A resident in a California skilled nursing facility refuses her scheduled bath. The CNA should:

Honor the refusal, document it, and notify the charge nurse

Have two staff hold the resident still and proceed quickly

Tell the resident she will lose her dinner privileges if she refuses

Bathe the resident anyway because hygiene is medically required

A newly admitted resident speaks only Tagalog. The CNA's best action is to:

Request a qualified medical interpreter through the facility's language-access service, as required for limited-English-proficient patients

Ask the resident's grandchild visiting at the bedside to interpret medical questions

Skip explanations and proceed with care

Use hand gestures and speak louder English

Effective handwashing with soap and water requires a minimum of:

20 seconds of vigorous friction with soap covering all surfaces, including between fingers, under nails, wrists

Rinsing under cold water without soap

Alcohol-based hand rub is preferred over soap and water EXCEPT when:

Hands are visibly soiled, after caring for a C. difficile or norovirus patient, before eating, after toileting

Pressure injury prevention for an immobile resident includes:

Reposition at least every 2 hours, off-load heels (heel float), keep skin clean and dry, use pressure-redistribution surfaces, maintain nutrition/hydration

Use a doughnut-shaped cushion under the sacrum

Massage reddened bony prominences vigorously

Leave in one position 6 hours to allow rest

A CNA notices unexplained bruises in the shape of fingerprints on a resident's upper arm. The resident whispers, 'The night CNA grabbed me hard.' The CNA's FIRST action is to:

Report to the charge nurse and administrator immediately and ensure mandated abuse report is filed per W&I §15630

Wait until the next staff meeting to bring it up

Tell only a coworker to get their opinion

Confront the night CNA directly

Standard post-mortem care positioning is to:

Place the body supine in good alignment with the head slightly elevated on a pillow, eyelids closed, dentures replaced if possible, before rigor mortis sets in

Place the body in a side-lying position with knees flexed

Place the body face-down to prevent fluid drainage

Position knees drawn to chest in a fetal position

A CNA, frustrated with a wandering resident, locks the resident in a room without a physician order or care-plan justification. This action is:

False imprisonment, prohibited use of restraint under 42 CFR §483.10(e) and §483.12(a)(2), abuse under W&I §15610.07, and grounds for criminal charges, civil liability, and certification revocation

Acceptable if it is only for a short period

Legal because the door has a window

CNA Practice Test

Frequently asked questions

How many California CNA practice questions are here?+

200 original practice questions across all 8 topics of the California CNA written exam, with answers, explanations, and statute citations on every question (42 CFR §483, HSC §1276.5, Title 22 CCR §72527, W&I §15630, HIPAA, OSHA, CDPH guidance).

Is this CNA practice test free?+

Yes — completely free with no signup required. You can take unlimited practice rounds without creating an account.

Are these the real California CNA exam questions?+

No. All 200 questions are original prose authored from public-domain sources (federal CFR, California HSC and W&I codes, Title 22 CCR, CDPH guidelines, ANA standards). We never copy from the real D&S Diversified exam.

What's the passing score for the California CNA exam?+

75% on the knowledge test (60-70 multiple-choice questions) administered by D&S Diversified/Headmaster. You must ALSO pass a 5-skill demonstration scored by a state-approved evaluator.

Is the California CNA exam available in Spanish, Chinese, or Vietnamese?+

The official CNA knowledge exam is offered in English and Spanish by D&S Diversified. PrepPass provides all 200 practice questions in English, 中文, Español, and Tiếng Việt so Filipino, Vietnamese, Chinese, and Latina caregivers can study in their strongest language first.

Why is California's CNA training 160 hours (vs federal 75)?+

HSC §1276.5 sets California's training requirement higher than the federal 75-hour minimum: 60 hours classroom + 100 hours supervised clinical = 160 hours total. The wage boost under SB 525 (healthcare workers reach $23/hr in June 2026) is driving more entrants — making this exam one of the most in-demand in California.

Sample practice questions

A few real questions from this free bank, with full explanations. Use the practice tool above for the whole set.

