There's no single national CNA exam. Each state board contracts with a testing vendor, most commonly Prometric, Pearson VUE, Headmaster, or D&S Diagnostics, and adopts a state-specific blueprint on top of the federal floor set by OBRA 87 (Omnibus Budget Reconciliation Act of 1987). What's consistent: every CNA working in a Medicare/Medicaid-certified facility must finish a state-approved training program of at least 75 hours (most states require more) and pass a two-part competency exam, a written or oral knowledge test plus an in-person skills evaluation with a live evaluator. Most candidates pass the written; many fail the skills. Practice your skills out loud.
CNA
CNA
Certified Nursing Assistant Exam
Launch your nursing career with your CNA certification.
Free forever. No credit card. Aligned to the State boards of nursing (vendor varies by state) blueprint.
About the CNA
Governing body: State boards of nursing (vendor varies by state)
At a glance
CNA exam facts
- Questions
- 60-75 written items + 5-6 in-person skills (varies by state)
- Duration
- 2-3 hours total (written ~90 min, skills ~30-40 min)
- Passing score
- Varies by state, commonly 70-80% on written; all skills must be performed correctly
- Cost
- $75-$175 depending on state and vendor
- Format
- Multiple choice (written or oral) plus hands-on skills demonstration
- When offered
- Multiple times monthly at approved testing sites in each state
The CNA written test is memorizable. The skills evaluation is where candidates lose certification, almost always to a missed critical safety step, not a missed clinical detail.
Live practice bank
485
CNA questions in our database right now, with full rationales on every choice.
Exam blueprint
What the CNA tests
The categories below come from the current State boards of nursing (vendor varies by state) test plan. Weights are the published ranges; the actual percentage varies slightly between exam forms.
Physical Care Skills
~38-42%The biggest single bucket. Activities of daily living: bathing, dressing, grooming, feeding, toileting, transfers, range of motion. Includes restorative skills and basic nursing skills (vital signs, intake/output).
Psychosocial Care Skills
~10-12%Emotional and mental health needs, cultural awareness, spiritual care, and supporting residents with cognitive impairment.
Role of the Nurse Aide
~25-30%Communication, residents' rights, ethical and legal behavior, abuse prevention and reporting. The residents' rights questions are nearly unmissable points if you've read them once.
Safety and Emergency Procedures
~15-20%Infection control, transfer techniques, fall prevention, fire and disaster response, basic emergency response.
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The two parts of the CNA exam
Every state's CNA certification has two components, both required to pass:
- Written (or oral) examination. Multiple choice, usually 60-75 questions, delivered by computer or paper depending on the vendor. Most states offer an oral version for candidates whose first language is not English. You must pass each part independently, failing one usually means re-testing only that part.
- Skills evaluation. Performed in person with a state-approved evaluator. You're randomly assigned 5-6 skills from a published list of 20-30 and must demonstrate each correctly. Critical safety steps, handwashing, identifying the resident, providing privacy, lowering the bed before leaving the room, are mandatory on every skill. Miss one and you can fail the entire skill regardless of how well you performed the rest.
Most candidates find the skills evaluation more stressful than the written. Rehearsing each skill aloud, in full, with a partner is the single most effective preparation.
Federal training requirements and state variations
OBRA 87 sets a federal floor: at least 75 hours of training, including a minimum of 16 hours of supervised clinical experience. Most states exceed this floor: California requires 160 hours, Maine requires 180, Alaska requires 140. Some states allow nursing students who've completed certain courses to challenge the exam without a separate CNA program.
Your training must be at a state-approved program. Verify approval with your state's department of public health or board of nursing before paying tuition, unapproved program hours don't count, no matter what the school says.
The skills you might be asked to demonstrate
Vendors publish the full list of testable skills before exam day. Practice every one, you find out which 5-6 you'll do on the day of. The most commonly assigned skills:
- Hand hygiene, required first on every other skill, and tested as its own item.
- Vital signs, radial pulse, respirations, blood pressure (manual cuff in most states).
- Transfers, bed to chair using a transfer/gait belt.
- Ambulation, assisting a resident to walk with a gait belt.
- Range of motion, passive ROM to one upper or lower extremity.
- Bed making, occupied or unoccupied.
- Personal care, partial bed bath, perineal care, mouth care, denture care, hand and nail care.
- Catheter care and output measurement.
- Feeding a resident.
- Counting and recording urinary output.
