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Exam Overview
An Overview of the Exam
Structure, Scoring, and Eligibility
Medical-surgical nurses form the largest nursing specialty in acute care. Board certification validates that a nurse can assess, plan, and evaluate care for adults with a wide range of medical and surgical conditions, and that the nurse practices within professional, ethical, and evidence-based standards. Two national credentials exist, and both are accredited, computer-based, and built from practice analyses of working medical-surgical nurses.
MEDSURG-BC™ at a Glance
| Feature | ANCC Medical-Surgical Nursing Board Certification |
|---|---|
| Credential | Medical-Surgical Registered Nurse, Board Certified (MEDSURG-BC™) |
| Questions | 150 multiple-choice questions: 125 scored and 25 unscored pretest questions mixed throughout |
| Time | 3 hours |
| Delivery | Computer-based testing at Prometric test centers; candidates schedule within a 120-day window after approval |
| Passing standard | Scaled score of 350; scaled scoring adjusts for small differences in difficulty between test forms |
| Fees | $295 for ANA members; $395 for nonmembers (each includes a $140 nonrefundable administrative fee) |
| Results | Preliminary pass or fail result at the test center; official results follow from ANCC |
| Retesting | Candidates may retest after 60 days, no more than three times in any 12-month period |
| Validity | 5 years; renewal requires 75 continuing education contact hours plus one additional professional development category, or retesting |
Eligibility Requirements (ANCC)
- A current, active RN license in a U.S. state or territory, or the legally recognized equivalent in another country
- The equivalent of 2 years of full-time practice as a registered nurse
- A minimum of 2,000 hours of clinical practice in medical-surgical nursing within the last 3 years
- 30 hours of continuing education in medical-surgical nursing within the last 3 years
Test Content Outline
Share of the 125 scored questions
Planning, Implementation, and Evaluation — 40%50 questions
Assessment and Diagnosis — 39%49 questions
Professional Role — 21%26 questions
| Domain | Scored items | What is tested |
|---|---|---|
| I. Assessment and Diagnosis | 49 (39%) | Health history, physical, psychosocial, and cognitive assessment; diagnostic and laboratory testing; fluids and electrolytes; identifying and prioritizing nursing diagnoses |
| II. Planning, Implementation, and Evaluation | 50 (40%) | Care planning; prevention and management of postoperative complications; patient teaching and education topics; patient safety; non-pharmacologic treatments; medication interactions and adverse effects; health and wellness promotion |
| III. Professional Role | 26 (21%) | Therapeutic communication; interdisciplinary collaboration; nursing ethics; evidence-based practice |
MEDSURG-BC™ and CMSRN® Compared
| Feature | MEDSURG-BC™ (ANCC) | CMSRN® (MSNCB) |
|---|---|---|
| Questions and time | 150 (125 scored), 3 hours | 150 (125 scored), 3 hours |
| Delivery | Prometric test centers | Pearson VUE test centers or live remote proctoring |
| Passing standard | Scaled score 350 | Standard score 95 |
| Practice requirement | 2 years as an RN; 2,000 med-surg hours in 3 years; 30 med-surg CE hours in 3 years | 2,000 hours of medical-surgical practice as an RN within the last 3 years |
| Fees | $295 ANA member; $395 nonmember | $267 AMSN member; $394 nonmember |
| Blueprint | 3 domains: Assessment and Diagnosis; Planning, Implementation, and Evaluation; Professional Role | 5 domains: Patient/Care Management; Holistic Patient Care; Elements of Interprofessional Care; Professional Concepts; Nursing Teamwork and Collaboration |
| Credential period | 5 years | 5 years |
Confirm Current Details
Testing organizations update fees, scheduling rules, and handbooks periodically. Confirm current details in the official ANCC or MSNCB candidate handbook before applying.Question Style
Every item is a four-option, single-best-answer multiple-choice question. Most items present a patient situation and ask for a priority, an interpretation, or the best nursing action. Key words such as FIRST, BEST, MOST appropriate, requires immediate follow-up, and indicates a need for further teaching define what the question is really asking.
What to Remember for the Exam
- 150 questions in 3 hours: about 72 seconds per question.
- Pretest items are not identified, so answer every question as if it counts.
- Assessment and Diagnosis plus Planning, Implementation, and Evaluation make up 79% of the scored items; Professional Role is 21%.
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