This overview includes information to help you prepare for a Certified Nursing Assistant exam. You will find details about training, eligibility, the knowledge and skills tests, registration, costs, scoring, retakes, registry status, and study resources.
Exam PartsKnowledge exam and skills evaluation | Training MinimumAt least 75 clock hours |
Passing RequirementPass both exam portions | Exam RulesVary by state and provider |
Exam Background and Purpose
A Certified Nursing Assistant, commonly called a CNA, provides basic care to patients, residents, or clients under the supervision of licensed nursing staff.
Common responsibilities include helping with bathing, dressing, grooming, eating, toileting, mobility, positioning, hydration, personal hygiene, and other activities of daily living. CNAs may also measure and record vital signs, observe changes in a person’s condition, and report concerns to the supervising nurse.
The nurse aide competency examination determines whether a candidate has the knowledge and practical skills needed to provide safe care within the nurse aide scope of practice.
Key point: There is no single national CNA exam format. States approve their own training and competency programs and may use Credentia, Prometric, another testing company, or a state-operated system.
CNA Training Requirements
Candidates generally complete a state-approved nurse aide training and competency evaluation program before testing.
Federal requirements establish a minimum of 75 clock hours of training, including at least 16 hours of supervised practical training. States may require more classroom, laboratory, or clinical hours.
Required Training Areas
- Communication and interpersonal skills
- Infection prevention and control
- Safety and emergency procedures
- Promoting independence
- Residents’ rights, privacy, and dignity
- Basic nursing and personal care skills
- Mental health and social service needs
- Care of cognitively impaired residents
- Restorative care and use of assistive devices
Additional State Requirements
Depending on the state, training program, and employer, candidates may also need to satisfy requirements involving:
- Minimum age or education
- Criminal background checks
- Fingerprinting
- Health screenings
- Immunization records
- Tuberculosis testing
- CPR or basic life support training
- State identification or Social Security documentation
CNA Test Overview
The CNA competency evaluation normally contains two parts: a knowledge examination and a clinical skills evaluation.
Candidates must pass both portions to complete the competency evaluation successfully. The portions may be scheduled together or on separate dates, depending on the state and testing provider.
Do not assume that another state’s question count, time limit, passing score, or skills list applies to you. Use the current candidate handbook for the state where you are testing.
Knowledge Examination Content
Knowledge examinations commonly organize CNA content into three broad areas: physical care skills, psychosocial care skills, and the role of the nurse aide.
Written and Oral Options
Many testing programs allow candidates to choose either a written examination or an oral examination. The oral version may play recorded questions through a headset and may include a reading-comprehension or word-recognition component.
Availability, languages, eligibility, and accommodation procedures vary. Choose the exam format during registration when your testing provider permits it.
Clinical Skills Evaluation
During the clinical portion, candidates demonstrate selected nurse aide skills for an evaluator. The evaluator uses a standardized checklist to determine whether each required step was performed correctly.
Many NNAAP testing programs require candidates to perform five randomly selected skills, but the exact number and list may differ in other states.
Commonly Tested CNA Skills
- Hand hygiene
- Measuring blood pressure, pulse, respirations, weight, or urinary output
- Assisting with ambulation
- Transferring a resident between a bed and wheelchair
- Positioning a resident
- Performing range-of-motion exercises
- Providing mouth, nail, foot, perineal, catheter, or personal care
- Assisting with feeding or hydration
- Applying antiembolic stockings
- Changing an occupied bed or providing bedpan assistance
Critical Steps
Some steps are considered essential to resident safety or infection control. Missing a critical step may result in failure of the skill even when most of the other steps were completed correctly.
Critical behaviors commonly include:
- Performing hand hygiene when required
- Confirming or addressing the resident appropriately
- Providing privacy
- Using proper safety precautions
- Protecting the resident from falls or injury
- Recording measurements accurately
- Leaving the resident in a safe position
Registration, Times, and Locations
Registration procedures depend on the state. Candidates may apply through a state nurse aide registry, health department, board of nursing, approved training program, or contracted testing provider.
