PRAC 6568: Clinical Skills and Procedures Self-Assessment Form
FNP Students

Skill / Procedure Confident (Can
complete
independently)

Mostly
Confident
(Can
complete
with
supervision)

Beginning
(Has performed
with supervision
or need
supervision to
feel confident)

New
(Has never
performed or does
not apply)

Rapid Strep Test Y
Ophthalmic
Examination

Y

Otoscopic
Examination

Y

Rapid Influenza
testing

Y

Inhalation Therapy Y
Interpret Chest X-ray Y
Peak flow meter Y
Pulmonary Function Tests Y
Asthma and allergy action
care plan

Y

EKG Performance and
Interpretation

Y

Wound Care Y
PPD Reading Y
KOH skin slide for
fungus

Y

Digital Rectal Exam Y
Fecal Occult Blood
Testing

Y

Interpret H/H Y
Mini Mental Status Exam Y
Gait and Balance
Assessment

Y

Breast Examination Y
Obtaining vaginal
culture

Y

HARK screening Y
Contraceptive Planning Y
Herpes Culture Y
Pap Smear Y
STI Testing Y

Auscultation Fetal
Heart Tones

Y

Fundal Height
Assessment

Y

Pregnancy Test Y
EPPDS Screening Y
Pelvic Exam Y
Testicular Exam Y
Prostate Exam/DRE Y
Urodynamic Study Y
Aerosol/Inhalation
Administration

Y

Interpret
Laboratory/Diagnostic
Testing

Y

Informed Consent Y
Normal Growth and
Development evaluation

Y

Cerumen Impaction
Removal (irrigation)

Y

Cerumen Impaction
Removal (curette)

Y

Fluorescein Staining Y
Wood’s Light Examination Y
Corneal Foreign Body
Removal

Y

Management of Epistaxis
(Packing and Removal)

Y

Remove Foreign Body
(ear, eye, nose, soft
tissue, other)

Y

Peak flow meter
Measurement and
Interpretation

Y

Pulmonary Function Test
Performance and
Interpretation

Y

Burn Treatment/dressing Y
Cryotherapy Y
Shave Biopsy Y
Punch Biopsy Y
Suturing
Simple Interrupted
Sutures and Suture
Removal

Y

Staple Placement Y
Skin Adhesive Placement Y
Toenail Avulsion Y
Incision and Drainage Y
Subungual Hematoma
Evacuation

Y

Skin Tag Removal Y
Wart
destruction/removal

Y

Wound Care and
Debridement

Y

Steri Strip Application Y
Tick Removal Y
KOH skin slide for
fungus

Y

Hemorrhoid, excision
of thrombus

Y

Local/Field Block for
Anesthesia

Y

Digital Block for
Anesthesia

Y

Trigger Point Injection Y
Joint Injection Y
Splinting Y
Basic microscopy
(yeast, BV)

Y

Contraceptive Placement
(Long term)

Y

IUD Placement and
Removal

Y

*Students are expected to achieve competency with the clinical skills list
**Procedures are skills that may be available for students but are not required.

Summary of strengths:
Patient education. I am able to help patients feel at ease , this is done through explaining
their care along with health outcomes using all the studies that I have acquired.

Opportunities for growth:

I know my limitations so I rest whenever necessary, I do not work additional hours if I
know I will not be on top of my game. My actions got to fit into my future strategy .

I have realized that honesty is very important in the nursing career and so I try to uphold
honesty at all times. I try to own my mistakes whenever it happens, this has made me to
learn alot.

Now, write 3–4 possible goals and objectives for this practicum experience. Ensure that they
follow the SMART Strategy, as described in the Learning Resources.
– Will definetly complete all my clinical assignments before each clinical rotation.
-Will implement information newly learned during all clinical days and develop at least
two questions for my instructor to ensure progress in my learning and understanding of the
material.
-Will watch my preceptor closely and pay attention to the details they pass on when giving
report.
– Will use SBAR format to report every information so that I don’t forget important
information.
Wll ask for feedback after every report from my preceptor and take down notes so I can
use it for the next time and be the best.