Guide to Studying for and Taking the CNA Competency Exam

To practice as a Certified Nurse’s Aide, sometimes referred to as a Certified Nurse’s Assistant, you have to have 75 hours of state-approved training and pass a competency examination. The exam will test both clinical skill and conceptual knowledge with a written multiple-choice section and a practical section. Various sample tests can be found online, and other study materials, such as practice books and textbooks, can be bought used or new from retailers.

Principles of the Certified Nursing Aide Competency Exam

The reason that nursing aides who work in certain facilities need to be certified is to assure that all of them, whatever their educational background, can demonstrate the same level of professionalism and competency in core skills. The CNA test, as with any standardized test, is designed to prove that students who pass it are qualified to work in any of the many kinds of facilities where CNAs may be employed. The following are some questions from a sample of the written portion of the CNA exam:

  • A resident [of a nursing home] who is lying in bed suddenly becomes short of breath. After calling for help, the nurse aide’s next action should be to:
    1. ask the resident to take deep breaths.
    2. take the resident’s vital signs.
    3. raise the head of the bed.
    4. elevate the resident’s feet.
  • When a person is admitted to the nursing home, the nurse aide should expect that the resident will:
    1. have problems related to incontinence.
    2. require a lot of assistance with personal care.
    3. experience a sense of loss relating to the life change.
    4. adjust more quickly if admitted directly from the hospital.
  • The doctor has told the resident that his cancer is growing and that he is dying. When the resident tells the nurse aide that there is a mistake, the nurse aide should:
    1. understand that denial is a normal reaction.
    2. remind the resident that the doctor would not lie.
    3. suggest the resident ask for more tests.
    4. ask if the resident is afraid of dying.

Some questions are designed to test the intuition and empathy of the exam-taker, and there may not be an actual right or wrong answer, so much as a gradient of more or less correct answers. Some answers are more straightforwardly right or wrong, and either you know the answer, or you don’t. For the correct answers to the above questions, scroll to the last paragraph of this article.

CNA Exam: The Practical Section

On-the-job skills are the emphasis of the practical part of the CNA exam. The test proctor will watch as you go through a care regimen with a patient (likely an actor playing a patient). You’ll have to demonstrate five skills routinely used by CNAs, and your score is generated based on how well you perform the tasks without being prompted and how well you communicate with the patient while giving care. Some of the skills that may be tested include:

  • Personal Care: Bathing and grooming patients is a large part of a CNA’s job. This skill is very likely to be tested in the clinical portion of the CNA exam.
  • Use of Restorative Devices: You need to know how to use and help others use mobility aids, such as walkers, crutches, and prostheses, and devices that generally improve a patient’s functions or lifestyle, such as catheters or other bowel and urinary control or training fixtures.
  • Mental Health Needs: Knowing how to address a patient’s mental health needs, and how to interact with patients who have schizophrenia, dementia, or psychosocial disabilities, is crucial, especially if you plan to be a CNA in a facility that specializes in nursing care for the mentally disabled.
  • General Nursing Skills: Maintaining a clean environment, washing hands (yours and patients’), recognizing symptoms and abnormalities in routine; all of these are required of CNAs regularly, and should be performed by rote.

The chart below visualizes the comparative importance of various general skills for registered nurses, which are similar to the skills you’ll need to keep sharp as a CNA.

The skills listed above may not all be tested fully in your practical CNA exam, but you won’t be told which will be tested prior to the exam, so you need to know them all well enough to perform them under pressure. There are many online forums where CNAs who have already taken the test offer advice for those who haven’t yet. Some of the tips provided include:

  • Talk Through It: Many CNAs who have taken the practical exam say that saying everything out loud to the patient as they did it helped them maintain a good flow throughout their exam routine. For example, saying “OK, sir, now I’m going to wash my hands before I empty your catheter bag,…” et cetera, helped the test-taker remember what they were doing and do everything in the right order.
  • Take Your Time: Trying to do everything quickly won’t get you a better score, and will probably stress you out and increase your likelihood of making a mistake. If you feel like you’re about to choke, pause for a moment to breathe. Your test proctor won’t hold this against you, and it could help your overall performance.
  • Give Yourself a Practice Test: You can create your own practice test for the practical part of the CNA exam by making a flash card of each type of skill you might be tested on, then shuffling them and having a friend pick a few out for you. That way, the skills you test are randomly selected, and you can get a feel for how the actual test will go while also practicing the actual skills.

How to Study for the CNA Exam

The tips for studying for the CNA exam are basically the same as those for studying for any other standardized test. Make flash cards, get a preparatory book and spend a few hours per day looking at it during the weeks before your test, take practice tests and get your friends to surprise you with pop-quizzes so you can test your knowledge on the fly. There are so many resources available to help you with the CNA exam that the only difficulty will be finding time and keeping your motivation up to actually do the work.

Getting a Job as a CNA

Once you pass the test, the next thing on your to-do list should be applying for jobs. If you can make some connections through your class, or do some volunteering or an internship to get your foot in the door at a facility, you’ll have an easier time scoring employment. If that doesn’t work out, you’ll just have to apply to jobs cold, but since the market is so strong for CNAs now, you shouldn’t have too hard of a time finding work. A few steps to take while job hunting to make sure your first job is a stepping stone to bigger and better ones are as follows:

  • Apply for a Lot of Jobs: If you apply for many positions, your chances of getting one are higher, and once you’ve gotten an offer, you can use it as leverage in bargaining for higher pay at subsequent offers.
  • Negotiate Your Pay: CNAs don’t earn a lot, compared to the national median income, but negotiating your pay is always a good plan, because your salary at your first job can influence your next job and your lifetime earnings.
  • Be Aggressive: Seeing someone in person is always better than just talking to them on the phone. Try hard to get a chance to make a good impression in person. People are wired to remember faces, so getting your face in front of someone with hiring power can be the deciding factor in your job search.

There may be some variance between states as to requirements for practicing nurse aides. Before you begin your nursing assistant training, contact your State Nurse Aide Registry and/or State Licensing Board to learn about their requirements. You also might check the requirements for nursing assistants in any state where you’d like to work later on to make sure you meet those qualifications. If you’re ready to start working toward a job as a Certified Nurse Aide, check out some of the accredited programs linked to on this site, and find one that can help kick start your career.

Schools with nursing assisting programs

Kaplan University Kaplan University — Kaplan University is an accredited university, offering 170 degrees and programs. Kaplan University's Associate of Applied Science in Medical Assisting and Nursing prepare students to pursue entry-level positions in the ambulatory medical field and for entry-level positions in health information management. Financial aid is available for those who apply and qualify.
Keiser University Keiser University — Keiser University is an accredited university offering over 80 programs. Keiser University's Associate of Science degree in Medical Assisting prepares you for a fulfilling career in health care, shaping you to be an essential part of a physician's office, clinic or other medical environments. The Associate of Science degree in Health Services program prepares students in both business and health service administration. Click Here
Sanford Brown College Sanford Brown College — Sanford Brown College offers more than 20 unique associate and bachelor's degree programs. The Associate of Applied Science in Nursing program prepares students for entry-level nursing in a private practice, hospital, clinic or government agency. Financial aid is available for those who apply and qualify. Click Here
National American University National American University — National American University is an accredited institution and offers more than 20 accelerated certificate and Associate of Science degree programs in the business, medical and technical fields. The AS in Nursing program at NAU offers comprehensive back office training to provide support to physicians and direct patient care in a variety of medical settings. Click Here

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