The Ultimate CNA Study Guide: Ace Your Nursing Assistant Exam

Becoming a Certified Nursing Assistant (CNA) is a rewarding career path, offering the chance to make a real difference in patients’ lives. CNAs work under the guidance of Registered Nurses (RNs), providing essential care such as assisting with meals, monitoring vital signs, and ensuring patient hygiene. To become a CNA, certification is crucial, proving your skills and knowledge in patient care. Many states rely on the National Council of State Boards of Nursing (NCSBN) to administer the CNA exam. Passing this exam is your key to working as a certified nursing assistant.

To help you succeed, this comprehensive Cna Study Guide will walk you through everything you need to know about the CNA exam and how to prepare effectively.

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Understanding the CNA Exam

The CNA exam, often administered through the National Nurse Aide Assessment Program (NNAAP) and facilitated by Credentia in many states, is designed to evaluate your competence as an entry-level nurse aide. Credentia handles the logistical aspects of the exam, ensuring smooth scheduling, administration, and delivery. It’s important to note that exam specifics can vary slightly by state within the 18 NCSBN jurisdictions that currently utilize this standardized exam. Always consult your state’s Candidate Handbook for the most accurate and up-to-date information related to your specific testing requirements.

This exam is tailored for individuals with 0 to 12 months of experience in direct patient care after completing their training. Eligibility criteria differ by state, but generally, candidates must complete a state-approved nurse aide training program. These programs typically combine classroom instruction, hands-on practical training, and real-world on-the-job experience to prepare you for the demands of the role and the exam.

Upon successfully passing both sections of the CNA exam, you’ll earn your CNA certification and be officially listed on your state’s nurse aide registry, granting you the legal right to practice as a certified nursing assistant.

CNA Exam Breakdown: Written and Skills Tests

The CNA exam is structured into two essential parts, both of which you must pass to achieve certification:

Written (or Oral) Exam: Assesses your theoretical knowledge of nursing assistant principles and practices.
Skills Demonstration Exam: Evaluates your practical ability to perform essential nursing assistant skills in a simulated environment.

Let’s delve into each section to understand what to expect and how to best prepare using a comprehensive cna study guide.

Written/Oral Exam Details

You have the option to choose between a written or an oral format for the knowledge-based portion of the CNA exam. This choice is made during the registration process, allowing you to select the format that best suits your learning style and strengths.

Written Exam: This version consists of 70 multiple-choice questions. Within these, 10 are unscored pretest items used for statistical analysis and future exam development, meaning only 60 questions contribute to your final score.
Oral Exam: The oral exam is designed as an alternative for candidates who may find reading and written tests challenging. It includes 60 multiple-choice questions, similar in content to the written exam, plus 10 reading comprehension questions focused on word recognition. Questions are delivered via headset recordings, and you respond by selecting from multiple-choice options.

Both the written and oral exams cover the same core content areas, ensuring that regardless of the format you choose, your knowledge across key CNA competencies is thoroughly assessed. These content domains are crucial for your cna study guide focus:

Core Content Domains:

Physical Care Skills (64%): This is the largest portion of the exam, emphasizing the practical, hands-on skills you’ll use daily as a CNA. It’s broken down further:
- Activities of Daily Living (ADLs) (22%): Approximately 13 questions will cover essential ADLs such as personal hygiene, dressing and grooming, nutrition and hydration support, assisting with elimination, and ensuring patient comfort, rest, and sleep.
- Basic Nursing Skills (35%): This significant section, with around 21 questions, focuses on critical skills like infection control practices, emergency safety procedures, performing therapeutic and technical procedures (within CNA scope), and the vital role of data collection and reporting patient information.
- Self-Care/Independence (7%): Around 4 questions will assess your understanding of promoting client independence and self-care, preventative measures, and supporting client autonomy.
Psychosocial Care Skills (10%): This domain addresses the equally important non-physical aspects of patient care.
- Emotional and Mental Health Needs (8%): About 5 questions will evaluate your ability to recognize and address patients’ emotional and mental well-being.
- Spiritual and Cultural Needs (2%): While smaller, with about 1 question, this section highlights the importance of respecting diverse spiritual and cultural backgrounds in patient care.
Role of the Nurse Aide (26%): This section ensures you understand your professional responsibilities and ethical obligations as a CNA.
- Communication (7%): Around 4 questions will test your communication skills, essential for effective patient interaction and teamwork.
- Client Rights (8%): Approximately 5 questions will focus on your knowledge of patient rights and how to protect them.
- Legal and Ethical Behavior (5%): About 3 questions will cover legal and ethical conduct expectations for CNAs.
- Member of the Health Care Team (6%): Around 4 questions will assess your understanding of your role within the broader healthcare team and collaborative practices.

