NHA CPCT/A exam prep
Free NHA CPCT/A exam prep with 30 original questions, native answer explanations, the current and announced January 2027 blueprints, and a four-week review schedule.
Use this NHA CPCT/A exam prep guide to work through 30 original, unofficial questions with explanations and follow a four-week review schedule. This is a study sample, not a full-length exam; the current and announced January 2027 blueprints are distinguished below.
CPCT-001. You're moving a patient with an indwelling urinary catheter from the bed into a wheelchair. Where does the drainage bag go?
- A. Resting on the patient's lap during the ride
- B. Hooked to the wheelchair frame below bladder level, clear of the floor
- C. Clipped to the IV pole above bladder level
- D. Set on the floor beside the chair while you get the patient positioned
Show answer and explanation
B. CDC's CAUTI guideline is blunt about this: keep the collecting bag below the level of the bladder at all times, don't rest the bag on the floor, and keep the catheter and tubing free from kinks.
A and C do not keep the bag below bladder level. D is the other half of the rule — the bag must stay off the floor, even while you position the patient. The frame position described in B is the one that satisfies both halves.
Sources: CDC: CAUTI recommendations.
Which blueprint applies to your test date
The CPCT/A has 100 scored questions plus 20 unscored pretest questions, in 2 hours. There is a current exam plan and an announced replacement—not two simultaneously live exam versions. Current test plan; announced test plan.
| Domain | Current plan: until the transition | Announced plan: January 2027 launch |
|---|---|---|
| 1. Patient Care | 45 items | 43 items |
| 2. Compliance, Safety, and Professional Responsibility | 20 items | 19 items |
| 3. Infection Control | 11 items | 16 items |
| 4. Phlebotomy → Phlebotomy and Nonblood Specimen Collection | 14 items | 12 items |
| 5. EKG | 10 items | 10 items |
| Total scored | 100 | 100 |
The left column uses the 2018 job-analysis plan; the right uses the 2025 job-analysis plan. Each item count is also that domain's percentage of the 100 scored questions. Both versions keep 120 total questions and two hours; the handbook identifies NHA exams as multiple choice. NHA Candidate Handbook, pp. 24–25.
Testing around January 2027? NHA announces a January launch but does not give an exact day in the announcement checked. Confirm which version applies to your appointment rather than assuming a January 1 switch. The transition and retake guidance below explains the late-2026 issue. NHA exam-update announcement.
Practice questions
Thirty original questions, written for this guide. These are not official NHA items and they are not retired exam content. Question 1 is above; Questions 2–30 follow here.
The split is 13 Patient Care, 6 Compliance/Safety/Professional Responsibility, 4 Infection Control, 4 Phlebotomy and specimen collection, 3 EKG. This is an editorial sample across the five domains, not an exact miniature of either exam. The selected topics are relevant to both plans, but the set does not test every task in either one.
Choose an answer before opening its explanation. Note the ones you missed and the ones you guessed right. The domain review and four-week schedule turn those observations into your next study session.
Patient Care
CPCT-002. You're recording intake for a patient on strict I&O. The breakfast tray had 240 mL coffee, 120 mL juice, and 180 mL water. The patient drank all the coffee, half the juice, and all the water. What do you record?
- A. 360 mL
- B. 420 mL
- C. 540 mL
- D. 480 mL
Show answer and explanation
D. 240 + 60 + 180 = 480 mL. You record what was actually consumed, not what was delivered.
C (540) counts the whole juice. B (420) drops the juice entirely. A (360) counts all the juice and misses the water. The habit worth building: work item by item and halve or quarter as you go, rather than eyeballing the tray at the end.
The arithmetic is our own; the test plans establish intake-and-output measurement as a study topic.
Sources: NHA CPCT/A Test Plan — 2018 job analysis; NHA CPCT/A Test Plan — 2025 job analysis.
CPCT-003. A patient had a left mastectomy with lymph node removal. The care plan says no blood pressures on the left arm. Her right arm is unrestricted. What do you do?
- A. Take the blood pressure on the right arm
- B. Take it on the left arm with a smaller cuff
- C. Use the left forearm instead of the upper arm
- D. Skip the reading and chart that it couldn't be obtained
Show answer and explanation
A. When one limb is restricted and the other isn't, you use the unrestricted one. That's it.
B and C both still compress the restricted limb — a smaller cuff or a lower site doesn't make it a different arm. D is the answer people pick when they're worried about doing the wrong thing, but a missing vital sign is its own problem, and there's a usable arm right there. If both arms were restricted, that's the point where you stop and ask the nurse.
The restriction is stated in this patient's care plan. This question is not a universal rule that every patient with a history of mastectomy has the same restriction. Both test plans include special considerations for blood-pressure measurement; delegation guidance supports following the patient's instructions and clarifying an unsuitable assignment.
Sources: NCSBN–ANA: National Guidelines for Nursing Delegation; NHA CPCT/A Test Plan — 2018 job analysis; NHA CPCT/A Test Plan — 2025 job analysis.
CPCT-004. A 78-year-old was alert and oriented when you started your shift. Now she doesn't know where she is and is trying to swing a leg over the side rail. What's the best action?
- A. Chart the change and hand it off at the end of shift
- B. Reorient her and recheck in an hour
- C. Stay with her, make sure she's safe, and tell the nurse now
- D. Raise all four side rails and carry on with your assignment
Show answer and explanation
C. A new change in level of consciousness needs a prompt report, and here it's paired with an immediate fall risk. Safety and the report happen together: stay with her and summon nursing help now, using the unit's urgent-response process.
A and B both delay a report that shouldn't wait — B is the tempting one, because reorienting is a reasonable thing to do, just not instead of telling someone. D raises a restraint question and still leaves the nurse uninformed.
Notice what the answer isn't: independently diagnosing why she's confused before getting help. Recognising the change and escalating it is.
Sources: MedlinePlus: Confusion; NCSBN–ANA: National Guidelines for Nursing Delegation; 42 CFR §482.13: Hospital patient rights.
CPCT-005. During morning care you find redness over the patient's sacrum that doesn't turn white when you press it. He's been on his back most of the night. Your assignment is to observe and report skin changes and reposition him according to the care plan; the nurse performs the skin assessment. What do you do?
- A. Document it in the chart as a stage 1 pressure injury
- B. Report it to the nurse, document what you actually saw, and reposition per the care plan
- C. Apply barrier cream and take another look tomorrow
- D. Cover the area with a sheet and leave the patient in the same position
Show answer and explanation
B. Your task is to identify and report the change, document the observation, and carry out the prescribed repositioning. Describe what you saw: location, colour, whether it blanched.
A records a clinical stage instead of following the observation-and-reporting assignment in the question. Knowing staging terminology for an exam is not the same as being assigned to perform a clinical assessment. C delays a report by a full day. D hides the finding and leaves the pressure unaddressed.
AHRQ's hospital toolkit distinguishes nursing assistants' skin observations during care from the nurse's assessment and calls for abnormalities to be reported and documented.
Sources: AHRQ: Preventing Pressure Ulcers in Hospitals; NCSBN–ANA: National Guidelines for Nursing Delegation.
CPCT-006. A patient with a PEG tube on continuous feeding asks you to lay the bed flat because her back hurts. Her care plan says keep the head of the bed elevated.
