1.1 About the Illinois Nurse Aide Competency Exam (INACE)
Key Takeaways
- The INACE is Illinois's own state-specific CNA exam administered by SIU Carbondale, not the national NNAAP used by most states
- The written portion has 85 multiple-choice questions with a 90-minute limit, organized into six duty areas (DA1-DA6)
- The clinical skills evaluation tests 5 randomly selected skills drawn from 21 mandated performance skills, scored as critical-element pass/fail
- You must pass BOTH the written and skills components, and the test bank is built from a 200-task job analysis grouped into the six duty areas
- The standard test fee for both components is $85, with results posted to the Health Care Worker Registry about two weeks after testing
- Handwashing and indirect care are 'mandatory' skills that may appear in any skills set, on top of the four randomly drawn skills
What the INACE Is
The Illinois Nurse Aide Competency Exam (INACE) is the state competency evaluation every aspiring Certified Nursing Assistant (CNA) must pass before being placed on the Illinois Health Care Worker Registry and working in a licensed long-term care facility. Unlike the roughly two dozen states that license the national NNAAP (National Nurse Aide Assessment Program) through Pearson VUE, Illinois contracts the Office of Continuing and Professional Education at Southern Illinois University Carbondale (SIU Carbondale) to develop and deliver its own exam on behalf of the Illinois Department of Public Health (IDPH).
Why a State-Specific Exam Matters
The INACE item bank was built from a job analysis of roughly 200 nurse-aide tasks that were grouped into six duty areas. Because the exam is keyed to Illinois practice, generic NNAAP study packets can mislead you on two fronts: the question count is higher (85 vs. ~60), and the skills checklists use Illinois critical elements rather than Pearson's. Study to the Illinois standard, not a national flashcard set.
Exam-at-a-Glance
| Component | Detail |
|---|---|
| Full name | Illinois Nurse Aide Competency Exam (INACE) |
| Test developer/administrator | SIU Carbondale (for IDPH) |
| Written questions | 85 multiple-choice |
| Written time limit | 90 minutes |
| Skills tested | 5 skills selected from 21 mandated skills |
| Scoring model | Critical-element pass/fail per skill; scaled score on written |
| Standard fee | $85 (written + skills) |
| Results posted | Health Care Worker Registry, ~2 weeks after testing |
The Two Components
Part 1 - Written (Knowledge) Examination
- 85 multiple-choice questions, four options each, scored objectively.
- 90 minutes; that is roughly 63 seconds per item, so pace yourself and flag-and-return rather than stalling.
- Items are distributed across the six duty areas, and your score report shows a cluster (duty-area) breakdown so you can see relative strengths.
- Delivered by computer-based testing (CBT) at most sites; an oral version (questions read through headphones) is offered for documented reading or language needs.
Part 2 - Clinical Skills (Manual) Evaluation
- An evaluator watches you perform 5 skills drawn from the 21 mandated performance skills.
- Handwashing and an indirect-care measurement (such as reporting a measurement and recording it) function as recurring 'always-present' elements, so they show up in nearly every set regardless of the random draw.
- Each skill has scored critical elements (steps that must be done in order and without contaminating). Miss a critical element - for example, failing to wash hands or compromising sterile technique - and that skill is marked failed even if the rest was perfect.
- You must verbalize what you are doing, address the resident by name, provide for privacy and safety (call light in reach, bed lowered, wheels locked), and observe standard precautions throughout.
Common Traps for New Candidates
- Treating INACE like NNAAP and being surprised by the 85-question length.
- Forgetting that the skills draw is random - there is no way to 'guess' the five, so all 21 must be rehearsed.
- Rushing handwashing: friction for the full timed interval and not re-contaminating the faucet handles are scored elements.
The Six Duty Areas (DA1-DA6)
Every written item maps to one duty area, and your cluster report uses these same labels. Learn them now - the rest of this guide is organized around them.
| Duty Area | Name | What It Covers | Sample Tested Behavior |
|---|---|---|---|
| DA1 | Communicating Information | Documentation, reporting changes, team and resident communication | Reporting a new reddened area to the nurse |
| DA2 | Performing Basic Nursing Skills | Vital signs, height/weight, intake and output, observation | Counting respirations for a full minute |
| DA3 | Performing Personal Care Skills | Bathing, grooming, oral care, dressing, toileting | Providing perineal care front-to-back |
| DA4 | Performing Basic Restorative Skills | Range of motion, ambulation, transfers, prosthetic/orthotic care | Assisting with a gait-belt transfer |
| DA5 | Mental Health & Social Service Needs | Dementia behaviors, emotional support, dignity in care | Redirecting a wandering resident calmly |
| DA6 | Providing Residents' Rights | Privacy, confidentiality, self-determination, abuse/neglect | Knocking and waiting before entering |
Illinois vs. the National NNAAP
| Feature | Illinois INACE | National NNAAP |
|---|---|---|
| Written items | 85 | ~60 |
| Developer | SIU Carbondale (IDPH) | NCSBN via Pearson VUE |
| Skills tested | 5 of 21 | 5 of ~22 |
| Standards basis | Illinois practice + federal OBRA | Federal OBRA baseline |
| Registry | IL Health Care Worker Registry | State-specific registries |
Worked Example
Maria finishes her training and registers for the INACE. On exam day she answers 85 questions in 78 minutes, then her evaluator assigns five skills: handwashing, oral temperature, ambulation with a gait belt, perineal care (female), and recording intake and output. She passes the written portion but contaminates her hands reaching for the faucet during handwashing without using a paper towel - a missed critical element. Because handwashing is failed, she must retake only the skills portion, not the written test. This illustrates why critical elements, not overall effort, decide each skill.
Who develops and administers the Illinois Nurse Aide Competency Exam (INACE)?
How is the INACE written exam structured?
A candidate passes the written exam but contaminates her hands during the handwashing skill. What is the consequence?
How many skills are tested on the clinical evaluation, and from how large a pool are they drawn?