200+ Free Massachusetts CNA Practice Questions

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A Massachusetts CNA is preparing to give a resident a complete bed bath. In which order should the body be washed?

Perineal area, legs, abdomen, chest, arms, face

Face, neck, arms, chest, abdomen, legs, back, perineal area

Back, buttocks, legs, abdomen, chest, face, arms

Arms, legs, face, back, abdomen, perineal area

to track

2026 Statistics

Key Facts: Massachusetts CNA Exam

Total Questions (60 scored)

Prometric / MA DPH

~70%

Passing Score Required

~42/60 scored questions

75 hrs

Training Required

MA DPH (federal OBRA minimum)

$40

Written Exam Fee

Prometric / MA DPH

2 yrs

Renewal Period

MA NAR

8 hrs

Paid Work to Renew

MA NAR requirement

Massachusetts uses Prometric and the NNAAP format (70 questions, 90 min). Unique to Massachusetts: mandatory abuse reporting is governed by MGL Chapter 19A, Section 15 — reportable to the Elder Protective Services (EPS) hotline at (800) 922-2275 for elders 60+. End-of-life care uses the Massachusetts MOLST form (Medical Orders for Life-Sustaining Treatment). Healthcare proxy decisions are governed by MGL Chapter 201D. LTC facilities are regulated under 105 CMR 150.000. The MA Nurse Aide Registry (MA NAR) is maintained at 67 Forest St., Marlborough, MA 01752. CNA renewal requires working 8+ hours as a CNA within the 2-year renewal period — no continuing education hours required.

Sample Massachusetts CNA Practice Questions

Try these sample questions to test your Massachusetts CNA exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 200+ question experience with AI tutoring.

1A Massachusetts CNA is preparing to give a resident a complete bed bath. In which order should the body be washed?

A.Perineal area, legs, abdomen, chest, arms, face

B.Face, neck, arms, chest, abdomen, legs, back, perineal area

C.Back, buttocks, legs, abdomen, chest, face, arms

D.Arms, legs, face, back, abdomen, perineal area

Explanation: The correct bed bath sequence moves from cleanest to dirtiest: face and neck first, then arms, chest, abdomen, legs, back, and finally the perineal area last. This clean-to-dirty order prevents cross-contamination and reduces the risk of spreading microorganisms from soiled areas to cleaner body parts.

2Before beginning a bed bath, the CNA should check the water temperature by:

A.Dipping one finger briefly and estimating warmth

B.Checking that steam is visible above the basin

C.Testing the water on the inside of the wrist to confirm it feels comfortably warm (100–115°F)

D.Asking the nurse to verify the water is the right temperature

Explanation: The inside of the wrist is more sensitive to temperature than the fingertips, making it the best method for checking bath water. The safe range is 100–115°F (38–46°C). Always confirm comfort with the resident before starting. Water that is too hot can cause burns, particularly in residents with diabetes or decreased sensation.

3A resident in a Massachusetts long-term care facility refuses her scheduled bed bath and says she does not want one today. The CNA should:

A.Insist on the bath because the care plan requires it

B.Skip the bath and document nothing since no care was given

C.Respect the resident's right to refuse, offer an alternative such as a sponge bath, document the refusal, and report to the charge nurse

D.Contact the resident's family to convince her to accept the bath

Explanation: Under OBRA 1987 and Massachusetts DPH regulations (105 CMR 150.000), residents have an absolute right to refuse any care. The CNA must respect this right, offer alternatives, document the refusal accurately, and report to the charge nurse. Forcing care on a resident is a form of abuse and may result in removal from the Massachusetts Nurse Aide Registry.

4When providing perineal care to a female resident, the CNA should cleanse:

A.From the anal area toward the urinary meatus using firm strokes

B.From the urinary meatus toward the anal area using gentle, single-direction strokes

C.In a circular motion around the entire perineal area

D.From side to side, alternating direction with each stroke

Explanation: Perineal care for female residents always proceeds from front (cleanest — urinary meatus) to back (dirtiest — anal area). Each stroke should use a clean portion of the washcloth. This front-to-back technique prevents fecal bacteria (such as E. coli) from contaminating the urethra, which would cause urinary tract infections (UTIs).

