Minnesota CNA Exam 2026: The Complete MN-NACE Guide
If you want to work as a nursing assistant in any Minnesota nursing home or certified boarding care home, your name has to appear on the Minnesota Nurse Aide Registry (NAR) — and to get there, you have to pass the Minnesota Nurse Aide Competency Evaluation (MN-NACE). This guide walks you through every requirement set by the Minnesota Department of Health (MDH) and its current testing vendor, D&SDT-Headmaster, plus the study plan, common pitfalls, and renewal rules that the official handbook glosses over.
This is updated for 2026 testing rules: 70 questions, 74% to pass (52 of 70 correct, effective August 5, 2024), 120 minutes, 30 minutes for skills, four knowledge attempts, three skills attempts, all within 24 months.
Start FREE Minnesota CNA Practice Now
MN-NACE-style multiple-choice questions written to MDH's 5.1–5.7 grade reading level, with AI explanations on every wrong answer. No credit card. No paywall.
What the Minnesota Nurse Aide Does (and What MDH Regulates)
Minnesota nurse aides provide direct, hands-on care under the supervision of a licensed nurse: bathing, toileting, vital signs, ambulation, feeding, and observing/reporting changes in resident condition. The role is regulated by MDH's Health Regulation Division, not the Minnesota Board of Nursing — that's the most common confusion newcomers run into. The Board of Nursing oversees LPNs and RNs; MDH owns the NAR.
Federal law (OBRA 1987) requires anyone working as a nursing assistant in a Medicare/Medicaid-certified nursing facility for more than 4 months to be on the state registry. Minnesota's NAR satisfies that requirement and is checked by every long-term care employer before hire.
Settings that require NAR listing:
- Skilled nursing facilities (nursing homes)
- Certified boarding care homes
- Most assisted living facilities also verify NAR status as a condition of employment, even when not federally required
Hospitals, home health, and hospice may employ unlicensed assistive personnel (UAP) who are not on the NAR, but the vast majority of Minnesota CNA jobs require active registry status.
Minnesota CNA Exam Format at a Glance
| Component | Details |
|---|---|
| Knowledge test | 70 multiple-choice questions |
| Knowledge time | 120 minutes (average completion ~36 min) |
| Knowledge passing score | 74% — 52 of 70 correct (effective Aug 5, 2024) |
| Reading level | 5.1–5.7 (below 6th grade) |
| Languages | English, Spanish, Somali, Hmong (oral option available) |
| Skills test | Randomly selected MDH-approved skills |
| Skills time | 30 minutes total for all assigned tasks |
| Skills passing | All critical (starred) steps must be performed correctly |
| Knowledge fee | ~$115 |
| Skills fee | ~$150 |
| Combined fee | ~$225–$265 total depending on test site |
| Knowledge attempts | 4 within 24 months |
| Skills attempts | 3 within 24 months |
| Testing vendor | D&SDT-Headmaster (replaced Pearson VUE Feb 1, 2022) |
| Registration | minnstate.edu/CNAtesting or in-facility test sites |
Fees vary slightly by test site (community college vs. in-facility). Confirm with your chosen site before registering.
Minnesota Training Requirement: 75 / 16
Minnesota requires a minimum of 75 hours of instruction from an MDH-approved Nurse Aide Training and Competency Evaluation Program (NATCEP), which must include at least 16 hours of supervised clinical practice with live residents in a long-term care setting. That's the federal floor — Minnesota does not exceed it, putting the state on the lighter end nationally.
Where to find approved programs:
- MDH's official directory: Find Training and Testing Sites
- Minnesota State Colleges & Universities (Minnesota State system) hosts the largest network of approved programs
- Many long-term care employers run tuition-free in-facility programs through the Next Generation Nursing Assistant Initiative — you train and test for free in exchange for a short work commitment
Typical program costs (when not free):
| Program type | Typical cost |
|---|---|
| Free (employer/state-sponsored) | $0 |
| Community/technical college | $400–$1,200 |
| Private accelerated | $875–$2,150 |
| International Institute (low-cost) | ~$125 exam-included pathway |
Background study: All Minnesota nurse aides must clear a Department of Human Services background study via NETStudy 2.0 with fingerprinting. Cost is $32–$40 and is separate from training.
Challenge candidates (people with healthcare experience or out-of-state training) may skip the 75-hour course and go straight to the exam, but must contact a test site directly to register and self-prepare.
Master the Knowledge Test — Free Prep
Our question bank covers all nine MN-NACE content areas with AI-powered explanations. Targeted to the actual MDH reading level and question style.