- A. Keep the head of the bed up as the plan directs, explain why, and tell the nurse she's uncomfortable
- B. Lower the bed flat — she asked
- C. Stop the feeding pump yourself and then lay her flat
- D. Turn her onto her left side and lay the bed flat
Show answer and explanation
A. Head-of-bed elevation during tube feeding is an aspiration precaution. Her comfort is a real problem and it deserves a real answer — but the answer is repositioning within the plan and telling the nurse, not overriding the plan.
B ignores the stated positioning instruction. C has you changing the feeding plan on your own to permit the requested position. D is a workaround dressed up as a compromise; the bed is still flat.
A PEG is a percutaneous endoscopic gastrostomy feeding tube. This question concerns discomfort during an otherwise routine feeding, not the emergency response to choking or another acute problem.
Sources: Memorial Sloan Kettering: How to Prevent Aspiration; NCSBN–ANA: National Guidelines for Nursing Delegation.
CPCT-007. A post-op patient is blowing hard into his incentive spirometer and getting frustrated that nothing moves.
- A. Tell him to blow harder
- B. Tell him to wait and use it only when a nurse is in the room
- C. Tell him to take fast shallow breaths to keep the indicator up
- D. Have him seal his lips on the mouthpiece and breathe in slowly and deeply, then hold it 3 to 5 seconds
Show answer and explanation
D. The device is used for inhalation. He should exhale normally first, seal his lips around the mouthpiece, then breathe in slowly, hold the breath 3 to 5 seconds, and exhale slowly.
A repeats the wrong direction of airflow. C works against the point — fast shallow breathing is not the slow, deep inspiration being practised. B leaves him doing nothing rather than correcting the technique within his prescribed instructions.
Frequency and target volume come from the patient's own order.
CPCT-008. A post-op patient is non-weight-bearing on the right leg and needs to move from stretcher to bed. His care plan specifies a lateral-transfer device and two trained staff for this transfer. You're the only person in the room. What do you do?
- A. Pivot him on the left leg using a gait belt
- B. Ask him to hop on the left leg while you steady him
- C. Get help and use the transfer device the care plan calls for
- D. Slide him across on the bed sheet yourself
Show answer and explanation
C. Get the help and equipment specified for this patient. The care plan requires two trained staff for this transfer; it is not a solo assignment.
A and B substitute a standing transfer for the prescribed lateral transfer. D discards both the equipment requirement and the staffing requirement. None follows the plan you were given.
A restriction on one leg does not, by itself, establish the correct transfer method or a universal staff count. Those details are explicit in this question so you do not have to guess them.
Sources: NCSBN–ANA: National Guidelines for Nursing Delegation.
CPCT-009. You're setting up a mechanical lift and notice the sling's straps are visibly frayed near the stitching.
- A. Use it this once and report it afterwards
- B. Take it out of service, get an intact sling that fits this lift, and report the damage
- C. Fold the frayed section over so it isn't taking the load
- D. Use a bed sheet in the lift frame instead
Show answer and explanation
B. Damaged slings come out of service. Full stop. FDA's lift-safety guidance says not to use a sling with frayed seams or other damage and to use a sling approved for the particular lift.
A uses known damaged equipment. C is improvised load-bearing on equipment holding a person. D substitutes an item never designed or rated for it.
Sources: FDA: Patient Lifts.
CPCT-010. You're about to put antiembolism stockings on a patient and notice one calf is newly red, warm, and painful to touch.
- A. Leave the leg alone and report what you found to the nurse before applying anything
- B. Apply them as ordered — that's what they're for
- C. Apply them, but loosely
- D. Massage the calf first to improve circulation
Show answer and explanation
A. New redness, warmth, and pain in one calf is a change in condition. Reporting it is your task; deciding what it means and whether compression is still appropriate is not.
CDC identifies these as possible symptoms of a deep vein thrombosis, which needs medical evaluation. They are not enough to diagnose one yourself. The new finding calls for nursing assessment before you proceed with the planned task.
B ignores the change. C is a compromise that still changes how you apply compression without direction. D substitutes an unprescribed intervention for the needed report.
Sources: CDC: About Venous Thromboembolism; NCSBN–ANA: National Guidelines for Nursing Delegation.
CPCT-011. A patient with advanced dementia can't tell you how he feels. He's grimacing, guarding his abdomen, and pulling away when you reposition him.
- A. Chart that he denies pain
- B. Ask his daughter to pick a number on the 0–10 scale and chart it as the patient's own report
- C. Document the specific behaviours you observed and report them to the nurse
- D. Assume it's positioning, reposition him, and say nothing
Show answer and explanation
C. When self-report isn't available, what you have is behaviour — so document the behaviour precisely and report it.
A records something false; he didn't deny anything. B records a proxy estimate as though the patient said it. Family observations can help the care team assess pain, but they must not be misrepresented as the patient's own statement. D might even be right about the cause, but it keeps the observation to yourself.
The care team may use a structured observational pain tool suited to a patient who cannot self-report. The observation in this question is a reason to report, not permission to invent a pain score.
Sources: NCI: Cancer Pain (PDQ), Health Professional Version.
CPCT-012. A nurse asks you to assist with a sterile dressing change for a stable patient. Facility policy allows appropriately trained technicians to provide this assistance; the nurse gives clear directions and will remain to supervise. You have never done it and have not been trained. Which of the Five Rights of Delegation is not met?
- A. Right task
- B. Right circumstance
- C. Right supervision
- D. Right person
Show answer and explanation
D. “Right person” covers whether this worker has the knowledge and skills to do this task. You do not have the stated training, so that's the one that fails.
A is established by the policy described in the question. B is supported by the stable patient and stated setting. C is supported by the nurse remaining to supervise. Supervision does not erase the competence gap.
The action that follows: say you haven't been trained on it, and ask for direction. That isn't refusing work. It's the rule working.
The full NCSBN–ANA labels are right task, right circumstance, right person, right directions and communication, and right supervision and evaluation. NHA's 2025 test plan shortens the last label to “right supervision.”
Sources: NCSBN–ANA: National Guidelines for Nursing Delegation; NHA CPCT/A Test Plan — 2025 job analysis.
CPCT-013. A patient receiving hospice care takes your hand during morning care and says quietly, "I'm scared."
- A. "Don't worry — everything's going to be fine."
- B. Sit down, stay with her, and ask what's worrying her
- C. Change the subject to something more cheerful
- D. Tell her you'll send the chaplain and leave to go find them
Show answer and explanation
B. Providing emotional support while giving care is a task on both test plans, and the supporting knowledge is therapeutic communication. Staying and asking is the whole skill.
A offers reassurance you cannot promise and closes the conversation. C does the same thing more politely. D is the near-miss: getting the chaplain may be exactly right, but not instead of the attention she's asking for right now. Stay first, then offer to arrange it.
Sources: NCI: End-of-Life Care for People Who Have Cancer; NHA CPCT/A Test Plan — 2018 job analysis; NHA CPCT/A Test Plan — 2025 job analysis.
Compliance, Safety, and Professional Responsibility
CPCT-014. You're at the bedside to draw blood. The room number matches your requisition, and the patient answers when you say "Mr. Reed?" Your facility uses full name and date of birth as its two identifiers. What should you do next?
- A. Go ahead — the room and the name match
- B. Check only the surname on the armband and proceed
- C. Ask a coworker to confirm it's Mr. Reed
- D. Ask the patient to state his name and date of birth, and check both against the requisition and the armband
Show answer and explanation
D. Use the two identifiers specified by the facility: name and date of birth. Ask the patient to state them and compare them with the requisition and armband. A yes/no response to a suggested name does not complete that check.
