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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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  • 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.

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

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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 nurse discovers a visitor assaulting a confused elderly patient with dementia. The visitor is the patient's son. What should the nurse do first?

β–Έ Why A is the answer

Patient safety is paramount. Direct intervention stops immediate harm per AMSN ethical standards. Security notification (C) should follow separation but doesn't address imminent danger. Documentation (B) is essential but secondary to intervention. APS reporting (D) is mandatory but not the first action. The nurse must protect vulnerable patients from abuse regardless of perpetrator relationship, as per Joint Commission safety goals.

Question 2

A 45-year-old homeless patient with uncontrolled type 2 diabetes (HbA1c 10.2%) and a foot ulcer is discharged. They use a shelter with inconsistent meal access and express distrust of healthcare systems. Which initial referral best addresses social determinants impacting health outcomes?

β–Έ Why B is the answer

FQHCs provide comprehensive, low-cost care addressing homelessness (no fixed address), distrust (community-integrated services), and financial barriers (sliding fees). This creates continuity for ulcer/wound management and diabetes control. Glucose monitoring (A) requires stable housing for device security. Mobile wound care (C) addresses ulcers but not systemic diabetes or distrust. Education (D) is ineffective without addressing access barriers first. AMSN standards prioritize establishing equitable care access before disease-specific interventions.

Question 3

A manager must reduce overtime costs. Data show 70% of overtime occurs when discharge paperwork delays bed turnover. The EHR discharge module is underutilized, and social work consults average 48-hour response times. Which intervention offers sustainable cost control?

β–Έ Why C is the answer

Option C addresses the root cause (paperwork delays) using existing resources, reducing overtime by improving efficiency. Hiring staff (A) increases fixed costs. Mandating overtime (B) contradicts cost-reduction goals. Outsourcing (D) adds expenses and risks care fragmentation. The cues (EHR underuse, social work delays) justify process improvement: team huddles proactively identify barriers, while EHR training streamlines documentation. This aligns with ANA’s emphasis on workflow redesign over staffing changes for financial stewardship.

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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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