TL;DR
The CNA Written Examination (NNAAP) exam is administered by Pearson VUE (for most states using the National Nurse Aide Assessment Program) with a Approximately 85-90% first-attempt for approved training program graduates pass rate. This guide covers all 5 content domains, common failure modes, and sample questions. The exam format is 70 multiple-choice questions (60 scored, 10 unscored pilot items) with a 90 minutes time limit.
CNA Written Examination (NNAAP): Complete Guide
Everything you need to know before you start studying.
Exam Facts
What the Exam Tests
Basic Nursing Skills
~45%The largest domain. Vital signs (temperature, pulse, respirations, blood pressure — know normal adult ranges and measurement techniques), hygiene and personal care (ADLs), nutrition and hydration, positioning and transfers, and skin care and observation (pressure injury staging, turning every 2 hours).
Safety & Infection Control
~13%Fall prevention, fire safety (RACE: Rescue-Alarm-Contain-Extinguish; PASS: Pull-Aim-Squeeze-Sweep), infection control (standard precautions, transmission-based precautions — contact, droplet, airborne), PPE donning/doffing order, hand hygiene (the single most important infection prevention measure), and body mechanics.
Client Rights & Legal/Ethics
~14%Resident Bill of Rights (OBRA 1987 — right to privacy, dignity, refuse treatment, personal belongings), advance directives, informed consent, abuse recognition and mandatory reporting, scope of practice for CNAs, and restraint regulations.
Psychosocial & Restorative Care
~20%Emotional and mental health support, dementia and Alzheimer's care (validation therapy, redirection, sundowning), cultural and spiritual sensitivity, grief stages (Kübler-Ross), end-of-life care, and restorative/rehabilitative skills (promoting independence, ROM exercises, assistive devices).
Communication
~8%Therapeutic communication techniques (active listening, open-ended questions), reporting vs recording, when to report immediately (vital sign changes, falls, skin breakdown), medical abbreviations, and communicating with impaired patients.
Common Reasons Candidates Fail
1. Confusing what CNAs can and cannot do
CNAs cannot administer medications, perform sterile procedures, take telephone orders, or diagnose. Questions that test scope of practice are common and candidates who aren't clear on boundaries choose wrong answers.
2. Mixing up vital sign normal ranges
You must know: adult pulse 60-100 bpm, respirations 12-20/min, BP ~120/80 mmHg, temperature 97.6-99.6°F. Questions often present a vital sign reading and ask whether it's normal or should be reported.
3. Infection control procedure order
PPE donning order (gown → mask → goggles → gloves) and doffing order (gloves → goggles → gown → mask) are frequently tested. Getting the order wrong in practice is a safety hazard; getting it wrong on the test costs points.
Practice Questions
Click "Reveal answer" to see the correct answer and explanation.
Q1.The CNA takes a resident's blood pressure and obtains a reading of 88/56 mmHg. The resident's baseline is 130/82 mmHg. What is the BEST action?
Q2.A resident with dysphagia is coughing during meals. The CNA should:
Q3.While repositioning a resident, the CNA notices a 2-cm reddened area on the sacrum that does not blanch when pressed. What stage is this pressure injury?
Q4.A resident with dementia becomes agitated and tries to hit the CNA during morning care. What should the CNA do FIRST?
Practice for the CNA written exam: Valenke covers vital signs, nursing skills, infection control, patient rights, and psychosocial care — focusing on your weakest areas.
Start free practice →Frequently Asked Questions
▶How many questions is the CNA written exam?
The CNA written exam (NNAAP) has 70 multiple-choice questions, of which 60 are scored and 10 are unscored pilot items. You have 90 minutes to complete it.
▶What is the CNA exam pass rate?
Approximately 85-90% of first-time candidates from approved training programs pass the CNA written exam. It has the highest pass rate among healthcare certifications because the content scope is focused on fundamental care skills.
▶What topics are on the CNA written exam?
The CNA exam covers Basic Nursing Skills (~45%), Safety & Infection Control (~13%), Client Rights & Legal/Ethics (~14%), Psychosocial & Restorative Care (~20%), and Communication (~8%). The exam also has a separate skills (practical) component.