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Nurse Aide Written (Knowledge) Examination, NNAAP Written Examination outline

The CNA Test

The CNA test is the nurse aide competency exam your state requires before it places you on its nurse aide registry, and it has two parts: a written (or oral) knowledge test and a hands-on skills evaluation. In states that use the NNAAP exam, the written test is 70 multiple-choice questions (60 scored, 10 pretest) in 2 hours, and the skills evaluation is five randomly selected skills. Other states use other testing companies, so the length, fee, passing standard and retake rules are the ones your own state sets.

At a glance

Questions70 (60 scored, 10 unscored)In states that use the NNAAP exam. Other states use other vendors, with their own length.
Time limit2 hoursFor the NNAAP written exam. Check your state's handbook.
DeliveryIn NNAAP states the written exam is delivered by Credentia at test centers or online: 70 multiple-choice questions (60 scored, 10 pretest) in 2 hours. An oral version (60 multiple-choice plus 10 reading comprehension questions) is available. A separate skills evaluation of five randomly selected skills is also required. Other states use different vendors and formats.
Passing standardSet by each state. Candidates must pass both the written (or oral) examination and the skills evaluation to be placed on the state nurse aide registry; in the NNAAP skills evaluation all five skills must be performed correctly.
Outline in force2024 NNAAP Written (Oral) Examination Content Outline, effective April 2024

Exam facts are taken from Credentia’s own published material, last checked October 2, 2026. Source. Confirm fees, dates and rules with the organization you register with before you book.

There is no single CNA exam

"CNA test" and "CNA exam" are everyday names for the nurse aide competency evaluation, and each state runs its own. A state picks a testing company, and the company brings its own exam. One national exam is the National Nurse Aide Assessment Program (NNAAP®), which is developed and managed by Credentia and was originally developed by the National Council of State Boards of Nursing. Many other states use Prometric or Headmaster (D&S Diversified Technologies) instead, each with its own content outline.

The subject is the same everywhere: safe, respectful basic care, mostly of residents in long-term care. The numbers are not. Everything on this page that is a number comes from the NNAAP, and it applies to you only if your state uses that exam.

The written test

In NNAAP states the written exam is 70 multiple-choice questions with a time limit of 2 hours. 60 of the questions are scored and 10 are pretest questions that do not count. That is about 103 seconds a question, which is generous: the test is checking what you know, not how fast you read.

An oral version is also available. It has 60 multiple-choice questions and 10 reading comprehension questions.

Credentia delivers the written exam at test centers or online. The skills evaluation is offered at a test center only. Whether the online written option is offered where you live is for your state's handbook to say. Other vendors' written tests have their own lengths and time limits.

The skills evaluation

The second part is not a written test at all. You perform nurse aide skills in front of an evaluator. In the NNAAP, five skills are selected at random, and all five must be performed correctly.

No set of practice questions prepares you for this part, and this site does not claim to. The place to practice skills is your training program, with the skills list in your state's candidate handbook in front of you.

What the written test covers

The NNAAP outline in effect since April 2024 groups the written test under three headings. Physical Care Skills is 64% of it: Activities of Daily Living (22%), Basic Nursing Skills (35%) and Self-Care and Independence (7%). Psychosocial Care Skills is 10%: Emotional and Mental Health Needs (8%) and Spiritual and Cultural Needs (2%). Role of the Nurse Aide is 26%: Communication (7%), Client Rights (8%), Legal and Ethical Behavior (5%) and Member of the Health Care Team (6%).

In questions out of the 60 that are scored, that is 21 on Basic Nursing Skills, 13 on Activities of Daily Living, 5 each on Emotional and Mental Health Needs and Client Rights, 4 each on Self-Care and Independence, Communication, and Member of the Health Care Team, 3 on Legal and Ethical Behavior, and 1 on Spiritual and Cultural Needs.

Basic Nursing Skills is the heart of it: infection control, safety and emergencies, technical procedures such as vital signs and positioning, and observing, recording and reporting.

What the questions are like

Most questions describe a resident and a situation and ask what the nurse aide should do. They are less about recalling a fact than about choosing the action that keeps the resident safe, respects the resident's rights and dignity, and stays inside what a nurse aide is allowed to do.

That last condition decides a lot of questions. When something is beyond the nurse aide's role, or a resident's condition has changed, the correct action is usually to report it to the nurse rather than to act on it alone.

What your state decides

A good deal, and none of it can be read off a national page like this one. Your state's candidate handbook, published by the state nurse aide registry or its testing company, is the governing source for all of the following.

  • Which testing company and which exam you take.
  • Who is eligible: generally people who have completed a state-approved nurse aide training program, plus whatever alternative routes the state recognizes, such as for nursing students or aides certified in another state.
  • The fee for each part of the exam.
  • The passing standard for the written test and for the skills evaluation.
  • How many times you may retake a part you did not pass, and how long after training you have to pass both.
  • Which skills can be selected for the skills evaluation.

