LPN Skills Checklist: 50+ Essential Procedures
Every LPN student must demonstrate competency in 50-75 essential nursing skills before graduation. This comprehensive checklist covers all procedures you'll learn, how they're tested, and tips to master each skill.
Skills Checklist Overview
- Total Skills Required: 50-75 procedures (varies by state)
- Testing Method: Practical check-offs with instructors
- Passing Standard: 100% accuracy on critical steps, 80-90% overall
- Practice Time: 100-200 hours in lab before testing
- Re-test Policy: Most programs allow 1-2 retakes per skill
LPN Skills by Category
Category 1: Vital Signs & Patient Assessment (8 Skills)
✅ Skill #1: Blood Pressure Measurement
What You'll Do: Measure systolic and diastolic blood pressure using manual sphygmomanometer and stethoscope
Critical Steps:
- Select correct cuff size (covers 80% of arm circumference)
- Position patient's arm at heart level
- Inflate cuff 20-30 mmHg above palpated systolic pressure
- Deflate slowly (2-3 mmHg per second)
- Record both systolic and diastolic readings
Common Mistakes: Wrong cuff size, arm not at heart level, deflating too fast
✅ Skill #2: Pulse Assessment (Radial, Apical, Pedal)
What You'll Do: Palpate and count pulse at various sites for 30-60 seconds
Key Points: Count for full 60 seconds if irregular, assess rate/rhythm/strength, document location
✅ Skill #3: Respiratory Rate & Assessment
What You'll Do: Count respirations for 60 seconds, assess depth/rhythm/effort, auscultate lung sounds
✅ Skill #4: Temperature Measurement (Oral, Tympanic, Temporal)
What You'll Do: Measure body temperature using appropriate thermometer type and site
✅ Skill #5: Oxygen Saturation (Pulse Oximetry)
What You'll Do: Apply pulse oximeter to finger/toe/earlobe, obtain SpO2 reading, document
✅ Skill #6: Pain Assessment (0-10 Scale)
What You'll Do: Use standardized pain scale, assess location/quality/duration, document PQRST
✅ Skill #7: Head-to-Toe Physical Assessment
What You'll Do: Systematic examination of all body systems using inspection, palpation, auscultation
✅ Skill #8: Intake & Output Measurement
What You'll Do: Accurately measure and record all fluids consumed and excreted over 24 hours
Category 2: Medication Administration (12 Skills)
✅ Skill #9: Oral Medication Administration
What You'll Do: Prepare and administer pills, tablets, liquids by mouth
5 Rights of Medication Administration:
- ✅ Right Patient (check 2 identifiers)
- ✅ Right Drug (verify order matches MAR)
- ✅ Right Dose (calculate if needed)
- ✅ Right Route (PO, SL, buccal)
- ✅ Right Time (within 30-min window)
✅ Skill #10: Subcutaneous Injection
What You'll Do: Inject insulin, heparin, or vaccines into subcutaneous tissue at 45-90° angle
Sites: Abdomen, upper arms, thighs (rotate injection sites)
✅ Skill #11: Intramuscular (IM) Injection
What You'll Do: Inject medication into muscle tissue at 90° angle (deltoid, vastus lateralis, ventrogluteal)
✅ Skill #12: Intradermal Injection (TB Test)
What You'll Do: Inject 0.1 mL under skin surface at 10-15° angle to create wheal
✅ Skill #13: Topical Medication Application
What You'll Do: Apply creams, ointments, patches, transdermal medications to skin
✅ Skill #14: Eye Drop & Ointment Administration
What You'll Do: Instill drops into conjunctival sac, apply ointment to lower lid
✅ Skill #15: Ear Drop Administration
What You'll Do: Pull pinna up/back (adults) or down/back (children), instill drops
✅ Skill #16: Nasal Medication Administration
What You'll Do: Position patient supine, administer nasal spray or drops
✅ Skill #17: Rectal Suppository Administration
What You'll Do: Insert suppository beyond internal sphincter (4 inches), hold buttocks together
✅ Skill #18: Vaginal Medication Administration
What You'll Do: Insert suppository or cream using applicator while patient in lithotomy position
✅ Skill #19: Inhaler Administration (MDI & Nebulizer)
What You'll Do: Teach proper inhaler technique, administer nebulizer treatment, assess effectiveness
