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North Carolina Certified Nursing Assistant — Requirements & Free Practice

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Licenses, application pathways and examination requirements

Each license and applicant pathway has its own requirements and exemptions. Choosing practice questions does not determine your eligibility.

Nurse Aide I Registry Listing

Registry listing for Nurse Aide I practice. G.S. 131E-255(f) authorizes up to four months of employment without listing; it is an employment exception rather than a separately issued temporary credential. Nurse Aide I plus four tasks under 21 NCAC 36 .0404(f) remains facility-specific Nurse Aide I practice, with training records held by the facility.

Licensing authority: North Carolina Department of Health and Human Services, Division of Health Service Regulation · Application information

Examination after approved Nurse Aide I refresher training

All of the following:

Approval
Obtain training-program approval to take the examination.
Assessment
Pass both the NNAAP Written (or Oral) Examination and Skills Evaluation; the oral format is the alternative format of the same registered written/oral examination.
Attempt Limit
A maximum of three examination attempts is allowed before retaking and passing a Nurse Aide I training program.
Score Window
Pass both parts within two years of successful training completion or within three attempts, whichever occurs first.
Training
Successfully complete a North Carolina state-approved Nurse Aide refresher training program.
Examination after approved Nurse Aide I training

All of the following:

Approval
Obtain training-program approval to take the examination.
Assessment
Pass both the NNAAP Written (or Oral) Examination and Skills Evaluation; the oral format is the alternative format of the same registered written/oral examination.
Attempt Limit
A maximum of three examination attempts is allowed before retaking and passing a Nurse Aide I training program.
Score Window
Pass both parts within two years of successful training completion or within three attempts, whichever occurs first.
Training
Successfully complete a North Carolina state-approved Nurse Aide I training program.
Examination with training waiver for an EMT or paramedic

All of the following:

Assessment
Pass both the NNAAP Written (or Oral) Examination and Skills Evaluation; the oral format is the alternative format of the same registered written/oral examination.
Attempt Limit
A maximum of three examination attempts is allowed before retaking and passing a Nurse Aide I training program.
Professional Credential
Hold a current unencumbered EMT or paramedic credential; that other-profession credential is an applicant condition.
Score Window
Pass both parts within two years of application approval or within three attempts, whichever occurs first.
Training Waiver
Submit a DHSR training waiver for approval.
Examination with training waiver for a former nursing student

All of the following:

Assessment
Pass both the NNAAP Written (or Oral) Examination and Skills Evaluation; the oral format is the alternative format of the same registered written/oral examination.
Attempt Limit
A maximum of three examination attempts is allowed before retaking and passing a Nurse Aide I training program.
Education
Have previously been enrolled in nursing school, not be currently licensed, and have completed a nurse aide-equivalent course in nursing school within the past two years.
Score Window
Pass both parts within two years of application approval or within three attempts, whichever occurs first.
Training Waiver
Submit a DHSR training waiver for approval.
Listing based on an unrestricted North Carolina nursing license
No examination is required for this applicant pathway.
Application
Submit the Licensed Nurse Form to DHSR. The underlying nurse licensure examination belongs to another profession and is not a nurse aide examination leaf.
Nursing License
Hold a current unrestricted license to practice nursing in North Carolina.

Official no-examination sources

Effective from 2026-09-22.

Examination with training waiver for military medical training

All of the following:

Assessment
Pass both the NNAAP Written (or Oral) Examination and Skills Evaluation; the oral format is the alternative format of the same registered written/oral examination.
Attempt Limit
A maximum of three examination attempts is allowed before retaking and passing a Nurse Aide I training program.
Military Training
Have received nursing or medical training credentials equivalent to nurse aide training in the United States Armed Forces.
Score Window
Pass both parts within two years of application approval or within three attempts, whichever occurs first.
Training Waiver
Submit a DHSR training waiver for approval.
Examination based on current North Carolina nursing education

All of the following:

Approval
Obtain approval from the school of nursing.
Assessment
Pass both the NNAAP Written (or Oral) Examination and Skills Evaluation; the oral format is the alternative format of the same registered written/oral examination.
Attempt Limit
A maximum of three examination attempts is allowed before retaking and passing a Nurse Aide I training program.
Education
Be currently enrolled in a North Carolina state-approved RN or practical nurse education program and complete coursework equivalent to approved nurse aide training.
Score Window
Pass both parts within two years of successful equivalent coursework completion or within three attempts, whichever occurs first.
Examination with training waiver for an out of state noncompact licensed nurse

All of the following:

Assessment
Pass both the NNAAP Written (or Oral) Examination and Skills Evaluation; the oral format is the alternative format of the same registered written/oral examination.
Attempt Limit
A maximum of three examination attempts is allowed before retaking and passing a Nurse Aide I training program.
Nursing License
Hold an out-of-state, noncompact nurse license in active and good standing status.
Score Window
Pass both parts within two years of application approval or within three attempts, whichever occurs first.
Training Waiver
Submit a DHSR training waiver for approval.
Examination with training waiver for an unlicensed nursing graduate

