Free CNA Practice Test by State 2026: 5,100+ Nursing Assistant Questions

The Fastest Path to a Healthcare Career Starts Here

Becoming a Certified Nursing Assistant (CNA) is one of the fastest and most affordable ways to launch a healthcare career. In as little as 4 to 8 weeks of training, you can be eligible to sit for the CNA certification exam and start working in hospitals, nursing homes, home health agencies, and rehabilitation centers. But the certification exam itself is the gatekeeper --- and without proper preparation, roughly 15-30% of candidates fail on their first attempt.

The CNA exam has two parts: a written knowledge test and a hands-on clinical skills evaluation. You must pass both. The written portion tests your knowledge of patient care, safety, infection control, and communication across 60 to 100 multiple-choice questions. The clinical skills portion requires you to demonstrate 3 to 5 randomly selected nursing skills in front of an evaluator, with every critical step performed correctly.

What this career pays: CNAs earn a median salary of $39,530 per year (BLS, May 2024), with the top 10% earning over $48,780. While this is an entry-level position, it offers immediate employment, valuable healthcare experience, and a clear pathway to higher-paying roles. Many CNAs use their certification as a stepping stone to LPN, RN, and other advanced nursing positions. The BLS projects about 211,800 openings for nursing assistants per year, making it one of the most in-demand healthcare positions in America.

This guide covers everything you need to pass your state's CNA exam: the format and passing scores, a complete state-by-state directory of free practice tests, a breakdown of every content domain, 10 sample questions with answers, a week-by-week study plan, and a comparison of free vs. paid resources.

---

Start Your FREE CNA Practice Test

Take FREE CNA Practice TestPractice questions with detailed explanations

Over 5,100 nursing assistant practice questions covering clinical skills, patient care, and state exam prep --- 100% FREE. No signup required.

---

CNA Exam Format: Everything You Need to Know

The Three Major Testing Vendors

Your state assigns a testing vendor --- you do not choose. Each vendor has slightly different question formats and procedures:

• Credentia (formerly NNAAP/Pearson VUE) --- Administers testing in 29 states, the largest program. Processes over 200,000 exams annually. The NNAAP (National Nurse Aide Assessment Program) is the most widely used exam format.
• Prometric --- Administers testing in multiple states including Florida, Connecticut, New York, Texas, Kentucky, and New Jersey.
• Headmaster / D&S Diversified Technologies --- Administers testing in 14 states including Arizona, Arkansas, Idaho, Kansas, Missouri, and Ohio.

---

Free CNA Practice Tests by State

---

CNA Exam Content Breakdown: What You Will Be Tested On

The CNA written exam tests five core domains. Understanding the weight and content of each domain helps you prioritize your study time.

Domain 1: Activities of Daily Living (ADLs) --- approximately 20-25% of the exam

ADLs are the fundamental self-care tasks you help patients perform every day. This domain tests whether you understand proper techniques, patient dignity, and safety during these activities.

• Personal hygiene --- Bathing techniques (bed bath, tub bath, shower), oral care (conscious and unconscious patients), denture care, hair care, shaving, and nail care. Know the proper water temperature for bathing (100-105 degrees F), the direction of perineal care (front to back), and how to provide oral care for an unconscious patient (side-lying position, suction available).

• Dressing and grooming --- Assisting patients with clothing while promoting independence. Know the rule: dress the affected (weak) side first, undress the unaffected (strong) side first. Understand how to maintain patient dignity and privacy during dressing.

• Nutrition and hydration --- Feeding techniques for dependent patients, aspiration precautions (upright positioning, chin tuck), thickened liquid preparation, calorie counts, fluid intake monitoring (I&O), and recognizing signs of dehydration and malnutrition. Know that most adults need 1,500-2,000 mL of fluid daily.

• Elimination --- Toileting assistance, bedpan and urinal use, catheter care (never disconnect, bag below bladder level, perineal care), colostomy care basics, intake and output measurement, and recognizing abnormal urine characteristics (dark, bloody, foul-smelling).

• Mobility and positioning --- Ambulation assistance, transfer techniques (bed to wheelchair, wheelchair to toilet), positioning schedules (reposition every 2 hours), range of motion exercises (active and passive), and use of assistive devices (walkers, canes, gait belts). Know that a gait belt must be used for all ambulation and transfer activities.

Domain 2: Basic Nursing Skills --- approximately 25-30% of the exam

This is the largest domain and covers the clinical skills CNAs perform daily.

