Most states use a written exam of 60–75 multiple-choice questions. For example, the NNAAP exam (administered by Credentia in many states) has 70 questions, while Prometric’s version has 60. A portion of the questions are unscored pretest items. You’ll typically have 90 minutes to 2 hours to finish.

Passing scores are set by each state, but most require roughly 70–80% on the written exam. The skills exam is scored differently: you must correctly perform the critical steps of each assigned skill to pass. You have to pass both the written and skills portions to become certified.

The CNA written exam focuses on three primary content areas:

• Physical care skills, including activities of daily living (ADLs), basic nursing skills, and restorative care
• Psychosocial care skills, including emotional, cultural, and spiritual support
• The role of the nurse aide, including communication, resident rights, safety, infection control, and legal and ethical responsibilities

Basic nursing skills and ADLs make up the largest percentage of exam questions. To strengthen these areas, try taking our CNA Practice Test to identify topics that need additional review.

You’ll demonstrate a set of randomly assigned skills — usually 3 to 5 — in front of an evaluator, often in a simulated care setting. Hand hygiene is almost always included, and skills like measuring vital signs, transferring a resident, or providing personal care are common. Each skill has critical steps you must perform correctly to pass.

Most well-prepared candidates pass on the first try — first-attempt pass rates in many states run around 70–80%. The written exam tests practical knowledge from your training program rather than trick questions. The skills portion is where most people fail, usually from skipping a critical step like hand hygiene or resident privacy, so hands-on practice matters as much as studying.

Practice tests are one of the most effective ways to prepare for the CNA exam. They help you become familiar with the exam format, identify weak areas, and build the confidence you need for test day.

After completing a practice exam, review any missed questions and return to your training materials to strengthen those topics. You should also physically practice each clinical skill instead of simply reading about it.

Before taking the official exam, work through all 12 of our free CNA practice tests to simulate the testing experience and improve your readiness.

Most states allow candidates to take each portion of the exam up to three times within two years of completing an approved training program. If you fail only one portion, you’ll usually need to retake only that section. If you use all available attempts, most states require you to complete another training program before becoming eligible to test again.

Before scheduling a retake, take another CNA practice exam to identify weak areas and improve your confidence. Because retake policies vary, always check your state’s specific requirements.

Exam fees vary by state, but most fall between about $90 and $200 for both portions combined. Retakes are charged per portion. In many states, if a nursing facility hires you within a year of certification, they’re required to reimburse your training and testing costs.

Each state contracts with a testing vendor — most commonly Credentia (NNAAP exam), Prometric, or Headmaster. The format and content are similar across vendors, but question counts, scheduling, and fees differ, so check which company runs testing in your state.

CNA certification is valid for 24 months. To renew, federal rules require that you’ve worked at least 8 hours in paid nursing or nursing-related services during that period, though some states set higher requirements. If your certification lapses, most states require retesting or retraining.