The Manual Skill Test: Mandatory First Tasks, Scoring & the 24 Task List
Key Takeaways
- The North Dakota manual skill test assigns three or four randomly selected tasks in a single 30-minute block, with a verbal alert when fifteen minutes remain.
- Your first task is always one of three mandatory tasks — bedpan with output, isolation gown plus urinary drainage bag, or perineal care on a manikin — and each embeds real soap-and-water hand washing that must be demonstrated at the end.
- To pass, you must correctly perform every key (bold) step plus 80% of the non-key steps on each assigned task; missing a single key step fails that task.
- Steps that are only verbalized do not count — every step must actually be demonstrated — and skill steps are generally not order-dependent unless the words BEFORE or AFTER appear in the step.
- All tasks except perineal care are performed on a live resident actor; perineal care is demonstrated on a manikin, and a failed skill test is retaken with three or four tasks, one of which repeats a previously failed task.
The Manual Skill Test: Mandatory First Tasks, Scoring & the 24 Task List
The knowledge exam is 72 questions you can guess your way through in places. The manual skill test is not — one missed key step fails the task, and a failed task fails the component. This section is a complete map of how North Dakota runs it.
1. Format
+-----------------------------------------------------------------------------+
| NORTH DAKOTA MANUAL SKILL TEST FORMAT |
| |
| TASKS ---> THREE (3) or FOUR (4) randomly selected tasks. |
| Task 1 is always a MANDATORY FIRST TASK. |
| Then TWO (2) or THREE (3) more from the task listing. |
| TIME ---> 30 minutes total for ALL your tasks. You are alerted |
| after 15 minutes have elapsed. |
| EVALUATOR ---> An RN Test Observer records what you do; D&SDT- |
| Headmaster scoring teams officially score and |
| double-check the form afterward. |
| SCENARIOS ---> The RN Test Observer reads a scenario immediately |
| before each task. You may ask to have any scenario |
| repeated at any time. |
| ACTOR ---> Live resident actor for every task EXCEPT perineal |
| care, which is demonstrated on a MANIKIN. |
| QUESTIONS ---> Once the timer starts you may not ask questions and |
| the RN Test Observer may not answer them. |
+-----------------------------------------------------------------------------+
Why do some candidates get three tasks and others four? Because the TMU© assignment algorithm builds each test to be comparable in overall difficulty and average completion time. A test containing a long task gets fewer tasks. You do not choose, and you cannot predict.
Between tasks you announce that you are finished and move to a designated relaxation area while the RN Test Observer and actor reset the room.
2. The Three Mandatory First Tasks
Every North Dakota skill test opens with one of these three:
- Assist a Resident with a Bedpan, Measure and Record Output with Hand Washing
- Donn (put on) an Isolation Gown and Gloves, then Empty a Urinary Drainage Bag, Measure and Record the Output, Doff (remove) the Gown and Gloves with Hand Washing
- Perineal Care for a Female Resident with Hand Washing — demonstrated on a manikin
[!IMPORTANT] Hand washing with actual soap and water is embedded in each of these three mandatory tasks and must be demonstrated at the end. This is the single most reliable prediction you can make about your skill test. Everywhere else on the North Dakota checklists, "perform hand hygiene" means cover all surfaces of hands with hand sanitizer and rub until completely dry. Practise both, and know which one belongs where.
Notice what all three have in common: gloves, body fluids, and measurement. Two of the three require you to measure and record output on a recording form, and one requires full isolation-gown technique. If your practice time is limited, these three tasks earn the highest return.
The recording form
If your test includes a task requiring a count or a measurement, the RN Test Observer supplies a recording form. You sign that form during the equipment and supplies demonstration, before your skill test begins. Measurements you record on it are compared against the observer's own measurements, and both are reviewed if you later request a test review.
3. How the Skill Test Is Scored
| Rule | What it means in the room |
|---|---|
| All key steps + 80% of non-key steps | Key steps are printed in bold on the checklist. You must perform every one correctly on every assigned task, and reach 80% on that task's non-key steps. Missing one key step fails the task outright. |
| Only listed steps are scored | You are scored on the steps printed for that task — nothing more. Extra flourishes earn nothing and burn clock. |
| Demonstration, not narration | "All steps must actually be demonstrated. Steps that are only verbalized WILL NOT COUNT." Saying "I would wash my hands here" scores zero. |
| Order usually does not matter | Steps are generally not order-dependent unless the step contains the words BEFORE or AFTER. Those words are the flag that sequence is being graded. |
| Self-correction is allowed | If you think you made a mistake, say so and re-demonstrate the step. You may repeat or correct any step on any task at any point in your 30 minutes, until you tell the observer you are finished. |
| You may direct the observer | At any time during any task you may direct the RN Test Observer to move anywhere needed to help provide safety for the resident — for example, to stand on the far side of the bed. |
[!TIP] The "finished" declaration is a commitment. When you verbally tell the RN Test Observer you are finished with the skill test, your window to correct anything closes. If time remains and you are unsure about a step, correct it before you say you are done.
