What is the CNA certification exam?

The CNA (Certified Nursing Assistant) certification exam is a two-part competency test required to work as a nursing assistant in hospitals, nursing homes, and other healthcare facilities. It is administered by state-approved testing vendors such as NNAAP, Prometric, or D&S Diversified. Passing the exam places you on your state's Nurse Aide Registry, which is required by federal law under OBRA (Omnibus Budget Reconciliation Act) for all nursing assistants working in Medicare- or Medicaid-certified facilities.

How many questions are on the CNA written exam?

The CNA written (or oral) exam typically contains 60-70 multiple-choice questions, though the exact number varies by state and testing vendor. The NNAAP exam, used in most states, has 70 questions covering topics such as Activities of Daily Living, basic nursing skills, residents' rights, communication, and safety/emergency procedures. You have approximately 90 minutes to complete the written portion.

What is the CNA passing score?

The CNA written exam requires a score of 70% or higher to pass (at least 49 out of 70 questions on the NNAAP exam). For the clinical skills portion, you must demonstrate 100% accuracy on each tested skill, including all critical steps. You must pass both the written and skills portions to receive certification. If you fail one part, most states allow you to retake only the failed section without repeating the other.

What are the two parts of the CNA exam?

The CNA exam has two distinct parts: (1) a written or oral knowledge exam with 60-70 multiple-choice questions covering nursing fundamentals, infection control, safety, residents' rights, and communication; and (2) a clinical skills demonstration where you perform 3-5 randomly selected hands-on skills (from a list of 20-25 possible skills) in front of a nurse evaluator. You must pass both parts to become certified. Some states offer an oral exam option for candidates with reading difficulties.

How long does CNA training take?

CNA training programs range from 4-12 weeks, depending on the state and program format. Federal law (OBRA) requires a minimum of 75 hours of training, including at least 16 hours of supervised clinical practice. However, most states exceed this minimum: California requires 150 hours, New York requires 130 hours, and Florida requires 120 hours. Programs are offered at community colleges, vocational schools, Red Cross chapters, and many nursing homes. Some employers offer free CNA training in exchange for a work commitment.

How much does CNA certification cost?

Total CNA certification costs range from $600 to $2,500 and include: training program ($500-2,000, though many employers and workforce programs offer free training), exam fee ($100-150 for both written and skills tests), background check ($30-100), state registration fee ($25-75), and sometimes costs for scrubs, a stethoscope, and textbooks ($50-150). Many nursing homes cover all training and testing costs for candidates who commit to working at their facility for a set period.

What clinical skills are tested on the CNA exam?

You will be tested on 3-5 randomly selected clinical skills from a list of 20-25 possible skills. Common skills include: hand hygiene (tested on nearly every exam), measuring vital signs (blood pressure, pulse, respiration, temperature), patient transfers using a gait belt, catheter care, perineal care, range-of-motion exercises, bed making (occupied and unoccupied), positioning patients (Fowler's, supine, prone, lateral), feeding assistance, and measuring intake and output. Each skill has critical steps that must be performed correctly.

How do I prepare for the CNA skills test?

The best preparation for the CNA skills test is repeated hands-on practice. Study each skill's step-by-step checklist from your state's testing vendor. Practice every skill in the correct order, paying special attention to critical steps: hand hygiene before and after every skill, identifying the patient, explaining the procedure, providing privacy (closing curtains/door), maintaining safety (bed locked, side rails), and proper body mechanics. Use a partner to practice on, time yourself, and have someone evaluate you with the official checklist. Many testing vendors publish skill demonstration videos online.

What happens if I fail the CNA exam?

If you fail the CNA exam, you can retake it. Most states allow you to retake only the portion you failed (written or skills) without repeating the passed portion. You typically must wait at least 1-2 days before retaking. Most states require you to pass within 2 years of completing your training program (some states allow 3 attempts within that period). There is a retake fee ($50-100 per attempt). If you exhaust all attempts or exceed the time limit, you may need to repeat the entire training program.

