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100+ Free CMSN(C)® Practice Questions

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2026 Statistics

Key Facts: CMSN(C)® Exam

165

Max Exam Questions

CNA

4 hours

Exam Time Limit

CNA

$588

CNA Member Fee (CAD)

CNA 2026

1,950

Required Practice Hours

CNA Option A

5 years

Certification Validity

CNA

5

CAMSN Standards

CAMSN

The CMSN(C) exam features 160-165 multiple-choice questions over a 4-hour time limit. It is the national specialty certification for Registered Nurses in Canada, validating advanced expertise across physiological health, psychosocial care, client education, health promotion, and professional nursing ethics.

Sample CMSN(C)® Practice Questions

Try these sample questions to test your CMSN(C)® exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A client admitted with suspected acute coronary syndrome (ACS) reports crushing chest pain radiating to the left jaw. What is the nurse's priority action?
A.Obtain a 12-lead electrocardiogram (ECG) immediately
B.Administer the prescribed sublingual nitroglycerin tablet
C.Draw venous blood samples for cardiac troponin levels
D.Reassure the client and encourage deep breathing exercises
Explanation: Obtaining a 12-lead ECG is the highest priority for a client with suspected acute coronary syndrome. This diagnostic test must be performed within 10 minutes of arrival to identify ST-segment elevation. Prompt identification of a STEMI determines the need for immediate reperfusion therapy.
2A client with New York Heart Association (NYHA) Class III heart failure is being discharged home. Which instruction is most critical for the nurse to include in the discharge teaching?
A.Weigh yourself daily at the same time and report a gain of 2 kg in 2 days
B.Restrict daily fluid intake to exactly 1.5 litres unless otherwise directed
C.Increase dietary potassium intake by consuming bananas and oranges daily
D.Perform moderate-intensity aerobic exercise for 45 minutes every day
Explanation: Daily weight monitoring is the most critical self-management strategy for clients with heart failure to detect fluid retention. A weight gain of 1.5 to 2 kg over 2 to 5 days indicates worsening fluid accumulation. Early reporting allows for adjustment of diuretic doses to prevent hospitalization.
3A client taking lisinopril for hypertension presents to the clinic complaining of a persistent, dry, hacking cough. What is the nurse's best response?
A.Explain that this is a common side effect of the medication and needs to be reported to the physician
B.Advise the client to use an over-the-counter cough suppressant containing dextromethorphan
C.Recommend that the client stop taking the lisinopril immediately until they see the doctor
D.Suggest drinking warm water with honey and lemon to soothe the irritated throat
Explanation: A persistent dry cough is a common side effect of ACE inhibitors like lisinopril due to bradykinin accumulation in the respiratory tract. The nurse must advise the client to report this to their physician. The medication will likely be switched to an angiotensin II receptor blocker (ARB).
4A client with atrial fibrillation on warfarin presents with an INR of 6.5 and reports bleeding gums. The client recently started metronidazole for a dental infection. What is the priority nursing action?
A.Hold the next warfarin dose, notify the provider, and prepare to administer vitamin K as prescribed
B.Administer the scheduled warfarin dose and reassess the INR in one week
C.Increase the warfarin dose to counteract a presumed dietary vitamin K surge
D.Discontinue the metronidazole immediately and resume the warfarin at the same dose
Explanation: An INR of 6.5 with active bleeding is dangerously supratherapeutic. Metronidazole is a CYP450 inhibitor that potentiates warfarin by inhibiting its metabolism, significantly raising the INR. The priority is to hold warfarin, notify the provider for possible vitamin K reversal, and monitor the client closely. This requires integrating pharmacology, lab interpretation, and bleeding risk assessment.
5The nurse is caring for an obese client who is on bed rest following major abdominal surgery. Which intervention is most effective for preventing deep vein thrombosis (DVT)?
A.Apply sequential compression devices (SCDs) and administer low-molecular-weight heparin as prescribed
B.Perform passive range-of-motion exercises of the upper extremities every 4 hours
C.Place a pillow under the client's knees to keep the hips and knees flexed
