Virginia CNA Exam 2026: Your Complete Nurse Aide Certification Guide
In Virginia, the credential you need to work as a nursing assistant in hospitals, nursing homes, home-health agencies, and long-term care facilities is the CNA (Certified Nurse Aide) — issued by the Virginia Board of Nursing under the Department of Health Professions (DHP). The exam itself is the standard NNAAP (National Nurse Aide Assessment Program) two-part test administered by Credentia (which acquired nurse-aide testing from Pearson VUE in April 2021). But Virginia has its own approved-program rules, application flow, and registry maintenance requirements. Miss a state-specific detail and your application bounces or your scores never post to the Virginia Nurse Aide Registry.
This guide walks through every rule, fee, deadline, and test component you need to pass the Virginia CNA exam on your first attempt in 2026 — and get listed on the registry so you can legally work.
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Virginia CNA Exam Format at a Glance
| Component | Details |
|---|---|
| Written Examination | 70 questions: 60 multiple-choice + 10 reading-comprehension |
| Oral Examination (alternative) | 160 items with a recorded oral version for candidates who prefer it |
| Written Time Limit | 2 hours (120 minutes) |
| Written Fee | $45 (paid to Credentia at scheduling) |
| Skills Evaluation | 5 randomly selected skills from the 23-skill NNAAP pool |
| Skills Time Limit | 25 minutes |
| Skills Fee | $95 |
| Total First-Time Exam Cost | $140 ($45 written + $95 skills) |
| Passing Score — Written | ~70% correct (NNAAP standard scoring) |
| Passing Score — Skills | Satisfactory on every selected skill |
| Attempts Allowed | 3 attempts per portion within 2 years of training completion |
| Testing Vendor | Credentia (replaced Pearson VUE in April 2021) |
| Scheduling System | Credentia CNA365 online portal |
| Credentia Customer Service | 888-204-6249 |
| VA Board of Nursing | (804) 367-4515 |
| Virginia DHP Initial Certification Fee | $0 (issued automatically after passing) |
| Virginia DHP Renewal Fee | $30 per year — Virginia CNAs renew annually (unusual; most states are biennial) |
| Eligibility Category | E1 (graduate of VA program) / E2 (RN-LPN student) / E3 (military medic) / E4 (lapsed CNA) |
Credentia offers live-proctored online delivery of the written/oral test for Virginia candidates — you can sit it from home or work with a webcam and a quiet, private space — in addition to traditional regional testing sites.
Virginia Training Hours: 120-Hour Floor, 140-Hour Modern Standard
The Virginia Board of Nursing requires candidates to complete a state-approved nurse aide education program before testing. The regulatory floor under 18VAC90-26 is 120 hours, but after the May 12, 2023 curriculum update — which added mandatory substance-abuse and opioid-misuse instruction — most Virginia programs now run 140 hours to cover the expanded content:
| Component | Virginia Floor (18VAC90-26) | Modern Standard |
|---|---|---|
| Classroom instruction | Set by program | ~60–80 hours |
| Skills laboratory | Set by program | 20 hours minimum |
| Direct clinical practice | 40 hours minimum | 40 hours |
| Pre-clinical instruction | 24 hours minimum before student touches a client | 24+ hours |
| Total program | 120 hours | 140 hours (post-2023) |
The May 2023 curriculum additions also include expanded dementia-care techniques, resident-rights protection, and opioid-misuse recognition — content that shows up on the 2026 NNAAP written exam. Programs are offered at community colleges, Virginia Health Services and other employer-sponsored apprenticeships, the American Red Cross, vocational high schools, and adult-education centers. Full-time programs run 4–8 weeks; evening/weekend tracks run 10–16 weeks.
Find an approved program on the Virginia Board of Nursing nurse-aide education programs page.
