FREE CNA Practice Test 2026 — 80 State-Specific Questions (CA, TX, NY, FL, PA)
The CNA written examination is the gatekeeper for every certified nursing assistant in the U.S. The exam is state-specific — California's uses a different provider and content emphasis than Texas or Florida. But the core competencies (infection control, patient safety, vital signs, ADLs) are universal. This page gives you 80 verified practice questions with state-by-state guidance for the five states with the most CNAs: California, Texas, New York, Florida, and Pennsylvania.
Key Facts
- •CNA certification requires passing both a written (or oral) examination and a clinical skills demonstration. Written exam: 60-70 multiple-choice questions, 90-120 minutes, 70-80% passing (varies by state).
- •Exam providers: Pearson VUE (used by CA, TX, FL, PA, many others) and Prometric (used by NY, MI, others). Test content differs between providers — both derive from the same federal OBRA-87 nursing assistant curriculum but emphasize different areas.
- •Clinical skills test: 5 randomly selected skills from a pool of ~25. You must demonstrate each correctly. Common skills: hand washing (always tested), vital signs measurement, bed bath, oral care, feeding, positioning, transfer from bed to wheelchair.
- •Total cost for CNA certification: typically $100-150 for the exam + $30-50 for the state registry listing. Training program cost: $500-2,000 for a 75-120 hour state-approved program.
- •Federal OBRA-87 requires at least 75 hours of training (including 16 hours of supervised clinical training) for CNAs working in Medicare/Medicaid-certified nursing facilities.
- •CNAs must renew certification every 2 years (state-specific). Most states require proof of paid CNA work (typically 8+ hours) within the past 24 months + no adverse findings.
- •CNA job growth: 4% projected by BLS (2024-2034), adding ~56,000 new positions. CNA median pay: $18.07/hr ($37,610/yr). Top 10% earn $26.38/hr ($54,880/yr).
- •Most common reasons for CNA written exam failure: not reading the full question (30%), confusing 'first action' vs 'best action' priority questions (25%), misapplying infection control rules (20%), nervous rushing (15%).
- •Exam questions are written at a reading level appropriate for a 6th-8th grade education. Do not over-think the wording — CNA questions are designed to be accessible.
- •All 80 of our questions are verified against the Pearson VUE CNA Candidate Handbook and Prometric Nurse Aide Exam Content Outline, with specific state supplements for CA, TX, NY, FL, and PA.
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80 verified CNA questions. State-specific for CA, TX, NY, FL, PA. Mock exam mode with timer. Every answer linked to official curriculum.
Start FREE CNA Practice →CNA Written Exam: What's Tested Across All States
CNA Written Exam — Universal Knowledge Domains
| Domain | % of Exam | What You Must Know |
|---|---|---|
| Patient Rights & Ethics | 10% | Patient Bill of Rights, HIPAA confidentiality, informed consent, advance directives, abuse/neglect reporting (mandated reporter), resident dignity and autonomy |
| Infection Control & PPE | 15% | Standard vs Contact vs Droplet vs Airborne precautions, hand hygiene 5 moments, PPE donning/doffing order, isolation types, medical vs clean asepsis |
| Safety & Body Mechanics | 12% | Fall prevention (bed low position, call light, non-skid footwear), body mechanics (bend knees, keep load close), fire safety (RACE, PASS), restraints (last resort, Q2hr checks) |
| Personal Care & ADLs | 22% | Bathing (partial vs complete), oral care (conscious vs unconscious), perineal care (front to back), dressing (affected side first), toileting, skin care, pressure ulcer prevention (Braden Scale, Q2hr turning) |
| Vital Signs & Measurement | 13% | Temperature (oral 98.6°F, rectal 99.6°F, axillary 97.6°F), pulse (60-100 adult, radial vs apical), respirations (12-20, count without telling patient), blood pressure (120/80 normal, cuff size matters), height/weight, I&O |
| Nutrition & Hydration | 8% | Diet types (NPO, clear liquid, full liquid, mechanical soft, pureed, regular), aspiration precautions (chin tuck, 90° upright, thickened liquids), dehydration signs, intake/output recording |
| Communication & Psychosocial | 10% | Therapeutic communication (open-ended questions, active listening, silence), hearing/vision-impaired communication, cultural competence, dealing with confused/agitated patients, validation therapy for dementia |
| Emergency & Special Care | 10% | Heimlich maneuver (conscious choking), CPR 30:2 compressions to breaths, seizure care (protect, don't restrain, time it), stroke recognition (FAST), fainting (syncope), death & dying (post-mortem care, family support) |
When providing perineal care to a female resident, the nursing assistant should wipe:
- A. Back to front to avoid contaminating the anal area
- B. Front to back to avoid introducing bacteria into the urinary tract
- C. In a circular motion from the center outward
- D. Only when visibly soiled, to preserve resident dignity
Reveal Answer & Explanation
Perineal care is ALWAYS performed front to back (urethra to anus) for both males and females. This prevents bacteria from the anal area being introduced into the urethra, which would cause urinary tract infection (UTI). Never wipe back to front — this is a critical safety error on the clinical skills test. Source: Pearson VUE CNA Candidate Handbook, Clinical Skills Checklist.