For every skill, the universal critical steps are: identify yourself and the resident, explain the procedure, provide privacy, perform hand hygiene before and after, raise the bed to working height, lower the bed and place the call light within reach before leaving. Miss any of these and you can fail the skill. Period.
Certification, renewal, and reciprocity
Pass both parts and your state adds you to its Nurse Aide Registry. Federal law requires CNAs working in long-term care to renew every 24 months, demonstrating paid nursing-related duties during the prior 24 months. Most states have a simple renewal form; some require continuing education.
Moving to another state? Many states accept reciprocity from a CNA in good standing, but the receiving state's registry must approve you before you practice. Apply early; reciprocity can take 30-60 days, and a gap on your timeline can mean a lost job offer.
Sample questions
Practice CNA questions
Reveal each answer and rationale to see how Precision Nursing teaches the reasoning behind every question.
Question 1
Safety and Emergency ProceduresA CNA is helping a resident transfer from the bed to a wheelchair. What should the CNA do first?
- A.Position the wheelchair at a 45-degree angle to the bed with brakes locked.
- B.Apply the transfer/gait belt to the resident.
- C.Perform hand hygiene and identify the resident.
- D.Lower the bed to the lowest position.
Show answer & rationale
Correct answer: C
Hand hygiene and resident identification are the universal first steps for every CNA skill. The wheelchair, gait belt, and bed height are all important parts of the transfer, but they come after the universal initial steps. Skipping hand hygiene or identification is grounds for a critical-step failure on the skills exam.
Question 2
Psychosocial Care SkillsA resident with dementia repeatedly tries to leave the unit and becomes agitated when redirected. Which approach is most appropriate?
- A.Apply soft restraints until the resident calms down.
- B.Calmly redirect the resident using a familiar, structured activity.
- C.Tell the resident sternly that they cannot leave.
- D.Place the resident alone in their room with the door closed.
Show answer & rationale
Correct answer: B
Redirection with a familiar activity addresses the underlying need without restricting the resident's rights. Restraints require a physician's order and are inappropriate for behavior management. Stern correction and isolation can escalate agitation and may violate residents' rights protections under federal law.
Study tips
What works for CNA prep
Memorize the universal critical steps and perform them aloud on every skill, every time. They're the most common cause of a skills fail.
Practice each testable skill with a partner playing the resident. Out loud, full procedure.
Drill vital signs daily, manual blood pressure is where many candidates lose the most points.
Use a state-specific CNA question bank; the federal blueprint is consistent but state vendors differ.
If English is your second language, ask about the oral exam; it can dramatically reduce stress.
Arrive 30 minutes early to the skills exam. Settled nerves perform critical steps better.
Confirm your state's hand-washing time requirement (often 20 seconds with vigorous friction).
FAQ
Common questions about CNA
Is there a single national CNA exam?
No. Each state contracts with a testing vendor (commonly Prometric, Pearson VUE, Headmaster, or D&S Diagnostics) and may adopt a state-specific blueprint. The federal floor is set by OBRA 87.
How long is the CNA exam?
Most candidates spend 2-3 hours on test day: about 90 minutes for the written portion and 30-40 minutes for the skills evaluation.
How much does the CNA exam cost?
$75-$175 depending on your state and vendor. Some employers reimburse the fee.
What is the minimum training required to take the CNA exam?
Federal law requires at least 75 hours, including 16 clinical hours. Most states require more (commonly 120-180 hours).
How many skills will I be tested on?
Most vendors randomly assign 5 or 6 skills from the published state list. Practice every skill on the list.
Can I retake the CNA exam if I fail?
Yes. Most states allow up to 3 attempts within 24 months of completing training. After 24 months, you may need to retrain.
How often must I renew my CNA certification?
Every 24 months. Federal law requires evidence of paid nursing-related work during the prior 24 months to renew.
Can I work as a CNA in another state with my current certification?
Often yes, through reciprocity. Apply to the new state's nurse aide registry; approval usually takes 30-60 days.
Honest answers
Before you sign up, three things you're probably wondering
“Is the free tier actually useful, or just a teaser?”
1,000+ full-rationale questions across every CNA blueprint category. No time limit. No paywall after the first five.
“Is it like the real exam?”
Same format, same difficulty curve, same item types, built directly against the State boards of nursing (vendor varies by state) published test plan. We're not the test-makers, but we follow their blueprint.
“Why not use the official free samples?”
Use both. The official samples are small and authoritative. We give you the volume, the rationales, and the weak-area analytics on top.
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Free forever. No credit card. Aligned to the State boards of nursing (vendor varies by state) published test plan.