Medical-Surgical Nurse Exam Overview

Medical-surgical nursing is one of the most rewarding nursing fields to work in. It is also one of the most challenging. These registered nurses care for patients before and after surgical procedures. They assist in patient care, pain management, and patient education. They do not just work inside hospitals. They also care for patients in ambulatory care centers, nursing homes, home health care, and clinics.

Many medical-surgical nurses are turning towards certification to distinguish themselves in the nursing field. A certification is confirmation that you are able to safely and competently provide the best in patient care. Hospitals, doctors, and state licensing boards do not require you to earn a certification. It is something that you earn voluntarily.

Passing the Medical-Surgical Nurse Exam is one of the key steps necessary to become a certified medical-surgical nurse. The exam is administered through the American Nursing Credentialing Center (ANCC), “the world’s largest and most prestigious nurse credentialing organization.” It is a content driven exam. You will only be asked questions that are specific to medical-surgical nursing.

The Medical-Surgical Nurse Exam consists of 175 multiple choice questions. Only 150 of these questions will count towards your overall score. The remaining 25 questions are considered “pretest questions” and will not count towards your score. However, these questions will not be flagged as pretest questions. So, you will never know which questions do or do not count towards your overall score. The actual exam will take 3 ½ hours to complete.

The exam was developed by a Content Expert Panel. The panel reviewed the key job skills, knowledge, and abilities medical-surgical nurses must possess in order to be successful. Exam questions will focus on four domains of practice. The more important the domain, the more questions you will receive about that domain.

  • Assessment and Diagnosis
  • Planning, Implementation, and Outcomes Evaluation
  • Professional Role
  • Health Teaching and Health Promotion

A medical-surgical nurse must hold a current RN license to sit for this exam. He will also need to have completed at least 2,000 clinical hours of medical-surgical nursing and 30 hours of continuing education programs within the last three years. All of these requirements must be met before you ever submit your application.

This exam is a computer-based test and is offered at hundreds of testing centers around the country. You do not have to be computer literate in order to pass. You will have the option of taking a 20 minute tutorial before the exam begins. Taking the tutorial is recommended regardless of how skilled you are in using the computer. The tutorial does not count towards your score and the time does not go against your actual exam time. It will help you become more comfortable using the computer and flagging questions.

You will know whether you passed or failed the Medical-Surgical Nursing Exam before you ever leave the testing center. To pass, you must earn a scaled score of at least 350. Your score will be based on the number of questions you answer correctly. So, you should guess if you are unsure of an answer. If you fail the exam, you will be able to retake it. However, candidates cannot test more than 3 times in any 12 months. You will receive a diagnostic score report to help you understand which domain areas you need to focus your studies on.

Once you pass the exam, you will become a certified medical-surgical nurse. A certificate, lapel pin, and wallet card will be mailed to you. You will also be able to send verification of certification reports to your employer. However, your certification status only lasts for 5 years. To keep your certification current, you will need to complete a series of continuing education programs.

To succeed on this exam, you must spend time preparing. The ANCC recommends developing a study plan at least 6 months before you want to schedule an exam. The questions on the exam can be quite detailed. You will not succeed if you take the test cold.

Should You Take the Medical-Surgical Nurse Exam?

Medical-surgical nurses may wonder just how beneficial taking the Medical-Surgical Nurse exam really is. There is no denying that you will have to spend months preparing for the exam. If you don’t pass on your first attempt, you will have to pay to take the exam once again. However, the benefits of becoming certified in your field far outweigh the money and time you end up spending.Should You Take the Medical-Surgical Nurse Exam?

Certification, for the most part, is a voluntary process. Candidates who take this exam are confident in their abilities and want an independent professional group to certify those abilities. Employers tend to value nurses more who take the initiative to become certified. It shows these nurses are dedicated to their career. They are motivated to prove to their patients and employers that they are some of the best nurses in the field.

The American Nursing Credentialing Center (ANCC) conducted a survey among nursing managers to gauge the importance of certification. These managers stated that “certification validates specialized knowledge, indicates a level of clinical competence, and enhances professional credibility.” Additional research has shown that certification also leads to improved patient care and a reduction in medical errors.

The Medical-Surgical Nurse exam will take 3 ½ hours to pass. Once you pass, you are awarded a certification that is valid for the next five years. During those five years, you can expect to see some of the following benefits.

