CNA Written Exam Format: 70 Questions, Two Hours, and the Oral Option

The NNAAP written exam: 70 questions, 60 scored, two hours

As checked on October 18, 2026, Credentia's Pennsylvania handbook describes the NNAAP written exam this way:

• 70 multiple-choice questions. The 2024 outline says 10 of them are pretest items that are not scored, so 60 count toward your result. The outline's item counts add up to 60.
• Two hours. You are told when 15 minutes are left.
• One answer per question. You fill in one oval on the answer sheet or on screen. At a test center, marks in the test booklet are not accepted; only the separate answer sheet counts.
• Online or at a test center, in English or Spanish (Pennsylvania's options).

Credentia's California, Virginia, Colorado, Alabama, Rhode Island and South Carolina pages give the same 70 questions. Some of them say the written exam is in English and point candidates who have trouble reading English to the oral exam. What's on the CNA written exam covers how the 60 scored items divide among the nine content areas.

The ten pretest questions you cannot spot

The pretest items are mixed in with the scored ones and look the same. Credentia collects statistics on them for future exams, and they do not count. Since you cannot tell which ten they are, treat every question as scored. Skipping a hard item because it "might be pretest" only costs you if it was a real one.

Pacing the CNA written exam, state by state

Divide the time by the number of questions and you get your average budget per question. Each figure below is labeled with its source, because states differ.

For the standard NNAAP exam, an even pace finishes with no time to spare. A steadier plan is to aim for about a minute and a half per question, which leaves you a reserve for flagged items. This checkpoint plan is a Passy suggestion, not a Credentia rule:

On this plan, the 15-minute warning arrives about when you finish your first pass, so you spend those minutes on the questions you marked. At a test center, bring the watch with a second hand that Pennsylvania's handbook asks for, so you can check your pace yourself.

To test the plan before exam day, pace yourself on CNA written-exam practice questions with a watch beside you and check whether you reach about ten answers every 15 minutes.

Test center or online: what changes on the written exam

Pennsylvania offers the written exam both ways. As checked on October 18, 2026, its handbook describes them like this:

In Pennsylvania, missing ID means you cannot test, the fee is not refunded, and the absence counts as one of your three opportunities. CNA exam day has the full checklist.

The CNA oral exam in brief

Federal rules let every candidate choose between a written and an oral exam, and an oral exam must be read from a prepared text in a neutral manner (42 CFR 483.154(b)(1)). On the NNAAP, as Credentia's Pennsylvania handbook describes it:

• 60 multiple-choice questions, each read twice, and 10 reading-comprehension (word recognition) questions on common job-related words, each read three times.
• Two hours for the whole exam.
• Both sections must be passed to pass the oral exam.
• Delivery: an MP3 player at Pennsylvania test centers, and a recorded voice online.

Tennessee's oral exam works differently: 75 multiple-choice questions given on a computer, which can be repeated as many times as needed. Credentia's Virginia, Colorado, Alabama, Rhode Island and California pages say you must request the oral exam when you apply, and Florida's Board of Nursing says the same for its oral or Spanish test. The CNA oral exam guide covers who should choose it.

Two CNA question-count conflicts to know about

Tennessee. As checked on October 18, 2026, three Credentia Tennessee pages describe the Knowledge exam differently:

• The overview page says "seventy-five (75) multiple-choice questions," with "ten (10) experimental questions intermingled" that do not count.
• The outline page says "seventy-five (75) multiple choice items with an added ten (10) items that are pretest."
• The Knowledge Exam page says "seventy-five (85) multiple-choice questions."

The overview and Knowledge Exam pages both give two hours and a 75% passing score. Passy does not pick a count. Plan your pacing for the higher number, and ask Credentia or the Tennessee Health Facilities Commission which is right for your test date. The CNA passing score guide explains Tennessee's 75%.

U.S. Virgin Islands. The outline page says the written exam "is comprised of sixty (70) multiple-choice items," while the same page elsewhere says seventy (70). The Pennsylvania handbook and the other Credentia pages checked give 70, which matches the written-exam description on the Virgin Islands page itself.