The E1–E4 Eligibility Categories (Virginia-Specific)
Credentia Virginia sorts every candidate into one of four eligibility buckets — each with its own testing window. Know yours before paying CNA365:
| Code | Route | Testing Window |
|---|---|---|
| E1 | Graduate of a Virginia Board-approved 120+ hour nurse aide program | 24 months from program completion; 3 attempts per portion |
| E2 | RN or LPN student with at least one completed clinical course including 40+ client-care hours | 12 months from Board application approval |
| E3 | Military medic/corpsman (Army 68W, Navy HM, Air Force 4N) with recent training | 12 months from Board application approval |
| E4 | Lapsed Virginia CNA (certificate expired; seeking reinstatement by retest) | 24 months from Board application approval |
E2, E3, and E4 candidates must submit a Board approval application first — do not pay Credentia until the Board issues approval or your fee is forfeited. A fifth path (out-of-state program graduates whose program meets equivalency) tests under the E1 route once the Board signs off.
Light-duty rule: Any candidate currently on medical light duty cannot sit the skills evaluation — no exceptions, per the VA handbook. You can still take the written exam; schedule skills after you are fully released.
Virginia Written Exam Content Breakdown (NNAAP)
The 70-question Virginia written exam follows the national NNAAP content outline. Ten of those 70 are reading-comprehension items (short passage + question stem) — the remaining 60 are straight multiple-choice. Questions are scenario-based and emphasize patient safety, resident dignity, and CNA scope of practice.
1. Physical Care Skills (~40%)
- Activities of Daily Living (14%): bathing, grooming, dressing, oral hygiene, toileting, nutrition/hydration, elimination
- Basic Nursing Skills (14%): vital signs, infection control, safety, emergency procedures, data collection and observation
- Restorative Skills (8%): positioning, prevention of contractures, range-of-motion exercises, ambulation
2. Psychosocial Care Skills (~10%)
- Emotional and mental-health needs of residents
- Spiritual and cultural needs
- Dementia, Alzheimer's, and cognitive-impairment care
- Behavioral symptoms and de-escalation
3. Role of the Nurse Aide (~50%)
- Communication (8%): with residents, families, team members; non-verbal cues; observation-and-reporting
- Client Rights (7%): OBRA residents' rights, HIPAA, privacy, dignity, confidentiality
- Legal and Ethical Behavior (3%): abuse/neglect reporting, mandated reporting, accurate documentation
- Member of the Healthcare Team (7%): scope of practice, chain of command, delegation, accepting-and-reporting assignments
You need roughly 70% correct to pass the written portion — about 49 of 70 questions.
The 23 NNAAP Skills: Know Every One
Credentia randomly selects 5 skills from the national 23-skill NNAAP pool for every Virginia candidate. Hand hygiene is on every candidate's list and is always tested first. The remaining 4 are drawn from the rest of the pool:
Hygiene and comfort: hand hygiene (handwashing), mouth care, denture care, perineal care for a female resident, partial bed bath, back rub
Mobility: transfer from bed to wheelchair using a transfer belt, ambulation with a transfer belt, positioning on side, passive range of motion (one shoulder or one knee and ankle)
Vitals and measurements: radial pulse, respiration count, electronic blood pressure (one arm), upright-scale weight
Elimination and nutrition: catheter care (female), measuring and recording urinary output from a drainage bag, feeding a client who cannot feed himself or herself
Dressing and skin: dressing a client with an affected (weak) right arm, applying one knee-high anti-embolism/elastic stocking, foot care (clean and dry between toes), fingernail care (clean and file on one hand)
Safety and specialized: making an occupied bed, assisting with use of a bedpan
The Non-Negotiable Critical Element Steps
Missing any of these automatically fails the skill, no matter how well you did the rest:
- Knock and identify yourself before entering the room
- Identify the resident by name/ID
- Explain the procedure before you start
- Perform hand hygiene before and after every skill (and after glove removal)
- Provide privacy — close the door and draw the curtain
- Position the bed safely at the end — lowest position, wheels locked, side rails per care plan, call light within reach
- Maintain dignity and communication throughout
Practice the Exact Virginia NNAAP Skills
Each of the 23 skills includes step-by-step procedures, critical-step callouts, and AI-powered explanations of why each step matters for resident safety.
