13.1 INACE Clinical Skills Test: Structure and Strategies
Key Takeaways
- You will be tested on 5 randomly selected skills from 21 — you must be prepared for all of them
- Universal steps for every skill: wash hands → identify → explain → privacy → perform → comfort/safety → wash hands
- Forgetting to wash hands is the #1 reason candidates fail the clinical skills test
- Verbalize your actions during the test — the evaluator assesses what they can observe or hear
- If you make a mistake, self-correct — evaluators may give partial credit
- Practice until skills are automatic — muscle memory reduces anxiety and prevents errors
Last updated: March 2026
INACE Clinical Skills Test: Structure and Strategies
The clinical skills evaluation is the hands-on portion of the Illinois Nurse Aide Competency Exam (INACE). You will be tested on 5 randomly selected skills from the 21 mandated performance skills. You will not know in advance which 5 skills will be tested, so you must be prepared to demonstrate all 21 proficiently.
Clinical Skills Test Structure
| Component | Details |
|---|---|
| Skills tested | 5 randomly selected from 21 |
| Time allotted | Approximately 31 minutes total |
| Evaluator | Trained nurse aide evaluator observes your performance |
| Patient | Mannequin or standardized patient (actor) |
| Setting | Simulated healthcare environment |
| Passing standard | Must perform all critical steps correctly |
Universal Steps for EVERY Skill
These steps must be performed with EVERY skill demonstration. Forgetting any of these is an automatic point deduction:
| Step | When | Why |
|---|---|---|
| 1. Wash hands | Before every skill | Infection control — #1 priority |
| 2. Identify the resident | Before starting | Safety — ensure correct person |
| 3. Explain the procedure | Before starting | Residents' rights — informed consent |
| 4. Provide privacy | Before starting | Close curtain, close door |
| 5. Perform the skill | During | Complete all critical steps correctly |
| 6. Ensure comfort and safety | After the skill | Position comfortably, call light in reach |
| 7. Wash hands | After every skill | Infection control |
Common Reasons Candidates Fail the Clinical Skills Test
| Reason | Prevention Strategy |
|---|---|
| Forgetting to wash hands | Make it automatic — before AND after every single skill |
| Skipping explanation | Always tell the resident what you are going to do |
| Not providing privacy | Always close the curtain/door before starting |
| Rushing | Slow down; accuracy > speed |
| Forgetting the call light | Always place it within reach at the end of every skill |
| Not checking water temperature | ALWAYS check water before applying to the resident |
| Breaking infection control | Gloves, clean to dirty, proper disposal |
| Improper body mechanics | Wide base, bend knees, keep load close |
| Not locking wheels | Lock wheelchair brakes AND bed wheels for every transfer |
| Nervousness | Practice repeatedly until it becomes automatic; breathe |
Tips for Exam Day Success
- Practice each skill until it is automatic — muscle memory reduces anxiety
- Talk through what you are doing — the evaluator can only assess what they can observe or hear
- Verbalize your actions — "I am now washing my hands" or "I am providing privacy by closing the curtain"
- If you make a mistake, correct it — the evaluator may give credit if you self-correct
- Do not rush — use all the time available; accuracy matters more than speed
- Breathe and stay calm — nervousness causes forgetfulness
- Treat the mannequin like a real person — talk to it, explain what you are doing
- Follow the sequence — complete steps in the correct order
- Wear appropriate attire — closed-toe shoes, scrubs, hair pulled back, no long nails or jewelry
- Review critical steps — focus on the steps that, if missed, will fail you
The 21 Mandated Performance Skills — Quick Reference
| # | Skill | Key Focus |
|---|---|---|
| 1 | Handwashing | 20 seconds, all surfaces, paper towel to turn off faucet |
| 2 | Indirect care | Bed making with proper technique |
| 3 | Positioning | Turning and positioning in bed safely |
| 4 | Transfers | Bed to wheelchair using gait belt, 45-degree angle |
| 5 | Ambulation | Assistive device, gait belt, walk at resident's pace |
| 6 | Passive ROM | Support above and below joint, stop if pain |
| 7 | Feeding/hydration | Fowler's position, 1/3 full spoon, 30 min upright after |
| 8 | Oral temperature | Sublingual pocket, 15 min after eating/drinking |
| 9 | Blood pressure | 1 inch above antecubital, brachial artery, 2-3 mmHg/sec deflation |
| 10 | Radial pulse/respirations | Fingertips (not thumb), 60 seconds each, count resp covertly |
| 11 | Weight/height | Same time, same scale, same clothing |
| 12 | Intake/output | Measure in mL, record all intake and output |
| 13 | Bed bath | Clean to dirty, 105-110°F, cover exposed areas |
| 14 | Perineal care (female) | Front to back, clean area of washcloth each stroke |
| 15 | Mouth care (conscious) | Fowler's position, brush all surfaces, rinse |
| 16 | Mouth care (unconscious) | Side-lying, no liquid in mouth, sponge swabs |
| 17 | Denture care | Line sink with towel, cool/warm water, denture brush |
| 18 | Dressing/undressing | Weak side on first, strong side off first |
| 19 | Hair care | Ends to scalp, resident's preferred style |
| 20 | Fingernail care | Soak, clean, trim straight, file smooth |
| 21 | Catheter care | Bag below bladder, don't touch spout to container |
Test Your Knowledge
What is the FIRST thing you should do before performing ANY clinical skill during the INACE?
A
B
C
D
Test Your Knowledge
During the INACE clinical skills test, how many skills will you be asked to demonstrate?
A
B
C
D
Test Your Knowledge
You realize you forgot to explain the procedure to the resident before starting a skill during the clinical test. What should you do?
A
B
C
D