CNA Exam and Certification Texas

The Texas Health and Human Services Commission is responsible for the administration of the CNA exam and management of the Nurse Aide Registry. A prospective nurse aide must complete 100 clock hours of training, including 60 clock hours of classroom instruction and 40 clock hours of hands-on care in a nursing facility. The training covers communications and interpersonal skills, physical needs of patients, resident independence and rights, safety and emergency procedures, and other areas of direct patient care to prepare students for their role as a Certified Nursing Assistant. Any individual listed as unemployable on the Employee Misconduct Registry (EMR) or convicted of a criminal offense will not be eligible to take the Nurse Aide Exam exam and should not enroll in a nursing assistant program. Once registered on the Nurse Aide Registry, CNAs must complete 24 hours of in-service education biennially to qualify for renewal.

CNA Classes in TX:

How to Apply for the Nurse Aide Exam Texas

Online registration and scheduling of the NNAAP are now available for Texas candidates. Submit your registration request online if you qualify under one of the eligibility routes described below:

New or Retrained Nurse Aide

If you successfully completed a state-approved nurse aide training program in the past 24 months, you can register for the exam online.

  • Receive email from Prometric confirming that your training program coordinator has uploaded your course completion information
  • Logon and complete the application in the TX Nurse Aide portal online
  • Pay the required test fees to Prometric and schedule your exam
  • Pass the Clinical Skills and Written or Oral Exam within 24 months of completing your training. Note: you will have three attempts to pass the exam before you are required to retrain

ER 5528 – Nurse Aide with Expired Status

Your nurse aide certification will expire if you do not complete the practice and in-service education requirements during the 24-month cycle. You’ll need to take the Written exam and Skills evaluation to renew your certificate.

  • Complete form NAR-5528 and submit to HHSC for authorization to test and submit the form with your application for the exam. Note: If you HAVE performed nursing or nursing related duties in a health care setting during the twenty-four (24) months and completed 24 hours of in-service education since registration or renewal, you do not need to re-test.

ER 5511- Nurse Aide With Equivalent Military Training

If you completed a military training program that is equivalent to civilian nurse aide training, providing 100 hours of instruction or more, you could apply to HHSC for authorization to take the exam.

  • Complete form 5511-NATCEP and submit to HHSC for authorization to test

ER 5512- RN/LVN Graduate

Nursing graduates are qualified to take the exam under eligibility route 5512. To be eligible to take the exam as a nurse graduate, you must apply within 24 months of completing a state-accredited nursing program.

  • Complete form 5512-NATCEP and submit to HHSC for authorization to take the exam.

ER 5513 – RN/LVN Students

If you completed basic nursing training in a state-accredited registered nurse or licensed vocational nursing program, you can contact HHSC for authorization to take the exam.

  • Complete form 5513-NATCEP and submit to HHSC for authorization to test

ER 5510 – Out-of-State Training

An out-of-state trained nurse assistant can take the exam for inclusion on the Nurse Aide Registry. You must have completed the training within the past 24 months.

  • Complete form 5510-NATCEP and submit to HHSC for authorization to test

You must complete a Texas Certified Nurse Aide Examination Application in the Prometric online portal. Complete the form clearly and accurately. Submit your payment with the application. You must have a social security number to take the test. After you complete the exam application and payment, you may schedule your exams at any convenient testing centers or via remote proctoring (Written/Oral exams only) on your preferred date and time. You will receive an Admission to Test Letter that will include the test site location and the exam start time.

If you have a qualifying disability recognized under the Americans with Disabilities Act, you may be eligible for special testing accommodations. You must submit the request with your application by using the ADA Accommodations tab on Prometic’s website. State the type of accommodation you need – examples are a separate testing room, extra time for the test, or someone to read and record your responses. Provide documents to support your request, such as a letter from the professional who diagnosed your condition and a description of the type of arrangements you received for the nursing assistant training program. Requests are determined on a case-by-case basis and should be submitted 6 weeks prior to the exam.

It is possible to reschedule a new test date if you’re unable to attend your scheduled exam. Prometric allows candidates to reschedule one time, without penalty charges, if they request a new date at least five calendar days before the exam date. Your new test date could be 24 hours after the initial exam date. If you need to reschedule an exam less than five calendar days before the exam, you must apply for an excused absence and a penalty may be applied. If you do not call Prometric at least five calendar days before the exam and do not show up for the exam, you’ll have to pay another application fee to schedule a new exam date.

Exam Costs

By federal and Texas laws, your nursing home employer must pay your exam fees for testing and retesting if the facility is funded by Medicare/Medicaid funded facility. If you cover the costs of the exam out-of-pocket, you may be eligible for a prorated reimbursement if you become employed at a state-funded facility within 12 months of certification.

The Written Exam and Skills Evaluation are administered on the same day for first-time testers, so you must pay for both components during registration.

The fees for the exam are as follows:

  • Written Exam and Skills Evaluation – $125
  • Oral Exam and Skills Evaluation– $135
  • Written Exam Retest – $35
  • Oral Exam Retest – $45
  • Skills Evaluation retest – $90

Nurse Aide Exam Overview Texas

A little preparation will go a long way to avert potential failure. The two parts of the Nurse Aide exam test your nurse assistant skills, such as your ability to properly make a bed and take a measurement, and your understanding of nursing principles and how they relate to legal and ethical principles. For the written (knowledge) test, you must correctly answer more than 80 percent to pass the exam. Reviewing your notes and practicing your skills are good measures to prepare for success. The Candidate Bulletin contains the Skills List and examples of questions on the written test that you can review. Online practice tests provide another means of preparing for the exam. If you pass both portions of the exam, your name will be added to the Texas Nurse Aide Registry.

