CNA practice test

What the real test usually looks like

There is no single CNA exam. Every state runs its own nurse aide competency exam, chooses who delivers it and sets its own rules, so the number of questions, the time limit and the retake rules all vary. Your state's candidate handbook is the best guide to yours. The examples below both use two parts: a written (or oral) multiple-choice test of nurse aide knowledge, and a skills evaluation where you perform hands-on tasks in front of an evaluator. Two public examples show the range:

• North Carolina. The state's candidate handbook describes the National Nurse Aide Assessment Program (NNAAP), which it says was developed by the National Council of State Boards of Nursing and is administered in the state by Credentia. The written exam has 70 multiple-choice questions in 2 hours, and 10 of them are unscored pretest questions. An oral version, in English or Spanish, has 60 multiple-choice questions read aloud plus 10 word-recognition questions. The skills evaluation asks you to perform 5 randomly selected skills in 30 minutes (NC handbook).
• Oklahoma. Prometric's candidate bulletin for Oklahoma lists a written test of 55 multiple-choice questions in 90 minutes, an oral option, and a clinical skills test of five scored skills with a time limit of 31 to 40 minutes, depending on the skills (Oklahoma bulletin). It is dated 2013, so check your own state's current handbook.

Content areas in the North Carolina outline (questions out of 70) (NC handbook):

• Physical care skills: activities of daily living (9), basic nursing skills such as infection control, safety, procedures and reporting (23), and restorative skills (5).
• Psychosocial care skills: emotional and mental health needs (6), and spiritual and cultural needs (2).
• Role of the nurse aide: communication (4), client rights (4), legal and ethical behavior (2), and member of the health care team (5).

What our mocks cover. Our full mocks are a general nurse aide knowledge test in a common written format: 70 questions in 120 minutes, in one section of nurse aide knowledge across the areas above. You can go back and flag questions, and there is no calculator. They do not include the hands-on skills evaluation or the oral (audio) version, and formats vary by state, so check your state's handbook for its length, time and rules.

Question types with worked examples

One worked example for each kind of question, with the trap most people fall into.

1. Daily living care. A client can feed herself but tires near the end of the meal. Set up the tray, open containers, sit at eye level and help only when she needs it. Trap: choosing the fastest answer. The test usually favors the one that keeps the client as independent as possible.

2. Infection control. When do you perform hand hygiene? Before and after contact with each client, after removing gloves, and whenever hands are visibly soiled. Trap: thinking gloves replace hand washing. They never do.

3. Safety. A client's call light should be placed within the client's reach, every time you leave the room. The North Carolina handbook uses a call light question among its own samples (NC handbook). Trap: picking a fixed place, such as "on the right side", when the point is that the client can reach it.

4. Client rights. A client wants to keep a family photo and a favorite blanket in the room. The aide supports this, because clients may keep personal belongings. Trap: choosing the answer that is most convenient for staff rather than the one that respects the client's choice.

5. Communication and emotional needs. A dying client starts talking about their fears. Sit with them, listen and let them express their feelings. Trap: changing the subject to cheer them up. Listening is the respectful choice.

6. Reporting and the care team. A client's breakfast is untouched for the second day in a row. Report it to the nurse. Trap: deciding on your own what to do about it. When a change in a client needs a judgment, the safe answer is to tell the nurse.

How to prepare

1. Get your state's candidate handbook. It names the test provider, the number of questions, the time limit, the skills list and the retake rules. Formats vary too much to assume.
2. Do the handbook's sample questions. Many handbooks include some; North Carolina's has a page of sample written questions and the full list of skills with their steps (NC handbook).
3. Study by content area. Basic nursing skills such as infection control and safety make up the largest share of the North Carolina outline, 23 of 70 questions, so give them the most time.
4. Learn the aide's role. Many questions turn on what an aide does and what is the nurse's call. When a choice needs a nursing judgment, the answer is usually to report to the nurse.
5. Think safety and dignity first. For every scenario, ask which answer keeps the client safe, respects their rights and privacy, and lets them do what they can for themselves.
6. Practice the skills hands-on. Our mocks cover the written part only. Practice the skills evaluation with your training program, step by step, including hand hygiene and the steps that start and end every skill.
7. Practice at the real pace. North Carolina's 70 questions in 2 hours is a little under 2 minutes a question, which leaves time to read each scenario carefully. Take full timed mocks so the pace feels normal on the day.

How scoring usually works

Scoring depends on the state. There is no national scale, and each state sets its own rules for the passing standard, the number of attempts and how results are reported. Two public examples:

• North Carolina: candidates must pass both the written (or oral) exam and the skills evaluation to be listed on the state's Nurse Aide I Registry. Score reports are posted online, generally within a few hours of the testing day, and a failing report explains how to retake either part. Candidates have two years from finishing training or three attempts, whichever comes first (NC handbook).
• Oklahoma: the bulletin says the written score report lists pass or fail and the percentage correct in each major section. A pass depends on the overall number of questions answered correctly, so it is possible to do poorly in some content areas and still pass overall. To pass the skills test, a candidate must pass all five skills (Oklahoma bulletin).

Our practice score is the number of our own questions you answered correctly, with a breakdown by question type, so you can see where to focus. It is a practice score: it is not a score on any state's exam, and it does not predict whether you will pass. Your state sets the score it requires.

Common mistakes on the CNA written exam

• Answering as the nurse. If a choice involves assessing, diagnosing or deciding treatment, it is usually not the aide's job. Report to the nurse.
• Picking the fastest option. Doing a task for a client who can do it, or rushing care, is rarely the right answer. Independence and dignity come first.
• Forgetting the client's right to refuse. Clients may refuse care. Respect it, offer a choice and report it.
• Skipping privacy. Pulling the curtain, closing the door and covering the client are part of every personal care task.
• Treating gloves as clean hands. Hand hygiene comes before and after care, and after gloves come off.
• Arguing with a confused client. Calm reassurance and gentle redirection work better than correcting facts.
• Reading too fast. Words such as "first", "best" and "most important" change the answer. Find the action the question asks for.