The CRNFA is a portfolio-based certification for perioperative nurses who work as first assistants in surgery, awarded by the National Assistant at Surgery Certification. This page gives you a plain summary of eligibility, fees and retake rules from the official handbook, a map of the content areas to our free practice sets, worked questions, a study plan and answers to common questions.
Numbers in brackets link to the official sources listed under Sources & last verified. Dates that have passed are removed automatically.
| Item | Detail | Source · Verified |
|---|---|---|
| Time limit | Start within 2 months of approval; submit within 3 months of start date[1] | National Assistant at Surgery Certification · Oct 27, 2026 |
| Passing score | Rubric evaluation by two peer evaluators (no numeric score published)[2] | National Assistant at Surgery Certification · Oct 27, 2026 |
| Exam fee (Current RNAS-C Holders) | $275[2] | National Assistant at Surgery Certification · Oct 27, 2026 |
| Exam fee (New Applicants) | $550[3] | National Assistant at Surgery Certification · Oct 27, 2026 |
| Retake fee | $100 resubmission fee[2] | National Assistant at Surgery Certification · Oct 27, 2026 |
| Retake policy | One revision within 60 days; failure requires full reapplication[2] | National Assistant at Surgery Certification · Oct 27, 2026 |
| Validity | 5 years[2] | National Assistant at Surgery Certification · Oct 27, 2026 |
| Renewal | $450 early (Jan 1–Jul 1) / $500 standard (Jul 2–Dec 31) every 5 years[4] | National Assistant at Surgery Certification · Oct 27, 2026 |
| Delivery | Online portfolio portal (Microsoft Word format)[2] | National Assistant at Surgery Certification · Oct 27, 2026 |
| Eligibility (APRN) | Master's/doctoral APRN degree, RN license, accredited APRN certification, AORN-standard RNFA program, 2,000 RNFA practice hours[2] | National Assistant at Surgery Certification · Oct 27, 2026 |
| Eligibility (RN) | Bachelor's degree+, RN license, CNOR, AORN-standard RNFA program, 2,000 RNFA practice hours[2] | National Assistant at Surgery Certification · Oct 27, 2026 |
| Score release | Goal: within 1 month of submission[4] | National Assistant at Surgery Certification · Oct 27, 2026 |
According to National Assistant at Surgery Certification, “The completed CRNFA Professional Portfolios are evaluated by two members of a NASC volunteer panel consisting of active and emeritus CRNFAs. The volunteers use a detailed rubric to evaluate and score each portfolio.”[2]
The CRNFA is not a multiple-choice sitting. You complete a professional portfolio through an online portal, using Microsoft Word documents, and submit it in Word format. Two peer evaluators from a volunteer panel of active and emeritus CRNFAs score it against a detailed rubric. No numeric passing score is published, so there is no number to aim for.
Eligibility depends on your background. An RN needs a bachelor's degree or higher in any field, a current CNOR, an unrestricted RN license and an RNFA program that meets AORN standards, plus 2,000 RNFA practice hours. An APRN needs a graduate-level APRN degree, an RN license, accredited APRN certification, the same type of RNFA program and 2,000 RNFA practice hours. Check the handbook for your own situation.
Timing and fees. Your start date must fall within 2 months of approval, and you must submit within 3 months of that start date. The fee is $550 for new applicants and $275 for current RNAS-C holders. The goal is to send results within 1 month of submission. If you do not pass, you may revise and resubmit once within 60 days for a $100 resubmission fee; otherwise you reapply in full.
Certification lasts 5 years. Renewal costs $450 early (January 1 to July 1) or $500 standard (July 2 to December 31). Fees and rules can change, so confirm them with the official body before you apply.
The content areas below are copied from the official CRNFA content outline published by National Assistant at Surgery Certification, with the share of the exam each area carries. The right-hand column shows which of our practice sets covers it.
| Official content area | Weight | Practice on this site |
|---|---|---|
| Emergency Situations[2] | 9% | CRNFA Anesthesia and Patient Safety in the OR Practise recognising a deteriorating patient in the OR and the first-assistant actions that support the team's response. |
| Infection Prevention[2] | 13% | CRNFA Surgical Instrumentation and Equipment Practise sterile technique, instrument handling and the reasoning behind each barrier and processing step. |
| Intraoperative Patient Care Interventions[2] | 35% | CRNFA Hemostasis and Tissue Management Practise tissue handling, exposure, hemostasis and the anatomy that guides where you retract and assist. |
| Perioperative Workplace Safety[2] | 13% | CRNFA Certified Registered Nurse First Ass... Practise allergy precautions, positioning safety and hazard control, with attention to how AORN-style guidance is worded. |
| Postoperative Patient Care Interventions[2] | 5% | CRNFA Wound Closure and Healing Practise closure choices, the stages of wound healing and the findings that signal a problem after surgery. |
| Preoperative Patient Assessment[2] | 10% | CRNFA Perioperative Patient Assessment Practise reviewing history, allergies and risk factors so the surgical plan fits the patient. |
| Professional Practice[2] | 15% | CRNFA Certified Registered Nurse First Ass... Practise scope of practice, documentation and accountability questions, then connect them to your own portfolio entries. |
Prepare for the CRNFA - Certified Registered Nurse First Assistant exam with our free practice test modules. Each quiz covers key topics to help you pass on your first try.