A relies partly on a room number, which is not a patient identifier. C outsources your check to someone who isn't doing the procedure. B checks only a surname and skips the patient's own participation.
Joint Commission's laboratory safety goal requires at least two patient identifiers and excludes room number or physical location. It does not mean that an armband can contain only one identifier.
Sources: Joint Commission: 2026 Laboratory National Patient Safety Goals; WHO: Guidelines on Drawing Blood, chapter 2.
CPCT-015. A coworker asks you to pull up a chart for someone who lives on her street. "Just tell me if she's okay."
- A. Decline — you may only open records for an authorized work purpose
- B. Look, but don't tell anyone what you saw
- C. Look it up and let your coworker read the screen
- D. Ask the nurse to look it up instead
Show answer and explanation
A. Under the HIPAA Privacy Rule, a facility's policies must identify who needs access to information to carry out their job duties. Curiosity is not a job duty. Neither is a favour for a friend.
B is the one people talk themselves into — but keeping the information to yourself does not make the access appropriate. C adds a second person to the same problem. D just moves the request to someone who also has no work reason to open it.
Authorized work can include duties other than personally treating the patient. The rule here is authorized role-based access, not a blanket ban on every non-treatment use.
Sources: HHS: Minimum Necessary Requirement.
CPCT-016. An elderly patient in your hospital has bruises on both upper arms. She tells you her son grabs her when he's angry, then says, "please don't say anything." Hospital policy requires staff to promptly report suspected abuse through its safeguarding process. What do you do?
- A. Keep it between you unless she changes her mind
- B. Call the son to hear his side
- C. Report it to the nurse and follow the facility's reporting process right away
- D. Watch for it to happen again before saying anything
Show answer and explanation
C. Report what you observed and what the patient told you through the required process now. Explain that you need to share the concern with the team responsible for her safety; do not promise secrecy.
A leaves the safety concern unreported. B contacts the alleged abuser rather than initiating the safeguarding process. D waits for another incident instead of responding to the information already available.
You're not deciding whether abuse occurred. You're reporting what you observed and what she told you.
This hospital scenario does not define every state's mandated-reporting law. Follow any reporting duty that applies to your role and setting; telling a nurse is not a substitute for a separately required report.
Sources: 42 CFR §482.13: Hospital patient rights; CDC: About Abuse of Older Persons.
CPCT-017. You approach an adult patient who can make her own care decisions with a blood collection tray for a routine, nonemergency test. The patient pulls her arm back and says, "No. Not today."
- A. Stop, don't collect, and tell the nurse she declined
- B. Continue — the order is written
- C. Ask her daughter to talk her into it
- D. Step out and come back in five minutes without mentioning it
Show answer and explanation
A. A written order authorises the test; it doesn't override this patient's refusal. Stop the collection and notify the nurse.
B proceeds without consent. C uses family pressure to try to get around the refusal rather than respecting it. D leaves the refusal unreported and returns without addressing it.
Reporting the refusal matters as much as respecting it — the nurse may need to know the specimen didn't happen.
Sources: 42 CFR §482.13: Hospital patient rights; WHO: Guidelines on Drawing Blood, chapter 2.
CPCT-018. A patient's family points at the monitor and asks you what his latest lab value means and whether the new medicine is working.
- A. Explain the result as well as you can
- B. Tell them lab results aren't something you can interpret, and let the nurse know they have questions
- C. Tell them it's "normal" if it's inside the range shown on screen
- D. Say you're not allowed to speak with families
Show answer and explanation
B. Following the chain of command — passing the question to the person who can answer it — is the right action. Interpreting what a result means for this patient's treatment requires clinical judgment, not just reading a screen.
A and C both interpret. C is the sneakier of the two: being inside a displayed reference range does not, by itself, answer whether the medicine is working. D is untrue; you can communicate with families within your role and privacy requirements, and help their question reach the appropriate nurse or clinician.
Sources: NCSBN–ANA: National Guidelines for Nursing Delegation; HHS: Minimum Necessary Requirement.
CPCT-019. While disposing of a used needle you stick your own finger.
- A. Finish your other tasks and mention it at the end of your shift
- B. Fill in an incident report at the end of the week
- C. Squeeze the site until it bleeds and carry on
- D. Wash the puncture site with soap and water, report the exposure immediately, and obtain the designated medical evaluation and follow-up
Show answer and explanation
D. OSHA's bloodborne pathogens standard requires that following a report of an exposure incident, your employer make a confidential medical evaluation and follow-up immediately available to you. Washing the site and reporting promptly avoids delaying that evaluation.
A and B both delay the response. C substitutes squeezing the wound for the washing, reporting, and evaluation that are needed.
What follows the report — testing, prophylaxis, anything else — is decided by a licensed healthcare professional, not by you and not by this page.
Sources: 29 CFR §1910.1030: Bloodborne pathogens.
Infection Control
CPCT-020. You take off your gloves after cleaning a patient following an incontinence episode. Your hands are visibly soiled.
- A. Use alcohol-based hand sanitizer and move on
- B. Put on fresh gloves — the gloves protected your hands
- C. Wash with soap and water
- D. Rinse with water
Show answer and explanation
C. CDC's rule has two halves and this question tests the second one. Alcohol-based hand rub is preferred for most clinical moments — but only when hands aren't visibly soiled. When they are, you wash.
A does not replace soap and water for visibly soiled hands. B rests on the assumption gloves make hand hygiene optional; CDC says plainly that glove use is not a substitute for cleaning hands. D skips the soap.
Sources: CDC: Clinical Safety—Hand Hygiene for Healthcare Workers.
CPCT-021. You're entering a room on Contact Precautions to reposition a patient. No additional isolation precautions or splash-producing procedure are involved. Which PPE and timing meet the Contact Precautions requirement?
- A. Gloves only — you won't be touching body fluids
- B. Gown and gloves, put on at the bedside and kept on to the next room
- C. Gown and an N95 respirator, but no gloves
- D. Gown and gloves, put on before you enter and taken off before you leave the room
Show answer and explanation
D. For hands-on care under Contact Precautions, put on gown and gloves on room entry and remove them before exiting. Perform hand hygiene after removal.
A drops the gown and misreads the risk — with Contact Precautions, the bed rails and tray table count too. C omits the required gloves; an N95 respirator does not replace them. B gets the PPE right and the timing wrong: waiting until the bedside delays protection, and keeping it on for the next room can carry contamination with you.
Additional isolation instructions or anticipated exposures can change the PPE required. They are explicitly absent here.
Sources: CDC: Precautions to Prevent Transmission of Infectious Agents; CDC: Clinical Safety—Hand Hygiene for Healthcare Workers.
CPCT-022. Before starting a blood collection, you notice the room's sharps container is filled above its fill line. You have not opened or used the needle. What should you do?
- A. Arrange replacement according to policy and have an appropriate sharps container available before starting
- B. Press the contents down to make room
- C. Start the draw and plan to set the used needle on the counter afterwards
- D. Start the draw and recap the needle for disposal later
Show answer and explanation
A. An overfilled container is a needlestick risk. Fix the disposal problem before you create a used sharp.
OSHA requires sharps containers to be accessible near the point of use, replaced routinely, and not allowed to overfill. Containers are closed before removal or replacement.
B puts your hand near contaminated sharps. C plans to leave a used sharp on a work surface. D substitutes recapping and delayed disposal for a properly available container. Routine recapping is not the workaround for an overfilled container.