5A Massachusetts CNA is providing perineal care to an uncircumcised male resident. After cleansing, the CNA should:

A.Leave the foreskin retracted for easier ongoing hygiene

B.Replace the foreskin over the glans immediately after cleansing

C.Apply powder to the retracted foreskin area

D.Ask the resident to replace the foreskin himself at his convenience

Explanation: The foreskin must be gently retracted for proper cleansing, but it must be replaced (returned) over the glans immediately after cleaning is complete. Leaving the foreskin retracted can cause paraphimosis — a painful, dangerous condition in which the retracted foreskin becomes a tight band that cuts off circulation to the glans, potentially requiring emergency intervention.

6The primary purpose of a back rub during resident care is to:

A.Stimulate urination and bowel movements

B.Improve circulation, relieve muscle tension, and reduce pressure ulcer risk

C.Provide an opportunity to take the resident's temperature

D.Replace the need for repositioning every 2 hours

Explanation: A back rub improves circulation to the skin and underlying tissues, relieves muscle tension, and provides comfort. It also gives the CNA an opportunity to inspect the skin for early signs of pressure ulcers — particularly over bony prominences like the sacrum, coccyx, and scapulae. It does not replace regular repositioning.

7Massachusetts requires a minimum of how many hours of state-approved training before a nurse aide can take the competency exam?

A.40 hours

B.60 hours

C.75 hours

D.120 hours

Explanation: Massachusetts requires a minimum of 75 hours of state-approved Nurse Aide Training (NAT) before a candidate may take the competency exam. This meets the federal OBRA 1987 minimum of 75 hours. The program must include both classroom instruction and supervised clinical experience. Programs are approved by the Massachusetts Department of Public Health (DPH).

8During a shower for a resident with a history of falls, the CNA should:

A.Allow the resident to shower independently to preserve dignity

B.Stand outside the bathroom to give privacy, checking in every 10 minutes

C.Stay within arm's reach of the resident and use non-skid bath mat and grab bars

D.Limit showers to once weekly to reduce fall risk

Explanation: Residents with fall history require close supervision during showers because wet surfaces dramatically increase slip risk. The CNA should remain within arm's reach, ensure a non-skid bath mat is in place, and confirm grab bars are accessible. Shower chairs can provide additional safety. Dignity is maintained by explaining all actions and covering the resident appropriately — not by leaving them unsupervised.

9A resident is unconscious and cannot manage oral secretions. When providing oral hygiene, the CNA should:

A.Sit the resident fully upright at 90 degrees before cleaning

B.Position the resident on their side (lateral position) with suction equipment available

C.Apply toothpaste generously and allow the resident to swallow it

D.Skip oral care to avoid aspiration risk until the resident is conscious

Explanation: Unconscious residents cannot protect their airway from aspiration. Positioning them on their side allows secretions to drain out by gravity rather than into the airway. Suction equipment (Yankauer catheter) should be immediately available. Use a small amount of mouth moisturizer or swabs — never toothpaste, which requires rinsing and swallowing. Never leave an unconscious resident upright during oral care.

10How often should oral hygiene be provided to residents in long-term care, at minimum?

A.Once per day, preferably in the evening

B.At least twice daily and after meals if possible

C.Only when the resident requests it

D.Once weekly by the dental hygienist

Explanation: Oral hygiene should be performed at least twice daily — typically in the morning and evening — and ideally after each meal. Good oral care prevents dental caries, gum disease, aspiration pneumonia (from oral bacteria), and mouth odors. For residents with dementia, the CNA may need to use creative approaches such as a flavored toothpaste or singing to encourage cooperation.

About the Massachusetts CNA Exam

The Massachusetts CNA competency exam is a two-part test administered by Prometric under contract with the MA Department of Public Health. The written exam uses the NNAAP format: 70 questions total (60 scored + 10 pretest), 90 minutes. You must answer approximately 42 of 60 scored questions correctly (~70%). The clinical skills exam requires demonstrating 5 randomly selected skills in 30 minutes with 100% accuracy on critical steps. Massachusetts requires a minimum of 75 hours of state-approved training before testing.

