Once you have completed the certification program required to become a Certified Nursing Assistant (CNA), you will need to take the CNA exam to earn a license. In order to pass this test, you will need to have a good grasp of the information you learned while going through the CNA program. The Certified Nursing Assistant exam is made up of two sections. One section is the written examination, and the other is the clinical skills test, often referred to as the CNA skills test. You will need to pass both sections, with each typically requiring a score of 70-80% or better to pass depending on your state.
The written portion will be multiple choice and will be taken on a computer. The clinical skills test will be performed in front of an evaluator. You will demonstrate the skills for the evaluator, making sure to correctly show the critical duties of each skill you are demonstrating. Depending on your location, the skills test for CNAs may cover three to six different practices required of nursing aides. Although there may only be a few skills which are needed to show proficiency during this portion of the test, aspiring nurses should know that the test designators can choose from around thirty different practical tasks that Certified Nursing Aides should be able to perform.
The video below provides some helpful tips for passing the CNA skills test. If you’ve failed the test previously, or if you’re taking the test for the first time, there are some helpful tips here to help you prepare for exam day.
Depending on your state, you may also have to record a measurement. Items that may be measured include:
- Blood Pressure
- Weight
- Urinary output
- Radial pulse
- Respirations
Actual “patients” or “clients” are utilized within this testing scenario. It will be important to interact with and speak with that subject as if they are a real patient. Test takers should brush up on the proper way to wash hands. Nursing aides will be expected to perform proper sanitary practices, including disposing of waste. Cleanliness is not only required of the aide but also the patient. Before going in to take the skills test, it is critical to make sure you carry a positive attitude and demeanor. This may go along way on the examination portion of the test also; potentially showing the examiner that the patient is in good hands. Just like the skills that are needed to pass the CNA skills test, communication can be practiced each time the prospective nursing aide is in a position to do so.
While more direct skills like moving patients from bed-to-bed and placing in the correct body position demand a thorough understanding by a Certified Nursing Aide, they should also understand that patients benefit from kindness and care as well. On top of this, anticipating what is required during each duty without having the examiner step in may potentially impress those watching, including the patient. It is important to understand that the test is practical and there are reasons for being proficient in what is needed by a Certified Nursing Aide. Not only will this make for a better CNA, but a safer one as well.
State Specific Requirements for CNAs
It is important to note that you need to complete CNA classes that are approved by the state where you wish to earn your license and practice. Each state will have a list of approved CNA course programs they recognize, so make sure you select a school that is certified in your state. You can find out more information on your state’s requirements on our state by state CNA classes page.
The skills test for CNA applicants will vary by state as different states utilize different testing providers, and each provider may test you on different skills. Testing providers by state are listed below, followed by the list of skills tested by each provider.
- American Red Cross, approved university, or private entities: IL, IN, KY, MA, ME, UT, WV
- Headmaster: AZ, MT, ND, NH, NJ, NV, OH, OR, SD, TN, VT
- Credentia: AL, AK, CA, CO, DC, GA, LA, MD, MN, MS, NH, NC, ND, PA, RI, SC, TX, VA, VT, WA, WI, WY
- Prometric: AL, AR, CT, DE, FL, HI, ID, LA, MI, NM, NY, OK, WY
| Skill | Pearson Vue | Prometric | Headmaster |
|---|---|---|---|
| Hand Hygiene (Hand Washing) | x* | x* | x |
| Applies one knee-high elastic stocking | x | x | |
| Assists to ambulate using transfer belt | x | x* | x |
| Assists with use of bedpan | x | x | x |
| Cleans upper or lower denture | x | x | x |
| Counts and records radial pulse | x | x | x |
| Counts and records respirations | x | x | x |
| Donning and removing PPE (gown and gloves) | x | ||
| Dresses client with affected arm | x | x | |
| Feeds client who cannot feed self | x | x | x |
| Gives modified bed bath (face and one arm, hand and underarm) | x | x | |
| Measures and records blood pressure | x | x | |
