CNA Study Guide
CNA Written Exam Format and Passing Score: Questions, Time, and What to Expect
CNA written exam format explained: 70 NNAAP items, 60 scored, 2-hour limit, state passing scores, oral option, pretest items, pacing, and written vs skills rules.
By MedCertPrep Team · Updated August 26, 2026
This guide explains the CNA written (or oral) knowledge test in detail: how many questions you will see, how time and passing scores work, how the written part differs from the skills evaluation, and what to expect on exam day. It is written for candidates who have confirmed eligibility and want a clear picture of the knowledge test before scheduling. For training hours, vendor handbooks, and registry rules, see CNA requirements. For domain weights and what to study, see the CNA study guide. For study method and skills critical-step drill, see How to pass the CNA. For checklist rehearsal, see the CNA skills test.
CNA rules are state-administered. Timing, cut scores, attempt limits, and delivery options can differ between Credentia NNAAP pathways and Prometric pathways. Confirm current details in your state's Candidate Handbook or Candidate Information Bulletin before you schedule.
What is the CNA written exam format?
Most U.S. states require a two-part nurse aide competency evaluation:
| Part | What it tests | This guide |
|---|---|---|
| Written or oral knowledge test | Safety, ADLs, infection control, rights, communication, scope | Covered here |
| Clinical skills evaluation | Hands-on performance against an official skills listing | See CNA skills test |
You must pass both parts for registry listing. A strong written score does not offset a failed skills demonstration.
On many Credentia NNAAP pathways, the written examination uses the structure described in state handbooks and the 2024 NNAAP Written Content Outline. Prometric states follow their own Candidate Information Bulletin, which may use different item counts or timing. Always open your vendor PDF for your state.
| Detail | Typical NNAAP written form (Credentia) |
|---|---|
| Total items | 70 multiple-choice questions |
| Scored items | 60 |
| Unscored pretest items | 10 |
| Time allowed | 2 hours (verify in your handbook) |
| Question format | Multiple choice, one best answer |
| Passing score | State-specific (not one national number) |
| Oral alternative | Available on many pathways (see below) |
| Blueprint | 2024 NNAAP Content Outline PDF |
How many questions are on the CNA written exam?
On the standard NNAAP written form used by many Credentia states:
| Block | Count | Counts toward score? |
|---|---|---|
| Scored items | 60 | Yes |
| Pretest (pilot) items | 10 | No |
| Total | 70 | 60 determine pass/fail |
The 10 pretest items are embedded throughout the exam. They are not labeled. Treat every question as if it counts.
Oral examination format (alternative)
Candidates who qualify for the oral option on NNAAP-style pathways typically face a different structure:
| Oral section | Items | Notes |
|---|---|---|
| Multiple-choice (oral delivery) | 60 | Questions read aloud; you mark answers on a sheet |
| Reading comprehension | 10 | Word-recognition / job-related terms |
| Total | 70 | You must pass both oral sections where required |
Many handbooks include a self-assessment reading test to help you decide between written and oral delivery. Confirm eligibility and rules in your state's Candidate Handbook on Credentia (Find My State).
Prometric states may publish different totals. Download your bulletin before you choose a study plan.
What score do you need to pass the CNA written exam?
Unlike national certifications with one published scaled score (for example, NHA CCMA at 390), CNA passing standards are set by each state and appear in your official handbook or bulletin.
| What to look for in your handbook | Why it matters |
|---|---|
| Minimum percentage on scored items | Often cited as 70%, 75%, or 80% of the 60 scored questions |
| Whether the rule applies to written only or oral sections separately | Oral pathways may require passing both MC and reading parts |
| Retake rules if you pass one section and fail another | Varies by vendor and state |
Practical math for NNAAP-style 60-scored-item forms:
| State-style passing rule (examples) | Scored items needed (approx.) |
|---|---|
| 70% of 60 | 42 correct |
| 75% of 60 | 45 correct |
| 80% of 60 | 48 correct |
These are illustrations only. Your state handbook is the only source that counts. Do not schedule based on a blog's "national passing score."
