20 free CNA written exam practice questions

Correct answer: A · Ease her weak left arm into its sleeve first, then help with the right arm

The weak arm goes into its sleeve first. That way the sleeve slides on while the stronger arm can still bend and reach, and the weak arm is not twisted or pulled into the last sleeve at an awkward angle. Starting with the stronger right arm leaves the weak arm for last, which is the harder order for it. Being seated and well supported makes dressing safer, but it does not make the order a free choice. Which arm is closer to the aide is a matter of convenience, not of her comfort or safety.

Look for this next time: When a resident has a weak arm, dress the weak arm first so it is not forced into the last sleeve.

Correct answer: D · Record the amounts she actually took, and tell the nurse she ate much less than usual

An intake record is only useful if it shows what the resident really ate and drank, and eating much less than usual is a change in her condition that the nurse needs to hear about. So the aide records the actual amounts in the facility's format and reports the drop now. Keeping the tray until she finishes pressures her and still would not make the record honest. She may decline food, but clearing the tray without recording it loses information the care team is tracking. Waiting for dinner delays the report of a change that has already happened.

Look for this next time: Record what a resident actually eats and drinks, and report a clear drop from her usual intake to the nurse.

Correct answer: C · On the chair frame, below his bladder and off the floor, with the tubing free of kinks

CDC's 2009 guideline on preventing catheter-associated urinary tract infections (HICPAC, updated 2019) says to keep the collecting bag below the level of the bladder at all times, not to rest it on the floor, and to keep the catheter and tubing free of kinks so urine keeps flowing. Hanging the bag on the chair frame below his bladder meets all three. On his lap, the bag sits at about the level of his bladder rather than below it, and on the armrest at chest height it is above it. The floor beside the wheel is exactly where the guideline says the bag should not rest.

Look for this next time: Keep a catheter drainage bag below the bladder and off the floor, with the tubing free of kinks.

Correct answer: A · Close the curtain and uncover only the part of her body being washed

Under the federal resident-rights rule, personal privacy includes personal care (42 CFR 483.10(h)(1)). Closing the curtain and uncovering only the area being washed protects her dignity, and keeping the rest of her covered also keeps her warmer. Uncovering her completely exposes her for the whole bath and leaves her colder, even if the bath goes a little faster. An open door lets anyone in the hall see her, whoever it is meant for. Privacy does not depend on whether the roommate is there, since staff or visitors can come in at any time.

Look for this next time: During a bath, close the curtain and uncover only the area you are washing.

Correct answer: D · Help him into a position his care plan allows, and tell the nurse about the pain now

Pain that keeps a resident awake is something the nurse needs to know about when the aide learns of it, whatever the hour. Repositioning him within what his care plan allows is part of the aide's role and may ease him while the nurse decides what else he needs. Giving medicine, even a nonprescription pain reliever, is not among the skills the federal nurse aide curriculum lists (42 CFR 483.152(b)), and it is the nurse's decision. Telling him to wait for the day nurse leaves him in pain for hours and delays the report. Dimming the light and checking later does nothing about the pain itself.

Look for this next time: Comfort the resident within the care plan, and report pain to the nurse when you learn of it, not at shift change.

Correct answer: C · Wash her hands with soap and water before touching anything else

CDC's hand hygiene guidance for health care workers (2024) prefers alcohol-based hand sanitizer in most clinical situations unless hands are visibly soiled, and calls for soap and water when they are. Stool on the skin is visible soil, so she washes with soap and water. An alcohol-based rub is the usual choice for hands that look clean, which is why it is tempting here. Fresh gloves over a soiled hand cover the problem instead of cleaning it; CDC says gloves are not a substitute for hand hygiene and that hands are cleaned after gloves come off. A surface disinfectant wipe is meant for equipment and surfaces, and wiping with it is not hand hygiene.

Look for this next time: Use soap and water when hands are visibly soiled; an alcohol-based rub is for hands that are not.

Correct answer: D · Remove the gloves, clean your hands, and use fresh gloves if the next task requires them

Moving from a soiled body site to a clean one requires removing contaminated gloves and performing hand hygiene. Use fresh gloves when the next task or the required precautions call for them; gloves are not routinely required just to touch intact facial skin. Caring for the same resident does not make used gloves clean. Rinsing or wiping disposable gloves does not replace removal and hand hygiene.