The Written/Oral Exams are administered in four different types of locations. The specific options that are available to you will appear in the TX Nurse Aide portal for selection for scheduling:

Computer-Based Testing (CBT) locations – open multiple days/weeks to candidates from any profession

Regional Testing Sites – open to nurse aide candidates from any training program

In-Facility Testing (IFT) sites – open to nurse aide candidates with pre-approval from the site

Live Remote Proctoring – available to any candidate with the required computer, internet, and space requirements

The Clinical Skills Exams are administered in two different types of locations. The option that is available to you will appear in the Texas Nurse Aide portal.

Regional Testing Sites – open to nurse aide candidates from any training program

In-Facility Test (IFT) Sites – open to nurse aide candidates with preapproval from the site

The Written Exam

The Written test contains 60 multiple-choice questions that test your knowledge of safe and effective patient care. You will take the Written Test on a computer at the test site or via remote proctoring. You do not need computer experience to take the test. You will use a computer mouse to select answers. You will have the chance to answer several practice questions to get familiar with the computer for you begin the test. The duration of the test is 90 minutes. A content outline available in the Candidate Bulletin will list all the topics covered in the test.

The Oral Exam

You have the option to take the Written exam in Oral format if you have a reading disability. The oral (audio) exam is available in English and you must request it when you submit your registration for the exam. At the test center, you will hear the questions read to you while on the computer. You may replay questions as many times as needed. The Oral exam contains questions similar to the Written exam in the first sixty questions. A second component of the exam is the reading comprehension consisting of 15 multiple-choice questions to evaluate your understanding of common English words used by nursing assistants. You must pass both parts of the exam to pass the overall exam.

The Skills Exam

For the clinical exam, be scored on five skills. Many students consider this part of the exam the most stressful, but you can alleviate anxiety if you prepare and remember your role as a CNA. The exam room will be set up to resemble an actual caregiving situation with the necessary equipment, a candidate volunteer, and the evaluator present. While performing three assigned skills, you will also be scored on two additional skills – Handwashing and Indirect Care. Indirect care is care related to resident rights, communication with the resident, resident safety and comfort, and infection control.

The time limit for each test will depend on the skills assigned. The instruction care will advise of the time limit. You must pass all five skills to pass the clinical skills test. You do not have to perform the skill perfectly but you must demonstrate competency. Each skill has a list of checkpoints. The Nurse Aide Evaluator will watch you perform the skill and compare your performance to the checkpoints for the skill.

Make sure you understand the tasks listed on the assignment card and ask questions before you begin. Verify that you have all the necessary equipment – ask the proctor if you don’t see the tools you need in the room. Follow the order of the skills list on the card and make sure to wash your hands thoroughly at the end of the evaluation. Make sure you dress appropriately for the exam in loose-fitting scrubs or uniform and flat, non-skid shoes with enclosed toes.

What To Bring To The Exam

A proctor will need to verify your two forms of ID before admitting you to the Written and Skills exam. Therefore, you should arrive early to check in, have your registration verified, and receive instructions for the exam.

You’re expected to present:

  • An ID with a recent photo and a second ID. Both forms of identification must contain your signature and match the name used to register for the exam. Acceptable forms of photo identification are a driver’s license, passport, student identification, government-issued military ID, or alien registration card
  • Authorization to Test Letter – present the original letter sent to you by Prometric via email
  • A watch with a second hand
  • You are required to wear flat, nonskid, closed-toed shoes to take the clinical skills test

No other materials are allowed in the exam room. You cannot take books, large personal items, and study resources into the exam room. Keep in mind that there may not be room for storage at the test site. All cell phones and similar devices must be switched off when the exam is in progress.

Receiving Your Scores

Since your test is given on a computer, you will get a score report emailed to you on the same day. The score report will list either pass or fail. Test site employees cannot discuss your scores with you.

For the clinical skills test, your score report will be emailed to your shortly after the completion of your test. You must pass all five skills to pass the Clinical Skills Test. The Nurse Aide Evaluator cannot discuss your results with you.

Once you pass the Clinical Skills and Written/Oral Test, your information will be provided to HHSC for entry in the Texas Nurse Aide Registry. Results are confidential and are not given over the phone.

If you failed the exam, you need to go to the Exam Scheduling portal on Prometric to submit payment and schedule a retest.

Contact the Registry

Texas Health and Human Services Commission
Nurse Aide Registry
Mail E-414
PO Box 149030
Austin, TX 78714-9030
(512) 438-2050

TX Nurse Aide
7941 Corporate Dr.
Nottingham MD 21236
Phone: 800.488.5787

NACES Plus Foundation, Inc.
8501 North Mopac Expressway, Suite 400
Austin, TX 78759
(800) 444-5178

Crystal G

Crystal is a certified Registered Nurse (RN) with a passion for writing about nursing education. Through her articles, Crystal shares insights and tips to help fellow nurses enhance their skills and stay updated with the latest developments in the field. With a focus on practical advice and relevant topics, Crystal's writing is a valuable resource for nursing professionals seeking to advance their careers.