All of the following:

Assessment
Pass both the NNAAP Written (or Oral) Examination and Skills Evaluation; the oral format is the alternative format of the same registered written/oral examination.
Attempt Limit
A maximum of three examination attempts is allowed before retaking and passing a Nurse Aide I training program.
Education
Hold a college degree in nursing and not be currently licensed.
Score Window
Pass both parts within two years of application approval or within three attempts, whichever occurs first.
Training Waiver
Submit a DHSR training waiver for approval.
Ordinary biennial renewal by qualifying employment
No examination is required for this applicant pathway.
Conduct
No substantiated finding of abuse, neglect, exploitation, or misappropriation of resident or patient property while employed in a nursing home.
Expiration
Renew every 24 months; renewed expiration is calculated from the last qualified employment date and extended to the last day of the month.
Forms
The aide submits the Online Renewal Form and an RN completes the Online Employment Verification Form.
Paid Work
Perform at least eight hours of nursing or nursing-related nurse aide duties for pay during the 24-month listing period.
Supervision
The duties must be delegated and supervised by a Registered Nurse.

Official no-examination sources

Effective from 2026-09-22.

  • renewal.html

    Renewal, complete qualification criteria and verification forms

Examination with training waiver for a current nursing student outside North Carolina

All of the following:

Assessment
Pass both the NNAAP Written (or Oral) Examination and Skills Evaluation; the oral format is the alternative format of the same registered written/oral examination.
Attempt Limit
A maximum of three examination attempts is allowed before retaking and passing a Nurse Aide I training program.
Education
Be currently enrolled in a nursing school program not located in North Carolina.
Score Window
Pass both parts within two years of application approval or within three attempts, whichever occurs first.
Training Waiver
Submit a DHSR training waiver for approval.
Examination after training completed outside North Carolina

All of the following:

Assessment
Pass both the NNAAP Written (or Oral) Examination and Skills Evaluation; the oral format is the alternative format of the same registered written/oral examination.
Attempt Limit
A maximum of three examination attempts is allowed before retaking and passing a Nurse Aide I training program.
Registry Status
Not be listed on any state nurse aide registry.
Score Window
Pass both parts within two years of successful training completion or within three attempts, whichever occurs first.
Training
Complete a state-approved Nurse Aide training program outside North Carolina within the previous two years.
Training Waiver
Submit a DHSR training waiver for approval.
Reciprocity under 10A NCAC 13O .0301
No examination is required for this applicant pathway.
Conduct
No pending or substantiated findings of abuse, neglect, exploitation, or misappropriation of resident or patient property on other state registries.
Documentation
Submit the completed application, registry verification no older than 30 days, Social Security card, unexpired government photo/signature identification and documentation of any name changes.
Other Registry
Hold active, good standing nurse aide certification or registration in another state; temporary or provisional status is not accepted.
Prior Competency
Have completed a state-approved nurse aide training and competency evaluation program or approved competency evaluation; the source does not identify the originating examination as NNAAP. It is originating-jurisdiction evidence, not an identifiable examination leaf.
Recent Qualification
DHSR Pathway 1 requires either eight hours of paid RN-delegated and supervised nurse aide work or passage of the approved competency evaluation within the past 24 months. Private duty and virtual work are not accepted.

Official no-examination sources

Effective from 2026-09-22.

Reciprocity under G.S. 93B 15.3
No examination is required for this applicant pathway.
Competency
Demonstrate professional competency by methods determined by the agency under G.S. 93B-15.3(b)(6).
Conduct
Be in good standing on all registries, with no voluntary surrender or revocation for unprofessional conduct and no active or pending unresolved disciplinary action. Prior resolved disciplinary actions must be verified as resolved, with corrective action if applicable.
Criminal History
State and federal background check information must show no disqualifying criminal history under G.S. 93B-8.1 and applicable law.
Fees
Pay applicable processing, verification and background-check fees under G.S. 93B-15.3(b)(9).
Originating Registration
For candidates not approved under Pathway 1, hold active nurse aide registration at the same or substantially equivalent practice level in a neighboring jurisdiction named in G.S. 93B-15.3 and DHSR Pathway 2 for at least one year; temporary or provisional status is not accepted.
Prior Competency
DHSR Pathway 2 states: Successful completion of a state-approved nurse aide competency evaluation (examination) program in the reciprocity state. G.S. 93B-15.3(b)(3) requires passage of the originating jurisdiction examination if an examination was required. No particular current nationwide examination is identified; the originating qualification remains a condition.
Residence
Establish North Carolina residence; P.O. Box addresses are not accepted.

Official no-examination sources

Effective from 2026-09-22.

