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200+ Free Iowa CNA Practice Questions

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Questions by Category

Basic-Nursing-Skills70 questions
Personal-Care-Skills50 questions
Role-Responsibilities31 questions
Mental-Health-Social30 questions
Legal-Ethical19 questions
2026 Statistics

Key Facts: Iowa CNA Exam

70

Written Questions

Headmaster/TMU Iowa

70%

Passing Score Required

Iowa DIAL (49/70 correct)

75 hrs

Training (Optional Pre-Test)

45 didactic + 30 clinical

$50

Written Exam Fee

Community college proctor

24 mo

DCW Registry Work Cycle

Iowa Admin. Code 441 Ch. 81

12 hrs

Annual In-Service Required

Iowa Code Ch. 135C

Iowa's standout difference: you can sit for the CNA exam WITHOUT completing the 75-hour training first — Iowa is the only state with no training prerequisite. The exam is administered by Headmaster/TMU Iowa using 70 questions with a 70% passing bar. Passing gets you listed on the Iowa Direct Care Worker (DCW) Registry maintained by DIAL, not a traditional 'CNA registry.' CNAs must complete 8 hours of qualifying work per 24-month cycle and 12 hours of annual in-service training to stay active. Iowa Code Ch. 135C governs long-term care facilities; Iowa Code Ch. 235B governs mandatory abuse reporting.

About the Iowa CNA Exam

The Iowa CNA (Direct Care Worker) competency exam is a two-part test administered by Headmaster/TMU Iowa under oversight of Iowa DIAL (Department of Inspections, Appeals & Licensing). The written portion is 70 multiple-choice questions (60 minutes) requiring 70% to pass (49 correct), plus a clinical skills demonstration. Iowa is unique: it is the only state that does NOT require completion of the 75-hour CNA training before taking the exam — candidates may test first and train later. The Iowa DCW Registry is maintained by DIAL under Iowa Admin. Code 441 Ch. 81.

Questions

70 scored questions

Time Limit

60 minutes written + skills evaluation

Passing Score

70% written (49/70) + skills competency

Exam Fee

$50 written (community college proctor) + $115–$135 skills (Headmaster / D&S Diversified Technologies (TMU Iowa) / Iowa DIAL)

Iowa CNA Exam Content Outline

39%

Basic Nursing Skills

Vital signs, infection control, safety, fall prevention, wound observation, oxygen use, emergency procedures, body mechanics, transfers

14%

Activities of Daily Living (ADL)

Bathing, dressing, grooming, oral hygiene, nutrition/feeding, elimination/toileting, rest and sleep support

26%

Role of the Nurse Aide

Iowa DIAL/DCW Registry, Iowa Admin. Code 441 Ch. 81, communication, documentation, client rights, OBRA, mandatory reporting, Iowa Code Ch. 235B, healthcare team, scope of practice

10%

Psychosocial Care Skills

Mental/emotional health, spiritual/cultural needs, resident dignity, cognitive impairment, end-of-life care

8%

Restorative Skills

ROM exercises, ambulation assist, assistive devices, restorative dining, rehabilitation goals

3%

Spiritual/Cultural Care

Respecting religious and cultural practices, chaplain referrals, culturally competent care

How to Pass the Iowa CNA Exam

What You Need to Know

  • Passing score: 70% written (49/70) + skills competency
  • Exam length: 70 questions
  • Time limit: 60 minutes written + skills evaluation
  • Exam fee: $50 written (community college proctor) + $115–$135 skills

Keys to Passing

  • Complete 500+ practice questions
  • Score 80%+ consistently before scheduling
  • Focus on highest-weighted sections
  • Use our AI tutor for tough concepts

Iowa CNA Study Tips from Top Performers

1Know Iowa's unique rule: NO training required before testing — only state with this policy
2Study Iowa Admin. Code 441 Ch. 81 — governs training, certification, and DCW Registry requirements
3Understand the DCW Registry (not 'CNA Registry') maintained by Iowa DIAL
4Memorize DCW renewal: 8 hours qualifying work per 24 months + 12 hours annual in-service
5Know Iowa Code Ch. 235B for mandatory abuse reporting — report to supervisor AND Iowa DHHS APS
6Know Iowa Code Ch. 135C — governs long-term care facilities and employer in-service requirements
7Know Iowa Code Ch. 144A — Iowa's advance directives/living wills law
8The exam is 70 questions, 60 minutes, 70% passing (49/70) — administered by Headmaster/TMU Iowa
9Practice vital signs: normal temp 97.6-99.6°F, pulse 60-100, resp 12-20, BP 90-140/60-90
10Review infection control: standard precautions, PPE sequences, hand hygiene steps

Frequently Asked Questions

Do I need to complete CNA training before taking the Iowa exam?

No — Iowa is the ONLY state that does NOT require completion of CNA training before testing. You may take the Iowa CNA competency exam first, then complete the required 75-hour training (45 didactic + 30 clinical) afterward. However, most employers and community colleges strongly recommend completing training before testing. Iowa Admin. Code 441 Ch. 81 governs training requirements.

Who administers the Iowa CNA exam?

The Iowa CNA written exam is administered by Headmaster / D&S Diversified Technologies through their TMU Iowa platform. Community colleges serve as proctor sites, and remote online proctoring is available through Credentia ($70 fee). The clinical skills evaluation is administered at community colleges or through Health Tech Associates. Iowa DIAL (Department of Inspections, Appeals & Licensing) oversees all certification.

What is the Iowa DCW Registry?

Iowa uses the Direct Care Worker (DCW) Registry, not a traditional 'CNA Registry.' It is maintained by Iowa DIAL under Iowa Admin. Code 441 Ch. 81. All CNAs working in Iowa long-term care facilities must be listed on the DCW Registry. The registry also records substantiated findings of abuse, neglect, or misappropriation of property.

How do I maintain my Iowa CNA certification?

To stay active on the Iowa DCW Registry, you must: (1) complete at least 8 hours of qualifying work as a CNA every 24 months, and (2) complete 12 hours of in-service training each calendar year. In-service training must be paid by the employer if you work in a state-licensed LTC facility under Iowa Code Ch. 135C.

How do I report abuse as an Iowa CNA?

Iowa CNAs are mandatory reporters under Iowa Code Ch. 235B. Suspected abuse, neglect, or exploitation must be reported immediately to: (1) your supervisor, and (2) the Iowa Department of Health and Human Services (DHHS) Adult Protective Services. For residents in long-term care facilities, you may also contact the Iowa Long-Term Care Ombudsman (LTCOP), which operates under Iowa DHHS.

What are the fees for the Iowa CNA exam?

Written exam: $50 if testing at a community college proctor site (Headmaster/TMU Iowa); online remote proctoring through Credentia costs $70. Clinical skills evaluation: $115 at a community college site or $135 through Health Tech Associates. Fees are subject to change — verify at the TMU Iowa website before scheduling.

Iowa CNA Resources