Nurse Aide Competency Evaluation (NNAAP)
There is no single national CNA exam. Testing is administered state by state against a state-specific candidate handbook, most commonly using the NNAAP. The written examination is 70 items of which only 60 are scored, the skills evaluation is five randomly selected skills with hand hygiene always among them, and you must pass both parts to be listed on your state registry.
Content outline and weights
Passing: Federal rule requires passing BOTH the written or oral examination and the skills demonstration, and each state sets its own standard for satisfactory completion. A candidate must be given at least three attempts; a state may cap the number but the cap may be no lower than three. This site does not publish a national passing score, because there is not one. (Office of the Federal Register (eCFR))
There is no national CNA exam
This is the first thing most sites get wrong. Nurse aide testing is administered per state, either by the state directly or by an entity the state approves — Credentia and Prometric, for example — against a state-specific candidate handbook. Your fees, your retake rules, your time limits and even which blood-pressure skill you may be asked to perform come from that handbook, not from a national standard.
What is national is the floor. 42 CFR part 483 subpart D sets the minimum every state programme must meet, and the widely used NNAAP examination provides the content outline and skills listing beneath many state programmes.
The two parts
You must pass both. Federal rule 483.154(e)(1) is explicit about it, and a pass in one does not carry the other.
Written examination — 70 multiple-choice items, of which 10 are pretest (non-scored) items. So 60 items are scored.
Oral examination — an alternative, not a penalty. Federal rule 483.154(b)(1)(i) requires that the competency evaluation "allow an aide to choose between a written and an oral examination". The oral version is 60 multiple-choice items plus 10 reading comprehension and word recognition items. If you request it, request it when you register.
Skills evaluation — five skills: Hand Hygiene always, plus four chosen at random, performed in front of a Nurse Aide Evaluator, with another candidate playing the resident.
The content outline
The 2024 NNAAP content outline is effective April 2024 and is based on the 2019–2020 Job Analysis and Knowledge, Skill, and Ability Study of Nurse Aides.
| Area | Share | Scored items |
|---|---|---|
| Basic Nursing Skills | 35% | 21 |
| Activities of Daily Living | 22% | 13 |
| Client Rights | 8% | 5 |
| Emotional and Mental Health Needs | 8% | 5 |
| Communication | 7% | 4 |
| Self-Care and Independence | 7% | 4 |
| Member of the Health Care Team | 6% | 4 |
| Legal and Ethical Behavior | 5% | 3 |
| Spiritual and Cultural Needs | 2% | 1 |
| Total | 100% | 60 |
Basic Nursing Skills and Activities of Daily Living together are 34 of the 60 scored items. Spiritual and Cultural Needs is one item.
The random draw is required by law
The skills evaluation is not randomised as a convenience. 42 CFR 483.154(b)(2) requires that the skills demonstration "consist of a demonstration of randomly selected items drawn from a pool consisting of the tasks generally performed by nurse aides", and that the pool include all the personal care skills listed at 483.152(b)(3).
That is why the skills randomiser on this site draws rather than lists. You cannot know which five you will get, and studying only the popular ones is a strategy the regulation is specifically designed to defeat.
Attempts
Federal rule 483.154(f)(2) guarantees at least three attempts. A state may cap the number, "but the maximum may be no less than three." Your state handbook has the actual figure.
What we do not state
A national passing score, fee or time limit. None exists. Each state sets the standard for satisfactory completion, and fees and time limits come from your state handbook. Colorado's fees appear on the cost page as a worked example of what a state handbook looks like — not as a national figure.
Exam guides
- What the CNA exam costs, and why the answer is your state's handbook
There is no national CNA exam fee. Each state sets its own, published in that state's candidate handbook, and the fee structure differs by which parts you take and which you retake. Colorado's published schedule is shown here as a worked example of the shape these fees take, not as a figure that applies anywhere else.
- CNA training requirements: the 75-hour federal floor and what your state adds
Federal rule sets a floor every state programme must meet: no fewer than 75 clock hours of training, at least 16 of them supervised practical training, and at least 16 hours of specified content before a trainee has any direct contact with a resident. States may require more. If a facility employs you or has offered you a job, it may not charge you for the programme.
22 original questions, weighted like the real blueprint. No signup. Results in minutes.
Primary references
- The 2024 National Nurse Aide Assessment Program (NNAAP) Written (Oral) Examination Content Outline — Credentia Nurse Aide LLC · primary · retrieved 2026-09-22, verified 2026-09-22
- Colorado Nurse Aide Written (or Oral) Examination and Skills Evaluation Candidate Handbook — Credentia Services LLC, in partnership with the Colorado Board of Nursing · primary · retrieved 2026-09-22, verified 2026-09-22
- 42 CFR Part 483 Subpart D — Requirements That Must Be Met by States and State Agencies, Nurse Aide Training and Competency Evaluation — Office of the Federal Register (eCFR) · government · retrieved 2026-09-22, verified 2026-09-22
- Colorado CNA skill evaluation (NNAAP skills test) — Credentia · primary · retrieved 2026-10-18, verified 2026-10-18