NNAAP written test vs skills evaluation – where do most people actually fail?
I'm finishing up my CNA training program in about 3 weeks and I'm trying to understand where most candidates actually fail the NNAAP. My instructor has been pretty focused on the skills evaluation and we've spent a lot of class time on the 22 tested skills, but I'm not sure whether I should be spending more of my personal study time on the written component instead.
I've been doing practice questions for the written portion every evening for the past 2 weeks and I'm scoring around 78–82% consistently, which feels decent. But I've heard the skills evaluation is where candidates unexpectedly fail because of procedural errors that seem minor – like not checking wristbands or forgetting to explain a procedure to the patient before performing it.
My weaker written areas are infection control specifics and range of motion procedures. For the skills side, I get tripped up on the exact hand hygiene steps and the sequence for some of the personal care skills. Is there a way to know which 5 skills you'll be tested on or is it completely random on the day of the exam?
Infection control on the written exam tends to focus on chain of infection concepts, standard precautions, and what goes in which waste container. If you're fuzzy on those, a few focused hours should move your score up since the questions are fairly predictable and follow a consistent pattern.
For skills practice, record yourself on video doing each skill and watch it back – you'll catch sequencing errors and skipped steps that you don't notice in the moment. I caught myself skipping the "explain the procedure to the resident" step consistently without realizing it until I saw the recording.
Procedural errors on skills are an automatic fail for specific critical steps – things like not washing hands before and after care, not identifying the patient, not providing privacy. Make sure you know which steps are critical elements in your state's version of the test, because failing even one critical element fails you on that entire skill.
Skills evaluation is where most candidates fail – the written portion has a much higher pass rate across the board. At 78–82% on written practice questions you're in good shape there. I'd shift your remaining prep time heavily toward skills if I were you.
The exact 5 skills vary by state and are drawn randomly the day of the exam, though hand hygiene usually appears in every test as a constant regardless of which other skills are selected.