6-Week Virginia CNA Study Timeline
| Week | Focus | Hours |
|---|---|---|
| 1 | Role of the nurse aide, communication, residents' rights, HIPAA | 8–10 |
| 2 | Infection control, safety, emergency procedures, body mechanics | 8–10 |
| 3 | Vital signs, personal care, basic nursing skills | 10–12 |
| 4 | Mobility, restorative care, range of motion, transfers | 8–10 |
| 5 | Psychosocial care, dementia care, end-of-life, nutrition | 8–10 |
| 6 | Full-length practice tests + live skills rehearsal with a partner | 10–15 |
Total recommended prep after training: 60–80 hours of self-study on top of your 120–140-hour program.
The 10 reading-comprehension items catch unprepared candidates off guard — drill short-passage reading under time pressure in week 6.
How to Register for the Virginia CNA Exam (Step-by-Step)
Virginia's registration flow is actually simpler than most states, but the ordering matters:
- Complete a Virginia Board-approved nurse aide training program (or qualify under an alternative route). Your program registrar submits completion records directly to Credentia.
- Create a Credentia CNA365 account at credentia.com/test-takers/va using the email address your program has on file. Mismatched emails delay eligibility posting by weeks.
- Pay the $140 first-time testing fee ($45 written + $95 skills) through CNA365. Accepted payment: credit card, prepaid card (Visa/MC/Amex), ACH/electronic check, or electronic voucher — no cash, no checks.
- Schedule both parts once your eligibility is confirmed. You can take the written online with live proctoring from home or work, or at a regional testing site. Skills are performed in person at an approved site.
- Pass both portions — results post to your CNA365 account within 24–48 hours.
- Credentia transmits your passing scores to the Virginia Nurse Aide Registry automatically. Unlike some states, you do not file a separate Board application or pay an initial certification fee — the Board issues your certificate (CNA license number) at no cost once both exam parts are recorded.
- Verify your certificate on the Virginia DHP License Lookup — typical posting time is a few business days after Credentia transmits scores.
Budget 2–6 weeks from exam pass date to an active, verifiable Virginia CNA credential.
Virginia-Specific Pitfalls (Avoid These)
- 2-year testing window: You must pass both portions of the NNAAP within 2 years of your training-program completion date, using no more than 3 attempts per portion. Blow either limit and you re-enroll in an approved program — start over.
- 40 hours of clinical minimum: Virginia requires at least 40 hours of direct, supervised clinical practice inside your training program before Credentia will release eligibility. Programs that cut clinicals short get candidates bounced from the testing queue.
- 90-day lapse rule: If your Virginia CNA certificate lapses more than 90 days past expiration, you cannot simply renew — you must submit a $30 reinstatement application to the Board, and the Board decides whether you need to retest on NNAAP.
- Annual renewal vs 24-month work rule (two separate clocks): Virginia collects the $30 renewal annually, but the federal OBRA work rule operates on a rolling 24-month lookback — you need at least one paid, RN/LPN-supervised nursing-related shift within the previous 24 months. Going 24 consecutive months without paid nursing-assistant work deactivates your registry listing and requires NNAAP retesting.
- Paid, not volunteer: Virginia counts only paid nursing-related work toward the renewal requirement. Volunteer hours, caring for a family member unpaid, and student-clinical hours do not count.
- Name match: Your government-ID name must match your training-program record, your Credentia CNA365 profile, and your Board record exactly. A middle-initial mismatch is the top reason score files fail to post to the registry.
- Fingerprinting for some employers: Long-term care facilities in Virginia must run a Central Criminal Records Exchange (CCRE) background check and may require Child Protective Services registry check before hire — budget 1–2 weeks.
- 120-day OBRA rule at nursing homes: Federal law gives you 120 days from your first paid day of work at a Medicare/Medicaid-certified nursing home to pass the NNAAP and be listed on the registry. Working past 120 days uncertified is illegal at those facilities.
Top Test-Taking Strategies for Each Component
Written Exam Strategies
- Read the stem twice — NNAAP questions often hide the real question in a qualifier like "first", "most important", "best", or "initial".
- Prioritize safety over efficiency — when two answers look right, the one that keeps the resident safer almost always wins.
- Protect dignity and privacy — any answer that exposes the resident, violates HIPAA, or skips consent is wrong even if clinically efficient.