Practice accuracy vs your state's cut score
Use mixed practice sets as a readiness signal, then compare against your handbook threshold.
| Mixed practice accuracy (approx.) | Typical interpretation |
|---|---|
| Below 65% | Major gaps; extend study before scheduling |
| 65% to 74% | Progress, but below common 75% to 80% state bars |
| 75% to 79% | Approaching range for many states; fix weak Physical Care clusters |
| 80% or higher on multiple different mixed sets | Reasonable readiness signal before scheduling |
Run diagnostics and timed sets on free CNA practice and domain hubs at CNA practice.
How is time allocated on the CNA written test?
Many Credentia NNAAP handbooks allow 2 hours (120 minutes) for the written examination. That averages about 2 minutes per item across 70 questions, which feels slower than CCMA or PTCE pacing but still rewards steady movement.
| Phase | Suggested time | Goal |
|---|---|---|
| First pass (all 70 items) | About 95 to 100 minutes | Answer or flag every item |
| Flagged review | About 15 to 20 minutes | Re-read stems on flagged items only |
| Buffer | About 0 to 5 minutes | Final scan for blanks |
Prometric bulletins may list different time limits. Confirm yours before exam day.
What content does the written exam cover?
Scored items map to three domains on the 2024 NNAAP outline. Full subdomain detail lives in the CNA study guide.
| Domain | Scored items | Weight |
|---|---|---|
| I. Physical Care Skills | 38 | 64% |
| II. Psychosocial Care Skills | 6 | 10% |
| III. Role of the Nurse Aide | 16 | 26% |
| Total | 60 | 100% |
Physical Care alone is larger than the other two domains combined. Written prep that ignores Basic Nursing Skills (infection control, safety, reporting) while over-focusing on low-weight Psychosocial topics under-prepares the exam.
What types of questions appear on the CNA written exam?
Items are multiple choice, but stems are usually scenario-based.
| Question style | What it tests | Example pattern |
|---|---|---|
| First action / safety | Infection control, falls, emergencies | What should the nurse aide do first? |
| Scope of practice | CNA vs nurse vs family | Which task is within the aide's role. See CNA scope of practice |
| Resident rights | Privacy, refusal, abuse reporting | Resident refuses care; what is correct? |
| ADL support | Hygiene, feeding, elimination, dignity | Clean-to-dirty, positioning, call light |
| Communication / reporting | What to tell the nurse | Which observation must be reported immediately? |
| Psychosocial | Dementia, agitation, cultural respect | Best response to anxious or confused resident. See CNA dementia and psychosocial care |
When two answers sound kind, the exam often rewards the option that protects safety, dignity, and correct reporting to the nurse.
Credentia NNAAP vs Prometric: what changes?
| Topic | Credentia (most NNAAP states) | Prometric (selected states) |
|---|---|---|
| Handbook | Candidate Handbook via Find My State | Candidate Information Bulletin by state |
| Written item count | Commonly 70 (60 scored) on NNAAP written form | Confirm in your bulletin |
| Skills listing | NNAAP Skills Listing in handbook | State clinical skills checklist |
| Official outline | 2024 NNAAP Content Outline PDF | Bulletin content weights for your state |
For national NNAAP framing, see NCSBN NNAAP & MACE. For scheduling and cut scores, always return to your vendor PDF.
What should you expect on written exam day?
Before check-in
| Checklist item | Done? |
|---|---|
| Government photo ID matches vendor account name exactly | |
| Appointment confirmation saved (time, site, and vendor) | |
| Know whether you are taking written or oral delivery | |
| Arrival time meets handbook early-check-in rules |
During the written test
- Use any tutorial or practice screens to confirm how to flag or review items.
- Read every option. CNA stems often turn on one word (first, report, refuse, privacy).
- Flag long scenarios and keep moving.
- Do not leave items blank if your vendor allows guessing without penalty.
- Remember: 10 pretest items are mixed in. Answer all 70.
After the written test
- Provisional results may be available at the site on some pathways.
- Official score reports show pass/fail for the knowledge test.
