North Dakota Nurse Aide Competency Exam: Format, Blueprint & Test-Day Rules

North Dakota Nurse Aide Competency Exam: Format, Blueprint & Test-Day Rules

Before you study a single clinical topic, you should know exactly what the North Dakota exam is, who scores it, and how many questions each subject area is worth. North Dakota publishes that breakdown openly — which means you can allocate study time by the numbers instead of guessing.

1. Who Does What

Three organizations appear on every North Dakota nurse aide document, and candidates routinely mix them up:

Your training program enters your initial training information into TMU©. You must then sign in, update your password, and complete the missing demographic fields before scheduling a test event. Candidates who show up without a completed TMU© account can be refused admission to the exam.

[!IMPORTANT] The exam is a package deal. You must pass both the knowledge exam and the manual skill test. Passing one does not certify you; Headmaster transmits your results to DHHS only after both components are passed, and DHHS then certifies you once all of its requirements are met.

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2. The Published Knowledge Exam Blueprint

The knowledge exam consists of 72 multiple-choice questions drawn from subject areas defined in the DHHS-approved North Dakota test plan, covering all the categories required by OBRA regulations. Unlike many state exams that publish only vague percentage bands, North Dakota prints the actual item count per subject area:

What Each Subject Area Actually Covers

The handbook defines each area in a sentence or two. Read these definitions carefully — several are broader than their names suggest:

• Basic Nursing Skills: any act or activity considered a basic skill necessary to perform the job of a CNA. Deliberately broad.
• Care Impaired: residents who are physically or mentally limited from receiving "standard" care, where the CNA must perform more extensively or differently to accommodate them.
• Communication and Interpersonal Skills: all communication — verbal and non-verbal, written and spoken — including anything related to hearing, seeing, feeling, tasting, or smelling.
• Data Collection: data acquisition, handling, and routing. This is where "who do I tell, and how do I record it?" lives.
• Disease Process: the stages and theory of diseases, and their detection, prevention, or treatment.
• Growth and Development Across the Ages: how humans progress along the timeline of their lives.
• Infection Control: the nature of infections; causes, prevention, and correct methods and procedures for dealing with infection.
• Mental Health: residents' mental processes, signs and stages of mental states (normal and care-impaired), and mental well-being and interaction between a CNA and co-workers.
• Personal Care: activities performed by a CNA for or to residents that are personal in nature, plus accommodations needed for care-impaired residents.
• Resident Rights: rights residents are legally entitled to and the facility's and CNA's roles in ensuring them.
• Role and Responsibility: any act or activity that is part of the basic role or responsibility of a CNA in the workplace. Also deliberately broad.
• Safety: safety of residents, of CNAs, of facility personnel generally, and facility safety issues.

[!TIP] Study-time allocation, by the numbers. Basic Nursing Skills and Role and Responsibility are 11 items each — together 22 of 72 questions, or 30.6% of the whole exam. Add Safety (8) and those three areas alone decide 41.7% of your score. Growth & Development is only 2 items; give it a focused hour, not a week.

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3. Knowledge Exam Mechanics

+-----------------------------------------------------------------------------+
|                   NORTH DAKOTA KNOWLEDGE/AUDIO EXAM AT A GLANCE             |
|                                                                             |
|   ITEMS          ---> 72 multiple-choice questions                          |
|   TIME           ---> 90 minutes; you are told when 15 minutes remain       |
|   PASSING SCORE  ---> 75% or better                                         |
|   DELIVERY       ---> Electronic ONLY, on TMU(c) internet-connected         |
|                       computers, at ALL North Dakota sites                  |
|   SIGN-IN        ---> Your TMU(c) username/email + password, plus a start   |
|                       code given to you by the Knowledge Test Proctor       |
|   AUDIO OPTION   ---> Available electronically; questions are neutrally     |
|                       read through headphones with play/pause/rewind        |
|                       controls. MUST be requested BEFORE you pay the fee,   |
|                       and there is an additional charge.                    |
|   CALCULATOR     ---> A basic calculator is allowed. Cell-phone and         |
|                       computer calculators are NOT.                         |
|   DICTIONARIES   ---> Foreign translation dictionaries, translating         |
|                       devices, and non-approved translators are BANNED      |
|                       by DHHS, in paper or electronic form.                 |
+-----------------------------------------------------------------------------+

You may not ask the proctor content questions such as "what does this question mean?" All test materials stay in the room; removing notes or materials is grounds for prosecution and a report to your training program and DHHS.

Sample item style

The handbook's own samples show the flavor: plain-language stems, four options, one clearly safest answer. For example, "Clean linens that touch the floor should be:" — answer: considered dirty and placed in the soiled linen hamper. The exam rewards the conservative, resident-safety answer almost every time.

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4. Test-Day Rules That Disqualify Candidates

More North Dakota candidates are turned away at check-in than fail on content. Memorize this list.

Identification — you need TWO documents

You must bring a U.S. government-issued, signed, non-expired, photo-bearing ID and your Social Security card.

• Acceptable photo IDs include a state driver's license (or the DMV letter issued while you wait for the new license), a state ID card, a signed U.S. passport, a Permanent Resident Card or USCIS work-authorization card, a U.S. military ID, a Tribal ID from a federally recognized Tribal Nation, or a school ID with a photo.
• Not accepted: electronic or digitally stored IDs such as Apple or Google Wallet; foreign passports and passport cards (unless the signed foreign passport contains a U.S. visa); a license or state ID card with a hole punched in it.
• The first and last names on both documents must exactly match the names in the North Dakota TMU© database. A mismatch means no admission and no refund.

Arrival, attire, and belongings

[!WARNING] The six-month penalty. Cheating, causing a disturbance, misconduct, being visibly impaired, or trying to remove notes or testing materials results in dismissal, a scored failed attempt, a six-month testing ban, and a report to DHHS. Using an electronic recording device carries the same outcome plus a report to your training program.

ADA accommodations

Accommodations must be approved in advance by D&SDT-Headmaster through the ADA Accommodation Request Application on the TMU© main page. Requests submitted without documentation of a diagnosed disability are not reviewed until that documentation arrives, so file early.

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5. Results, Attempts, and Disputes

• Results are viewed by signing in to your TMU© account and opening the Tests tab; you can view and print both the knowledge and skill results.
• Attempts: a candidate who completed training with an approved program is allowed three attempts to pass both portions, counted from the date of training completion. Failing three attempts at knowledge, skills, or both means going through an approved nurse aide training program again.
• Retesting: if you fail one portion, you pay for that portion before scheduling a new date. Contact your training facility or a regional testing facility from the Test Site List Form 1700ND on Headmaster's North Dakota page.
• Test review: you may dispute results or a testing condition. Headmaster asks you to phone first; a formal review carries a $25 non-refundable deposit, refunded only if the finding goes in your favor. Reviews are completed within ten business days, and after you turn 18 Headmaster will discuss results only with you — not your instructor, not your family.
• Challenge: eliminated. "Effective July 1, 2024, the option to Challenge the North Dakota Certified Nurse Aide Exam is no longer available."

[!NOTE] Fees. The candidate handbook publishes the $25 test-review deposit but does not print a testing fee schedule; testing fees are handled through TMU© and your training program or regional test site. Confirm the current amount with your test site rather than relying on a third-party figure. Note separately that N.D. Admin. Code 33-43-01-11(1)(f) forbids DHHS from charging any fee for initial certified nurse aide registry listing or renewal.