D.Restrict fluid intake to prevent fluid overload and subsequent venous pooling
Explanation: The combination of mechanical prophylaxis (SCDs) and chemical prophylaxis (low-molecular-weight heparin) is the gold standard for DVT prevention in postoperative clients. SCDs promote venous return, while heparin prevents thrombin activation. Together, they target multiple risk factors of Virchow's triad.
6A client with a history of peripheral arterial disease (PAD) reports severe pain in the calf muscles when walking short distances. The pain resolves after resting for 5 minutes. What term should the nurse use to document this finding?
A.Intermittent claudication
B.Paresthesia
C.Raynaud's phenomenon
D.Rest pain
Explanation: Intermittent claudication is the classic symptom of peripheral arterial disease. It is characterized by ischemic muscle pain in the lower extremities that is triggered by exercise and relieved by rest. This occurs because narrowed arteries cannot meet the metabolic demands of active muscles.
7A client is admitted to the emergency department with an acute asthma exacerbation. The client is tachypneic, using accessory muscles, and has audible wheezing. Which medication should the nurse prepare to administer first?
A.Salbutamol via nebulizer
B.Fluticasone propionate via metered-dose inhaler
C.Salmeterol via dry powder inhaler
D.Methylprednisolone intravenously
Explanation: Salbutamol is a short-acting beta-2 agonist (SABA) that rapidly relaxes bronchial smooth muscle to relieve acute bronchospasm. It is the first-line rescue medication for acute asthma exacerbations. Nebulized administration ensures rapid delivery during severe distress.
8The nurse is caring for a client with chronic obstructive pulmonary disease (COPD) who is receiving oxygen therapy. Which respiratory assessment finding should prompt the nurse to intervene immediately?
A.A decrease in respiratory rate from 18 to 8 breaths per minute
B.An oxygen saturation (SpO2) reading of 90% on 2 L/min nasal cannula
C.The presence of a productive cough with thick, white sputum
D.Audible coarse crackles at the lung bases that clear with coughing
Explanation: A decrease in respiratory rate to 8 breaths per minute indicates respiratory depression, which is a major risk in hypercapnic COPD clients. Excessive oxygen administration can blunt their hypoxic drive, leading to hypoventilation and carbon dioxide narcosis. The nurse must assess the client's ventilation and adjust oxygen therapy immediately.
9A client with lobar pneumonia has been receiving intravenous antibiotics for 24 hours. Which assessment finding indicates to the nurse that the treatment is ineffective and the client's condition is deteriorating?
A.New onset of confusion and restlessness
B.A temperature of 38.2 C (100.8 F)
C.White blood cell count of 11.5 x 10^9/L
D.Rust-colored sputum production during coughing
Explanation: In an older or acutely ill client, a new onset of confusion and restlessness is an early sign of hypoxia. It suggests that the pneumonia is worsening, leading to impaired gas exchange and inadequate cerebral oxygenation. The nurse must perform a comprehensive respiratory assessment and notify the provider.
10The nurse is performing tracheostomy suctioning for a client. Which action is essential to prevent hypoxia during the procedure?
A.Limit each suction pass to a maximum of 10 to 15 seconds
B.Apply continuous suction while inserting the catheter
C.Instill 5 mL of sterile normal saline into the trachea before suctioning
D.Set the suction pressure to 180 to 200 mmHg
Explanation: To prevent hypoxia, each suction pass must be limited to 10 to 15 seconds, and the client must be hyperoxygenated before and after the procedure. This time limit prevents excessive oxygen depletion from the airway. The nurse should also allow the client to rest between passes.

About the CMSN(C)® Exam

The Certified in Medical-Surgical Nursing (Canada) or CMSN(C) designation is the national specialty credential for Canadian Registered Nurses specializing in adult medical-surgical nursing. Offered by the Canadian Nurses Association (CNA), the exam assesses clinical competence across the five National Practice Standards established by the Canadian Association of Medical and Surgical Nurses (CAMSN): Physiological Health, Psychosocial Health, Teaching and Learning, Promoting Health, and Professional Practice. The credential validates a high level of specialized knowledge, skill, and clinical judgment in caring for clients with acute, chronic, and complex health variations.