How many times can I retake the CNA exam?

Most states allow 3 attempts to pass each portion of the CNA exam within 2 years of completing your training program. Some states, like California, allow unlimited retakes within the 2-year window. The retake fee is typically $50-100 per attempt. If you fail the written exam, review the content areas where you scored lowest. If you fail the skills test, focus on the specific skills you missed and practice the critical steps until they become automatic. After exhausting all attempts, most states require you to complete a new training program.

Is CNA certification valid in all states?

CNA certification is state-specific, not nationally recognized. However, most states offer reciprocity (endorsement), allowing you to transfer your certification to another state. To transfer, you must be in good standing on your current state's Nurse Aide Registry, have no findings of abuse, neglect, or misappropriation, and meet the new state's requirements. Some states require additional training hours, a new background check, or a competency evaluation. The process typically takes 2-6 weeks. Check with both your current and destination state's nursing board for specific reciprocity requirements.

How long is CNA certification valid?

CNA certification is typically valid for 2 years, though this varies by state (some states require annual renewal). To maintain certification, you must work at least 8 hours of paid nursing-related services during each 24-month period and complete any required continuing education (typically 12-48 hours per renewal period depending on the state). If your certification lapses, most states require you to retake and pass the competency exam to be reinstated on the Nurse Aide Registry. Keeping your certification current is essential for employment.

What are residents' rights (OBRA)?

Residents' rights are federal protections established by OBRA (Omnibus Budget Reconciliation Act of 1987) that guarantee the dignity and well-being of nursing home residents. Key rights include: the right to be treated with dignity and respect, the right to privacy (during care, visits, phone calls, and mail), the right to make personal choices (clothing, schedule, activities), the right to be informed about care and medical condition, the right to refuse treatment, the right to be free from abuse/neglect/restraints, the right to manage personal finances, the right to voice grievances without fear of retaliation, and the right to participate in care planning. CNAs must know and protect these rights in daily practice.

What is the scope of practice for a CNA?

A CNA's scope of practice includes: assisting with Activities of Daily Living (bathing, dressing, grooming, feeding, toileting, ambulation), measuring and recording vital signs, performing range-of-motion exercises, repositioning and transferring patients, recording intake and output, applying non-medicated skin care, maintaining a clean and safe environment, and reporting observations to the nurse. CNAs may NOT: administer medications, perform assessments or nursing diagnoses, insert or remove tubes (IV, catheter, NG tube), change sterile dressings, give injections, or make care plan decisions. The CNA always works under the supervision of a licensed nurse (RN or LPN).

How much does a CNA earn?

According to the Bureau of Labor Statistics, the median annual salary for CNAs in the United States is approximately $38,200 (as of 2024), or about $18.36 per hour. Salaries vary significantly by location and setting: the highest-paying states include Alaska ($46,000+), New York ($44,000+), and California ($43,000+). Hospital CNAs generally earn more than those in nursing homes or home health. Night and weekend shifts often include differential pay of $1-3 per hour extra. CNA employment is projected to grow 4% from 2022-2032, with strong demand driven by the aging population.

Can a CNA become an RN?

Yes, many CNAs use their experience as a stepping stone to becoming a Registered Nurse (RN). Common pathways include: completing an Associate Degree in Nursing (ADN, 2 years) and passing the NCLEX-RN, or earning a Bachelor of Science in Nursing (BSN, 4 years). Some programs offer LPN bridge programs (CNA to LPN in 1 year, then LPN to RN in 1-2 years). CNA experience is valuable for nursing school applications and provides a strong clinical foundation. Many employers offer tuition assistance or reimbursement for CNAs pursuing nursing degrees.

What is the difference between a CNA and an LPN?