Sources: 29 CFR §1910.1030: Bloodborne pathogens.
CPCT-023. A patient has no isolation sign on the door and no known or suspected infection. Which statement about standard precautions is correct?
- A. They apply only to patients with a known infection
- B. They apply to every patient, whatever their known or suspected infection status
- C. They replace transmission-based precautions when no organism has been identified
- D. They apply only when you expect contact with blood
Show answer and explanation
B. That's the whole idea. Standard precautions are the baseline for every patient in every setting. Transmission-based precautions are added on top when standard precautions alone do not fully address the transmission risk — they are used in addition to standard precautions, not instead of them.
A and D both make standard precautions conditional on a known infection or anticipated blood contact. They apply regardless. C inverts the relationship between the two categories; additional precautions can be started for a suspected infection before an organism is identified.
Sources: CDC: Precautions to Prevent Transmission of Infectious Agents.
Phlebotomy and specimen collection
CPCT-024. You've drawn three tubes. The unit clerk is calling your name from the hallway. Where do you label the tubes?
- A. At the nurses' station, where the label printer is
- B. Hand them to the patient to hold while you fetch labels
- C. At the bedside, before you leave the room, with the patient still there
- D. Label the first one now and the rest when you get back
Show answer and explanation
C. “Label specimens at the bedside” is its own task on both test plans. Joint Commission's laboratory safety goal requires labeling blood and other specimen containers in the patient's presence.
A separates labeling from the patient. B hands specimens to the patient and still leaves them unlabelled. D creates the worst version — two identical unlabelled tubes and one labelled one. Finish accurate labeling and verification before leaving.
Sources: Joint Commission: 2026 Laboratory National Patient Safety Goals; WHO: Guidelines on Drawing Blood, chapter 2; NHA CPCT/A Test Plan — 2018 job analysis; NHA CPCT/A Test Plan — 2025 job analysis.
CPCT-025. Why does the order in which you fill blood collection tubes matter?
- A. It stops the tubes from clotting too quickly
- B. It reduces the risk of additives carrying over from one tube and altering results in the next
- C. It reduces the volume of blood you need
- D. It shortens the time the tourniquet stays on
Show answer and explanation
B. Additive carryover. WHO's phlebotomy guidance directs collecting tubes in the correct order to avoid cross-contamination of additives between tubes.
A, C, and D describe real concerns in phlebotomy — clotting, sample volume, tourniquet time — none of which is what order of draw is for.
One practical warning that matters more than the question. WHO's own guidance says colour coding and additives vary, and to verify the order with your local laboratory; the table printed in that 2010 document is an illustration based on a 2003 consensus, not a current standard. CLSI also explains the additive-carryover rationale. Learn the reason from this page. Learn the sequence from your lab's current chart, not from a colour diagram you found online.
Sources: WHO: Guidelines on Drawing Blood, chapter 2; CLSI: Order of Blood Draw Tubes and Additives.
CPCT-026. The requisition says the test requires fasting. The patient mentions he had coffee with sugar about an hour ago.
- A. Hold off, report that the fasting requirement wasn't met, and follow the direction you're given
- B. Draw it anyway and note the coffee somewhere later
- C. Draw it and tell the lab it was a fasting specimen
- D. Tell him to fast overnight and come back tomorrow on his own
Show answer and explanation
A. Verifying means acting on what you find, not noting it afterwards. When a blood test requires fasting, coffee with sugar does not meet the plain-water instruction. Report the issue and obtain directions before proceeding.
B proceeds before anyone resolves whether the planned collection is appropriate. C is worse — that's a false statement about a specimen, and a clinician may make a decision on it. D sounds responsible but sends the patient away without anyone clinically responsible knowing; rescheduling is a decision for the responsible care team.
This is relevant to both plans. The 2018 plan already lists fasting, medication, and basal state as testing requirements; the 2025 plan makes verifying adherence a standalone task.
Sources: MedlinePlus: Fasting for a Blood Test; NHA CPCT/A Test Plan — 2018 job analysis; NHA CPCT/A Test Plan — 2025 job analysis.
CPCT-027. You've collected a urine specimen for a nonwaived laboratory test. The requisition says it must be refrigerated, and the laboratory's collection instructions identify a designated specimen refrigerator.
- A. Leave it at the nurses' station until the courier comes
- B. Put it in the refrigerator marked “medications only” on the unit
- C. Follow the stated handling requirement and get it to the lab the way your facility directs
- D. Freeze it, to be safe
Show answer and explanation
C. Specimen handling requirements — temperature, light, and time — exist to preserve the sample for its intended test. Meeting the stated requirement is the task.
A ignores the requirement completely. B uses the wrong refrigerator despite the designated storage instruction. D substitutes your own judgment for the stated condition; freezing is not a stronger version of refrigerating, it's a different one.
This question supplies the refrigeration requirement. It does not mean every urine test uses the same storage conditions.
Sources: 42 CFR §493.1242: Specimen submission, handling, and referral.
EKG
CPCT-028. You're placing chest electrodes for a 12-lead and they won't stick — the patient's chest is damp and hairy.
- A. Press harder and hope they hold
- B. Move the chest leads to the arms so they'll adhere
- C. Tape over the electrodes that are already on
- D. Prepare the skin the way your facility directs — clean and dry the site, clip hair if policy allows — then apply fresh electrodes
Show answer and explanation
D. Prepare the skin and restore electrode contact before recording. MedlinePlus describes cleaning the electrode sites and clipping or shaving hair when needed for adhesion; use your facility's procedure and the equipment instructions.
A doesn't address why they're failing. C covers the problem rather than correcting skin contact. B changes the required electrode locations. A machine may still print a tracing after incorrect placement, but the number of printed leads does not make the recording correctly acquired.
Sources: MedlinePlus: Electrocardiogram; NHA CPCT/A Test Plan — 2018 job analysis; NHA CPCT/A Test Plan — 2025 job analysis.
CPCT-029. During a resting ECG, a patient says he is cold and is visibly shivering. He is alert and reports no new symptoms. You see extra movement-related disturbance on the recording. What is the best step to improve recording conditions?
- A. Help him become warm and comfortable, ask him to relax and remain still, then repeat the recording according to protocol
- B. Label the tracing as atrial fibrillation based on the disturbance alone
- C. Increase the paper speed instead of addressing the shivering
- D. Unplug his clinical monitoring equipment without checking its purpose
Show answer and explanation
A. Movement, including shivering, can alter an ECG recording. Helping the patient become warm, relaxed, and still addresses the stated source of movement-related interference.
B assigns a rhythm diagnosis from an artifact description alone. C changes the recording speed without removing the shivering. D disconnects clinical equipment without a justified instruction and does not address the stated problem.
Comfort and stillness do not rule out a real arrhythmia. Report new symptoms or persistent abnormal findings through the clinical team rather than assuming every abnormal tracing is artifact.
Sources: MedlinePlus: Electrocardiogram; NCSBN–ANA: National Guidelines for Nursing Delegation.
CPCT-030. A telemetry alarm sounds. The screen shows a chaotic waveform with no organised complexes. You go to the room: the adult patient is unresponsive and only gasping. As a BLS-trained responder, you check for a pulse for no more than 10 seconds and cannot definitely feel one. No AED is attached yet.
