Virginia CNA Exam Guide 2026: Format, Fees, Skills, and Rules

Virginia CNA Exam 2026: The Correct Numbers First

Virginia uses the National Nurse Aide Assessment Program (NNAAP) for certification by examination. Credentia is the testing administrator, and the Virginia Board of Nursing decides whether a successful candidate is placed on the Virginia Nurse Aide Registry.

Here is the short version: the written test presents 70 multiple-choice items in two hours, but only 60 are scored because 10 are unscored pretest items. The skills evaluation assigns five skills in total, including Hand Hygiene, and allows 30 minutes. First-time testing costs $140: $45 for written or oral testing and $95 for skills.

Those details matter because several Virginia CNA pages still repeat older or incorrect figures. Always check the current Credentia Virginia handbook before scheduling.

2026 Exam Snapshot

The Virginia Board of Nursing reaffirmed in a September 2025 announcement that Credentia is the designated examination administrator.

Four Common Virginia CNA Number Traps

Do not turn the size of Open Exam Prep's Virginia practice bank into an official exam count. A practice collection can be larger than the exam so that candidates can rotate topics. The official written exam still presents 70 items.

Choose the Correct Eligibility Route Before Paying

Credentia assigns applicants to an eligibility route. The current Virginia eligibility page reflects route changes that took effect for applications submitted on or after January 30, 2024.

E3 is not the military-medic category. Virginia law can allow the Board to consider relevant military education and experience, but that is not how Credentia defines E3.

E1 candidates who fail either part three times, or fail to complete both parts inside the 24-month window, must complete another approved nurse aide program before reapplying. Credentia states that every candidate receives three attempts for each exam part; the applicable route also controls the deadline.

Candidates on medical light duty may take the written examination but may not take the skills evaluation. The handbook says the skills candidate must be able to perform every assigned task.

Virginia's 140-Hour Training Rule

Virginia's statute still describes a 120-hour baseline, which is one reason outdated summaries persist. The controlling program regulation is more specific: 18VAC90-26-50 requires an approved nurse aide education program to provide at least:

• 140 clock hours total
• 20 hours specifically for laboratory skill acquisition
• 24 hours of instruction before direct client contact
• 40 hours of direct clinical care

Observation does not count toward the 40 clinical hours. Facility employment orientation does not count toward the 140-hour program total. Verify that a school appears on the Board's approved nurse aide program list before enrolling.

First-time graduates of a Virginia-approved nurse aide program use E1 after completing one of these programs. RN or LPN students and graduates should read the E2 and E3 documentation rules before assuming they need a separate CNA course.

How Registration Works

For a first certification by examination, Virginia routes the application and testing process through Credentia.

1. Confirm your route. E1 applicants use their approved-program completion record. E2, E3, and E4 applicants need the documentation specified for that route.
2. Create a Credentia account. Start from the Virginia test-taker page, not an old Pearson VUE page.
3. Complete the testing application. Make sure your legal name matches the identification you will present.
4. Schedule skills first. The handbook tells candidates to select PR for the skills evaluation, then select AW for written or AO for oral.
5. Pay both first-time components. The first attempt requires payment for skills plus written or oral testing.
6. Choose delivery. Skills are in person. The written or oral exam may be taken at a test center or through Credentia's live online proctoring when available.
7. Pass both parts under the same active application. Passing one part does not place you on the registry.

Credentia says test-center reservations should be made at least 10 calendar days before the date. Online written or oral appointments may be available as early as the next day, but availability varies.

Written and Oral Exam: What Is Actually Scored

Written option

The written examination gives you two hours for 70 multiple-choice items. Ten are pretest items used to collect statistical information and do not contribute to the score. They are not identified, so answer every item.

The official handbook does not publish a percentage passing score. Virginia regulations say the Board determines the minimum standard. Credentia reports whether you passed; claims that Virginia requires exactly 70% or 80% should not be treated as official unless the Board or current handbook publishes that number.