Applications may require:
- Proof of approved training
- Government-issued identification
- Social Security or state identification information
- Training-program approval or instructor verification
- Background-check or fingerprint information
- Testing fees
- Accommodation documentation
Testing may be offered at training programs, nursing facilities, community colleges, vocational schools, testing centers, or other state-approved locations. Some knowledge examinations may also be available through online proctoring.
Costs and Reimbursement
CNA costs vary significantly. Candidates may need to pay separately for training, textbooks, uniforms, health screenings, background checks, fingerprinting, the knowledge examination, the clinical skills evaluation, and retesting.
Some programs or healthcare employers provide free or employer-paid training.
Federal reimbursement protections may apply. A qualifying facility cannot charge an employed nurse aide, or an individual who already has an employment offer from the facility, for required training that begins after the offer. Certain individuals hired within 12 months after completing training may also qualify for prorated reimbursement.
What Should I Expect on Test Day?
How Is the CNA Exam Scored?
Candidates must pass both the knowledge examination and the clinical skills evaluation.
There is no universal national passing score. Each state or testing program establishes its own satisfactory-completion standard.
The skills evaluation is scored according to the checklist used by the evaluator. Candidates must complete the required skills and satisfy all applicable critical-step requirements.
After both portions are passed, the testing provider or program reports successful completion to the state nurse aide registry. Processing time varies by state.
Retaking the CNA Exam
Candidates who do not pass are normally told which portion or areas were unsuccessful. Many states allow candidates to retake only the portion they failed.
Federal rules require candidates to receive at least three opportunities to complete the competency evaluation successfully. States may establish deadlines, waiting periods, fees, retraining rules, and maximum-attempt limits, but the allowed maximum cannot be fewer than three attempts.
Before Retesting
- Review the score report or evaluator feedback.
- Confirm whether you need to repeat one portion or both portions.
- Check the deadline for completing all attempts.
- Practice failed skills using the exact state checklist.
- Verify the retest fee and scheduling process before submitting payment.
Nurse Aide Registry Status
After successful completion, the state records the candidate’s information in its nurse aide registry. Employers use the registry to verify whether an individual is eligible to work as a nurse aide and whether the record contains any reportable findings.
State renewal procedures vary. Federal rules require states to identify and remove registry entries for individuals who perform no nursing or nursing-related services for 24 consecutive months, except for records containing certain findings.
Keep employment records and complete any renewal, continuing education, or in-service requirements established by your state and employer.
How Can I Prepare for the CNA Exam?
Begin with the candidate handbook and clinical skills checklist for your state. A general study guide can strengthen your knowledge, but the official checklist determines the steps required during your skills evaluation.
Practice each skill repeatedly until you can complete the steps safely, in order, and without prompting. Speak clearly during practice so that communication becomes a normal part of the procedure.
CNA Study Checklist
- Obtain the current candidate handbook for your state.
- Review infection control, hand hygiene, and standard precautions.
- Study residents’ rights, privacy, dignity, abuse prevention, and confidentiality.
- Review vital signs, nutrition, hydration, elimination, mobility, positioning, and personal care.
- Practice recognizing and reporting abnormal changes.
- Study communication techniques for residents with dementia or cognitive impairment.
- Practice each clinical skill using the official checklist.
- Complete timed knowledge-practice questions.
- Review why every missed answer was incorrect.
CNA Study Resources
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CNA, Certified Nursing Assistant, Certified Nurse Assistant, nurse aide, and related terms are used by state nurse aide registries, testing providers, and healthcare training programs. Mometrix Media LLC and StudyGuideZone.com are not affiliated with or endorsed by any state nurse aide registry, board of nursing, health department, healthcare licensing authority, or CNA testing provider.