Look for this next time: Change gloves and clean your hands when you move from a soiled body site to a clean one on the same resident.

Correct answer: A · A gown and gloves, even though she will touch only the table

CDC's Transmission-Based Precautions guidance (2024) calls for a gown and gloves for all interactions that may involve contact with the patient or the patient's environment. The overbed table is part of the resident's environment, so the aide wears a gown and gloves even for this short task. Gloving only if she touches the resident or the bed ignores the table and leaves her clothing unprotected. A mask on entering the room is the Droplet Precautions step and does not replace a gown and gloves here. Wearing nothing extra treats the table as clean, when the guidance counts the environment too.

Look for this next time: Under Contact Precautions, touching the resident's environment calls for a gown and gloves, not only touching the resident.

Correct answer: A · Stay with her, encourage her to keep coughing, and call out for the nurse

A strong cough and the ability to talk mean air is still getting through. The American Red Cross advises that when a choking person can cough, cry, or speak, you encourage them to keep coughing, keep watching them, stay with them, and be ready to act if their condition changes. So the aide stays and calls for the nurse from where she is. Abdominal thrusts are part of the care for a person who cannot cough, speak, or cry, not for one who is coughing well. Sips of water are not part of that advice while she is still coughing to clear the food. Leaving for the nurses' station means no one is watching if her cough weakens or stops.

Look for this next time: If a choking resident can still cough or speak, stay with her, encourage coughing, and get help without leaving.

Correct answer: B · Help her into well-fitting, non-skid footwear, then help her stand

Thin socks can slide on a smooth floor. Well-fitting, non-skid footwear gives her feet grip and support before she puts weight on them, so the aide puts it on first. Holding her arm more firmly does not stop her feet from sliding. A second person at her side still leaves her standing in socks that can slip. Bare feet are not a safe substitute for non-skid footwear and leave her feet unprotected. CDC reports that falls are the leading cause of injury death for adults 65 and older, so simple steps before standing matter.

Look for this next time: Put well-fitting, non-skid footwear on a resident before helping her stand or walk.

Correct answer: D · Record the pulse and report it and her symptom to the nurse right away

A pulse well above her usual rate, together with a new symptom, is an abnormal change. Federal training rules list recognizing abnormal changes in body functioning and reporting them to a supervisor as a basic nursing skill (42 CFR 483.152(b)(2)). The aide records the count and tells the nurse now, including what the resident said. Waiting an hour to recount delays the report of a change that is already there. An end-of-shift note reaches the nurse eventually, but hours late. Feeling better lying down does not make the change safe to leave unreported; the nurse decides what it means.

Look for this next time: Report a vital sign that is well off the resident's usual value, and any new symptom, to the nurse right away.

Correct answer: B · That the scale balances at zero with nothing on it

A scale that does not start at zero adds the same error to every reading, so the aide checks that it balances at zero before he steps on. Keeping shoes on adds weight that is hard to subtract exactly, and it makes today's weight hard to compare with the last one. Steadying himself on the wall takes part of his weight off the platform, so the reading comes out low. An estimate from the nurse is not a measurement, and the record needs a measured weight, not a guess.

Look for this next time: Make sure a scale reads zero before a resident steps on, so the weight you record is accurate.

Correct answer: A · Give her the time she needs, and help only with the buttons she cannot do

Federal training rules include promoting residents' independence and training residents in self-care according to their abilities (42 CFR 483.152(b)), and residents have the right to make choices about their care. She can do most of the buttons, so the aide lets her and helps only where she needs it. Buttoning the blouse for her is faster, but it takes away a task she can still do herself. Putting the blouse off for a robe sets aside her choice of clothes for the aide's schedule. Choosing a pullover for her without asking replaces her choice with the aide's.

Look for this next time: Let residents do what they can for themselves, and help only with the part they cannot manage.

Correct answer: C · Acknowledge her worry for her children, and walk with her to a familiar activity

Federal training rules cover techniques for the needs and behaviors of residents with dementia and appropriate responses to that behavior (42 CFR 483.152(b)(5)). Responding to the feeling behind her words and offering a familiar activity, while staying with her, keeps her calm and safe. Correcting her with facts she may not be able to hold on to can upset her more without changing what she believes. Keeping her in her room with the door closed until she settles can amount to involuntary seclusion, which the federal abuse rule prohibits. Leaving her at an exit door ignores both her distress and her safety.