- A. Silence the alarm and recheck in a few minutes
- B. Call for help, activate the emergency response, start CPR with chest compressions at 100 to 120 per minute, and have an AED brought immediately
- C. Print the strip and take it to the nurse before anything else
- D. Adjust the electrodes to get a cleaner tracing
Show answer and explanation
B. An unresponsive adult who is not breathing normally and has no definite pulse within 10 seconds needs an immediate cardiac-arrest response. Activate help, begin CPR, and get an AED without delaying care to print or troubleshoot a tracing.
The AHA's 2025 adult guidelines set the compression rate at 100 to 120 per minute and depth at least 2 inches, avoiding more than 2.4 inches. High-quality CPR also includes full recoil, minimal interruptions, and appropriate ventilation; trained healthcare responders follow their BLS protocol and use the AED as soon as available.
A and C both delay the arrest response. D treats the monitor as the problem despite the bedside findings.
The teaching point sitting under this item: do not wait to name the rhythm before responding to this patient's arrest. Both test plans include recognising dysrhythmias and responding to potentially life-threatening arrhythmias; this question tests the immediate BLS response, not advanced rhythm-treatment selection.
Sources: AHA: 2025 Adult Basic Life Support Guidelines; NHA CPCT/A Test Plan — 2018 job analysis; NHA CPCT/A Test Plan — 2025 job analysis.
About your score on these 30 questions. A percentage here is your performance on these 30 items and nothing more. It is not a scaled score, it doesn't predict whether you'll pass, and four questions in a domain can't measure what you know about that domain. Use it the way it's actually useful: find the ones you missed and the ones you guessed right, and review those explanations and the related tasks in the test plan.
Your four-week schedule
This assumes about an hour a day, five days a week — 20 sessions and 20 hours — for someone who has finished a patient care technician training program and is reviewing rather than learning from scratch. It's our recommendation, not an NHA requirement or a promise that 20 hours is enough preparation.
The sequence keeps Patient Care first because it is the largest domain on either plan. Week 2 finishes that block and adds Compliance, Safety, and Professional Responsibility; Week 3 covers Infection Control and specimen collection; Week 4 covers EKG and mixed review.
| Week / session | Focus | What to do |
|---|---|---|
| 1 / 1 | Patient Care: vital signs and special conditions | Review the Patient Care section. Explain the explicit limb restriction in Question 3, then answer it. Write down how you would clarify an unsuitable measurement assignment. |
| 1 / 2 | Patient Care: activities of daily living and observation | Review personal-care and rounding tasks in your applicable test plan. Answer Questions 4 and 11; separate what you observe from what you would diagnose. |
| 1 / 3 | Patient Care: mobility, transfers and transport | Review Questions 8 and 9 and their explanations. Identify the stated transfer plan, staffing, equipment and sling-safety requirements before choosing an answer. |
| 1 / 4 | Patient Care: intake and output | Work the intake example below, then answer Question 2. Recalculate each drink separately using the amount actually consumed. |
| 1 / 5 | Patient Care: skin and circulation | Answer Questions 5 and 10. Practise writing the observations you would report without inventing a diagnosis or changing treatment. |
| 2 / 6 | Patient Care: catheters and feeding tubes | Answer or revisit Question 1, then answer Question 6. Explain the bag-position rule and the patient-specific feeding position. |
| 2 / 7 | Patient Care: devices, ostomy care and peripheral IV removal | Review these tasks in the applicable plan and your course procedures. List the competence, directions and reporting requirements; do not substitute unsupervised practice for training. |
| 2 / 8 | Patient Care: respiratory support and end-of-life care | Answer Questions 7 and 13. Describe the direction of airflow in incentive spirometry and write a response to a patient expressing fear. |
| 2 / 9 | Delegation, scope and communication | Answer Questions 12 and 18. Name the missing Right of Delegation and explain why communicating a family question is different from interpreting treatment. |
| 2 / 10 | Identification, consent, privacy and safeguarding | Answer Questions 14–17. For each, name the patient right or required verification that controls the answer. |
| 3 / 11 | Infection Control: hand hygiene and precautions | Answer Questions 20, 21 and 23. Explain what Standard Precautions always provide and when additional precautions are needed. |
| 3 / 12 | Infection Control: sharps and exposure response | Answer Questions 19 and 22. Explain why disposal readiness is checked before the procedure and why a needlestick report cannot wait. |
| 3 / 13 | Infection Control: aseptic/sterile techniques and version-specific review | Review the sterile-technique tasks in your plan. For the announced version, give particular attention to the explicit sterile-field and soiled-equipment-processing tasks; use supervised course procedures for hands-on skills. |
| 3 / 14 | Phlebotomy: preparation, identification and labeling | Answer Questions 24 and 26. Write a sequence that checks preparation requirements before collection and completes labeling in the patient’s presence. |
| 3 / 15 | Phlebotomy and specimen handling | Answer Questions 25 and 27. Explain additive carryover and the difference between a specimen-specific refrigeration instruction and a universal storage rule. |
| 4 / 16 | EKG: patient preparation and recording quality | Answer Questions 28 and 29. Distinguish poor electrode contact from movement-related interference; do not diagnose a rhythm from a description of artifact. |
| 4 / 17 | EKG: emergency recognition and monitoring tasks | Answer Question 30. Review your trained BLS response. Then check the applicable EKG outline, including external monitoring and patient education for the announced version. |
| 4 / 18 | Mixed retrieval practice | Try all 30 questions without opening explanations first. A voluntary 30-minute limit matches one minute per item arithmetically, not the difficulty or pacing of an official exam. Use the remaining session time to review. |
| 4 / 19 | Correct missed and guessed answers | Rework each missed or guessed item against its explanation and teaching source. Record the principle, the detail you missed, and the next related topic to review. |
| 4 / 20 | Coverage and test-day checks | Compare all five official domains with your notes, including topics this sample does not test. Confirm your exam version, identification, delivery instructions and any approved accommodation. |
Split a session roughly into ten minutes recalling last session's material from memory, thirty-five minutes on review, and fifteen minutes writing down the specific principle behind anything you missed — not the answer letter, the principle. That split is our suggestion; adjust it.
If you have two weeks, run weeks 1 and 2 as one week and weeks 3 and 4 as the second; retaining all 20 hours means about two hours on each of ten study days. If you have one week, do the 30 questions first, then prioritise missed or uncertain concepts while checking all five domains against the official outline. Do not study only the domains where this small sample caught a mistake. If you have longer, spread the same sequence out and redirect time toward topics you cannot yet explain or perform within your training.
What each domain actually asks you to do
The test plan isn't just a topic list. It includes tasks, written as things a patient care technician does, and the knowledge supporting them. Reading both parts changes what you study. A topic does not have to be a standalone task to be relevant. 2018 plan; 2025 plan.
Patient Care — 45 items currently, 43 on the announced plan
The largest domain by a wide margin, and the widest. It runs from bathing, bed-making, and personal care through vital signs, weights, intake and output, and skin integrity; then through devices — oxygen, suction, feeding tubes, ostomies, catheters; then mobility, which is its own cluster: range of motion, ambulation with assistive devices, splints, transfers, transport, mechanical lifts, sequential compression devices. It ends with first aid, BLS, hospice/end-of-life care, grief, and postmortem care. These are coverage topics, not independent permission to perform every procedure. 2018 plan, Domain 1; 2025 plan, Domain 1.
