1.1 Exam Format, Passing Scores, and Testing Logistics

Nebraska CNA Competency Exam Format & Logistics

In Nebraska nurse aide competency evaluation is not administered by a single national vendor such as Headmaster. The Nebraska Department of Health and Human Services (DHHS) sets the exam standards, and approved post-secondary education providers administer the written/oral and clinical skills exams and report results to the Nurse Aide Registry. Approved re-competency testing providers include community colleges (CCC, MPCC, NECC), Nebraska Health Care Learning Center (NHCLC), Providence Health Career Institute, Clarkson College, Nebraska Methodist College, and Quality Career Pathways (see the current DHHS provider list).

To be listed as Active on the Nebraska Nurse Aide Registry, candidates must pass both components: the written/oral exam and the skills exam.

Written/Oral Knowledge Exam

Per Nebraska DHHS, the written/oral exam consists of 50 multiple-choice questions. A passing grade is 70 percent or greater (at least 35 correct). An oral option may be available through the testing provider for candidates who need audio administration.

Content maps to the state-approved curriculum in 172 NAC 108, including communication, infection control, safety/emergency procedures, resident rights, basic nursing skills, personal care, mental health/social service needs, care of cognitively impaired residents, and basic restorative services.

Subject Matter Domains

Study across the official training units rather than a vendor-specific outline:

1. Role, communication, and resident rights
2. Infection control and safety/emergency procedures
3. Personal care skills (bathing, grooming, dressing, toileting, feeding, skin care, transfers)
4. Basic nursing skills (vital signs, height/weight, environment, reporting changes, end-of-life care)
5. Mental health, social service, and cognitive impairment care
6. Basic restorative services (self-care training, assistive devices, ROM, positioning, bowel/bladder training)

Clinical Skills Exam

Per Nebraska DHHS, the skills exam consists of a demonstration of six skills.

Skills are randomly selected from the pool of nurse aide tasks taught in the approved curriculum. Practice every skill on your training checklist—including hand hygiene, transfers, vital signs, personal care, and elimination care—until you can perform mandatory steps without hesitation.

Skills passing formula (Nebraska DHHS):
[Score >= 70% on EACH of 6 skills] AND [all mandatory steps for that skill performed correctly]

Scheduling, Identification, Attire & Retakes

How to Schedule

• If you completed training at a community college or approved program, schedule testing through that program or an approved DHHS post-secondary testing provider.
• For re-competency (lapsed status reactivation), use the DHHS Post-Secondary Education Providers Approved for Nurse Aide Re-Competency Testing list and bring registry verification or eligibility documentation as instructed.
• Providers submit successful results to Nebraska DHHS; registry activation commonly takes about three weeks.

Identification & Attire

Follow the instructions of your testing provider. Typical expectations include:

• Government-issued photo ID (Methodist College requires a state-issued photo ID for testing).
• Clinical attire suitable for hands-on care (scrubs, closed-toe shoes) and a watch with a second hand when vital signs may be tested.
• Arrive early; late arrival or missing required ID usually means you cannot test and may forfeit fees (provider policies vary).

Retake Rules (DHHS)

Exam attempt flow:
Approved training complete -> Attempt 1 -> Attempt 2 -> Attempt 3
[If 3rd fail on that exam -> Mandatory 75-hour course retake]

Test-Taking Strategies

Knowledge Exam

• Read all four options before choosing.
• Watch absolute words (ALWAYS, NEVER, FIRST, MOST).
• When two answers look plausible, choose the option that protects resident safety, rights, or infection control.

Skills Exam

• Verbalize key safety steps (privacy, identify resident, lock brakes, lower bed).
• If you miss a step, say so and correct it before finishing the skill, if the evaluator allows self-correction under that provider's rules.
• Treat every skill as graded on both overall performance and mandatory steps.

Official sources to verify before test day: DHHS Nurse Aide page, Nurse Aide Requirements, and the current DHHS re-competency provider PDF.