The CNA Exam Blueprint: Every Topic and Skill Tested (2026 Guide)

What a CNA "blueprint" actually covers

People ask for the CNA exam blueprint expecting one document. There isn't one. The nurse aide credential is administered state by state, and the contracted vendor is state-specific: most states use Credentia (which runs the NNAAP) or Prometric, while a few use Pearson VUE or run their own program. So the honest version of a blueprint has two layers — the structure that's the same everywhere, and the details that shift with your state's contract.

Here's the part that doesn't move. The competency evaluation has two separately scored components: a written (or oral) knowledge test and a hands-on skills evaluation. You have to pass both to be placed on your state's nurse aide registry. The knowledge test may be computer-based or paper depending on the state and vendor, and an oral/audio alternate is offered for candidates with reading difficulty. The skills evaluation is done in person on a live person or manikin and scored by an evaluator, or recorded per the vendor's protocol.

What moves: item counts, time limits, fees, retake rules, and the exact domain labels. Below I've laid out the published content outline that most candidates can actually work from, then flagged clearly where you need to open your own state handbook instead of trusting a number you read online.

The written test content outline, domain by domain

Prometric publishes a Nurse Aide Written Test Content Outline with named domains and percentage weights. That's the most concrete public blueprint available, so it's the one worth studying against — with one caveat. Credentia's NNAAP written test covers parallel nurse-aide content (physical care skills, psychosocial care skills, and role and responsibilities of the nurse aide), but the exact domain labels and weights differ from Prometric's. Domain names and weights are vendor-specific. Check which vendor your state uses before you build a study calendar around any weighting.

Domain (Prometric outline)	Weight	What it looks like in practice
Role of the Nurse Aide	20%	Scope of practice, reporting to the nurse, resident rights, confidentiality, abuse and neglect reporting, communication with residents and families
Promotion of Safety	22%	Infection control, standard precautions, body mechanics, fall prevention, fire and emergency response, restraint alternatives
Promotion of Function and Health of Residents	20%	ADLs, mobility and transfers, range of motion, restorative care, nutrition and hydration, promoting independence
Basic Nursing Care Provided by the Nurse Aide	24%	Vital signs, measurement and recording, personal care, elimination, skin care, comfort measures
Providing Specialized Care for Residents with Changes in Health	14%	Dementia and cognitive changes, end-of-life care, oxygen use, common chronic conditions, recognizing and reporting changes

Where the weights should change your study plan

Basic nursing care and safety carry the heaviest weight in that outline, and they're also the areas where wrong answers on the written test tend to come from habit rather than ignorance — people answer the way their facility does it, not the way the textbook says. Standard precautions, vital sign ranges, and when you report versus when you act are the recurring traps. If you want a sense of how those show up as actual test items, the breakdown of the kinds of questions on the CNA written exam is a useful companion to this outline.

How many questions, and how long you get

This is where bad information circulates most. The knowledge-test item count varies by vendor and state — no single figure is national. Credentia (NNAAP) state handbooks commonly specify a 70-question multiple-choice Written Examination, with the alternate Oral Examination made up of 60 multiple-choice plus 10 reading-comprehension questions. Prometric state materials commonly specify a 60-question multiple-choice written test. Both of those come from specific state handbooks, they differ by vendor, and individual states may deviate.

Time limits follow the same pattern. Credentia state handbooks commonly allow 2 hours (120 minutes) for the 70-question Written Examination and 30 minutes for the skills evaluation. Prometric state materials commonly allow 90 minutes for the 60-question written test. Don't quote a single national time limit to yourself on test day — read the handbook for your state.

One more thing candidates ask about: unscored or pilot questions. The reviewed Credentia and Prometric state candidate handbooks don't disclose a number of unscored or pretest items on the nurse aide written test. Any such count would be vendor- and state-specific and isn't published, so treat the full item count as your working figure. If you want the vendor-by-vendor comparison in more detail, we cover it in how many questions are on the CNA written exam.

