NURS 206 (Health Assessment) Practical Skills Test
Latest 2026/2027 | Newly Released
San Diego State University (SDSU)
Guaranteed Pass | Graded A +
COMPLETE PRACTICAL SKILLS EXAM – 5 Stations
Section 1: Vital Signs & Therapeutic Communication Station
Item 1. Infection Prevention & Patient Identification
• Critical Elements: Performs hand hygiene using soap and water or alcohol-
based rub for a minimum of 20 seconds; verifies two patient identifiers (name,
date of birth, or medical record number); confirms allergy status using the allergy
band and asks the patient directly about latex or adhesive allergies.
• Pass Criteria: Hands are cleansed before touching the patient; two identifiers
and allergy status are confirmed verbally and visually.
• Fail Criteria: Touches the patient before hand hygiene; fails to verify two
identifiers or allergy status.
Item 2. Therapeutic Introduction & Cultural Humility
• Critical Elements: Introduces self by name and role; explains the purpose and
sequence of vital signs in plain, non-medical language; asks for verbal consent;
ensures privacy by closing the door/curtain; drapes the patient appropriately;
asks about preferred pronouns and language needs before proceeding.
• Pass Criteria: Patient can repeat back what will be done and gives verbal
agreement; privacy is maintained; cultural preferences are acknowledged.
,• Fail Criteria: Omits consent or privacy measures; uses medical jargon without
clarification; ignores patient cues regarding modesty.
Item 3. Body Temperature — Alternative Route Selection
• Critical Elements: Selects route based on patient age and clinical condition
(temporal artery, tympanic membrane, axillary, or oral); ensures proper probe
cover use and placement; for temporal artery, scans across the forehead and
down to the hairline; for tympanic, pulls pinna down and back (infant) or up and
back (adult) to straighten the canal.
• Pass Criteria: Appropriate route selected for patient population; accurate
reading obtained; correct anatomical positioning for the selected route.
• Fail Criteria: Uses tympanic route in a patient with impacted cerumen or ear
surgery without selecting an alternative; fails to straighten the ear canal.
Item 4. Blood Pressure — Special Populations
• Critical Elements: Selects appropriate cuff size (bladder width 40% and length
80% of arm circumference); uses a thigh cuff or large adult cuff for patients with
obesity; positions the arm at heart level with the palm upward; palpates the
brachial artery; inflates 20–30 mmHg above the palpated systolic pressure;
deflates at 2 mmHg per second; identifies Phase I (onset) and Phase V
(disappearance) Korotkoff sounds.
• Pass Criteria: Correct cuff size for arm circumference; arm supported at heart
level; accurate technique; reading is reproducible.
• Fail Criteria: Uses a regular adult cuff on a large arm (cuff too small falsely
elevates reading); arm dangling at the side; rapid deflation (>4 mmHg/sec).
Item 5. Apical Pulse — Infant vs. Adult Variation
• Critical Elements: For adults, locates the apical pulse at the fifth intercostal
space, left midclavicular line; for infants, locates at the fourth intercostal space,
left midclavicular line; uses the stethoscope bell; counts for 60 seconds if the
rhythm is irregular or 30 seconds × 2 if regular; assesses rate, rhythm, and
quality.
• Pass Criteria: Correct anatomical location for the patient's age; full 60-second
count if irregular; accurate notation of regularity and amplitude.
• Fail Criteria: Counts for less than 30 seconds; uses the diaphragm instead of
the bell; misses an irregular rhythm.
Item 6. Respiratory Pattern & Effort
, • Critical Elements: Counts respirations immediately after pulse while fingers
remain on the wrist (or observes chest rise without announcing); assesses rate,
rhythm, depth, and pattern for 30–60 seconds; notes abnormal patterns
(Cheyne-Stokes, Kussmaul, Biot's respirations); assesses work of breathing (nasal
flaring, retractions, accessory muscle use, pursed-lip breathing).
• Pass Criteria: Respiratory rate and pattern assessed without patient awareness;
full count completed; abnormal patterns are identified and described.
• Fail Criteria: Explicitly states "I am counting your breathing"; counts for less
than 30 seconds; misses signs of increased work of breathing.
Item 7. Oxygen Saturation — Alternative Sites
• Critical Elements: Selects an appropriate site with adequate perfusion;
removes nail polish or selects an alternative site (earlobe, forehead reflectance
sensor, or toe) if artificial nails or poor peripheral perfusion are present; allows
the reading to stabilize; notes the SpO₂ value, the extremity or site used, and the
patient's activity level.
• Pass Criteria: Stable reading obtained; interfering factors addressed;
alternative site selected when indicated.
• Fail Criteria: Places probe on a cold, cyanotic, or artificial-nail digit without
modification; fails to allow waveform stabilization.
Item 8. Pain Assessment — Non-Verbal & Special Populations
• Critical Elements: Uses a validated pain scale appropriate for the patient's
condition (FLACC for infants/non-verbal, CPOT for intubated adults, PAINAD
for dementia, or 0–10 numeric/FACES for verbal adults); assesses facial
expression, body movements, vocalization, and consolability if non-verbal.
• Pass Criteria: Pain is assessed using an age- and condition-appropriate
standardized tool; all domains of the selected tool are addressed.
• Fail Criteria: Uses a verbal 0–10 scale on a non-verbal or cognitively impaired
patient; omits behavioral indicators.
Item 9. Orthostatic Vital Signs
• Critical Elements: Obtains baseline blood pressure and pulse after 5 minutes
of supine rest; assists the patient to stand; waits 1–3 minutes; re-measures blood
pressure and pulse; calculates the difference; maintains fall precautions
throughout.