  • Self-Confidence Boost – It is human nature to enjoy being told that you are good at something. Passing the Medical-Surgical Nurse exam does just that. It provides a huge confidence boost. You now have independent confirmation that you are more than competent in your job. Your decision-making abilities improve because you aren’t second-guessing yourself anymore. Your increased confidence comes through as you treat your patients, giving them even better care. Nursing managers take notice and begin offering you more variety in your assignments. Your job becomes more enjoyable because you know you have what it takes to succeed.
  • Increased Knowledge – Professional development is a key component of the certification process. You will be required to complete a certain number of professional development hours in order to become certified. However, the learning does not stop once you earn this certification. To keep your certification, you must spend at least 150 hours learning and improving your skills. This will not only help you increase your knowledge base, but it will help you perform your job even better. There will always be a few skills that you need to improve on. Certification allows you to take classes to improve those skills and get professional credit for them. It also helps you take initiative on problem areas in your department. You can take classes to help solve those areas, receive professional development credit, and win points with your manager.
  • Improved Career and Income Opportunities – It is a fact that doctors and hospitals prefer to work with certified medical-surgical nurses. These employers know that certified nurses have the skills, competencies, and experience needed to provide the best patient care. A survey conducted by the American Board of Nursing Specialties found that nursing managers “overwhelmingly prefer to hire certified nurses because certification attests to an individual’s proven knowledge base and documented experience in a given specialty.” More than 90% of the managers surveyed indicated they would hire a certified medical-surgical nurse over a non-certified nurse. Your income opportunities will also increase. Employers are willing to pay more for people who can exhibit competencies in the field. A separate nursing salary survey indicated that certified nurses can command up to $9,000 more a year than non-certified nurses.
  • Employer Sponsored – Some nurses may be worried about the added expense of registering for the exam and completing all of the professional development requirements. Many employers will assist you with these fees. It is extremely beneficial for a hospital or clinic to tout how many certified nurses they have on staff. So, they are often more than willing to help you out with the expense. Plus, employer required classes, seminars, or workshops can often be used towards your professional development requirements. Make sure that you understand the implications of having your employee assist you with these fees. Some may require you to work a certain length of time to avoid having to repay the money. Others may dictate which classes you must take.

Registering for the Medical-Surgical Nurse Exam

The American Nursing Credentialing Center (ANCC) has laid out specific eligibility requirements for this exam. So, not every medical-surgical nurse will be able to sit for it. This exam is designed to test basic entry-level knowledge along with knowledge you have gained working in the industry.Registering for the Medical-Surgical Nurse Exam

Who Can Register
The medical profession takes earning a certification seriously. The certification is one more tool a doctor or hospital can use to show they are hiring the best patient care providers. They must be assured that the certification is not just awarded to any nurse. A certification is only valued if specific standards are required. Medical-surgical nurses must meet the following requirements to sit for this exam.

  • Have an unexpired, active RN license
  • Practiced as a registered nurse full-time at least 2 years
  • Completed at least 2,000 clinical medical-surgical nursing hours over the past 3 years
  • Completed at least 30 hours of continuing education related to medical-surgical nursing over the past 3 years.

Each of these requirements must be completed before you submit your application. You cannot plan on completing your remaining 200 clinical hours by the time you want to take the Medical-Surgical Nurse Exam.

Required Documentation
Registration for the exam is done through ANCC. Each candidate will be required to submit an application 2 – 3 months before they want to sit for the exam. The application form is quite extensive. Make sure to carefully fill it out. If there are any omissions, it will delay the process for weeks. The form will ask you about your current employer and any primary nursing positions that you have held. The Professional Development Record section will document your continuing education work. You will have list the courses you took, where you took the course, when you took the class, and the number of contact hours. You are not required to send in the actual certificates of completion. However, you should have that information handy. ANCC may decide to do some spot audit-checks. Your will also be required to submit a copy of your current RN license.

Registration fees must be paid when you submit your application. The registration fee will vary from year to year. Members of the American Nursing Association are eligible for a discount. Medical-surgical nurses who practice in the Department of Defense or U.S. Department of Veteran Affairs medical facilities may also be eligible for a registration fee discount.