Understanding this detailed outline is the first step in creating an effective cna study guide tailored to your needs.

Skills Test: Demonstrating Your CNA Abilities

The skills demonstration portion of the CNA exam is a practical assessment where you’ll perform five core nursing assistant skills in a simulated healthcare setting. A Nurse Aide Evaluator will observe and assess your performance against a checklist of specific tasks for each skill. You’ll have 30 minutes to complete all five skills. One of the five skills will always be Hand Hygiene, ensuring fundamental infection control competency. The remaining four skills are chosen randomly from a set list, with one of these requiring you to take and record a measurement (like blood pressure or urinary output).

You’ll be interacting with a candidate volunteer who will role-play as a patient needing assistance, adding a realistic element to the evaluation. The testing area will be equipped with all necessary supplies for you to perform the skills accurately.

Key Skills Evaluated:

The 23 potential skills you might be asked to demonstrate are:

Hand hygiene
Applies one knee-high elastic stocking
Assists in ambulation using a transfer belt
Assists with use of bedpan
Cleans upper or lower denture
Counts and records radial pulse
Counts and records respirations
Donning and removing PPE (gown and gloves)
Dresses client with affected (weak) right arm
Feeds client who cannot feed self
Gives modified bed bath (face and one arm, hand, and underarm)
Measures and records electronic blood pressure
Measures and records manual blood pressure
Measures and records urinary output
Measures and records the weight of an ambulatory client
Performs modified passive range of motion (PROM) for one knee and one ankle
Performs modified passive range of motion (PROM) for one shoulder
Positions on side
Provides catheter care for female
Provides foot care on one foot
Provides mouth care
Provides perineal care (peri-care) for female
Transfers from bed to wheelchair using a transfer belt.

Each skill is broken down into a series of steps, and crucially, each skill includes Critical Steps. These are specific actions that must be performed correctly to pass that particular skill. Your cna study guide should prioritize mastering these critical steps for each skill.

CNA Exam Registration: Your Pathway to Certification

To register for the CNA exam, you must go through Credentia, the official testing vendor. The first step is to select the state where you intend to practice as a CNA. The Credentia website will then guide you to the specific platform and requirements for that state. A primary prerequisite across all states is the completion of a state-approved nurse aide training program.

Registration Steps:

Create a CNA365 Account: Visit the Credentia website and sign up for a new CNA365 account or log in if you already have one.
Start Your Application: Once logged in, begin a new application and select the eligibility route that applies to you (typically, completion of a state-approved training program).
Provide Required Information and Documents: Fill out all necessary information and upload any supporting documents, such as proof of training program completion, as requested.
Application Approval: After submitting your application, you will receive an email notification confirming whether your application has been approved. Only after approval can you proceed to register for the exam itself.
Schedule Your Exam: Once approved, you can schedule both the written/oral exam and the skills demonstration exam. Credentia offers flexibility in scheduling, allowing you to choose dates, times, and locations that work best for you.
Choose Exam Format and Location: You can select to take the written/oral exam online remotely or in person at a testing center. Online exams offer convenience, while testing centers provide a traditional exam environment.
Payment: Finally, you will need to pay the exam fees through Credentia’s online platform using a credit card or prepaid credit card. Exam fees vary by state, but generally, budget around $100 for the complete exam.