• Vital signs --- Temperature (oral: 97.6-99.6 degrees F, rectal: 98.6-100.6 degrees F, axillary: 96.6-98.6 degrees F), pulse (normal: 60-100 bpm, radial and apical), respiration (normal: 12-20 per minute, count for full minute), blood pressure (normal: approximately 120/80 mmHg), and pulse oximetry (normal: 95-100%). Know when to report abnormal values and which values are critical.

• Height and weight measurement --- Proper technique for standing scale, wheelchair scale, and bed scale. Accuracy matters because medication dosing and nutritional assessments depend on correct measurements.

• Specimen collection --- Clean-catch midstream urine collection, stool specimens, sputum specimens. Know the proper labeling (patient name, date, time, type) and storage requirements.

• Skin care and pressure injury prevention --- Stage classification of pressure injuries (Stage 1: intact skin with nonblanchable redness; Stage 2: partial-thickness skin loss; Stage 3: full-thickness skin loss; Stage 4: full-thickness tissue loss with exposed bone/tendon), turning schedules (every 2 hours), pressure-relieving devices, moisture management, and nutritional support. CNAs are responsible for skin assessment and reporting, not wound treatment.

• Rest and comfort --- Bed making (occupied and unoccupied), pain assessment (reporting patient pain to the nurse), sleep promotion strategies, and comfort positioning.

Domain 3: Safety and Emergency Procedures --- approximately 15-20% of the exam

• Fall prevention --- Risk assessment awareness, bed rails (side rails up per care plan, NEVER all four rails up as this constitutes a restraint), call light within reach, non-skid footwear, clutter-free environment, adequate lighting, and lock wheelchair brakes during transfers.

• Fire safety --- RACE (Rescue, Alarm, Contain, Extinguish/Evacuate) and PASS (Pull, Aim, Squeeze, Sweep) procedures. Know the location of fire extinguishers and fire exits. Understand evacuation procedures for immobile patients.

• Choking response --- Abdominal thrusts (Heimlich maneuver) for conscious patients, back blows and chest thrusts for infants, and positioning for unconscious patients. Know the universal sign of choking (hands at throat) and the difference between partial and complete airway obstruction.

• Restraint use --- Restraints require a physician's order and are a last resort. When applied, check circulation (pulse, sensation, skin color) every 15 minutes, release every 2 hours, offer fluids and toileting, and document. Never tie restraints to bed rails. Know that all 4 side rails raised constitutes a restraint.

• Body mechanics --- Proper lifting technique (bend at knees, keep load close to body, use legs not back), use of mechanical lifts for patients who cannot bear weight, and pivot technique for standing transfers. Improper body mechanics is the leading cause of CNA workplace injuries.

Domain 4: Infection Control --- approximately 15-20% of the exam

• Hand hygiene --- The single most important infection control measure. Proper handwashing technique (wet, soap, lather for at least 20 seconds, rinse, dry with paper towel, use towel to turn off faucet). Know when to wash (before and after patient contact, before and after glove use, after contact with body fluids, before eating, after using the restroom).

• Standard precautions --- Applied to ALL patients regardless of diagnosis. Include hand hygiene, PPE use (gloves, gown, mask, eye protection as needed), safe sharps disposal, proper biohazard waste handling, and respiratory hygiene (cover coughs, dispose tissues).

• Transmission-based precautions --- Three types beyond standard precautions: Contact (gown + gloves, dedicated equipment --- for MRSA, C. diff, scabies), Droplet (surgical mask within 3-6 feet --- for influenza, pertussis), and Airborne (N95 respirator, negative pressure room --- for tuberculosis, measles, chickenpox).

• Cleaning and disinfection --- Clean from clean to dirty areas, top to bottom, outside to inside. Know the difference between cleaning (removing soil), disinfection (killing most organisms), and sterilization (killing all organisms including spores).

• Bloodborne pathogen safety --- Universal precautions for blood and body fluid exposure. Post-exposure protocol: wash the area immediately, report to supervisor, complete an incident report, and seek medical evaluation.

Domain 5: Communication and Interpersonal Skills --- approximately 10-15% of the exam

• Patient rights --- Privacy, dignity, autonomy, the right to refuse treatment, access to personal belongings, freedom from abuse and neglect, participation in care planning, and the right to make complaints. The Residents' Rights section of the Omnibus Budget Reconciliation Act (OBRA) is foundational to this domain.

• Cultural competence --- Respecting diverse beliefs, dietary preferences, religious practices, and communication styles. Never impose your own values on patients.

• Communication techniques --- Active listening, therapeutic communication, open-ended questions, reporting changes in patient condition using objective language (describe what you observe, not your interpretation), and proper documentation.