Two useful review threads run through the domain. The first is observe, record, report. The second is prioritising: the 2018 plan already contains a prioritising-care task, while the 2025 plan adds an explicit critical-thinking knowledge statement. Read the patient's actual instructions and the change in condition, not a shortcut such as “always tell the nurse before doing anything.” 2018 plan, tasks 1F, 1GG and 1HH; 2025 plan, tasks 1N–1O and knowledge k33.
Worked intake example: A patient drinks 150 mL of water and three-quarters of a 200 mL drink. Record 150 + (0.75 × 200) = 300 mL, not the 350 mL originally served. If output is also recorded, keep it separate; subtracting output would calculate a balance, not the intake asked for. This is an original arithmetic example.
For an observation report, name what you saw. “Red area over the sacrum that did not blanch” and “grimacing when repositioned” convey observable findings. A clinical diagnosis or a pain score the patient never gave is not a substitute. Use the reporting process and any observational tool you have been instructed to use. AHRQ skin-assessment guidance; NCI pain assessment: cognitive impairment.
Compliance, Safety, and Professional Responsibility — 20 items currently, 19 on the announced plan
Scope of practice, patient identification, consent, abuse identification and mandated reporting, OSHA and workplace injury, accident reporting, Joint Commission safety guidelines, equipment safety, emergency response, HIPAA, the Patients' Bill of Rights, chain of command, and documenting in the electronic record. 2018 plan, Domain 2; 2025 plan, Domain 2.
Know which problem you are solving. An unfamiliar assigned task calls for clarification of competence and directions. A routine blood collection refused by a decision-capable adult calls for stopping and reporting the refusal. An unauthorized request to open a record calls for declining access. Those are different principles, not one test-taking trick. NCSBN–ANA delegation guidelines, pp. 3–4; 42 CFR §482.13(b)(2); HHS role-based access guidance.
The 2025 plan gives consent, professional behaviour and environmental safety checks their own task statements. These clearer labels do not mean the underlying principles were absent from the older plan. 2018 plan, Domain 2; 2025 plan, tasks 2C–2F.
Infection Control — 11 items currently, 16 on the announced plan
This is the only domain whose scored-item allocation increases: from 11 to 16 of the 100 scored questions. That is five additional scored questions, or five percentage points, not a published allocation of one question to each new task. 2018 summary table; 2025 summary table.
The existing content covers standard and transmission-based precautions, disinfecting equipment, PPE, biohazard disposal, exposure control plans, and aseptic and sterile technique. The 2025 plan adds setting up and maintaining a sterile field and preparing soiled equipment for sterile processing as distinct tasks, makes PPE application and removal a task in its own right, and names CAUTI specifically among healthcare-associated infections where the old plan said only “urinary tract infection.” 2018 plan, Domain 3; 2025 plan, Domain 3.
Apply the distinction: Standard Precautions are the baseline for every patient. Select protection for the anticipated exposure, and add transmission-based measures when indicated. For direct care under Contact Precautions, gown and gloves address contact with the patient or contaminated surroundings; remove them before leaving and clean your hands. Gloves do not cancel the hand-hygiene step. CDC isolation guidance, III.A–III.B.1; CDC hand-hygiene guidance.
Review sterile-field procedures with your program's supervised skills instruction and the applicable facility procedure. The four Infection Control questions here do not test every sterile technique or processing task.
Phlebotomy and specimen collection — 14 items currently, 12 on the announced plan
Fewer items, wider title. The nonblood side — urine, stool, sputum, semen — moves from a subtopic into the domain's name: Phlebotomy and Nonblood Specimen Collection. 2018 plan, Domain 4; 2025 plan, Domain 4.
Equipment checks, capillary punctures, venipuncture, adverse reactions, preanalytical errors, handling and transport, blood cultures, bedside labelling, chain of custody. The 2025 plan makes point-of-care testing and verifying that the patient has met testing requirements standalone tasks. Fasting requirements and CLIA-waived quality control were already present in the 2018 plan. 2018 plan, Domain 4 knowledge and task 4J; 2025 plan, tasks 4B, 4N and 4O.
Think before, during, and after collection. Before: verify the patient and preparation requirements. During: use the prescribed collection method and sequence. After: finish labeling with the patient present and follow that specimen's handling instructions. Correct technique cannot rescue a tube assigned to the wrong patient. WHO chapter 2, steps 2 and 8–10; Joint Commission laboratory identification goal; 42 CFR §493.1242.
EKG — 10 items on both versions
The same size on both plans, but not the same content. Patient and skin preparation, electrode application for 3-, 5-, and 12-lead, recognising cardiopulmonary compromise, identifying and resolving artifact, recognising and reporting dysrhythmias, responding to life-threatening arrhythmias, and equipment maintenance. 2018 plan, Domain 5; 2025 plan, Domain 5.
The 2025 plan removes the two separate machine-setting tasks — verifying paper speed and verifying sensitivity — and adds applying external cardiac monitors, ambulatory and telemetry, and educating patients about them. Holter monitors, telemetry monitors, and telemetry alerts/alarms appear as explicit supporting knowledge. Reasons for different paper speeds remain in the plan. 2018 plan, tasks 5G–5H; 2025 plan, tasks 5G–5I and knowledge k127–k131.
Separate the patient from the recording problem. Poor adhesion and shivering can affect an ECG. Correct recording conditions within your training, but do not decide that an abnormality is harmless because a patient appears comfortable. A patient who is unresponsive, not breathing normally, and has no definite pulse within 10 seconds needs the trained BLS response, not a cleaner printout first. MedlinePlus ECG guidance; AHA adult BLS, §6.1.
Recognising and reporting dysrhythmias is part of the tested role. It is not authority to make an independent medical diagnosis or choose advanced treatment outside your training and authorized role. NCSBN–ANA delegation guidance, pp. 3–4.
Testing in late 2026? Read this part
NHA has announced that the new CPCT/A exam arrives in January 2027. It also says this: anyone who tests and fails within the 30 days before the launch will need to retest on the new exam. NHA transition announcement.
Put that next to the retake rule in NHA's Candidate Handbook — a minimum 30-day wait between the first three attempts — and a failure close to launch can change which blueprint applies to the next attempt. That does not mean every December 2026 failure automatically has the same retake outcome. The exact launch day and your permitted retest date matter. Candidate Handbook, p. 34.
Study the current plan for an appointment before the transition. For a retake that falls after it, use the new plan and review the changed tasks below. Reading those changes is useful preparation, but no fixed extra hour of study can guarantee that you have covered them.
NHA has not published an exact day in January in the announcement checked. It said it would give specific timeframes closer to launch, so check that announcement page before you book anything close to the boundary. Official transition details.
There's a second thing worth knowing if your timing is tight. The Candidate Handbook says NHA may use a “pilot scoring period” when the first exam form on a new test plan is released — a delay between testing and getting your pass/fail result while its psychometricians finish the cut-score work. That is a general policy, not a confirmed CPCT/A delay. When a credential deadline matters, confirm the result timetable for your appointment rather than assuming immediate results or moving your test solely because of a possible pilot. Candidate Handbook, p. 43.
What changed in the new version
NHA describes the update as having “minimal impact to exam topics and content areas.” The exam keeps five numbered domains, but Domain 4 is renamed and some task and knowledge statements change. Here's what a straight comparison of the two published test plans shows. This is our reading of the documents, not NHA's official crosswalk. NHA announcement; 2018 test plan; 2025 test plan.
Newly explicit tasks and knowledge
- Assisting with enemas. The 2025 plan adds an explicit assistance task and supporting knowledge about enema types and methods.
