The National Nurse Aide Assessment Program (NNAAP)


The National Nurse Aide Assessment Program (NNAAP) is the largest nurse aide certification exam program in the United States.  The NNAAP consists of two sections: a written or oral portion and a skills demonstration component. The oral portion is offered in English and Spanish. 

Once the candidate successfully completes both components of the exam, their state can add their name to the state nurse aide registry. The state registry is used to assure employers that the potential hire has met the federal and state requirements for employment.  The certification exam is developed for entry-level nurse aides/nursing assistants who have zero to 12 months of experience after certification.

The NNAAP test plan serves as a guide for both exam development and candidate preparation, including the selection of content to be tested. Based on the test plan, each unique NNAAP exam reflects the knowledge, skills and abilities essential for the prospective entry-level nurse aide to meet the needs of clients.  Candidates are given the choice to choose between a written or an oral examination.  Exam content will cover the following:

  • Physical Care Skills – This is divided into three sections, Activities of Daily Living, Basic Nursing Skills and Restorative Skills.  Activities of Daily Living covers information such as hygiene, nutrition, sleep and dressing/grooming. For Basic Nursing Skills, content will include infection control, safety/emergency, data collection, and therapeutic/technical procedures. Lastly, Restorative Skills will encompass prevention and self-care/independence.
  • Psychosocial Care Skills – In the NNAAP, this portion will cover Emotional and Mental Health needs, as well as Spiritual and Cultural needs.
  • Roles of the Nurse Aid – This third portion will test Communication, Client Rights, Legal and Ethical Behavior, and being a Member of the Health Care Team.

Provisions to the NNAAP test plan are made based on studies of observed activities for newly-certified nurse aides. The activities identified in these studies are analyzed in relation to the following:

  • The importance of their performance
  • Their impact on maintaining client safety
  • The settings where they were performed
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