About two in three Certified Medical-Surgical Registered Nurse (CMSRN) candidates pass. MSNCB’s published statistics show 4,845 people tested in 2025, with 3,246 passing, a 67% pass rate. That continues a gradual decline from 72% in 2023 and 69% in 2024, while the number of candidates has grown. The figure covers everyone who tested, not first attempts only.
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Written and reviewed by the LexPort exam-prep team, led by our Founder & Exam-Prep Lead. LexPort builds certification practice questions — this is exam-preparation material, not medical advice. Last reviewed October 2026.
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67%. MSNCB’s statistics list 4,845 candidates tested in 2025, of whom 3,246 passed and 1,599 failed.
Is the CMSRN getting harder to pass?
The published rate has edged down: 72% in 2023, 69% in 2024 and 67% in 2025, as the number of candidates rose.
Is that a first-time pass rate?
No. MSNCB publishes an overall rate for everyone who tested in the year; it does not report first-time candidates separately.
How many people took the CMSRN?
4,845 in 2025, up from 2,746 in 2023, according to MSNCB’s statistics table.
Why does MSNCB publish these numbers?
MSNCB states that it publishes certification statistics annually, in accordance with accreditation standards.
Judge the difficulty yourself
These are three CMSRN practice questions at exam difficulty. See where you land. The app has 5,200+, timed and scored.
Question 1
When admitting a patient with terminal COPD exacerbation, the nurse discovers conflicting advance directives: a notarized living will refusing mechanical ventilation and a newer POLST form allowing temporary intubation. The patient is currently unable to clarify. Which document takes precedence?
▸ Why B is the answer
POLST forms are actionable medical orders that supersede prior directives when more recent. Option B follows legal hierarchy for advance care documents. Option A ignores temporal precedence of updated wishes. Option C delays care when clear orders exist. Option D misrepresents POLST as non-binding. Nurses must prioritize the most current provider-signed orders per National POLST guidelines.
Question 2
A patient complains that their discharge was delayed by 4 hours due to misplaced medication reconciliation forms, causing them to miss a family event. Which response best demonstrates service recovery?
▸ Why A is the answer
Service recovery for operational failures requires apology, resolution, and symbolic amends. Option A acknowledges harm (apology), fixes the issue (expedite), and offers tangible goodwill (waived fees) for the inconvenience, per AMSN’s patient-centered standards. Option B justifies the delay ("complex") and defers to feedback, not redress. Option C focuses on blame, not patient impact. Option D compounds the delay (reschedule), worsening the outcome. Cues (delay due to internal error, social impact) demand efficient correction and restitution.
Question 3
A 72-year-old patient with advanced Alzheimer's disease is admitted for dehydration. He becomes agitated when repositioned, hitting staff and pulling his NG tube. His daughter mentions he calms with soft music. Which intervention should the nurse implement first?
▸ Why C is the answer
Playing preferred music aligns with restraint alternatives by using personalized sensory intervention (cue: daughter's input) before escalating to restrictive measures. Restraints (A) violate least-restrictive principles for chronic confusion. Haloperidol (B) risks sedation side effects in elderly dementia without exhausting non-pharmacological options. Hand-holding (D) may increase agitation through forced touch, unlike music's non-threatening nature. The Joint Commission mandates trialing individualized de-escalation strategies before restraints or medications.
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