Important Scheduling Deadlines:

Online Exams: You can often schedule an online exam up to the day before your desired test date, depending on availability.
Testing Center Exams: If you prefer to test at a center, register at least 10 calendar days in advance to secure your preferred date and time.

Always refer to your state’s Candidate Handbook for the most precise registration details, deadlines, and fee information. Your cna study guide should include a checklist of these registration steps to keep you organized.

CNA Test Day: What to Expect

Being well-prepared for CNA test day can significantly reduce anxiety and boost your performance. Here’s what you need to know for both online and on-site exams:

Required Items for All Exams:

Two Valid IDs: Bring at least two forms of current, unexpired, government-issued identification. One must include your photo and signature, and one should be your Social Security card.
Optional Items: You may also bring two No. 2 pencils, an eraser, a watch with a second hand (though digital watches may be restricted in online exams), and any other supporting documents specifically required by your state or testing center.

Specifics for Online CNA Exams:

System Test: Prior to your exam day, conduct a system test on your computer or laptop to ensure it meets all technical requirements for the online exam platform. This prevents technical glitches on exam day.
Mobile Device and 360° Room Scan: You’ll need a mobile device capable of downloading Credentia’s mobile app. On test day, you’ll use this app to perform a 360-degree scan of your testing room to ensure it meets proctoring requirements (private, quiet, no unauthorized materials).
Testing Room Requirements: Your testing room must be private, with a clear workspace. No other individuals are allowed in the room during your exam.
Onboarding Procedure: Familiarize yourself with the complete online exam onboarding procedure beforehand to avoid any confusion or delays on test day.

Tips for a Smooth Test Day:

Arrive Early (for On-site Exams): If testing at a center, arrive at least 15-30 minutes early to allow time for check-in procedures. For online exams, log in a bit early to ensure your system is ready.
Dress Comfortably and Professionally: Choose comfortable clothing that is also professional and respectful of the testing environment.
Stay Calm and Focused: Practice relaxation techniques to manage test anxiety. Focus on each question and skill demonstration one at a time.
Follow Instructions Carefully: Pay close attention to all instructions given by the exam proctor or evaluator. If you have any questions, don’t hesitate to ask before the exam begins.

Your cna study guide should include a pre-test day checklist to ensure you have everything prepared and know what to expect, minimizing stress and maximizing your focus on demonstrating your CNA skills and knowledge.

Understanding Your CNA Scores and Results

Your official CNA Score Report will clearly indicate whether you have passed or failed each section of the exam.

Skills Demonstration Score: For the skills test, your report will show a rating of “Satisfactory” or “Unsatisfactory” for each of the five skills you were evaluated on. To pass this portion, you must receive a “Satisfactory” rating on all five skills. Any “Unsatisfactory” rating on even one skill means you have failed the skills portion of the exam.
Written/Oral Exam Score: The score for the written or oral exam will simply indicate “Pass” or “Fail.” You need to pass this section in addition to the skills section to achieve full CNA certification.

Accessing Your Scores:

Online Access: Typically, your exam results will be available within a few hours after you complete the exam. You will receive an email notification once your results are ready to view in your CNA365 account on the Credentia website.
Mailed Results: In some states, score reports are also mailed to you physically. If this is the case in your state, expect to receive your results within 5 to 7 business days after your exam date.

After Passing:

State Nurse Aide Registry Listing: If you successfully pass both portions of the CNA exam, your name will be added to your state’s nurse aide registry. This listing process usually takes a few weeks to a couple of months. Once listed, you are officially certified and eligible to work as a CNA in your state.

If You Don’t Pass:

Retake Options: If you fail any portion of the exam, don’t be discouraged. Most states allow you to retake the exam multiple times. The typical allowance is up to three attempts within two years of completing your training program.
Retake Only Failed Section(s): Generally, if you fail only one section (either the written/oral or the skills test), you will only need to retake the section you did not pass. You won’t have to repeat the section you already passed.
Grievance Process: If you believe there was an error in the exam administration or scoring, most states have a process for submitting a written grievance or complaint. Consult your state’s Candidate Handbook for details on how to do this.

