Iowa Nursing Assistant / Nurse Aide Guide

CNA - Certified Nursing Assistant - Aide Practice Exam

Is a License or Certification needed: You need to pass a state-certified nursing assistant program and the state exam in order to be certified. This must be done in order to work as a nursing assistant in the state of Iowa and be listed on the Iowa State Direct Care Worker Registry.

Who Grants Certification: Many of Iowa's community colleges offer training for certified nursing assistants (CNAs). Written and skills tests also are provided by these schools for CNA candidates.

Successful completion of both a written and skills test is required to be placed on the Iowa Direct Care Worker Registry (DCW). If a potential CNA does not pass either one of the tests in three attempts, the 75-hour course and tests must be retaken.

See Iowa Association of Community College Trustees for contact information about programs in CNA training and testing.

The Qualifications to become Certified: There is more than one route to qualify to register as a nurses aide in the state of Iowa. These include:

  • You have successfully completed an Iowa State Department of Health approved training program consisting of 30 hours of classroom instruction and 75 hours of clinical training.
  • You have passed the Iowa nurse aide competency evaluation including both written and skill portions.
  • You are listed in good standing as a CNA on the Iowa State Direct Care Worker Registry.

How to Apply for Certification and to take the Exam: In order to apply for nurse aide registration in the state of Iowa, you will need to complete one of the state-approved training program as stated above.

Test Content: Both written and skills parts must be passed to be listed on the Iowa State Direct Care Worker Registry. The written section is 60 questions in length. You will have 90 minutes to complete the exam. A minimum score of 70% is required to pass both test portions.

The written exam questions are based on the Iowa state-approved test plan. Content topics include:

  • Activities of Daily Living/Basic Nursing Skills
  • Restorative Services
  • Common Diseases and Disorder
  • Infection Control
  • Mental and Social Needs
  • Cognitive Impairment
  • Resident’s Rights
  • Safety and Emergencies
  • Communication and Interpersonal Skills
  • Role and Responsibilities of the CNA

The skills evaluation will be set within a specific amount of time to finish a given number of skills, usually around 30 minutes to finish 5 skills. You will need to practice these skills. They will not need to be absolutely perfect, but you will need to be deemed competent in these skills. The nurse aide skills usually include things like:

  • Infection Control
  • Communication
  • Rights and preferences
  • Safety, comfort and needs

Certification Renewal and Continuing Education Requirements: According to the law in Iowa, to renew your CNA registration, it is required that you have worked 8 hours at your place of employment in the paid role of a nurse aide during the past 24 months. This must be paid employment, not volunteer work, and in a nursing environment such as a nursing home, home health setting or a hospital.

According to the Department of Inspections, Appeals and Licensing, qualifying employment is the only way to remain active as a CNA. 

Only nursing facilities, skilled nursing facilities, and long-term care units in hospitals are required to update CNA employment but other health care facilities are not required to report CNA employment. 


IA Direct Care Worker Registry
IA Department of Inspections, Appeals and Licensing


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