The Certification Examination for School Nurses is a computer-based exam of up to 200 multiple-choice questions, taken in a 4-hour session. This page is for registered nurses working in schools who are preparing for it. It lists the official content areas, links our free practice sets for each, walks through three sample questions, and gives a study plan and answers to common questions.
The CSN has 200 questions, takes about 4 hours and costs $400[1][2] (National Board for Certification of School Nurses, verified Oct 27, 2026).
Numbers in brackets link to the official sources listed under Sources & last verified. Dates that have passed are removed automatically.
| Item | Detail | Source · Verified |
|---|---|---|
| Number of questions | Up to 200 multiple-choice questions (175 scored + 25 unscored pretest)[1] | National Board for Certification of School Nurses · Oct 27, 2026 |
| Time limit | 4 hours[1] | National Board for Certification of School Nurses · Oct 27, 2026 |
| Passing score | Scaled score of 620[3] | National Board for Certification of School Nurses · Oct 27, 2026 |
| Exam fee | $380 early bird / $400 regular / $450 late[2] | National Board for Certification of School Nurses · Oct 27, 2026 |
| Retake fee | $280 early bird / $300 regular / $350 late (tested within past 12 months)[4] | National Board for Certification of School Nurses · Oct 27, 2026 |
| Retake policy | Unlimited attempts; reapply for any future window after current window ends[1] | National Board for Certification of School Nurses · Oct 27, 2026 |
| Validity | 5 years[1] | National Board for Certification of School Nurses · Oct 27, 2026 |
| Renewal | Every 5 years by continuing education or re-examination; fee $255 regular ($355 late)[4] | National Board for Certification of School Nurses · Oct 27, 2026 |
| Delivery | Computer-based at PSI test centers or via PSI remote online proctoring[2] | National Board for Certification of School Nurses · Oct 27, 2026 |
| Eligibility | Current US RN license + BSN or higher (or NBCSN-approved master's in education with school nursing concentration) + 1,000 clinical practice hours in school nursing within past 3 years[1] | National Board for Certification of School Nurses · Oct 27, 2026 |
| Score release | Unofficial pass/fail at testing close; official results in 2–7 days[1] | National Board for Certification of School Nurses · Oct 27, 2026 |
| Registration deadline | February 1, 2027 (Spring 2027 window)[5] | National Board for Certification of School Nurses · Oct 27, 2026 |
| Registration opens | November 23, 2026 (Spring 2027 window)[5] | National Board for Certification of School Nurses · Oct 27, 2026 |
| Testing window | October 22 – November 22, 2026 (Fall 2026 window)[5] | National Board for Certification of School Nurses · Oct 27, 2026 |
According to National Board for Certification of School Nurses, “The Certification Examination for School Nurses is a computer-based exam composed of a maximum of 200 multiple choice, objective questions with a total testing time of four (4) hours.”[1]
The exam is run by the National Board for Certification of School Nurses (NBCSN) and leads to the NCSN credential. It is computer-based and delivered with PSI, either at an approved PSI test center or through PSI remote online proctoring. It has up to 200 multiple-choice questions, made up of 175 scored questions and 25 unscored pretest questions, with a total testing time of 4 hours.
Your result is reported as a scaled score, and the passing scaled score is 620. The board states that this is not a consistent percentage or number of correct answers, so do not convert it into a target percentage. You receive an unofficial pass/fail result when the exam closes, and official results follow in 2–7 days.
To apply you need a current US RN license, a BSN or higher (or an NBCSN-approved master's in education with a school nursing concentration), and 1,000 clinical practice hours in school nursing within the past 3 years. The exam fee is $380 early bird, $400 regular and $450 late. There is no limit on attempts: you reapply for any future window after the current window ends. A retake within the previous 12 months costs $280 early bird, $300 regular or $350 late.
The credential is valid for 5 years. You renew by continuing education or by re-examination, at $255 regular or $355 late. Registration for the Spring 2027 window runs from November 23, 2026 to February 1, 2027. Dates and fees are set per window, so confirm them on the NBCSN website before you plan.
The content areas below are copied from the official CSN content outline published by National Board for Certification of School Nurses. The right-hand column shows which of our practice sets covers it.
| Official content area | Practice on this site |
|---|---|
| Health Appraisal & Nursing Practice[2] | CSN Health Assessment Practise screening methods, assessment findings and the nursing actions that follow from them. |
| Health Promotion/Disease Prevention[2] | CSN Health Education & Promotion Practise health education topics, prevention measures and ways to support healthy habits across a school community. |
| Professional Responsibility[2] | CSN Professional Practice & Ethics Practise ethical reasoning, scope of practice, confidentiality and documentation decisions. |
| School Health Practice Considerations[2] | CSN School Health Policies & Legal Require... Practise how health policies, legal requirements and the school setting shape what a school nurse does. |
Prepare for the CSN - Certified School Nurse 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 school nurse is planning care for a student with cystic fibrosis. Which accommodation is MOST directly related to the condition?