✅ Skill #20: Medication Dosage Calculation
What You'll Do: Calculate doses using ratio/proportion, metric conversions, pediatric weight-based dosing
Category 3: IV Therapy & Blood Draw (8 Skills)
✅ Skill #21: Peripheral IV Catheter Insertion
What You'll Do: Insert IV catheter into peripheral vein (hand, forearm, antecubital)
Note: Some states restrict LPNs from IV insertion (check your state scope)
✅ Skill #22: IV Site Assessment & Maintenance
What You'll Do: Assess for infiltration, phlebitis, infection; change dressing q72-96h
✅ Skill #23: IV Fluid Administration
What You'll Do: Hang IV bags, prime tubing, regulate flow rate using gravity or pump
✅ Skill #24: IV Medication Administration (Secondary Line)
What You'll Do: Administer IV piggyback medications via secondary tubing
✅ Skill #25: IV Push Medication Administration
What You'll Do: Slowly inject medication directly into IV line over specified time
⚠️ Scope Alert: Many states prohibit LPNs from IV push. Check your state board.
✅ Skill #26: Blood Draw (Venipuncture)
What You'll Do: Collect blood samples using vacuum tubes or syringe, label specimens
✅ Skill #27: Blood Glucose Monitoring (Fingerstick)
What You'll Do: Perform capillary blood glucose test using glucometer, document result
✅ Skill #28: Blood Transfusion Monitoring
What You'll Do: Monitor patient during transfusion, assess for reactions (most states: RN must start transfusion)
Category 4: Wound Care & Dressings (7 Skills)
✅ Skill #29: Sterile Dressing Change
What You'll Do: Remove old dressing using aseptic technique, clean wound, apply new sterile dressing
✅ Skill #30: Wound Assessment & Measurement
What You'll Do: Measure wound dimensions (L×W×D), assess drainage type/amount, stage pressure ulcers
✅ Skill #31: Wet-to-Dry Dressing Application
What You'll Do: Apply saline-moistened gauze to wound, allow to dry, remove (debridement)
✅ Skill #32: Negative Pressure Wound Therapy (NPWT/VAC)
What You'll Do: Apply foam dressing, seal with transparent film, connect to suction device
✅ Skill #33: Surgical Drain Management
What You'll Do: Empty Jackson-Pratt or Hemovac drains, measure output, maintain suction
✅ Skill #34: Staple/Suture Removal
What You'll Do: Remove staples using staple remover or cut/pull sutures per physician order
✅ Skill #35: Pressure Ulcer Prevention & Care
What You'll Do: Reposition q2h, use pressure-relief devices, apply barrier creams
Category 5: Catheter & Elimination Care (6 Skills)
✅ Skill #36: Urinary Catheter Insertion (Foley)
What You'll Do: Insert sterile catheter into bladder, inflate balloon, connect to drainage bag
Female: 2-3 inches insertion | Male: 7-9 inches insertion
✅ Skill #37: Urinary Catheter Care & Removal
What You'll Do: Perform catheter hygiene, deflate balloon, gently remove catheter
✅ Skill #38: Straight Catheterization (In-and-Out)
What You'll Do: Insert catheter, drain bladder, immediately remove (no balloon inflation)
✅ Skill #39: Urine Specimen Collection (Clean Catch, Catheter)
What You'll Do: Collect midstream urine or aspirate from catheter port using sterile technique
✅ Skill #40: Enema Administration
What You'll Do: Insert rectal tube, administer solution (tap water, saline, Fleet), assist with expulsion
✅ Skill #41: Fecal Impaction Removal
What You'll Do: Manually remove hardened stool from rectum using lubricated gloved finger
Category 6: Respiratory Care (6 Skills)
✅ Skill #42: Oxygen Administration (Nasal Cannula, Mask)
What You'll Do: Apply oxygen delivery device, set flow rate per order, monitor SpO2
✅ Skill #43: Incentive Spirometry Teaching
What You'll Do: Instruct patient to inhale deeply through device, hold 3-5 seconds, repeat 10x/hour
✅ Skill #44: Nasopharyngeal/Oropharyngeal Suctioning
What You'll Do: Suction airway secretions using sterile catheter, yankauer, or wall suction
✅ Skill #45: Tracheostomy Care
What You'll Do: Clean stoma, change inner cannula, replace trach ties, suction as needed
✅ Skill #46: Chest Physiotherapy (CPT)
