Federal rules set the outline for every state. A nurse aide competency evaluation has to include a written or oral exam and a demonstration of skills, and each state sets the passing standard and picks who runs the test. Check your state nurse aide registry or your training program to find out which testing company you’ll use.
Who runs the exam in some large states
| State | Testing company |
|---|---|
| California | Headmaster, Credentia or the Regional Testing Center |
| Florida | Prometric |
| Massachusetts | Headmaster |
| New York | Prometric |
| Pennsylvania | Credentia (NNAAP) |
| Texas | Prometric |
How the written exam compares
| Testing company (state handbook) | Questions | Time | Passing |
|---|---|---|---|
| Credentia NNAAP (Pennsylvania) | 70 | 2 hours | TODO: Credentia’s Pennsylvania pages don’t state the written pass mark. |
| Prometric (Florida) | 60 | 90 minutes | Set by the state |
| Headmaster (Massachusetts) | 60 | 60 minutes | 76% |
Credentia’s oral version has 60 multiple-choice questions and 10 reading comprehension questions, read aloud. Federal rules let any aide choose an oral exam instead of the written one.
How the skills test compares
- Credentia (Pennsylvania): 5 skills in 30 minutes. Handwashing is always one of them, and one of the other four is always a measurement skill. You have to pass all 5.
- Prometric (Florida and New York): 5 scored skills in 31 to 40 minutes, three assigned skills plus handwashing and indirect care. You have to pass all 5.
- Headmaster (Massachusetts): 3 or 4 tasks in 40 minutes, starting with a required task that includes handwashing. You pass a task by getting every critical step and 80% of the other steps right.
If you don’t pass the first time
Plenty of people retake part of the CNA exam. Federal rules require every state to allow at least 3 attempts, and each state sets what happens next. In Pennsylvania, failing either part 3 times means retraining. In Florida, it means 120 hours of training. Massachusetts allows 4 attempts at the knowledge test and 3 at the skills test.
Sources
- U.S. Code of Federal Regulations (eCFR), 42 CFR 483.154, nurse aide competency evaluation. A written or oral exam plus a skills demonstration, states set the passing standard, at least 3 attempts. Checked October 16, 2026.
- Credentia, Pennsylvania NNAAP exam overview. 70 written questions in 2 hours, the oral option, the skills test, retraining after 3 failed attempts. Checked October 16, 2026.
- Credentia, Pennsylvania NNAAP skills evaluation. 5 skills in 30 minutes, handwashing and a measurement skill are always included, all 5 must be passed. Checked October 16, 2026.
- Prometric, Florida certified nursing assistant candidate information bulletin. 60 questions in 90 minutes, 5 scored skills including handwashing and indirect care, 120 hours of training after 3 failed attempts. Checked October 16, 2026.
- Prometric, New York nurse aide candidate bulletin. Prometric runs New York’s exam with the same format as Florida. Checked October 16, 2026.
- Headmaster, Massachusetts nurse aide candidate handbook (May 2026). 60 questions in 60 minutes with a 76% pass mark, 3 or 4 skill tasks in 40 minutes, attempt limits. Checked October 16, 2026.
- Texas Health and Human Services, Nurse aide training and competency evaluation program. Texas uses Prometric. Checked October 16, 2026.
- California Department of Public Health, CNA testing vendors. California’s approved testing vendors. Checked October 16, 2026.