- Stay within CNA scope — you do not give injections, assess wounds, insert catheters, or interpret lab values. If an answer has you doing RN-level work, eliminate it.
- Residents choose, then report — questions about resident preferences usually want you to honor the choice and report to the nurse, not override the resident.
- Pace yourself — 70 questions in 120 minutes is roughly 1 minute 40 seconds per question. Flag hard ones and move on.
- The 10 reading-comprehension items are generous on time — do not rush them; the passages reward careful re-reading.
Skills Evaluation Strategies
- Verbalize every step — evaluators score what they observe and hear. Saying "I am now washing my hands for 20 seconds" helps the evaluator check the box.
- Never skip hand hygiene — perform it before and after the skill as a whole, and again after glove removal.
- Leave the unit safe — bed in lowest position, wheels locked, side rails per care plan, call light within reach, personal items in their original place. Every evaluator scans this at the end.
- If you make a mistake, correct it out loud — evaluators can award credit for recognized corrections on non-critical steps, but never for unfixed critical-element misses.
- Practice with a real 25-minute timer — it feels short the first time. Do at least 3 mock runs with a study partner before test day.
- Count pulse and respirations for a full minute — shortcuts are a fast automatic fail.
Test-Day Checklist
- Two forms of valid government-issued ID (one with photo, one with signature); name must match your Credentia CNA365 profile exactly
- Admission letter from Credentia (printed or mobile)
- Two sharpened #2 pencils (Virginia handbook reminder)
- Closed-toe, non-slip shoes for the skills test
- Clean scrubs or professional attire — no fake nails, hair tied back, only a plain wedding band
- Wristwatch with a second hand (for pulse and respiration counting)
- No phones, no food, no notes, no water bottles at the testing station
- Arrive 30 minutes early — late arrivals forfeit the fee
- For online-proctored written tests: a quiet private room, working webcam and mic, a government ID on hand, and no one else in the room
Master Every Critical Step
Our course highlights the exact critical-element steps evaluators watch for — the ones that fail candidates who otherwise performed the skill correctly.
Virginia Nurse Aide Registry, Renewal, and Reciprocity
The Virginia Nurse Aide Registry
The Virginia Nurse Aide Registry is maintained by the Virginia Board of Nursing within the Department of Health Professions (DHP). Every employer required to hire certified nurse aides (nursing facilities, hospitals running long-term care units, home-health agencies, etc.) must verify your listing on the registry before your first shift. The registry records your full name, certification date, expiration date, any findings of abuse/neglect/misappropriation, and current status (active, inactive, lapsed).
Look yourself up any time on the DHP License Lookup.
Annual Renewal (Virginia Is Unusual — Most States Renew Every 2 Years)
- Cycle: Every year, by the last day of your birth month — Virginia is one of only a handful of states on an annual nurse aide renewal cycle (the DHP fee schedule confirms $30 per year, not per 2 years)
- Fee: $30 per annual renewal
- Work lookback (federal OBRA, 2-year window): Although Virginia collects the $30 annually, the work requirement follows federal OBRA — you must have performed paid nursing-related activities under RN/LPN supervision at least once within the previous 24 months to avoid retesting on NNAAP
- Method: DHP Online Licensing Portal — log in with your license number and PIN
- CE: Basic CNA renewal does not require continuing education hours, though many employers require 12 hours of in-service training annually separately
If your certificate lapses 90 days or less past expiration, you can still renew online with the $30 fee. Beyond 90 days, it becomes a reinstatement application (also $30) and the Board may require NNAAP retesting if you cannot document 24-month paid work.
