Free CNA Final Exam Practice Test 2026

The Certified Nursing Assistant (CNA) competency evaluation is the state-administered licensing exam required to become a certified nurse aide. It consists of two components: a written (or oral) knowledge test and a hands-on clinical skills evaluation. The written portion typically includes 60–100 multiple-choice questions covering all domains of CNA practice, and candidates must score 70–75% or above (varies by state) to pass. The clinical skills portion requires candidates to demonstrate 3–5 randomly selected nursing skills in front of an evaluator. Both portions must be passed to receive CNA certification and be listed on the state nurse aide registry.

The CNA exam covers eight primary content domains: (1) Roles and Responsibilities of the Nurse Aide — scope of practice, OBRA requirements, chain of command, care plans, mandatory reporting; (2) Safety and Emergency Procedures — fall prevention, fire safety (RACE/PASS), body mechanics, emergency response; (3) Infection Control — standard precautions, transmission-based precautions, hand hygiene, PPE; (4) Communication and Interpersonal Skills — therapeutic communication, documentation, HIPAA, barriers to communication; (5) Patient Rights and Independence — OBRA resident rights, informed consent, abuse/neglect, ombudsman; (6) Personal Care Skills — bathing, oral care, perineal care, skin integrity, dressing; (7) Basic Nursing Skills — vital signs, ambulation, I&O, catheter care, ROM, therapeutic applications; (8) Mental Health and Social Service Needs — Maslow's hierarchy, dementia care, grief stages, depression recognition, therapeutic response.

Most states require a minimum passing score of 70% on the written portion of the CNA competency evaluation. Some states require 75%. The clinical skills portion is scored on a pass/fail basis for each skill — you must demonstrate the skill correctly according to the evaluator's checklist, including hand hygiene before and after each skill. If you fail one component (written or skills), you typically need only to retake the failed component, not both. Most states allow 3 attempts within a specific timeframe (usually 24 months from program completion). Check your specific state's requirements on the state nurse aide registry website.

Common CNA clinical skills that may be evaluated include: handwashing technique; vital signs (blood pressure, temperature, pulse, respirations); personal care (bed bath, perineal care, oral care, back rub, hair care, nail care); positioning (Fowler's, lateral, repositioning in bed); transfers (bed to wheelchair using gait belt, two-person transfer); ambulation with assistive devices; range of motion exercises; catheter care; measuring urinary output; applying anti-embolism stockings; making an occupied or unoccupied bed; feeding a dependent resident; and applying a cold pack. The specific skills evaluated vary by state and testing organization (Pearson Vue, Prometric). Know all skills but practice the highest-frequency ones most thoroughly.

High-priority infection control concepts for the CNA exam: (1) Handwashing is the single most effective infection prevention measure — wash for at least 20 seconds; soap and water required for C. diff and norovirus, not just alcohol sanitizer; (2) Standard Precautions apply to ALL patients regardless of known diagnosis; (3) Transmission-based precautions — Contact (MRSA, C. diff — gloves and gown), Droplet (influenza, pertussis — surgical mask), Airborne (TB — N-95 respirator, negative pressure room); (4) Correct order for donning PPE: gown, mask, goggles, gloves; doffing: gloves, goggles, gown, mask; (5) Never recap needles — dispose directly in sharps container; (6) Chain of infection has 6 links — breaking any link prevents infection.

OBRA 87-mandated resident rights that CNAs must know: right to be treated with dignity and respect; right to privacy during personal care and communications; right to refuse treatment; right to be free from abuse, neglect, and exploitation; right to be free from unnecessary physical and chemical restraints; right to participate in care planning; right to voice grievances without retaliation; right to be informed of rights and facility rules; right to manage personal finances; right to receive visitors of their choice; right to send and receive mail unopened; right to be transferred or discharged only for valid reasons with proper notice. Every CNA action should be filtered through the question: 'Does this respect this resident's rights and dignity?'

Clinical skills exam preparation: (1) Practice each skill until the steps are automatic — evaluators score based on a specific step-by-step checklist; (2) Always begin and end every skill with hand hygiene (this is a critical step that will cause automatic failure if missed); (3) Explain each step to the 'resident' (mannequin or volunteer) as you perform it — communication is part of the evaluation; (4) Maintain privacy throughout (close the curtain/door); (5) Ensure safety (lower side rails, use gait belt, verify proper identification); (6) Know the correct body mechanics for every skill; (7) Practice with a partner and use your state's specific skills checklist (available from Pearson Vue or Prometric) — different states use slightly different protocols; (8) Time yourself — evaluators note if skills take excessive time.