A Certified Nursing Assistant (CNA) is a healthcare professional who provides direct, hands-on care to patients under the supervision of a licensed nurse. The CNA test is the mandatory certification examination required to practice, ensuring candidates possess the knowledge and practical skills necessary to safely and effectively provide patient care. This assessment is a foundational step, confirming a candidate’s competency before they are added to the state’s Nurse Aide Registry.
Meeting the Eligibility Requirements
Before applying for the certification exam, individuals must satisfy specific prerequisites that vary by state. Federal regulations require a minimum of 75 hours of state-approved nurse aide training, including classroom instruction and supervised clinical practice. Some states mandate a higher number of training hours, sometimes exceeding 100. Candidates must also pass a criminal history records check, as certain convictions can prevent working in a direct patient care role. Eligibility confirmation is handled through the state’s designated testing vendor or regulatory body.
Understanding the Two Test Components
The CNA certification assessment is composed of two distinct parts that must both be passed to earn certification. The first is the Knowledge Portion, which candidates can take as either a written or an oral exam, measuring theoretical understanding of patient care principles. The second part is the Clinical Skills Portion, a hands-on evaluation of a candidate’s ability to perform specific patient care tasks. Successfully completing both components validates the candidate’s mastery and ability to apply skills safely.
Detailed Breakdown of the Written Exam
The written exam, or Knowledge Portion, is typically multiple-choice, containing between 60 and 70 questions. Candidates are allotted 90 minutes to complete the test, which covers standardized content domains reflecting the work of a nurse aide. These domains include safety, infection control, patient rights, communication, and basic nursing care. The questions assess understanding of physical care skills, such as activities of daily living, and psychosocial care skills, involving emotional and mental health needs.
For candidates who have difficulty with the standard written English exam, an oral or audio-based alternative is available, sometimes offered in Spanish. The oral version typically consists of 60 multiple-choice questions and an additional 10 reading comprehension questions.
Detailed Breakdown of the Clinical Skills Exam
The Clinical Skills Exam requires candidates to demonstrate practical competence by performing a specific number of nursing tasks. Candidates are usually asked to perform four to six skills, which are randomly chosen from a standardized list of approximately 25 to 30 procedures. Common skills include handwashing, measuring and recording vital signs, transferring a patient with a gait belt, and performing personal care like feeding or mouth care. The performance is observed and graded by a Nurse Evaluator, who is typically a Registered Nurse.
The evaluation process is highly structured, with each skill broken down into a series of required steps. Specific actions are designated as “critical steps,” and failure to perform one correctly results in an automatic failure of the entire skill. Handwashing is a skill that all candidates are tested on and must perform without error. Candidates are given a set time limit, often around 30 to 40 minutes, to complete all the assigned skills.
Registration, Scheduling, and Fees
The administrative logistics for the CNA test are handled by state-contracted testing organizations, such as Prometric, Pearson VUE, or Headmaster. Registration requires the candidate to submit an application through the vendor’s website after completing their state-approved training program. Testing fees vary by state and vendor but typically involve separate charges for the knowledge and clinical skills exams. Candidates select a testing window and location from a list of authorized regional or in-facility test centers provided by the vendor.
Certification, Renewal, and Retesting
Upon successfully passing both the knowledge and skills portions, the candidate’s name is added to the state’s Nurse Aide Registry, officially granting CNA certification. Certification must be maintained through a regular renewal process, typically occurring every two years. To qualify for renewal, most states require the CNA to have worked a minimum number of paid hours providing nursing-related services—often at least eight hours—under licensed nurse supervision within the preceding 24 months. Some states also require the completion of continuing education hours.
If a candidate fails either the written or the skills exam, they are generally allowed to retest, with many states permitting up to three attempts. If a candidate fails to pass within the allowed attempts or mandated time limit, they may be required to complete the state-approved training program again before retesting.