1.3 The Written/Knowledge Test
Key Takeaways
- The knowledge test is 70 multiple-choice questions with a 60-minute maximum; only 52 correct (74%) are needed to pass.
- Each question has one best answer; a basic calculator and scratch paper are provided and must be left in the room.
- Content follows the federal OBRA/NNAAP domains — Basic Nursing Skills and Personal Care Skills carry the most weight, so study them first.
- Minnesota offers the test in English, Spanish, Somali, and Hmong, plus an audio (oral) version that reads questions aloud — both must be requested when you schedule.
- Foreign-language translation dictionaries are NOT permitted; choose a translated or oral version instead if reading English is a barrier.
How the Written Test Is Built
The knowledge test is 70 multiple-choice questions, delivered electronically on an internet-connected computer through TMU at every Minnesota test site. Each question has four options and one best answer. You have a maximum of 60 minutes, and the proctor warns you when 15 minutes remain — that works out to roughly 51 seconds per question, brisk but workable if you flag-and-move past hard items.
A few logistics matter. The Knowledge Test Proctor hands out instructions and re-checks your ID before you enter the room. You may not ask what a question means once testing begins. A basic calculator and scratch paper are provided for the few math items (intake/output totals, temperature, time), but all materials stay in the room — removing notes is grounds for prosecution and reporting to MDH. Questions are not weighted evenly; Headmaster builds each form against the OBRA content blueprint, so the heaviest domains appear most often. Study the heavy areas first.
Content Domains and High-Yield Topics
Minnesota's content follows the federal OBRA nurse-aide standards (the NNAAP framework). The domains and their approximate emphasis:
| Domain | Approx. Weight | High-Yield Topics |
|---|---|---|
| Basic Nursing Skills | ~22% | Vital signs, positioning, transfers, range of motion, nutrition, hydration, elimination, intake & output (I&O) |
| Personal Care Skills | ~18% | Bathing, grooming, oral/denture care, dressing the affected side first, perineal care, bed making |
| Restorative / Mental Health & Social Service Needs | ~14% | Promoting independence, dementia care, depression/anxiety, behavioral symptoms, person-centered care |
| Spiritual & Cultural Needs | ~2% | Respecting beliefs, dietary/religious preferences, dignity |
| Role of the Nurse Aide | ~11% | Scope of practice, delegation, professional boundaries, the registry, OBRA |
| Communication | ~8% | Therapeutic communication, active listening, reporting vs. recording, SBAR |
| Client Rights | ~7% | OBRA resident rights, dignity, privacy, informed consent, abuse reporting |
| Legal & Ethical Behavior | ~3% | Confidentiality/HIPAA, mandatory reporting, false documentation |
| Infection Control, Safety, Emergencies | ~13% | Standard/transmission precautions, hand hygiene, PPE, fall prevention, RACE/PASS |
The exact percentages vary slightly by form, but the pattern is stable: Basic Nursing Skills and Personal Care Skills together (~40%) are the single highest-yield band, and infection control/safety is consistently heavy. Master clinical skills, personal care, and infection control and you have covered the majority of the test.
Language Options and the Audio (Oral) Exam
Minnesota deliberately separates reading ability from nursing knowledge so a candidate who knows the material is not penalized for English-reading speed.
- Languages: The knowledge test is offered in English, Spanish, Somali, and Hmong. (Spanish, Somali, and Hmong testing was added beginning January 27.) The official Candidate Handbook is published in English.
- Audio (oral) version: Questions are read aloud through headphones/earbuds plugged into the testing computer; on-screen controls let you play, rewind, and pause each question. This is ideal for candidates who understand spoken material but read slowly.
- Request at scheduling: Both a translated form and the oral version must be requested when you schedule through TMU — you cannot switch on test day.
- Prohibited aid: Foreign-language translation dictionaries are NOT permitted during testing. If language is a barrier, use the translated or oral option rather than risk a No-Aid violation.
A practical rule: if reading English under time pressure is hard for you, register for the oral version. Losing points to reading speed when you actually know the care is the most avoidable failure mode on this test.
How to Read and Answer the Questions
NNAAP-style items are short clinical scenarios with one best answer — not trick questions. A reliable approach:
- Read the full stem and decide what it is really asking before looking at options (safety? privacy? the next step? reporting?).
- Eliminate the clearly wrong options first. Two of the four are usually obviously off; the decision is between the remaining two.
- Favor the answer that is safest for the resident and within a nurse aide's scope. When a choice involves a clinical judgment a nurse must make (diagnosing, changing a care plan, giving medications), it is almost always wrong for a CNA.
- Watch for "first/best/most important" qualifiers — multiple options may be acceptable, but only one is the priority. Airway, safety, and infection control usually win.
- Never leave a blank. There is no penalty for guessing, and an unanswered item is simply wrong. With 60 minutes for 70 items, make a first pass answering everything you know, then return to flagged ones.
Common distractor traps: choosing the option that does the task for the resident instead of promoting independence; skipping hand hygiene or privacy; and selecting an action that is the nurse's responsibility, not the aide's. Anchor on resident dignity, safety, infection control, and accurate observing-and-reporting, and most ambiguous items resolve themselves. Because the test is electronic in TMU, you can review and change flagged answers before you submit — use that review pass deliberately rather than rushing to finish early.
Finally, anchor a handful of must-know numbers that the written test returns to repeatedly: normal adult vital signs (temperature about 97-99°F, pulse 60-100 beats/min, respirations 12-20 breaths/min, blood pressure under 120/80 mmHg, oxygen saturation 95% or higher); reposition an immobile resident at least every 2 hours to prevent pressure injuries; and the abuse-reporting contact, the Minnesota Adult Abuse Reporting Center (MAARC) at 1-844-880-1574. Knowing these cold turns several scenario questions into instant answers and frees your time for the genuinely tricky items.
Which accommodation is explicitly NOT allowed on the Minnesota knowledge test?
Which content area should a Minnesota candidate prioritize first when studying for the knowledge test?
A knowledge-test item asks for the FIRST action when helping a resident who is weak on one side get dressed. Which choice is the best CNA answer?