| Empty, measure and record urinary output | x | x | |
| Measures and records weight of ambulatory client | x | x | |
| Performs modified passive range of motion (PROM) for one knee and one ankle | x | x | |
| Performs modified passive range of motion (PROM) for one shoulder | x | x | |
| Positions client on side | x | x | x |
| Provides catheter care for female | x | x | |
| Provides foot care on one foot | x | x | |
| Provides mouth care | x | x | x |
| Provides perineal care (PERI-CARE) for female | x | x | |
| Transfers from bed to wheelchair using transfer belt | x | x | x |
| Indirect Care | x* | ||
| Change bed linen while the resident remains in bed (not tested in Wyoming) | x | x | |
| Provide hand and nail care | x | x | |
| Gives partial bed bath and back rub | x | ||
| Provide resident with passive range of motion (ROM) exercises to one elbow and wrist | x | ||
| Abdominal Thrust | x | ||
| Ambulation with cane or walker | x | ||
| Back rub | x | ||
| Dressing client | x | ||
| Fluid intake | x | ||
| Hair care | x | ||
| Mouthcare of a comatose client | x | ||
| Passing fresh water | x | ||
| Range of motion exercise | x | ||
| Transfer from wheelchair to bed using a gait belt | x |
* Indicates a required skill
Another thing to point out is that not all states use the term ‘Certified Nursing Assistant’. In some states, this position is referred to as a ‘Nursing Aide’ instead. This could cause some confusion when you are researching things for your specific state, so just keep this in mind in the event you see it referred to as a ‘Nursing Aide’ instead.
Once you pass your state issued CNA exam, you will then be a licensed CNA. In order to keep that license active, you may need to complete a continuing education course every two years. Whether or not you need to complete this course will be determined by the state you work in. Before paying for this course, check with your employer and find out if they offer continuing education subsidization. Most employers will end up reimbursing their CNA for this fee once they pass the continuing education course. You can find out more about continuing education on the CNA Zone website.
As you prepare for the skills test, it’s important to remember that the tests are conducted in a clinical setting and replicate a sample patient experience. Thus, it is important to have a strong grasp of all hands-on skills that you may have to demonstrate competency in.
CNA Skills You May Be Tested On
- Hand Hygiene
- Applying knee-high elastic stockings
- Bedpan assistance
- Ambulation using a transfer belt
- Denture cleaning
- Recording a radial pulse
- Counting and recording respirations
- Dressing clients with weak or injured arms
- Feeding patients
- Assisting with bed baths
- Recording and measurement of patient or client blood pressure, weight, and urinary output
- Patient side positioning
- Foot care
- Providing mouth care
- Perineal care
- Moving the patient from a wheelchair to a bed using a transfer belt
Tips for the CNA Skills Test
We’ve compiled a number of tips from people who have passed the exam, and you may find many of these useful as you work through your CNA skills test practice routine.
- Make absolutely certain that you have the handwashing procedure down to a science. If you fail the handwashing skill you’ll fail the exam. Make absolutely certain that you do each step in the proper order and for the proper duration.
- Practice all of your measurements – blood pressure, urinary output, weight, radial pulse, and respiration
- Make certain you know the bold steps and complete them properly. Missing these will lead to failure.Practice on another person. Let them have the step by step instructions for the skill. Have them stop you and correct you when you make a mistake. You want to get to a point that you can perform the skills by muscle memory. Write down or highlight steps that you struggle with and drill them continuously up to the day of your test.
- Almost every skill starts with introducing yourself and explaining the procedure facing the patient, and finishes with ensuring that the signalling device is within reach, the bed is in low position, and you must wash your hands. If you can remember this useful tip it will knock out several steps you’ll need to remember for most of your skills.
- On the day of the exam, you’ll receive the list of skills you’ll need to demonstrate. Calm yourself and focus on those skills and begin running yourself through your mental checklist for each skill before you begin. Once you successfully run through the list, you’ll be confident when you begin the exam.
- If you’re unfamiliar with any equipment that you’ve had little access to practicing with, be sure to ask questions before the exam begins. You will not be allowed to ask questions once the test has started.
