Certified Nursing Assistant

Everything you need to know about the Texas CNA exam

Athena Kan
Nov 23, 2022


Congratulations! You've completed your Certified Nursing Assistant (CNA) class in Texas. But this is only part of the way through your journey. The next step is to pass the state's CNA exam. This guide will walk you through everything you need to do to successfully pass the test and become an official CNA. If you aren’t yet a CNA, read our guide on how to become a CNA in Texas.

What is required to take the Texas CNA exam?

In order to take the CNA exam, you must have completed a state-approved CNA training program within the last 2 years. If you're looking for a CNA training program, you can look for classes on Dreambound.

Alternatively, you can "challenge" the exam in very specific circumstances. If you have:

  • Completed 100+ hours of military training equivalent to a CNA course since July 1, 1989
  • Completed a RN or LVN class in the last 2 years
  • Completed a CNA class in another state in the last 2 years
  • Are currently enrolled in an RN/LVN class
  • An expired CNA license (haven't done nursing-related work in the last 2 years)

then you may be eligible to take the exam as well. Note that if you are already a licensed CNA in another state you are likely eligible for reciprocity, which means you don't have to take the test at all. You can read more on the Texas HHS website.

You will need a Social Security Number and 2 photo IDs as well.

How can I register for the CNA exam in Texas?

Your school will let Prometric know you are ready to take the exam after you complete your class. After they do that, you will get login information for  Prometric's portal. There, you will complete your application to take your test, choose a testing location, and submit your payment. The cost for the full exam is $125 ($135 in Spanish). 

There is a $25 fee if you need to reschedule and let them know 5-29 days before the day of your exam. If you reschedule with fewer than 5 days' notice you will lose your full test fee.

CNA schools often are testing facilities as well so you may be able to take your exam at your school. Otherwise, you can take the written portion online or at designated Computer-Based Testing locations. The clinical portion must be taken in person at designated sites.

How long does the CNA exam take?

The Texas Certified Nurse Assistant (CNA) exam is made up of two parts: a multiple-choice exam and a clinical skills exam. The multiple-choice portion consists of 60 multiple-choice questions, and you will have 90 minutes to complete it. If you choose to take this portion orally rather than written, you will have 120 minutes.

The clinical skills part of the exam requires you to demonstrate your ability in performing certain procedures on another person. This is where most applicants fail, because you need to demonstrate the procedures exactly correctly. Some of these procedures are over 20 steps long, and if you get even one step wrong you may lose a point! The length of time depends on the procedures you get and how quickly you complete them, but you should budget about half an hour to an hour. You will need to demonstrate 3 procedures.

What do I need to bring for the CNA exam?

When you arrive at the testing center to take your CNA exam, you'll need to bring:

  • Your Authorization to Test letter. Prometric emails this to you after your schedule your exam.
  • A photo ID (driver's license, state ID card, passport, or military ID). It can't be expired.
  • A second photo ID. For example, a library card, school ID, or another of the above documents.
  • Flat, nonskid, closed-toed shoes. You are suggested but not required to wear scrubs. Prometric suggests you wear a watch with a second hand as well.

What's the best way to study for my Texas CNA exam?

The best way to study for your Texas CNA exam is to use the study materials provided by your school. Your school may provide practice tests or even a practice exam, and you should review your textbook/homework. It's important to review your knowledge of basic nursing terminology and procedures before taking the test so that you're familiar with all of its terms and concepts.

Once you've studied up on everything from basic medical terminology to body systems, take a few practice tests—the more sample questions you can complete on your own time, the better prepared you'll be for what comes next! Prometric offers several practice exams.

For the clinical skills portion, we highly recommend watching YouTube videos! Be sure to look for Texas-specific videos posted after 2020, as Texas only started using Prometric as its exam provider on 9/1/2020. After you feel comfortable with the procedures, ask a family member or friend if you can demonstrate the procedure on them. It'll simulate the exam circumstances since you'll be testing in front of a real person and might be nervous about it!

What happens if I fail my Texas CNA exam?

You will find out if you pass the oral/written portion the same day and you will find out about the clinical skills portion shortly after (in less than a few days after taking your test).

You are eligible to retake each section (written/oral or practical) up to 3 times before you are required to take your CNA class again. Retaking the written portion costs $35 ($45 if oral/Spanish) and the clinical portion costs $90.

What are some other tips for the Texas CNA exam?

  • Some CNA students swear by taking an oral exam instead of written exam since you have more time to complete the oral exam (120 min oral vs 90 min written). This could be a good option for you, but we find that this doesn't actually help too much.
  • It is much more common to fail on the clinical skills portion of the exam than the multiple-choice section. In fact, accord to Prometric 40% of students fail the clinical skills portion on the first try. Be sure to practice your clinical skills more than your written! Even something seemingly small like handwashing can prevent you from passing.
  • You can work for 4 months as a CNA before you need to pass your exam. You also have 3 attempts per section. So, don't stress about not passing immediately. 72% of students pass their clinical skills portion on a retest, which is a higher pass rate than first attempts. That said, try to take your exam as soon as possible since the material will be fresh in your brain. You also get paid more after passing the exam, and some employers hire only those who have passed.
  • Here are the clinical skills based on level of difficulty. We’ve also included the clinical skills pass rate per procedure. Be sure to focus on the ones that trip students up the most: catheter care, measure & record pulse, mouth and denture care, partial bed bath, perineal care, and range of motion elbow and wrist.
Clinical skills by difficulty as published by Prometric
Clinical skills’ pass rate as published by Prometric

Where can I find more information about the Texas CNA test?

You can find out more about the CNA exam by visiting the Prometric website. You can also contact Prometric at [email protected] or at 800.488.5787.


Passing the CNA exam can be stressful, but hopefully some of this information helped clear up any questions you might have. Soon you will be able to start working as a CNA and making a big difference in your patients’ lives!

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Written by
Athena Kan

Athena is Co-founder and CEO of Dreambound.

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