Preparing for the CMSRN (Certified Medical-Surgical Registered Nurse) certification from MSNCB? A printable CMSRN practice test PDF gives you an offline format to review cardiovascular nursing, respiratory care, gastrointestinal conditions, renal care, postoperative nursing, and patient safety that the medical-surgical nursing certification examination assesses. Med-surg nurses manage the broadest patient populations in acute care — the CMSRN validates expertise across multiple body systems and nursing domains. This page provides a free PDF download and a comprehensive CMSRN exam preparation guide.
The CMSRN is issued by the Medical-Surgical Nursing Certification Board (MSNCB) and requires two years of RN experience with 2,000 hours of med-surg nursing practice in the past three years. The exam consists of 150 scored questions administered over three hours at Prometric testing centers. CMSRN certification is renewable every five years through continuing education or re-examination and is recognized as a mark of excellence in medical-surgical nursing practice.
Your CMSRN practice test PDF covers the major nursing knowledge domains tested on the MSNCB CMSRN examination.
Cardiovascular care accounts for a significant portion of CMSRN content: heart failure management (HFrEF vs HFpEF; RAAS inhibition — ACE inhibitors/ARBs reduce preload and afterload; diuretics — loop diuretics furosemide for fluid overload; daily weight monitoring; fluid restriction; orthopnea and paroxysmal nocturnal dyspnea assessment; BNP/NT-proBNP elevation in decompensation), acute coronary syndrome nursing (STEMI vs NSTEMI differentiation; troponin trend — initial and 3-hour draw; aspirin, anticoagulants, and P2Y12 inhibitors; post-cardiac catheterization care — vascular access site — femoral hematoma monitoring, radial artery occlusion check; hold anticoagulants per protocol; activity restrictions), cardiac dysrhythmias (atrial fibrillation — rate control goals, anticoagulation for stroke prevention — CHA₂DS₂-VASc score; ventricular tachycardia recognition — sustained vs non-sustained; pacemaker patients — magnet use, electromagnetic interference education), and hypertensive urgency vs emergency (urgency = severe BP without target organ damage — oral antihypertensives; emergency = target organ damage — IV antihypertensives, ICU-level monitoring; posterior reversible encephalopathy syndrome signs).
Respiratory care: COPD exacerbation management (controlled oxygen therapy — target SpO2 88-92% to preserve hypoxic drive; bronchodilators — short-acting beta-2 agonists, anticholinergics; systemic steroids; antibiotics for bacterial exacerbations; ABG interpretation — respiratory acidosis with metabolic compensation in chronic COPD; BiPAP as non-invasive ventilation before intubation), pneumonia care (CAP vs HAP organisms — MRSA and Pseudomonas risk factors for HAP; VAP bundle for intubated patients; incentive spirometry use; early ambulation), and pulmonary embolism nursing (Virchow's triad — stasis, hypercoagulability, endothelial injury; massive PE shock presentation vs submassive; anticoagulation — heparin infusion, LMWH, direct oral anticoagulants; IVC filter indications; bleeding precautions education). GI/GU care: upper GI bleed (hematemesis vs melena; orthostatic vital signs; large-bore IV access; NPO status; H. pylori testing; proton pump inhibitor infusion; post-endoscopy monitoring), hepatic encephalopathy (lactulose dosing — target 2-3 soft stools daily; ammonia-reducing diet — limiting protein from red meat; rifaximin; neurological status monitoring — asterixis), acute kidney injury nursing (prerenal vs intrinsic vs postrenal distinction; hourly urine output monitoring — oliguria <0.5 mL/kg/hr; fluid challenge for prerenal; nephrotoxic drug avoidance; contrast nephropathy prevention — hold metformin, IV hydration protocol), and electrolyte imbalances (hypokalemia EKG — flattened T waves, U waves, arrhythmia risk; hyperkalemia EKG — peaked T waves, widened QRS, sine wave; SIADH vs diabetes insipidus — hyponatremia vs hypernatremia; fluid restriction vs replacement).
Postoperative nursing: respiratory complication prevention (incentive spirometry every hour while awake; cough and deep breathing exercises; early ambulation — first ambulation within 4-8 hours of surgery; patient positioning — HOB elevation; TCDB instructions), surgical site infection prevention (SSI bundle — appropriate antibiotic timing pre-op; normothermia maintenance; blood glucose control <180 mg/dL; incision assessment — REEDA — redness, edema, ecchymosis, drainage, approximation), pain management (multimodal analgesia — scheduled NSAID or acetaminophen plus opioid PRN; CIWA-Ar protocol for alcohol withdrawal risk; opioid side effects — constipation prophylaxis with bowel regimen, respiratory depression monitoring, naloxone availability), DVT prophylaxis (Caprini score risk stratification; sequential compression devices while in bed; ambulation; anticoagulant prophylaxis per protocol; patient education — call light use, no leg crossing), and fluid/electrolyte management post-op. Patient safety fundamentals: pressure injury prevention (Braden scale — score ≤18 = at risk; repositioning every 2 hours; moisture management; nutrition optimization), fall prevention (Morse or STRATIFY scale; bed alarm for high-risk patients; call light within reach; non-slip footwear; toileting schedule), medication reconciliation (transitions of care — admission, transfer, and discharge reconciliation; high-alert medications — insulin, anticoagulants, concentrated electrolytes), and SBAR communication (handoff structure for safe information transfer).
Focus on cardiovascular care and postoperative nursing — these are the highest-weighted CMSRN content areas. After this PDF, take online CMSRN practice tests at cmsrn for instant scored feedback across all nursing domains.
After completing this PDF, take full online CMSRN practice tests at cmsrn — instant scoring across cardiovascular, respiratory, GI/GU, postoperative, and patient safety nursing with explanations for every answer. Use both: PDF for offline clinical concept review, online for timed MSNCB CMSRN exam simulation.