Latest 2026/2027 | Newly Released
San Diego State University (SDSU)
Guaranteed Pass | Graded A +
COMPLETE PRACTICAL SKILLS EXAM – 5 Stations
Section 1: Vital Signs & Therapeutic Communication Station
Item 1. Infection Prevention & Patient Identification
• Critical Elements: Performs hand hygiene using soap and water or alcohol-
based rub for a minimum of 20 seconds; verifies two patient identifiers (name,
date of birth, or medical record number); confirms allergy status using the allergy
band and asks the patient directly about latex or adhesive allergies.
• Pass Criteria: Hands are cleansed before touching the patient; two identifiers
and allergy status are confirmed verbally and visually.
• Fail Criteria: Touches the patient before hand hygiene; fails to verify two
identifiers or allergy status.
Item 2. Therapeutic Introduction & Cultural Humility
• Critical Elements: Introduces self by name and role; explains the purpose and
sequence of vital signs in plain, non-medical language; asks for verbal consent;
ensures privacy by closing the door/curtain; drapes the patient appropriately;
asks about preferred pronouns and language needs before proceeding.
• Pass Criteria: Patient can repeat back what will be done and gives verbal
agreement; privacy is maintained; cultural preferences are acknowledged.
,• Fail Criteria: Omits consent or privacy measures; uses medical jargon without
clarification; ignores patient cues regarding modesty.
Item 3. Body Temperature — Alternative Route Selection
• Critical Elements: Selects route based on patient age and clinical condition
(temporal artery, tympanic membrane, axillary, or oral); ensures proper probe
cover use and placement; for temporal artery, scans across the forehead and
down to the hairline; for tympanic, pulls pinna down and back (infant) or up and
back (adult) to straighten the canal.
• Pass Criteria: Appropriate route selected for patient population; accurate
reading obtained; correct anatomical positioning for the selected route.
• Fail Criteria: Uses tympanic route in a patient with impacted cerumen or ear
surgery without selecting an alternative; fails to straighten the ear canal.
Item 4. Blood Pressure — Special Populations
• Critical Elements: Selects appropriate cuff size (bladder width 40% and length
80% of arm circumference); uses a thigh cuff or large adult cuff for patients with
obesity; positions the arm at heart level with the palm upward; palpates the
brachial artery; inflates 20–30 mmHg above the palpated systolic pressure;
deflates at 2 mmHg per second; identifies Phase I (onset) and Phase V
(disappearance) Korotkoff sounds.
• Pass Criteria: Correct cuff size for arm circumference; arm supported at heart
level; accurate technique; reading is reproducible.
• Fail Criteria: Uses a regular adult cuff on a large arm (cuff too small falsely
elevates reading); arm dangling at the side; rapid deflation (>4 mmHg/sec).
Item 5. Apical Pulse — Infant vs. Adult Variation
• Critical Elements: For adults, locates the apical pulse at the fifth intercostal
space, left midclavicular line; for infants, locates at the fourth intercostal space,
left midclavicular line; uses the stethoscope bell; counts for 60 seconds if the
rhythm is irregular or 30 seconds × 2 if regular; assesses rate, rhythm, and
quality.
• Pass Criteria: Correct anatomical location for the patient's age; full 60-second
count if irregular; accurate notation of regularity and amplitude.
• Fail Criteria: Counts for less than 30 seconds; uses the diaphragm instead of
the bell; misses an irregular rhythm.
Item 6. Respiratory Pattern & Effort
, • Critical Elements: Counts respirations immediately after pulse while fingers
remain on the wrist (or observes chest rise without announcing); assesses rate,
rhythm, depth, and pattern for 30–60 seconds; notes abnormal patterns
(Cheyne-Stokes, Kussmaul, Biot's respirations); assesses work of breathing (nasal
flaring, retractions, accessory muscle use, pursed-lip breathing).
• Pass Criteria: Respiratory rate and pattern assessed without patient awareness;
full count completed; abnormal patterns are identified and described.
• Fail Criteria: Explicitly states "I am counting your breathing"; counts for less
than 30 seconds; misses signs of increased work of breathing.
Item 7. Oxygen Saturation — Alternative Sites
• Critical Elements: Selects an appropriate site with adequate perfusion;
removes nail polish or selects an alternative site (earlobe, forehead reflectance
sensor, or toe) if artificial nails or poor peripheral perfusion are present; allows
the reading to stabilize; notes the SpO₂ value, the extremity or site used, and the
patient's activity level.
• Pass Criteria: Stable reading obtained; interfering factors addressed;
alternative site selected when indicated.
• Fail Criteria: Places probe on a cold, cyanotic, or artificial-nail digit without
modification; fails to allow waveform stabilization.
Item 8. Pain Assessment — Non-Verbal & Special Populations
• Critical Elements: Uses a validated pain scale appropriate for the patient's
condition (FLACC for infants/non-verbal, CPOT for intubated adults, PAINAD
for dementia, or 0–10 numeric/FACES for verbal adults); assesses facial
expression, body movements, vocalization, and consolability if non-verbal.
• Pass Criteria: Pain is assessed using an age- and condition-appropriate
standardized tool; all domains of the selected tool are addressed.
• Fail Criteria: Uses a verbal 0–10 scale on a non-verbal or cognitively impaired
patient; omits behavioral indicators.
Item 9. Orthostatic Vital Signs
• Critical Elements: Obtains baseline blood pressure and pulse after 5 minutes
of supine rest; assists the patient to stand; waits 1–3 minutes; re-measures blood
pressure and pulse; calculates the difference; maintains fall precautions
throughout.
