How Many Questions Can You Miss on the CNA Written Exam?

The short answer: there is no national number. On the NNAAP nurse aide written examination you answer 70 multiple choice questions, but only 60 of them are scored, and the passing standard for those 60 is set by your state board rather than by a single countrywide rule. Any page that tells you "you can miss 15" is quoting one state's number, or nobody's. Your state candidate handbook is the only source that binds.

That answer is less satisfying than a number, so it is worth explaining where the confusion comes from and what to do about it, because the structure of the exam genuinely does change how you should study.

Why the numbers you find online disagree with each other

Search this question and you will get confident, specific, contradictory answers: miss up to 15, miss 12 to 18, you need 70 percent, you need 80 percent. They disagree because they are answering slightly different questions and none of them say so.

Three things vary. First, the testing vendor: many states use the NNAAP examination administered by Credentia, while others test through Prometric or another vendor with a different question count and a different skills list. Second, the passing standard, which state boards set individually and publish in their own candidate handbooks. Third, and this is the one almost everybody gets wrong, the difference between the questions you answer and the questions that count.

How many questions are actually scored on the CNA exam?

Sixty. The NNAAP written examination is built from 70 multiple choice items, and 10 of those are pretest items that Credentia includes to gather statistical data on new questions before they go live. Pretest items are not scored. You cannot tell which ones they are while you are sitting there, and you should not try.

If you take the oral version instead, the structure changes: 60 multiple choice items plus 10 reading comprehension items that test recognition of words commonly used in long-term care. Either way you get 2 hours, and you are told when 15 minutes remain.

The practical consequence of the pretest items is that a handful of the questions you sweat over on test day are worth nothing. You have no way of identifying them, so the only sane strategy is to treat all 70 as real.

What is a passing score for the CNA exam?

It depends on your state, and your state candidate handbook publishes it. What is consistent everywhere is the scoring unit: your result comes from the 60 scored items, not from all 70. So if you are trying to reverse-engineer a target, do it against 60, and get your state's actual standard rather than an average of what strangers on the internet remember.

It is also worth knowing that these exams are scored against a cut score established through a formal standard-setting process, not against a fixed percentage plucked out of the air. That is why the answer is a state-published standard rather than a universal "75 percent" folk rule.

Where candidates actually lose the points

Counting permitted misses is the wrong optimization anyway. A more useful question is which parts of the exam carry enough weight to sink you, and the 2024 NNAAP content outline answers that precisely. It splits the 60 scored questions like this:

Inside Physical Care Skills, one subcategory dominates: Basic Nursing Skills is 35 percent of the exam on its own, or 21 of your 60 scored questions. That covers infection control, safety and emergency response, technical procedures, and data collection and reporting. Activities of Daily Living adds another 22 percent, or 13 questions.

Put those two together and you have 34 of 60 questions, well over half the exam, sitting in material most programs cover in the first few weeks. Meanwhile Spiritual and Cultural Needs is a single question. Candidates who spend equal time on every chapter are misallocating badly.

The skills evaluation has a stricter rule, and it is not a percentage

The written test is only half of what stands between you and the state registry. The skills evaluation asks you to perform five assigned skills in 30 minutes for a Nurse Aide Evaluator, and its scoring works nothing like the written exam.

Each skill contains Critical Element Steps. These are the steps that protect the client's safety, and if you miss even one of them you fail that skill outright, no matter how well you performed the rest. Performing only the Critical Element Steps does not save you either, since you still have to demonstrate enough of the remaining steps to meet the passing standard for that skill. So on the skills side, the honest answer to "how many can I miss" is zero, at least for the steps that matter.

Two of the five skills are predictable, which is the single most useful thing to know about the evaluation. Hand hygiene is always assigned. You will also always get exactly one measurement skill: blood pressure, radial pulse, respirations, urine output or weight. That is 40 percent of your skills evaluation that you can rehearse to the point of boredom before you walk in.

What to do instead of counting misses

The candidates who pass comfortably are not the ones with the best estimate of the cut score. They are the ones who spent their study time answering questions rather than rereading handouts, because the exam tests retrieval under a clock and rereading trains recognition instead.

A workable routine looks like this. Pull your state candidate handbook and read the sections on fees, scheduling, attempts and the skills list, so the administrative side stops taking up mental space. Work through Credentia's free official NNAAP practice written exam packet to calibrate against the real item style. Then drill your own program's material one content area at a time, starting with Basic Nursing Skills because it is 21 questions.

That last part is where most candidates get stuck, because the free question sets online are not written against the packet your instructor handed you. You can close that gap by uploading your own handouts and generating a CNA practice test from them, which produces questions about the material your program actually taught rather than a generic bank. Take a set, mark what you missed, then generate a fresh one from the next content area the following night. Rotating through the outline this way surfaces the weak patch before an evaluator does.

For the skills half, the equivalent move is to upload your program's skills checklist and drill the sequence, since most skills failures are ordering failures rather than technique failures. Then rehearse out loud with a classmate holding the checklist.

How many times can you retake the CNA exam?

Attempt limits and deadlines are set by your state, and the written and skills components are tracked separately, so a candidate who passes one and fails the other only retakes the half they lost. Some states also impose an outer deadline: Washington, as one published example, requires candidates who have not completed testing within three years to retrain and retest. Since retests generally cost the full fee again, and those fees are set per state, the arithmetic favors drilling properly the first time.

Is the CNA written exam hard?

Not conceptually. Nothing on it is intellectually difficult for someone who completed a state-approved training program. It is broad, though, and 60 scored questions across ten content areas means a thin patch anywhere shows up in your result. Most candidates report the skills evaluation as the harder half, which fits: it is performance under observation with an all-or-nothing rule on the Critical Element Steps.

Passing puts you on your state's nurse aide registry, which is what employers verify before they hire. It is also the point at which it stops being an academic exercise and starts being a wage, and it is worth knowing what a first offer is actually worth in your market before you accept the first one you are given. Plenty of new CNAs go on to use the same study routine for the NCLEX-PN or, later, NCLEX practice questions on the way to an RN seat, and the TEAS practice test if nursing school admission comes first.

Last updated August 2026. Exam structure and content outline figures in this article come from Credentia's published NNAAP written examination materials and the 2024 NNAAP content outline. Passing standards, fees and attempt limits are set by individual state boards and are published in state candidate handbooks. PDFQuiz is an independent study tool and is not affiliated with or endorsed by Credentia, Prometric, NCSBN or any state nurse aide registry.