The 2024 National Nurse Aide Assessment Program (NNAAP®)

You can choose either written or oral exam.

Written Exam

The Nursing Assistant Evaluator will hand out materials and give instructions for taking the Written Examination. 

The Written Examination has seventy (70) multiple-choice questions. You will have two (2) hours to complete the Written Examination. You will be told when fifteen (15) minutes remain to finish. Fill in only one (1) box on the answer sheet for each question. Markings in the test booklet will not be accepted as answers. Your answers must appear on the separate answer sheet.

Oral Exam 

An Oral Examination may be taken in place of the Written Examination if you have difficulty reading English. You must request an Oral Examination when filling out your application. The Oral Examination is provided on an MP3 player, which is provided with earphones at the test center. You will be asked to listen to a recording of the Oral Examination and follow along in the test booklet as the questions are read aloud on the MP3 player.

The Oral Examination consists of two (2) parts, and you must pass both parts to pass the Oral Examination. The first part of the Oral Examination has sixty (60) multiple-choice questions. Each of these questions is read twice. As each question is read, you will be asked to choose the correct answer and mark it on your answer sheet.

The second part of the Oral Examination has ten (10) multiple-choice questions. These questions test your ability to speak a minimum amount of English by recognizing common words used as a nurse assistant in long-term care facilities. Each word is read three (3) times. You are asked to match the word you hear on the recording to the written word in the test booklet. As you find the match, you mark your answer on the answer sheet.

The Oral Examination takes two (2) hours to complete. You will be told when fifteen (15) minutes remain to finish. Fill in only one (1) box on the answer sheet for each question. You may write in the test booklet, but markings in the test booklet will not be accepted as answers. Your answers must appear on the separate answer sheet.

Content Outline

The revised content outline is based on the findings from the 2019–2020 Job Analysis and Knowledge, Skill, and Ability Study of Nurse Aides published by the National Council of State Boards of Nursing (NCSBN) in 2023. The examination content outline will be effective April 2024. The NNAAP written examination is comprised of seventy (70) multiple-choice items; ten (10) of these items are pretest (non-scored) items on which statistical information will be collected. The NNAAP oral examination is comprised of sixty (60) multiple-choice items and ten (10) reading comprehension (word recognition) items.

I. Physical Care Skills in the exam 

A. Activities of Daily Living........ 22% ............13 

1. Hygiene 
2. Dressing and Grooming 
3. Nutrition and Hydration 
4. Elimination 
5. Rest/Sleep/Comfort 

B. Basic Nursing Skills.................35% ............ 21 

1. Infection Control 
2. Safety/Emergency 
3. Therapeutic/Technical Procedures 
4. Data Collection and Reporting 

C. Self-care/Independence........... 7% .............4 

II. Psychosocial Care Skills 

1. Emotional and Mental Health Needs ..............8%.............5 
2. Spiritual and Cultural Needs ....2%..............1 

III. Role of the Nurse Aide 

1. Communication....................... 7 % .............4 
2. Client Rights ........................... 8% .............5 
3. Legal and Ethical Behaviour...... 5% .............3 
4. Member of the Health Care Team ................... 6% .............4