Its been 10 years since I became a CCNA, about 8 since I achieved the CCNP, and about 6 since the CCSP.  Somewhere in between there I became a CCSI, which is a Cisco Certified Systems Instructor.  I have personally taken over 30 Cisco Exams.  I have seen the test engine change, the test vendor change, and the material become more advanced.  Here are ten things I think you should know about taking the CCNA exam.

1. You have to take the exam at a Pearson VUE test center.  Obvious one I know, but realize this, a year ago you could use both Prometric as well as Pearson VUE.  Today, Prometric has been dropped because of cheating issues so you have to use Pearson VUE, same company as Pearson Education; these are the folks that publish Cisco Press books.  Coincidence?  Nah!
2. The Exam DOES have simulations on it so be familiar with it.  You can get an overview of the test engine on the Cisco Web Site.  Dont waste time at the test center trying to figure it out. 
3. If you dont have a login to the Cisco Web Site you should get one.  Why?  Because it gets you access to the CCNA Prep Center. It's free so sign up!
4. Cisco wants you to pass the test.  Why?  Because you will be likely to continue using and recommending their products as well as continuing with more certifications like the CCNP, CCSP, CCVP and so on. 
5. You can learn the same material in just about any book you buy but nothing will compare to Instructor-led training.  I prepared with the Sybex book years ago.  NOTHING made any sense.  Much of the background and context was lost.  Once I had an instructor in front of me to answer the background and context questions it all came together. 
6. You can learn everything from reading alone but it will be easier if you practice on real equipment.  When you do it you remember it.  Simple fact.  I suggest a simulator for the CCNA level stuff.  You can also get labs on ebay for a fair price that you can add equipment to as you further your certification level.  All you need for the CCNA is a switch and a router.  Actually 2 switches.  There is an emulator out there but there are two critical flaws in it.  1.) You currently can't emulate a switch, 2.) You have to get your own IOS using a login to a CCO account.  A CCO account is a login to the Cisco Connection Online (CCO).
7. Your time doesn't start until you start clicking around in the interface.
8. You can ask for more paper.  You have to give it back when you are done and most places give you a laminated sheet and dry erase now. 
9. If you have any memory charts write them down before you start the test.  This way it doesn't cut into your time. 
10. Take the combined exam because in the end you get fewer questions.  Really Cisco split up the certification into two exams but it hasn't always been that way.  In the past it was one exam with all the material on it.  You can spend the money to take both exams but I wouldn't.

I'm sure there are more but off hand this is my list.  Feel free to use the comments to add your own tips and dont forget to subscribe to this blogs feed for more CCNA tips, tutorials, and recommendations.