Failing and retaking
If you fail the skill test, you retake it with three or four tasks, one of which will be one of the tasks you previously failed. Combined with the three-attempt limit counted from your training completion date, this means a candidate who fails the same task twice is in real jeopardy.
4. The Complete Published Task List
North Dakota publishes 24 skill tasks. Three are the mandatory first tasks above; the remaining 21 are the random pool. Grouped by the knowledge subject area they map to:
| Group | Tasks |
|---|---|
| Mandatory first tasks (3) | Assist a Resident with a Bedpan, Measure and Record Output with Hand Washing • Donn an Isolation Gown and Gloves, Empty a Urinary Drainage Bag, Measure and Record Output, Doff the Gown and Gloves with Hand Washing • Perineal Care for a Female Resident with Hand Washing (manikin) |
| Personal care (6) | Bed Bath (Partial) — Whole Face and One Arm, Hand and Underarm • Denture Care • Mouth Care — Brushing a Resident's Teeth • Nail Care — One Hand • Dressing a Bedridden Resident • Making an Occupied Bed |
| Mobility, transfers & restorative (7) | Ambulation with a Gait Belt • Ambulation with a Walker • Stand and Pivot-Transfer a Weight-Bearing, Non-Ambulatory Resident from their Bed to a Wheelchair using a Gait Belt • Stand and Pivot-Transfer a Weight-Bearing, Non-Ambulatory Resident from a Wheelchair to their Bed using a Gait Belt • Position Resident on their Side in Bed • Range of Motion Exercise for a Resident's Hip and Knee • Range of Motion Exercise for a Resident's Shoulder |
| Measurement & data collection (4) | Vital Signs: Count and Record a Resident's Pulse and Respirations • Vital Signs: Take and Record a Resident's Manual Blood Pressure • Weighing an Ambulatory Resident • Fluid Intake |
| Nutrition & hydration (2) | Feeding a Dependent Resident • Passing Fresh Water |
| Circulation & emergency (2) | Applying an Anti-Embolic Stocking to One Leg • Abdominal Thrust |
Two counting details that catch people out: the North Dakota vital-signs tasks require you to count the pulse for 60 seconds and count respirations for 60 seconds — not thirty seconds doubled. And the anti-embolic stocking task expects you to turn the stocking inside out down to the heel, place it over toes, foot and heel, then roll it up the leg, finishing with a smooth, wrinkle-free, non-restricting stocking and a check of the toes for pressure.
5. The Universal Steps Buried in Almost Every Task
Read the 24 checklists side by side and the same opening and closing steps repeat. Drill this spine until it is automatic, and you will start every task with points already banked:
+-----------------------------------------------------------------------------+
| THE ND SKILL-TASK SPINE (nearly every task) |
| |
| OPENING |
| 1. Knock on the door. |
| 2. Introduce yourself to the resident. |
| 3. Perform hand hygiene (sanitizer; rub until COMPLETELY DRY). |
| 4. Explain the procedure to the resident. |
| 5. Provide privacy - pull the curtain (or expose only the body part). |
| 6. Raise the bed height / position equipment for good body mechanics. |
| |
| CLOSING |
| - Leave the resident covered / clothed and comfortable. |
| - Place the call light or signal device WITHIN EASY REACH. |
| - Maintain respectful, courteous interaction throughout. |
| - Perform hand hygiene again at the end. |
| - On MANDATORY FIRST TASKS: real soap-and-water hand washing. |
+-----------------------------------------------------------------------------+
The call light step is worth singling out. It is not a courtesy — it is a printed, scored step on task after task, and it is the step candidates most often skip while rushing to declare themselves finished.
How many tasks does the North Dakota manual skill test assign, and how much time is allowed?
A candidate performing Range of Motion for a resident's shoulder realizes she forgot to lower the bed but is running short on time. She tells the RN Test Observer, "At this point I would lower the bed and put the call light within reach." How is this scored?
Which statement about hand hygiene on the North Dakota skill test is correct?
A candidate performs every step on the Making an Occupied Bed task except one step printed in bold, and scores 92% on that task's remaining steps. What is the outcome for that task?