North Carolina CNA Exam 2026: NA I and NA II Without the Confusion
North Carolina uses two separate nurse-aide listings. Nurse Aide I (NA I) is the entry credential tested through Credentia's NNAAP process and listed by the North Carolina Division of Health Service Regulation. Nurse Aide II (NA II) is an additional North Carolina Board of Nursing listing for aides trained to perform a defined set of expanded tasks under Registered Nurse supervision.
They are not two levels of the same examination. Passing the NA I examination does not create an NA II listing, and maintaining one listing does not automatically maintain the other.
Current NA I Exam Facts
| Item | Current North Carolina detail |
|---|---|
| Training | State-approved program with at least 75 hours, including at least 16 hours of practical training |
| Knowledge examination | 70 questions: 60 scored questions and 10 unscored pretest questions |
| Knowledge time | 2 hours |
| Skills evaluation | 5 skills in 30 minutes; Hand Hygiene is included, and one skill measures and records a value |
| Official skills list | Credentia currently describes 23 essential skills |
| Combined fee | $140 |
| Written or oral examination only | $40 |
| Skills evaluation only | $100 |
| Completion window | Pass both parts within 2 years or 3 attempts, whichever comes first |
| Registry posting | Credentia says a successful candidate normally appears on the registry in 2–5 business days |
These figures come from the current Credentia exam overview, exam-fee page, skills page, skills-evaluation page, and eligibility criteria. Always recheck the candidate handbook before paying because vendors and fees can change.
Credentia reports the result as pass or fail. Its public North Carolina pages do not publish a raw percentage cutoff, and they do not say that a candidate must earn “100% on every critical step.” Prepare to perform every checkpoint safely, but do not build a study plan around an unofficial percentage.
What the Knowledge Exam Covers
The written or oral examination tests three broad clusters:
- Physical care skills, including activities of daily living, basic nursing skills, and restorative care.
- Psychosocial care skills, including emotional, cultural, spiritual, and mental-health needs.
- Role of the nurse aide, including communication, resident rights, legal and ethical behavior, and teamwork.
The 10 pretest questions are mixed into the examination and are not identified. Treat all 70 questions as if they count. The oral option changes how questions are delivered; it does not reduce the content standard.
Use the official content outline as the blueprint. Then practice scenario questions that make you choose the safest action inside NA I scope. High-value topics include hand hygiene, transmission precautions, resident rights, reporting changes, transfers, fall prevention, nutrition, elimination, communication, dementia care, and recognizing emergencies.
How the 30-Minute Skills Evaluation Works
The evaluator assigns five skills. Hand Hygiene is included, and one assignment requires a measurement such as weight, pulse, respirations, urinary output, or blood pressure. The current official list contains 23 essential skills, so an old “22 skills” checklist is incomplete.
Do not memorize a homemade list from a video and assume its wording is current. Open Credentia's current North Carolina skills list, download the current skill pages, and rehearse those exact steps.
A useful rehearsal loop is:
- Ask a partner to choose five official skills without telling you in advance.
- Set a 30-minute timer.
- Perform Hand Hygiene and the other four skills while verbalizing only what the official instructions allow you to verbalize.
- Have the partner mark the official checkpoints, including indirect-care behaviors.
- Repeat missed skills from the beginning rather than practicing only the missed step.
Safety habits should be automatic: identify the client, explain the procedure, provide privacy, use infection-control precautions, protect the client from falls, leave the bed in a safe position, and place the call light within reach when the skill requires it. Measurement skills also require an accurate recorded result within the tolerance stated by Credentia.
Training and Eligibility
North Carolina's approved NA I curriculum is at least 75 hours and includes at least 16 hours of practical training. The official state curriculum introduction is the reliable source for those minimums.
Schools and employers can impose additional admission requirements such as health screening, immunization records, drug screening, background checks, uniforms, or minimum age policies. Those local admission rules should not be presented as universal statewide licensing requirements. Confirm them with the specific approved program before enrolling.
After an approved training program, a candidate must pass both examination parts within the eligibility window. Credentia states that a candidate has three attempts or two years, whichever comes first. If only one part is failed, the candidate normally retakes that part and pays the corresponding fee.
NA I Registry and Renewal
Passing both parts leads to listing on the North Carolina Nurse Aide I Registry. Credentia says posting normally takes 2–5 business days. Verify the listing before representing yourself as active to an employer.
An NA I listing is maintained through qualifying paid nursing or nursing-related work. The familiar rule is at least eight hours during the preceding 24 months. Employment verification and any renewal workflow should be checked on the current NC DHHS registry site because forms and submission methods can change.
Do not mix NA I rules with NA II rules. The agencies, scopes, and renewal systems are separate.
NA II: A Separate 160-Hour Path
The North Carolina Board of Nursing's current NA II course guidelines specify 80 hours of classroom and laboratory instruction plus 80 hours of direct patient care, for 160 hours total. The candidate must meet the Board's prerequisites and complete an approved program; the Credentia NA I exam does not substitute for this course.
NA II tasks are limited to the Board-approved task list and must be performed under appropriate RN supervision. Examples can include selected sterile procedures, tracheostomy care, suctioning, ostomy care, urinary procedures, enteral-care tasks, and observation or discontinuation tasks involving established IV therapy. The exact task list and delegation conditions matter more than a broad label such as “advanced CNA.”
The Board's current Nurse Aide II information lists a $24 initial listing fee and $24 renewal fee. Renewal requires at least eight compensated hours performing nursing care activities under direct RN supervision during the previous 24 months. If an NA II listing has been expired for no more than 24 months, the Board describes a competency-evaluation route; after more than 24 months, the full program is required again. Confirm the current rule in the Board's NA II FAQ before acting.
A Focused Four-Week Review Plan
Week 1: Role, rights, and infection control
Review scope of practice, reporting, communication, resident rights, abuse prevention, hand hygiene, PPE, and standard precautions. Finish each session with short scenario sets.
Week 2: Activities of daily living
Study bathing, grooming, dressing, oral care, toileting, nutrition, hydration, and positioning. Pair written questions with hands-on skill rehearsal.
Week 3: Basic nursing and restorative care
Practice vital signs, intake and output, transfers, range of motion, fall prevention, observation, and documentation. Rehearse measurement skills until both technique and recording are reliable.
Week 4: Full simulations
Complete timed knowledge sets and several five-skill, 30-minute simulations. Review every missed answer by explaining why the correct option is safest and why each distractor is outside scope, out of sequence, or incomplete.
Common Mistakes to Avoid
- Studying an old 22-skill list instead of the current 23-skill list.
- Using an unofficial raw passing percentage as a readiness target.
- Treating NA I and NA II as one credential or one registry.
- Memorizing skill steps without practicing them under a 30-minute limit.
- Assuming a school's admission requirements apply to every approved program.
- Letting an online summary override the current Credentia or state instructions.
Official Sources to Keep Open
- Credentia North Carolina exam overview
- Credentia North Carolina exam fees
- Credentia skills list
- Credentia eligibility criteria
- NC-approved NA I curriculum introduction
- NC Board of Nursing NA II course guidelines
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