Where Can You Challenge the CNA Exam?

studying for cna challenge exam

Some people are quick studies, and some people don’t have much patience. Either way, if you’re looking to become a CNA, you may find it advantageous both from a time saving perspective and a cost perspective to skip a formal training course. For those with prior healthcare experience or education, there’s a unique opportunity: challenging the CNA exam.

We’ll take a look into the ins and outs of challenging the CNA exam, exploring the advantages, disadvantages, and providing a comprehensive list of states where this approach is permitted. Understanding this process is crucial for aspiring CNAs looking to streamline their path into the healthcare profession.

Understanding the Process of Challenging the CNA Exam

Challenging the CNA exam is a pathway designed for individuals with existing healthcare knowledge or educational background. Here’s a breakdown of the process:

  • Concept Explained: Challenging the CNA exam involves demonstrating your proficiency in the skills and knowledge required for the role without undergoing formal training.
  • Requirements and Qualifications: Individuals aiming to challenge the CNA exam typically need to showcase prior healthcare experience, completed nursing education, or equivalent qualifications.
  • Process and Steps: The process involves submitting an application to the state nursing board, providing evidence of eligibility, and then taking the CNA exam. Successful completion grants you CNA certification.

Pros and Cons of Challenging the CNA Exam

Challenging the CNA exam comes with its set of advantages and disadvantages:

  • Advantages:
    • Time and Cost Savings: Challenging the exam allows you to bypass formal training, saving both time and money.
    • Recognition of Prior Knowledge: It acknowledges and leverages your existing healthcare expertise.
  • Disadvantages:
    • Risk of Failure: Without formal training, there’s a higher risk of not passing the exam.
    • Need for Solid Understanding: Challenging the exam requires a robust understanding of CNA duties, responsibilities, and protocols.

States Allowing Challenging the CNA Exam

If you’re considering challenging the CNA exam, it’s essential to know where this option is available. Here’s a list of states that permit challenging the CNA exam:


In Florida, individuals can challenge the Certified Nursing Assistant (CNA) exam without completing a state-approved training program. Here’s a summary of the process:

  1. Training Program Not Required:
    • Unlike some states, there is no requirement for applicants to undergo a state-approved training program before taking the CNA exam.
  2. Educational Requirement for Challenge:
    • Applicants challenging the exam without completing an approved training program must have either a high school diploma or its equivalent.
    • Alternatively, applicants can be 18 years of age or older.
  3. Background Screening:
    • Applicants must successfully pass a required background screening as part of the certification process.
  4. Nursing Assistant Competency Examination:
    • The CNA exam consists of two portions:
      • Written Portion: Both written and skills-demonstration portions are required unless the applicant completed an approved training program within six months of applying.
      • Skills-Demonstration Portion: This practical section assesses the applicant’s ability to perform essential nursing assistant skills.
  5. Minimum Score Requirement:
    • Applicants must achieve a minimum score on the nursing assistant competency examination. The specific minimum score is established by the board.
  6. Examination Administration:
    • The CNA competency examination is approved by the board and administered at a site and by personnel approved by the Department of Health.
    • Learn more


In Missouri, individuals have the opportunity to challenge the Certified Nurse Assistant (CNA) exam under specific criteria. Here’s a summary of the process:

  1. Approval to Challenge:
    • Individuals meeting special criteria can challenge the CNA exam without completing the full certified nurse assistant course.
    • The challenge includes both a written (knowledge) and practicum (skills) test.
    • If the challenge exam is unsuccessful, the applicant must complete the full CNA course and exam for certification.
  2. Submitting a CNA Challenge Request:
    • Interested individuals must submit a written request expressing their intent to challenge the CNA exam.
    • The request should include an explanation of how they qualify for the challenge.
    • Required documents include a clear copy of the individual’s Social Security Card, a valid email address, current mailing address, and daytime telephone number.
    • Additional documents based on the qualification for challenging (e.g., transcript, letter of recommendation, or proof of training) must be submitted.
    • The request is emailed to [email protected].
  3. Requirements to Challenge the CNA Exam:
    • Individuals meeting specific criteria are eligible to challenge the exam.
    • Criteria include:
      • Enrollment in a professional (RN) or practical (LPN) program for at least four (4) months with successful completion of a Fundamentals of Nursing course.
      • RN or LPN nursing licensure candidates who have failed the state licensure examination.
      • Individuals certified and active on another state’s nurse aide registry.
      • Students who have completed a nursing program outside the United States and are awaiting licensure in the country.
      • Completion of the Unlicensed Assistive Personnel (UAP) training, with training hours mirroring CNA training.
      • Individuals listed on the Missouri State Certified Nurse Assistant Register on inactive status.
      • Any other individuals with a background, education, and training in gerontology and health occupations, meeting the components of the approved training curriculum.
  4. Documentation for Specific Qualifications:
    • Each qualification category requires specific documentation for the challenge process.
    • Documentation includes official transcripts, letters from program directors, certification of completion, proof of out-of-country license or certificate, and background check information.
  5. Submission of Materials:
    • All required documents and materials must be submitted along with the challenge request.
  6. One Attempt Only:
    • Individuals are allowed only one attempt to take the challenge examination, which includes both the knowledge and skills test.
  7. Evaluation by Health Education Supervisor:
    • For individuals with backgrounds in gerontology and health occupations, their education and training will be evaluated by the supervisor of Health Education, Division of Regulation and Licensure.
  8. Successful Challenge or Full Course Completion:
    • Successful completion of the challenge exam leads to CNA certification in Missouri.
    • If unsuccessful, the applicant must complete the full CNA course and exam for certification.
    • Learn more


In Montana, candidates have the opportunity to challenge the state examination once without the prerequisite of completing a state-approved training program. However, should the examination result in failure, the individual is then required to enroll in an approved program for further preparation. Notably, those who successfully complete approved programs are granted up to three attempts at the examination.

Upon successfully challenging the examination, nurse aides undergo an additional assessment by a licensed nurse within their employing agency. This evaluation encompasses a comprehensive review of all skills outlined in the state curriculum. For a detailed listing of the requisite skills, individuals may refer to the Montana Department of Public Health and Human Services (DPHHS) website.

The CNA exam in Montana is proctored by Headmaster. You will need to contact them directly if you would like to challenge the exam.


Individuals possessing qualifications equivalent to a Nurse Aide Training and Competency Evaluation Program (NATCEP) now have the opportunity to challenge the Nurse Aide competency exam. This unique avenue allows qualified candidates to request examination participation without undergoing the conventional NATCEP. To initiate the challenging process, candidates are required to diligently complete and adhere to the Challenge Application & Instructions. Access to the application and instructions is conveniently available by clicking here. It is imperative to note that only applications that are both complete and accurate will be processed.

You can find the challenge instructions here.

Factors to Consider Before Challenging the CNA Exam

Before deciding to challenge the CNA exam, consider the following factors:

  • State-Specific Requirements: Each state may have unique prerequisites, so thoroughly review them before making a decision.
  • Preparation Materials: Ensure you have access to adequate study materials and resources to prepare for the exam.
  • Knowledge and Skill Preparation: Assess your existing knowledge and skills to determine if you’re well-prepared for the challenge.

Preparing for the CNA Challenge Exam

Preparation is key to success when challenging the CNA exam. Here’s how you can get ready:

  • Recommended Study Materials: Utilize CNA exam study guides, textbooks, and online resources to reinforce your knowledge.
  • Self-Study Options: Consider self-study options, such as online courses or practice exams, to enhance your understanding of CNA responsibilities.
  • Diligent Preparation: Approach the challenge with dedication and diligence, ensuring you cover all relevant topics.

At the end of the day, challenging the CNA exam can be a viable option for those with prior healthcare experience or education. Understanding the process, weighing the pros and cons, and being aware of the list of states allowing this approach are crucial steps in making an informed decision. If you’re considering this route, take the time to thoroughly prepare, adhere to state-specific guidelines, and embrace the opportunity to embark on a fulfilling career in healthcare.

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