NNAAP skills randomiser

The pool is the NNAAP skills listing as published in a state candidate handbook: 23 skills, of which hand hygiene is always drawn and the remaining four are chosen at random. Two of the 23 are marked state specific in the handbook itself - skill 12, electronic blood pressure, and skill 23, manual blood pressure - and the handbook instructs evaluators not to substitute one for the other, so a state uses one or the other and never both. The variants below let you exclude whichever your state does not test. The randomisation here is not a stylistic choice: 42 CFR 483.154(b)(2) requires the real draw to be random, which is why studying a shortlist of popular skills is unsafe. The timer is optional because federal rule sets no time limit; per-skill timing comes from your state handbook.

Draw five and you will usually get hand hygiene plus a mix of one vital sign, one personal care skill and one mobility skill. That distribution is not a coincidence: federal rule 483.154(b)(2) requires the pool to include all the personal care skills at 483.152(b)(3), which is why bathing, mouth care, dressing, toileting, feeding, skin care and transfers dominate the listing. Every skill also carries Critical Element Steps in bold in the handbook; missing one fails that skill outright, but performing only the Critical Element Step does not pass it either - you must still meet the per-skill cut score.