• Team communication --- Shift report/handoff, reporting abnormal findings to the nurse (vital sign changes, skin changes, behavioral changes, pain), and understanding the chain of command (CNA reports to charge nurse, charge nurse reports to DON).

• End-of-life care --- Supporting dying patients and their families, signs of approaching death, post-mortem care, emotional support, and advance directives (DNR, living will, healthcare power of attorney). Know that CNAs provide comfort care and emotional support but do not make medical decisions about end-of-life care.

---

CNA Training Requirements by State

California requires 160 hours (60 classroom + 100 clinical), making it one of the most rigorous CNA training programs in the nation. Maine leads at 180 hours. The federal minimum under OBRA is 75 hours, with at least 16 hours of clinical training.

---

10 CNA Sample Questions with Answers

Question 1: A resident refuses to take their morning medications. What should the CNA do?

Answer: Respect the resident's right to refuse and immediately report the refusal to the nurse. CNAs do not administer medications, but they must report medication refusals so the nurse can follow up. Document the refusal, including the time and any reason the resident gave. Never force, trick, or coerce a resident into taking medications --- this violates their rights.

---

Question 2: While giving a bed bath, the CNA notices a red area on the resident's sacrum that does not blanch when pressed. What should the CNA do?

Answer: This is a Stage 1 pressure injury (intact skin with nonblanchable redness). The CNA should immediately report the finding to the nurse, document the observation including location, size, and appearance, reposition the resident off the affected area, and ensure the care plan includes appropriate pressure-relief interventions. Do not attempt to treat the area --- assessment and treatment are nursing responsibilities.

---

Question 3: What is the proper temperature range for bath water when giving a bed bath?

Answer: Bath water should be 100 to 105 degrees Fahrenheit (38 to 41 degrees Celsius). Always test the water temperature with a thermometer or on the inside of your wrist before applying it to the resident. Water that is too hot causes burns (a leading cause of injury in long-term care), while water that is too cold causes discomfort and chilling.

---

Question 4: A resident is choking on food and cannot cough, speak, or breathe. What should the CNA do immediately?

Answer: Perform abdominal thrusts (Heimlich maneuver): stand behind the resident, place your fist just above the navel, grasp your fist with the other hand, and deliver quick upward thrusts until the object is expelled or the resident becomes unconscious. If the resident becomes unconscious, lower them to the floor, call for help/activate emergency response, and begin CPR (check for visible obstruction before giving breaths). If the resident is in a wheelchair, perform thrusts from behind the chair.

---

Question 5: A CNA is assigned to care for a resident on droplet precautions. What PPE is required?

Answer: Droplet precautions require a surgical mask when within 3 to 6 feet of the resident. Gloves and gown are required per standard precautions if there is risk of contact with body fluids. The resident should be in a private room or cohorted with another resident with the same infection. Note: droplet precautions do NOT require an N95 respirator (that is airborne precautions) or a negative pressure room.

---

Question 6: When measuring blood pressure, the CNA gets a reading of 88/52 mmHg. What should the CNA do?

Answer: This reading is significantly below normal (hypotension). The CNA should keep the resident safe (seated or lying down to prevent falls from dizziness), retake the measurement to confirm accuracy, and immediately report the finding to the nurse. Do not wait until the end of your rounds --- hypotension can indicate a serious medical condition requiring immediate nursing assessment. Document the reading, the time, and that it was reported.

---

Question 7: How often should a CNA reposition an immobile resident to prevent pressure injuries?

Answer: At minimum, every 2 hours. This is the standard of care for pressure injury prevention. Use the clock system (supine, right side, left side, prone if tolerated) and document each position change. Use pillows and positioning devices to keep bony prominences from touching each other. Encourage the resident to shift weight in a wheelchair every 15 minutes.

---

Question 8: A resident with dementia becomes agitated and tries to hit the CNA. What is the appropriate response?

Answer: Stay calm, do not take the behavior personally, maintain a safe distance, use a calm and reassuring voice, and try to identify the trigger (pain, fear, overstimulation, toileting need). Never restrain, strike, or yell at the resident. If the situation is unsafe, step away and call for help. Report the incident to the nurse and document it. Behavioral changes in dementia patients may indicate pain, infection (UTI), or medication side effects.

---

Question 9: A CNA notices that a coworker is taking supplies from the facility and putting them in their personal bag. What should the CNA do?

Answer: Report the observation to your supervisor immediately. Theft of facility property is a violation that must be reported through the proper chain of command. Do not confront the coworker directly or ignore the situation. Failure to report could make you complicit. Document what you observed, including the date, time, and specific items involved.

