North Carolina CNA Practice Test — Free NNAAP Prep

North Carolina employs roughly 44,600 certified nursing assistants — one of the ten largest CNA workforces in the country and growing fast. The state's 10.7 million residents are spread across the Research Triangle, Charlotte metro, Triad (Greensboro/Winston-Salem), and large rural footprints across the coastal plain and Appalachian western counties. North Carolina is one of the fastest-growing states in the US by net migration, and the 65+ population is projected to nearly double by 2040.

Demand is concentrated in the Charlotte and Raleigh-Durham metros, but the Triad, Wilmington, Asheville, and rural counties along I-95 face tighter relative shortages. Rural Eastern NC and the Western Carolina mountains consistently offer sign-on bonuses, shift differentials, and tuition assistance that the academic systems in the Research Triangle don't need to match. The state's significant retiree migration into the foothills and the Outer Banks supports a strong assisted living and home health pipeline.

The average CNA wage in North Carolina is approximately $15.87/hour. North Carolina taxes earned income at a flat 4.5% — lower than most Southeastern states — and cost of living outside central Charlotte and central Raleigh runs well below the national median. Median home prices in Greensboro, Winston-Salem, Fayetteville, and most of the coastal plain remain affordable. Purchasing power for a NC CNA wage typically buys substantially more housing than the same nominal wage in Virginia or Tennessee.

North Carolina requires 75 hours of state-approved Nurse Aide I training — the federal minimum — though most NC community college programs run 80–120 hours because the state mandates additional skills-lab and supervised clinical hours on top of classroom theory. Programs are offered through the North Carolina Community College System (NCCCS), high school career and technical programs, and many NC nursing facilities that train candidates in exchange for an employment commitment.

The exam is administered by Credentia — not Prometric — under contract with the NC Department of Health and Human Services, Division of Health Service Regulation. The written portion covers the standard NNAAP content domains, and the clinical skills portion requires demonstrating five randomly selected hands-on skills (always including handwashing) in front of a Credentia evaluator. Once you pass, your name is added to the NC Nurse Aide I Registry. North Carolina also offers a separate Nurse Aide II credential after additional training that opens doors to higher-acuity facility roles.

You have up to 3 attempts within 2 years of completing your training program. If you exhaust all three or let the 2-year window lapse, North Carolina requires you to complete a new approved program before retesting. Schedule directly at credentia.com once your training program submits your eligibility.

The largest CNA employers in North Carolina include Atrium Health (Charlotte-based, the largest health system in the state), Novant Health, Duke Health, UNC Health, ECU Health, WakeMed, Cone Health, Cape Fear Valley Health, and the Veterans Affairs medical centers in Durham, Fayetteville, Asheville, and Salisbury. Atrium and Novant set the wage ceiling for the state and offer some of the strongest LPN/RN pipeline benefits in the Southeast, but most prefer 6–12 months of facility experience before hiring CNAs into acute care.

Long-term care operators are the most common entry point for new North Carolina CNAs. Liberty Healthcare and Rehabilitation Services (NC-headquartered), Saber Healthcare Group, PruittHealth, Principle LTC, and dozens of independent SNFs hire new graduates aggressively. Many will pay for your community college training program in exchange for a 6- to 12-month employment commitment.

Home health is one of the fastest-growing CNA segments in North Carolina, supported by the state's aggressive aging-in-place programs and the rapid growth of assisted living communities along the coast and in the foothills. BAYADA, Well Care Home Health, Liberty Home Care, Encompass Health, and dozens of regional agencies recruit CNAs statewide. Home health in NC typically requires a reliable vehicle but offers scheduling flexibility and per-visit pay structures that often beat facility hourly rates.