Credentia (NNAAP) vs Prometric: Comparing the Two CNA Test Vendors (2026 Guide)

Why your state's vendor changes the exam you sit

Nurse aides talk about "the CNA exam" like it's one test with one set of rules. It isn't. The credential is administered state by state, and each state contracts with a vendor to deliver the competency evaluation. Most states use Credentia, which runs the National Nurse Aide Assessment Program (NNAAP), or Prometric. A few use Pearson VUE or run their own program.

That contract decides how many questions you'll answer, how long you get, how the skills evaluation is structured, what you pay, and how many times you can retake a failed part. So the first practical step in prep isn't buying a book — it's finding out which vendor your state uses and downloading that vendor's candidate handbook for your state. Everything below is a comparison of the two you're most likely to meet.

One warning before the details: both vendors publish state-specific handbooks, and the figures in them differ from state to state. What follows is drawn from the handbooks named in each line. Treat them as the common pattern, not as a national rule.

Credentia (NNAAP) vs Prometric at a glance

The knowledge test: item count and clock

This is the difference candidates notice first. The knowledge-test item count varies by vendor and state, and there's no national figure. Credentia's NNAAP state handbooks commonly describe a 70-question multiple-choice Written Examination, usually with 2 hours (120 minutes) allowed. Prometric state materials commonly describe a 60-question multiple-choice written test with 90 minutes allowed. Both numbers come from specific state handbooks, and individual states may deviate.

Do the arithmetic on either one and you'll see the same thing: neither is a race. Nurse aides who fail the written test rarely fail because the clock beat them. They fail because they guessed on infection-control and resident-rights items they never drilled. If you want the item-count question broken down further, we cover it in how many questions are on the CNA written exam.

The oral option

Both vendors offer an oral or audio alternate for candidates who have difficulty reading. Under NNAAP state handbooks that alternate is structured as 60 multiple-choice questions plus 10 reading-comprehension questions. Prometric offers an oral version as well. You normally have to select this option when you register — not on test day — so read your handbook before you submit the form.

What's actually on it

Prometric publishes a Nurse Aide Written Test Content Outline with five domains and weights: Role of the Nurse Aide at 20%, Promotion of Safety at 22%, Promotion of Function and Health of Residents at 20%, Basic Nursing Care Provided by the Nurse Aide at 24%, and Providing Specialized Care for Residents with Changes in Health at 14%. Credentia's NNAAP written test covers parallel nurse-aide territory — physical care skills, psychosocial care skills, and the role and responsibilities of the nurse aide — but the domain labels and weights are not the same. Domain names and weights are vendor-specific, so check the outline for the vendor your state uses rather than assuming the Prometric split applies to you.

The skills evaluation: same rule, different packaging

Here the two vendors converge more than they diverge. The number and selection of tested skills vary by vendor and state, but the structure is consistent: you perform a small set of randomly selected hands-on skills and you must pass all of them. There is no partial credit and no averaging across skills.

Credentia's NNAAP state handbooks specify 5 randomly selected skills, commonly with 30 minutes allowed, and a Satisfactory result required on all 5 of 5. Prometric specifies 5 clinical skills — 3 prompted plus 2 unprompted, the unprompted pair being handwashing and an indirect-care skill — all of which must be passed. Handwashing is commonly treated as a mandatory or critical skill either way, which is why experienced aides drill it until it's automatic.

The practical difference is the prompting. Prometric candidates are expected to produce two skills without being told to; NNAAP candidates work through a selected set. In both cases the evaluation is performed in person on a live person or manikin and scored by an evaluator or recorded per the vendor's protocol. If you want the skill-by-skill breakdown, start with our guide to the specific skills tested on the CNA skills exam.

Scoring and passing: no national cut score exists

There is no single national CNA passing score. The competency evaluation has two components and both must be passed, but the standard is set per state and vendor.

On the skills side, the rule is explicit with both vendors: candidates must perform all selected skills correctly. Credentia (NNAAP) state handbooks require a Satisfactory result on all 5 of 5 skills, and Prometric likewise requires passing all 5 clinical skills. On the knowledge side, written cut scores are set by the state, and many state registries report results only as Pass/Fail with no numeric score released at all. Any source telling you the national CNA passing score is a specific percentage is guessing — it varies.

Both components are scored separately, and you have to pass both before your name goes on the state nurse-aide registry. Fail one and you keep the pass on the other in most states, then retake only the failed part under that state's rules. We unpack the scoring model further in what counts as a passing score for the CNA exam.

Pass rates

There's no centrally published national CNA pass rate either. Because the credential is administered separately by each state through Credentia (NNAAP), Prometric, Pearson VUE, or a state-run program, results aren't aggregated into a single official national figure. Any nationwide pass-rate number you see should be treated as an estimate, not an official statistic — and it certainly isn't a fair way to compare the two vendors.

Fees and retake rules: both are state-set

Testing fees vary by state and are set in each state's contract with the vendor. There is no national CNA exam fee. Fees are commonly split between the written (or oral) test and the skills evaluation, and combined totals published in state handbooks typically fall in roughly the $100–$200 range depending on the state. Both vendors state that fees are non-refundable and non-transferable, and that a new examination fee is required to retake any failed part. Look up your own state handbook for the exact amount.

Retake rules are state-set and also vary. A common pattern in Credentia (NNAAP) state handbooks is that you must pass both the written (or oral) and skills components within 3 attempts per component and within a fixed window from training completion — commonly 2 years, though some states use 1 year — whichever comes first. Exhaust the attempts or the window and you have to complete a new state-approved training program before you can test again.

Those are examples, not a template — verify your own state. Our CNA retake policy breakdown goes deeper on attempts, windows, and what happens when the clock runs out.

What both vendors have in common

Under all the state-by-state variation sits a federal floor. Under 42 CFR 483.152, a state-approved Nurse Aide Training and Competency Evaluation Program must be no fewer than 75 clock hours, including at least 16 hours of supervised practical or clinical training and at least 16 hours of specified instruction before any direct resident contact. That's a minimum, and many states require more.

Eligibility itself is state-set on top of that floor. You'll typically need to finish a state-approved program — or qualify through an equivalent or challenge route where your state allows one — before you can sit the competency evaluation, and states add their own conditions on age, background checks, and extra training hours. Scheduling then happens through whichever channel your state's vendor uses: the Credentia portal, the Prometric portal, Pearson VUE, or a state agency.

The knowledge test may be computer-based or paper depending on the state and vendor, and the written-versus-oral choice is offered in both NNAAP and Prometric state handbooks. The skills evaluation is in person either way. If you're still working out what your state expects before testing, check the CNA exam requirements by state.

How to prepare when the vendor differs but the job doesn't

Here's the reassuring part. The two vendors package the exam differently, but they're testing the same competencies, because they're both measuring against the same federal training standard and the same daily work. Infection control, resident rights, safe transfers, vital signs, communication, reporting changes in condition — those are the content of the job, and they're the content of both written tests.

So build your prep around content, not vendor branding. Then handle the vendor differences last, in the week before you test: read your state handbook, note your actual item count and time limit, confirm your fee and how it's split, and rehearse the skills format your vendor uses. Practicing under a longer clock than you'll get is harmless; walking in expecting the wrong skills structure is not.

Rehearse the skills out loud with a partner and a checklist. Say each step as you do it, including the ones that feel obvious — knocking, introducing yourself, checking the call light, washing your hands. Evaluators score what they observe, not what you meant to do.