Assessment

160-165 multiple-choice questions

Time Limit

4 hours

Passing Score

Determined by Angoff method

Exam Fee

$588 CAD for members / $780 CAD for non-members (Canadian Nurses Association (CNA))

CMSN(C)® Exam Content Outline

55%

Physiological Health

Managing client care related to cardiovascular, respiratory, gastrointestinal, renal, endocrine, neurological, musculoskeletal, oncology, perioperative, wound/skin care, infection control, and pain management.

15%

Psychosocial Health

Assessing and addressing delirium, dementia, anxiety, depression, coping styles, substance use and withdrawal, spiritual distress, and palliative or end-of-life care.

10%

Teaching and Learning

Developing and evaluating patient-centered education, teaching strategies (e.g. teach-back), barriers to learning, discharge planning, and health literacy.

10%

Promoting Health

Implementing falls prevention programs, risk reduction strategies, screening guidelines, immunizations, and encouraging lifestyle modifications.

10%

Promoting Health

Implementing falls prevention programs, risk reduction strategies, screening guidelines, immunizations, and encouraging lifestyle modifications.

10%

Professional Practice

Applying the CNA Code of Ethics, legal frameworks (such as informed consent, emergency consent, MAID), delegation to unregulated care providers (UCPs), interdisciplinary communication, SBAR, and quality improvement.

How to Pass the CMSN(C)® Exam

What You Need to Know

  • Passing score: Determined by Angoff method
  • Assessment: 160-165 multiple-choice questions
  • Time limit: 4 hours
  • Exam fee: $588 CAD for members / $780 CAD for non-members

Keys to Passing

  • Complete 500+ practice questions
  • Score 80%+ consistently before scheduling
  • Focus on highest-weighted sections
  • Use our AI tutor for tough concepts

CMSN(C)® Study Tips from Top Performers

1Familiarize yourself with the 5 National Practice Standards developed by the Canadian Association of Medical and Surgical Nurses (CAMSN).
2Prioritize physiological nursing interventions (fluid balance, perioperative safety, and system-specific care), which make up 55% of the exam content.
3Review the differences between DKA and HHS, and the diagnostic parameters and immediate priorities for each.
4Study atypical presentations of disease in older adults, such as acute confusion/delirium indicating a urinary tract infection or dehydration.
5Understand the legal and ethical guidelines in Canada regarding informed consent, delegation to unregulated care providers (UCPs), and Medical Assistance in Dying (MAID).
6Use practice questions to build stamina for the 4-hour, 160-165 question exam format.

Frequently Asked Questions

What is the CMSN(C) designation?

The CMSN(C) (Certified in Medical-Surgical Nursing (Canada)) is the national specialty credential for Canadian Registered Nurses (RNs) specializing in adult medical-surgical nursing, administered by the Canadian Nurses Association (CNA).

What are the eligibility requirements for the CMSN(C) exam?

Candidates must hold an active RN license in a Canadian province or territory. Under Option A, you need at least 1,950 hours of experience in medical-surgical nursing within the past 5 years. Under Option B, you need 1,000 hours of experience plus a formal post-basic specialty course of at least 300 hours completed in the last 10 years.

How long is the CMSN(C) certification exam?

The exam consists of 160 to 165 multiple-choice questions, and you are given 4 hours (240 minutes) to complete it. Testing is computer-based and can be proctored online via ProctorU or in person at Meazure Learning centers.

What is the passing score for the CMSN(C)?

The passing mark is established using the modified Angoff method by an expert panel of medical-surgical nurses. Results are reported on a pass/fail basis rather than as a numerical grade, and candidates typically receive their results 4 weeks after the exam window closes.

How much does the CMSN(C) exam cost?

The application fee is $588 CAD for CNA members and $780 CAD for non-members. Proctoring fees may add $85 for online or $110 for in-person testing. If you need to rewrite the exam, the fee is $378 CAD for members and $500 CAD for non-members.

How do I maintain my CMSN(C) certification?

CNA certifications are valid for 5 years. You can renew either by accumulating 100 continuous learning hours related to medical-surgical nursing over the 5-year term, or by rewriting the certification exam.