1.1 Credentia PA Exam Format, Scoring Rules & Official Blueprint
Key Takeaways
- The written examination has 70 multiple-choice items: 60 scored items and 10 unscored pretest items; the oral examination has 60 multiple-choice items plus 10 reading-comprehension word-recognition items, and either knowledge format allows 2 hours.
- Credentia’s public Pennsylvania handbook does not publish a numeric written cut score, so candidates should rely on the official score report rather than a claimed 70% or 42-of-60 rule.
- The skills evaluation requires 5 skills in 30 minutes: Hand Hygiene is always included, one of the other 4 is a measurement skill, and every assigned skill must be satisfactory.
- Pennsylvania’s current list contains 21 testable hands-on skills; Assists With Use of Bedpan and Electronic Blood Pressure are explicitly marked not tested, while Manual Blood Pressure is tested.
- A critical element must be correct, but critical elements alone do not pass a skill; candidates must also perform enough other steps to meet that skill’s cut score.
Pennsylvania NNAAP exam architecture
Pennsylvania uses the National Nurse Aide Assessment Program (NNAAP), administered by Credentia for the Commonwealth. Registry placement requires passing both a knowledge component—written or oral—and the clinical Skills Evaluation. The Pennsylvania Department of Education approves nurse aide training programs; the Department of Health maintains the Nurse Aide Registry; and Credentia handles registration, scheduling, testing, score reports, and registry services.
Knowledge examination formats
The current Pennsylvania handbook distinguishes the formats precisely:
| Format | Current composition | Time |
|---|---|---|
| Written | 70 multiple-choice items: 60 scored and 10 unscored pretest items | 2 hours |
| Oral | 60 multiple-choice items plus 10 reading-comprehension/word-recognition items | 2 hours |
The oral format is an alternative to the written examination for a candidate who has difficulty reading English; the handbook also describes English and Spanish oral availability. Do not add 10 pretest items to the oral count—the published oral total is 60 multiple-choice plus 10 word-recognition items.
Credentia’s public Pennsylvania handbook explains how results are delivered and what happens after a failure, but it does not publish a numeric knowledge-exam cut score. Therefore, a claim such as “70%” or “42 of 60” is not an official Pennsylvania rule. Treat all items as important and use the official Credentia score report as the result.
April 2024 written blueprint
The revised outline has been effective since April 2024. The nine scored categories total 60 questions and contain 16 leaf topics:
| Domain and category | Weight | Scored questions | Leaf topics to study |
|---|---|---|---|
| Physical Care—Activities of Daily Living | 22% | 13 | Hygiene; Dressing and Grooming; Nutrition and Hydration; Elimination; Rest/Sleep/Comfort |
| Physical Care—Basic Nursing Skills | 35% | 21 | Infection Control; Safety/Emergency; Therapeutic/Technical Procedures; Data Collection and Reporting |
| Physical Care—Self-Care and Independence | 7% | 4 | Self-care and independence |
| Psychosocial—Emotional and Mental Health Needs | 8% | 5 | Emotional and mental health needs |
| Psychosocial—Spiritual and Cultural Needs | 2% | 1 | Spiritual and cultural needs |
| Role—Communication | 7% | 4 | Communication |
| Role—Client Rights | 8% | 5 | Client rights |
| Role—Legal and Ethical Behavior | 5% | 3 | Legal and ethical behavior |
| Role—Member of the Health Care Team | 6% | 4 | Team membership |
Physical-care content accounts for 64% of scored questions. That makes infection control, safety, basic procedures, measurement, ADLs, and independence the core of written preparation, while rights, communication, legal behavior, teamwork, and psychosocial needs remain substantial and cannot be skipped.
Skills Evaluation draw and scoring
The evaluator gives the candidate an instruction card listing five skills. Hand Hygiene is always one of the five. Four more are randomly selected, and one of those four is a measurement skill. The candidate has 30 minutes for all five; at 25 minutes the evaluator announces that 5 minutes remain. A satisfactory result is required on all five.
Bold steps in the handbook are Critical Element Steps. Missing or incorrectly performing one means that skill is not passed. Performing only the critical steps is also insufficient: the candidate must correctly demonstrate enough of the remaining steps to meet the skill’s cut score.
A candidate who notices an error during the current skill should tell the evaluator which step is being corrected and then perform the correction. For an order-dependent step, the candidate must state when the corrected action belongs. Once the next skill begins, the prior skill cannot be corrected. If the evaluator has to prompt a missed glove action for infection control, the candidate does not receive correction credit for that step.
Pennsylvania’s 21 testable skills
Credentia publishes 23 numbered skills, but two are explicitly excluded in Pennsylvania: Skill 4, Assists With Use of Bedpan, and Skill 12, Electronic Blood Pressure. The resulting 21-skill pool is mapped to teaching in this guide:
| Testable skill | Where it is taught |
|---|---|
| Hand Hygiene | 4.2 |
| Apply One Knee-High Elastic Stocking | 9.3 |
| Assist to Ambulate Using Transfer Belt | 9.3 |
| Clean Upper or Lower Denture | 7.3 |
| Count and Record Radial Pulse | 6.2 |
| Count and Record Respirations | 6.2 |
| Don and Remove PPE—Gown and Gloves | 4.3 |
| Dress Client With Affected Right Arm | 7.4 |
| Feed Client Who Cannot Feed Self | 8.1 |
| Give Modified Bed Bath—Face, One Arm, Hand, Underarm | 7.1 |
| Measure and Record Urinary Output | 6.4 |
| Measure and Record Weight of Ambulatory Client | 6.4 |
| Modified PROM for One Knee and One Ankle | 9.1 |
| Modified PROM for One Shoulder | 9.1 |
| Position on Side | 9.2 |
| Catheter Care for Female | 8.3 |
| Foot Care on One Foot | 7.4 |
| Mouth Care | 7.3 |
| Perineal Care for Female | 7.2 |
| Transfer Bed to Wheelchair Using Transfer Belt | 9.3 |
| Measure and Record Manual Blood Pressure | 6.3 |
Measurement scoring details
| Measurement | Required method or tolerance |
|---|---|
| Radial pulse | Count for one full minute; record within ±4 beats of evaluator |
| Respirations | Count for one full minute; record within ±2 breaths of evaluator |
| Manual blood pressure | Follow PA’s manual protocol; systolic and diastolic each within ±8 mm Hg |
| Urinary output | Read at eye level on a flat surface, round up to nearest 25 mL if between lines; record within ±25 mL |
| Ambulatory weight | Zero the scale first; record within ±2 lb or ±0.9 kg |
Current logistics and fees
At a test center, arrive 30 minutes early. Bring two current, legible, signature-bearing forms of official identification; one must be photo identification, and the name must match the registration. The handbook also lists three sharpened No. 2 pencils, an eraser, and a watch with a second hand. A late arrival or missing required identification prevents testing, forfeits the fee, and counts as an opportunity.
As of this guide’s update, the first Written plus Skills or Oral plus Skills appointment is $135. A written-only or oral-only retest is $50, and a skills retest is $85. The first appointment requires payment for both components. Fees are nonrefundable. Candidates should recheck the live Credentia Pennsylvania fee page before paying because fees and operational policies can change.
The written/oral component may be offered at a test center or by online proctoring; the skills component is performed at an approved test site. Online candidates need the equipment, private room, identification, system test, and room-scan setup specified by Credentia.
Which statement accurately describes the current Pennsylvania NNAAP knowledge formats?
How are the five Pennsylvania Skills Evaluation assignments selected?
A candidate notices an order-dependent step was omitted during the skill currently being performed. What should the candidate do?