Knowledge Test Content Breakdown
The 70-question MN-NACE knowledge test draws from nine content areas aligned to the federal OBRA curriculum and the Minnesota-approved NATCEP curriculum. Approximate weighting (consistent across MDH-published exam blueprints):
1. Role of the Nurse Aide (~10%)
- Scope of practice and what Minnesota CNAs cannot do (no medication administration, no sterile procedures, no IV care, no tube insertion)
- Working under RN/LPN delegation
- Chain of command and reporting structure
- Documentation and shift reports
2. Promoting Safety (~12%)
- Fall prevention and bed/wheelchair safety
- Fire safety: RACE (Rescue, Alarm, Confine, Extinguish) and PASS (Pull, Aim, Squeeze, Sweep)
- Restraint alternatives — Minnesota emphasizes restraint-free care
- Body mechanics for staff and resident lifts
- Incident reporting
3. Promoting Function and Health of Residents (~14%)
- Activities of daily living (ADLs)
- Range of motion (active and passive)
- Rehabilitation and restorative care
- Nutrition, hydration, and feeding assistance
- Skin integrity and pressure injury prevention
4. Basic Nursing Skills (~14%)
- Vital signs (BP, pulse, respirations, temperature, pain)
- Height and weight
- Intake and output (I&O)
- Specimen collection (urine, stool — NOT blood)
- Catheter and ostomy care (external care only — CNAs do not insert)
5. Personal Care Skills (~14%)
- Bathing (bed bath, partial, shower, tub)
- Oral care, denture care, and care for the unconscious resident
- Perineal care (front to back, every shift)
- Hair, nail, and skin care
- Dressing and grooming
6. Mental Health and Social Service Needs (~10%)
- Dementia and Alzheimer's care (validation therapy, redirection)
- Depression and anxiety
- Sundowning and behavioral interventions
- Sexuality and intimacy in long-term care
- Cultural competency — Minnesota's resident population includes large Hmong, Somali, Karen, and Indigenous communities
7. Care of Cognitively Impaired Residents (~8%)
- Communication strategies for dementia
- Wandering and elopement prevention
- Catastrophic reactions
- Resident-centered care planning
8. Basic Restorative Services (~8%)
- Prosthetic and orthotic care
- Assistive devices (canes, walkers, gait belts)
- Bowel and bladder retraining
- Ambulation
9. Resident Rights (~10%)
- OBRA-mandated rights (privacy, dignity, choice, grievance)
- HIPAA basics
- Abuse, neglect, and financial exploitation reporting — mandatory under Minnesota's Vulnerable Adults Act
- Advance directives and end-of-life wishes
The Skills Test: 22 Possible Skills, Up to 5 Drawn
The Minnesota skills test is administered in person in full clinical attire (scrubs, closed-toe shoes, hair pulled back). You'll be assigned a random set of skills (typically 4–5 including hand hygiene) drawn from the MDH-approved skills list, with 30 minutes total to complete all of them.
Hand hygiene and indirect care steps are required on virtually every skill. Skipping a starred ("critical") step automatically fails that skill.
Most Frequently Tested Minnesota Skills
| Category | Skills |
|---|---|
| Infection control | Hand hygiene (always), donning/doffing PPE |
| Vital signs | Radial pulse, respirations, electronic blood pressure, manual blood pressure |
| Personal care | Partial bed bath, mouth care, denture care, perineal care for female resident, fingernail care, dressing |
| Mobility & positioning | Transfer from bed to wheelchair using gait belt, ambulate with gait belt, position resident on side, passive ROM (one shoulder, one knee/ankle) |
| Nutrition & elimination | Feeding a resident, measuring and recording urinary output, providing catheter care, applying knee-high anti-embolism stockings |
| Other | Making an occupied bed, weighing an ambulatory resident, providing modesty/privacy |
Critical (Starred) Steps That Fail You Instantly
Drop any of these and the skill is marked failed regardless of the rest:
- Hand hygiene at the start and end of every skill
- Identify the resident (name + photo or wristband)
- Explain the procedure before touching the resident
- Provide privacy (close door, pull curtain)
- Lock wheels on bed and wheelchair before any transfer
- Use a gait belt for ambulation and stand-and-pivot transfers
- Position the call light within reach before leaving
- Lower the bed to the lowest position before leaving
- Wipe female perineal care front-to-back, one stroke per area (then turn the cloth)
- Empty graduates at eye level on a flat surface when measuring output
Minnesota's skills handbook calls these out with stars (★). Memorize them — they are the difference between pass and retake.
Practice the Exact Skills Examiners Look For
Our AI tutor walks you through critical-step checklists for all 22 Minnesota skills and quizzes you on automatic-fail triggers. Free, unlimited practice questions.
