A set of surgical instruments carefully arranged on a blue drape during an operation.

What’s the Certified Medical-Surgical Nurse Exam Like?

/ Exam Prep / By / August 20, 2025
Share

Medical-Surgical Nursing Certification: ANCC vs. MSNCB

Unlike many certifications where only one body offers a credential, medical-surgical nurses can choose between two respected certification pathways: the American Nurses Credentialing Center (ANCC) and the Medical-Surgical Nursing Certification Board (MSNCB). The ANCC awards the Registered Nurse–Board Certified (RN-BC) credential, while the MSNCB awards the Certified Medical-Surgical Registered Nurse (CMSRN®) credential.

This guide outlines eligibility requirements, exam format, scoring, and preparation resources to help you decide which path best fits your career.

Eligibility Requirements

ANCC (RN-BC)

To sit for the exam, you must:

  • Hold a current, active RN license

  • Have practiced the equivalent of 2 years as a full-time RN

  • Accrued 2,000 hours of clinical practice in med-surg nursing within the past 3 years

  • Completed 30 hours of continuing education in med-surg nursing within the past 3 years

MSNCB (CMSRN®)

To sit for the exam, you must:

  • Be an RN with a current U.S. license

  • Have practiced 2 years as an RN in a med-surg setting

  • Accrued 2,000 hours of practice in med-surg within the past 3 years

Exam Format and Content

Both exams are computer-based, 150-question tests (125 scored and 25 unscored items), with 3 hours allotted for completion.

ANCC (RN-BC) Content Domains

Content Domain Number of Questions
Assessment and Diagnosis 52
Planning, Implementation, Evaluation 58
Professional Role 15

MSNCB (CMSRN®) Content Areas

Organized into six patient problem areas, with questions spanning seven domains of nursing practice.

Patient Problem Area Number of Questions
Gastrointestinal 24–27
Pulmonary 22–26
Cardiovascular/Hematological 24–27
Diabetes/Endocrine/Immunological 27–30
Urological/Renal 21–24
Musculoskeletal/Neurological/Integumentary 22–26

Domains of Practice Covered:

  1. Helping

  2. Teaching/Coaching

  3. Diagnosing/Monitoring

  4. Nursing Interventions

  5. Managing Emergencies

  6. Ensuring Quality

  7. Organization/Work Role Competency

See also  The Ins and Outs of Being a Certified Medical-Surgical Nurse

Test Setting

  • Both exams are offered through Prometric testing centers.

  • After application approval, you’ll receive authorization to schedule your test at a convenient location and time.

  • Security is strict—personal items like phones and bags are not allowed in the exam room.

Scoring

  • ANCC (RN-BC): Scaled score; must earn 350 out of 500 to pass.

  • MSNCB (CMSRN®): Standard score of 95 (≈71% correct) required to pass.

  • Both provide detailed score reports to highlight strengths and weaknesses.

Study and Preparation

Prepare confidently with:

⏳ Tip: Allow 2–3 months to prepare. Avoid last-minute cramming for this high-stakes exam.

The Payoff

Earning either credential (RN-BC or CMSRN®):

  • Confirms your expertise in medical-surgical nursing

  • Valid for 5 years

  • Boosts professional credibility, patient trust, and career advancement opportunities

Resources

Springer Publishing Editorial Staff
Follow
Latest posts by Springer Publishing Editorial Staff (see all)
See also  The Ins and Outs of Being a Certified Medical-Surgical Nurse
Share

Must Read