The skills evaluation blueprint

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. Credentia (NNAAP) state handbooks specify 5 randomly selected skills, performed in 30 minutes, with all 5 needing to be correct. Prometric specifies 5 clinical skills — 3 prompted, plus 2 unprompted, those being handwashing and an indirect-care skill — all of which must be passed. Handwashing is commonly treated as a mandatory or critical skill. Don't present the specific count as national; confirm it in your handbook.

What "all of them" really means

Each skill is scored pass/fail against a checklist of steps, and certain steps are flagged as critical. Missing a critical step fails the whole skill, and failing one skill fails the component. That's why candidates who know the material still fail — they nail the technical part of a transfer and forget to lock the wheels, or they complete perfect perineal care and never lower the bed at the end. Practise the bookends (knock, introduce, privacy, wash hands, call light within reach, bed lowered) until they're reflex, because they appear in nearly every checklist. The full rundown of which skills get tested and how they're scored is worth reading before you rehearse.

How scoring works — and why there's no national passing score

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 requirement is absolute rather than percentage-based: 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. There's no partial credit that lets a strong performance on four skills carry a weak fifth.

On the written side, cut scores are set by the state. Many state registries report results only as Pass/Fail with no numeric score released at all, which surprises candidates who expect a percentage on their score report. Any figure you see online presented as "the national CNA passing score" — 80%, 75%, whatever — is somebody's state number being generalised. It varies. Our fuller treatment of what counts as a passing score walks through why the reporting format differs so much.

The same caution applies to pass rates. Because the credential is administered separately by each state, pass rates aren't aggregated into a single official national figure. Any nationwide pass-rate number floating around should be treated as an estimate, not an official statistic.

Eligibility: the federal floor under everything

Eligibility is set by the state, but it sits on a federal foundation. Under 42 CFR 483.152, a state-approved Nurse Aide Training and Competency Evaluation Program (NATCEP) 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 floor, not a target. Many states require considerably more. Candidates typically must complete a state-approved program — or qualify through an equivalent or challenge route where a state allows one — before sitting the competency evaluation. States layer on their own requirements too: minimum age, background check, additional training hours.

Scheduling: who you actually book with

You schedule through your state's contracted vendor once you're eligible, which is usually on completion of your approved training program. Credentia (NNAAP) and Prometric each run their own candidate portal and handbook for the states they serve; where a state uses Pearson VUE or runs its own program, that agency handles scheduling. The channel is vendor-specific, and therefore state-specific — start from your state registry's page rather than a general search.

Fees and retakes: two more state-set variables

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. Get the exact amount from your own state handbook.

Retake rules are state-set and vary as well. A common pattern in Credentia (NNAAP) state handbooks: a candidate 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're completing a new state-approved training program before you can test again.

State	Confirmed retake pattern
Virginia	3 attempts per exam, 2-year window
South Carolina	Both parts within 2 years or 3 attempts
North Carolina	3 attempts per exam
Georgia	3 attempts per part within 1 year of training

Those are examples, not a template. Verify your own state. The state-by-state view of what's required to sit the exam is a good starting point for tracking down your registry's rules.

Turning the blueprint into a study plan

The practical move is to split your prep the way the exam splits itself. Written prep is recall and judgement work: vital sign ranges, infection control, resident rights, when to report. Skills prep is muscle memory: rehearse out loud, with a partner playing the resident, in the order the checklist expects.

A workable sequence

• Start with the heaviest-weighted written domains — basic nursing care and safety — while your clinical hours are still fresh.
• Rehearse handwashing and the indirect-care steps daily, since they're the ones commonly treated as mandatory or critical.
• Work through practice questions in mixed sets rather than domain blocks, so you're pulling from everything the way the real test does.
• Sit at least one timed run under whatever limit your vendor's handbook gives you, so the clock isn't a surprise.
• Review every miss against the reason, not just the correct letter.

If you're starting from scratch on scheduling your prep, our CNA study guide lays out a week-by-week approach that maps onto this same blueprint.

The short version

Two components, both must pass. The written test follows a published content outline with named domains and weights, though the labels and weights belong to the vendor your state contracts with. The skills evaluation is all-or-nothing on the skills you're assigned. Item counts, time limits, fees, and retake windows are all state and vendor variables — read your own handbook and treat any "national" figure with suspicion. Everything else is practice.