Oral option

The oral examination replaces the written examination for a candidate who has difficulty reading English. It contains:

• 60 multiple-choice questions that are read aloud
• 10 word-recognition questions using common long-term-care terms

The candidate must pass both oral parts. For online-proctored oral testing, the handbook says to provide a wired headset. The oral option is not an easier content test; it changes how questions are delivered.

Use the Official 2024 Content Outline

The current NNAAP outline took effect in April 2024. Its percentages apply to the 60 scored written items, not all 70 items presented.

This table gives you a better study order than a generic list. Basic Nursing Skills plus Activities of Daily Living account for 34 of the 60 scored items. Start with infection control, safety, emergency response, technical procedures, observation and reporting, hygiene, dressing, nutrition, hydration, elimination, rest, and comfort.

Then study role boundaries. Communication, client rights, legal and ethical behavior, and health-care-team responsibilities account for another 16 scored items. Many questions in these areas ask for the safest action a nurse aide can take without exceeding the care plan or licensed-nurse delegation.

The remaining 10 scored items cover self-care and independence, emotional and mental health needs, and spiritual and cultural needs. Do not skip the small domains. A one-item area can still decide a close result.

Skills Evaluation: Five Skills, 30 Minutes

The evaluator gives you an instruction card listing five skills. Hand Hygiene is always one of those five. Four more are selected from the official list, and one of the four is a measurement skill. You must receive a Satisfactory result on all five skills.

The handbook lists these 23 possible skills:

1. Hand Hygiene
2. Apply one knee-high elastic stocking
3. Assist to ambulate using a transfer belt
4. Assist with use of a bedpan
5. Clean an upper or lower denture
6. Count and record radial pulse
7. Count and record respirations
8. Don and remove PPE: gown and gloves
9. Dress a client with an affected right arm
10. Feed a client who cannot feed themself
11. Give a modified bed bath
12. Measure and record electronic blood pressure
13. Measure and record urinary output
14. Measure and record ambulatory weight
15. Perform passive range of motion for one knee and ankle
16. Perform passive range of motion for one shoulder
17. Position a client on their side
18. Provide catheter care for a female client
19. Provide foot care on one foot
20. Provide mouth care
21. Provide perineal care for a female client
22. Transfer from bed to wheelchair using a transfer belt
23. Measure and record manual blood pressure

This current list does not include making an occupied bed or fingernail care. Use the handbook's Virginia list rather than a skills video from another state.

How skills are scored

Each skill is divided into observable steps. Bold steps in the handbook are Critical Element Steps. Missing or incorrectly performing a critical element causes that skill to be Unsatisfactory, but completing only the critical elements is not enough. You must also complete enough of the remaining steps to meet that skill's standard.

Important scoring mechanics:

• The timer is 30 minutes for all five skills.
• The evaluator announces when 25 minutes have elapsed.
• One assigned skill will require a measurement and a written recording.
• You may state that you made a mistake and identify the step you want to correct.
• You must correct it before beginning the next skill.
• Some glove and ordered-step mistakes cannot receive credit through a late correction.
• Except for permitted hand-hygiene verbalization, you must perform rather than merely describe steps.

Do not memorize one universal opening and closing script and assume it replaces the checklist. Privacy, explanation, positioning, call-signal placement, infection control, and documentation requirements vary by skill. Practice from the exact Virginia skill pages.

A Study Plan Built Around the Scoring

Phase 1: Knowledge priorities

Spend the first half of your study time on the 57% represented by Basic Nursing Skills and Activities of Daily Living. For each topic, practice the sequence: recognize the risk, choose the action within CNA scope, protect the client, then report the relevant observation.

Next, drill client rights and role questions. When two answers seem reasonable, ask:

• Does one answer preserve the client's choice and dignity?
• Is the action within a nurse aide's assigned role?
• Should the aide report rather than diagnose or change treatment?
• Does the answer protect privacy and safety?

Virginia CNA practice questionsPractice questions with detailed explanations

Phase 2: Skills rotation

Make a 23-row checklist from the current handbook. Practice Hand Hygiene daily and rotate four other skills each session. Every session should include one measurement skill.