CNAs and LPNs (Licensed Practical Nurses) differ in education, scope, and pay. CNAs complete a 4-12 week training program (75-180 hours) and assist with basic care like bathing, feeding, and vital signs under nurse supervision. LPNs complete a 12-month program (approximately 1,500 hours) and can administer medications, perform wound care, insert catheters, and develop care plans under RN supervision. CNAs earn a median of $38,200/year while LPNs earn approximately $59,730/year. LPNs have significantly more clinical autonomy and responsibility, but CNAs serve as the essential foundation of hands-on patient care.

What are the most common CNA clinical skills tested?

The most frequently tested CNA clinical skills include: hand hygiene (virtually always tested), measuring blood pressure, measuring pulse and respirations, patient transfers using a gait/transfer belt, catheter care, perineal care, range-of-motion exercises (upper and lower extremity), feeding a dependent patient, bed making (occupied bed), positioning in Fowler's and lateral positions, recording intake and output, and applying anti-embolism stockings. Hand hygiene and infection control are woven into every skill. Always begin each skill by washing hands, identifying the patient, explaining the procedure, and providing privacy.

Do CNAs need to know vital signs normal ranges?

Yes, CNAs must know normal vital sign ranges and when to report abnormalities to the nurse immediately. Normal adult ranges are: temperature 97.8-99.1 degrees F (36.5-37.3 degrees C) orally; pulse 60-100 beats per minute (regular rhythm); respirations 12-20 breaths per minute (unlabored); blood pressure systolic 90-120 mmHg and diastolic 60-80 mmHg; and pulse oximetry (SpO2) 95-100%. Report immediately if: temperature is above 101 degrees F or below 97 degrees F, pulse is above 100 or below 60 (or irregular), respirations are above 24 or below 10, systolic BP is above 160 or below 90, or SpO2 is below 90%.

Is this free CNA prep as good as paid courses?

Our free CNA prep covers the same competency areas tested on state certification exams, including all NNAAP content domains: Activities of Daily Living, basic nursing skills, residents' rights, communication, and safety procedures. Paid CNA prep courses typically cost $30-100 and offer similar practice questions. Our platform adds AI-powered features that most paid courses lack: instant explanations for wrong answers, AI hints on difficult questions, and an AI study assistant available for 10 free questions daily. All study content is regularly updated and completely free.

What's included for free?

All study guides, practice questions, and explanations are completely free. We also include 10 AI-powered questions daily. For unlimited AI assistance, you can upgrade to Pro.

Why is the content free?

OpenExamPrep was founded by Ran Chen, a CFP® who passed multiple financial exams and believes quality exam prep shouldn't cost hundreds of dollars. With AI, we can create quality content at scale and make it accessible to everyone.

Is the content up to date?

Yes! Our content is aligned with the latest exam outlines and updated regularly. Last update: January 2026.

CNA

Certified Nursing Assistant

1.1 About the CNA Certification Exam 1.2 Exam Content Areas 1.3 Clinical Skills Evaluation 1.4 How to Use This Course

2.1 CNA Scope of Practice 2.2 The Healthcare Team 2.3 Delegation and Supervision 2.4 Documentation and Reporting 2.5 Time Management and Organization 2.6 Professionalism and Work Ethics

3.1 Verbal Communication 3.2 Nonverbal Communication 3.3 Active Listening 3.4 Communication with Special Needs Patients 3.5 Cultural Sensitivity and Diversity 3.6 Handling Difficult Communication Situations

4.1 Chain of Infection 4.2 Hand Hygiene 4.3 Personal Protective Equipment (PPE)4.4 Standard Precautions 4.5 Transmission-Based Precautions 4.6 Cleaning, Disinfection, and Sterilization

5.1 Fall Prevention 5.2 Fire Safety 5.3 Body Mechanics and Safe Lifting 5.4 Restraints and Alternatives 5.5 Emergency Response Procedures 5.6 Disaster Preparedness

6.1 Bathing and Showering 6.2 Oral Hygiene and Denture Care 6.3 Hair Care, Grooming, and Shaving 6.4 Dressing and Undressing 6.5 Perineal Care 6.6 Toileting and Incontinence Care

