Iowa CNA Exam Guide 2026: Fees, TMU Test & Registry

Iowa CNA Exam Guide 2026

Iowa's nurse aide process has two exam components but more than one testing workflow. In 2026, Headmaster/D&S Diversified Technologies administers and scores the knowledge exam through TMU, while approved community colleges and Health Tech Associates handle skills testing separately. Iowa also lists a Credentia remote knowledge option. The Iowa Department of Inspections, Appeals, and Licensing (DIAL) oversees training and the Direct Care Worker (DCW) Registry.

For the standard certification path, complete a DIAL-approved 75-hour course, pass both competency components, and confirm your registry listing. A candidate who is specifically eligible to challenge may request testing through TMU without first completing an approved course, but that is an eligibility route—not a blanket rule for every applicant.

free Iowa CNA practice questionsPractice questions with detailed explanations

The 2026 Answer at a Glance

The two components do not have to be passed on the same attempt. If you pass one and fail the other, Iowa's rule says you retake only the failed component.

Who Runs Each Part—and What It Costs

Do not assume one registration covers everything. DIAL's current testing page lists these options:

A site's checkout page is the final authority before payment. Registration, payment, scheduling, results, and retakes for a Headmaster knowledge exam occur in TMU. Skills appointments follow the chosen skills site's instructions and are not automatically created with a TMU booking.

What changed in 2026

Iowa moved community-college knowledge testing to the Headmaster/TMU workflow. DIAL describes colleges as testing locations and proctors rather than the administrators of registration, payments, records, and results. Current college notices identify February 2, 2026 as the operational start for the new system. Skills testing remains a separate college or Health Tech workflow.

This split is the most important practical difference from many older Iowa guides. Make two appointment checklists: one for the knowledge provider and one for the skills site.

Training, Challenge Eligibility, and Registry Placement

DIAL's normal route to Iowa nurse aide certification requires a 75-hour approved course and successful completion of both competency tests. The course includes 30 hours of supervised clinical experience. DIAL approves training programs but does not issue a CNA license or certificate; the DCW Registry listing is the official record. After the requirements are completed, qualifying candidates are entered in the registry and receive a six-digit identification number.

The February 2026 Headmaster handbook also permits a Nurse Aide Testing Request from someone who completed approved training or is eligible to challenge. It does not say that every applicant may skip training. If you believe another education, occupation, or state-approved category makes you challenge-eligible, obtain confirmation from DIAL or the testing program before paying.

Plan for processing time. After training and both passing results are complete, DIAL says processing varies and advises allowing at least two weeks for your name to appear on the DCW Registry. Make sure the name used by your program matches the name you will use in TMU.

Headmaster Knowledge Exam Format

The current Iowa Headmaster candidate handbook specifies:

• 70 multiple-choice questions
• 60 minutes
• 70% minimum to pass
• computer delivery at a proctor site or by approved remote proctoring
• an audio version available when selected before payment

Headmaster's audio option does not add an exam fee. Remote audio candidates must supply wired headphones or earbuds; Bluetooth devices are not allowed. Credentia has its own remote-testing handbook and check-in rules, so do not use Headmaster instructions for a Credentia appointment.

Current Headmaster test plan

The February 2026 handbook lists 13 knowledge areas. Use these question counts instead of older six-domain percentage charts:

Basic Nursing Skills is the largest single area, but it accounts for 14 questions—not the 39% shown in some older materials. Nearly two-thirds of the test lies outside Basic Nursing Skills, Role and Responsibility, and Disease Process, so a one-topic study plan is risky.

Skills Exam: Use Your Site's Current Checklist

Iowa law requires a skills demonstration and a score of at least 70%. However, Headmaster does not administer Iowa's skills component, and the Headmaster knowledge handbook is not a statewide skills manual. The selected community college or Health Tech Associates supplies the live appointment, candidate instructions, equipment rules, and scoring checklist.

Before paying, ask the site for five items: its current fee, available dates, accepted identification, candidate handbook or checklist, and retake procedure. Do not rely on a national video for an exact number of selected skills or an exact time limit unless your Iowa testing site confirms it.

For practice, rehearse the site's checklist exactly. Common safety habits—introducing yourself, explaining care, providing privacy, using hand hygiene, positioning safely, leaving the call light within reach, and reporting observations—should become automatic, but only the current site checklist tells you what is scored for your appointment.

Attempts and the 75-Hour Reset Rule

Iowa Administrative Code gives each candidate three opportunities to pass each component. The rule is component-specific:

1. Pass knowledge but fail skills: retake skills only.
2. Pass skills but fail knowledge: retake knowledge only.
3. Fail either component three times: complete or repeat the approved 75-hour course before further testing.

This is different from claims that candidates receive unlimited retakes or must repeat both components after every failure. Keep each score report and verify which attempt TMU or the skills site recorded.

