Nursing Assistant Test Guide

Certified Nursing Assistants (CNAs), often called nurses’ aides, are the frontline workers who take care of patients in a variety of healthcare settings. CNAs assist patients with activities of daily living under the supervision of a licensed nurse, either an RN or LPN. Due to a booming growth in the aging population, the job outlook for CNAs is expected to grow much faster than other occupations. CNAs should be people who desire challenging yet rewarding work. Some essential traits of successful CNAs include:

• Physical Fitness (CNAs are very active on the job and are often required to lift and transfer patients)
• Compassion (CNAs care for patients who are sick, injured, or elderly at their most vulnerable times)
• Patience (CNA tasks can often be tedious and patients may move slowly and have communication difficulties)
• Communication (Excellent people skills include active listening and the ability to clearly communicate with patients and family members)
• Team Player (CNAs collect important information to share with other members of the healthcare team such as licensed nurses, social workers, nutritionists, administrators)

What do CNA’s do?

Certified nursing assistants care for people and work under the supervision of licensed RNs and LPNs. Common tasks that CNAs perform for patients include: bathing, showers, dressing, transferring from bed to wheelchair, using mechanical lifts, turning and repositioning bedridden patients, providing hygiene for incontinent patients, assisting with meals, maintaining dietary restrictions, taking vital signs, measuring meal intake, weights, and output of urine, collecting non-invasive body fluid specimens, and documenting patient interactions in the medical record. Above all else, CNAs aim to provide dignity, respect, and privacy for all patients while providing care.

Where do CNAs work?

Certified nursing assistants work in most places where patients are treated in healthcare. They have the ability to work in many different job settings and serve a variety of patient populations. Some common places where CNAs work include: hospitals, long-term care facilities, rehabilitation centers, hospices, assisted living centers, psychiatric hospitals, adult day care, and home health care.

When do CNAs work?

Because CNAs are needed 24 hours a day at most facilities, multiple shifts are needed to be filled around the clock, including weekends and holidays.

How does one become a CNA?

Although training requirements vary state to state, all CNA students must attend a state-approved education program and pass a competency exam. CNA educational programs can be found in local hospitals, technical and vocational schools, community colleges, and nursing homes and usually last 4-18 weeks. The American Red Cross also offers a CNA training program (for more info visit http://www.redcross.org/take-a-class/cna-training). Costs for CNA programs can vary from $300-1500 dollars, and some employers may offer free CNA training with the requirement for students to commit to working at the facility for a certain length of time. Before choosing and enrolling in a program, make sure to check with your state Board of Nursing or Board of Health to make sure the program is approved in your state (since there is no national governing body for accrediting CNA courses). Depending on the state, some students may be eligible to work up to 4 months after graduating from their CNA training while waiting to take the competency exam.

Once students have completed the CNA training program, they are eligible to take the competency exam. Multiple testing organizations may handle the administration of the exam, depending on the state, including the National Nurse Aid Assessment Program (NNAAP), Prometric, and Pearson Vue. Check with your CNA school or your state’s CNA Registry for the testing schedule in your state. 

The exam will contain a written portion with multiple-choice questions, as well as a clinical portion, in which you must demonstrate skills on a mannequin or patient actor. It is recommended that you prepare for the exam using online practice tests to ensure your success. Most states require that you score at least 70% on both the written and clinical portions of the exam in order to pass. Some of the subjects coverd by the written exam may include:

• Safety
• Communication
• Infection Control
• Data Collection
• Personal Care
• Basic Nursing Skills
• Mental Health
• CNA Roles and Responsibilities
• Disease Processes
• Patient Rights
• Adult Growth and Development

The clinical portion of the exam will measure your skills and interaction with patients and evaluate areas such as infection control (handwashing), providing privacy and explaining things to patients, taking vital signs, and safe transferring of patients. Students who do not pass the competency exam may be allowed to retake it after a waiting period of 14-90 days (varies by state) or they may have to re-do their training course depending on state requirements.

Once you have passed the certified nursing assistant exam, your name will be added to a state registry, which is used by employers to ensure that the potential hire has met the federal and state requirements for CNA employment. If considering working at a long-term care facility, check out the facilities’ recent ratings and inspection reports at www.medicare.gov/nursinghomecompare.

Some states have continuing education requirements for CNAs to stay up to date in their knowledge, and some states require mandatory criminal background checks as well. Many CNAs are also required by employers to be certified in basic life support (BLS) cardiopulmonary resuscitation (CPR) through the American Heart Association.

Why should I become a CNA?

According the U.S. Department of Labor Statistics, regarding the job outlook for CNAs: There is a 17% expected growth in CNA jobs by 2024, which is much faster than the average for all occupations (7%). The median salary in 2015 was $25,710, although it can greatly vary by state. Working as a CNA can provide a rewarding lifelong career, or can serve as a stepping stone to other medical professions such as a medication aide, wound care associates, or nursing. Although it is not an easy job, it is a very important job, and can provide rewarding meaningful employment with the satisfaction of truly helping people at the end of a day’s work.

To find test preparation materials, see our Nursing Assistant Practice Test.