7.1 Vital Signs Overview 7.2 Temperature Measurement 7.3 Pulse Measurement 7.4 Respirations Measurement 7.5 Blood Pressure Measurement 7.6 Positioning, Transfers, and Mobility

8.1 Understanding Dementia 8.2 Communication with Dementia Residents 8.3 Dementia Care Strategies 8.4 Depression and Anxiety in the Elderly 8.5 Abuse Recognition and Reporting

9.1 Residents' Rights 9.2 HIPAA and Confidentiality 9.3 Advance Directives and End-of-Life Care 9.4 CNA Scope of Practice 9.5 Ethical Principles in Healthcare 9.6 Documentation and Reporting

Free AI Tutor Included•10 questions/day

Free CNA Exam Prep

Certified Nursing Assistant

Pass your CNA exam without spending hundreds on expensive prep courses. Free study guides, practice questions, and AI-powered learning.

Quick Facts

Chapters

Sections

Our Cost

Updated January 2026

CNA

Study Guide Practice Flashcards

43 terms 17 blogs 7 comparisons

Your Study Path

CNA Professional License: Complete Roadmap

Follow this path to maximize your chances of passing on the first try

Complete CNA Training Program

Enroll in and complete a state-approved CNA training program (75-180 hours). Includes classroom instruction and supervised clinical practice.

hours

Personal Care & Basic Nursing SkillsYou are here

Master bathing, grooming, vital signs, positioning, transfers, nutrition, and mobility — these make up 36% of the written exam.

hours

Safety, Infection Control & Communication

Study hand hygiene, PPE, fall prevention, fire safety, body mechanics, reporting, and documentation (36% of exam).

hours

Clinical Skills Practice & Written Review

Practice the 5 randomly-selected clinical skills for the hands-on test. Common skills: hand washing, blood pressure, catheter care, perineal care, transfers.

hours

Estimated total study time

75 hours

That's about 8 weeks at 10 hours/week

Can You Take the CNA Exam?

Check if you meet the basic eligibility requirements

Age

16-18 years or older (varies by state)

Education

Complete a state-approved CNA training program (75-180 hours depending on state)

Background Check

Required in most states

Fingerprinting

Required in most states

Additional Requirements

•Training program must include both classroom and clinical components
•Must pass both written/oral test AND clinical skills evaluation
•Background check must be clear of disqualifying offenses (abuse, neglect, theft)
•Some states accept Red Cross or community college CNA programs

CNA Quick Facts

Time to Get Licensed

2-6 weeks after completing training

From start to license in hand

Exam Provider

Prometric (12 states), Pearson VUE, or D&S Diversified (varies by state)

In-Person Only

Schedule Your Exam

Retake Policy

Most states allow 3 attempts within 2 years of completing training. You only retake the portion you failed. After exhausting attempts, you must retrain.

Total Cost Breakdown

Exam Fee$100-150 (varies by state — written + skills combined)

Background Check$25-75 (varies by state)

Pre-License Education$500-1,500 (CNA training program, varies widely)

Total Estimated Cost$625-1,725 total (training + exam + background check)

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What You'll Study

9 chapters covering everything you need to pass

Introduction to the CNA Exam

4 sections

Role and Responsibilities

6 sections

Communication and Interpersonal Skills

6 sections

Infection Control

6 sections

Safety and Emergency Procedures

6 sections

Personal Care Skills

6 sections

Basic Nursing Skills

6 sections

Mental Health and Cognitive Care

5 sections

Legal and Ethical Considerations

6 sections

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CNA Exam Details

Certified Nursing Assistant

Administered by State Nursing Boards (NNAAP, Prometric, D&S Diversified)

Official Source

70% written + 100% skills

Passing Score

60-70

Questions

Minutes

$100-150 (varies by state)

Exam Fee

Study time: 50-100 hours

Prerequisites: Complete approved CNA training program (75-180 hours)

Valid for: 2 years (renewable)

Exam Content Breakdown

Based on the official State Nursing Boards (NNAAP, Prometric, D&S Diversified) content outline