6-Week Study Timeline (After Your NATCEP Course)
| Week | Knowledge focus | Skills focus | Hours |
|---|---|---|---|
| Week 1 | Resident rights, role of nurse aide, communication | Hand hygiene, PPE | 8–10 |
| Week 2 | Infection control, safety, body mechanics | Bed making, transfers with gait belt | 10–12 |
| Week 3 | Personal care, ADLs, skin integrity | Bed bath, perineal care, oral care | 10–12 |
| Week 4 | Vital signs, I&O, nutrition | Radial pulse, respirations, BP, feeding | 10–12 |
| Week 5 | Cognitive care, mental health, dementia | Positioning, ROM, ambulation | 8–10 |
| Week 6 | Full-length practice tests + weak areas | Mock skills run-through with timer | 10–15 |
Total recommended study: 60–80 hours after your NATCEP. Candidates who pass on the first attempt typically average 65 hours of post-class review.
7 Minnesota-Specific Pitfalls That Cost Candidates Their Pass
- Confusing MDH and the Board of Nursing. All NAR matters — testing, registry, renewal, complaints — go to MDH at 651-201-4200 or health.fpc-nar@state.mn.us. The Board of Nursing handles LPN/RN licensing and will redirect you.
- Letting your 24-month testing window expire. Once you complete your NATCEP, the clock starts. Miss the window, and you must retake the entire 75-hour course.
- Skipping the background study. NETStudy 2.0 with fingerprinting must clear before you can be employed, even if you pass the exam. Start it the same week you start your course.
- Wearing the wrong attire on skills day. No open-toed shoes. No street clothes. Long hair must be tied back. Test sites turn candidates away — and you forfeit the fee.
- Forgetting Minnesota offers oral testing in 4 languages. If English is your second language, request the Spanish, Somali, or Hmong oral version when you register. It is free.
- Misreading scope of practice on the knowledge test. Minnesota CNAs cannot administer medications, perform sterile dressing changes, insert catheters, or take orders directly from physicians. Multiple-choice questions test these limits constantly.
- Bringing electronics into the testing room. Phones, smart watches, fitness trackers — all must be off and stowed. A buzz mid-skill = automatic dismissal.
- Burning all four knowledge attempts (or all three skills attempts) before passing. Exhausting your attempts inside the 24-month window voids every prior attempt and forces you to complete an entirely new 75-hour NATCEP before you can retest. Budget retakes — don't wing them.
- Cheating or suspected misconduct. MDH policy bans any candidate caught cheating from all Minnesota testing for 45 calendar days, the attempt counts as a failure, and repeat offenders can be permanently blocked from the registry.
How to Register for the MN-NACE (Step-by-Step)
Minnesota uses a two-server system through Headmaster's Testing Management Unit (TMU) — you must register on the correct server for your test-site type, or your seat gets canceled:
- Create a TMU account at mn.tmutest.com — use your legal name exactly as it appears on your government ID
- Pick the correct server:
- Minnesota State server if you plan to test at a community/technical college (St. Paul College, Minneapolis College, Century College, South Central, Alexandria, Northland, etc.)
- In-Facility server if you will test at an MDH-approved nursing home or long-term care facility
- Pay the test fees at registration — knowledge ~$115, skills ~$150 (retake fees vary by site: Century ~$120/$250, Minneapolis ~$115/$175)
- Upload your NATCEP completion certificate (or challenge-candidate packet)
- Schedule your date. Knowledge is typically offered on-demand; skills slots are limited and book 2–6 weeks out in the Twin Cities
- Request ADA accommodations at least 10–14 business days in advance with documentation, or your exam day will proceed without them
Headmaster candidate support: 800-393-8664 or 888-401-0462 (Mon–Fri 7 a.m.–7 p.m. Central), minnesota@hdmaster.com. The current candidate handbook is Minnesota Candidate Handbook V7 (dated 3/2025) — download it before you register.
Minimum age to sit for the MN-NACE is 16 years old, one of the lowest in the country — Minnesota has 19 state-approved high school NATCEP programs that let juniors and seniors test before graduation.
Test-Day Checklist
Bring:
- Valid government-issued photo ID — name must exactly match your TMU registration
- Confirmation email or registration printout
- Watch with a second hand (for pulse and respirations) — analog only, no smartwatches
- Optional: pen for scratch notes (test site provides paper)
Wear:
- Full clinical scrubs (any color)
- Closed-toe, non-slip shoes
- Hair tied back; nails short and unpolished; no jewelry beyond a plain wedding band
Arrive:
- 20–30 minutes early
- Cell phone off, in your bag, in the designated cubby
Mindset:
- Talk through every step out loud — the evaluator scores what they see and hear
- If you skip a critical step, ask immediately to redo it before starting the next step (some sites allow self-correction within the same skill)
- Don't rush. Average completion uses well under the 30-minute window.
After You Pass: NAR Listing, Renewal, and Reciprocity
Getting on the Registry
Headmaster transmits passing scores directly to MDH. Allow up to 30 business days for your name to appear on the public NAR at nar.web.health.state.mn.us. Employers cannot legally schedule you for unsupervised CNA shifts in a nursing home until that listing is active.
