Exam guide
CMC Exam Guide
Format, the November 2026 test plan, eligibility and an 8-week plan for AACN's cardiac medicine subspecialty exam
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The exam at a glance
| Item | Detail |
|---|---|
| Questions | 90: 75 scored, 15 unscored pretest |
| Time | 2 hours |
| Item type | Multiple choice, 4 options |
| Passing score | 50 of 75 scored (exams to 11/18/2026) |
| Fee | $150 member, $240 nonmember |
| Retest | $125 member, $170 nonmember |
| Retakes | Up to 4 per rolling 12 months |
| Window | 180 days after applying (normally 90) |
| 2025 first-time pass rate | 71.3% |
The revised exam has its own passing standard; check AACN's cut score page before testing.
What is on it
| Content area | To 11/18/2026 | From 11/19/2026 |
|---|---|---|
| Cardiovascular conditions | 23% | 21% |
| Non-cardiovascular conditions | 23% | 21% |
| Therapeutic interventions | 39% | 44% |
| Monitoring and diagnostics | 16% | 14% |
New or expanded from 11/19/2026:
- Cardiac arrest; SCAD under ACS
- VADs, temporary and durable (such as Impella, LVAD)
- Drugs: ACEI, ARB, ARNI, MRA, SGLT2i, beta-blockers, CCBs, lipid-lowering, pulmonary vasodilators, sedation and analgesia
- Delirium; fluid and acid-base imbalances
- Chest tubes, oxygen devices, cardiac rehab, cardiac MRI and CT
- Adrenal disorders dropped
Who can take it
- Current, unencumbered U.S. RN or APRN license
- ABSNC- or NCCA-accredited direct-care adult specialty certification, such as CCRN (direct or tele-critical care pathway), PCCN (direct care pathway) or CEN; shown as CCRN-CMC
- 1,750 direct-care hours with acutely or critically ill adults in 2 years (875 in the last year, 875 cardiac), or 2,000 in 5 years (144 in the last year, 1,000 cardiac)
- Hours in the U.S. or Canada, or abroad at a Magnet or JCI-accredited facility
- Audit verifier: clinical supervisor or RN or physician colleague; not yourself or a relative
CMC goes Inactive if the tied certification lapses. Non-AACN proof must be valid 90 days past applying.
Renew every 3 years: 432 hours with acutely or critically ill adult cardiac patients (144 in the last year), a current specialty certification, and 25 Category A Clinical Judgment cardiology CERPs or a passed exam.
How to study
- Week 1: Take a Mock Exam cold for a baseline; read the new test plan. Start Daily Review.
- Weeks 2 to 3: Therapeutic interventions, with the IABP Management, Vasopressors and Inotropes, and Ventilator Modes and Settings One-Pagers. Add Impella, ECMO and CRRT.
- Week 4: Cardiovascular conditions, with Rhythm Gallery and ACLS Algorithms in Brief.
- Week 5: Non-cardiovascular conditions, with Shock Types at a Glance, Electrolyte Imbalances, ABG Interpretation in 6 Steps and Sedation, Pain and Delirium Scales.
- Week 6: Monitoring and diagnostics, with Hemodynamic Normals and Capnography. Second Mock Exam.
- Week 7: Weakest Subject daily; rework Trouble Questions. Third Mock Exam.
- Week 8: Daily Review, flagged questions, One-Pager skim. Last Mock Exam 3 or more days out.
Test-day tips
- Current government photo ID with signature, matching your AACN record. No military or temporary IDs.
- Test center: arrive by your appointment time; over 15 minutes late, no admission. Scratch paper on request.
- Remote: check in 15 to 30 minutes early; check-in can take 60+ minutes. Over 30 minutes late, no admission. Digital notepad only.
- Pace about 80 seconds per item; bookmark hard ones and go back.
- No guessing penalty: answer every item.
- Up to two 5-minute breaks; the clock keeps running.
Exam content is confidential; sharing it can lead to revocation of certification.
Official resources
- CMC Exam Handbook (Aug 2026), with 8 sample questions: aacn.org/certhandbooks
- CMC Test Plan, effective 11/19/2026; page 3 lists Testable Nursing Actions
- CMC Exam Bibliography: 18 titles, such as the 2025 AHA guidelines and AACN Essentials of Critical-Care Nursing (5th ed., 2023)
- Certification Exam Policy Handbook (Sep 2026)
- AACN exam statistics and cut scores page
- AACN CMC Practice Exam and Questions (subscriptions match the new plan): free 7-day, 30-question trial
AACN says current CMC study materials still apply to the revised exam.
CMC®, CCRN® and PCCN® are registered service marks of AACN Certification Corporation. ICU Basics is not affiliated with or endorsed by AACN. Other marks belong to their owners.
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Sources
- AACN Certification Corporation. CMC Exam Handbook. August 2026. Link
- AACN Certification Corporation. Cardiac Medicine Certification (CMC) Test Plan. Effective 11/19/2026. Link
- AACN Certification Corporation. CMC Exam Bibliography: References Used for Item Validation. Effective 11/19/2026. Link
- AACN Certification Corporation. Certification Exam Policy Handbook. September 2026. Link
- AACN. Certification Exam Statistics and Cut Scores. Link
- AACN Certification Corporation. Executive Summary of CMC Exam Development (2025 study of practice). Link
- AACN Newsroom. Revised CMC and CSC Exams Launch Nov. 19, 2026 (August 19, 2026). Link
- AACN. CMC (Adult) Certification. Link
- AACN. CMC and CSC Frequently Asked Questions. Link
- AACN Store. CMC Adult Certification Practice Exam and Questions, Free Trial. Link