What You'll Do: Perform percussion and postural drainage to mobilize lung secretions
✅ Skill #47: Peak Flow Meter Use
What You'll Do: Teach patient to exhale forcefully into device, record peak expiratory flow rate
Category 7: Nutrition & GI Care (5 Skills)
✅ Skill #48: Nasogastric (NG) Tube Insertion
What You'll Do: Insert tube through nose into stomach, verify placement with pH test/X-ray
✅ Skill #49: NG Tube Feeding Administration
What You'll Do: Check residual volume, administer formula via gravity or pump, flush tube
✅ Skill #50: Gastrostomy Tube (G-tube/PEG) Care
What You'll Do: Clean stoma site, administer feedings, check for leakage/infection
✅ Skill #51: Ostomy Care (Colostomy/Ileostomy)
What You'll Do: Empty pouch, clean stoma, apply new barrier wafer and pouch
✅ Skill #52: Feeding Assistance & Aspiration Precautions
What You'll Do: Position patient upright (45-90°), provide small bites, monitor for choking
Category 8: Patient Hygiene & Mobility (8 Skills)
✅ Skill #53: Complete Bed Bath
What You'll Do: Wash patient's entire body while in bed, maintain privacy and warmth
✅ Skill #54: Partial Bath & Perineal Care
What You'll Do: Assist with washing face, hands, genitals, and buttocks
✅ Skill #55: Hair Care & Shampooing
What You'll Do: Wash hair in bed using inflatable basin or assist at sink
✅ Skill #56: Oral Care (Conscious & Unconscious Patients)
What You'll Do: Brush teeth, clean dentures, provide mouth care with swabs for unconscious patients
✅ Skill #57: Occupied Bed Making
What You'll Do: Change linens while patient remains in bed, using logrolling technique
✅ Skill #58: Patient Transfer (Bed to Chair/Wheelchair)
What You'll Do: Use proper body mechanics, gait belt, or mechanical lift to transfer patient safely
✅ Skill #59: Ambulation Assistance (Walker, Cane, Crutches)
What You'll Do: Teach proper assistive device use, walk alongside patient for safety
✅ Skill #60: Range of Motion (ROM) Exercises
What You'll Do: Perform passive or active-assisted ROM to maintain joint flexibility
Category 9: Safety & Emergency Procedures (8 Skills)
✅ Skill #61: CPR (Adult, Child, Infant)
What You'll Do: Perform chest compressions and rescue breaths per AHA guidelines
✅ Skill #62: Choking Relief (Heimlich Maneuver)
What You'll Do: Perform abdominal thrusts to dislodge airway obstruction
✅ Skill #63: AED (Automated External Defibrillator) Use
What You'll Do: Apply pads, analyze rhythm, deliver shock if advised by device
✅ Skill #64: Fall Prevention & Safety Measures
What You'll Do: Implement bed alarms, non-slip socks, bed rails, call light within reach
✅ Skill #65: Restraint Application (Last Resort)
What You'll Do: Apply soft restraints per policy, monitor q15-30min, document attempts at alternatives
✅ Skill #66: Seizure Precautions & Management
What You'll Do: Protect head, turn to side, time seizure, do NOT restrain or insert objects in mouth
✅ Skill #67: Hand Hygiene & Infection Control
What You'll Do: Perform proper handwashing (20 seconds) or hand sanitizer use, don/doff PPE
✅ Skill #68: Sterile Technique & Gloving
What You'll Do: Open sterile packages, don sterile gloves without contamination, maintain sterile field
How LPN Skills Are Tested (Check-Off Process)
Step-by-Step Check-Off Process
- 1. Lab Practice (Weeks 1-8): Practice each skill 5-10 times on mannequins, classmates, or simulated patients
- 2. Instructor Observation: Demonstrate skill while instructor observes and marks competency checklist
- 3. Critical Steps: Must perform ALL critical steps correctly (marked with ⚠️ on checklist)
- 4. Non-Critical Steps: Must achieve 80-90% accuracy on remaining steps
- 5. Pass/Fail Decision: Instructor declares "Pass" or "Needs Remediation"
- 6. If Failed: Remediation practice + re-test (usually 1-2 attempts allowed)
- 7. Final Competency: Some programs require cumulative skills test before graduation
10 Tips to Pass Every Skills Check-Off
- 1. Verbalize Your Steps: Talk through what you're doing ("Now I'm checking the patient's ID bracelet"). Instructors can't read your mind.
