All Nursing Exams

CNA test: what the written and skills parts cover

The CNA test has a written (or oral) part of 60 to 79 questions and a skills part of 3 to 5 skills; you must pass both to be certified.

Checked November 15, 2026
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Short answer: The CNA test has two parts, and you must pass both: a written (or oral) multiple-choice test and a skills test where you perform nurse aide tasks in front of an evaluator. On the National Nurse Aide Assessment Program (NNAAP), the written test has 70 questions in 2 hours and the skills test has 5 skills in 30 minutes; other test companies use 60 or 79 questions and 3 to 5 skills.

A bar chart of the 60 scored NNAAP written questions: 38 on physical care skills, 16 on the role of the nurse aide and 6 on psychosocial care

Why the numbers change by state

Federal rules (42 CFR 483.154) set the frame for every state. The test must offer a written or an oral version, must cover every topic of the federal training curriculum, and must draw its skills at random from a pool that includes all personal care skills. Each state then picks a test company, and each company builds its own test. That is why your handbook, not a general website, is the final word.

The written (or oral) test

Test company and example state Questions Time Notes
Credentia NNAAP (for example North Carolina, Pennsylvania) 70: 60 scored and 10 unscored pretest items 2 hours Oral version: 60 multiple-choice plus 10 word-recognition items
Credentia, Tennessee 75 scored plus 10 pretest items See the Tennessee handbook Tennessee calls it the Knowledge exam
Prometric (Florida, Texas, New York) 60 90 minutes New York's oral version adds a 16-question reading section with 30 extra minutes
Headmaster, Ohio 79 90 minutes Pass mark 70% or better

Pretest items are new questions being tried out. Credentia says they are used to gather statistics and do not affect your score.

What the NNAAP written test covers

Credentia's 2024 content outline splits the 60 scored NNAAP questions like this:

Area Share Questions
Activities of daily living (hygiene, dressing, nutrition, elimination, rest and comfort) 22% 13
Basic nursing skills (infection control, safety and emergency, procedures, data collection and reporting) 35% 21
Self-care and independence 7% 4
Emotional and mental health needs 8% 5
Spiritual and cultural needs 2% 1
Communication 7% 4
Client rights 8% 5
Legal and ethical behavior 5% 3
Member of the health care team 6% 4

Added up, physical care skills make 64% of the test, the role of the nurse aide 26%, and psychosocial care 10%. Basic nursing skills alone are more than one third.

The skills test

Test company Skills you perform Time How you pass
Credentia NNAAP (North Carolina) 5 skills drawn at random; hand hygiene is always one, plus a measurement skill 30 minutes Every critical element step (in bold in the handbook) must be done correctly, or the skill fails
Prometric (Florida) 3 assigned skills, plus Handwashing and Indirect Care, which are scored during the whole test: 5 scored skills 31 to 40 minutes, set by the skills you get Pass all five skills
Headmaster (Ohio) 3 or 4 tasks; the first is one of five mandatory tasks with hand washing built in 35 minutes All key steps (in bold) plus 80% of the other steps on each task

In Prometric states, Indirect Care means the things you do during every skill: respecting the resident's rights and choices, talking with the resident, safety, comfort and infection control.

Often another candidate plays the resident. Credentia's North Carolina handbook says a candidate volunteer plays a weakened elderly person, and Florida requires candidates to play the resident for each other. Some skills, such as perineal care in Ohio, are done on a manikin.

You may correct a mistake if you tell the evaluator and then do the step again. Credentia and Prometric both say you cannot go back to a skill you have already finished. Ohio also allows corrections if you tell the RN Test Observer.

The possible skills for each company are in CNA skills list: the skills on the skills test.

Pass rules: you need both parts

Federal rules say you must pass both the written or oral test and the skills test. The state must give you at least three attempts. States add their own limits:

  • North Carolina: pass both within two years of training, or within 3 attempts, whichever comes first.
  • Texas: pass both within 24 months of training, with three attempts at each part.
  • Ohio: three attempts within two years of finishing training.
  • Florida: after three failed attempts, you must complete at least 120 hours of state-approved training before you test again.

If you fail one part, you register again for that part. North Carolina and Florida both list a separate fee for each part. In Ohio, a skills retest always includes a task you failed before.

What to do next

  1. Find your state's test company and read its handbook, including the skills list and timing.
  2. Practice each skill aloud with a partner, saying what you are doing, as you would on test day.
  3. Use the free practice options in CNA practice tests: free official options.

Common questions

Can I take the test in Spanish?

Some states allow it. North Carolina offers the oral exam in English and Spanish, and Florida offers the written test in English and Spanish. Skills tests in both states are in English only.

What is a critical step?

A step so important that missing it fails the whole skill, even if every other step is right. Credentia and Headmaster print these steps in bold in their handbooks.

Sources