Background <p>Practical examinations are critical components of nursing education, designed to assess students’ competence in clinical skills. However, these evaluations often elicit a range of psychological, emotional, and educational experiences among student nurses.</p> Aim <p>This qualitative study explores the lived experiences of student nurses during practical examinations in Ghanaian nursing institutions.</p> Methods <p>This study employed a phenomenological approach to explore the experiences of 18 student nurses during practical examinations in selected nursing schools in Ghana. Using purposive sampling, participants were recruited and interviewed through semi-structured interviews conducted between December 2024 and April 2025. The data were analyzed using Braun and Clarke’s method. The study followed Lincoln and Guba’s criteria, including credibility, dependability, confirmability, and transferability for trustworthiness.</p> Results <p>Five (5) key themes and ten subthemes were identified, including emotional responses to practical examinations, perceived preparedness and skill confidence, examiner influence and supervision style, environmental and logistical challenges, and recommendations for improvement.</p> Conclusion <p>These findings provide evidence for curriculum and policy reforms in nursing education across resource-constrained settings. It also highlights the need for more student-centered examination approaches to enhance learning and confidence. We recommend that nursing regulatory bodies and academic authorities collaborate to revise clinical assessment guidelines to prioritize student support, fairness, and skill development.</p> Clinical trial number <p>Not applicable.</p>