These are practice questions written for this site, not questions from the real exam. Each explanation shows why the right answer is right and why the others are wrong.
Question: A Bookwalter retractor system is best classified as which type of retractor?
Answer: B. Self-retaining retractor
Explanation:
The correct answer is self-retaining retractor. A Bookwalter system attaches to the OR table and holds tissue open without a person gripping it, which is what defines the category. A hand-held retractor needs someone to hold it throughout. A malleable retractor is a bendable blade that is usually held by hand and shaped to the site. A vein retractor is a small, fine instrument for delicate vessel work, not a table-mounted frame.
Rule to remember: classify a retractor by how it is held. If it is fixed to the table or locks open on its own, it is self-retaining. If a team member must hold it, it is hand-held.
Question: A patient with a known latex allergy should be scheduled as which type of surgical case?
Answer: B. First case of the morning before latex particulates accumulate in the air
Explanation:
The correct answer is first case of the morning. Latex particles can linger in the air after latex products are used, so scheduling the patient before that build-up lowers exposure. Last case of the day is wrong because particles accumulate over the day and the patient would face the highest level. A separate operating room alone is not the standard answer, since timing and a latex-safe environment matter. Saying no special scheduling is needed because gloves are latex-free ignores airborne particles and other latex items in the room.
Rule to remember: for latex allergy, think of the whole environment and schedule the patient early.
Question: Which phase of wound healing is characterized by fibroblast proliferation and collagen deposition?
Answer: C. Proliferative phase
Explanation:
The correct answer is the proliferative phase, when fibroblasts multiply and lay down collagen, with new vessel growth and wound contraction. The hemostasis phase comes first and is about clot formation to stop bleeding. The inflammatory phase follows, clearing debris and bacteria with immune cells. The maturation or remodeling phase is the late stage, when collagen is reorganised and the scar gains strength, rather than being laid down for the first time.
Rule to remember: match the key cell or event to the phase. Clot means hemostasis, immune clean-up means inflammation, fibroblasts and collagen build-up mean proliferation, and reorganisation means remodeling.
Start with the official CRNFA handbook and the portfolio page, because the portfolio is what gets scored. Read the eligibility rules, the portfolio documents and the rubric, and confirm your own requirements and fees before anything else.
Then use our practice sets to find gaps in the content areas listed above. Take one topic set at a time, starting with Preoperative Patient Assessment, then the intraoperative sets, which cover the largest share of the outline. After each set, read every explanation, including those for questions you got right, and write down the rule behind each miss in your own words.
Revisit weak topics in short, repeated sessions rather than one long block. When a set feels comfortable, move to the next area, and return to the earlier sets later to check that the knowledge stuck.
Keep the portfolio in view throughout. Use what you review to describe your own cases, decisions and professional practice in clear, specific terms, and plan your start date so you can submit inside the allowed window. Our questions are written by us and are not real exam questions, so treat them as a way to refresh knowledge, not as a prediction of your result. Ready to begin? Start the practice test.
No. The CRNFA is evaluated through a professional portfolio, completed in Microsoft Word documents and submitted through an online portal. Two peer evaluators from a volunteer panel score it against a rubric. Our practice questions help you refresh the clinical knowledge behind the portfolio, but they do not reproduce the format of the certification itself.
No numeric passing score is published. Your portfolio is scored with a detailed rubric by two volunteer evaluators who are active or emeritus CRNFAs. Because there is no published number, the safest approach is to read the rubric in the official handbook and make sure each portfolio document addresses it directly.
The application fee is $550 for new applicants and $275 for current RNAS-C holders. A resubmission after an unsuccessful portfolio costs $100. Renewal is $450 if you renew early, between January 1 and July 1, or $500 from July 2 to December 31. Confirm current amounts with the National Assistant at Surgery Certification.
You get one opportunity to revise and resubmit. The revisions must be completed and submitted within 60 days, and there is a $100 resubmission fee. If the revised portfolio also fails, you must reapply in full. Read the evaluator feedback closely before you revise.
Your start date must be within 2 months of the date your application is accepted. You then must submit the completed portfolio within 3 months of that start date. The certifying body's goal is to notify you of results within 1 month of submission, though that is a goal, not a promise.
Certification is granted for 5 years. Before it ends you renew, at $450 if you renew early between January 1 and July 1, or $500 between July 2 and December 31. Check the official recertification handbook for the current requirements.
How we verify: editorial & fact-checking policy. Report an error: contact us.