TMU Registration and Scheduling Checklist

For a Headmaster knowledge appointment:

1. Confirm that your training program created your TMU account, or submit the testing request if you completed training or have approved challenge eligibility.
2. Check that your first and last names exactly match your acceptable photo ID.
3. Pay the $50 knowledge fee in TMU.
4. Select an on-site or remote event and reserve the date.
5. If testing remotely, run the technology check and prepare a private, distraction-free room.
6. Review the appointment in TMU rather than relying on an old college confirmation process.

Headmaster allows online rescheduling until one full business day before the appointment, excluding weekends and holidays. Less notice can result in a no-show and forfeited fee. On-site candidates should arrive 20 minutes early; late arrivals are not admitted.

Official Headmaster results are available in the candidate's TMU account after 7:00 p.m. Central Time on the day the test is scored. Headmaster does not mail or email the result.

Identification and Exam-Day Rules

Bring one current, non-expired acceptable photo ID. The first and last names must exactly match TMU. The handbook accepts specified government, military, tribal, immigration, passport, and current-year high-school IDs; check the complete list before test day. A secure digital ID may qualify, but a photo, screenshot, fax, or emailed image of an ID does not. A physical ID is the safer choice.

At an on-site Headmaster exam, do not bring a calculator, scratch paper, translation aid, study material, or electronic device to your seat. Once the exam starts, you may not leave and return. Remote candidates must follow the camera, room-scan, audio, browser, and device rules in the current handbook.

Accommodations require advance approval through the TMU ADA application process. Do not wait until the appointment to request them.

A Focused Study Plan Based on 70 Questions

Phase 1: Build the safety framework

Learn what a nurse aide may observe, measure, assist with, document, and report. For scenario questions, separate the first safe CNA action from nursing assessment or treatment. Drill infection control, resident rights, emergencies, falls, transfers, positioning, vital signs, and changes in condition.

Phase 2: Follow the 13-area blueprint

Give Basic Nursing Skills the largest block because it has 14 questions. Then rotate through Role and Responsibility and Disease Process, followed by the five five-question areas. Finish every cycle with the smaller categories so that Mental Health, Nutrition, Personal Care, Care of the Impaired, and restorative care are not neglected.

A practical 14-day knowledge plan is:

• Days 1–3: Basic Nursing Skills
• Days 4–5: Role and Responsibility plus Client/Resident Rights
• Days 6–7: Disease Process plus Care of the Impaired
• Day 8: Infection Control
• Day 9: Safety and Data Collection
• Day 10: Communication and Mental Health
• Day 11: Nutrition and Personal Care
• Day 12: Aging Process and Restorative Care
• Days 13–14: two timed 70-question simulations and targeted review

Iowa CNA practice questionsPractice questions with detailed explanations

Phase 3: Rehearse skills separately

Knowledge scores do not prove performance readiness. Use the exact checklist from the site where you will test, practice on your feet, and have a partner score only after the complete attempt. Repeat missed critical or safety steps from the beginning rather than practicing them in isolation.

After You Pass: Certification and Active Registry Status

Iowa CNA certification itself does not expire. What changes is whether the DCW Registry shows the work status needed for employment in a nursing facility or certified long-term care setting. DIAL requires at least eight hours of qualifying paid nurse aide work during each two-year period to remain active. If you have no qualifying CNA work for two years or longer, DIAL says to retake both competency tests to restore active status.

The often-quoted 12 hours of in-service education per year is not a universal registry-renewal fee or requirement for every person on the registry. It applies to nurse aides employed by a certified long-term care facility; the facility must provide and the aide must complete the training. Keep employer records of both work and in-service hours.

Candidates already active and in good standing on another state's registry may use Iowa's registry transfer process. Submit the official DIAL application and wait for Iowa confirmation before assuming you are cleared to work.

Final Readiness Checklist

Before the knowledge exam, confirm that you can:

• finish 70 mixed questions within 60 minutes
• score above 70% consistently, with a margin for test-day variation
• explain all 13 Headmaster knowledge areas
• distinguish a CNA action from nurse-only assessment or treatment
• identify the correct knowledge provider, appointment, fee, and ID rules

Before the skills exam, confirm that you have the current checklist from your specific site, can perform each practiced procedure without prompting, and know its arrival, ID, cancellation, and retake rules.

After both passes, verify your six-digit DCW Registry number through DIAL rather than treating a score screen as the final employment check.

Official 2026 Sources

Use primary sources whenever a school page or prep site conflicts with this guide:

• Iowa DIAL CNA certification and registry
• Iowa DIAL testing locations and current fees
• February 2026 Headmaster Iowa Candidate Handbook
• Iowa Administrative Code 441, Chapter 81
• TMU Iowa
• Credentia Iowa

Fees, calendars, and local skills procedures can change. Recheck the live provider page before paying or traveling.