The credential that qualifies someone to work as a nursing assistant in hospitals, nursing homes, and other long-term care settings in the United States. Most states use the National Nurse Aide Assessment Program (NNAAP) written and skills exams (or a state-specific equivalent built on the same federal training and testing requirements under OBRA), which certify that a candidate has completed an approved nurse aide training program and can safely perform hands-on resident care under the supervision of a licensed nurse.
Who it's for
Entry-level caregivers seeking their first credential in direct patient care — often a stepping stone toward LPN or RN licensure — as well as career changers moving into healthcare and current home health aides seeking formal certification to work in a licensed facility. CNA certification is typically the fastest path into a paid clinical role, usually requiring only a few weeks of state-approved training rather than a multi-year degree.
What's covered
- Physical Care Skills — activities of daily living (bathing, grooming, feeding, toileting, mobility, positioning), basic nursing skills (vital signs, infection control, safety and body mechanics, measuring intake/output), and restorative skills (range-of-motion exercises, prosthetic and orthotic care, promoting resident independence)
- Role of the Nurse Aide — communication, resident rights, legal and ethical behavior, and functioning as a member of the healthcare team, including reporting and documentation
- Psychosocial Care Skills — meeting residents' emotional, mental health, spiritual, and cultural needs, including supporting residents with cognitive impairment and end-of-life care
What to expect
CNA certification requires passing two components: a written (or oral) knowledge exam of around 60-70 multiple-choice questions, typically with a 90-minute to 2-hour time limit depending on the state, and a separate hands-on skills evaluation in which an evaluator observes the candidate perform a randomly selected set of resident-care tasks (such as handwashing, transferring a resident, or taking vital signs) to a strict checklist standard. This practice exam and question bank cover the knowledge/written portion only — the skills evaluation must be demonstrated in person and can't be practiced through multiple-choice review.
How to prepare
Because the written exam draws directly from material covered in a state-approved nurse aide training program (typically 75+ hours combining classroom instruction and supervised clinical practice), the most effective prep revisits training materials and practices recall of specific procedures and terminology rather than general test-taking strategy. Physical Care Skills is both the largest domain and the one most connected to the hands-on skills exam, so building genuine fluency with ADLs and basic nursing procedures pays off on both halves of certification, not just the written test.
Certification details
- Administering body: Varies by state — commonly Pearson VUE, Prometric, or a state-run testing program, most built on the NNAAP exam framework; some states use their own state-specific written and skills exams with similar content.
- Eligibility: Completion of a state-approved nurse aide training program (minimum hours vary by state, commonly 75-120+ hours) that includes both classroom and supervised clinical instruction.
- Exam format: A written/oral knowledge exam (roughly 60-70 multiple-choice questions) plus a separate hands-on skills evaluation covering a randomly selected set of resident-care tasks.
- Passing score: Varies by state and testing vendor, commonly requiring roughly 70-75% correct on the written portion in addition to passing all required skills on the checklist evaluation.
- Renewal: CNA certification typically must be renewed every 2 years, generally requiring proof of paid work as a nurse aide within that period; lapsed certifications can require retesting.