9.1 Written and Oral Test Format

Know the knowledge-test route before you practice

The Texas nurse aide competency evaluation has two required parts: a knowledge test and a Clinical Skills test. Both are delivered by Prometric under contract with Texas Health and Human Services (HHSC), so every candidate in the state tests through the same system. For the knowledge side you take either the Written test or the Oral test — not both. The Written test has 60 multiple-choice questions with a 90-minute limit.

The Oral test also has 60 multiple-choice questions, but the proctor or audio system reads each item aloud, you are allowed roughly 120 minutes, and it adds a short English reading-comprehension section that must be passed the same day.

Do not treat the Oral test as an easier version of the exam. It is a different delivery format for the same knowledge questions, plus a reading requirement. Candidates who process spoken language more accurately than print may prefer it, but they still must understand resident rights, safety, infection control, communication, basic nursing skills, personal care, mobility, dementia care, and reporting. Either way, the exam measures safe entry-level CNA judgment.

Fees and packages

You register for a package, not a single sitting. Current Prometric first-time fees are $125 for Written + Skills and $135 for Oral + Skills; the small extra cost on the Oral package reflects the added reading-comprehension component. Retakes of an individual component carry their own fee (Written only $35, Oral only $45, Clinical Skills only $90), so passing both parts on the first attempt is the cheapest path. Confirm exact current fees on the Prometric Texas nurse aide page before you pay, because Prometric updates pricing periodically.

Format comparison

Pacing math you should internalize

Ninety minutes for 60 questions averages 1.5 minutes per item. Many items take under 30 seconds because the safe answer is obvious. Others run longer because the stem stacks several details — a resident behavior, a hazard, a tempting-but-unsafe distractor. A workable plan: target about 20 questions every 30 minutes, leaving roughly 10 minutes at the end to revisit flagged items. The Oral route's larger 120-minute window absorbs the time spent listening to each item read aloud, so it is not 'extra study time' — it is structurally necessary.

Plan your route early. Switching late creates confusion about fees, scheduling, accommodations, and test-day instructions. If reading printed stems is genuinely difficult, review the Oral option and any accommodation process well before your desired date. If listening to spoken questions distracts you, the Written route fits better. The best route is the one that lets you show knowledge accurately under official conditions.

Remote proctoring, where offered for the Written or Oral test, changes the location and monitoring process — not the content. You still need valid government identification, a compliant private testing space, reliable internet, and strict attention to Prometric instructions. Crucially, a remote knowledge test does not make certification remote: the Clinical Skills test is site-based because it requires observed performance of randomly assigned skills.

Avoid unsupported score claims while studying. Texas does not publish a fixed 70-percent passing score for the knowledge test, so do not anchor on that number. A stronger target is functional readiness: complete 60-question practice sets inside 90 minutes, explain why each correct answer is the safest CNA action, articulate why each distractor is wrong, and keep repairing weak domains. That prepares you for either route without relying on an unconfirmed cutoff.

Finally, on test day, read or listen for the actual task in the stem. Many candidates miss items by answering the question they expected rather than the one asked. Pause long enough to identify the resident's immediate need, the CNA's role, and whether the item wants the first action, the best response, a reportable finding, or the correct prevention step.

What both routes have in common

Whatever route you pick, the underlying competency standard is identical, and it ties directly to the required nurse-aide training. While federal law sets a 75-hour floor, Texas exceeds it and requires at least 100 clock hours of state-approved training — roughly 60 hours of classroom instruction plus 40 hours of clinical practice — before you are eligible to test. You then have a window of about 24 months from completing that training to pass both the knowledge and skills tests before retraining may be required. You typically get a limited number of attempts per component within that window, so do not waste sittings on guesswork.

Bring an acceptable government-issued photo identification whose name matches your registration exactly; a name mismatch is one of the most common reasons candidates are turned away at the door. Arrive early, and treat the check-in process — ID, signature, palm or photo capture, locker for personal items — as part of the exam rather than an afterthought. None of this content changes between Written and Oral; only the way you receive the 60 questions changes.