For each skill:

1. Read the complete official checklist.
2. Mark the bold critical elements.
3. Perform the skill without notes.
4. Record every omitted or misplaced step.
5. Repeat until you can complete it correctly under time pressure.
6. Combine five skills and use one 30-minute timer.

A five-skill mock is more useful than racing each task separately. It tests transitions, equipment setup, glove changes, recording, and recovery from a mistake.

Fees, Retakes, and Employer Payment

Credentia's Virginia fee page lists:

If you fail only one part, you pay for and repeat only that part, subject to your route's attempt and expiration limits. The handbook also states that nursing homes must pay NNAAP fees for their nurse aide employees, including required retesting. Ask the facility how it handles vouchers before paying personally.

Virginia's Board fee schedule lists $0 for initial CNA certification. Exam fees paid to Credentia and certification fees paid to the Board are separate categories.

Test-Day Checklist From the Handbook

For in-person testing, arrive 30 minutes early. The handbook requires:

• Two current, official, signature-bearing IDs
• A photo on at least one ID
• The same name on identification and the testing application
• Three sharpened No. 2 pencils
• An eraser
• An analog watch with a sweeping second hand

A digital watch or smartwatch does not satisfy the analog-watch instruction.

Skills candidates also act as the client for another candidate. Wear flat, slip-on, non-skid shoes; a loose short-sleeve top or tank top; and loose pants that can roll up. Tell the evaluator before testing about open sores, allergies, or range-of-motion limitations. Candidates with open skin sores must reschedule the skills test.

For online written or oral testing, complete Credentia's system and room requirements before appointment time. Do not assume that an online knowledge exam makes the skills portion remote; skills remain hands-on.

After You Pass: Registry and Renewal

Passing both parts does not immediately authorize use of the CNA title. Credentia submits the result to the Virginia Board of Nursing, and you must wait until your name appears on the registry before representing yourself as a Virginia Certified Nurse Aide. Verify status through the Virginia DHP License Lookup.

Virginia's certification regulation says initial CNA certification lasts two years. After that initial period, certification is renewed annually. The Board's current fee page lists a $30 annual CNA renewal fee.

For renewal, 18VAC90-25-80 requires an annual application, fee, and attestation that you performed nursing-related activities for compensation within the two years immediately before expiration. The regulation does not state an eight-hour minimum. If you did not perform qualifying paid work, you must repeat and pass the state examination before renewal.

A certificate lapsed more than 90 days requires reinstatement. The current reinstatement rule requires either verification of qualifying compensated nursing work or evidence that you repeated and passed the state examination.

Endorsement Is a Different Path

If you are currently certified in another state, do not automatically register as a first-time E1 candidate. Virginia accepts CNA endorsement applications through the Board. The official endorsement checklist requires a qualifying state-approved education program, a completed competency evaluation, current registration in another state, and no abuse, neglect, or property-misappropriation finding.

The Board lists a $0 CNA application fee, but eligibility still depends on document verification. A former Virginia CNA generally uses reinstatement rather than endorsement.

Final Readiness Check

Before scheduling, you should be able to answer yes to each question:

• Do I know whether I am E1, E2, E3, or E4?
• Does my application name exactly match both IDs?
• Can I explain why 70 presented items means 60 scored items?
• Have I studied from the April 2024 content weights?
• Can I perform every skill on Virginia's current 23-skill list?
• Can I complete five skills in one 30-minute mock?
• Can I identify every critical element without ignoring other steps?
• Have I practiced at least one measurement skill in every session?
• Do I know my remaining attempts and application expiration date?
• Will I verify my registry entry after passing?

The best final review is simple: use the official handbook for procedures, the official Virginia rules for eligibility and renewal, and practice questions to diagnose knowledge gaps. Do not let a stale percentage, an old 120-hour claim, or a practice-bank count replace the current exam facts.

Official Virginia CNA Sources

• Credentia Virginia test-taker page
• Current Virginia candidate handbook
• Credentia eligibility routes
• Credentia Virginia exam fees
• Virginia nurse aide program regulation
• Virginia CNA certification regulation
• Virginia Board of Nursing fee schedule
• Virginia DHP License Lookup