You can submit an application online or via regular mail. If you apply online, you will immediately be sent a Receipt of Application Notice. If you mail your application, it can take up to 4 weeks to receive the Notice. This notice only lets you know that ANCC received your information. It does not give you any authority to schedule the exam.

ANCC will carefully review your application to make sure all requirements have been completed. Then, they will send out an Eligibility Notice or a letter requesting further information. This notice can take between 2 (if you applied online) and 6 (if you applied via regular mail) weeks to receive. If your application has been denied, you will receive a partial registration fee refund. ANCC keeps a portion of your registration fee for administrative costs.

Registering for the Exam
Your Eligibility Notice will give you a 90 day window period to schedule the exam. If you are unable to schedule an exam during that 90 day period, you can request a one-time extension. However, you will have to pay a non refundable fee for this extension.

This exam is offered at Prometric Testing Centers located throughout the country. Most of these centers will offer the exam 6 days a week. Remember that it is your responsibility to schedule your Medical-Surgical Nurse Exam. You can schedule the exam at a time convenient for you, but do not wait until the last minute to make an appointment. Prometric testing centers do not just administer exams for ANCC. They offer a wide variety of exams throughout the day. Spots will fill up quickly, especially on the weekends. If you fail to make an appointment during your 90 day window, your registration fee will be forfeited and you will need to complete the application process once again.

Registering for the Medical-Surgical Nurse Exam

The American Nursing Credentialing Center (ANCC) has laid out specific eligibility requirements for this exam. So, not every medical-surgical nurse will be able to sit for it. This exam is designed to test basic entry-level knowledge along with knowledge you have gained working in the industry.Registering for the Medical-Surgical Nurse Exam

Who Can Register
The medical profession takes earning a certification seriously. The certification is one more tool a doctor or hospital can use to show they are hiring the best patient care providers. They must be assured that the certification is not just awarded to any nurse. A certification is only valued if specific standards are required. Medical-surgical nurses must meet the following requirements to sit for this exam.

  • Have an unexpired, active RN license
  • Practiced as a registered nurse full-time at least 2 years
  • Completed at least 2,000 clinical medical-surgical nursing hours over the past 3 years
  • Completed at least 30 hours of continuing education related to medical-surgical nursing over the past 3 years.

Each of these requirements must be completed before you submit your application. You cannot plan on completing your remaining 200 clinical hours by the time you want to take the Medical-Surgical Nurse Exam.

Required Documentation
Registration for the exam is done through ANCC. Each candidate will be required to submit an application 2 – 3 months before they want to sit for the exam. The application form is quite extensive. Make sure to carefully fill it out. If there are any omissions, it will delay the process for weeks. The form will ask you about your current employer and any primary nursing positions that you have held. The Professional Development Record section will document your continuing education work. You will have list the courses you took, where you took the course, when you took the class, and the number of contact hours. You are not required to send in the actual certificates of completion. However, you should have that information handy. ANCC may decide to do some spot audit-checks. Your will also be required to submit a copy of your current RN license.

Registration fees must be paid when you submit your application. The registration fee will vary from year to year. Members of the American Nursing Association are eligible for a discount. Medical-surgical nurses who practice in the Department of Defense or U.S. Department of Veteran Affairs medical facilities may also be eligible for a registration fee discount.

You can submit an application online or via regular mail. If you apply online, you will immediately be sent a Receipt of Application Notice. If you mail your application, it can take up to 4 weeks to receive the Notice. This notice only lets you know that ANCC received your information. It does not give you any authority to schedule the exam.

ANCC will carefully review your application to make sure all requirements have been completed. Then, they will send out an Eligibility Notice or a letter requesting further information. This notice can take between 2 (if you applied online) and 6 (if you applied via regular mail) weeks to receive. If your application has been denied, you will receive a partial registration fee refund. ANCC keeps a portion of your registration fee for administrative costs.

Registering for the Exam
Your Eligibility Notice will give you a 90 day window period to schedule the exam. If you are unable to schedule an exam during that 90 day period, you can request a one-time extension. However, you will have to pay a non refundable fee for this extension.

