- Basic Nursing Skills is worth 35% of the knowledge exam - study it first and longest.
- The written exam has 70 items (60 scored, 10 pretest) with a two-hour limit.
- The oral version swaps items for 60 questions plus 10 word-recognition items, same two hours.
- All five randomly selected Skills Evaluation tasks must be rated satisfactory, including hand hygiene and one measurement skill.
Quick Facts Snapshot
This is the one-page version of everything covered in the full CNA Study Guide 2026. Bookmark it, print it, or screenshot it - it's built for a five-minute refresh the night before test day, not for first-time learning. The current NNAAP (National Nurse Aide Assessment Program) structure, developed and managed by Credentia Nurse Aide LLC, has two required parts: a knowledge exam and a hands-on Skills Evaluation.
| Component | Format | Time Limit |
|---|---|---|
| Written Knowledge Exam | 70 multiple-choice items (60 scored, 10 pretest) | 2 hours |
| Oral Knowledge Exam | 60 multiple-choice items + 10 word-recognition items | 2 hours |
| Skills Evaluation | 5 randomly selected skills, all must be satisfactory | 30 minutes |
Notice the oral option isn't just the written test read aloud - it drops the pretest items and adds a separate word-recognition component. Both formats still allow the full two hours, so pacing pressure is lower than most candidates assume. For a deeper dive into how tough this actually is relative to other healthcare entry exams, see How Hard Is the CNA Exam? Complete Difficulty Guide 2026.
The 9 Domains, Ranked by Weight
Every question on the knowledge exam maps to one of nine content domains. Knowing the weight of each domain tells you exactly where to spend your remaining study hours. This is the single most useful table in this cheat sheet - treat it as your allocation formula.
| Domain | Weight |
|---|---|
| Basic Nursing Skills | 35% |
| Activities of Daily Living | 22% |
| Emotional and Mental Health Needs | 8% |
| Client Rights | 8% |
| Self-Care and Independence | 7% |
| Communication | 7% |
| Member of the Health Care Team | 6% |
| Legal and Ethical Behavior | 5% |
| Spiritual and Cultural Needs | 2% |
Together, Basic Nursing Skills and Activities of Daily Living make up 57% of the entire knowledge exam. If you only have time to master two domains, these are the two. For a full breakdown of what each domain actually tests, including sample topics and terminology, go through CNA Exam Domains 2026: Complete Guide to All 9 Content Areas.
Domain 2: Basic Nursing Skills (35%)
This domain covers the physical, hands-on core of the job - the tasks you'll also be tested on directly during the Skills Evaluation.
- Vital signs: temperature, pulse, respiration, blood pressure
- Measuring height, weight, and intake/output
- Infection control and hand hygiene technique
- Positioning, transferring, and body mechanics
- Recognizing and reporting changes in condition
Domain 1: Activities of Daily Living (22%)
ADL questions test your ability to assist residents with the tasks of daily living while promoting the maximum independence a resident's condition allows.
- Bathing, grooming, dressing, and toileting assistance
- Nutrition and hydration support, including special diets
- Mobility assistance and fall prevention
- Rest, sleep, and comfort measures
Key Takeaway
Study Basic Nursing Skills and Activities of Daily Living before anything else. Together they account for more than half of every scored question on the knowledge exam.
Written and Oral Exam Format
Both the written and oral versions of the knowledge exam are delivered as multiple-choice questions, and the current version may be offered through live online proctoring in addition to in-person test centers. Choose whichever format matches how you process information best - the content tested is identical either way.
- Written exam: 70 total items, 60 scored and 10 unscored pretest items, two-hour limit.
- Oral exam: 60 multiple-choice items plus 10 separate word-recognition items, two-hour limit.
- Delivery: Live online proctoring may be available depending on your state's testing arrangement.
If you're unsure what score you actually need on test day, don't guess - the exact scoring mechanics are laid out in CNA Passing Score 2026: Exactly What You Need to Pass.
Skills Evaluation Checklist
The Skills Evaluation is where knowledge becomes demonstration. A Nurse Aide Evaluator observes you perform five randomly selected skills within a 30-minute window. Two elements are guaranteed to appear:
- Hand hygiene - always one of the five required skills
- A measurement skill - such as vital signs, height, or weight
Every single one of the five skills must be rated satisfactory. There's no partial credit for averaging four good performances against one weak one - each skill is pass/fail on its own, independent of the others.
