CMSRN

Thecertifiedmedical-Surgicalregisterednurse(Cmsrn®)Exam

The CMSRN exam is developed and administered by the Medical-Surgical Nursing Certification Board (MSNCB). It measures the knowledge an experienced registered nurse needs to practice safely and effectively in the medical-surgical specialty. Exam content is validated through a job task analysis of practicing medical-surgical nurses, so the blueprint reflects what med-surg nurses actually do: manage care, coordinate with the team, and lead at the bedside.

Exam Format

The exam contains 150 multiple-choice questions in 3 hours, which allows about 72 seconds per question. 125 questions are scored; the other 25 are unscored pretest questions being evaluated for future use, and they are not identified, so answer every question as if it counts. Each question has four answer options and one best answer. Many questions are short clinical or unit scenarios that ask what the nurse should do first, which action is most appropriate, which task can be delegated, or which statement shows that teaching was effective.

The Five Blueprint Domains

The MSNCB blueprint divides the 125 scored questions among five domains. Patient/Care Management is the largest, and Nursing Teamwork and Collaboration is second. About two-thirds of the blueprint covers care management, coordination, professional practice, and teamwork rather than disease-specific content.

Domain	TopicsontheBlueprint
Patient/CareManagement	Patientsafety(safetyprotocols riskassessment safetyculture bundles eventreporting); , , , ,
32%·40questions	infectionpreventionandantimicrobialstewardship;medicationmanagement(safeadministration ,
	education polypharmacy disposal); pain management; non-pharmacological interventions; , ,
	surgicalandproceduralnursing;nutrition
HolisticPatientCare	Patient-centered care and advocacy; diversity and inclusion cultural and linguistic needs implicit , ,
15%·19questions	bias; patient and family education and health literacy; health promotion; palliative and end -of -life
	care postmortemcare organdonation andregulatoryreporting , , ,

Whateachdomaincovers(Continued)

Domain	TopicsontheBlueprint
ElementsofInterprofessional	Nursingprocessandclinicaljudgment;interprofessionalcollaboration rounding andcare , ,
Care	coordination;transitionmanagement dischargeplanning readmissionrisk andsocial , , ,
17%·21questions	determinantsofhealth;documentation theelectronichealthrecord anddowntimeprocedures; , ,
	technologyandnursinginformatics
ProfessionalConcepts	Communication chain of command SBAR and de-escalation; critical thinking time management , , , , ,
15%·19questions	andprioritization;healthypracticeenvironment resilience andmoraldistress;scopeofpractice , , ,
	ethics and patient rights; quality management; evidence-based practice and research ,
NursingTeamworkand	Delegationandsupervision;staffingandbudgeting;careerdevelopmentrelationships mentoring , ,
Collaboration	andprecepting;professionaldevelopment competency andpeerreview;leadership shared , , ,
21%·26questions	decision-making change management and conflict resolution; disaster planning and incident , ,
	command

Eligibility

Scoring and Passing Requirements

The passing point is set by a criterion-referenced standard-setting study (a modified Angoff procedure) in which expert medical-surgical nurses judge the knowledge a minimally competent certified nurse should have. Your result is reported as a standard score, and you must reach a standard score of 95, which corresponds to about 71% of the scored questions answered correctly (roughly 89 of 125). There is no penalty for wrong answers, so never leave a question blank.

CMSRN at a Glance

ExamAspect	Details
Administeredby	Medical -Surgical Nursing Certification Board (MSNCB)
Questions	150 multiple-choice (125 scored 25 unscored pretest); four options each ,
Time	3hours
Delivery	Computer-based at Pearson VUE testing centers or online with live remote proctoring (OnVUE) ,
Testingwindow	90daysfromtheAuthorizationtoTest
Examfee	$267 for Academy of Medical -Surgical Nurses (AMSN) members; $394 for nonmembers (each
	includesanonrefundable$90processingfee)
Retesting	Reapply after receiving a failing result; a reduced first-time retake fee ($189 member $315 ,
	nonmember)applieswithinoneyear