This exam is offered at Prometric Testing Centers located throughout the country. Most of these centers will offer the exam 6 days a week. Remember that it is your responsibility to schedule your Medical-Surgical Nurse Exam. You can schedule the exam at a time convenient for you, but do not wait until the last minute to make an appointment. Prometric testing centers do not just administer exams for ANCC. They offer a wide variety of exams throughout the day. Spots will fill up quickly, especially on the weekends. If you fail to make an appointment during your 90 day window, your registration fee will be forfeited and you will need to complete the application process once again.

Medical-Surgical Nurse Exam Content

The Medical-Surgical Nurse Exam is a content driven exam. Its sole focus is to measure your understanding of concepts critical to the medical-surgical nursing profession. These multiple choice questions are not designed to trick you. There aren’t any complex reading passages to decipher or trigonometry problems to solve. Each question is designed to test your knowledge of concepts essential to the field.

Medical-Surgical Nurse Exam ContentThis exam is highly respected because of the process used to develop it. Content panel experts in the field of medical surgical nursing analyze job surveys to determine which abilities and skills are essential. Then, a team of certified nurses write exam questions based on the results of the analysis. The questions are reviewed by the experts to ensure they meet certain psychometric and validity standards. This stringent process is used to ensure that the test is appropriately vetted. Employers can be confident that the exam measures the key functions necessary to be successful.

There are 175 questions on this exam, but only 150 questions will count towards your overall score. The other 25 questions are called experimental or pretest questions. Unfortunately, you never know which questions count towards your overall score. Do your best to answer every question. Your score will be based on the number of questions you answered correctly.

You are given the option of taking a 20 minute tutorial before the Medical-Surgical Nurse Exam starts. Many people are not familiar or comfortable taking an exam on the computer. This tutorial gives you the chance to become familiar with the exam format, shows you how to flag questions you may want to return to, and helps you manage the time clock. Since it is practice, your answers do not count towards your score. Nor does the time you spend on the tutorial count towards your 3/12 hours. It will also give you the chance to ask the testing center staff any computer related questions before the exam clock begins. The exam concludes with a short 10 minute survey. This survey is your opportunity to give your opinion of the exam. Your responses may be used to help shape future Medical-Surgical Nurse Exams.

Medical-Surgical Nurse Exam Test Day Procedures

The Medical-Surgical Nurse Exam is offered exclusively through Prometric testing centers. Each testing center will follow the same procedures and policies for administering this exam. It is essential to become familiar with these procedures before the day of the exam. Serious consequences will occur if you fail to comply. You may not be seated for the exam and your registration fee could be forfeited.

You are advised to arrive at the testing center at least 15 – 30 minutes before your scheduled exam time. These extra minutes should give you plenty of time to check-in and get situated before the exam starts. If you arrive after your scheduled appointment time, Prometric does not have to seat you. Arriving more than 30 minutes after your scheduled appointment is considered a “no show.” Your 90 day testing window automatically expires. If you want to reschedule, you will have to pay a fee to open up a new 90 day testing window period. This must be done no later than 60 days from the date the initial window period expired.

Identification and Fingerprinting
You will be asked to present identification during the check-in process. Your identification can be a driver’s license, passport, United States military identification, or state issued identification card. It must be no older than 10 years and display your photograph and signature. You cannot present your college identification or employee identification badge. The testing center will only accept government issued identification. If you fail to bring proper identification, you will not be allowed to sit for the exam. You will be required to schedule a new window testing period for a fee.

You will also be required to provide a fingerprint scan before you are seated. Biometric scans are becoming quite common when taking computer-based standardized tests. Unfortunately, people have found all sorts of clever ways to cheat on these exams. Fingerprint scans ensure that you will not be able to switch places with someone who has already aced the test. If you leave the testing room for any reason, you will be asked for a fingerprint scan. You will be allowed back in the testing room if your fingerprint scans match up. All scans are erased within 24 hours to protect your privacy.

What You Should Not Bring
Cell phones, calculators, purses, backpacks, watches, Kleenex, paper, pens, books, water, and food are prohibited inside the testing room. These items are prohibited primarily to deter cheating. If you are caught with any of these items, you may be asked to leave the testing room and your scores could be cancelled. The center does provide personal lockers where you can store your belongings. However, they do not assume any liability if something is taken.

Testing Room Conditions
Once you have completed the check-in procedures, you will be escorted into the testing room. A testing center staff member will assign you to a computer terminal. You are not allowed to pick which area of the room you want to sit in.

