CNA Skill: Hand and Nail Care | Step-by-Step Guide for the Florida Exam

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This skill evaluates your ability to provide hand and nail care to one of the resident's hands. It tests gentle grooming technique along with your communication, safety awareness, and infection control practices. There is no hair care and no nail clipping in this skill; nails are left smooth with an emery file, never cut.

Equipment and Supplies Needed

• 2 towels
• Orangewood stick
• Emery nail file
• Lotion
• Wash basin
• 2 washcloths (one to wash with soap, one clean and soap-free to rinse)

Step-by-Step Procedure

Below are the criteria checklist checkpoints for Hand and Nail Care on the Florida CNA clinical skills exam, the same checkpoints the evaluators score. Checkpoints marked (IC) are the universal indirect care checkpoints, which are scored on every skill.

1. Greet resident, address by name, and introduce self? (IC)
2. Provide explanations to resident about care before beginning and during care? (IC)
3. Use water of safe temperature for soaking fingers or hand?
4. Place fingers or full hand into basin of water to soak before removing residue from under nails?
5. Clean hand surfaces using wet washcloth, cleaning between fingers, and if soap used, rinse or remove soap using a clean, soap-free, wet washcloth?
6. Use flat edge of orangewood stick to remove residue under tips of each fingernail, and remove residue from edge of orangewood stick, if present, before using again to clean under another fingernail?
7. Rest resident's hand on barrier such as a dry towel once removed from basin while providing nail and hand care?
8. Dry hand before completing care?
9. Leave nails smooth (e.g., free of jagged edges)?
10. Apply lotion to cleaned hand after nail care finished?
11. Support resident's arm if raised off table when providing nail and hand care?
12. Remove visible excess lotion from hand if present at completion of hand care?
13. Complete skill having rinsed, dried and stored basin, placing soiled linens in hamper, disposing of trash, disposing of or storing emery board and orangewood stick, and leaving overbed table dry?
14. Ask resident about preferences during care? (IC)
15. Use Standard Precautions and infection control measures when providing care? (IC)
16. Ask resident about comfort or needs during care or before care completed? (IC)
17. Promote resident's rights during care? (IC)
18. Promote resident's safety during care? (IC)

Common Mistakes on the Prometric Test

Based on our experience preparing thousands of students for Florida's CNA state exam, here are the most common mistakes candidates make on this skill:

• Using the pointed tip of the orangewood stick: The checklist calls for the flat edge under the tips of each fingernail, removing residue from the stick before moving to the next nail.
• Skipping the soaking step: The fingers or full hand must soak in the basin of water before you remove residue from under the nails.
• Forgetting the finishing checkpoints: Dry the hand, leave the nails smooth and free of jagged edges, apply lotion, and remove any visible excess lotion.
• Putting on gloves: this skill is done without gloves; no checkpoint calls for them, and they make the nail work clumsier.

Test Day Tips for Hand and Nail Care

• Be gentle and narrate what you're doing: the evaluator watches how you interact with the resident.
• Ask the resident about preferences: whether the water temperature is comfortable and whether they would like lotion.

Frequently Asked Questions

Can you cut a resident's nails on the CNA exam?

No. There are no nail clippers in this skill. You soak the hand, clean under the nail tips with the flat edge of an orangewood stick, and leave the nails smooth using an emery file, free of jagged edges, never cut.

Master This Skill with Video Demonstrations

Reading the steps is a great start, but watching the skill performed correctly makes a huge difference on test day. Our online CNA course includes:

• HD video demonstration of Hand and Nail Care performed exactly as Prometric expects
• Detailed narration explaining each checkpoint the evaluator looks for
• Practice scenarios and tips from experienced CNA instructors
• All 22 clinical skills plus written exam preparation

Start with a free course preview. See the quality of our video instruction before you commit.

All 22 CNA Clinical Skills

See the full CNA clinical skills guide, or jump to any skill: Handwashing · Mouth Care (Brushing Teeth) · Denture Care · Feeding a Resident · Taking a Pulse · Measuring Respirations · Changing an Occupied Bed · Dressing with One-Sided Weakness · Female Catheter Care · Bedpan Assistance · Emptying Urinary Drainage Bag · Female Perineal Care · Range of Motion (Lower Body) · Range of Motion (Elbow and Wrist) · Range of Motion (Shoulder) · Partial Bed Bath · Change of Position · Wheelchair Transfer · Foot Care · Ambulation with Gait Belt · Indirect Care.