1.2 Written Knowledge Exam: Format and Strategy

Format, Scoring, and Retakes

The written portion — D&S Headmaster calls it the knowledge exam — is computer-based and consists of 75 multiple-choice questions with a 60-minute time limit. The passing standard is 75%, which works out to roughly 57 of 75 correct. That 75% bar is higher than the 70% used by many other states, so California candidates cannot afford careless misses.

Candidates get three attempts to pass the knowledge portion within two years of completing training. If you pass skills but fail knowledge, you retake only the knowledge exam and pay only that portion's fee — you do not restart the whole process. If the two-year window expires before you pass, you must complete a new CDPH-approved training program.

The Content Blueprint

The 75 questions are distributed across defined subject areas. Use this to allocate study time, but do not ignore the small categories — near the 75% line, one or two questions decide the result.

The Audio / Oral Option

California offers an audio version of the knowledge exam for candidates whose reading speed, English fluency, or visual processing makes the standard reading format harder. Key rules:

• The audio option must be selected before payment — the knowledge exam is a $35 base fee and the audio version adds $10 for $45 total; it is a separate test event, not an ADA accommodation, and it cannot be switched on at check-in.
• The audio exam delivers the same content at the same difficulty; it is not an easier test.
• Candidates must use wired headphones or earbuds. Bluetooth audio devices are not permitted.
• In the reciprocity oral examination, the recorded format pairs spoken questions with a follow-along booklet and includes reading-comprehension items — a reminder that comprehension, not just recognition, is still being tested.

Candidates who need a formal disability accommodation (extended time, a reader, separate room) should request it through the D&S Headmaster ADA process well before scheduling, because approvals are not granted on test day.

Translation Dictionaries

For the standard English exam, D&S rules allow a word-for-word foreign-language translation dictionary — but not a dictionary with definitions, a dictionary with handwritten notes, or any electronic translator. If you plan to use a dictionary, practice with the same type beforehand; flipping pages on every question burns your 60 minutes fast.

Test-Taking Strategy for CNA Questions

With about 48 seconds per question, steady pacing beats rushing. Most CNA items are short once you know the decision rules. Use a four-step read:

1. Read the last sentence of the stem first — it usually states what is actually being asked.
2. Identify the resident risk or the CNA duty in play.
3. Eliminate any choice that is outside CNA scope or unsafe / undignified.
4. Choose the answer that protects safety, preserves dignity, supports independence, or reports to the nurse.

The Four-Part Filter

Watch the Keywords

Misreading one word loses easy points. Slow down for first, next, best, immediately, except, most appropriate, requires reporting, and within CNA scope. A 'first' question almost always wants the immediate safety action (a choking, falling, or bleeding resident). A 'next' question wants what follows the safety step (stay with the resident, call the nurse, do not move them unless there is danger). A 'best' question wants the most complete, resident-centered choice.

Common Wrong-Answer Traps

Avoid choices that sound helpful but exceed the CNA role: giving medication, changing oxygen flow, diagnosing an infection, applying a restraint for convenience, or sharing private information with family. Also avoid waiting/passive answers when a resident has a new, urgent change.

A Worked Example

Consider a stem like: "A resident who usually feeds herself suddenly refuses to eat and seems confused. " Run the filter. Scope: the CNA cannot diagnose the confusion. Safety: a new change could signal infection, a stroke, low blood sugar, or another acute problem. Reporting: a new, sudden change always goes to the nurse. " The pattern repeats across dozens of items: a new or sudden finding is a reporting trigger, while a stable, longstanding situation usually calls for routine, dignity-preserving care.

Pacing and Review

Manage the clock deliberately. At 60 minutes for 75 questions, you can spend a little extra on hard items only if you move quickly through the easy ones. Mark anything you are unsure of, pick the safest plausible answer, and keep moving so no question is left blank — blank answers are scored as wrong. If time remains, revisit flagged questions and re-check any item containing except, first, immediate, or most appropriate, since those are the words most often misread under pressure. A calm, methodical pace usually outperforms second-guessing every answer.