Before the actual exam begins, you are able to take a 20 minute tutorial. It doesn’t matter how skilled a computer user you are. You should take the tutorial to learn how to answer the questions and flag ones that might give you difficulty. It’s also your opportunity to ask the staff members any questions you might have. Staff members can answer general questions about the computer or testing room procedures. They will not be able to answer any questions specific to the Medical-Surgical Nurse exam. You are not allowed to speak with any of the other test-takers in the testing room.

There are no scheduled breaks during the Medical-Surgical Nurse exam. If you need to leave the room, you must raise your hand. A staff member will take your fingerprint scan and dismiss you. Keep in mind that the exam clock will not stop if you decide to take a break. Your fingerprint will be scanned once again when you re-enter the room.

It is unlikely, but you may experience computer issues that impact your test performance. If that occurs, you must alert a testing center staff member and note the issue on your survey. You will also need to contact ANCC directly.

Renewing Your Medical-Surgical Nurse Certification

Once you pass the Medical-Surgical Nurse exam, you will earn your certification. However, this certification is only valid for 5 years. Nursing is a field that is constantly evolving. Continuing education is essential in order to provide patients with the best care possible. The American Nursing Credentialing Center (ANCC) wants to make sure that medical-surgical nurses do not stop learning or practicing once they earn a certification. So, they require you to undergo a recertification process every 5 years.

You should submit your certification renewal application at least 3 months before you certification expires. ANCC will not backdate your certification if you send in your application a few days late. In fact, action can be taken against you if you claim to be certified after your certification has expired.

There are a variety of options you can choose from to complete the renewal requirements. These requirements cannot be completed a few months before your certification expires. They need to be completed throughout your 5 year certification period. Many employer sponsored workshops, seminars, or conferences can be used to fulfill the requirement.

Renewing Your Current Certification
There are two different paths for renewing your current certification. The path you choose will depend on how many clinical hours you have accumulated practicing medical-surgical nursing. If you do not have enough clinical hours, you will be required to retake the Medical-Surgical Nurse Exam. The exam will be the same exam people take during the initial certification process. However, the odds of you receiving the exact same test you took 5 years ago are quite slim. Let’s take a look at your two options.

  • Option A: Professional Development and Practice Hours – Have a current RN license, have a current ANCC certification, complete 75 continuing education (CH) hours over the past 5 years, and complete 1 or more of the 8 renewal categories for your certification credential within the five years preceding your renewal application submission.
  • Option B: Professional Development and Medical-Surgical Nurse Exam – Have a current RN license, have a current ANCC certification, complete 150 professional development hours over the past 5 years, and pass the Medical-Surgical Nurse Exam

ANCC has laid out specific guidelines for completing the professional development requirements. They have identified 6 different categories that professional development can fall into. You must complete work in at least two of these 6 categories: academic credits, continuing education credits, presentations, publication or research, preceptor (provide teaching or clinical supervision), or professional service (volunteering with a recognized health-care organization). Do not send transcripts or supporting documentation to prove that you have completed these requirements. ANCC will review your information and contact you if they have any questions or need proof.

When you submit your renewal application, you will also need to send your renewal fee. If you are taking the exam, this fee will cover the cost of sitting for the exam. If you fail the exam, you will be required to submit another application and another renewal fee.

What Happens if your Certification Expires?
Once your certification has expired, it has expired. ANCC is very strict and will not backdate or give you a grace period to renew your certification. This can have significant implications if your employer or state licensing board requires you to hold a certification. You are not allowed to claim certified status once your credentials have expired.

ANCC will still allow you to send in a renewal application. However, you will not just have to pay the standard renewal fee. You will also have to pay a reactivation fee. Here is a look at your renewal options for certifications that have expired.

  • Option C: Professional Development, Practice Hours, Certification Lapsed for less than 2 years: Have a current RN license, have a lapsed ANCC certification, complete 150 professional development hours over the past 5 years, and complete at least 1,000 practice hours in medical-surgical nursing
  • Option D: Professional Development and Medical-Surgical Nurse Exam (available for those who do not meet the practice hours requirement or have allowed their certification to lapse more than 2 years): Have a current RN license, have a lapsed ANCC certification, complete 150 professional development hours over the past 5 years, and pass the Medical-Surgical Nurse Exam

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