CNA Training in North Carolina

Are you looking forward to pursuing a career in the medical field? A North Carolina-based CNA could be the best option for you. It requires the terms that have been associated with the Nursing Home Reform Act are followed here, as the law requires. Also, it ensures that you are fully prepared and trained so that you can give high-quality care to residents and patients in the healthcare facility.

Step 1: Select the Correct Path

Here, a candidate has to pass through either of two levels to be a successful assistant, i.e. Nurse Aide 1 and 2. You can choose the testing and training path for the first level that leads you to the North Carolina-based Nursing Assistant certification.


The DHHS (Department of Health and Human Services) maintains the DHSR (Division of Health Service Regulation) NC division. The division maintains the Health Care Personnel Registry and approves the training program of level-1 Nurse Aide. If you want to begin a nursing career, you must have your name added to this registry in North Carolina. And, you should complete the Nurse Aide’s training and evaluation program for competency. Here are some paths to become a Certified NC-based Nurse Aide 1.

  • Finish the required competency test and training program that is approved in the state.
  • Get a waiver of training and complete the test for competency at one of the facilities that offer a program approved in the state.
  • Meet the licensing requirements of the state, in case you are an LPN and RN.

Routes via CNA Training

To be eligible for the exam in the state, you should meet the requirement of any of the routes discussed below:

  • Route E1: If you have successfully completed the Nurse Aide I program in this state, you can take the CNA exam provided that both are approved in the state.
  • Route E3: If you have completed the Nurse Aide 1 course at any of the North Carolina state-approved proprietary schools or community colleges, you are eligible to give the exam.
  • Route E5: Those who are currently pursuing a North Carolina approved education program of nursing to be a Licensed Practical Nurse or Registered Nurse are also eligible. They can take this exam within a 2-year period of completing an NC approved nursing program.

However, there are certain rules for Route E1, E5, and E3:

  • Candidates must pass the parts within 3 attempts or two years after finishing the course.
  • If the candidate does not clear the exam after 3 attempts and cannot appear for an exam within a period of two years, he/she has to go through the training again and give both exams.

Routes via Waiver

The candidate has to submit the request NC DHHS for a waiver of training for the state’s Nurse Aide 1 examination.

  • Route E8: EMTs or Emergency Medical Technicians, nurses with inactive or expired registry listings, unlicensed nursing graduates, and military medics.
  • Route E9: A person who underwent training in the last 24 months from another state but not registered on the registry there.

If you comply with the eligibility for either of the routes, you have to take and clear the CNA exam’s both portions within 2 years or three attempts. However, if you cannot clear both portions after 3 attempts or 2 years, you must clear the NC-approved program of training and take the exam again.

Step 2: Get Trained for Nurse Aide I

Training in North Carolina teaches the students how to finish their certain CNA tasks as Nurse Aide I employee. The curriculum changes according to program, but it includes training of minimum hands-on skills and instructions, so you are able to provide care to patients and residents.


The training program of this level of the Nurse Aide curriculum meets the requirements as defined for the North Carolina state. It includes a minimum 75-hour of laboratory, clinical instruction, and combined classroom. In these 75 hours, at least 16-hour of laboratory training and combined clinical experience must be included.

The curriculum comprises of the content that covers 23 modules, and every module provides information on a specific area that a student of this Nurse Aide level should know. It meets the federal requirements for workers in long-term care facilities that are federally certified.

Clinical and Laboratory Training

The clinical and laboratory training includes various components, such as:

  • The instructor demonstrating the skills
  • Students can practice the skills
  • Check-off the proficiency

Every student will need to perform at least 15 skills that are on the checklist of performance skills summary in a program’s curriculum approved in the state. These skills should be performed under the supervision of an instructor of clinical training. After a student demonstrates proficiency in the lab, the direct resident and patient care skills should be performed. The skills covered are:

  • Personal Care: It provides partial and complete bed bath, perineal care, foot care, undressing or dressing, fingernail care, mouth care, and denture care for an unconscious or conscious person.
  • Infection Control and Prevention:  Provide hand hygiene, as well as take-off and put on personal protective equipment, such as masks and gowns
  • Measurements: Record and measure vital signs like weight and height.
  • Nutrition and Hydration: Assist the patient or resident with various needs like feeding or dining when they are not able to eat themselves.
  • Elimination: Gather urine specimens, record and measure urinary output, eliminate required urinals or bedpans, empty drainage bags of urinary, and provide catheter care.
  • Mobility: Perform ROM (range of motion) exercises, move to chair or wheelchair from bed, apply restrains, and ambulation assistant.

Refresher Course

  • Before taking the competency exam again, the nursing assistant has to refresh his/her skills. If you have a waiver of training but the expiration date of the registry has passed, you will still need to finish the refresher course.
  • The paramedics, office assistants of medical, and EMTs need to have some additional skills so that they can clear a competency exam of level 1 Nurse Aide. They can choose a refresher course instead of complete training.

However, the refresher course cannot include clinical training.

Step 3: Clear the Exam

The skills, oral, and written exam part of the exam are administered by the Pearson VUE.

  • Apply for the Test: The registration process is online wherein you need to create an account, ID, and password under Pearson VUE. This is needed to complete the essential fields accurately.
  • Payment Method: Accepted payment methods include Master Card, American Express, Electronic voucher, and Visa. The exam fee is not refundable, and thus you must pay the fee again while re-scheduling if you are not able to take the exam on time.
  • Test Location: The testing locations are in-facility and regional testing sites. If a person has some disability, he/she can request for some special accommodation. Regional testing sites are located at multiple locations in the state, and any person can take a test there. The list is available with Pearson VUE and on the website of the NC Nurse Aide. If a person chooses route E3, E1, and E5, in-facility testing locations are made available.
  • Important Documents: It is essential to reach a minimum of half-hour before the test time. You have to carry a few things along with yourself.
    • Current identification forms that bear a signature and are official.
    • A non-laminated signed social security card issued by the U.S. government. If the applicant is serving the armed forces, he/she can use the U.S. Military I.D. instead.
    • Number 2 pencils (3, sharpened) and eraser
    • Alien registration card or (EAD) Authorization document
    • Watch that contains the second hand
  • Different Parts of the Exam: In North Carolina, skills evaluation and oral/written tests are the two parts of the examination. These parts are different because the first one is a hands-on skills demonstration, and the other is MCQ type questions.

Oral or Written Exam

The CNA written exam contains 70 MCQs that should be finished within 2 hours. But oral exam offers Spanish and English options that cover 10 MCQs and 60 general MCQs to test your English speaking ability, covering the words of a nurse aide as well.

Skills Evaluation

The exam checks the applicants if they are in a really caregiving situation or not. Nurse Aide Evaluator administers the test and provides all the equipment. The variety of skills can be asked for the demonstration, and in those, a few are called critical element steps. With randomly selected skills, everyone can perform the critical element steps to clear the test. A skill of measurement is included in the randomly selected skills.

  • Results: After completion of this examination, the evaluator gives the evaluation results of the skills to the Pearson VUE and fax the answer sheets. Within 10 minutes, you will get the exam results. If the applicant passes the exam, they are on their way to get certified, but if not passed, a re-test is required.

Following the above guide can be helpful in achieving the goals of a rewarding medical career in North Carolina. However, you may also need to know the renewal process, once it expires. You have to maintain as a working Nurse Aide I for 8 hours per day for every two years. Your renewal will be for 24 months if you last worked a year ago.

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