Renewal — Every 24 Months (No Fee, No CEUs)
Minnesota has one of the most candidate-friendly renewal rules in the country: no fee, no continuing education, no renewal test. Just three items, every 24 months:
- Work at least 8 paid hours as a nursing assistant within the past 24 months (orientation, training, and in-service hours do not count — only paid patient-care hours)
- Complete and sign the Nursing Assistant Registry Update form (PDF on the MDH site)
- Attach a recent pay stub showing your employer name and the qualifying hours
How to submit: As of January 8, 2024, MDH launched the online Minnesota Nurse Aide Registry portal. You can create an account and upload the update form and pay stub electronically, or email the packet to health.FPC-NAR@state.mn.us. Allow up to 30 business days for processing. There is no renewal fee.
Qualifying employers (no job description needed): nursing homes, certified home health agencies, hospices, assisted living facilities. If you work in any other setting (hospital UAP, clinic tech, group home), attach a signed job description so MDH can confirm the duties meet the nursing-assistant definition.
If You Lapse
A 24-month gap with no qualifying paid work = expired status. To get back on the NAR, you must retest (both knowledge and skills) — the 75-hour course is not required again, but the exam is.
Interstate Reciprocity (Endorsement)
Moving to Minnesota with an active out-of-state CNA certification?
| Your situation | Minnesota path |
|---|---|
| On another state's registry in good standing with 8+ paid CNA hours in the past 24 months | Apply as Interstate Endorsement Candidate — no retest, no MN fee |
| Lapsed >24 months in old state, or no recent qualifying work hours | Apply as Test-Out (Challenge) Candidate — must pass MN-NACE |
| Never trained as a CNA | Complete a 75-hour Minnesota NATCEP first |
How to apply for endorsement: Download the Interstate Endorsement Forms (PDF) from MDH, complete every section, and email the packet to health.FPC-NAR@state.mn.us. MDH verifies your home-state registry status directly — do not ask your old state to fax anything. Processing takes up to 30 days and Minnesota charges no endorsement fee (unlike most neighboring states). The dedicated endorsement line is 651-215-8705 (9 a.m.–3 p.m. M-F).
Leaving Minnesota? Most states accept Minnesota CNAs via reciprocity if you're in good standing on the MN NAR. Contact the destination state's nurse aide registry directly — they will verify your status through MDH.
Minnesota CNA Salary and Job Outlook (2026)
Minnesota CNAs earn above the national median, driven by the Twin Cities healthcare market and rural workforce shortages.
| Metric | Value |
|---|---|
| Statewide average wage | $19.38–$19.65/hour |
| Statewide annual average | $40,310–$40,875 |
| Minneapolis–St. Paul metro | $19.58/hour median (Payscale, 2026) |
| Top 10% of Minnesota CNAs | Up to $25.70/hour |
| Hospital CNAs (vs. nursing home) | +$2–$4/hour premium typical |
| Travel CNA assignments | $25–$30+/hour with stipends |
Major Minnesota employers: Allina Health, Fairview/M Health, HealthPartners, Essentia Health, Mayo Clinic Health System, Sanford Health, Ecumen, Presbyterian Homes & Services, Good Samaritan Society.
Demand is high. Minnesota's aging population and ongoing long-term care staffing shortage mean most graduates have a job offer before their NAR listing finalizes. The Bureau of Labor Statistics projects 4–5% growth for nursing assistants through 2032 — Minnesota's growth tracks slightly higher.
Career Ladder from CNA
| Next step | Typical timeline | Why CNAs choose it |
|---|---|---|
| Trained Medication Aide (TMA) | 75 add-on hours | Higher hourly rate; expanded scope in Minnesota LTC |
| LPN | 12–18 months | Bridge programs widely available at Minnesota State colleges |
| RN (ADN or BSN) | 2–4 years | Many employers offer tuition assistance for working CNAs |
| Surgical Tech / Phlebotomist / EMT | 4–12 months | Lateral moves into hospital-based care |
Pass the Minnesota CNA Exam with Confidence
Full MN-NACE-aligned question bank with AI explanations, skills checklists with critical steps starred, and personalized study plans — all 100% free, all updated for 2026 MDH rules.
Official Minnesota CNA Resources
- MDH Nurse Aide Registry — Main page
- MDH Testing Information
- MDH Approved Training/Testing Sites Directory
- Stay on the Registry — Renewal rules
- Search the Public NAR
- Minnesota State Nursing Assistant Testing — Register here
- D&SDT-Headmaster Minnesota Nurse Aide Hub
- MDH NAR contact: 651-201-4200 / 800-397-6124 / health.fpc-nar@state.mn.us
Buy on Amazon
Practice exams on ExamEdge
Take courses on Udemy
Online course on Mometrix