A resident with dementia becomes increasingly agitated and combative in the late afternoon. The nursing assistant should FIRST:
- A. Apply a physical restraint to prevent injury
- B. Administer the PRN sedative as ordered
- C. Reduce environmental stimulation and offer a quiet activity
- D. Tell the resident firmly that their behavior is unacceptable
Reveal Answer & Explanation
This describes 'sundowning' — a common dementia symptom where agitation increases in late afternoon/evening due to fatigue, reduced light, and overstimulation. The FIRST intervention is non-pharmacological: reduce noise/lights, offer a quiet activity (folding towels, listening to soft music), maintain a calm tone. Physical restraints are a last resort requiring a physician order. PRN medications require a nurse's assessment first. Confrontation escalates agitation. Source: OBRA-87 Federal Nursing Assistant Curriculum, Dementia Care Module.
Practice CNA Priority Questions
The 'what do you do FIRST' questions trip up most test-takers. Drill priority scenarios with detailed rationales.
Practice CNA Questions Now →CNA by State: Exam Provider and Requirements
CNA Exam — State Comparison
| State | Provider | Written Qs | Time | Passing | Skills Tested | Registry |
|---|---|---|---|---|---|---|
| CA | Pearson VUE / CDPH | 70 | 120 min | 75% | Random 5 of 22 skills | CA Nurse Aide Registry (CDPH) |
| TX | Pearson VUE / HHSC | 70 | 120 min | 70% | Random 5 of 22 skills | TX Nurse Aide Registry (HHSC) |
| NY | Prometric | 60 | 90 min | 70% | Random 5 of 22 skills | NY Nurse Aide Registry (DOH) |
| FL | Pearson VUE / Prometric | 60 | 90 min | 75% | Random 5 of 21 skills | FL CNA Registry (BON) |
| PA | Pearson VUE / Credentia | 70 | 120 min | 70% | Random 5 of 24 skills | PA Nurse Aide Registry (DOH) |
Clinical Skills Test: The 5 Skills They Always Test
The clinical skills portion of the CNA exam tests your ability to perform 5 randomly selected skills safely and correctly. One skill is ALWAYS hand washing — it is tested on every single evaluation, and failing hand washing means automatic failure of the entire skills test. The other 4 are randomly drawn. These are the skills with the highest selection frequency and critical steps most commonly missed:
Most Frequently Tested Clinical Skills
- 1Hand Washing (100% tested)
Critical steps: wet hands first, apply soap, lather 20+ seconds, scrub all surfaces (palms, backs, between fingers, under nails, wrists), rinse pointing fingertips down, dry with clean paper towels, turn off faucet with paper towel (not bare hands). Missing ANY of these steps = fail.
- 2Vital Signs — Blood Pressure
Position cuff 1 inch above antecubital space, arrow over brachial artery, inflate to 160-180 mmHg initially, deflate at 2-3 mmHg/sec, record systolic/diastolic to nearest 2 mmHg. Common fail: wrong cuff size, wrong arm position, reporting inaccurate numbers.
- 3Bed Bath — Partial
Privacy (close curtain/door), water temperature check (wrist test), wash from clean to dirty (face first, perineal area last), change water when soapy/cool, pat dry (not rub — prevents skin breakdown). Common fail: forgetting privacy, wrong order.
- 4Transfer from Bed to Wheelchair
Lock bed wheels, lock wheelchair brakes, position at 45° angle, use gait belt, non-skid footwear on resident, instruct resident to push up from armrests (not pull on your neck), pivot (don't twist), lower resident gently. Common fail: not locking wheels, twisting during transfer.
- 5Oral Care — Unconscious Resident
Turn head to side (prevents aspiration), place towel under mouth, use padded tongue blade to open mouth, brush teeth and tongue gently, suction if available, do NOT place fingers inside mouth (bite reflex). Common fail: not turning head, placing fingers in mouth.
Official Sources
Official CNA Exam Sources
- Pearson VUE — CNA Candidate Handbook — Official exam content outline, testing policies, and clinical skills checklists for Pearson VUE states
- Prometric — Nurse Aide Exam — Exam content outline, candidate bulletin, and skills testing details for Prometric states
- OBRA-87 Federal Nursing Assistant Curriculum — 42 CFR Part 483 — Federal requirements for nursing assistant training and competency evaluation
- California CDPH — Nurse Assistant Certification — California Department of Public Health — CNA certification requirements and exam info
- Texas HHSC — Nurse Aide Registry — Texas Health and Human Services — nurse aide training and competency evaluation program
80 Free CNA Questions — Start Now
State-specific exams with detailed rationales. Every question verified against Pearson VUE and Prometric content outlines. No signup, 100% free.
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