Certified Nursing Assistant (CNA) Written Exam — NNAAP®
The nurse aide written exam — daily care, safety, infection control, client rights and your role on the care team.
About the exam
To work as a certified nursing assistant you finish a state-approved training program and pass your state's competency evaluation: a written (or oral) knowledge test and a hands-on skills test. Passing both puts you on your state's nurse aide registry. Most states use the National Nurse Aide Assessment Program (NNAAP®), written by NCSBN and given by Credentia; a few states use their own test, but the content is very similar.
The NNAAP written exam has 70 multiple-choice questions in 2 hours — 60 scored and 10 unscored pretest questions you can't tell apart. An oral version reads the questions aloud and adds 10 word-recognition items. The questions follow the 2024 content outline: Physical Care Skills (daily living, basic nursing skills, independence) 64%, Psychosocial Care Skills 10%, and Role of the Nurse Aide (communication, client rights, legal and ethical behavior, the care team) 26%.
Our practice covers every part of that outline with real-life care situations — bathing and feeding, falls and choking, infection control, vital signs, dementia, residents' rights and reporting abuse — with every answer explained, plus flashcards, step-by-step care cases and illustrated guides. The skills test is done in person and isn't simulated here, but the guides walk through the key skills.
How we track your progress
Every blueprint domain moves through five levels as you study:
- Not startedNo questions answered in this domain yet.
- Getting startedFirst questions answered — not enough yet to judge.
- DevelopingAt least 5 answered and 50% or better on your recent questions.
- ProficientAt least 15 answered and 70% or better on your recent questions.
- Exam readyAt least 25 answered, 80% or better recently, and holding up on hard questions.
The exam blueprint
2024 NNAAP® Written (Oral) Examination Content Outline, effective April 2024 (NCSBN) — the test used by most states. — Physical Care Skills 64% · Psychosocial Care Skills 10% · Role of the Nurse Aide 26%. Tap a domain to see its topics.
1 Activities of Daily Living 22% · 13 of 60 scored of the exam
52 practice questions in this domain so far
2 Basic Nursing Skills 35% · 21 of 60 scored of the exam
82 practice questions in this domain so far
3 Self-Care and Independence 7% · 4 of 60 scored of the exam
16 practice questions in this domain so far
4 Emotional and Mental Health Needs 8% · 5 of 60 scored of the exam
20 practice questions in this domain so far
5 Spiritual and Cultural Needs 2% · 1 of 60 scored of the exam
6 practice questions in this domain so far
6 Communication 7% · 4 of 60 scored of the exam
16 practice questions in this domain so far
7 Client Rights 8% · 5 of 60 scored of the exam
20 practice questions in this domain so far
8 Legal and Ethical Behavior 5% · 3 of 60 scored of the exam
12 practice questions in this domain so far
9 Member of the Health Care Team 6% · 4 of 60 scored of the exam
16 practice questions in this domain so far
What you get when you access this exam
Free with your QuizMe account.
Real care situations
Every question is tagged to one of the nine NNAAP content areas — from bathing, feeding and toileting to falls, choking, infection control and residents' rights.
Hints that teach
Reveal the safety rule or care principle behind the question when you're stuck. Every answer explains why it's right and why the others aren't.
Adaptive practice
Questions steer toward your weakest areas, weighted like the real exam, and get harder as you get stronger.
Timed practice tests
60 questions at the real NNAAP pace, with a pacing indicator and a full review of every answer.
Flashcards, care cases and guides
Flashcards for normal vital signs, infection control and terms, step-by-step care cases, and illustrated guides for key skills.
Progress in every area
Each content area moves from Not started to Exam ready, so you know exactly what to study next.
Test at home or at a center
Your training program or employer usually helps you apply. You register with your state's testing vendor (Credentia for NNAAP states), pay the state fee, and schedule the written or oral exam and the skills evaluation — often on the same day. You need both to be listed on your state's nurse aide registry.
Written or oral exam
- 70 multiple-choice questions in 2 hours; you get a warning when 15 minutes remain.
- Choose the oral version if reading English is hard for you — questions are read aloud.
- Bring the ID your state requires; the name must match your registration exactly.
- Some states allow the written exam online with a remote proctor — check your state's Credentia page.
Skills evaluation
- Done in person with a nurse evaluator and a volunteer or mannequin acting as the resident.
- You perform 5 skills chosen at random — hand hygiene and a measurement skill are common.
- All 5 skills must be done correctly, including the critical steps.
- Talk to the 'resident', give privacy, and wash or sanitize your hands as you would on the job.
Exam-day game plan
How to walk in ready — and how to pace 60 scored-style questions in 1 hour 43 minutes.
Pacing checkpoints
Our timed test gives 60 questions at the real exam's pace (70 questions in 2 hours). The real exam adds 10 unscored pretest questions. The hands-on skills evaluation is separate and isn't simulated here.
The week before
- Take a full timed practice test, then review every question you missed.
- Memorize normal ranges: temperature, pulse, respirations and blood pressure.
- Practice your skills out loud, step by step, including hand hygiene.
- Check your appointment time, test site and the ID your state accepts.
During the test
- Safety first: when two answers seem right, pick the one that protects the client.
- Your job is to observe and report — the nurse assesses, diagnoses and gives medicine.
- Watch for words like FIRST, BEST and MOST IMPORTANT.
- Answer every question — unscored pretest items look the same as scored ones.
- Respect the client's rights: privacy, choice and dignity are usually part of the right answer.
Keep your head
- A few nerves are normal. Breathe slowly and reread the question.
- Think about what a careful, kind nurse aide would really do.
- Change an answer only when you find a clear reason in the question.
After you pass
- Passing both parts puts you on your state's nurse aide registry — employers check it before you work.
- To stay active you generally must work for pay doing nursing-related tasks; under federal rules, if you go 24 months in a row without paid nursing work you must retrain or retest.
- Nursing homes must give nurse aides at least 12 hours of in-service training every year.
- Renewal steps and fees vary by state — check your state registry's rules.
Official sources and further reading
- NCSBN — 2024 NNAAP content outline (PDF) ↗The official list of what the written and oral exams cover, effective April 2024.
- Credentia — NNAAP exam overview ↗Exam format, oral option and the skills evaluation (Pennsylvania page; check your own state's Credentia site).
- 42 CFR 483.152 — Nurse aide training requirements ↗The federal minimum: 75 hours of training with at least 16 hours of supervised practical training.
Ready to start?
240 questions and scenarios across the blueprint — and growing.
NNAAP® is a registered trademark of the National Council of State Boards of Nursing (NCSBN). QuizMe and thinQtank Learning are not affiliated with or endorsed by NCSBN, Credentia or any state agency. All questions are original. Exam details are summarized from NCSBN and Credentia pages; fees, rules and formats vary by state and change — always confirm with your state's nurse aide program.