CHES Exam Format: What to Expect on Test Day

One of the most effective ways to reduce test anxiety is to eliminate surprises. When you understand exactly how an exam is structured, how much time you have, what types of questions you will face, and what the testing environment looks like, you can focus your energy on demonstrating what you know rather than navigating the unfamiliar.

This guide breaks down the CHES exam format in detail so you can approach test day with clarity and confidence. For a broader overview of the certification itself, see our CHES certification guide, and for a breakdown of the content framework, explore the Eight Areas of Responsibility.

Exam Structure

The CHES exam is a computer-based test consisting of 165 multiple-choice questions. However, not all 165 questions count toward your score.

• 150 scored items: These questions determine whether you pass or fail. They are distributed across the Eight Areas of Responsibility, the competency framework established by NCHEC.
• 15 pilot items: These are unscored questions that NCHEC is evaluating for potential use on future exams. They are embedded throughout the test and are indistinguishable from scored items.

Because you cannot tell which questions are pilot items, treat every question as if it counts. The pilot items do not penalize you, but you also cannot afford to guess which ones they are and skip them.

Time limit: You have 3 hours to complete the entire exam. For most candidates, this provides adequate time to answer all questions with some room for review, but time management remains important, particularly if you tend to deliberate on scenario-based items.

Testing windows: NCHEC offers the CHES exam during designated testing windows, typically scheduled in April and October each year. Registration deadlines fall well in advance of the testing window, so plan accordingly.

Question Types

All questions on the CHES exam are multiple-choice with four answer options. However, the cognitive demand of those questions varies. Understanding the different types helps you prepare for the range of thinking the exam requires.

Knowledge Recall

These questions test whether you can remember foundational facts, definitions, and concepts. For example, a recall question might ask you to identify the correct definition of a health education term or name the theory associated with a particular construct.

Knowledge recall questions tend to be the most straightforward on the exam. If you have studied the core content systematically, these should be approachable.

Application

Application questions go a step beyond recall. They present a situation and ask you to apply a concept, principle, or procedure to determine the correct response. For example, you might be asked to select the most appropriate data collection method for a given population or to identify which program planning model fits a described scenario.

These questions require you to understand not just what concepts mean but how they are used in practice.

Scenario-Based

Scenario-based questions are the most demanding type on the CHES exam. They present a realistic professional situation, often with multiple contextual details, and ask you to make a judgment about the best course of action. A scenario might describe a community health program facing a particular challenge and ask you to determine the most appropriate response based on sound health education practice.

These items often span multiple Areas of Responsibility. A single scenario might test your understanding of assessment (Area I), planning (Area II), and ethics (Area VIII) simultaneously. Practicing with scenario-based questions before the exam is one of the most effective preparation strategies you can use.

Pro Tip: When facing scenario-based questions, read the entire scenario carefully before looking at the answer options. Identify the core issue being tested, then evaluate each option against best practice rather than choosing the first option that sounds reasonable.

How the Exam Is Scored

The CHES exam uses a criterion-referenced, scaled scoring system. Here is what that means in practical terms:

Criterion-referenced means your score is evaluated against a fixed standard of competence, not against other test-takers. You do not need to score higher than a certain percentage of candidates. You need to demonstrate that you meet the competency threshold set by NCHEC.

Scaled scoring means your raw score (the number of questions answered correctly) is converted to a scaled score to account for slight variations in difficulty between different exam forms. This ensures fairness across testing windows. The scaled score needed to pass is determined by a panel of subject matter experts through a standard-setting process.

What You Need to Know About Passing

• There is no penalty for guessing. Unanswered questions are scored the same as incorrect answers, so you should answer every question.
• Your score report will indicate whether you passed or failed, along with diagnostic information showing your performance in each Area of Responsibility. This feedback is useful for professional development and, if necessary, for planning a retake.
• NCHEC does not publish a specific passing percentage because the scaled score conversion makes a simple percentage cutoff misleading. Focus on preparing thoroughly across all eight areas rather than trying to calculate a target number of correct answers.

Test-Day Logistics

The CHES exam is administered at Pearson VUE testing centers, a national network of standardized testing facilities. Knowing what to expect at the center helps you avoid day-of stress.

Before Test Day

Schedule your appointment as soon as you receive your authorization to test. Popular testing centers fill up quickly, especially near the end of a testing window. Choosing an earlier date within the window gives you more options and avoids the last-minute rush.

Visit the testing center in advance if possible, or at minimum confirm its location and plan your route. Arriving late can result in being turned away.

Review Pearson VUE's identification requirements. You will need to present valid, government-issued photo identification. The name on your ID must match the name on your exam registration exactly.

Check-In Process

When you arrive at the testing center, expect the following:

• Identity verification. The test administrator will check your photo ID and may take your photograph and a digital signature.
• Personal item storage. You will be asked to store personal belongings, including your phone, watch, wallet, and any study materials, in a provided locker. These items are not permitted in the testing room.
• Prohibited items. Food, drinks, hats, and bulky clothing may not be allowed. The center will provide you with scratch paper or a dry-erase board for notes during the exam.

During the Exam

• You can take unscheduled breaks if needed, but the clock does not stop. Any time spent away from your workstation counts against your 3-hour limit.
• The testing software allows you to flag questions for review. If you are unsure about an answer, mark it and return to it after completing the rest of the exam.
• The testing room is monitored by proctors and surveillance cameras. This is standard for all Pearson VUE examinations.

Pro Tip: Use the first minute of your exam to take a few deep breaths and orient yourself to the testing interface. Familiarize yourself with the flag and review features before diving into the questions. Pearson VUE offers a practice tutorial on their website that simulates the exam interface.

After the Exam

You will receive a preliminary pass or fail result on screen immediately after completing the exam. Official score reports are sent by NCHEC within several weeks and include the Area of Responsibility diagnostic breakdown.

If you do not pass, NCHEC allows you to retake the exam during a subsequent testing window. Your diagnostic report will help you identify areas to strengthen before your next attempt.

Preparing With the Right Resources

Understanding the exam format is the first step. Effective preparation requires more than awareness of logistics; it requires deliberate, structured study across all eight Areas of Responsibility.

Build a study plan with exam weighting in mind. Allocate your study time proportionally to the weight each area carries on the exam. Areas with higher weighting deserve more hours in your schedule.

Practice with realistic questions. Seek out practice materials that include scenario-based items, not just simple recall questions. The more you practice making decisions in context, the more prepared you will be for the exam's most challenging items. Explore our scenario-based question practice guide for targeted preparation.

Simulate test conditions. At least once before exam day, complete a full-length practice session under timed conditions. This builds familiarity with the pacing required to complete 165 questions in 3 hours and helps you identify areas where you tend to spend too much time.

Plan your study timeline. Most successful candidates dedicate 8 to 12 weeks to focused preparation. Build your study plan with milestones and review periods, and consult our CHES study plan guide for a structured approach.

Review test day tips in the days leading up to your appointment. Small logistical details like knowing what to bring, when to arrive, and how the check-in process works can make a meaningful difference in your composure and performance.

The CHES exam is challenging but entirely manageable with the right preparation. Understanding the format is your advantage. Use it.

This content is not affiliated with or endorsed by NCHEC. CHES and MCHES are registered trademarks of NCHEC.