SCRN Exam

The SCRN exam is a computer-based test delivered by PSI, either at a PSI test center or through live remote proctoring. ABNN offers three one-month testing windows a year, in February, May and September, and you apply online before the deadline for the window you choose.

Domain I asks you to connect anatomy to the bedside: which artery supplies which region, which deficits each stroke syndrome produces, how to tell a stroke from a mimic, how the brain recovers through neuroplasticity, and what happens inside ischemic and hemorrhagic brain tissue. Domain II covers the first hours: triage, assessment with the NIH Stroke Scale, imaging, thrombolysis, thrombectomy, hemorrhage management, complications, medications, quality metrics such as door-to-needle time, and where the patient goes next. Domain III covers the hospital stay: ongoing assessment, ischemic and hemorrhagic management, complications, safety, the multidisciplinary plan of care, activities of daily living, the therapeutic environment, psychosocial care, education, quality metrics and early rehabilitation and discharge planning. Domain IV covers rehabilitation goals, levels of rehabilitative care, spasticity and safety, education, medications and community resources, and Domain V covers risk factors, social determinants of health, diagnostic tests, medications, quality metrics and community education.

ABNN tests three levels of knowledge: knowledge, interpretation, and problem solving and evaluation. Expect most questions to ask you to interpret a finding or choose an action rather than simply recall a fact. The SCRN is a generalist exam and does not focus on one care setting.

The SCRN is criterion-referenced: you are measured against a fixed passing standard, not against other candidates. Stroke nursing experts and PSI psychometricians set the passing point, and the raw passing score is set equal to a scaled score of 200 so that every exam form is held to the same standard. A scaled score of 200 or higher passes.

Only the 150 scored questions count, and you cannot tell which 20 questions are pretest items, so give every question your best effort. There is no penalty for a wrong answer, so answer every question. You receive your pass or fail result and your scaled score at the end of the exam at the test center, or by email if you test remotely.

• Patient scenarios that ask you to identify the likely stroke type, artery or syndrome from the deficits
• Code stroke situations that test triage, NIH Stroke Scale scoring, imaging order and treatment timing
• Thrombolysis and thrombectomy questions on eligibility, dosing, blood pressure limits, monitoring and complications
• Hemorrhagic stroke questions on blood pressure targets, reversal agents, vasospasm and intracranial pressure
• Acute care questions on dysphagia, positioning, safety, complications, aphasia, neglect and family support
• Rehabilitation and discharge questions on levels of care, spasticity, medications and community resources
• Prevention questions on risk factors, antiplatelets, anticoagulants, statins, blood pressure goals and teaching
• Data questions with vital-sign trends, lab values, stroke scores and door-to-needle metrics

• Hold a current, unrestricted registered nurse license in the United States, Canada or a United States territory. Nurses licensed in other countries may qualify with a comparable license verified by an approved credential evaluation service and the ability to read English.
• Have one year of full-time experience, which ABNN defines as 2,080 hours, in direct or indirect stroke nursing as a registered nurse within the three years before you apply.
• Expect that some applications are audited (about 5% at random). Keep proof of your license and a supervisor who can verify your stroke nursing hours.
• Certification lasts five years and expires on December 31 of the fifth year. You renew either by retaking the exam or by documenting continuing education and stroke nursing practice hours.

You may reschedule once at no charge if you do so at least 2 business days before your appointment. Testing windows cannot be extended, and a missed appointment or arriving more than 15 minutes late forfeits the fee. If you do not pass, you may test again in a later window with a new application and the full fee. You may take the exam only once per testing window and no more than three times in any 12-month period. Check the current ABNN Candidate Handbook before you apply, because fees, windows and policies are updated each year.