1.2 Credentia NNAAP Format

The Two-Part NNAAP Exam

Credentia gives the National Nurse Aide Assessment Program (NNAAP) in Maryland (through the Credentia Platform). Since October 23, 2024, MBON has also approved D&SDT-Headmaster, which gives its own Maryland knowledge and skill tests, so confirm which vendor your training program uses before you register. Either way the exam checks whether a candidate has the knowledge, skills, and judgment for safe entry-level CNA-I work. The structure is fixed: one knowledge exam plus one skills evaluation, and you must pass both to be certified.

Passing only one part does nothing for employment.

The knowledge exam is taken as a written test, or as an oral test if you request that option on your application. The skills evaluation is separate and is performed in front of a trained Nurse Evaluator. Split your study time accordingly: concepts you answer on screen, and procedures you can perform out loud, in correct order, with resident safety built into every step.

Credentia's Maryland NNAAP Format

Headmaster's Maryland format is different: 70 multiple-choice questions in 60 minutes with 73% needed to pass (an audio version costs $5 more), and a skill test of three or four tasks in 30 minutes. The first task is one of three mandatory tasks with hand washing built in, and each task needs every key step plus 80% of the other steps.

What the Knowledge Exam Tests

The 2024 NNAAP content outline groups items into three domains: physical care skills (including self-care and independence), psychosocial care skills, and the role of the nurse aide. The largest weight sits in physical care and the nurse-aide role. Maryland practice materials emphasize the same pattern — basic nursing skills, personal care (bathing, grooming, toileting), resident rights, documentation, infection control, body mechanics, communication, restorative care, and Maryland-specific scope rules. Treat this credential chapter as scope knowledge, not just paperwork: the exam still tests whether you can recognize safe care.

A reliable answering habit: ask who owns the decision. A CNA observes, reports, documents facts, and performs delegated basic care. The nurse assesses, changes the care plan, and responds to abnormal findings. That boundary drives the right answer in scenarios about resident refusal, falls, abnormal vital signs, skin changes, intake and output, and ethics. If an option has the aide diagnosing, medicating (outside the CMA path), or altering the plan of care, treat it as wrong: those acts are outside CNA scope.

What the Skills Evaluation Rewards

The skills test is a performance exam, not a recitation. You are proving you can do the procedure in a resident-safe sequence. The same anchors appear on most skills:

• Hand hygiene at the start and after glove removal; on Credentia's test, hand hygiene is also always one of the five skills.
• Explain the procedure to the client.
• Provide privacy (close the door/curtain).
• Protect against falls and contamination throughout.
• Keep the call signal within reach at the end, and leave the bed in a low position when the skill lists it.

Indirect-care steps (the explain / privacy / call-signal cluster) appear on most skills, so practicing them as automatic habits protects your score across all five skills. Hand washing itself is always one of Credentia's five skills, and it has strict friction-time and paper-towel-to-faucet steps.

For a failed skills evaluation, Credentia's score report lists the five performed skills, marks each satisfactory or unsatisfactory, and prints the numbers of the missed or incorrect steps. Any unsatisfactory skill fails that skill, and all five must be satisfactory to pass. Missing a Critical Element Step, such as locking the wheelchair wheels before a bed-to-wheelchair transfer, fails the skill.

Avoid the Pass-Percentage Trap

Some unofficial prep sites quote a raw written percentage cut score for Credentia. Credentia's Maryland framing is simpler: pass the Written (or Oral) Examination and pass the Skills Evaluation. Headmaster does publish a number: 73% on its knowledge test. Build your plan around the verified facts — 70 written items, 2 hours (60 minutes with Headmaster), the skills test, 30 minutes, and the retesting rules after a failure — not a shortcut percentage.

Practical Prep Sequence

Use this order: (1) learn Maryland credential rules so eligibility and deadlines are clear; (2) drill knowledge domains with practice questions; (3) rehearse the skills list until you can verbalize every safety step while performing it; (4) treat each failed practice run as a score-report rehearsal — identify the missed critical step, redo the entire skill in sequence, and never memorize only the isolated error.

Knowledge Topics and the Numbers To Memorize

Memorize the normal adult vital-sign ranges:

Other anchors: the PPE removal order (gloves, goggles/face shield, gown, mask — "dirtiest first," mask last); positioning a resident in Fowler's position (head of bed 45–60°) for breathing or eating; keeping urinary drainage tubing free of kinks and the bag below bladder level; and measuring apical pulse for a full 60 seconds. Resident-rights items center on the Omnibus Budget Reconciliation Act (OBRA) of 1987, which guarantees dignity, privacy, freedom from abuse and unnecessary restraints, and the right to refuse care.

If a question pits efficiency against a resident's right to refuse, the right to refuse wins — document and report it.

Worked Skills Example: Handwashing

Because handwashing is always one of Credentia's five skills, and its lathering and rinsing steps are Critical Element Steps, rehearse it as a scored sequence: turn on water and wet hands, apply soap, lather with friction for at least 20 seconds keeping fingertips pointed down, rinse from clean (wrist) to dirty (fingertips), dry with a paper towel, and use a dry paper towel to turn off the faucet so you never recontaminate clean hands. Touching the faucet bare-handed or holding hands upward, which lets dirty water run back over clean skin, breaks steps on Credentia's list.