1. Patient Rights
A resident in a California skilled nursing facility refuses her scheduled bath. The CNA should:
- a.Have two staff hold the resident still and proceed quickly
- b.Honor the refusal, document it, and notify the charge nurse
- c.Tell the resident she will lose her dinner privileges if she refuses
- d.Bathe the resident anyway because hygiene is medically required
Answer: b
Explanation: Under 42 CFR §483.10(a) and California HSC §1599.65, residents have the right to be treated with dignity and to make choices about care, including the right to refuse treatment. The CNA must honor the refusal, document the refusal and any reason given, and notify the licensed nurse so the care plan can be revisited. Forcing care (a, d) constitutes battery and abuse; threats or coercion (c) violate dignity and the Patients' Bill of Rights. Refusal documentation protects the resident, staff, and facility.
Source: 42 CFR §483.10(a); HSC §1599.65
2. Communication & Culture
A newly admitted resident speaks only Tagalog. The CNA's best action is to:
- a.Ask the resident's grandchild visiting at the bedside to interpret medical questions
- b.Skip explanations and proceed with care
- c.Use hand gestures and speak louder English
- d.Request a qualified medical interpreter through the facility's language-access service, as required for limited-English-proficient patients
Answer: d
Explanation: Title VI of the Civil Rights Act and HSC §1259 require hospitals and SNFs that receive federal funds to provide meaningful language access, typically through qualified interpreters (in person, phone, or video). Family members—especially minors—should not interpret clinical information; they may misinterpret or filter sensitive content. Speaking louder (a) does not aid comprehension; minor-interpreter use (b) violates federal guidance; skipping explanations (d) violates informed consent and dignity.
Source: Title VI Civil Rights Act 1964; HSC §1259
3. Safety & Infection Control
Effective handwashing with soap and water requires a minimum of:
- a.5 seconds of scrubbing
- b.20 seconds of vigorous friction with soap covering all surfaces, including between fingers, under nails, wrists
- c.Air-drying without towel
- d.Rinsing under cold water without soap
Answer: b
Explanation: CDC handwashing guidance specifies at least 20 seconds of vigorous friction with soap on all hand surfaces, including between fingers, under nails, and wrists, then rinse and dry with a clean towel, turning off the faucet with the towel. Five seconds (a) is inadequate; rinse alone (c) does not remove organic soil and pathogens; air-drying (d) is slower and not standard in clinical care. Handwashing is the single most important infection-control measure.
Source: CDC Standard Precautions; WHO 'My 5 Moments'
4. Safety & Infection Control
Alcohol-based hand rub is preferred over soap and water EXCEPT when:
- a.Hands are visibly soiled, after caring for a C. difficile or norovirus patient, before eating, after toileting
- b.After removing gloves
- c.Before donning gloves
- d.Between residents
Answer: a
Explanation: CDC guidance: alcohol-based hand rub (60-95% alcohol) is preferred for most clinical encounters because it is fast and more effective than handwashing for non-spore organisms. However, soap-and-water handwashing is required when hands are visibly soiled, after caring for C. difficile or norovirus (spores survive alcohol), before eating, and after using the restroom. Other situations (b, c, d) are appropriate for alcohol rub.
Source: CDC hand hygiene
5. Basic Nursing Skills
Pressure injury prevention for an immobile resident includes:
- a.Use a doughnut-shaped cushion under the sacrum
- b.Massage reddened bony prominences vigorously
- c.Reposition at least every 2 hours, off-load heels (heel float), keep skin clean and dry, use pressure-redistribution surfaces, maintain nutrition/hydration
- d.Leave in one position 6 hours to allow rest
Answer: c
Explanation: Per NPUAP/EPUAP guidelines, prevention requires turning at least every 2 hours, off-loading heels (pillow under calf, not under heel itself), keeping skin clean and dry, using pressure-redistribution mattresses, and maintaining nutrition/hydration. Prolonged single position (a) causes ischemia; massaging reddened areas (b) damages capillaries; doughnut cushions (c) concentrate pressure on a ring and worsen tissue damage.
Source: NPUAP/EPUAP pressure injury prevention
6. Basic Nursing Skills
A normal pulse oximetry (SpO2) reading on room air for most adults is:
- a.Variable, no normal
- b.60-80%
- c.Below 85%
- d.95-100%
Answer: d
