Certified Medical-Surgical RN (CMSRN) Certification Guide

Certification is one of the most meaningful ways to reinforce confidence. Whether you’re a seasoned medical-surgical nurse or looking to deepen your clinical foundation, the Certified Medical-Surgical Registered Nurse (CMSRN®) certification is one of the most respected credentials you can pursue. 

As a clinician myself, I know how important it is to obtain recognition that reflects your expertise and opens doors across facilities nationwide.

This guide will walk you through everything you need to know about CMSRN, from eligibility to exam prep to renewal.

What Is CMSRN® certification?

The CMSRN® is a nationally recognized credential awarded by the Medical-Surgical Nursing Certification Board (MSNCB) to registered nurses who demonstrate competence in medical-surgical nursing practice. MSNCB describes certification as a formal recognition that a clinician has met standardized eligibility criteria and demonstrated competence through a validated exam process.

The CMSRN® is:

• Accredited by the Accreditation Board for Specialty Nursing Certification (ABSNC)

• Endorsed by the Academy of Medical-Surgical Nurses (AMSN)

• Accepted by the ANCC Magnet Recognition Program® as an approved certification

This accreditation confirms that the exam is valid, reliable, and aligned with current clinical practice standards.

Why pursue CMSRN® certification?

While certification is optional, it’s an investment that pays off in multiple ways: personally, professionally, and clinically.

According to MSNCB, certification allows nurses to:

• Validate expertise in a specialized knowledge base

• Demonstrate commitment to professional growth in the Medical-Surgical specialty

• Increase confidence and satisfaction in nursing practice

• Strengthen credibility with patients, peers, and employers

• Potentially increase earning potential

• Support organizational goals like Magnet® designation

From my own experience supporting clinicians across the country at Nomad, I’ve seen how certification not only enhances practice; it empowers nurses to lead, advocate, and elevate patient care.

CMSRN® certification requirements

To apply for the CMSRN® exam, MSNCB requires that nurses meet three main eligibility criteria at the time of application and throughout the 90-day testing window:

1. Current, unencumbered RN license

Must be issued in the U.S., its territories, or Canada. International nurses may apply if license equivalency is verified through organizations like WES.

2. 2,000 hours of practice in a medical-surgical setting

These hours must be completed within the past 3 years and may include clinical practice, management, or education roles. *It is recommended, but not required, to have at least 2 years of qualifying RN experience prior to sitting for the CMSRN examination.

How to get CMSRN® certified

Here’s a clear roadmap based on MSNCB’s application process:

1. Gather your materials

You’ll need:

• Last 4 digits of SSN

• RN license details

• Government-issued photo ID

• A credit card or FailSafe voucher (if your employer participates)

2. Apply online

Applications are submitted via amsn.org through the Certification Portal.

3. Submit eligibility documentation

Include your medical-surgical experience and RN license verification.

4. Pay exam fees

• AMSN members: $267

• Non-members: $394 All fees include an $79 non-refundable processing fee.

5. Receive authorization to test (ATT)

The ATT email gives you a 90-day window to schedule your exam.

6. Schedule your exam

You can choose:

• A Prometric testing center, or

• Live Remote Proctoring (LRP) from home (requires system check).

7. Take the exam

Results are delivered immediately upon completion.

CMSRN® certification cost

Initial Exam Fees

• AMSN member: $267

• Standard: $394, Includes $79 non-refundable processing fee.

Retake Fees

• AMSN member: $189

• Standard: $315, discount available only within one year and not for FailSafe participants.

What you’re tested on: CMSRN® exam

The CMSRN® exam contains 150 multiple-choice questions (125 scored + 25 unscored), and you are given three hours to complete it.

Domains of medical-surgical nursing practice

According to the current exam blueprint, the test covers the following weighted domains:

Passing Score

You must achieve a standard score of 95, which is approximately 71% correct on the 125 scored questions.

Sample CMSRN® practice questions

These sample questions mirror the style of CMSRN® items but are original and not copied from the exam.

Question 1: A postoperative patient is reporting increasing abdominal pain and a rigid abdomen. Which action should the nurse take first?

 A. Administer prescribed analgesics B. Notify the provider immediately C. Encourage deep breathing exercises D. Increase the patient’s IV fluids

Correct Answer: B Rationale: Symptoms suggest possible peritonitis; rapid provider notification is critical.

Question 2: A patient with heart failure is receiving IV furosemide. Which assessment finding requires priority action?

A. Mild dizziness during ambulation B. Potassium level of 2.9 mEq/L C. Trace peripheral edema D. Urine output of 200 mL in 4 hours

Correct Answer: B Rationale: Severe hypokalemia increases the risk of dysrhythmias.

Question 3: Which intervention best supports safe medication management for an older adult with polypharmacy?

A. Educate on keeping all medications in a pill organizer B. Encourage the patient to discontinue unnecessary medications C. Review medications with a pharmacist and reconcile regularly D. Advise the patient to avoid over-the-counter medications

Correct Answer: C ⁠Rationale: Interdisciplinary medication review reduces the risk of adverse effects.

How do I renew my CMSRN® certification?

Your CMSRN® credential is valid for five years. MSNCB recommends planning your renewal path early to avoid scrambling at the end of your cycle.

You can recertify in two ways:

1. Recertification by contact hours (most common)

Requirements:

• 1,000 practice hours in a med-surg setting over your 5-year period

• 90 verified contact hours

  • At least 68 must be med-surg related

• Current, unencumbered RN license

Fees:

• AMSN member: $193

• Standard: $303

• Late fee (after expiration): $79

2. Recertification by exam

Requirements mirror the contact-hour pathway, except you retake the CMSRN® exam instead.

How will employers know I am CMSRN certified when applying to positions through Nomad?

When submitting to jobs through Nomad, we have a dedicated certification page that we strongly encourage our clinicians to submit copies of their specialty certifications into so that employers can see the extra commitment you have made to your practice! Specialized and advanced certifications show you have taken the next step in ensuring high quality, evidence based care for your patients.

Is the CMSRN® certification worth it?

If you’re committed to strengthening your practice, developing your critical thinking, and advancing patient outcomes, the answer is yes.

Here’s what I’ve seen firsthand:

• Nurses return from assignments more confident in their assessments.

• Certification increases professional mobility, especially for travel nurses.

• Many facilities actively prefer or financially incentivize certification.

At its core, the CMSRN® is more than a credential; it’s a commitment to excellence, and I’m honored to support clinicians who choose this path.

Final thoughts

Every clinician deserves the opportunity to advance, grow, and feel proud of the care they deliver. Certification is one of the most meaningful ways to honor your expertise and open doors for your future.

If you’re preparing for your CMSRN® exam, or considering it, know that you’re taking a powerful step forward. And at Nomad Health, we’re here to support your journey, wherever it leads.

If you’d like help finding assignments that align with your goals, connect with us anytime.