Receiving approval to challenge means that individuals who meet special criteria (listed below) are not required to take the entire certified nurse assistant course but rather will be allowed to successfully complete exam with “one attempt” to become a CNA in Missouri. The exam includes a written (knowledge) and practicum (skills). If the challenge exam is failed, the applicant will be required to successfully complete the full CNA course and exam to become certified in Missouri.

*NOTE: Individuals are only given one attempt to take the challenge examination. The challenge examination includes the knowledge and skills test.

Submitting a CNA Challenge Request

Individuals meeting any of the requirements to challenge the exam must submit the following.

  • Written Request that states you would like to Challenge the CNA exam.
  • Include in your request an explanation of how you qualify to challenge the exam.
  • Clear Copy of Individual’s Social Security Card
  • Valid email address
  • Current mailing address
  • Daytime telephone number
  • Submit the extra required documents that needed for which qualification you are using to challenge. (Example: transcript, letter of recommendation, or proof of training, etc.)
  • Email your request to


Requirements to Challenge the CNA Exam

  • Individuals who were enrolled in professional (RN) or practical (LPN) program for at least four (4) months or who are enrolled in this program and have successfully completed a Fundamentals of Nursing course that included a clinical rotation within the last five years may challenge the final examination of the course. Submit the following documentation: an official copy of the transcript with a letter on school letterhead from the program director verifying successful completion of the fundamentals of nursing and clinical rotation.

  • RN or LPN nursing licensure candidates who have failed state licensure examination. Submit a copy of nursing program certification of completion and notice of fail from Board of Nursing.

  • Individuals who are certified and active on another state’s nurse aide registry shall not be required to challenge the final examination. Click to visit information on the Missouri Reciprocity criteria and requirements.

  • Students who have completed a nursing program outside the United States and who are awaiting licensure in this country. Submit a copy of out of country license or certificate, copy of school transcript translated to English and a copy of out of country criminal background check translated to English.

  • Individuals who have completed the Unlicensed Assistive Personnel (UAP) training. Please keep in mind this program’s training hours should mirror the CNA training. The CNA training consists of 175 total training hours. Submit one or both of the following an official letter that states you completed the UAP not the PCT, this letter must be signed & dated from the Administrator or HR representative. This letter should also include the training hours completed through the UAP program. Or a Certificate of Completion and this should also state UAP (Unlicensed Assistive Personnel) not PCT (Patient Care Tech), and include the training hours completed through the UAP program.

  • Individuals listed on the Missouri State Certified Nurse Assistant Register on inactive status submit a copy of Missouri certificate or the Missouri CNA registry print-out.

  • Any other persons whose background, education and training in gerontology and health occupations includes the components of the approved training curriculum may challenge the examination after taking those portions of the course as determined to be necessary based on evaluation of their credentials by the supervisor of Health Education, Division of Regulation and Licensure. Provide proof of your education and training in gerontology and health occupations.