Certified Nursing Assistant (NNAAP) Exam Study Guide

The National Nurse Aide Assessment Program (NNAAP) exam is the certification test that qualifies you to work as a Certified Nursing Assistant. It is built around two independent parts, and you must clear both to earn certification.

Two Parts, One Certification

The written (knowledge) portion contains 70 multiple-choice items, and you are given a 90-minute time limit to complete them. Separately, a hands-on skills assessment evaluates whether you can safely perform core nurse-aide duties. To become certified you must pass both the written and skills assessments — a strong score on one part cannot make up for a failing score on the other.

What This Means for Your Prep

Because the two parts are scored independently, your study plan should be split too: dedicate time to memorizing knowledge-based content for the written test and repeatedly rehearsing physical skills for the practical evaluation. Treat them as two separate exams you happen to take on the same certification track.

With 70 multiple-choice items and a 90-minute time limit, you have on average just over one minute per question. That is a comfortable pace for a well-prepared test-taker, but it rewards a deliberate strategy.

A Simple Pacing Plan

• First pass: Answer every question you know immediately. CNA items are largely recall-based, so most should take well under a minute.
• Flag and move on: If a question stalls you, mark it and continue rather than burning several minutes on a single item.
• Second pass: Use the time you banked to revisit flagged questions and review your work.

Why Pacing Works Here

Because the average of roughly 77 seconds per item is generous relative to the recall nature of most CNA questions, spending time up front on the easy questions builds a buffer for the harder ones — and leaves margin to double-check before time expires.

The written portion is a focused, time-bounded test: 70 multiple-choice questions in 90 minutes. That works out to roughly one minute and eighteen seconds per question on average, which is generous enough to read carefully but tight enough that you shouldn't get stuck on any single item.

Pacing Tips

• Don't camp on hard questions. With about 1.3 minutes per item, flag anything that stumps you, make your best guess, and move on. You can return if time allows.
• Answer everything. Multiple-choice items reward an educated guess over a blank — eliminate obviously wrong options first to improve your odds.
• Budget a review pass. If you average closer to one minute per question, you'll finish with time to revisit flagged items before the 90 minutes are up.

Practicing full-length, 70-question timed sets is the single best way to build the pacing instinct this format rewards.

Certification through the NNAAP is not a single hurdle — it is two. You must pass both the written and skills assessments to earn your CNA credential. A strong written score cannot compensate for a failed skills demonstration, and vice versa.

Plan Your Preparation Around Both

• Written: Master the knowledge tested across the 70 multiple-choice questions — infection control, resident rights, safety, basic nursing skills, and communication.
• Skills: Rehearse each hands-on task until your technique is automatic, including hand hygiene and indirect-care steps that evaluators watch for on every skill.

Because both parts must be passed, schedule dedicated practice for each and don't neglect the skills demonstration in favor of written cramming — the two carry equal weight toward your final result.

Since certification requires that you pass both the written and skills assessments, an effective plan gives real attention to each.

For the Written Portion

The 70 multiple-choice items typically cover core nurse-aide knowledge: infection control, resident rights, safety and emergencies, basic nursing skills, communication, and mental-health and social-service needs. Use flashcards and practice questions to build fast, confident recall — a good fit for the roughly one-minute-per-question pace of the 90-minute test.

For the Skills Assessment

The hands-on portion asks you to demonstrate a small set of randomly selected skills, almost always including handwashing and indirect care steps such as privacy, safety, and communicating with the resident. Rehearse each skill out loud and in order until the sequence is automatic, since evaluators look for specific required steps.

Putting It Together

Alternate knowledge review with physical rehearsal so neither part is neglected. Because the two scores stand alone, consistent practice on both is the most reliable path to certification.