Look for this next time: With a resident who has dementia, respond to the feeling, redirect gently, and stay with her rather than arguing or isolating her.

Correct answer: B · Sit down with her and invite her to say more about what feels wrong

Moving into a facility is a major change, and federal training rules include residents' mental health and social service needs, such as how to respond to resident behavior (42 CFR 483.152(b)(4)). Sitting with her and inviting her to talk shows that her feelings matter and helps the aide learn what is behind them. Telling her everyone feels this way brushes her feelings aside. Leaving her alone right after she says she does not belong can feel like rejection. Asking the roommate to cheer her up hands the aide's role to another resident, who may not be someone she wants to confide in. If her sadness continues, the aide tells the nurse what she has noticed.

Look for this next time: When a new resident is upset, sit with her and listen before you offer reassurance.

Correct answer: D · Use short, simple sentences, give him time, and ask him to point or gesture

The National Institute on Deafness and Other Communication Disorders (NIDCD, 2025) advises short, uncomplicated sentences, plenty of time to talk, and encouraging any type of communication, including gestures and pointing. Short sentences, extra time, and an invitation to point or gesture put that advice into practice. Finishing his sentences takes the conversation away from him and may guess wrong. NIDCD advises avoiding correcting the person's speech, so correcting each word works against that advice. Having the nurse speak for him leaves him out of his own conversation, while NIDCD advises including the person with aphasia in conversations.

Look for this next time: With aphasia, keep sentences short, allow time, and welcome gestures or pointing instead of correcting or speaking for the person.

Correct answer: B · Accept her choice and offer to set up the shower for the evening instead

Federal resident-rights rules give residents the right to refuse treatment and to choose their activities and schedules (42 CFR 483.10(c)(6) and (f)(1)). Offering the evening shower she asked for respects that choice, and the aide lets the nurse know about the change as the facility's policy directs. Giving the shower anyway overrides her refusal. Linking the afternoon outing to the shower turns her choice into a threat of losing a privilege. Bringing in a second aide to get it done before breakfast is pressure that disregards what she said.

Look for this next time: Respect a resident's refusal, offer another time, and let the nurse know as your facility's policy directs.

Correct answer: B · Decline, and tell the nurse about the request and the daughter's worry

A sheet tied to keep him in the chair is a physical restraint. Federal rules give residents the right to be free from restraints imposed for discipline or convenience and not required to treat medical symptoms, and when restraints are indicated, the facility must use the least restrictive alternative for the least amount of time (42 CFR 483.10(e)(1) and 483.12(a)(2)). That is not the aide's or the family's decision, so the aide declines and tells the nurse about the request and the fall worry. Tying the sheet loosely is still a restraint, and telling the nurse afterward does not make it allowed. Using it only at mealtimes is a restraint on a schedule. A sheet tucked tightly around him holds him in place just the same.

Look for this next time: Do not improvise a restraint at a family member's request. Report the concern to the nurse; any authorized restraint requires the applicable assessment, orders, care plan, and monitoring.

Correct answer: C · Make sure the resident is safe, then report it right away by the facility's procedure

Grabbing and yelling may be abuse. Protect the resident and report immediately under the facility procedure and applicable law. Federal rules distinguish facility duties from covered individuals' duties to report reasonable suspicion of a crime; internal reporting alone may not discharge external reporting obligations. Do not wait for a bruise, the end of the shift, or a supervisor's permission. A family call does not replace the required reporting routes.

Look for this next time: Protect the resident and report suspected abuse immediately. Follow the facility procedure and applicable external reporting duties; do not wait for proof or permission.

Correct answer: C · Tell the nurse she has not been trained for this task and cannot do it

The aide must tell the nurse she is not trained or competent to perform this task. A request from a nurse does not supply the missing competence or legal authority. Delegation rules differ by state; any permitted task still requires appropriate training, demonstrated competence, and supervision. Asking an equally untrained coworker or watching a video and trying it on the resident is unsafe. The federal training rule separately prohibits students from performing services before training and proficiency assessment.

Look for this next time: If you have not been trained for a task, tell the nurse instead of attempting it or handing it off.