Personal Care Skills18%

Bathing, grooming, dressing, toileting, perineal care

Basic Nursing Skills18%

Vital signs, positioning, transfers, nutrition, mobility

Infection Control12%

Hand hygiene, PPE, standard precautions, transmission-based precautions

Safety & Emergency12%

Fall prevention, fire safety, body mechanics, emergency response

Communication12%

Verbal/nonverbal, reporting, documentation, therapeutic communication

Role & Responsibilities12%

Scope of practice, delegation, healthcare team, professionalism

Mental Health8%

Dementia care, Alzheimer's, depression, behavioral interventions

Legal & Ethical8%

Residents' rights, HIPAA, advance directives, abuse reporting

What's Included

9 Chapters

Complete exam coverage

Practice Quizzes

With detailed explanations

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I'm Ran Chen, an engineer with 20+ years of coding experience. I passed my Life Insurance license, EA exam, SIE, Series 6, 63, 65, and finally the CFP® exam.

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What's Next After the CNA?

After passing the CNA, you can pursue these career paths

NCLEX-PN

Licensed practical nurse

NCLEX-RN

Registered nurse (via bridge program)

Home Health Aide

Home care certification

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CNA Exam FAQ

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CNA Exam vs NCLEX-PN CNA Exam vs NCLEX-RN CNA Exam vs CMA Exam CNA Exam vs CPT Exam ATI TEAS vs CNA CNA vs CDA PTCE vs CNA

Official State Nursing Boards (NNAAP, Prometric, D&S Diversified) Resources

Verify information with these official sources

Prometric CNA Testing NNAAP Information State CNA Registry

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CNA

1Introduction to the CNA Exam

2Role and Responsibilities

3Communication and Interpersonal Skills

4Infection Control

5Safety and Emergency Procedures

6Personal Care Skills

7Basic Nursing Skills

8Mental Health and Cognitive Care

9Legal and Ethical Considerations

Free CNA Exam Prep

Quick Facts

CNA

CNA Professional License: Complete Roadmap

Complete CNA Training Program

Personal Care & Basic Nursing SkillsYou are here

Safety, Infection Control & Communication

Clinical Skills Practice & Written Review

Can You Take the CNA Exam?

CNA Quick Facts

Time to Get Licensed

Exam Provider

Retake Policy

Total Cost Breakdown

Free CNA Prep That Actually Works

350+ Practice Questions

AI Tutor Explains Mistakes

Updated for 2026

$0 Forever

What You'll Study

Introduction to the CNA Exam

Role and Responsibilities

Communication and Interpersonal Skills

Infection Control

Safety and Emergency Procedures

Personal Care Skills

Basic Nursing Skills

Mental Health and Cognitive Care

Legal and Ethical Considerations

CNA Exam Details

Certified Nursing Assistant

Exam Content Breakdown

What's Included

9 Chapters

Practice Quizzes

Free to Start

Quality Exam Prep Shouldn't Cost Hundreds

What's Next After the CNA?

NCLEX-PN

NCLEX-RN

Home Health Aide

CNA Exam FAQ

What is the CNA certification exam?

How many questions are on the CNA written exam?

What is the CNA passing score?

What are the two parts of the CNA exam?

How long does CNA training take?

How much does CNA certification cost?

What clinical skills are tested on the CNA exam?

How do I prepare for the CNA skills test?

What happens if I fail the CNA exam?

How many times can I retake the CNA exam?

Is CNA certification valid in all states?

How long is CNA certification valid?

What are residents' rights (OBRA)?

What is the scope of practice for a CNA?

How much does a CNA earn?

Can a CNA become an RN?

What is the difference between a CNA and an LPN?

What are the most common CNA clinical skills tested?

Do CNAs need to know vital signs normal ranges?

Is this free CNA prep as good as paid courses?

What's included for free?

Why is the content free?

Is the content up to date?

Compare the CNA

Official State Nursing Boards (NNAAP, Prometric, D&S Diversified) Resources

More Free Resources

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