CNA guide · updated 2026-09-29

NNAAP written exam content outline (2024)

The 2024 NNAAP outline has three domains: Physical Care Skills (64%), Role of the Nurse Aide (26%) and Psychosocial Care Skills (10%). Basic Nursing Skills alone is 35% of the scored exam, about 21 of the 60 scored questions.

Where the outline comes from

NCSBN revised the NNAAP outline from its 2019-2020 job analysis of nurse aides, published in 2023. Credentia, which runs the exam in NNAAP states, publishes the outline as a one-page PDF. It applies to both the written and the oral exam.

Full outline with weights

Domain / area	Weight	Approx. scored items
I. Physical Care Skills	64%	38
A. Activities of Daily Living (hygiene, dressing and grooming; nutrition and hydration; elimination; rest, sleep and comfort)	22%	13
B. Basic Nursing Skills (infection control; safety, prevention and emergency; technical procedures; data collection and reporting)	35%	21
C. Self Care / Independence	7%	4
II. Psychosocial Care Skills	10%	6
A. Emotional and Mental Health Needs	8%	5
B. Spiritual and Cultural Needs	2%	1
III. Role of the Nurse Aide	26%	16
A. Communication	7%	4
B. Client Rights	8%	5
C. Legal and Ethical Behavior	5%	3
D. Member of the Health Care Team	6%	4

What each area tests in practice

Activities of Daily Living: bathing and perineal care, oral and denture care, dressing a client with a weak side, feeding and aspiration precautions, fluid intake, bedpans and catheter care, positioning for comfort.
Basic Nursing Skills: hand hygiene and PPE order, isolation precautions, fall and restraint rules, body mechanics and transfers, fire and choking response, vital signs, weight, range of motion, skin checks, and what to report to the nurse.
Self Care / Independence: letting clients do as much as they can, assistive devices, restorative routines.
Emotional and Mental Health Needs: anxiety, depression, confusion and dementia behaviors, grief, dying clients.
Spiritual and Cultural Needs: respecting religious practices, diet restrictions and cultural preferences.
Role of the Nurse Aide: communicating with clients who have hearing, vision or speech loss, privacy and confidentiality, the right to refuse, recognizing and reporting abuse, scope of practice, working with the nurse.

How to use the weights

Study time should follow the weights. Basic Nursing Skills plus Activities of Daily Living cover 57% of the scored exam, so infection control, safety and daily care deserve most of your hours.

Do not skip the small areas. Client Rights (8%) and Communication (7%) together are worth about as much as all of Activities of Daily Living's nutrition and elimination questions, and the answers follow a few consistent principles, so they are quick points once learned.

Written exam only

The outline covers the knowledge exam. The skills evaluation is a separate hands-on test with its own list of skills, and it is not part of these weights. The practice questions here follow the written outline.

Common mistakes when reading the outline

Some study sites repeat older percentages, or mix up the domain totals with the sub-area percentages. In the 2024 outline, the sub-areas add up to the domain totals: 22 + 35 + 7 = 64% for Physical Care Skills, 8 + 2 = 10% for Psychosocial Care Skills, and 7 + 8 + 5 + 6 = 26% for Role of the Nurse Aide. If a guide shows different numbers, it is probably out of date.

Frequently asked questions

Did the NNAAP outline change in 2024?

Yes. The current outline is the 2024 version based on the 2019-2020 NCSBN job analysis. Older study guides may still show the previous weights.

Is the oral exam outline different?

No. The same outline applies to both. The oral exam adds 10 reading comprehension (word recognition) questions.

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Sources: 2024 NNAAP Written (Oral) Examination Content Outline (NCSBN / Credentia). Independent study material. Not affiliated with or endorsed by NCSBN or Credentia.