Your cna study guide should include information on score reporting procedures and retake policies specific to your state, so you are fully informed about what happens after you take the exam, regardless of the outcome.

CNA Online Prep Course: Enhance Your Exam Readiness

For those seeking a structured and comprehensive approach to exam preparation, a CNA online prep course can be an invaluable resource. Mometrix offers a highly-rated online CNA prep course designed to give you all the tools and resources you need to maximize your chances of success on the CNA exam.

Key Features of the Mometrix CNA Online Prep Course:

Extensive Review Lessons: The course includes over 40 in-depth review lessons covering every topic area of the CNA exam outline, ensuring no content area is missed in your preparation.
Practice Questions: Gain confidence and test your knowledge with over 600 CNA practice questions that simulate the actual exam format and difficulty. These questions help you identify areas where you need further study.
Digital Flashcards: Utilize over 300 digital flashcards to reinforce key concepts, vocabulary, and procedures. Flashcards are a proven method for effective memorization and quick review, making them a valuable addition to your cna study guide.
Money-Back Guarantee: Mometrix stands behind the quality of their prep course with a money-back guarantee, providing you with peace of mind and assurance in your investment in exam preparation.
Mobile Access: Study anytime, anywhere with convenient mobile access to all course materials. Learn on the go, fitting study sessions into your busy schedule.

Check out the Mometrix CNA Online Prep Course to learn more and enroll!

Flashcards

Mometrix recognizes that everyone learns differently. Their CNA online prep course is carefully designed to cater to a variety of learning styles, ensuring that every student has the resources and support they need to feel fully prepared and confident on exam day.

Effective Study Strategies for the CNA Exam

Succeeding on the CNA exam is not just about the amount of time you study, but also how effectively you study. Smart study strategies are essential for making the most of your preparation time.

Utilizing CNA Practice Tests Strategically

Regularly assessing your progress is crucial, and CNA practice tests are an excellent tool for this. They pinpoint your strengths and weaknesses, allowing you to focus your study efforts where they are most needed.

Maximize Practice Test Benefits:

After each free CNA practice test you take, carefully analyze your performance, paying close attention to these question categories:

Incorrect Answers (❌): These questions highlight areas where your knowledge is lacking or incorrect. Review the concepts related to these questions thoroughly.
Guessed Answers (🤔): Even if you guessed correctly, these questions indicate areas of uncertainty. Strengthen your understanding of these topics to avoid guessing on the actual exam.
Challenging or Time-Consuming Questions (⌛): Questions that took you a long time or felt difficult reveal areas where you may need more practice to improve speed and confidence.

For each question in these categories, ask yourself why it was challenging. Was it a lack of understanding of the underlying concept? Do you need more practice applying the knowledge? Are certain terms confusing? Use these insights to guide your review and target your cna study guide efforts effectively.

Deep Comprehension vs. Memorization

While practice tests often provide answer explanations, remember that these are usually brief and may only cover a portion of the broader concept. Don’t just memorize answers. Focus on understanding the why behind each correct answer. Explore all related concepts until you have a complete and solid understanding. Deeper comprehension, rather than rote memorization, will prepare you for any variation of a question you might encounter on the actual CNA exam.

Strategic Approach to CNA Practice Tests

Here’s a recommended strategy for incorporating CNA practice tests into your study plan:

Initial Untimed, Open-Book Test: Take your first practice test without any time limits and with your cna study guide and notes readily available. Focus on applying what you’ve learned and understanding the rationale behind each answer. This is a learning exercise, not just a test.
Timed, Open-Book Practice: For your second practice test, keep your study materials accessible, but set a timer. Practice pacing yourself to complete the test within the actual exam time limit. This helps you get used to working under time pressure.
Simulated Test Day Conditions: For subsequent practice tests, simulate real test day conditions as closely as possible. Put away your study materials, set a timer, and take the test in a quiet environment, mimicking the testing center setting. This helps reduce test day anxiety and builds stamina.
Consistent Practice: Continue taking practice tests regularly throughout your study period until you feel confident and consistently score well, or until you run out of practice tests. Regular practice reinforces your knowledge and makes you more comfortable with the exam format and question types.

