What’s on the CNA Exam? Written Test and Skills Evaluation Explained
The CNA (Certified Nursing Assistant) exam has two required parts: a written (or oral) knowledge exam and a hands-on skills evaluation, and a candidate must pass both to be listed on their state’s nurse aide registry. There is no single national CNA exam. Testing is administered state by state. One widely used program is Credentia’s NNAAP (National Nurse Aide Assessment Program) exam, used in more than a dozen states and territories, while other states contract different vendors with their own version of the same two part format. In states that use the NNAAP framework, the written exam is typically 70 multiple-choice questions (60 scored, plus 10 unscored pretest questions candidates cannot identify) with a two-hour time limit, and the skills evaluation typically asks candidates to perform five randomly selected nurse aide skills, always including handwashing, within a 30-minute window. Exact question counts, fees, retake rules, and scheduling details vary by state and testing vendor, so always confirm current requirements with your own state’s nurse aide registry or testing vendor before test day.
Why There Is No Single “CNA Exam”
CNA certification is regulated at the state level, not by one national body. Each state’s nurse aide registry contracts with a testing vendor to develop and administer its exam. Credentia’s NNAAP exam is used in more than a dozen states and territories, and other states use different vendors with their own exam programs and their own scheduling, fee, and retake procedures. The core structure tends to be consistent across vendors: a written or oral knowledge test plus a hands-on skills evaluation, both required to pass. But the specifics, how many questions, how long you have, what happens if you fail one part, are set by your state and vendor. This article describes the NNAAP framework, since it is one program a large group of states share, and flags where things commonly vary. If your state uses a different vendor, confirm the specifics with that vendor’s candidate handbook.
Figures reflect the NNAAP framework, used in more than a dozen states and territories. Confirm current numbers with your own state’s nurse aide registry or testing vendor.
What’s on the Written Exam
The written portion tests the knowledge a nurse aide needs to safely care for residents, organized into three broad content areas. Physical Care Skills carries the most weight by a wide margin, since day-to-day resident care, hygiene, mobility, nutrition, and safety, is the core of the nurse aide role. Role of the Nurse Aide covers communication, resident rights, and legal and ethical behavior. Psychosocial Care Skills, the smallest area, covers emotional, mental health, and cultural and spiritual needs.
Content weighting based on the NNAAP written examination content outline. Some states using other vendors organize content differently.
Within Physical Care Skills, the exam draws on three subareas: activities of daily living (hygiene, dressing and grooming, nutrition and hydration, elimination, rest and comfort), basic nursing skills (infection control, safety, prevention and emergency response, technical procedures, and reporting what you observe), and self care and independence (helping residents maintain and regain the ability to care for themselves). Within Role of the Nurse Aide, expect questions on communicating with residents and staff, protecting resident rights, and working within legal and ethical boundaries as a member of the care team.
What’s on the Skills Evaluation
The skills evaluation is a hands-on, one-on-one demonstration in front of an evaluator, not a written test. In NNAAP states, a candidate performs five nurse aide skills within a 30-minute window. Handwashing is always one of the five. The other four are randomly selected from the full skills list, and one of the four always includes a measurement skill, such as blood pressure, pulse, respirations, or weight. Every skill has to be performed correctly and in the required sequence to count, so there is no partial credit for getting most of a skill right.
Because the skills are demonstrated on a mannequin or a role-playing evaluator rather than an actual resident, candidates are expected to narrate certain steps out loud, explaining what they would normally say or check with a real resident, such as verifying identity or explaining a procedure before starting it. This is a common point of confusion for first-time test takers, since it is easy to focus on the physical steps and forget to verbalize the communication and safety checks the evaluator is also scoring.
What to Expect on Test Day
Requirements vary by state and vendor, so the specifics belong in your own state’s candidate handbook, not a generic article. That said, a few things are consistent across nearly every state’s nurse aide exam: bring a valid, government-issued photo ID that matches your registration, arrive with enough time to complete check in before your scheduled start, and expect a testing environment without notes, personal devices, or outside reference materials. For the skills evaluation specifically, wear clothing you can move freely in, since you will be performing physical tasks like transfers and positioning in front of an evaluator.
Ready to see how the content areas above show up in real practice questions? Try our CNA practice test, or start with a free CNA practice test to get a feel for the written exam format before you commit to a full study plan.
Frequently Asked Questions
Is the CNA exam the same in every state?
No. Testing is state-regulated. Credentia’s NNAAP exam is used in more than a dozen states and territories, but the exact format, fees, and policies are set by each state’s nurse aide registry and testing vendor. Always check your own state’s requirements.
How many questions are on the CNA written exam?
In states using the NNAAP framework, the written exam is typically 70 multiple-choice questions, 60 of which are scored. States using other vendors may structure their written exam differently.
How many skills are tested on the CNA skills evaluation?
In NNAAP states, candidates typically perform five randomly selected skills within a 30-minute window, and handwashing is always one of the five. Every skill must be performed correctly to count.
Do I need to pass both the written exam and the skills evaluation?
Yes. Both parts are required to be listed on your state’s nurse aide registry, though states vary in how they handle retesting a single failed part versus the entire exam.
Sources
- Credentia, NNAAP Nurse Aide Assessment
- Credentia, 2024 NNAAP Written (Oral) Examination Content Outline
- Credentia Pennsylvania Candidate Handbook, Exam Overview
- Credentia Pennsylvania Candidate Handbook, The Skills Evaluation
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For educational and exam preparation purposes only. Not a substitute for formal clinical training.