How is the CNA structured?

The Certified Nursing Assistant (CNA) exam is structured to assess both theoretical knowledge and practical skills necessary for the role. The exam is typically divided into two main parts: a written (or oral) examination and a clinical skills test. Here's a detailed breakdown of each section:

1. Written (or Oral) Examination
Format: This portion is usually conducted in a multiple-choice format and consists of around 60 to 100 questions, depending on the state. The questions are designed to assess the candidate’s knowledge of basic nursing concepts, patient care, and other relevant topics.

Content Areas: Topics typically covered include infection control, patient rights, communication, basic nursing skills, personal care skills, mental health care, care for the cognitively impaired, and basic restorative services.
Oral Option: Some states and testing providers offer an oral version of the written exam for those who have reading difficulties or prefer an auditory testing method. This might be available in English or other languages, depending on the state.

2. Clinical Skills Test
Skills Assessment: This part requires candidates to demonstrate several nursing assistant tasks in a controlled, clinical setting, usually a mock clinical environment. Candidates are evaluated on their ability to perform these skills accurately and safely.
Number of Skills: Typically, candidates are asked to perform 3 to 5 selected skills from a set of possible skills that a CNA needs to know. These skills are selected randomly and might include tasks like handwashing, measuring vital signs (like blood pressure, pulse, respiration), patient mobility assistance (like transferring from bed to wheelchair), and personal care skills (like assisting with grooming or bathing).

Evaluation: Each skill is evaluated based on a checklist that includes key action steps and safety measures. To pass, candidates must perform all critical steps correctly. The evaluator observes and checks off each step as the candidate performs them.

General Testing Conditions and Scoring
Duration: The written exam typically lasts about 90 minutes to two hours, while the skills test duration depends on the number of skills being tested but generally takes about 30 to 45 minutes.

Scoring: Each part of the exam is scored separately. Candidates must pass both the written (or oral) and the clinical skills test to become certified. The passing score for the written test is usually a percentage of correct answers, typically around 70% to 80%, while the skills test requires a near-perfect performance on each demonstrated skill, especially on critical safety steps.

Retakes: If a candidate fails one part of the exam, they usually have the option to retake just that part, depending on state regulations.

Candidates are encouraged to check with their specific state’s guidelines and the testing agency’s rules for detailed information about the exam structure, content, and preparation recommendations, as these can vary slightly by jurisdiction.