- 2. Memorize Critical Steps First: Focus on the steps marked as "critical" (patient ID, hand hygiene, sterile technique, 5 Rights).
- 3. Practice at Home: Use family members to practice vital signs, YouTube videos for techniques, flashcards for med calculations.
- 4. Use Mnemonics: "ADPIE" (nursing process), "5 Rights" (medication), "OLDCART" (pain assessment).
- 5. Go Slowly: Speed doesn't matter during check-offs. Accuracy does. Take your time.
- 6. Ask to Restart: If you mess up early, ask "May I start over?" Most instructors will let you (once).
- 7. Arrive Early: Get to the lab 15 minutes before your check-off to mentally prepare and review notes.
- 8. Watch Classmates: If your program allows observing others' check-offs, watch and learn from their mistakes.
- 9. Study the Checklist: Get a copy of the competency checklist beforehand. Know exactly what the instructor is looking for.
- 10. Stay Calm: Nervousness causes mistakes. Take deep breaths. Remember: You've practiced this 10+ times already.
5 Most Common Reasons Students Fail Skills Check-Offs
❌ #1: Forgetting Hand Hygiene
This is the #1 failure reason. Always wash hands BEFORE touching patient and AFTER removing gloves. Say it out loud: "I'm performing hand hygiene now."
❌ #2: Not Checking Patient Identity
You MUST verify 2 identifiers (name + DOB or name + medical record number) before ANY procedure. Automatic fail if skipped.
❌ #3: Breaking Sterile Technique
Touching non-sterile surfaces with sterile gloves, reaching across sterile field, or contaminating equipment = automatic fail.
❌ #4: Medication Math Errors
Calculate doses TWICE. Show your work. If unsure, ask instructor to verify before administering (they'll let you in real practice).
❌ #5: Skipping Safety Steps
Forgetting to lock wheelchair brakes, raise bed rails, or put call light within reach = safety violation = fail.
Frequently Asked Questions
Do I need to memorize every skill step-by-step?
Yes, for check-offs you must perform skills from memory without notes. However, in real clinical settings you can reference procedure manuals. Focus on memorizing critical steps and safety measures.
What if I'm really bad at one particular skill?
Common! Most students struggle with IV insertion or NG tube placement. Request extra lab time, watch YouTube tutorials, and practice on simulation equipment. Some schools offer peer tutoring.
Can I use my phone or notes during check-offs?
No. Check-offs test your ability to perform skills from memory. Bring nothing but yourself. However, you CAN ask the instructor clarifying questions about the scenario.
How long does each skills check-off take?
Most skills take 5-15 minutes. Complex skills (NG tube insertion, catheterization) may take 20-30 minutes. Budget 45 minutes for your appointment including setup time.
Do skills expire if I don't use them?
In school, no. Once you pass a check-off, it's done. However, as a working LPN, many facilities require annual competency validation for high-risk skills (IV therapy, medication administration).
Master Your LPN Skills with Confidence
Explore our complete training guides and clinical resources to excel in every competency.
By submitting, you agree to receive information from schools that match your interests.