Pass the CNA Exam in Texas: Step-by-Step Guide to Ace the Written and Skills Tests

Ready to become a Certified Nurse Aide but nervous about the exam? You’re not alone. Most first-time testers struggle with timing, infection control, and small mistakes that lead to retakes. The good news: with a focused plan and the right practice, you can pass the Texas CNA exam on your first attempt.

In this guide, you’ll learn exactly what’s on the test, how to study, what to bring on test day, the most common errors to avoid, and how CNA Training Institute in Sugar Land helps you train, test, and get hired fast.

What Is the Texas CNA Exam?

The Texas CNA exam (Nurse Aide Competency Evaluation) has two parts:

• Written (Knowledge) Test: Multiple-choice questions that assess your understanding of safe and effective care.
• Skills (Practical) Test: You demonstrate a set of randomly selected skills on a live person or manikin.

Key points to know:

• Texas Health and Human Services (HHS) oversees the Nurse Aide Registry and approves testing procedures in the state.
• The test vendor, scheduling process, and fees can change. Always follow your Authorization to Test and the latest guidance from Texas HHS and your test site.
• You must pass both parts to be listed on the Texas Nurse Aide Registry.

Texas CNA Exam Eligibility and Requirements

To sit for the exam in Texas, you typically need:

• Completion of a state‑approved CNA training program (Texas requires at least 100 hours total; programs commonly include at least 60 classroom hours and 40 clinical hours).
• Valid, unexpired government‑issued photo ID that matches your registration name.
• Proof of training completion as required by the testing provider.
• Compliance with health and safety requirements for clinical training (e.g., immunizations or screenings set by your training site).

Important timelines:

• You generally have up to 24 months from training completion to pass both parts.
• If you do not pass after the allowed number of attempts (often up to three), Texas may require retraining before retesting. Always confirm the latest HHS policy and your test vendor’s candidate handbook.

What’s on the Written (Knowledge) Test?

The written exam uses multiple‑choice questions that cover:

• Safety and Infection Control
• Basic Nursing Skills (vital signs, measurements, reporting)
• Personal Care (bathing, dressing, grooming, toileting)
• Communication and Interpersonal Skills
• Resident Rights and Independence
• Mental Health, Dementia, and Aging
• Restorative Care and Mobility
• End‑of‑Life Care
• Role and Responsibilities of the Nurse Aide (scope of practice, reporting, ethics)

How to prepare:

• Master infection control first. Hand hygiene, PPE order, and standard precautions appear across many questions.
• Learn “priority” words: first, best, most important. Safety and resident dignity usually come first.
• Use practice tests under timed conditions. Aim for 80–85% on practice exams to give yourself a buffer.

What’s on the Skills (Practical) Test?

You’ll be randomly assigned several skills to perform. One is always hand hygiene. The others are chosen from a standardized list (examples below). You must perform steps in the correct order and use proper infection control, safety, and communication.

Common CNA Skills in Texas

• Hand hygiene (required)
• Putting on and removing PPE (gown and gloves)
• Vital signs: pulse, respirations, blood pressure, temperature
• Ambulation with gait belt; transfer from bed to wheelchair
• Positioning: lateral, Fowler’s, Sims’; using a bedpan; perineal care
• Catheter care, urinary output measurement
• Dentures care; mouth care for unconscious resident
• Feeding a resident; recording intake; I&O totals
• Range of motion exercises (shoulder, elbow, wrist, hip, knee, ankle)
• Dressing a patient with a weak arm; dressing and undressing with dignity

Passing tips:

• Say each step out loud as you perform it. This shows the evaluator you know the order and reminds you not to skip safety or privacy.
• Always provide privacy, lock wheels when needed, use hand hygiene at the right times, and ensure the call light is within reach before you finish.
• If you make a small mistake, correct it immediately and continue. Don’t freeze—many errors can be corrected on the spot.

Texas CNA Exam Scoring: How You’re Graded

• Written test: Scored by number of correct answers. Passing scores are set by the test vendor and state policy.
• Skills test: Each skill has critical steps (like hand hygiene, safety, and resident rights). Missing a critical step can result in failing that skill, even if you performed other steps correctly.

Pro tip: Focus on critical steps for each skill as you study. They’re your non‑negotiables.

Two‑Week Study Plan to Pass the CNA Exam

This plan assumes you’ve completed training and are preparing for testing. Adjust based on your schedule.

Week 1

• Day 1–2: Review infection control (hand hygiene, PPE, standard/contact/droplet precautions). Take one mixed practice test.
• Day 3: Basic nursing skills: vital signs, pain scale, intake/output, reporting abnormal findings.
• Day 4: Personal care: bathing, dressing, grooming, toileting, pericare.
• Day 5: Resident rights, dignity, communication, abuse/neglect reporting, HIPAA basics.
• Day 6: Skills lab: practice 5–7 skills with a partner; record yourself to check technique.
• Day 7: Full practice written test; review missed questions. Light skills review.