Answer: A. Access to pancreatic enzymes with meals and snacks
Explanation:
Option A is correct. Cystic fibrosis commonly affects the pancreas, so the body struggles to absorb nutrients from food. Enzymes taken with meals and snacks address that need directly, which is why the plan must allow access to them at school.
Preferential seating in the front row helps with vision or hearing needs, not this condition. Wearing a hat indoors has no link to the disease. A reduced homework load in all subjects is a blanket change that does not follow from the condition and could limit the student without cause.
The rule to remember: a good accommodation answers a specific need created by the diagnosis. When several options sound kind, choose the one tied to how the condition affects the body.
Question: A school nurse performing a scoliosis screening asks the student to bend forward at the waist with arms hanging. What is this test called?
Answer: B. Adams forward bend test
Explanation:
Option B is correct. In the Adams forward bend test the student bends at the waist with arms hanging, and the nurse looks along the back for rib or lumbar asymmetry that suggests structural scoliosis.
The Trendelenburg test checks hip abductor strength by watching the pelvis while the student stands on a single leg, so it does not involve bending forward. The Thomas test looks for tightness in the hip flexors with the person lying down. The Romberg test checks balance and position sense, usually with the eyes closed.
The rule to remember: match the test to its maneuver and what it reveals. Each named test has a distinct position and a distinct finding, so link the body position in the stem to the name.
Question: Why should school nurses participate in policy development?
Answer: B. To ensure that health policies meet the needs of students and comply with laws.
Explanation:
Option B is correct. School nurses bring clinical knowledge of student health needs and of how a policy works in practice, so their input helps make policies workable and legally sound.
Increasing school funding is not the purpose of policy participation and is not something the nurse's input can promise. Reducing teacher workload may be a side effect of a clear policy, but it is not the reason for the nurse's role. Focusing on student behavior is too narrow, because health policy covers much more than behavior.
The rule to remember: when a question asks why the nurse takes part in policy work, look for the answer about meeting student health needs and complying with the law, not administrative or unrelated goals.
Start with the official material. Read the NBCSN certification handbook and the exam outline so you know the content areas and the rules on eligibility, fees and dates. Then take a short mixed set, such as CSN School Nurse MCQ, to see where you stand before you plan anything.
Next, work through the sets that match each content area, giving extra time to the areas where you missed the most. Good starting points are CSN Health Assessment, CSN Health Education & Promotion, CSN Professional Practice & Ethics and CSN School Health Policies & Legal Requirements.
After each set, read the explanation for every question, including the ones you got right, and write down the rule behind each miss. Return to the topic in your own school nursing notes or in official sources. Because the passing score is scaled and not a fixed percentage, aim for steady understanding rather than a target percentage.
In the last days before the exam, do a long mixed session under timed conditions to practise pacing, then rest. Our questions are written by us and are not real exam questions.
The passing scaled score is 620. NBCSN converts your number of correct answers to a scaled score, and the board says this is not a consistent percentage or number of correct answers. You see an unofficial pass/fail result when the exam closes, and official results arrive within 2–7 days.
The exam has a maximum of 200 multiple-choice questions: 175 scored questions and 25 unscored pretest questions. The total testing time is 4 hours. It is computer-based, and you can test either at a PSI test center or remotely with a PSI online proctor.
You need a current US RN license, a BSN or higher (or an NBCSN-approved master's in education with a school nursing concentration), and 1,000 clinical practice hours in school nursing within the past 3 years. Check the NBCSN handbook for the full rules before you apply.
The fee is $380 early bird, $400 regular or $450 late. If you tested within the previous 12 months, a retake costs $280 early bird, $300 regular or $350 late. There is no limit on attempts, and you reapply for any future window after the current window ends.
Registration for the Spring 2027 window opens November 23, 2026 and closes February 1, 2027. The Fall 2026 testing window runs October 22 to November 22, 2026. Windows and deadlines are set by NBCSN, so confirm them on the official test dates page.
The credential is valid for 5 years. To maintain it, you recertify by continuing education or by re-examination. The regular renewal fee is $255, and a late application costs $355. Check the NBCSN site for current renewal requirements.
How we verify: editorial & fact-checking policy. Report an error: contact us.