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How Do You Pass the CMSRN Exam?

You pass the medical-surgical certification test by dedicating most of your study time to the Patient/Care Management domain, which makes up 32% of the test. Build a study plan using active recall and pace yourself to answer 150 questions within the 180-minute time limit.

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Built to help you pass faster β€” by exam-prep publishers with 10+ years' experience

  • πŸ’‘ Key Takeaways β€” the one transferable rule per question
  • πŸ” Hint highlights β€” the decisive cue phrases in each stem
  • πŸ“– Full rationales β€” why every option is right or wrong

Every CMSRN question is written to the current exam outline for quick learning and a clear pass strategy.

Written and reviewed by the LexPort exam-prep team, led by our Founder & Exam-Prep Lead. LexPort builds certification practice questions β€” this is exam-preparation material, not medical advice. Last reviewed July 2026.

Get the full CMSRN question bank β€” free

5,200+ practice questions with rationales on iOS & Android

4.7Β· 30 ratings

Where should I focus my study time?
Start with Patient/Care Management. This domain covers 32% of the test, totaling 40 scored items. Your next priority is Nursing Teamwork and Collaboration at 21% (26 items). Mastering these two areas covers over half your score.
How are the remaining domains weighted?
Elements of Interprofessional Care makes up 17% (21 items). Holistic Patient Care and Professional Concepts each account for 15% (19 items each). Allocate your review time to match these exact percentages.
What score do I need to pass?
You need a standard scaled score of 95. This translates to answering about 71% of the scored items correctly.
How many questions are on the test?
You will face 150 multiple-choice questions. Only 125 of these count toward your final score. The remaining 25 are unscored pretest items used to evaluate future test material.
How should I pace myself during the test?
You have 180 minutes to complete the 150 items. This gives you about 72 seconds per item. Do not linger on difficult questions. Pick your single best answer, flag it if necessary, and keep moving.
What types of questions will I see?
The test uses multiple-choice, single-best-answer formats. You will also encounter case studies. For specific examples of case study formatting, review the official MSNCB candidate handbook.
What is the best way to study the material?
Use active recall instead of passive reading. Test yourself repeatedly using our 5213 practice items. Review the rationale for every incorrect answer to understand the underlying clinical concept.
What is a common mistake candidates make?
Many test-takers spend too much time trying to identify the 25 unscored pretest items. You cannot tell them apart from the scored items. Treat every prompt as if it counts toward your passing score of 95.
Where do I take the test?
You test through Pearson VUE. You can choose to sit at a physical testing center or use the OnVUE remote proctoring system from your home. For technical requirements regarding remote testing, consult the MSNCB certification guide.

Start by finding your gaps

Every honest study plan starts with knowing what you don't know. Try three practice questions. The app has 5,200+, timed and scored.

Question 1

A 68-year-old patient with severe OSA (using home CPAP) and hypertension emerges from general anesthesia after abdominal surgery. Upon PACU arrival, they have snoring respirations at 8 breaths/min and SpOβ‚‚ 88% on 2L nasal cannula. Which intervention aligns with current ASA practice guidelines?

β–Έ Why B is the answer

Jaw thrust with airway adjunct addresses obstruction from OSA and sedation residuals, aligning with ASA guidelines prioritizing airway maneuvers before oxygenation escalation. Option A ignores obstruction risk and may cause COβ‚‚ retention. Option C incorrectly assumes opioid cause despite slow rate not matching typical overdose. Option D skips basic maneuvers and escalates care prematurely. OSA history and low respiratory rate are key cues requiring immediate obstruction relief before oxygenation adjustments.

Question 2

A nurse feels conflicted after honoring a family's request to withhold a terminal diagnosis from an elderly patient, contrary to personal beliefs about autonomy. Which reflective action best addresses ethical resolution?

β–Έ Why C is the answer

Journaling (C) explores the nurse's moral conflict (discriminating cues: cultural family request, personal belief clash) through self-examination of values and boundaries. Ethics committees (B) offer group solutions but not personal growth. Textbook study (A) provides theory without application to the specific dilemma. Policy review (D) clarifies rules but not internal conflicts. Reflective practice requires nurses to reconcile personal and professional ethics to maintain integrity in complex care situations.

Question 3

When introducing a new electronic health record (EHR) system, a Millennial nurse excels with digital navigation but struggles with structured handoff communication. A Baby Boomer nurse masters handoffs but resists EHR workflows. Which training strategy best addresses generational learning differences?

β–Έ Why A is the answer

Option A leverages generational strengths through reciprocal learning, fostering mutual respect. Option B ignores divergent needs, reducing effectiveness. Option C isolates skill development, reinforcing gaps. Option D assumes deficiency rather than recognizing complementary expertise. Peer mentoring capitalizes on experiential knowledge (Boomer strength) and tech adaptability (Millennial strength) while promoting intergenerational collaboration.

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Get the full CMSRN question bank β€” free

5,200+ practice questions with rationales on iOS & Android

CMSRN Β· Exam Simulator

A patient with severe anorexia nervosa began receiving central TPN 48 hours ago. The nurse notes a serum phosp…

A) Increase the current TPN infusion rate.
B) Administer PRN intravenous calcium gluco
C) Notify the provider to decrease rate.
D) Obtain an order for regular insulin.
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