Week 2

• Day 8–9: Mobility and transfers, gait belt use, positioning, ROM exercises. Drill critical steps.
• Day 10: Dementia care basics, communication with confused or anxious residents, de‑escalation.
• Day 11: Skills lab: simulate a full test with random skills (include hand hygiene). Time yourself.
• Day 12: Written practice under timed conditions. Target 80–85%+
• Day 13: Light review; pack your test‑day bag; sleep early.
• Day 14 (Test Day): Calm warm‑up, practice hand hygiene once, positive self‑talk.

What to Bring on Test Day

• Two forms of ID if required (check your authorization letter)
• Scrubs and closed‑toe, non‑skid shoes
• Watch with a second hand for vital signs
• Hair ties, minimal jewelry, short nails (no acrylics), and no strong perfumes
• Authorization to Test email/letter and any required documents

Top Mistakes That Cause CNA Exam Fails (and How to Avoid Them)

• Skipping hand hygiene or touching contaminated surfaces after washing. Solution: Announce and perform hand hygiene before and after resident contact and whenever you contaminate your gloves.
• Not ensuring safety: forgetting to lock wheels, adjust bed height, or leave call light within reach. Solution: Make a mental checklist you say out loud.
• Breaking privacy or dignity: not knocking, not closing the curtain, or exposing too much. Solution: Narrate and cover the resident appropriately.
• Incorrect measurement or recording of pulse, respirations, BP, or urinary output. Solution: Practice with a partner and repeat back results before documenting.
• Silence under stress: not communicating during skills. Solution: Keep talking—explain, reassure, and report.

Texas‑Specific Tips

• Policies, fees, and scheduling can change. Always check Texas HHS and your testing vendor’s current candidate handbook.
• Some Texas sites (like ours in Sugar Land) let you train and test at the same location, reducing test‑day anxiety.

How CNA Training Institute Helps You Pass

CNA Training Institute in Sugar Land, Texas, is the ONLY State Accredited Exam Center in Fort Bend County. We offer:

• 3‑week completion in a state‑approved, 100‑hour program (classroom + clinical)
• Hands‑on skills labs with the exact equipment you’ll use on the test
• Texas exam prep: timed practice tests, skills checklists, and mock evaluations
• CPR/BLS (AHA) certification available on campus (same‑day card)
• 100% job placement assistance and resume/interview coaching
• Trusted by 2,000+ graduates with a 4.7★ Google rating (858+ reviews)

Located at 140 Eldridge Road # G, Sugar Land, TX 77478. Have questions? Call (346) 633‑4628 or email [email protected].

Sample Skills Checklist You Can Practice Today

1. Hand Hygiene: Wet, lather 20 seconds, scrub all surfaces, rinse fingertips down, dry, turn off with towel.
2. PPE: Gown on → gloves over cuffs; remove gloves → gown, avoid contamination.
3. Ambulation with Gait Belt: Lock wheels, bed to safe height, shoes on, gait belt snug, stand pivot, walk 10–15 feet while holding belt at sides, return, remove belt, call light in reach.
4. Transfer to Wheelchair: Lock bed and chair, footrests out, use pivot technique, ensure alignment, call light.
5. Mouth Care (Unconscious): Turn to side, padded swabs, little fluid, suction if available, no toothpaste; lip moisturizer.
6. Catheter Care: Clean 4 inches away from meatus, front to back, new area of cloth each stroke, no tugging.
7. Perineal Care: Drape for privacy, front to back for females, change cloth surfaces, rinse and dry thoroughly.
8. Feeding: Verify resident, sit upright, small bites, alternate solids/fluids, record intake.
9. Range of Motion: Support joints, move smoothly, ask about pain, perform each motion 3 times.
10. Measuring Urinary Output: Read at eye level, place on flat surface, record accurately, empty into toilet, rinse equipment.

FAQs About the Texas CNA Exam

How many questions are on the written test?

It varies by vendor, but expect a multiple‑choice test that covers all major topics listed above. Your candidate handbook provides the exact details.

Can I retake just the failed part?

Yes. If you pass one part and fail the other, you typically need to retake only the part you failed within the allowed retake window set by Texas HHS and the vendor.

What score do I need to pass?

Passing standards are set by the state and the testing provider. Your candidate handbook and score report will show the thresholds.

How soon will I know my results?

Many sites provide same‑day or quick results. Check your test site’s policy.

Conclusion: 

With the right plan and practice, you can pass the Texas CNA exam on your first try. Focus on infection control and safety, drill critical steps, and simulate test conditions. If you want expert coaching, hands‑on labs, and a calm, familiar test environment, we’re here to help.

Ready to start your CNA career? Call us at (346) 633‑4628, register for our next class at cnatraininginstitute.org, or schedule a free campus tour today.