Following the completion of a Certified Nursing Assistant (CNA) education, a student must then take appropriate state testing. This is to ensure the student received the necessary education from the program and is up to the state level. The certification exam provided by the state also works as a means of identifying nurses and registering the nurses within the state’s database. In general, after completing the Certified Nursing Assistant program and completing the examination test, the certification is good for only the current state of residence. Should the CNA holder move to a different state, they must become recertified and take the examination again. They do not need to enroll in any additional education, but the exam must be taken in the new state.

The NNAAP, or “National Nurse Aid Assessment Program” is the examination offered for those looking to become a registered and official CNA. The NNAAP is broken down into two different portions: a written or oral potion and a skills demonstration.

In order to receive certification and have their name recorded in the state nurse aid’s registry, the testing individual must successfully complete and pass both portions of the exam (the exam is offered in both English and Spanish).

It is important to note that while the majority of states and jurisdictions do use the NNAAP as the main method for testing and certifying CNAs, not all states use it. The 25 current jurisdictions that do use the NNAAP include: Alabama, Alaska, California, Colorado, Washington D.C., Georgia, Guam, Louisiana, Mariana Islands, Maryland, Minnesota, Mississippi, New Hampshire, North Carolina, North Dakota, Pennsylvania, Rhode Island, South Carolina, Texas, Vermont, Virginia, Virgin Islands, Washington, Wisconsin and Wyoming.


The NNAAP is the most widely accepted nursing program and examination. However, every state has the ability to set individual requirements for CNA certification. While education generally remains the same, the differences often have to do with the number of hours in the classroom or in clinical settings. For example, the state of Michigan, which does not administer the NNAAP, offers its own Bureau of Community and Health Systems certification while overseeing the Michigan Nurse Aide Registry. Other states may have more extensive background checks and other requirements before taking a test. Due to this, it is necessary to look into the exam type for the state of residence. Additional information on state requirements and certification exams administered can be found at the Nursing Licensure Organization website.

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