The entry rung of the nursing ladder
Certified Nursing Assistant: what the exam is, and how to practice for the CNA free
229 original practice questions. Every answer explained and cited.
A Certified Nursing Assistant (CNA) gives hands-on daily care — bathing, feeding, mobility, and vital signs — under a nurse’s supervision. This page explains the role, how you get certified, and what the two-part CNA competency exam covers, then hands you a free, growing bank of original CNA-style questions to practice with, no signup required to start.
229
original CNA-style practice questions, every answer explained and cited
1.50M
nursing assistants employed in the U.S. — the largest direct-care workforce (BLS)
75+ hrs
federal minimum training under OBRA ’87 before the competency exam (many states require more)
5
knowledge areas, from physical care and safety to residents’ rights
The role, explained
What is a Certified Nursing Assistant (CNA)?
A Certified Nursing Assistant (CNA) — called a nurse aide, nursing assistant, or in some states a State Tested Nursing Assistant (STNA) — provides the hands-on daily care that keeps patients and residents safe, clean, fed, and comfortable, always working under the supervision of a licensed nurse (an RN or LPN/LVN). CNAs are the largest direct-care workforce in the country: roughly 1.5 million work in nursing homes and long-term-care facilities, hospitals, assisted-living communities, hospice, and home health. Their core work is activities of daily living (ADLs) — bathing, dressing, grooming, feeding, toileting, and mobility — plus measuring and recording vital signs, repositioning to prevent pressure injuries, and, most importantly, observing residents closely and reporting any change to the nurse.
Certification is driven by federal law. The Omnibus Budget Reconciliation Act of 1987 (OBRA '87) requires anyone working as a nurse aide in a Medicare- or Medicaid-certified nursing facility to complete a state-approved training program of at least 75 hours (many states require more — often 100 to 150+ hours, including a set number of supervised clinical hours) and then pass a competency evaluation before their name is entered on that state's Nurse Aide Registry. The competency evaluation comes in two parts: a written (or oral) knowledge test, almost always multiple choice, and a hands-on skills demonstration in which the candidate performs several randomly selected nursing-assistant skills in front of an evaluator — hand hygiene is a near-universal required skill. The most widely used version of this exam is the National Nurse Aide Assessment Program (NNAAP), administered by Credentia (test delivery has historically run through Pearson VUE test centers); some states instead use Prometric or another approved vendor, so the exact format and passing standard are set state by state.
The defining discipline of the CNA role — and the theme running through good practice questions — is scope: a CNA observes, provides care, and reports to the nurse, but does not assess, diagnose, or (in most states) administer medications, start IVs, or perform sterile procedures. That focused, supervised scope is exactly what the competency exam tests. On the nursing career ladder, CNA is the entry rung most climbers start on: it's a paid, hands-on way into healthcare, and many CNAs use the experience as a stepping stone to becoming an LPN/LVN and then an RN, or move sideways into the multi-skilled Patient Care Technician (PCT) role.
How you get certified
The CNA competency exam has two parts
After a state-approved training program, you sit a competency evaluation to earn certification and get listed on your state’s Nurse Aide Registry. Most states use the NNAAP; a few use Prometric or another approved vendor, so the exact item count and passing standard vary by state.
1 · The written (knowledge) test
- Multiple-choice questions, offered in writing or (in many states) orally
- Covers all five nurse-aide knowledge areas — the same areas our questions drill
- Tests what a nurse aide must know: safe care, precautions, communication, and scope
- This is exactly the part our practice bank is built to rehearse
2 · The skills demonstration
- You perform several randomly selected skills for an evaluator
- Hand hygiene (handwashing) is almost always a required skill
- Skills are scored on critical steps — indirect care, safety, and resident dignity
- You generally must pass both parts to reach the Nurse Aide Registry
Under the federal Omnibus Budget Reconciliation Act of 1987 (OBRA ’87), nurse aides in Medicare- or Medicaid-certified nursing facilities must complete at least 75 hours of state-approved training before testing — many states require 100 to 150+ hours, including supervised clinical time. Confirm your state’s exact requirements with its nurse-aide registry or health department.
The scope line
What a CNA does — and what’s the nurse’s job
The single most-tested idea on the CNA exam is scope: a nurse aide observes, provides care, and reports — but does not assess, diagnose, or (in most states) give medications. Exact boundaries are set by each state and employer.
