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Fingernail care: CNA skills test steps

Updated · Reviewed against official sources

Check the water temperature, soak the hand, clean under each nail with an orangewood stick, dry the hand thoroughly including between the fingers, and file the nails smooth with an emery board. Do not cut nails unless your facility policy and the care plan allow it.

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

  1. 1Knock, introduce yourself by name and title, and greet the resident by name.
  2. 2Identify the resident (for example, check the name band or ask the resident to state their name) per facility policy.
  3. 3Explain the procedure in simple words and ask the resident to help as much as they are able.
  4. 4Key step: Provide privacy: close the door and pull the curtain.
  5. 5Key step: Perform hand hygiene before touching the resident.
  6. 6Key step: Fill a basin with warm water and check the temperature to be sure it is safe and comfortable.
  7. 7Soak the resident's fingers or hand for the time your facility directs.
  8. 8Key step: Clean under each fingernail gently with an orangewood stick, wiping the stick on a towel after each nail.
  9. 9Key step: Dry the hand thoroughly, including between the fingers.
  10. 10Shape and smooth the nails with an emery board or file.
  11. 11Support the hand throughout the procedure.
  12. 12Empty and rinse the basin and dispose of used supplies.
  13. 13Key step: Return the bed to its lowest position and make sure the wheels are locked.
  14. 14Key step: Place the call light and personal items within the resident's reach.
  15. 15Key step: Open the privacy curtain, perform hand hygiene, and report anything unusual to the nurse.

Common mistakes

  • Skipping the water temperature check.
  • Leaving moisture between the fingers.
  • Pushing too hard under the nail.
  • Cutting nails without permission.

Quick answers

What is an orangewood stick?
A small wooden stick used to gently clean under fingernails.
Can CNAs trim fingernails?
Rules vary by facility and resident condition. Residents with diabetes or circulation problems usually need nail care from a nurse or podiatrist.

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.

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Related

Sources

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