How Many Questions Are on the CNA Exam?
The CNA exam has two parts with very different formats. Here’s exactly how many questions you’ll face, how many you need to get right, and how the scoring actually works.
The quick answer
The CNA written exam has 60 to 70 multiple-choice questions. Of those, approximately 50 to 60 are scored and 10 are unscored pretest items. You also take a separate clinical skills evaluation where you demonstrate 3 to 5 hands-on nursing skills. You must pass both parts to earn your certification.
The two parts, broken down
Part 1: Written Knowledge Exam
Computer-based, multiple choice
Part 2: Clinical Skills Evaluation
Hands-on demonstration with evaluator
Both parts are typically scheduled on the same test day — written exam in the morning, clinical skills in the afternoon. Plan to spend 4 to 6 hours at the testing center including check-in, breaks, and waiting time between sections.
How questions are distributed by topic
Not all topics get equal coverage. Basic Nursing Skills alone accounts for nearly a quarter of your exam. Here’s the approximate distribution across 60 scored questions:
If you master just the top 3 topics — Basic Nursing Skills, Infection Control, and ADLs — you’ve covered 56% of the exam. That’s 33 to 34 questions out of 60. Focus your study time here first, then fill in the remaining topics. This strategy alone accounts for why students who follow a structured study schedule pass at significantly higher rates.
The scoring math: how many do you need right?
The numbers that matter
That margin is more generous than most students realize. Getting 15 to 18 questions wrong and still passing means you don’t need perfection — you need solid preparation on the high-weight topics and basic familiarity with the rest. Most candidates who fail miss the passing score by only 1 to 3 questions, typically because they underestimated Infection Control or Patient Rights.
About the pretest questions: The 10 unscored items are mixed randomly throughout the exam. You cannot identify them. They might feel unusually difficult or cover obscure topics you never studied — that’s often a clue they’re pretest questions. Don’t let them rattle you. Even if you guess on all 10, your score is unaffected because they aren’t counted.
What the test screen actually looks like
If you’ve never taken a computer-based exam, here’s what you’ll see. The interface is simple and straightforward:
The correct answer is B — wait 15 to 20 minutes after hot or cold beverages before taking an oral temperature. The interface shows your question number, time remaining, and how many questions you’ve flagged for review. You can navigate forward and backward freely and change answers until you submit.
Question count by testing vendor
The exact number of questions varies slightly depending on which vendor administers the exam in your state:
| Testing Vendor | Written Questions | Time Limit | Skills Tested | States |
|---|---|---|---|---|
| Credentia (NNAAP) | 70 questions | 90 minutes | 5 skills | 15+ states (PA, NC, GA, etc.) |
| Prometric | 60 questions | 90 minutes | 3–5 skills | TX, CA, FL, etc. |
| Pearson VUE | 60–70 questions | 90–120 minutes | 5 skills | VA, VT, NC, etc. |
| D&S Diversified | 65 questions | 90 minutes | 5 skills | Select states |
Your state determines which vendor you use — it’s not a choice. Your training program will tell you which vendor administers the exam in your state and how to register. The content covered is the same across all vendors; only the exact question count and interface differ slightly.
Timing strategy: 90 seconds per question
With 90 minutes for 65 questions, you have roughly 1 minute 23 seconds per question. That’s plenty if you pace yourself. Most candidates finish with 15 to 20 minutes to spare. Here’s the optimal approach:
First 60 minutes: Work through every question at a steady pace. Answer the ones you know instantly (should be 70% of them). Flag questions where you’re torn between two answers — don’t agonize, just flag and move on.
Minutes 60 to 80: Return to flagged questions. With the pressure of other questions behind you, the answer often becomes clearer. Eliminate obviously wrong options first, then choose between the remaining two.
Final 10 minutes: Quick scan of all answers. Only change an answer if you’re genuinely certain your first choice was wrong. Research consistently shows that first instincts are correct more often than changed answers on standardized tests.
There is no penalty for guessing on the CNA exam. A blank answer is guaranteed zero points. A guess has a 25% chance of being correct. If time is running out, select an answer for every remaining question — even random selections will statistically add 2 to 3 correct answers to your score.
Frequently asked questions
Is the CNA exam the same in every state?
The content is the same across all states — the NNAAP content outline is the national standard. However, the exact number of questions (60 to 70), the testing vendor (Credentia, Prometric, Pearson VUE), and the interface vary by state. The passing score also varies slightly, ranging from 70% to 75% depending on your state.
What happens if I run out of time on the CNA exam?
Any unanswered questions when time expires are marked as incorrect. There is no penalty for guessing, so if you see time running low, quickly select an answer for every remaining question. Most candidates finish the written exam with 15 to 20 minutes to spare at a steady pace.
Can I go back and change my answers?
Yes. On the written exam you can navigate forward and backward between questions, flag items for later review, and change your answers as many times as you want before submitting the test. However, once you click the final submit button, the exam is locked and cannot be reopened.
How many clinical skills do I need to pass?
You must pass ALL of your assigned skills to pass the clinical portion. If you fail even one skill, you fail the entire clinical evaluation and must retake it. Each skill is graded on critical steps — missing a critical step like hand hygiene or patient identification results in automatic failure of that skill regardless of how well you performed every other step.
Do I take both parts of the CNA exam on the same day?
In most states, yes. The written exam and clinical skills evaluation are typically scheduled on the same day at the same testing site. Some states allow you to schedule them on different days if needed. Check with your testing vendor for scheduling options in your state.
What if I pass one part but fail the other?
You only need to retake the part you failed. Your passing score on the other part remains valid for 12 to 24 months depending on your state. Most states allow 2 to 3 retake attempts. Retake fees are typically $30 to $50 for the written portion and $70 to $100 for the clinical skills portion.
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