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When assisting a Texas nursing facility resident with a complete bed bath, which area of the body should the CNA wash LAST?

The face and neck

The arms and chest

The legs and feet

The perineal area

to track

2026 Statistics

Key Facts: Texas CNA Exam

$115

Exam Fee (TX)

Prometric

Written Questions

Prometric

70%

Written Passing Score

Prometric TX

100 hrs

Min. Training Required

HHSC (40 TAC Ch. 94)

21 skills

Possible Skills Tested

Prometric TX

24 hrs

Abuse Reporting Deadline

HHSC

The Texas CNA exam is administered by Prometric and costs $115 for the combined written and skills test. Texas requires a minimum 100-hour HHSC-approved training program (60 classroom + 40 clinical) under 40 TAC Chapter 94 — more than the federal OBRA minimum. The written test has 60 questions in 90 minutes with 70% to pass. Skills test evaluates 5 of 21 possible skills. Maximum 3 attempts before retraining. Certification renewal every 24 months with proof of at least one paid nursing service. Mandatory abuse/neglect reporting to HHSC within 24 hours (Texas Abuse Hotline: 1-800-252-5400). Registry verification through TULIP system.

Sample Texas CNA Practice Questions

Try these sample questions to test your Texas CNA exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 199+ question experience with AI tutoring.

1When assisting a Texas nursing facility resident with a complete bed bath, which area of the body should the CNA wash LAST?

A.The face and neck

B.The arms and chest

C.The legs and feet

D.The perineal area

Explanation: The perineal area should always be washed last during a complete bed bath, moving from the cleanest area (face) to the dirtiest (perineal). This sequence prevents cross-contamination and reduces the risk of urinary tract infections. This principle applies in all Texas long-term care facilities regulated by the Texas Health and Human Services Commission (HHSC).

2A resident at a Texas long-term care facility has left-sided weakness following a stroke. When helping the resident get dressed, the CNA should:

A.Dress the left (weaker) side first to minimize discomfort and strain

B.Dress the right (stronger) arm first to prevent muscle fatigue

C.Have the resident choose which arm to dress first

D.Call the nurse before assisting with dressing to get permission

Explanation: The correct technique is to dress the weak or affected side first and undress the strong side first. When dressing the left (weaker) arm first, the garment is positioned over the arm with limited mobility before threading the stronger arm through. This reduces pain and the risk of injury. The mnemonic is: "Dress the worst first, undress the best first."

3While providing oral care to an unconscious resident at a Texas nursing facility, the CNA should position the resident:

A.Flat on the back (supine) to prevent neck strain

B.In a sitting position at 90 degrees

C.On the side (lateral position) with the head turned to allow drainage

D.Prone (face-down) to keep the airway clear

Explanation: An unconscious resident must be positioned on their side (lateral/Sims position) with the head turned during oral care to prevent aspiration of fluids into the lungs. The supine position is dangerous for unconscious patients because secretions and fluids can pool in the throat and be aspirated. This is a critical safety measure taught in all Texas HHSC-approved CNA training programs.

4A resident in a Texas nursing facility requests that the CNA leave the room during a bed bath. The CNA should:

A.Refuse and explain that the bath must be completed for the resident's health

B.Leave the room but check back every 5 minutes to ensure safety

C.Respect the resident's right to privacy and modify the approach to meet the resident's wishes

D.Notify the nurse immediately that the resident is being non-compliant

Explanation: Residents have the right to privacy and to refuse or modify care per OBRA (Omnibus Budget Reconciliation Act), which is enforced in all Texas nursing facilities by HHSC. The CNA should work with the resident to find an acceptable approach, such as having the resident wash certain areas independently. Resident rights are protected under Texas Health and Safety Code Chapter 242 and federal law.

5When performing nail care for a diabetic resident at a Texas long-term care facility, the CNA should:

A.Clip toenails straight across and report any abnormalities to the nurse

B.Clip and file the toenails to keep them short and smooth

C.Refer all nail care for diabetic residents to the nurse or podiatrist

D.Soak the feet for 30 minutes before clipping to soften the nails

Explanation: CNAs should NOT clip the toenails of diabetic residents. Diabetics have reduced blood circulation and nerve sensation in the feet, making even minor cuts from nail clipping potentially serious. Toenail care for diabetic residents must be performed by a nurse or licensed podiatrist. The CNA can soak and clean the feet but must refer nail trimming to a licensed professional. This is a scope-of-practice limitation in Texas.

6A resident at a Texas nursing facility has dentures. When storing the resident's dentures overnight, the CNA should:

A.Store them dry in a labeled container to prevent bacterial growth

B.Rinse them with hot water and store in the resident's bedside drawer

C.Place them in a labeled container with cool water or a denture cleanser solution

D.Wrap them in a tissue and place them on the bedside table

Explanation: Dentures should be stored in a labeled container filled with cool water or a denture cleanser solution when not being worn. Hot water can warp dentures, causing them to not fit properly. Storing them dry can cause the plastic to crack or distort. Tissues and napkins are inappropriate because dentures can accidentally be thrown away. Each resident's denture container must be labeled with their name per Texas HHSC regulations.

7While assisting a female resident with perineal care following urinary catheter use in a Texas nursing facility, the CNA should clean:

A.In a circular motion around the catheter tubing

B.From the catheter insertion site outward, using a clean stroke each time

C.Back to front using gentle pressure

D.Starting from the outer areas and moving toward the catheter insertion site

Explanation: Catheter perineal care should be performed starting from the urethral meatus (catheter insertion site) and moving outward away from the body, using a clean stroke each time to avoid introducing bacteria toward the urethra. This technique, along with cleaning the catheter tubing for several inches, reduces the risk of catheter-associated urinary tract infections (CAUTIs), which are a major focus of HHSC inspections in Texas long-term care facilities.