- Passing written alone is not enough. You still need a satisfactory skills evaluation per CNA skills test.
How do written retakes work?
Retake windows, attempt limits, and whether you retest only the failed part are state-specific. Confirm in your Candidate Handbook or Candidate Information Bulletin.
| Topic | What to verify in your handbook |
|---|---|
| Attempt limit | How many tries before retraining is required |
| Eligibility window | Months after program completion you may test |
| Partial retakes | Whether you can retake only skills or only written after a split result |
| Fees | Separate fees per attempt |
Use the wait period for subdomain tagging and timed practice, not passive re-reading.
How should written exam format shape your study plan?
| Exam feature | Study response |
|---|---|
| 60 scored items, Physical Care 64% | Weight practice toward Physical Care |
| 2-hour limit on 70 items | Add timed 60- to 70-item blocks in weeks 3 to 4 |
| Scenario-heavy stems | Practice "first action" and scope questions |
| 10 embedded pretest items | Answer every question |
| State-specific cut score | Find your percentage in the handbook, then track practice against it |
| Two-part competency rule | Pair written study with weekly skills rehearsal |
Calendar: 4-week CNA study plan.
What mistakes do candidates make about the written exam?
| Mistake | Why it hurts | Fix |
|---|---|---|
| Assuming one national passing score | States set different cut percentages | Read your handbook threshold |
| Ignoring Role and Psychosocial | Physical Care is largest, but 36% of items are outside it | Weekly sets in Role and Psychosocial |
| Studying written only | Skills failure blocks registry listing even with a strong written score | Rehearse official skills weekly |
| Untimed-only practice | Runs out of time or panics on exam day | Add timed blocks before scheduling |
| Using unofficial skills lists | Critical steps differ by state PDF | Download Credentia or Prometric checklist |
| Choosing oral without reading rules | Oral may require passing two subsections | Take handbook self-assessment if offered |
Frequently Asked Questions
How many questions are on the CNA written exam?
On many Credentia NNAAP pathways, the written form has 70 multiple-choice items: 60 scored and 10 unscored pretest items. Prometric states may differ. Confirm in your official bulletin.
What is the passing score for the CNA written exam?
There is no single national passing score. States set their own cut scores in the Candidate Handbook or Candidate Information Bulletin, often as a percentage of scored items (commonly in the 70% to 80% range on NNAAP-style 60-item forms). Verify yours before scheduling.
How long is the CNA written exam?
Many NNAAP handbooks allow 2 hours for the written examination. Prometric timing may differ. Confirm in your vendor document.
Is the CNA written exam the same as the skills test?
No. The written (or oral) test is a knowledge exam. The skills evaluation is a separate hands-on checklist performance. You must pass both for registry listing.
Can I take the CNA exam orally instead of written?
Many Credentia states offer an oral option with a different item structure (typically 60 multiple-choice items plus 10 reading comprehension items on NNAAP-style forms). Confirm eligibility and passing rules in your handbook.
Do wrong answers count against you on the written test?
NNAAP-style written exams do not use negative marking. An unanswered item is a missed scored question. Select your best answer rather than leaving blanks.
How is the CNA written exam different from the CCMA or PTCE?
CNA is state-administered with vendor-specific handbooks, a two-part competency model (knowledge plus skills), and state-set cut scores. CCMA and PTCE are national credential exams with fixed scaled passing standards and no separate skills demonstration on the same day.
Where do I find the official written outline?
Download the 2024 NNAAP Written Content Outline. For state rules, open Credentia (Find My State) or Prometric (select your exam and state).
Schedule with clarity, then study by weight
- Confirm eligibility on CNA requirements.
- Open your vendor handbook and note item count, time limit, and passing percentage.
- Take a diagnostic on free CNA practice.
- Map a calendar with the 4-week CNA study plan.
- Pair written practice with CNA skills test rehearsal every week.
Know the written format first. Then let the NNAAP weights drive what you practice.
Practice what you just read
Use blueprint-aligned questions and timed mocks for CNA to turn this guide into exam-day readiness.