Exam Prep

CNA Exam Guide

Everything you need to know about the NNAAP exam — structure, domains, scoring, skills, and what to expect on test day.

Written Exam

State/vendor format varies

90 min · 70% to pass

Skills Exam

5 skills

All critical steps required

Passing Score

49 / 70

70% minimum on written

Attempts Allowed

3 attempts

Within 24 months

Written Exam Domains

Question counts, timing, and domain weighting vary by state and testing vendor. Use the current handbook to prioritize study.

Physical Care Skills
47%
  • Personal hygiene, bathing, grooming
  • Elimination care (bedpan, catheter, ostomy)
  • Nutrition and feeding assistance
  • Mobility, transfers, positioning
  • Vital signs (temp, pulse, respiration, BP)
  • Skin care and pressure-injury prevention
  • ROM exercises and assistive devices
Psychosocial Care Skills
11%
  • Emotional and mental health support
  • Residents with dementia / Alzheimer's
  • End-of-life care and dignity
  • Cultural and religious considerations
Communication & Interpersonal Skills
16%
  • Verbal and nonverbal communication
  • Observing and reporting changes
  • Documentation and charting
  • Communicating with families
Legal & Ethical Behavior
9%
  • Resident rights under OBRA
  • Abuse/neglect — recognition and reporting
  • Confidentiality and HIPAA basics
  • Advance directives
Member of the Health Care Team
17%
  • Role and scope of the CNA
  • Infection control and standard precautions
  • Safety and emergency procedures
  • Long-term care environment
  • Rehabilitative and restorative care

Skills Exam

You'll perform 5 randomly selected skills in front of a trained evaluator. Each skill has a checklist of steps — critical steps must be completed perfectly.

Critical Steps

Critical steps are actions that directly affect resident safety, dignity, or rights. Missing any single critical step on a skill means that skill fails — even if you performed all other steps correctly.

The most commonly missed critical steps:

  • Wash hands before and after every skill
  • Explain what you're doing before beginning
  • Provide privacy (curtain, door) throughout
  • Raise/lower bed to working height and back
  • Lock wheels on wheelchair before any transfer
How Scoring Works
Pass all critical steps on all 5 skills → Pass
Miss a critical step on any skill → Fail that skill → retake
Tip: Handwashing is almost always a critical step. Never skip it. Evaluators will mark you off even if you "forget" at the very beginning.

Common NNAAP Skills

Handwashing
Indirect care (bed making, occupied and unoccupied)
Perineal care (male and female)
Mouth care
Denture care
Nail care (fingernails)
Catheter care
Range of motion (active and passive)
Anti-embolism stockings
Transfer — bed to wheelchair
Transfer using gait belt
Positioning in bed (supine, lateral, Fowler's)
Vital signs — blood pressure
Vital signs — oral temperature
Vital signs — radial pulse and respiration
Feeding a resident
Recording intake and output
Urinary catheter drainage bag care
Mechanical soft diet preparation
Weight measurement

This is not an exhaustive list. Practice all skills on your state's official skills checklist — any skill can appear on exam day.

Registration & Scheduling

1. Complete a training program

Enroll in and complete a state-approved CNA training program. Minimum hours vary by state (75–180 hrs). Your program submits your completion to the state licensing agency.

2. Receive your ATT letter

After your state approves your training record, your state's testing vendor sends your Authorization to Test (ATT) by mail or email. This typically takes 2–6 weeks. You cannot schedule without it.

3. Schedule with your testing vendor

Your state uses Pearson VUE, Headmaster LMS, or Prometric. Visit your vendor's website or candidate portal to select your test site, date, and time, and pay the exam fee.

4. Test day

Arrive 30 min early with your ATT letter and government-issued photo ID. No personal items in the testing room. Cell phones must be stored outside.

Recommended Study Strategy

  1. 1Complete all 17 study modules in order — each builds on the previous.
  2. 2After every 2–3 modules, take a category quiz to check retention.
  3. 3Drill flashcards daily — even 10 minutes per day compounds fast.
  4. 4Practice all 30+ clinical skills out loud, in order, from memory.
  5. 5Take at least 3 full-length practice quizzes in the final 2 weeks.
  6. 6Do a full CNA-Ready timed simulation in the last 3 days; official question counts and timing vary.

Frequently Asked Questions

Answers to the most common questions about the CNA licensing exam.

Ready to start studying?

All 17 modules, 2,100+ practice questions, and 23 clinical skill walkthroughs — in one place.