A CNA does
- Activities of daily living: bathing, grooming, feeding, toileting
- Mobility, transfers, and positioning with correct body mechanics
- Measuring and recording vital signs and intake and output
- Observing residents and reporting any change to the nurse
Reserved for the licensed nurse
- Nursing assessment, care planning, and clinical judgment
- Administering medications and IV therapy (in most states)
- Sterile procedures and initiating patient teaching
- Any decision the aide must escalate — report it, don’t act beyond scope
Where CNA sits on the ladder
CNA is the entry rung — and a launch point up the ladder
Most people don’t start nursing as an RN. CNA is the paid, hands-on way in: real bedside experience makes it a natural launch point toward LPN/LVN and then RN, or sideways into the multi-skilled Patient Care Technician role. Those rungs are live here today.
Want the full picture of the ladder and every credential along it? Read the nursing career ladder & exams guide.
Five knowledge areas
The CNA knowledge areas our questions cover
Practice one area at a time, or mix all five into a full-length CNA-style test. Every question is written to the nurse-aide scope of practice — observe, provide care, and report to the nurse.
Area 1
Physical Care Skills
ADLs, hygiene, nutrition, elimination, mobility and transfers, and vital signs.
Area 2
Safety & Emergency
Fall prevention, safe transfers, restraints, and emergency response.
Area 3
Infection Control
Hand hygiene, standard precautions, PPE, and medical asepsis.
Area 4
Communication & Psychosocial
Therapeutic communication, dignity, and residents' psychosocial needs.
Area 5
Role & Legal-Ethical
The nurse-aide role, residents' rights, and mandatory reporting.
Ready to practice?
Take a free CNA practice test now
A full-length practice test drawn from all five CNA knowledge areas — the closest free rehearsal to the written exam. No account required to start.
Common questions
The CNA exam, explained
- What is a CNA, and what is the NNAAP exam?
- A Certified Nursing Assistant (CNA) is a direct-care worker who provides hands-on daily care — bathing, dressing, feeding, mobility, vital signs — under the supervision of a licensed nurse. To be certified, you pass a state nurse-aide competency exam. The most widely used one is the National Nurse Aide Assessment Program (NNAAP), administered by Credentia; some states use Prometric or another approved vendor instead.
- What is on the CNA exam, and how is it structured?
- The competency evaluation has two parts. The first is a written (or oral) knowledge test — multiple-choice questions covering physical care skills, safety and emergencies, infection control, communication and residents' psychosocial needs, and the nurse-aide role and residents' rights. The second is a hands-on skills demonstration, where you perform several randomly selected nursing-assistant skills in front of an evaluator; hand hygiene (handwashing) is almost always one of them. You generally must pass both parts to be listed on your state's Nurse Aide Registry.
- How do you become a CNA?
- Under federal law (OBRA '87), anyone working as a nurse aide in a Medicare- or Medicaid-certified nursing facility must first complete a state-approved training program — a federal minimum of 75 hours, though many states require 100 to 150+ hours including supervised clinical time — and then pass the state competency exam. Passing places you on the state Nurse Aide Registry, which is what lets you work as a CNA. Exact hour requirements and the testing vendor vary by state.
- How many CNA practice questions does NursingCEA have?
- The live count is shown at the top of this page and pulled directly from our CNA question database, so it's always current. Every question is original, written to the five nurse-aide knowledge areas, includes a full rationale, and cites a real clinical source.
- Is NursingCEA affiliated with Credentia, the NNAAP, or Pearson VUE?
- No. NNAAP® is a program of Credentia, and Pearson VUE is a separate testing company; none of them endorse, sponsor, or certify through this site. Our questions are original practice material written to the same nurse-aide topic areas — not real exam items — and NursingCEA does not issue any certification or place anyone on a Nurse Aide Registry.
All questions and study material on this site are original, written for practice and study only — they are not medical advice or a substitute for clinical judgment, institutional policy, or a licensed provider. Nurse-aide training hours, testing vendors, and scope-of-practice boundaries are set by each state and employer and vary. NNAAP® is a program of Credentia; Pearson VUE is a separate testing company. Neither, nor any state nurse-aide registry, endorses, sponsors, or certifies through this site. NursingCEA does not issue any certification, contact hours, or continuing-education credit, and does not place anyone on a Nurse Aide Registry.