CNA practice test, CNA practice questions and CNA skills test prep for the NNAAP and Prometric exams

Federal law requires every state to run a nurse aide competency evaluation, but it does not write the test. Under 42 CFR 483.154 the evaluation may only be administered by the state directly or by a state-approved entity that is neither a Medicare-participating skilled nursing facility nor a Medicaid-participating nursing facility, which is exactly why states contract it out to an independent vendor. Credentia administers the NNAAP in a large group of states, Prometric administers the nurse aide exam in states including Florida, New York, Texas, Connecticut, Kentucky, Louisiana and New Jersey, and a handful of states use other vendors or run the exam themselves. The practical consequence is that a CNA practice test built for one vendor can misrepresent the length, the timing and the skills format of the exam you are actually going to sit. Before you study anything, find out which vendor your state nurse aide registry uses.

• The state, not a national board, owns the exam and sets the cut score
• Credentia runs the NNAAP; Prometric runs the nurse aide exam in a different set of states
• Federal rules bar a participating nursing facility from administering the evaluation
• Check your state registry first, then study to that vendor's format

Both vendors test the same underlying job, and the content outline Prometric publishes is a fair map of what any nurse aide exam asks: the role of the nurse aide, safety, promoting function and health, basic nursing care, and caring for residents whose health is changing. Basic nursing care is the largest single area and safety is close behind, which tells you where to spend practice time. The questions are not academic. They are situational: a resident does something, and you choose the response that is correct, safe and inside a nurse aide's scope. Scope is the theme that runs through the whole exam, because a large share of the wrong answers are things a nurse would do rather than things an aide may do.

• Situational questions about real resident-care decisions, not textbook recall
• Scope of practice separates the right answer from the plausible one repeatedly
• Federal rules require the exam to cover every subject in the training curriculum
• You have a legal right to take the exam orally instead of in writing

The written test is the part people revise for and the skills evaluation is the part that ends attempts. Under federal rules the skills you perform are drawn at random from a pool, so you cannot predict your list and you have to be competent at all of them. Credentia assigns five skills and gives you 30 minutes for the whole set, with a warning when 25 minutes have elapsed, and you must be marked Satisfactory on five out of five. Prometric also scores five skills, but the structure is different: three skills are assigned to you, and hand hygiene and indirect care are scored alongside them. Indirect care is the one that surprises people. It covers residents' rights and preferences, communication, safety, comfort and infection control, and it is scored across the whole evaluation rather than as a separate task you are told to perform. Prometric also does not prompt you to wash your hands. Your handwashing technique is evaluated at the start of the test and you are expected to know to do it without being told.

• Skills are randomly selected from a pool, so there is nothing to guess
• Credentia: 5 skills in 30 minutes, all 5 must be Satisfactory
• Prometric: 3 assigned skills plus hand hygiene and indirect care, timing varies by skill
• Indirect care runs through the whole evaluation and is easy to lose points on

This is the question with the least honest answer online. Neither Credentia nor Prometric publishes a national passing percentage in its candidate handbook, because the standard is set by your state as part of approving the competency evaluation. The widely repeated figures of 70 or 75 percent are not published national cut scores, and you should treat any site quoting one as an estimate. What both vendors do state plainly is the skills rule: you must pass all five skills. There is no partial credit and no averaging a failed skill against four good ones. You also have to pass both parts, and on the oral version of the NNAAP you have to pass both the multiple-choice section and the reading comprehension section separately.

• The written cut score is state-set and not published as a national percentage
• Treat any quoted 70 or 75 percent as an estimate rather than a rule
• Skills is unambiguous: 5 out of 5 Satisfactory, no partial credit
• The oral exam requires passing its two sections independently

Attempt limits are set by your state, and they are usually tied to a clock as well as a count. North Carolina, for example, requires candidates to pass both the written and the skills examination within two years of completing an approved training program or within three attempts per exam, whichever comes first, after which the training has to be repeated. An unexcused absence counts as an attempt there, which is a quietly expensive detail. Once you are on the registry, federal rules add one more thing worth knowing: 42 CFR 483.156 requires the state to remove from the registry anyone who has performed no nursing or nursing-related services for 24 consecutive months. Certification does not lapse on a renewal date the way a subscription does; it lapses because you stopped working. If you are taking time out, that 24-month clock is the one to watch.

• Attempt limits and time windows are state rules, commonly three attempts
• Some states count an unexcused absence as a used attempt
• Federal rule: 24 consecutive months without nursing work removes you from the registry
• Confirm your own state's limits with its nurse aide registry before you schedule