---

Question 10: What are the five rights of delegation that apply to CNA assignments?

Answer: The five rights of delegation are: (1) Right task --- the task is within the CNA scope of practice; (2) Right circumstances --- the patient condition and available resources are appropriate; (3) Right person --- the CNA is competent to perform the task; (4) Right direction --- clear instructions were given; (5) Right supervision --- appropriate monitoring and follow-up are provided. A CNA should never accept a task that is outside their scope (such as administering medications, changing sterile dressings, or performing assessments).

---

How to Prepare: 3-Week CNA Exam Study Plan

Week 1: Master the Written Content by Domain

• Study one domain per day: ADLs (Day 1), Basic Nursing Skills (Day 2), Safety (Day 3), Infection Control (Day 4), Communication (Day 5)
• Create flashcards for all vital sign ranges, temperature values, positioning schedules, and hand hygiene timing
• Begin taking 30 practice questions daily on OpenExamPrep
• Review each missed question and understand why the correct answer is correct

Week 2: Practice Clinical Skills and Increase Written Practice

• Practice every skill on the skills checklist with a partner who evaluates you using the actual scoring criteria
• Focus on the skills that appear on every exam: hand hygiene, vital signs (pulse, respirations, blood pressure), positioning, and transfers
• Practice narrating your actions (many states require you to verbalize steps as you perform them)
• Increase to 50 written practice questions daily under timed conditions (1.5 minutes per question)
• Take a full-length practice exam at the end of the week

Week 3: Full Practice Exams, Skills Refinement, and Final Review

• Take 2-3 full-length timed practice exams (match your state's question count and time limit)
• Practice the clinical skills checklist daily, focusing on skills you find weakest
• Review the patient rights section (OBRA Residents' Rights) --- this is tested heavily
• Review infection control precautions (standard, contact, droplet, airborne) one final time
• Do a final review of all flashcards the night before your exam
• Get a full night of sleep before exam day

---

7 CNA Exam Study Tips That Actually Work

1. Practice hand hygiene until it is automatic --- Hand hygiene is tested on EVERY CNA skills exam and is a critical step in almost every other skill. If you forget to wash your hands before or after a procedure, you automatically fail that skill. Practice the full technique (20+ seconds, proper drying, faucet off with towel) until it is second nature.

2. Master vital signs by actually measuring them --- Do not just read about vital signs. Practice measuring pulse (count for a full 60 seconds), respirations (count without the patient knowing), and blood pressure (listen for Korotkoff sounds) on real people. The skills test evaluates technique, not just knowledge.

3. Learn the "whys" behind patient rights --- Understanding why each right exists helps you answer scenario questions correctly. A resident can refuse a bath because they have the right to self-determination. A resident can refuse medication because they have the right to refuse treatment. Knowing the underlying principle helps you handle novel scenarios.

4. Study body mechanics with your body, not just your eyes --- Practice proper lifting technique, gait belt placement, and transfer procedures physically. The skills test evaluates your actual body mechanics, and poor habits learned from reading alone will show up under test pressure.

5. Know when to report to the nurse --- The CNA exam loves questions about "what should you do?" The answer is almost always "report to the nurse" for any abnormal finding, change in condition, or patient complaint. CNAs observe and report; nurses assess and intervene.

6. Memorize infection control categories --- Create a simple chart: Standard (everyone), Contact (gown + gloves), Droplet (surgical mask), Airborne (N95 + negative pressure room). Link each type to specific diseases. This shows up on every written exam.

7. Practice the skills with narration --- Many states require you to verbalize what you are doing during the skills test ("I am checking the resident's identification," "I am washing my hands for 20 seconds"). Practice speaking your steps aloud so it feels natural on exam day.

---

Free vs. Paid CNA Exam Prep Resources

---

Why OpenExamPrep for CNA Exam Prep

• Completely free --- no signup, no credit card, no trial period that expires
• 5,100+ nursing assistant questions covering all five exam domains
• All 51 jurisdictions covered --- practice tests tailored to your state's testing vendor and format
• AI-powered tutor that explains the clinical reasoning behind each answer
• Updated for 2026 --- reflects current testing vendor formats and content updates
• Instant access --- start practicing right now from any device, no downloads needed
• Unlimited practice exams --- take as many full-length practice tests as you need

---

CNA Career Pathway: Where This Certification Takes You

Passing the CNA exam is not just an end goal --- it is a launching pad for a healthcare career:

Many nursing schools give priority admission to applicants with CNA experience, and the patient care skills you develop as a CNA translate directly to nursing practice.

---

Frequently Asked Questions