- Orthotics and prosthetics — donning and doffing, and assisting the patient with them.
- One-to-one monitoring for patients on special precautions — suicidal, aggressive, disoriented, or in withdrawal. New supporting knowledge covers withdrawal symptoms, warning signs of suicide, and how one-on-one monitoring is set up.
- Setting up and maintaining a sterile field, and preparing soiled equipment for sterile processing. These are newly explicit tasks, not a published allocation of two of the five additional Infection Control questions. Aseptic and sterile techniques already appeared in the older plan.
- Point-of-care testing — rapid strep, urine dipstick, pregnancy, mononucleosis — becomes an explicit task. The old plan already mentioned point-of-care testing in Patient Care knowledge and included CLIA-waived quality control in Domain 4.
- Applying external cardiac monitors (ambulatory and telemetry) and teaching patients how to use them, with new knowledge on Holter monitors, telemetry monitors, and telemetry alarms.
Sources: 2018 plan, Domains 1, 3, 4 and 5; 2025 plan, Domains 1, 3, 4 and 5.
Tasks that got wider or more explicit
Range of motion goes from passive only to passive, active, and assistive active. Respiratory support adds nebulizer treatment next to turn-cough-deep-breathe and incentive spirometry. Weight-bearing transfers become partial weight-bearing transfers. Catheter knowledge expands to insertion and removal. Bathing adds CHG (chlorhexidine gluconate) bathing, and hot and cold therapies are named. Consent, professional behaviour, and environmental safety checks each become their own Compliance task instead of scattered supporting knowledge. These are changes to the published coverage statements, not permission to perform procedures outside your role. 2018 plan, Domains 1–2; 2025 plan, Domains 1–2.
What dropped or narrowed in the wording
The two standalone EKG machine-setting tasks — verifying paper speed and verifying sensitivity — are gone. Reasons for different paper speeds remain as supporting knowledge. EKG special considerations no longer explicitly list right-sided or posterior chest placement. “Noncurative care” becomes “palliative care,” and the emergency-scenario example “hostage” becomes “terroristic threat.” Removing an example from a list does not establish that all knowledge related to it is excluded. 2018 plan, Domains 1, 2 and 5; 2025 plan, Domains 1, 2 and 5.
Shared principles still deserve your time
Fasting requirements, prioritising care, special blood-pressure considerations and CLIA-waived quality control already appear in the 2018 plan. Do not skip them for a 2026 appointment because a later plan uses a clearer task label. 2018 plan, Domains 1 and 4.
And the Five Rights of Delegation stay on both versions. The new plan spells them out where the old one only named them: right task, right circumstance, right person, right direction and communication, right supervision. 2018 plan, delegation knowledge; 2025 plan, task 1PP and knowledge k64.
Scoring, and what your score report actually means
NHA reports a scaled score from 200 to 500, and 390 passes. A scaled score is not the number or percentage of questions you answered correctly. Candidate Handbook, pp. 31–32.
390 is not 78 percent. Dividing 390 by 500 does not convert this score to percent correct. The handbook does not supply a fixed raw number of correct answers that corresponds to 390. Don't build your study targets around that invented conversion.
Your score report also gives you a performance category for each domain: above, near, or below the passing standard. Three things about those categories, all from the Candidate Handbook:
- They're ranges, not scores. “Above” could sit anywhere in the above range, including its bottom edge.
- They can't be added up to your overall result. They describe performance in separate content areas, not pieces of a point total.
- A domain with five or fewer questions shows N/A instead of a category. Neither published CPCT/A plan allocates that few scored questions to a domain.
“Near the passing standard” does not mean satisfactory. NHA says so directly. Candidate Handbook, pp. 32–34.
If you failed and you're planning a retake: put the bulk of your time into the domains marked below and near, working through those tasks in the test plan one at a time. Don't drop the “above” domains entirely — the range problem cuts both ways. Your next attempt can use different questions, and the categories you got last time do not guarantee the ones you'll get next time. Candidate Handbook, pp. 33–34.
Test day and retakes
Where you test. At your school or employer if it's an authorized NHA test site, at a PSI testing centre, or through live remote proctoring at a suitable location. If you registered as an individual rather than through an institution, you'll test with a third-party provider. When you take live remote proctoring, NHA assigns the provider — you don't choose it. Candidate Handbook, p. 14.
What you bring. A current government-issued photo ID, such as a driver's license or passport. The handbook says it should include your photograph, signature, and permanent address; it also requires proof of address when the address differs from registration. Check the ID and address instructions for your appointment in advance, especially when your accepted ID does not display an address. Candidate Handbook, p. 25.
What you can't bring. Phones, tablets, e-readers, cameras, watches, earbuds, AI glasses, translators, and personal calculators are prohibited personal items in the exam room. Use only the authorized testing setup and any specifically approved accommodation. There's a calculator built into the exam and you may use that one. No reference books or notes. Candidate Handbook, pp. 26–27.
Scratch paper. Your proctor supplies two sheets and a writing instrument if you're testing at an institution; a whiteboard, marker, and eraser at a PSI centre; or access to a digital whiteboard for live remote proctoring. Do not bring your own notes or scratch paper. Everything physical goes back to the proctor before you leave. Candidate Handbook, p. 26.
Breaks. The exam is one continuous session. At an in-person site a proctor may allow a break under the handbook's conditions, and the clock keeps running. Under the standard live-remote-proctoring rules, no breaks are allowed and no one else may be in the room. An approved accommodation can affect the applicable arrangements or require a different testing location; confirm those arrangements before test day. Candidate Handbook, pp. 22–23 and 26–27.
Results. Preliminary results are available immediately for computer-based exams taken at your institution. The handbook gives a 48-hour timetable for exams taken through PSI, either in a testing centre or via PSI live remote proctoring. Do not extend that statement to every other remote provider without checking. Preliminary is not final, and NHA warns against treating a preliminary report as the formal certificate. Candidate Handbook, pp. 31–32.
Rescheduling. The handbook permits rescheduling within six months of the original date without an additional exam fee when its notice conditions are met. For PSI or another remote provider, cancel or reschedule at least 24 hours before your slot or you can forfeit the fee and have to repurchase the exam. For an institutional test, request the change before the original exam start time; the institution's site administrator controls that arrangement. Candidate Handbook, p. 21.
Retakes. There is a minimum 30-day wait between the first three attempts. After three unsuccessful attempts, the waiting period becomes one year, and the handbook requires a one-year wait for repeated failures thereafter. You re-register and pay the full price every time. A retake spanning the January 2027 transition also needs the applicable new blueprint. Candidate Handbook, p. 34; CPCT/A transition rule.
Accommodations. Requested through NHA's accommodation process with supporting documentation from an objective qualified professional — or, for a high school student, an eligible IEP or qualifying 504 plan. Allow 30 days for review. For an approved extra-time request, the handbook specifies 150 percent of standard time unless the documentation justifies more and explains why. Approval isn't automatic, and some approved accommodations mean you can't use live remote proctoring. Confirm the provider has the approved arrangements in place before your appointment. Candidate Handbook, pp. 21–23.
Questions people ask
Do I need a set number of venipunctures or EKGs to sit the CPCT/A?