8When helping a resident use a bedpan in a Texas nursing facility, the CNA should:

A.Place the bedpan under the resident and leave for 30 minutes

B.Warm the metal bedpan before use and provide privacy with the call light within reach

C.Position the resident flat on the back with a pillow under the head for comfort

D.Remove the bedpan immediately after use without covering

Explanation: When using a bedpan, warm a cold metal bedpan by running warm water over it (cold metal can cause discomfort or skin injury). Always ensure privacy for the resident, and leave the call light within reach so they can signal when finished. The resident should be raised to as close to a normal sitting position as possible (bed at 30-45 degrees) and should not be left for extended periods. Cover the bedpan when removing it to respect dignity.

9A Texas CNA notices a resident's incontinence brief is soiled. The CNA should change it:

A.Only at scheduled times (morning, noon, and evening) to maintain routine

B.Immediately after discovering it is soiled to prevent skin breakdown

C.After informing the charge nurse and getting approval

D.Only if the resident complains of discomfort

Explanation: Soiled briefs must be changed immediately upon discovery to prevent skin breakdown, pressure injuries, and infections such as urinary tract infections. Prolonged contact with urine and feces causes skin maceration and irritation that can quickly progress to serious pressure injuries. Texas nursing homes are cited and penalized by HHSC inspectors for failure to maintain skin integrity related to incontinence care.

10A resident with contractures in both hands is receiving a bed bath at a Texas nursing facility. When cleaning between the fingers, the CNA should:

A.Force the fingers open to clean thoroughly between them

B.Gently open the hand and clean between the fingers without forcing the joints

C.Skip this area to avoid causing pain

D.Use a cotton swab to insert between the closed fingers

Explanation: Residents with contractures have permanently flexed joints that cannot be fully straightened. The CNA should gently work within the resident's range of motion, carefully and slowly opening the hand as much as is comfortable, then cleaning between the fingers without forcing the joints. Forcing contracted joints can cause severe pain, muscle tears, or fractures. Skipping hygiene in flexed areas leads to skin breakdown and infection.

About the Texas CNA Exam

The Texas CNA exam certifies nurse aides to provide basic patient care in Texas. Administered by Prometric under the Texas Health and Human Services Commission (HHSC), it includes a 60-question written NNAAP test and a clinical skills demonstration (5 of 21 possible skills). Texas requires 100 hours of training under 40 TAC Chapter 94.

Questions

60 scored questions

Time Limit

90 min written + skills test

Passing Score

70% written + 100% skills

Exam Fee

$115 (Prometric / Texas HHSC)

Texas CNA Exam Content Outline

39%

Physical Care Skills - Basic Nursing

Vital signs, infection control, PPE, fall prevention, body mechanics, wound observation, emergency response, data collection

14%

Physical Care Skills - ADL

Bathing, grooming, dressing, toileting, nutrition/hydration, feeding, elimination, perineal care, rest/comfort

11%

Psychosocial - Emotional & Mental Health

Dementia/Alzheimer's care, therapeutic communication, depression, grief, behavioral interventions, end-of-life care

Restorative Care

ROM exercises, ambulation, assistive devices, self-care independence, prevention of complications

Role - Communication

Reporting change of condition, documentation, SBAR, HIPAA

Role - Member of Healthcare Team

Delegation from RN/LPN, interdisciplinary team, care planning, professionalism

Role - Client Rights

OBRA 1987 rights, dignity, privacy, right to refuse, advance directives, abuse prevention

Role - Legal & Ethical

40 TAC Chapter 94 scope of practice, mandatory reporting within 24 hours, Texas Nurse Aide Registry

Psychosocial - Spiritual & Cultural Needs

Cultural competency, diverse beliefs, religious accommodations

How to Pass the Texas CNA Exam

What You Need to Know

Passing score: 70% written + 100% skills
Exam length: 60 questions
Time limit: 90 min written + skills test
Exam fee: $115

Keys to Passing

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

Texas CNA Study Tips from Top Performers

1Schedule through Prometric at prometric.com/nurseaide

2Texas requires 100 hours of training — more than many states' 75-hour minimum

3Basic Nursing Skills is the largest section at 39% — master vital signs, infection control, and emergency response

4Know 40 TAC Chapter 94 scope of practice and mandatory 24-hour reporting deadline

5Texas Abuse Hotline: 1-800-252-5400 — know this number for the exam

6Use the TULIP system for registry verification after passing

Frequently Asked Questions

Who administers the Texas CNA exam?

Texas CNA exams are administered by Prometric under the Texas Health and Human Services Commission (HHSC). Schedule at prometric.com/nurseaide.

How much does the Texas CNA exam cost?

The Texas CNA exam costs $115 for the combined written and skills test, paid through Prometric.

How many training hours does Texas require?

Texas requires a minimum 100-hour HHSC-approved training program (60 classroom + 40 clinical) under 40 TAC Chapter 94. This is more than the 75-hour federal OBRA minimum.

What is the Texas Abuse Hotline?

The Texas Abuse Hotline is 1-800-252-5400 or online at txabusehotline.org. Texas CNAs are mandatory reporters and must report suspected abuse or neglect to HHSC within 24 hours.

How do I verify my Texas CNA certification?

Texas CNA certification can be verified through the TULIP (Texas Unified Licensure Information Portal) system maintained by HHSC. Certification renews every 24 months with proof of at least one paid nursing service.