The CNA exam is a two-part certification test you must pass after completing a nurse aide training program to become a Certified Nursing Assistant. It includes a written multiple-choice section and a hands-on skills evaluation, both of which you need to pass to get placed on your state’s nurse aide registry and start working legally in healthcare facilities.
Two Parts: Written and Skills
The exam is split into a knowledge test and a practical demonstration. The written portion consists of 70 multiple-choice questions, though 10 of those are unscored pretest questions used for statistical purposes. That means 60 questions actually count toward your result. Topics span physical care skills, psychosocial care, and the professional role of a nurse aide.
The skills evaluation is the hands-on portion. You’ll perform specific nursing tasks in front of an evaluator, typically at a testing center set up to simulate a patient care environment. Expect to demonstrate things like taking vital signs, helping a patient move or reposition in bed, hand washing, and basic hygiene procedures. You’ll be scored on whether you follow each step correctly and safely. Most states require you to perform five skills selected randomly from a longer list, so you need to be comfortable with all of them.
If English isn’t your first language, some states offer an oral version of the written exam, where questions are read aloud to you. The oral exam costs the same as the written version.
What the Written Exam Covers
The questions are organized around three broad domains. The largest is physical care skills, which covers activities of daily living (feeding, bathing, dressing), infection control, safety and emergency procedures, and basic data collection like recording a patient’s weight or temperature. You’ll also see questions on restorative care, meaning how to help patients maintain or regain independence with tasks like walking or range-of-motion exercises.
The second domain is psychosocial care. These questions test your understanding of patients’ emotional, mental, spiritual, and cultural needs. Think: how to respond to a patient who is anxious, grieving, or confused, and how to respect individual preferences and beliefs during care.
The third domain focuses on your role as a nurse aide. This includes communication (with patients, families, and the nursing team), client rights, legal and ethical behavior, and how you function as part of a larger healthcare team. Questions here often test whether you know the boundaries of your scope of practice, like when to report a change in a patient’s condition rather than acting on your own.
Who Can Take the Exam
To sit for the CNA exam, you first need to complete a state-approved nurse aide training program. The federal minimum is 75 hours of combined classroom and clinical instruction, but many states require more. Michigan, for example, follows the 75-hour federal floor, while states like California and others set their minimums higher, sometimes at 100 to 160 hours. Your training program will include supervised clinical practice in a real healthcare setting, which is required before you’re eligible to test.
Once you’ve finished your program, you’ll receive documentation confirming your eligibility. Some states also allow certain nursing students or military-trained medics to sit for the exam through alternative eligibility routes, though these candidates may have different attempt limits.
Exam Day Requirements
Identification requirements vary by state, but the general expectation is two forms of current, official ID with your signature, one of which must include a photo. The name on your IDs needs to match the name you used when you registered. California requires your original Social Security card plus a photo ID. Washington only requires one form of photo ID. Nevada also requires just one photo ID but explicitly prohibits bringing any outside materials into the testing area.
Check your specific state’s requirements well before your test date. Showing up with the wrong ID or a name mismatch can mean you won’t be allowed to test, and you may lose your exam fee.
Costs and Fees
The first time you test, you pay for both parts together. Looking at Credentia, one of the major testing vendors, the written exam costs $45 and the skills exam costs $95, totaling $140. If you fail one part but pass the other, you only need to retake and repay for the section you didn’t pass. Fees can differ depending on your state and which testing company administers the exam there, so confirm pricing when you register.
Who Administers the Exam
The CNA exam isn’t run by a single national organization. Each state contracts with an approved testing vendor. Credentia is one of the largest, administering the National Nurse Aide Assessment Program (NNAAP) in states including California, Pennsylvania, Virginia, Georgia, North Carolina, Colorado, and about a dozen others. Other vendors, such as Prometric and D&S Diversified Technologies (Headmaster), handle testing in remaining states. The core content tested is similar across the country because it’s based on federal requirements, but the specific vendor, scheduling process, and exam logistics depend on where you’re testing.
What Happens If You Don’t Pass
Most states give you three attempts to pass each part of the exam. If you pass the written but fail the skills test (or vice versa), you only need to retake the section you failed. A few states are more generous: Maryland and Washington allow four attempts. Some eligibility routes in Pennsylvania only allow a single attempt.
If you use up all your allowed attempts without passing, you’ll need to go back and complete a state-approved training program again from the beginning. After finishing that retraining, you must retake both the written and skills portions, even if you previously passed one of them. The clock and attempt count reset once you complete the new training.
There’s also typically a time limit on how long you have to use your attempts. If too much time passes after your training without passing the exam, your eligibility can expire regardless of how many attempts you have left. The exact timeframe depends on your state, so check when you register.
After You Pass
Once you pass both sections, your name is added to your state’s nurse aide registry. This is what employers check to verify your certification. Most states require you to renew your registry listing every two years, and you’ll typically need to show that you’ve worked a minimum number of hours as a CNA during that period to stay active. If your certification lapses, some states let you reinstate it by retaking the exam rather than repeating the full training program, but the rules vary.
Your certification is state-specific. If you move, you’ll generally need to apply for reciprocity in the new state, which involves a background check and verification of your current registry status. Some states grant reciprocity smoothly, while others may require additional steps.