Questions

70 scored questions

Time Limit

90 min written + 30 min skills (5 skills)

Passing Score

~70% (42/60 scored questions)

Exam Fee

$40 written / $50 oral / $70 skills per attempt (Prometric (under MA DPH contract))

Massachusetts CNA Exam Content Outline

35%

Physical Care Skills

ADL, bathing, grooming, oral hygiene, dressing, nutrition, elimination, transfers, ROM, restorative care

25%

Basic Nursing Skills & Safety

Vital signs, infection control, standard precautions, fall prevention, fire safety (RACE/PASS), emergency response

20%

MA Regulations & Role of Nurse Aide

MGL Ch. 19A elder abuse reporting, 105 CMR 150.000, MA NAR registry, scope of practice, delegation, MOLST

12%

Psychosocial & Mental Health Care

Dementia care, emotional support, spiritual care, resident rights, dignity, cultural competence

Communication & Documentation

Medical terminology, charting, HIPAA, Healthcare Proxy (MGL Ch. 201D), interdisciplinary team, SBAR

How to Pass the Massachusetts CNA Exam

What You Need to Know

Passing score: ~70% (42/60 scored questions)
Exam length: 70 questions
Time limit: 90 min written + 30 min skills (5 skills)
Exam fee: $40 written / $50 oral / $70 skills per attempt

Keys to Passing

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

Massachusetts CNA Study Tips from Top Performers

1Know MGL Chapter 19A, Section 15 — Massachusetts mandatory elder abuse reporting (elders 60+)

2Memorize the MA EPS hotline: (800) 922-2275 for elder abuse; MA DPH: (800) 462-5540 for LTC facility abuse

3Study the Massachusetts MOLST form — it is a physician order, not just a preference document

4Know MGL Chapter 201D for Healthcare Proxy — designates substitute decision-maker, not same as MOLST

5Review 105 CMR 150.000 — Massachusetts LTC regulations governing nursing facilities

6Renewal: every 2 years, 8+ hours worked as CNA, no fee, no CE hours required

7Exam: Prometric NNAAP format, 70 questions (60 scored + 10 pretest), 90 min, ~70% to pass

8Practice all 5 randomly selected clinical skills — 100% accuracy on critical steps required to pass

Frequently Asked Questions

Who administers the Massachusetts CNA exam?

The Massachusetts CNA competency exam is administered by Prometric under contract with the Massachusetts Department of Public Health (MA DPH). The written exam uses the NNAAP format with 70 questions (60 scored + 10 pretest) and is 90 minutes. For testing locations and scheduling, visit the Prometric website or call the MA Nurse Aide Registry (MA NAR) at (617) 753-8144.

What is the passing score for the Massachusetts CNA exam?

You must correctly answer approximately 42 out of 60 scored questions (~70%) on the written exam. The clinical skills exam requires 100% accuracy on critical steps for all 5 randomly selected skills. The 10 pretest questions are not scored — they are used to evaluate future exam questions.

How do I report elder abuse as a Massachusetts CNA?

Massachusetts CNAs are mandatory reporters under MGL Chapter 19A, Section 15. Suspected abuse, neglect, or exploitation of an elder (age 60+) must be reported to Elder Protective Services (EPS) at (800) 922-2275. Suspected abuse in long-term care facilities should also be reported to the MA DPH abuse hotline at (800) 462-5540. You must also notify your supervisor. Failure to report is a violation of state law.

What is a MOLST form in Massachusetts?

MOLST stands for Medical Orders for Life-Sustaining Treatment. It is a Massachusetts medical order form used in long-term care settings to document a resident's wishes regarding CPR, mechanical ventilation, artificial nutrition, and hospitalization. As a CNA, you must follow the MOLST; it has the force of a physician order. The MOLST is different from a Healthcare Proxy, which designates a decision-maker under MGL Chapter 201D.

How do I maintain my Massachusetts CNA certification?

Massachusetts CNAs must renew every 2 years with the MA Nurse Aide Registry (MA NAR). To renew, you must have worked at least 8 hours as a CNA during the renewal period. There are no continuing education requirements for renewal. Renewal is free. If you have not worked 8+ hours, you must retest. The MA NAR is located at 67 Forest St., Marlborough, MA 01752, phone (617) 753-8144.

What are Massachusetts CNA training requirements?

Massachusetts requires a minimum of 75 hours of state-approved CNA training before you can test. This meets the federal OBRA minimum of 75 hours. Training must be completed at a MA DPH-approved program. After completing training, you must pass both the written and clinical skills exams through Prometric. You have 4 attempts at the written exam and 3 attempts at the skills exam.