Exam guide
CSC Exam Guide
Format, blueprint, eligibility and an 8-week plan for AACN's Cardiac Surgery subspecialty exam
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The exam at a glance
| Feature | CSC exam |
|---|---|
| Questions | 90: 75 scored, 15 unscored pretest |
| Time | 2 hours |
| Item type | Multiple choice, 4 options, one best answer |
| Format | Scored by number correct; go back, change answers, bookmark |
| Passing standard | 55 of 75 scored correct (raw score, set 1/31/2022) |
| Cost | $150 AACN member, $240 nonmember; retest $125 / $170 |
| Where | PSI test center or live remote proctoring |
| Test window | Currently 180 days after you apply (normally 90) |
| Retakes | Up to 4 attempts in a rolling 12 months |
AACN may reset the cut score for the revised exam, so check it again before you test. 2025 first-time pass rate: 52.2%.
What is on it
| Content area | From 11/19/2026 | Through 11/18/2026 |
|---|---|---|
| Procedures | 9% | 11% |
| Complications | 37% | 33% |
| Therapeutic interventions | 43% | 43% |
| Monitoring and diagnostics | 11% | 13% |
- Procedures: CABG on and off pump, valves, robotic and minimally invasive, TAVR and TMVR, maze, surgical LAA closure, aortic repair
- Complications: bleeding, tamponade, vasoplegia, cardiogenic shock, RV failure, dysrhythmias, AKI, stroke, delirium, HIT
- Interventions: resternotomy, CPR after cardiac surgery, pacing, IABP, temporary VADs, ECMO, CRRT, drains, drugs
- Monitoring: hemodynamics, echo, ECG, labs, ABG, mixed venous gas, pulse oximetry, EtCO2, radiography
Who can take it
- Current, unencumbered U.S. RN or APRN license
- Current ABSNC- or NCCA-accredited specialty certification in direct adult care (e.g., CCRN Direct Care or Tele-critical Care, PCCN Direct Care, CEN, CNOR, CPAN); CSC attaches to it, as in CCRN-CSC
- Practice hours in a U.S., Canadian or comparable facility, by one of two options:
| Option | Total hours | Last year | Cardiac surgery* |
|---|---|---|---|
| 2 years | 1,750 | 875 | 875 |
| 5 years | 2,000 | 144 | 1,000 |
CSC lasts 3 years. It goes inactive if the specialty certification it is attached to lapses.
How to study
Every day, clear Daily Review first: misses return tomorrow, and known questions space out toward exam day.
- Week 1: set your exam date, read the test plan, and take a baseline CSC Mock Exam.
- Weeks 1-2: Therapeutic Interventions, with subject practice, Level Up, and the Vasopressors and Inotropes, IABP Management, ECMO, Impella and CRRT One-Pagers.
- Weeks 3-4: Complications, with the Shock Types, Electrolyte Imbalances and Rhythm Gallery One-Pagers.
- Week 5: Procedures and Monitoring, with the Hemodynamic Normals and ABG Interpretation One-Pagers.
- Weeks 6-7: Weakest Subject and Trouble Questions, plus two timed Mock Exams.
- Week 8: let final-week review bring back past misses, skim your One-Pagers, and rest the day before.
Test-day tips
- Bring a current government photo ID with signature that matches your AACN record; no military or temporary ID.
- Test center: if you arrive more than 15 minutes late, you will not be admitted. Scratch paper is available on request.
- Remote: check in 15-30 minutes early and expect a room scan. No scratch paper; you get a digital notepad.
- Pace about 80 seconds per question, bookmark hard items, and answer every question. Guessing is not penalized.
- Two 5-minute breaks are allowed, but the clock keeps running.
- Drugs appear by generic name. While AACN makes the switch, some items also show the trade name.
Official resources
- CSC Certification page (eligibility, fees, apply)
- CSC Exam Handbook, August 2026 (8 sample questions, earlier plan)
- CSC Test Plan and Exam Bibliography, effective 11/19/2026
- Certification Exam Policy Handbook, September 2026 (test-day rules)
- Exam Statistics and Cut Scores
- AACN CSC practice exam (free 30-question trial)
AACN says current CSC study materials remain useful for the revised exam. Its bibliography lists 18 references used to validate items. Three cardiac texts:
- Bojar. Manual of Perioperative Care in Adult Cardiac Surgery, 6th ed., 2021
- Hardin, Kaplow. Cardiac Surgery Essentials for Critical Care Nursing, 4th ed., 2025
- Jacobson, Marzlin, Webner. Cardiovascular Nursing Practice, 3rd ed., 2021
CSC® and CCRN® are registered service marks of AACN Certification Corporation; other credentials belong to their owners. ICU Basics is independent and is not affiliated with, endorsed by or sponsored by AACN.
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Sources
- AACN Certification Corporation. CSC Exam Handbook. August 2026. Link
- AACN Certification Corporation. Cardiac Surgery Certification (CSC) Test Plan. Effective 11/19/2026. Link
- AACN Certification Corporation. CSC 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. CSC Certification (Adult). Link
- AACN. Revised CMC and CSC Exams Launch Nov. 19, 2026. August 19, 2026. Link
- AACN. 2025 National Practice Analysis of Cardiac Surgery Nurses (CSC Study of Practice). Link
- AACN. Frequently Asked Questions About CMC and CSC Certification. Link
- AACN. CSC Adult Certification Practice Exam and Questions, Free Trial. Link