Relisting after failure to meet renewal requirements

All of the following:

Assessment
Pass both the NNAAP Written (or Oral) Examination and Skills Evaluation; the oral format is the alternative format of the same registered written/oral examination.
Attempt Limit
A maximum of three examination attempts is allowed before retaking and passing a Nurse Aide I training program.
Prior Listing
Have a previous Nurse Aide I listing and fail the qualifying work requirements for renewal.
Score Window
Follow E1 or E3 timelines: both parts within two years of successful approved training completion or three attempts, whichever occurs first.
Training
Complete retraining and retesting as DHSR directs; approved refresher or full training eligibility applies to the accepted program.
Renewal by retesting before current listing expires

All of the following:

Assessment
Pass both the NNAAP Written (or Oral) Examination and Skills Evaluation; the oral format is the alternative format of the same registered written/oral examination.
Attempt Limit
A maximum of three examination attempts is allowed before retaking and passing a Nurse Aide I training program.
Registry Status
Be active and in good standing on the North Carolina Nurse Aide I Registry but not meet ordinary renewal requirements.
Score Window
Apply to take the examination within the 90 days before listing expiration and pass both parts within three attempts before expiration.
Training Waiver
Submit a DHSR training waiver for approval.
Examination for a retired or non practicing nurse

All of the following:

Applicant Status
Be a retired or non-practicing nurse.
Approval
Obtain DHSR approval for examination eligibility.
Assessment
Pass both the NNAAP Written (or Oral) Examination and Skills Evaluation; the oral format is the alternative format of the same registered written/oral examination.
Attempt Limit
A maximum of three examination attempts is allowed before retaking and passing a Nurse Aide I training program.
Training Waiver
The approved training program is waived under 10A NCAC 13O .0301(k); training becomes required after failure to pass the competency examination in three attempts.

National Nurse Aide Assessment Program (NNAAP) Skills Evaluation

This assessment does not have a question bank.

Provider
Credentia Nurse Aide LLC (develops and manages the NNAAP exam); administered by Credentia at test centers
Format
Performance evaluation at a test center, scored and retaken separately from the Written (or Oral) Examination: the candidate performs five skills on a candidate volunteer acting as the client and is rated by a Nurse Aide Evaluator; each skill is scored Satisfactory or Unsatisfactory and all five must be Satisfactory to pass
Time limit
30 minutes
Examination sources

NNAAP Written (or Oral) Examination

Provider
Credentia Nurse Aide LLC (develops and manages the NNAAP exam); administered by Credentia online or at test centers
Format
Multiple-choice examination taken online or at a test center, in English or Spanish, scored and retaken separately from the Skills Evaluation; candidates may choose the Oral Examination form, in which the multiple-choice questions are read aloud by recorded voice (MP3 player at test centers) and ten reading comprehension (word recognition) questions are added, and both Oral sections must be passed
Exam questions
70 multiple-choice items: 60 scored and 10 pretest (non-scored); the Oral form has 60 multiple-choice items and 10 reading comprehension (word recognition) items
Time limit
2 hours
Examination outline
  • I. Physical Care Skills — A. Activities of Daily Living (22% of the exam; 13 questions) (22%)
    • Activities of Daily Living — 1. Hygiene
    • Activities of Daily Living — 2. Dressing and Grooming
    • Activities of Daily Living — 3. Nutrition and Hydration
    • Activities of Daily Living — 4. Elimination
    • Activities of Daily Living — 5. Rest/Sleep/Comfort
  • I. Physical Care Skills — B. Basic Nursing Skills (35% of the exam; 21 questions) (35%)
    • Basic Nursing Skills — 1. Infection Control
    • Basic Nursing Skills — 2. Safety/Emergency
    • Basic Nursing Skills — 3. Therapeutic/Technical Procedures
    • Basic Nursing Skills — 4. Data Collection and Reporting
  • I. Physical Care Skills — C. Self-Care and Independence (7% of the exam; 4 questions) (7%)
    • Self-Care and Independence
  • II. Psychosocial Care Skills — A. Emotional and Mental Health Needs (8% of the exam; 5 questions) (8%)
    • Emotional and Mental Health Needs
  • II. Psychosocial Care Skills — B. Spiritual and Cultural Needs (2% of the exam; 1 question) (2%)
    • Spiritual and Cultural Needs
  • III. Role of the Nurse Aide — A. Communication (7% of the exam; 4 questions) (7%)
    • Communication
  • III. Role of the Nurse Aide — B. Client Rights (8% of the exam; 5 questions) (8%)
    • Client Rights
  • III. Role of the Nurse Aide — C. Legal and Ethical Behavior (5% of the exam; 3 questions) (5%)
    • Legal and Ethical Behavior
  • III. Role of the Nurse Aide — D. Member of the Health Care Team (6% of the exam; 4 questions) (6%)
    • Member of the Health Care Team
Examination sources