The Texas Department of Aging and Disability Services (DADS) 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 NNAAP 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.
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How to Apply for the NNAAP 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 NNAAP online.
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. Apply to DADS for authorization to test and submit the form with your application for the exam.
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 DADS for authorization to take the exam.
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. Apply to DADS 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 DADS for authorization to take the exam.
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 and apply to DADS for authorization to take the exam.
ER 5525 – Training Program Closed
You might be eligible to take the exam if you completed a training program that closed in the past 24 months. Contact DADS for more information.
Online scheduling through the Credential Management Services lets you schedule a test date within hours and reduces the transit time of submitting an application via the postal service. Before you register, you must create an account to submit your registration, track the process of the submission, and view your score report. You should submit your reservation at least 11 days before your desired test date and make the payment using a credit card or prepaid credit card.
The steps simplified:
- Create an account to receive updates.
- Follow the step-by-step instructions to set up your reservation at least 11 days before the desired test date.
- Submit your payment using a credit card or prepaid credit card. The exam fee is non-refundable and non-transferrable. Your application will not be completed until you make the payment.
- Upload the Approval letter from DADS during the registration.
- Contact a Pearson Vue support representative at (866) 377-0252 if you need assistance with the reservation process.
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 Pearson’s Vue 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 could take up to 30 days for review.
It is possible to reschedule a new test date if you’re unable to attend your scheduled exam. Pearson Vue allows candidates to reschedule one time, without penalty charges, if they request a new date at least nine 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 nine calendar days before the exam, you must apply for an excused absence and a penalty may be applied. If you do not call Pearson Vue at least nine 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.
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 – $85.50
- Oral (Spanish or English) Exam and Skills Evaluation– 85.50
- Written Exam Retest – $22.50
- Oral (Spanish or English) Exam Retest – $22.50
- Skills Evaluation retest – $63
NNAAP Exam Overview Texas
A little preparation will go a long way to avert potential failure. The two parts of the NNAAP 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 Handbook contains the NNAAP 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 Exam
The Written test contains 70 multiple-choice questions that test your knowledge of safe and effective patient care. An experienced registered nurse aide evaluator will supervise the exam, providing instructions at the beginning and alerting candidates fifteen minutes before the end of the two-hour exam. All the topic questions will fall into three main categories. Physical care skills delve into your ability to assess the patient’s physical needs, hygiene being of the most important. It also addresses nutrition, immobility, and physical activity. The psychosocial needs of patients account for another category of questions that relate to your ability to empathize with patients by listening to their complaints and respecting their rights and need for socialization. The role of the nurse aide is the final category that covers your interaction with patients and other health care providers, your management skills, and use of discretion. The Candidate Handbook contains the sections in each category and the percentage they account for on the overall exam.
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 or Spanish, but you must request it when you submit your registration for the exam. If you’re having difficulty choosing between the Written or Oral exams, you can take a reading assessment to help you decide. A simple assessment is available in the Candidate Handbook. It contains a few reading comprehension questions in multiple-choice format and answers to tally your final score. If you score lower than 17 on the assessment, you should register for the Oral exam. At the test center, an evaluator will provide an MP3 player and headset that you’ll use to listen to the questions. Each question will be read twice, and you’ll provide your responses on the answer sheet. 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 ten 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, you’ll have to successfully complete five separate skills for the state-appointed evaluator. 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. One of the skills will be handwashing, and the other four will be selected at random from the NNAAP Skills List. At least one of the randomly selected skills will be “Recording a Measurement.” You must perform the critical element steps for each skill correctly to pass the exam. However, be careful that you don’t pay so much attention to the CES that you neglect the simple tasks. It helps to keep the patient’s needs and rights at the top of your mind because that is more important than mechanically going through your list of skills. Treat the resident actor just as you would a real patient. That means talking to the “patient,” introducing yourself, informing him/her of what you’ll be doing, being courteous and respectful, and checking the room for hazards or waste. 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. Since you’ll have to play the role of a resident for another volunteer, it is integral that 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 one 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. If your name changes, you should contact Pearson Vue to submit official documentation of your name change. Acceptable forms of photo identification are a driver’s license, passport, student identification, government-issued military ID, or alien registration card.
Other items to take to the center are:
- Three no. 2 sharpened pencils
- A watch with a second hand
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
You should be able to collect your official score report at the test site on the same day as the exam. If for some reason, the NAE is unable to provide the scores reports, they will be available for viewing in your online account within 5 to 7 business days. There are separate reports for the Written or Oral Exam and the Skills Evaluation. Each score will reveal whether you passed or failed the exam. If you failed the skills evaluation, the report will list the skills you failed and the actions that you missed or performed incorrectly. Each report will also include guidelines for retesting if you fail one or both parts of the exam. You must pay another fee to retest. Federal requirements give each candidate an opportunity to pass the exam within two years or three attempts. If you pass the exam, your name will be added to the Texas Nurse Aide Registry.
Contact the Registry
Texas Department of Aging and Disability Services
Nurse Aide Registry
PO Box 149030
Austin, TX 78714-9030
Pearson Vue Registration and Scheduling Services
NACES Plus Foundation, Inc.
8501 North Mopac Expressway, Suite 400
Austin, TX 78759