Moving to Virginia from Another State (Endorsement)
Virginia offers certification by endorsement for out-of-state CNAs under 42 CFR 483.152 equivalency. Requirements:
- Active, unencumbered certification on another state's OBRA nurse-aide registry in good standing
- No substantiated findings of abuse, neglect, or misappropriation on any state registry
- Online application through the DHP licensing portal (checklist PDF) plus registry verification from your home state
- Fingerprint-based background check through the Central Criminal Records Exchange (CCRE)
- Proof of program completion — certificate or director letter from your original state
- Virginia charges no endorsement application fee — a rare structural advantage
- Most endorsement applicants do not need to retest on NNAAP if their home-state training met or exceeded Virginia's 120-hour minimum and meets 42 CFR 483.152
- Processing time: typically 30–45 business days once out-of-state verification arrives
- Disqualifier: if you challenged the test in your home state (non-approved program or one-day review course), you do not qualify for Virginia endorsement and must re-enroll in a Virginia program
Advanced Certified Nurse Aide (ACNA) — The Virginia Career Ladder
Virginia is one of the only states with a statutory Advanced CNA credential, governed by 18VAC90-25-110(A). Requirements:
- Current Virginia CNA certification in good standing
- At least 3 years of CNA certification history
- No findings of abuse, neglect, or misappropriation on any nurse-aide registry in any jurisdiction
- No Board disciplinary action in the preceding 5 years
- A licensed-nurse recommendation documenting at least 6 months of direct-care supervision within the past year
- Completion of a 120-hour Board-approved advanced training program with competency evaluation
- Continuing education: ACNAs must complete at least 3 CE hours per year to maintain the advanced credential (basic CNAs have no CE requirement)
ACNAs can perform a broader scope (limited medication reminders, specialized care tasks) in approved long-term care settings — and typically earn a $2–$4/hour premium over basic CNAs in the same facility. More on the LeadingAge Virginia Advanced CNA page.
Virginia CNA Salary (2026)
- State average: $19–$21/hour, roughly $41,000–$45,000 annually (2026 BLS and multiple private wage surveys)
- Northern Virginia (Arlington, Fairfax, Alexandria): $22–$27/hour — the highest metro in the state due to DC-area cost of living
- Hampton Roads (Virginia Beach, Norfolk, Newport News): $18–$22/hour
- Richmond metro: $18–$21/hour
- Rural Southwest Virginia: $15–$18/hour
- Hospital CNAs typically earn 10–15% more than long-term-care CNAs in the same region
Virginia's CNA wages sit close to the national median — higher than most southern states, lower than the Northeast, Pacific Northwest, or California. The best wage premiums come from working acute-care hospitals in the Northern Virginia corridor, becoming an Advanced CNA, or picking up weekend/night shift differentials.
Career Advancement from Virginia CNA
| Path | Typical Duration |
|---|---|
| CNA → LPN (Virginia practical-nurse program) | 12–18 months |
| CNA → ADN (RN) | 2 years |
| CNA → BSN (RN) | 3–4 years |
| CNA → Advanced CNA | 120-hour advanced program + 3 years experience |
| CNA → Medication Aide (with additional training) | 68-hour state program |
Many Virginia CNAs continue working in nursing facilities while enrolling in LPN or RN programs at Virginia community colleges (Tidewater, NOVA, J. Sargeant Reynolds, Piedmont, Mountain Empire, Germanna, and others) — tuition-reimbursement programs at large employers like Sentara, VCU Health, Inova, and HCA Virginia often fully cover the bridge.
Pass the Virginia CNA Exam with Confidence
Our platform covers every content area on the NNAAP written exam plus step-by-step walkthroughs for all 23 Credentia skills. Features include:
- Virginia-specific content (Board of Nursing rules, 120-hour floor with post-2023 opioid curriculum, CNA365 scheduling, annual $30 renewal, E1-E4 categories, ACNA pathway)
- AI-powered explanations for every wrong answer
- Full-length practice tests mirroring the 70-question (60 + 10 RC) format
- Clinical skills checklists with critical-element highlighting
- Updated for 2026 exam content and fees
No credit card required. Zero cost. Start studying today.
Official Virginia CNA Resources
- Virginia Board of Nursing — Nurse Aide page — applications, endorsement, reinstatement
- Virginia Board of Nursing — Fee Schedule — $0 initial, $30 renewal, $30 reinstatement
- Virginia DHP License Lookup — public credential verification
- VA Board-approved nurse aide education programs
- Credentia Virginia test-taker portal — handbook, skills list, CNA365 login
- Credentia Virginia handbook knowledge base — eligibility, fees, registry articles
- LeadingAge Virginia — Advanced Certified Nursing Aide
- CMS Nurse Aide Registry
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