolic pressure. The point where the sounds disappear is the diastolic pressure.

Measuring and recording manual blood pressure: CNA skills test steps

Updated November 12, 2026 · Reviewed against official sources

Place the correct-size cuff on the bare upper arm with the arm supported at heart level, inflate, then deflate slowly while listening over the brachial artery: the first clear sound is the systolic reading and the point where sounds disappear is the diastolic. Your recorded reading must fall within the tolerance in your candidate handbook compared with the evaluator's reading.

Your state's nurse aide candidate handbook is the authority on exam format, skills lists and scoring. This page explains the general picture and links the official sources.

Steps

KEYmarks 5 steps that candidate handbooks commonly treat as critical. Missing a critical step usually fails the skill.

1Knock, introduce yourself by name and title, and greet the resident by name.
2Identify the resident (for example, check the name band or ask the resident to state their name) per facility policy.
3Explain the procedure in simple words and ask the resident to help as much as they are able.
4Key step: Provide privacy: close the door and pull the curtain.
5Key step: Perform hand hygiene before touching the resident.
6Clean the stethoscope earpieces and diaphragm with alcohol wipes.
7Have the resident sitting or lying comfortably with the arm bare, supported and at about heart level, palm up.
8Place the deflated cuff snugly on the upper arm, about one inch above the elbow, with the artery marker over the brachial artery.
9Locate the brachial pulse at the inner elbow with your fingertips.
10Place the earpieces in your ears and the diaphragm over the brachial artery.
11Close the valve and inflate the cuff to the level your handbook or instructor specifies (above the point where the pulse can no longer be felt or heard).
12Open the valve and deflate slowly and steadily while listening.
13Note the first clear sound (systolic) and the point where the sound disappears (diastolic).
14Deflate the cuff completely and remove it.
15Key step: Record the reading accurately; it must be within the tolerance in your candidate handbook.
16Clean the stethoscope again and store equipment.
17Key step: Place the call light and personal items within the resident's reach.
18Key step: Open the privacy curtain, perform hand hygiene, and report anything unusual to the nurse.

Common mistakes

Using a cuff that is too small or too large, which gives false readings.
Deflating too fast and missing the first sound.
Placing the cuff over clothing.
Forgetting to record the reading or writing it in the wrong place.
Arm hanging down or unsupported.

Tips

Practice on as many different people as you can; reading the gauge accurately takes repetition.

Quick answers

How close does my blood pressure reading have to be on the skills test?: Your reading is compared with the evaluator's, and it must fall within the tolerance printed in your candidate handbook. See our guide on blood pressure tolerance.
Which sound is the systolic pressure?: The first clear tapping sound as the cuff deflates is the systolic pressure. The point where the sounds disappear is the diastolic pressure.

What to do next

Skills and the written test are scored separately, and you must pass both. Check your written readiness in about 15 minutes.

Take the free 20-question test

Sources

Checked: November 12, 2026. Rules, fees and vendors change — always confirm with your state's official page and candidate handbook.