CNA Certified Nursing Assistant Exam — Everything You Need to Know in 2026

The CNA exam has two separate parts. The written (or oral) knowledge test covers nursing theory, patient care, safety, and communication. The clinical skills evaluation is a hands-on assessment where you demonstrate 3 to 5 nursing procedures — positioning a patient, hand hygiene, measuring vital signs, assisting with ADLs — in front of a state evaluator. You must pass both parts to earn your Certified Nursing Assistant credential.

The exam is state-administered, so the format varies depending on where you live. Most states use one of three testing companies: Prometric, Pearson VUE, or Headmaster. The number of questions and passing threshold differ by state and provider. Check with your state nursing aide registry or your training program to find out which version applies to you.

A CNA credential is required for employment in nursing homes, assisted living facilities, hospitals, and home health agencies. CNAs provide direct patient care under the supervision of licensed nurses and are the most hands-on caregivers in most clinical settings.

You need 70% to pass — that's at least 49 correct out of 70 scored questions.

Register through your state nursing aide registry or the testing company assigned to your state. Your training program should provide scheduling instructions after you complete the required hours. The fee ranges from $25 to $125. Some states cover the cost of the first attempt for graduates of approved programs.

After your application is approved, schedule your written and clinical skills exams. Most states require you to pass both within a set window — often 24 months of completing training — or you'll need to repeat parts of the training.

A state-approved CNA training program is required before you can test. Federal law requires at least 75 hours of training, including 16 hours of supervised clinical instruction, but most states require more.

Training hours vary significantly by state. California requires 160 hours, Florida requires 120 hours, Texas requires 100 hours, and New York requires 100 hours. Programs typically run 4 to 12 weeks and are offered at community colleges, vocational schools, hospitals, and some long-term care facilities.

Testing providers vary by state. Knowing which company handles your state helps you find the right practice materials and exam format.

Texas, Florida, Georgia, and North Carolina use Headmaster for CNA testing. California, Ohio, Michigan, Washington, and Massachusetts primarily use Prometric. Illinois uses Pearson VUE. Your state nursing aide registry's website lists the current testing provider.

Retake rules also differ by state. Most allow unlimited attempts but require a 2-week to 60-day waiting period between exams. Fees for retakes are typically the same as the initial exam fee.

CNAs earn between $30,000 and $42,000 annually on average, with higher wages in California, Washington, and Massachusetts. In high-demand metros, entry-level CNAs can start above $18 per hour. Night shifts, weekend differentials, and agency placements can push take-home pay higher.

The CNA credential is a common starting point for healthcare careers. Many LPNs and RNs began as CNAs. Nursing schools frequently count CNA experience toward clinical hours, and some employers offer tuition assistance for working CNAs pursuing nursing degrees.

The Bureau of Labor Statistics projects solid job growth for nursing assistants through 2032, driven by an aging population and increasing demand for long-term care.

The candidates who fail typically do one of three things: they cram at the last minute, they study everything equally instead of targeting their weak areas, or they read passively without testing themselves. All three are fixable.

The most effective approach: take a practice test first, before you've studied anything. Your score tells you exactly which of the 9 topics need the most attention. Then focus your flashcard sessions on those weak areas using spaced repetition — reviewing at increasing intervals so the information actually sticks.

As your exam date gets closer, switch to full timed practice tests under realistic conditions. You want to be scoring comfortably above the passing threshold before you walk in.

Once you know your weak areas, flashcards are the fastest way to close the gaps. Prepdex builds your study sessions around the topics where you're losing points — not a generic review of everything.

Each session takes about 10-15 minutes. You study the topics that matter most for your score, in the order the exam weights them. The spaced repetition scheduling makes sure you see things again before you forget them.