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Tennessee Certified Nursing Assistant — Requirements & Free Practice

US-TN · License preparation

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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.

Certified Nurse Aide

Certification and enrollment on the Tennessee Nurse Aide Registry, governed by nursing-home nurse-aide requirements.

Licensing authority: Tennessee Health Facilities Commission · Application information

Initial certification after approved nurse aide training

All of the following:

Application
Submit the E1 application through the Tennessee Credentia platform.
Attempts
Maximum three attempts for each examination; failure after the third attempt, or expiration of the two-year period, requires retraining.
Score window
Pass both current NNAAP examinations within 24 months after training completion.
Training
Complete an HFC-approved nurse aide training program.
Competency examination challenge by a military trained medic

All of the following:

Attempts
Maximum three attempts for knowledge and three for skills; three failures in either portion or expiration of two years requires training.
Military training
Provide DD-214 and documentation of classroom and clinical experience as a military-trained medic.
State approval
Submit an E2 challenge application and all required documents for state approval.
Competency examination challenge by an LPN or RN student

All of the following:

Attempts
Maximum three attempts for knowledge and three for skills; three failures in either portion or expiration of two years requires training.
Education
Enrollment in an LPN or RN program; original transcripts must verify completion of the basic nursing fundamentals and skills covered in nurse aide training.
State approval
Submit an E2 challenge application and all required documents for state approval.
Reactivation after a lapse without continuous qualifying employment

All of the following:

Attempts
Maximum three attempts per examination before retraining is required.
Employment gap
Continuous qualifying employment cannot be documented; HFC requires retraining and retesting.
Prior status
Previously certified nurse aide whose certification has expired.
Training
Complete approved training again and pass both NNAAP examinations within the applicable two-year period.
Work restriction
A formerly active nurse aide may not work as a nurse aide until official notification of reinstated active registry status.
Certification by reciprocity
No examination is required for this applicant pathway.
Excluded certification
Florida-issued nurse aide certification is not accepted for reciprocity.
Existing certification
Active nurse aide certification on another registry, in good standing with no abuse or other derogatory findings.
Previous tennessee certification
A previously Tennessee-certified applicant should ask the Registry about reinstatement eligibility before applying for reciprocity.
Registry checks
Credentia verifies certification and checks abuse registries for every jurisdiction named in the application, including Tennessee.

Official no-examination sources

Effective from 2026-09-22.

Certification after Tennessee retraining when reciprocity is excluded

All of the following:

Applicant group
The HFC instructions require an individual living in Florida to retrain and retest; the handbook excludes Florida-issued certifications from reciprocity.
Application
Submit the E1 application through the Tennessee Credentia platform.
Attempts
Maximum three attempts for each examination; failure after the third attempt, or expiration of the two-year period, requires retraining.
Score window
Pass both current NNAAP examinations within 24 months after training completion.
Training
Complete an HFC-approved nurse aide training program.
Reinstatement of expired certification with continuous qualifying employment
No examination is required for this applicant pathway.
Annual employment proof
Provide proof of at least eight hours of work in each year from the year preceding expiration through the current year.
Employment continuity
Document continuous CNA employment in a certified facility; the HFC instructions assign retraining and retesting to applicants who cannot provide this employment evidence.
Expired certification
Certification has expired, requiring reinstatement rather than ordinary renewal.

Official no-examination sources

Effective from 2026-09-22.

Biennial registry renewal
No examination is required for this applicant pathway.
Employment
Verify at least eight hours of nurse aide work in the preceding 24 months in a licensed or certified health care facility.
Excluded work
Private duty, sitter, companion services and private physician offices are not accepted for renewal.
Renewal interval
Renew every two years through Credentia.
Verification
Provide a pay stub, payroll printout, or notarized facility attestation containing the information specified by HFC.

Official no-examination sources

Effective from 2026-09-22.

Other state approved E2 competency examination challenge

All of the following:

Attempts
Maximum three attempts for knowledge and three for skills; three failures in either portion or expiration of two years requires training.
Eligibility
The current E2 category leaves approval to the state; this route records that approval condition without inventing additional qualifying applicant categories.
State approval
Submit an E2 challenge application and all required documents for state approval.

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