Eligibility and Registration Basics
Before you can sit for either exam part, you need to meet your state's eligibility requirement - most commonly, completion of a state-approved nurse aide training program, though some states accept an approved alternative route (such as certain healthcare experience or coursework). Requirements vary by state registry, so confirm your specific path in CNA Requirements 2026: Eligibility, Prerequisites & How to Qualify.
- Complete a state-approved training program or an accepted alternative pathway
- Register with your state's nurse aide registry for both exam parts
- Pass both the knowledge exam and the Skills Evaluation
- Meet any state-specific documentation or background check steps
Budgeting matters here too - training, testing, and any retake fees add up differently depending on where you live, which is why it's worth reviewing CNA Certification Cost 2026: Complete Pricing Breakdown before you enroll in a program.
Key Takeaway
You must pass both the knowledge exam and the Skills Evaluation - there is no averaging between the two parts, and each must be completed on its own merits.
One-Week Review Schedule
If you already completed formal training and just need a structured final push, allocate your remaining days by domain weight instead of splitting time evenly across all nine areas.
Basic Nursing Skills (35%)
- Drill vital sign ranges and technique
- Rehearse infection control and hand hygiene steps
- Review body mechanics and positioning
Activities of Daily Living (22%)
- Practice ADL assistance scenarios
- Review nutrition, hydration, and mobility support
Client Rights, Mental Health, Communication
- Cover Emotional and Mental Health Needs (8%)
- Cover Client Rights (8%) and Communication (7%)
Skills Rehearsal and Light Review
- Run through the full hand hygiene checklist
- Practice a measurement skill start to finish
- Skim Legal/Ethical, Spiritual/Cultural, and Health Care Team domains
This isn't a generic weekly template - it's built directly around the actual domain weights above, so heavier topics get proportionally more of your limited review time. For a longer-range plan that starts from day one of training, see the full CNA Study Guide 2026.
What to Memorize Cold
These are the specific facts and habits that show up repeatedly across both the knowledge exam and the Skills Evaluation. Treat this as your final memorization list.
- The full hand hygiene sequence, step by step, without skipping or reordering
- Normal ranges for temperature, pulse, respiration, and blood pressure
- How to properly perform and document a measurement skill
- The difference between reporting an observation and interpreting/diagnosing it (outside your scope)
- Core client rights, including privacy, dignity, and the right to refuse care
- Basic communication techniques for residents with cognitive or sensory impairment
- Standard precautions and when additional precautions apply
Employers hiring for this role - hospitals, long-term care facilities, assisted living communities, and home health agencies - expect fluency in these exact areas from day one, which is part of why the certification carries real weight in hiring decisions. If you're weighing whether the credential is worth the time and cost, Is the CNA Certification Worth It? Complete ROI Analysis 2026 breaks down the return in detail, and CNA Salary Guide 2026: Complete Earnings Analysis covers what the role pays. Once certified, browsing CNA Jobs is a natural next step.
Want to see exactly how many candidates clear both exam parts and what tends to separate a pass from a retake? CNA Pass Rate 2026: What the Data Shows walks through the available data. And if scheduling logistics are still an open question, check CNA Exam Dates 2026: Testing Windows, Deadlines & Scheduling before you lock in a test date.
For newcomers still getting oriented on terminology, the site's foundational explainers are worth a quick read: What Is CNA?, CNA Meaning, and What Does CNA Stand For? all cover the basics, while CNA Training details what a state-approved program actually involves. Once you're ready to test your recall against real exam-style questions, head to our CNA practice test platform and run a full-length timed set under the same two-hour structure you'll face on exam day.
Frequently Asked Questions
The written exam contains 70 multiple-choice items total - 60 scored and 10 unscored pretest questions - with a two-hour time limit.
The oral option has 60 multiple-choice items plus 10 separate word-recognition items instead of pretest items, and it also allows two hours to complete.
Yes. Five skills are randomly selected, always including hand hygiene and one measurement skill, and all five must be individually rated satisfactory.
Basic Nursing Skills, at 35% of the knowledge exam, is by far the largest domain and should receive the most review time, followed by Activities of Daily Living at 22%.
The knowledge exam may be offered through live online proctoring in addition to traditional testing sites, depending on your state's arrangement, while the Skills Evaluation must be demonstrated in person before a Nurse Aide Evaluator.