The CNA written exam is a multiple-choice knowledge test you must pass, along with a hands-on skills evaluation, before your name can be added to your state’s nurse aide registry. Through Credentia, the vendor used in many states, it contains 70 questions and gives you two hours to finish.1Credentia. Exam Overview Sixty questions are scored; the other ten are unscored pretest items used to develop future exams, and you won’t be told which is which. Every question has four answer choices with one correct response, and you can flag questions and return to them before submitting.
What the Exam Covers
Questions are pulled from the seven curriculum areas your training program was required to teach.2eCFR. 42 CFR 483.154 – Nurse Aide Competency Evaluation The heaviest share is physical care: bathing, grooming, dressing, feeding, repositioning, and transfers. Expect basic nursing questions too, on vital signs, weight, recognizing abnormal changes in a resident, and when to report those changes to a nurse.3eCFR. 42 CFR 483.152 – Requirements for Approval of a Nurse Aide Training and Competency Evaluation Program
The remaining categories are where candidates who studied only the hands-on material tend to lose points. Infection control and safety get their own block, including emergency response and the Heimlich maneuver. Mental health and social services questions ask whether you can adapt to a resident’s emotional needs, support their independence, and involve family members appropriately. Dementia care is its own category, focused on communication and appropriate responses to behaviors of cognitively impaired residents. Residents’ rights come up in scenario form: privacy, confidentiality, personal choice, and mandatory reporting.3eCFR. 42 CFR 483.152 – Requirements for Approval of a Nurse Aide Training and Competency Evaluation Program
The Oral Alternative
Federal regulations give you the right to take an oral version of the exam instead of a written one.2eCFR. 42 CFR 483.154 – Nurse Aide Competency Evaluation The content is the same, but a proctor reads each question aloud from a prepared script in a neutral tone. The oral exam is intended for candidates with reading difficulties or limited English literacy and is typically offered in both English and Spanish. The written version is generally English-only unless your state has approved additional languages.
The Skills Test Is Separate
Passing the written exam alone does not certify you. The competency evaluation has two parts, and most states require you to complete both. In the skills portion, a licensed nurse evaluator watches you perform a randomly selected set of tasks on an actor or mannequin and scores you against a checklist. The pool includes every personal care skill in the federal training curriculum: bathing, grooming, dressing, toileting, feeding, skin care, and transfers.2eCFR. 42 CFR 483.154 – Nurse Aide Competency Evaluation Because the selection is random, prepare for all of them. You can usually schedule the two parts on the same day or separately, and if you pass one and fail the other, most states let you retake only the failed component.
Before You Can Register
You need a completion certificate from a state-approved nurse aide training program. Federal law sets the floor at 75 hours, including at least 16 hours of supervised hands-on practice. At least 16 hours of classroom instruction in communication, infection control, safety, promoting independence, and residents’ rights must come before any direct resident contact.3eCFR. 42 CFR 483.152 – Requirements for Approval of a Nurse Aide Training and Competency Evaluation Program Many states require more hours than the federal minimum.
Most states also require a criminal background check. Disqualifying offenses vary, but serious crimes involving violence, abuse, neglect, or theft from vulnerable adults are disqualifying almost everywhere. Some states allow waivers for older or less-serious convictions through an appeals process. Check your state’s nurse aide registry or health department for the exact list before you enroll in a program.
To register, upload your training completion certificate and valid identification through your state’s testing vendor portal. You need a government-issued photo ID, and the name on it must match your training records. If you’ve had a name change, bring supporting documents such as a marriage certificate.
Fees, and Who Should Be Paying Them
Combined fees for the written and skills portions typically run $100 to $150, though the exact amount varies by state. Fees are generally non-refundable and paid by credit or debit card at scheduling. If your employer or program issued a voucher, enter the voucher code before checkout; some vouchers cover both components, others only one.4Credentia. What Fees and Types of Payment Are Available on the Credentia Platform
Read this part carefully if a nursing facility is involved. If a facility has already employed you or given you an offer of employment when your training begins, federal law prohibits the facility from charging you anything for training or testing, including textbooks. If you weren’t employed during training but a facility hires you within 12 months of completing your program, that facility must reimburse your training and testing costs on a prorated basis during your employment.3eCFR. 42 CFR 483.152 – Requirements for Approval of a Nurse Aide Training and Competency Evaluation Program A facility asking you to pay out of pocket in those situations is violating federal regulation.
Testing at a Center
Plan to arrive at least 30 minutes before your scheduled start.5Credentia. Test Center Exams Staff will match your admission ticket to your photo ID. Your phone, smartwatch, and personal items go in lockers; nothing comes into the testing room with you. The room is monitored, and each computer terminal shows one question at a time. After submitting, you leave without discussing questions with other candidates.
Testing Online From Home
A growing number of states allow the written exam through remote online proctoring. As of 2025, Credentia offers this option in over 15 states and territories, including Alabama, California, Colorado, Georgia, Maryland, Nevada, North Carolina, Pennsylvania, Virginia, and Washington.6Credentia. Online Exams The setup requirements are specific:
- A desktop, laptop, or Chromebook with a single monitor. Tablets and smartphones can’t be used for the exam itself.
- A wired internet connection is preferred; WiFi works at 3 Mbps or better, and other people in the household should stay offline during your exam.
- A private room with solid walls (not glass), at least one door, good lighting, and no distractions.
- A second device (smartphone or tablet) with the ExamRoom 360 app, used by the proctor for a 360-degree room scan and continuous monitoring alongside your computer camera.
Complete the system test and practice simulation ahead of time. Check-in opens 30 minutes before your appointment, and you still need a government-issued photo ID to show the proctor on camera.6Credentia. Online Exams Disconnect any VPN, close other applications, and unplug extra monitors before starting.
Accommodations and Language
Testing accommodations are available for documented disabilities under the Americans with Disabilities Act, including extended time, large print, screen-reading software, a scribe, a distraction-free room, or wheelchair-accessible stations.7U.S. Department of Justice. ADA Requirements: Testing Accommodations If you received accommodations under an IEP or Section 504 plan in school, that documentation usually supports the same accommodations here. Submit your request well before your test date so it can be reviewed in time.
For Spanish-speaking candidates, the oral exam is typically offered in Spanish. The written exam is offered only in English in most states, though a handful have begun adding written translations in Spanish and other languages. Confirm with your state’s testing vendor.
Scoring and Results
Scoring is automated. Your percentage is calculated from the 60 scored questions; the 10 pretest items don’t count.1Credentia. Exam Overview The minimum passing score varies by state, generally in the 70% to 80% range. Online exam scores are usually available within a few hours on your testing platform. Test center results for both written and skills exams typically post within 24 hours.8Credentia. Results
Once you pass both components, your vendor sends your results to the state nurse aide registry. Your name is added, employers can verify your status, and that registry listing is what actually lets you work as a CNA.
If You Don’t Pass
Federal regulations guarantee at least three attempts at the competency evaluation, and many states allow more.9eCFR. Requirements That Must Be Met by States and State Agencies: Nurse Aide Training and Competency Evaluation, and Paid Feeding Assistants Your score report includes a numeric score and diagnostic feedback on which content areas gave you the most trouble, so you can direct your study time.10Credentia. Exam Results You pay the testing fee again for each retake. If you use all of your state’s allowed attempts without passing, most states require you to complete a full training program again before you can test once more. Check your state’s specific limit before your first attempt.