NHA's additional procedure-count requirements — 30 venipunctures and 10 capillary sticks, or 10 EKGs — belong to its Certified Phlebotomy Technician and Certified EKG Technician credentials, respectively. The Candidate Handbook does not attach those counts to CPCT/A. Your training program can still require supervised skills completion; the absence of a separate NHA CPCT/A count does not waive your program or applicable workplace requirements. Candidate Handbook, pp. 7–8 and 12.
Is there medication administration on the exam?
Neither published plan lists a standalone medication-administration task or a standalone dosage-calculation task. That does not mean every medication-related fact is irrelevant: testing requirements already include medication considerations, and the announced plan names nebulizer treatment and assistance with enemas. Study the actual task and knowledge statements rather than treating a word search as a complete coverage rule. 2018 test plan; 2025 test plan.
Is purchasing preparation material required?
No. NHA says purchasing or using its preparation materials is not required to sit a certification exam and does not guarantee a passing score. The official test plans linked on this page are available to read without purchasing preparation materials. Candidate Handbook, p. 23; current free test plan; announced free test plan.
Is “CPCT” the same thing as “CPCT/A”?
This guide is for NHA's Certified Patient Care Technician/Assistant (CPCT/A). Check the full credential name and issuing organization on your program instructions and exam authorization. A similar abbreviation does not establish that another exam uses these rules or these blueprints. Candidate Handbook, pp. 2 and 5.
What does the exam cost, and am I eligible?
NHA requires an exam fee for each attempt and directs candidates to its own exam listing for the applicable amount. Use your NHA registration account or institutional registration process for the fee attached to your application. Candidate Handbook, p. 5 and registration instructions.
For standard certification, the general route is a high school diploma or equivalent plus an accepted training or work-experience pathway. The training pathway has a five-year recency rule; a completion date five years or more before registration does not qualify through that pathway. The work-experience route requires at least one year of supervised experience in the last three years, or two years in the last five, in the field covered by the exam. The handbook also specifies eligible apprenticeship, military, employer-training and pre-externship arrangements. Candidate Handbook, pp. 6–8.
Being within 12 months of high-school graduation is a provisional-certification route, not automatic full certification. Provisional certification expires 12 months after the exam and must be converted while active after the remaining requirements are met. Under approved early-testing routes, unfinished employer on-the-job training or an externship can hold up certificate issuance; the handbook gives those routes 180-day and 90-day completion/reporting windows, respectively. Candidate Handbook, pp. 7–8, 11 and 38.
NHA certification requirements are separate from any state permission-to-practise requirements. Passing CPCT/A does not automatically establish that you meet a particular nurse-aide registry, state or employer requirement. Use the applicable handbook route for NHA eligibility and the relevant authority for any separate requirement. Candidate Handbook, p. 12.
Sources
The links beside each explanation identify its teaching sources. The test plans establish exam coverage; they do not, by themselves, prove a clinical answer correct. PDF page numbers below are one-based.
NHA exam documents
- NHA CPCT/A Test Plan — 2018 job analysis — 2018 job-analysis basis; current plan before the announced transition. PDF pp. 1–2: structure and weights; pp. 2–15: tasks and knowledge.
- NHA CPCT/A Test Plan — 2025 job analysis — 2025 job-analysis basis; announced January 2027 launch. PDF p. 1: structure and weights; pp. 2–8: tasks and knowledge.
- NHA Candidate Handbook — Updated June 1, 2026. PDF pp. 5–8, 11–14: fees, eligibility, scope and delivery; pp. 21–27: scheduling, accommodations and conduct; pp. 31–34: scoring/results/retakes; p. 38: provisional conversion; p. 43: pilot scoring.
- NHA CPCT/A exam-update announcement — Announcement posted July 2025; future launch stated as January 2027. Opening announcement; 30-day retest paragraph; current/new exam-plan sections.
Teaching and regulatory references
- CDC: CAUTI recommendations — III.A–III.B.2, Proper Techniques for Urinary Catheter Maintenance.
- NCSBN–ANA: National Guidelines for Nursing Delegation — PDF pp. 3–4: delegation and Five Rights; pp. 8–9: delegatee responsibilities.
- MedlinePlus: Confusion — Home Care; When to Contact a Medical Professional.
- AHRQ: Preventing Pressure Ulcers in Hospitals — Sections 3.2.3–3.2.4, comprehensive skin assessment and documentation/reporting.
- Memorial Sloan Kettering: How to Prevent Aspiration — Preventing Aspiration; tube-feeding positioning.
- MedlinePlus: Using an incentive spirometer — How to Use an Incentive Spirometer.
- FDA: Patient Lifts — Best practices: training, compatible slings, inspection and load limits.
- CDC: About Venous Thromboembolism — Signs and symptoms of DVT.
- NCI: Cancer Pain (PDQ), Health Professional Version — Assessment of Pain: Special Considerations, Cognitive impairment.
- NCI: End-of-Life Care for People Who Have Cancer — Supporting emotional needs: company, listening, fears and spiritual support.
- Joint Commission: 2026 Laboratory National Patient Safety Goals — PDF p. 1, NPSG.01.01.01, EP 1–2.
- HHS: Minimum Necessary Requirement — How the Rule Works; Uses and Disclosures of, and Requests for, Protected Health Information.
- 42 CFR §482.13: Hospital patient rights — (b)(2), (c)(2)–(3), (e).
- CDC: About Abuse of Older Persons — Prevention; Need to report abuse or find services.
- 29 CFR §1910.1030: Bloodborne pathogens — (d)(2)(vi)–(vii); (d)(4)(iii)(A); (f)(1), (f)(3); (g)(2)(vii)(K).
- CDC: Clinical Safety—Hand Hygiene for Healthcare Workers — Recommendations; glove use and hand hygiene.
- CDC: Precautions to Prevent Transmission of Infectious Agents — III.A, III.B and III.B.1.
- WHO: Guidelines on Drawing Blood, chapter 2 — §2.2.3 Steps 2, 8–10; Table 2.3 explanatory paragraph.
- CLSI: Order of Blood Draw Tubes and Additives — Opening explanation and discussion of additive carryover.
- MedlinePlus: Fasting for a Blood Test — What is fasting?; coffee and accidental eating/drinking questions.
- 42 CFR §493.1242: Specimen submission, handling, and referral — (a)(1)–(7), especially storage/preservation and transportation.
- MedlinePlus: Electrocardiogram — How the Test is Performed.
- AHA: 2025 Adult Basic Life Support Guidelines — §6.1 recognition, §6.2 initiation, §7.3 rate/depth, §8 ventilation, §9.2 defibrillation.
How this page was made. The two NHA plans, the Candidate Handbook, the transition announcement and the teaching references listed above were checked for this version. The comparison of the two test plans is our own reading of two public documents — it is not NHA's official crosswalk. The 30 practice questions, the study schedule, and the domain summaries are our editorial work. This page was developed and source-checked with AI assistance, consistent with our editorial methodology. Source checking is not professional clinical review, and this version does not carry a clinician-review credit.
Last verified: 10 September 2026, covering the linked NHA documents, transition announcement and cited teaching and regulatory references. Confirm the official rules for your appointment before you register or test.
Independence. Castleport Test Prep is an independent exam prep publisher. We are not affiliated with, endorsed by, or approved by the National Healthcareer Association. Exam and credential names are used to identify their subjects, and trademarks belong to their respective owners. These original practice items are unofficial, not certification-exam questions. Nothing here guarantees certification, employment, pay, or licensure. Study content does not replace supervised skills training or applicable workplace requirements.
Castleport Test Prep Editorial Team