From the test to the registry

The goal of the test is a place on your state's nurse aide registry. To get there you must pass both parts, the written (or oral) test and the skills evaluation; passing one does not carry the other. Your state's handbook explains how results reach the registry and what to do if you pass only one part.

What is tested

The 9 domains of the current outline and the share of the exam each one carries.

DomainWeightWhat it covers
I.AActivities of Daily Living5 tasks22%
  • Hygiene: help residents with bathing, oral and denture care, perineal care, and skin, hair, and nail care.
  • Dressing and grooming: help residents dress and groom, including those with a weak or affected side.
  • Nutrition and hydration: help with meals and fluids, feed residents safely, follow ordered diets, and watch intake.
  • and 2 more tasks
I.BBasic Nursing Skills4 tasks35%
  • Infection control: hand hygiene, standard and transmission-based precautions, protective equipment, and handling of linens and waste.
  • Safety and emergency: prevent falls and injuries, use body mechanics and safe transfers, and respond to choking, fire, and other emergencies.
  • Therapeutic and technical procedures: carry out nurse aide procedures such as vital signs, height and weight, positioning, bedmaking, and range-of-motion exercises.
  • and 1 more task
I.CSelf-Care and Independence1 task7%
  • Support residents' self-care and independence through restorative care, encouragement, and assistive devices.
II.AEmotional and Mental Health Needs1 task8%
  • Respond to residents' emotional and mental health needs, including confusion and dementia, depression, anxiety, grief, and end-of-life care.
II.BSpiritual and Cultural Needs1 task2%
  • Respect and accommodate residents' spiritual beliefs and cultural practices when giving care.
III.ACommunication1 task7%
  • Communicate effectively with residents, families, and staff, including residents with hearing, vision, speech, or cognitive impairment.
III.BClient Rights1 task8%
  • Protect resident rights: privacy, confidentiality, dignity, choice, the right to refuse care, and freedom from abuse, neglect, and restraints.
III.CLegal and Ethical Behavior1 task5%
  • Act legally and ethically: stay within the nurse aide scope of practice, report abuse and neglect, and avoid negligence and other misconduct.
III.DMember of the Health Care Team1 task6%
  • Work as a member of the health care team: follow the care plan and the nurse's direction, accept delegation properly, and manage time and responsibilities.

Practice for the CNA exam

See how you would do on questions written to the same outline before you pay the exam fee.

The free CNA diagnostic is being prepared and is not open yet. The exam facts and the content outline on this page are current.

The CNA exam: common questions

How many questions are on the CNA test?

In states that use the NNAAP exam, 70 multiple-choice questions: 60 scored and 10 pretest. States that use other testing companies have written tests of different lengths, so check your state's candidate handbook.

How long is the CNA exam?

The NNAAP written exam has a time limit of 2 hours. The skills evaluation is a separate part. Other vendors' written tests have their own limits, so check your state's handbook.

Is the CNA exam the same in every state?

No. Each state chooses its own testing company and sets its own fees, passing standard and retake rules. A number of states use the NNAAP from Credentia; many others use Prometric or Headmaster instead.

What score do I need to pass the CNA test?

Each state sets its own passing standard for the written test. You must pass both the written (or oral) test and the skills evaluation; in the NNAAP skills evaluation, all five skills must be performed correctly.

How much does the CNA test cost?

There is no single fee. Each state sets its own, and your state's candidate handbook lists the fee for each part of the exam.

What is on the CNA test?

On the NNAAP written exam: Basic Nursing Skills (35%), Activities of Daily Living (22%), Client Rights (8%), Emotional and Mental Health Needs (8%), Communication (7%), Self-Care and Independence (7%), Member of the Health Care Team (6%), Legal and Ethical Behavior (5%) and Spiritual and Cultural Needs (2%). The skills evaluation tests hands-on skills separately.

Is the CNA test hard?

No national pass rate is published, so there is no official figure to judge by. The written questions are practical rather than technical, and the trap to watch for is an action that sounds helpful but is outside the nurse aide's role. The skills evaluation is demanding in a different way: in the NNAAP, every one of the five selected skills has to be performed correctly in front of an evaluator.

Is there an oral version of the CNA written test?

In the NNAAP, yes. The oral version has 60 multiple-choice questions and 10 reading comprehension questions.

Can I take the CNA test online?

In NNAAP states, Credentia delivers the written exam at test centers or online. The skills evaluation is hands-on and done in person. Whether the online written option is available to you depends on your state.

How many times can I retake the CNA exam?

Your state sets the number of attempts and the period in which you must pass both parts. We do not quote a number because it differs from state to state; your state's candidate handbook gives the rule that applies to you.

NNAAP® and National Nurse Aide Assessment Program are marks of their owner, Credentia Nurse Aide LLC; the program was originally developed by the National Council of State Boards of Nursing (NCSBN). This site is an independent study resource and is not affiliated with, endorsed by, or sponsored by Credentia, NCSBN, Prometric, Headmaster/D&S Diversified Technologies, or any state nurse aide registry.