Certified Medical-Surgical Registered Nurse (CMSRN)
Certification Review Notes
Introduction
The Certified Medical-Surgical Registered Nurse (CMSRN) credential is offered by the
Medical-Surgical Nursing Certification Board (MSNCB), in collaboration with the Academy
of Medical-Surgical Nurses (AMSN). It validates a nurse’s expertise in caring for adult patients
with a broad range of medical conditions in hospital or outpatient settings.
To be eligible, candidates must hold an active RN license and have at least two years of practice
in a medical-surgical environment, with 2,000 hours of experience in the last three years.
The exam consists of 150 multiple-choice questions, with 125 scored and 25 unscored pretest
items, and is completed in three hours. The test blueprint includes physiologic, psychosocial,
and professional practice domains.
I. Physiologic Needs (Approximately 61% of the Exam)
1. Cardiovascular System
Understanding the structure and function of the heart, vascular system, and hemodynamics is
vital.
Key Topics:
, Heart failure (left/right, systolic/diastolic) — monitor for pulmonary edema, jugular vein
distension, crackles, and edema.
Coronary artery disease and myocardial infarction — manage chest pain (MONA:
morphine, oxygen, nitrates, aspirin), monitor ECG changes, and teach risk reduction.
Arrhythmias (AFib, VTach, heart block) — identify on telemetry; apply ACLS
principles.
Hypertension — pharmacologic therapy (ACE inhibitors, ARBs, beta-blockers) and
lifestyle modification.
Nursing Interventions:
Assess vital signs, heart sounds, and perfusion.
Monitor response to medications such as digoxin, diuretics, or vasodilators.
Educate patients about fluid restriction and sodium control.
2. Respiratory System
Common Conditions: COPD, asthma, pneumonia, pulmonary embolism, and ARDS.
Assessment: Observe respiratory effort, oxygen saturation, and arterial blood gases (ABGs).
Interventions:
Maintain airway and oxygenation.
Implement incentive spirometry and early ambulation post-op.
Administer bronchodilators, corticosteroids, and antibiotics as ordered.
Certification Review Notes
Introduction
The Certified Medical-Surgical Registered Nurse (CMSRN) credential is offered by the
Medical-Surgical Nursing Certification Board (MSNCB), in collaboration with the Academy
of Medical-Surgical Nurses (AMSN). It validates a nurse’s expertise in caring for adult patients
with a broad range of medical conditions in hospital or outpatient settings.
To be eligible, candidates must hold an active RN license and have at least two years of practice
in a medical-surgical environment, with 2,000 hours of experience in the last three years.
The exam consists of 150 multiple-choice questions, with 125 scored and 25 unscored pretest
items, and is completed in three hours. The test blueprint includes physiologic, psychosocial,
and professional practice domains.
I. Physiologic Needs (Approximately 61% of the Exam)
1. Cardiovascular System
Understanding the structure and function of the heart, vascular system, and hemodynamics is
vital.
Key Topics:
, Heart failure (left/right, systolic/diastolic) — monitor for pulmonary edema, jugular vein
distension, crackles, and edema.
Coronary artery disease and myocardial infarction — manage chest pain (MONA:
morphine, oxygen, nitrates, aspirin), monitor ECG changes, and teach risk reduction.
Arrhythmias (AFib, VTach, heart block) — identify on telemetry; apply ACLS
principles.
Hypertension — pharmacologic therapy (ACE inhibitors, ARBs, beta-blockers) and
lifestyle modification.
Nursing Interventions:
Assess vital signs, heart sounds, and perfusion.
Monitor response to medications such as digoxin, diuretics, or vasodilators.
Educate patients about fluid restriction and sodium control.
2. Respiratory System
Common Conditions: COPD, asthma, pneumonia, pulmonary embolism, and ARDS.
Assessment: Observe respiratory effort, oxygen saturation, and arterial blood gases (ABGs).
Interventions:
Maintain airway and oxygenation.
Implement incentive spirometry and early ambulation post-op.
Administer bronchodilators, corticosteroids, and antibiotics as ordered.
