CNA Certification Guide

This guide covers the CNA certification process: choosing your state's testing provider, registration, fees, the written test, the 5-skill test, and a study plan. Information is current as of November 2026. Because the CNA exam is state-regulated, every detail below should be verified with your state's nurse aide registry.

Practice test content is for exam preparation only and does not constitute medical advice. Actual patient care must be performed per facility policy and state regulations under the supervision of licensed nurses.

Step 1: Complete a State-Approved Training Program

You must complete a state-approved nurse aide training program (typically 4 to 12 weeks, including classroom and clinical hours). Programs cost roughly $1,000-5,000 depending on the state and school. Community colleges, vocational schools, and some care facilities offer approved programs. After training, you are eligible to take the state exam.

Step 2: Know Your State's Testing Provider

• NNAAP (NCSBN): about 30 states, including (as of recent reporting) AL, AK, CA, CO, DC, GA, MD, MS, NC, PA, RI, SC, VA, WA, and others.
• Prometric: about 20 states, including CT, DE, FL, HI, ID, LA, NM, NY, OK, TX, and others.
• Headmaster: about 10 states, including AZ, AR, KY, MA, MI, MN, MO, NJ, NV, OH, OR, TN, UT, WI, WY, and others.

Provider-state assignments change. Check your state's nurse aide registry for the current provider, application process, and fees.

Step 3: Register and Pay

The exam fee is commonly about $90-100, paid to the testing provider or your state registry. Registration is usually online through the provider or registry website. Some states bundle the written and skills test into one fee.

Step 4: The Written Test

Questions are scenario-based: you read a short situation and choose the best action. Passing scores are set by each state, commonly in the 75-80 percent range; there is no national passing score. Confirm your state's requirement.

Step 5: The Skills Test

You perform 5 skills drawn at random from a state-defined skills list, typically within 25 to 40 minutes. Each skill is scored pass/fail against a checklist of key steps, and you must pass all 5.

Typical skills include: hand hygiene, donning and removing gloves, measuring blood pressure, measuring temperature, oral care (including dentures), bed bath or sponge bath, perineal care, assisting with feeding, offering fluids, assisting with toileting, using a bedpan, changing an occupied bed, repositioning, transfer to wheelchair, walking with a gait belt, dressing, hair care, nail care, catheter care (pericare), oxygen safety, end-of-life care, bleeding control, restraint check, and placing the call light.

The exact list varies by state; study the skills list your state publishes, and practice every skill during your training program. A common mistake is rushing: examiners watch for the critical steps (hand hygiene, privacy, safety) on every skill.

Step 6: Pass and Join the Registry

After passing both parts, you are placed on your state's nurse aide registry. Keep your certification current: many states require renewal (often every 2 years) with documented work hours or retesting. If you move to another state, check whether your certification transfers.

Study Plan (3 Weeks)

Week 1 - Basic Nursing Skills and Safety. These dominate the NNAAP outline (Basic Nursing Skills is 39 percent). Study vital signs and normal ranges, hand hygiene, standard precautions, isolation, specimen collection, I and O, restraints, oxygen safety, and emergency basics. Drill the Basic Nursing Skills and Promotion of Safety sections.

Week 2 - ADL, Restorative, and Psychosocial Care. Study feeding, toileting, bathing, oral care, transfers, positioning, pressure ulcer prevention, ROM, assistive devices, dementia care, and communication. Use the ADL, Restorative, and Psychosocial sections.

Week 3 - Role of the Nurse Aide and full tests. Study communication, client rights, legal and ethical behavior, scope of practice, and the care team. Take the full CNA practice test twice, review every explanation, and practice your state's skills list with a study partner.

Frequently Asked Questions

1. How long does it take to become a CNA?

Training programs typically run 4 to 12 weeks, and you can test within a few weeks of finishing. Plan for about 2 to 4 months from start to registry.

2. Can I work as a CNA before passing the exam?

Some states allow a temporary permit or trainee status while you complete training and testing; most employers require registry listing. Check your state's rules.

3. What if I fail the written test or the skills test?

You may retest per your state's rules, usually after paying a retest fee. Many states allow retaking only the failed portion. Check with your registry.

4. Do I need to renew my CNA certification?

Most states require renewal every 2 years, often with documented paid work hours. Unused certifications may require a refresher course or retesting.

5. Are the skills the same in every state?

The skills are broadly similar but the exact list and checklist steps differ by state. Always study the skills list your state publishes.

6. What is the best way to prepare for the skills test?

Practice each skill out loud, following the checklist order, until the critical steps (hand hygiene, privacy, safety, communication) become automatic. Practicing with a classmate who can observe and give feedback is highly effective.

Official Sources

• NCSBN NNAAP
• Prometric
• Headmaster
• Your state's nurse aide registry (state government website)

Fees, passing scores, provider assignments, and renewal rules change. Verify everything with your state's nurse aide registry before you register.