Preparation for becoming certified and passing the skills test will occur during on the job clinical experience. Despite having prior exposure to these potential test requirements, potential nursing aides must have the ability to practice the skills outside of the healthcare facility before being asked to do them in front of an examiner. These skills CNAs are required to demonstrate are not simply to pass the test, but are required for the proper care of those in need. Therefore, it is recommended that applicants for certification do their homework before going in to take the test.
Many people find that creating their own CNA skills study guide can prove helpful to their eventual score. It’s important to be able to memorize and successfully perform the steps of each skill, so creating flash cards with each step can be an effective way to really hammer home the details of each of the skills a CNA is expected to have down pat. Another good way to brush up on these hands-on patient/client skills is to watch CNA test skills videos. A listing of more of these videos can be found here.
It is a good idea to spend some time performing the critical skills you will need to know as a CNA. To do so, you can practice with family or friends to get comfortable performing these tasks on clients. Put together a checklist and give it to your friend or family member prior to starting. List each step required for a particular skill and have that person let you know if you miss a step. Practice at home, at school, at work, etc. You want these skills to become second nature to you, prior to even taking the exam. Practice the steps for each of them often. Your attention to the patient, their rights, their safety, and their needs should be your priority. During the actual exam, the evaluators are going to be watching to make sure you are attentive to your patient’s needs.
Because you will need all the hands-on practice you can get, consider finding places to volunteer or intern with. Get with the nursing assistant instructor and find out if they will let you spend some time in that room practicing as well. Also, some Red Cross locations offer practice testing materials. You can check here to find out more details from your local American Red Cross testing center.
Remember practice, practice, practice!
CNA Skills Test Practice Videos
The following videos can help you learn more about the correct techniques of some of the more commonly tested skills from the CNA exam.
Apply one knee-high elastic stocking
Assist to ambulate using a transfer belt
Cleaning upper or lower dentures
Count and record radial pulse
Count and record respirations
Donning and removing PPE (a.k.a. gown and gloves)
Dress client with affected right arm
Feeding the client
Give modified bed bath
Measuring and recording urinary output
Weighing an ambulatory client
Passive range of motion for one knee and one ankle
Passive range of motion for one shoulder
Position client on side
Catheter care for female
Foot care
Mouth care
Provide perineal care for female
Transfer from bed to wheelchair using transfer belt
Indirect care
Assist resident needing to use a bedpan
Change bed linen while the client remains in bed
Hand and nail care
Passive range of motion to one elbow and wrist
CNA Skills Test FAQ
As a CNAs practice their skills prior to taking the test, they often have a lot of questions. We’ll try to answer some of the more common ones we’ve heard.
Is the CNA skills test hard?
Many people fail the skills test on the first try, so it would be unfair to say that it’s easy. That said, most people find the test to be easier after becoming more comfortable with the format of the test and overcoming their nerves. If you search message boards around the web you’ll find that many aspiring CNAs used their first failure as a tool to help them succeed on their next attempt.
How many times can you take the CNA skills test?
Unfortunately, many people will not pass the CNA skills test on the first try. The exam is difficult, and that’s why most states will allow you to take the test three times within two years of completing your CNA program.
How long does the CNA skills test take?
The skills test usually takes 25-30 minutes depending on you provider. Typically you’ll be asked to perform five skills during your skills test.
What score is needed to pass the CNA skills test?
The passing score for the CNA skills test is somewhere between 70% and 80% depending on the state where you’re seeking certification and the provider administering your skills test.
How is the CNA skills test graded?
When you demonstrate the individual skills during the test, the Nurse Aide Evaluator will run through a checklist for each skill marking down any deficiencies you have for that skill. A typical passing score is somewhere between 70-80% depending on your state. Not every element is scored equally, with certain steps (sometimes called “bold steps”) being critical elements for passing a certain skill.
Need a practice exam to help you prepare for the written test?
If you need some assistance with passing the written exam, you might want to check out our CNA practice tests to help you prepare.