CNA guide · updated 2026-09-29

CNA written exam vs oral exam

Both follow the same 2024 NNAAP content outline and both give you 2 hours. The written exam is 70 multiple-choice questions; the oral exam is 60 multiple-choice questions read aloud plus 10 reading comprehension (word recognition) questions, and you must pass both parts of the oral exam.

Side by side

	Written	Oral
Content outline	2024 NNAAP	2024 NNAAP
Questions	70 multiple choice (10 pretest)	60 multiple choice + 10 reading comprehension
Time	2 hours	2 hours
Delivery	Read on screen or paper	Read aloud: MP3 player at test centers, recorded voice online
Passing	Pass/fail	Must pass multiple choice and reading comprehension parts

Why the oral option exists

Federal regulation requires states to let an aide choose between a written and an oral exam. The oral option exists for candidates who have difficulty reading, including many for whom English is a second language. It is not an easier exam; it tests the same knowledge.

What the reading comprehension part is

The 10 reading comprehension items check that you can recognize common words used on the job. You need to pass this part separately. If you would struggle to read words like "bedpan", "gloves" or "oxygen" on a chart or sign, practice job vocabulary before choosing the oral exam.

Who should pick which

Pick the written exam if you read English comfortably and like to reread a question at your own pace.
Pick the oral exam if reading slows you down or makes you second-guess, but you understand spoken English well.
Either way, the study plan is the same: follow the outline weights and practice scenario questions.

Practicing for the oral exam

Read practice questions out loud, or have someone read them to you, and answer without looking at the text. This builds the habit of holding four options in memory. Then check your answer and read the explanation normally.

The study plan is the same

Because both versions follow the 2024 NNAAP outline, prepare the same way. Put most of your time into Physical Care Skills (64%): infection control, safety, emergencies, hygiene, nutrition, elimination and measurements. Then cover Role of the Nurse Aide (26%) and Psychosocial Care Skills (10%). Timed practice matters for both formats, because two hours goes faster when questions are read aloud and you cannot skim ahead.

For the oral exam, practice listening to a whole question before deciding. People who choose the oral version sometimes lock onto the first option that sounds familiar. Hold off until you have heard all four.

Deciding in one minute

Read a practice question silently. If you understand it on the first read, choose the written exam.
If you needed to reread it twice but understood it when someone read it aloud, consider the oral exam.
If spoken English is also hard, spend extra time on job vocabulary first, since the oral exam still includes a word-recognition section.

Frequently asked questions

Is the oral CNA exam easier?

No. It covers the same content outline. It only changes how the questions are delivered and adds a word-recognition section.

Can I switch from written to oral for a retake?

State rules vary. Check your state handbook or ask Credentia when you schedule.

Try the free CNA practice test

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Sources: Credentia NNAAP Handbook: The NNAAP Written (or Oral) Examination · 42 CFR 483.154 - Nurse aide competency evaluation · 2024 NNAAP Written (Oral) Examination Content Outline (NCSBN / Credentia). Independent study material. Not affiliated with or endorsed by NCSBN or Credentia.