By using CNA practice tests strategically as part of your comprehensive cna study guide, you can effectively target your study efforts, build confidence, and maximize your preparation for the CNA exam.

Frequently Asked Questions About the CNA Exam

To further assist you in your preparation, here are answers to some frequently asked questions about the CNA exam:

Q: What is the CNA exam?

A: The CNA exam is a certification exam for individuals seeking to become Certified Nursing Assistants. It consists of two parts: a written or oral knowledge test and a clinical skills demonstration test, both essential for earning your CNA certification.

Q: What is the cost of the exam?

A: The CNA exam cost varies by state, but on average, it is approximately $100 for both sections of the exam. Check your state’s specific fees in the Candidate Handbook.

Q: What are the testing dates and locations?

A: CNA testing is offered year-round at various locations. Consult your training program instructor or Credentia’s website for testing sites and schedules available in your area.

Q: How do I get my CNA certification?

A: First, enroll in and complete a state-approved nurse aide training program. After successful completion, you will be eligible to register for and take the CNA exam to earn your certification.

Q: How long does it take to become a certified nursing assistant?

A: The duration to become a CNA depends on the training program, but typically, programs range from 6 to 12 weeks in length.

Q: How much does a CNA make an hour?

A: As of 2022 data, the median hourly wage for CNAs in the United States is approximately $14.82 per hour, but this can vary by location and employer.

Q: What is a CNA certification?

A: A CNA certification is official recognition that you have met the required competencies to work as a Certified Nursing Assistant. It is earned after passing the two-part CNA exam (written/oral and skills).

Q: How long is a CNA license good for?

A: CNA certifications are typically valid for 24 months. Many states require CNAs to work for a minimum number of hours (e.g., 8 hours) during this 24-month period to maintain active status without needing to re-test.

Q: How much does it cost to take a CNA test?

A: The cost to take the CNA test ranges from state to state, with most states charging between $80 and $100 for both the written and skills sections combined.

Q: How long do I have to wait to take my state test for CNA after training?

A: Some states allow up to 12 months after completing your training program to pass the CNA exam and obtain your certification. Check your state’s specific timeframe.

Q: What score do you have to get to pass the CNA test?

A: Passing scores for the CNA test are set by each state individually. Some states require a passing score of 70%-75%, while others may require 80%. Consult your state’s requirements.

Q: How much is a CNA salary annually?

A: The average annual CNA salary in the US ranges from approximately $20,075 to $34,126, depending on location, experience, and employer.

Q: What are the duties of a CNA?

A: CNA duties are diverse and patient-centered, primarily focused on providing basic care. This includes assisting with daily living activities, monitoring vital signs, and supporting the nursing staff in various patient care tasks. Some CNAs may also handle administrative tasks like using billing software.

Q: What can you do as a CNA in a hospital setting?

A: In a hospital, CNAs play a vital role in patient care, assisting nurses in all aspects of patient support. This includes monitoring vital signs, assisting with patient mobility and hygiene, responding to patient calls, and providing a comforting presence.

Q: How many hours per week do CNAs typically work?

A: Full-time CNA work hours are generally 32-40 hours per week, but this can vary depending on the facility and employment terms. Part-time positions are also common.

Q: What happens if I don’t pass the CNA exam?

A: If you don’t pass the exam, most states permit you to retake it, often up to three times within two years of completing your training. You usually only need to retake the section(s) you failed, not the entire exam.

This cna study guide and FAQ section are designed to be your comprehensive resource for navigating the CNA exam process. With diligent preparation and effective study strategies, you can confidently pursue your CNA certification and embark on a fulfilling career in healthcare.

By Kate Nockunas

Kate has been Mometrix’s Nursing and Medical Editor for over four years. She holds a bachelor’s degree in Communications from Vanderbilt University, a bachelor’s degree in Nursing from Marymount University, and a master’s degree in Education from Johns Hopkins. Kate is a critical care registered nurse with ongoing experience in ICU and PACU settings.

Last Updated: February 11, 2025

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