Explanation: Normal SpO2 on room air is 95-100% for most adults; 90-94% may indicate mild hypoxia and warrants closer monitoring; below 90% is significant hypoxia requiring immediate evaluation and possible supplemental oxygen. Some chronic COPD residents have a baseline of 88-92% and may have a physician-set lower target to avoid suppressing hypoxic drive. Report values outside the resident's individualized parameters to the nurse. Probe placement, motion, nail polish, cold extremities, and poor perfusion can falsely lower the reading.
Source: Fundamentals; pulse oximetry
7. Restorative Care
A CNA observes a small area of intact skin on a resident's sacrum that is red and does not blanch (turn white) when pressed. This finding is classified as:
- a.Stage 1 pressure injury
- b.Deep tissue injury (DTI)
- c.Stage 3 pressure injury
- d.Unstageable pressure injury
Answer: a
Explanation: NPIAP staging: Stage 1 = intact skin with non-blanchable erythema (redness that does not turn white when pressed). Stage 2 = partial-thickness loss with exposed dermis. Stage 3 = full-thickness loss with visible subcutaneous fat. Stage 4 = full-thickness loss with exposed bone, tendon, or muscle. Unstageable (c) = depth obscured by slough/eschar. DTI (d) = persistent non-blanchable deep red, maroon, or purple discoloration suggesting deeper damage under intact or non-intact skin. CNAs must report any new redness immediately per 42 CFR §483.25(b) and Title 22 CCR §72523 (incident reporting).
Source: 42 CFR §483.25(b); Title 22 CCR §72523
8. Mental Health
A CNA notices unexplained bruises in the shape of fingerprints on a resident's upper arm. The resident whispers, 'The night CNA grabbed me hard.' The CNA's FIRST action is to:
- a.Report to the charge nurse and administrator immediately and ensure mandated abuse report is filed per W&I §15630
- b.Wait until the next staff meeting to bring it up
- c.Tell only a coworker to get their opinion
- d.Confront the night CNA directly
Answer: a
Explanation: Under W&I §15630, a CNA in a long-term care facility is a mandated reporter of suspected elder/dependent adult abuse. The reporting flow: report immediately to the charge nurse and administrator AND personally ensure a report is made by phone to the local LTC Ombudsman or law enforcement (immediately for physical abuse) and a written report (SOC 341) within 2 working days. Confronting the suspected abuser (a) risks evidence destruction and retaliation. Waiting (c) or gossiping (d) violates mandated reporter duty and may expose the CNA to criminal penalty under §15630(h).
Source: W&I §15630; W&I §15610.07
9. Emotional Support
Standard post-mortem care positioning is to:
- a.Place the body supine in good alignment with the head slightly elevated on a pillow, eyelids closed, dentures replaced if possible, before rigor mortis sets in
- b.Place the body in a side-lying position with knees flexed
- c.Place the body face-down to prevent fluid drainage
- d.Position knees drawn to chest in a fetal position
Answer: a
Explanation: Standard post-mortem care: supine, good body alignment, head slightly elevated on a pillow (to prevent facial discoloration from blood pooling), eyelids gently closed, dentures replaced before rigor mortis (begins ~2-4 hours after death), clean linens, and dignity maintained. Identify body per facility policy (usually two ID tags: wrist/ankle and outside of shroud or bag). Honor cultural practices first. Side-lying (a), prone (c), and fetal (d) are not standard and may impair dignity and identification. 42 CFR §483.10 protects dignity in all care, including post-mortem.
Source: 42 CFR §483.10; Title 22 CCR §72527
10. Legal & Ethical
A CNA, frustrated with a wandering resident, locks the resident in a room without a physician order or care-plan justification. This action is:
- a.False imprisonment, prohibited use of restraint under 42 CFR §483.10(e) and §483.12(a)(2), abuse under W&I §15610.07, and grounds for criminal charges, civil liability, and certification revocation
- b.Acceptable if family approves
- c.Acceptable if it is only for a short period
- d.Legal because the door has a window
Answer: a
Explanation: Confining a resident against their will without medical justification, physician order, and informed consent is false imprisonment (civil and criminal tort) and unlawful restraint under federal nursing home regulations. Duration (a), door windows (b), or family approval (c) do not legalize unlawful confinement. The resident has the right to be free from restraints not required for medical symptoms. CDPH may issue immediate jeopardy citations; the CNA faces termination, certification revocation under HSC §1337.9, and possible criminal prosecution. Always use approved behavior plans and least restrictive interventions.
Source: 42 CFR §483.10(e); 42 CFR §483.12(a)(2)