CNRN Certification

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The Certified Neuroscience Registered Nurse credential was created in 1978 under the direction of the American Association of Neurosurgical Nurses (AANN), which is now known as the American Association of Neuroscience Nurses.[1] The American Board of Neuroscience Nursing (ABNN) is the independent organization which designs and implements the CNRN certification program and examination.[2] The ABNN most recently revised the content outline of the CNRN exam in 2014 following a role delineation study. Previous role delineation studies were completed in 1996, 1997, 2001, 2005, and 2009.[1]

Function of the Test

CNRN Study Guide

CNRN is a nationally-accredited professional nursing credential. Candidates for the CNRN examination must have current, unrestricted licensure as a Registered Nurse and be a practicing professional in the field of Neuroscience Nursing, whether in clinical practice, consulting, research, administration, or education. Candidates must also have a documented record of at least 4,160 hours of practice in the field within the past five years.[1]

Because candidates must already be RNs to take the CNRN exam, certification in neuroscience nursing does not confer any additional licensure privileges; however, certification is beneficial as an exercise in professional development, motivating candidates to improve their skills and abilities and enhancing their future career prospects. The ABNN reports that one of its primary purposes is to advance and promote the field of neuroscience nursing by maintaining a credentialing program for neuroscience nursing professionals.[1]

As of the end of 2013, there were 4,643 current CNRNs, of whom 554 earned the certification for the first time in that year. The CNRN certification expires after five years. Those who wish to renew the credential can retake the certification exam or submit documentation of continuing education hours and work hours.[1]

Test Administration

CNRN Flashcards

The CNRN exam is a computer-based exam which is offered at over 200 Iso-Quality testing centers.[1] The examination is administered during three months of the year: March, July, and October. The deadline for any given testing window is about one and a half months before the testing month begins.[1] The fee to take the examination is $285 for AANN members and $380 for non-members. An additional $25 fee applies for candidates who pay by check instead of credit card.[1]

The examination comprises 220 multiple-choice questions and has a time limit of four hours. Candidates receive an unofficial pass/fail score report immediately following the examination. Official scores follow by mail approximately one month after the conclusion of the exam window.[1] For example, if one candidate took the examination on March 1st and another took the examination on March 31st, both would expect to receive official scores in late April or early May.

Unsuccessful candidates who wish to retake the exam may do so as often and as many times as they wish, though because the test is only administered in three windows per year, there is a de facto limit of three attempts per year. In addition, repeat test takers must submit a new application and exam fee for each attempt.[1]

Candidates who require special testing accommodations for a disability should submit a request for accommodations to the ABNN.[3] There does not appear to be any special deadline for the submission of accommodation requests.

Test Format

Test Structure

The CNRN exam contains 220 multiple choice questions that have to do with two major topics. The first one covers Disorders, which is broken down into seven categories: Trauma; Cerebrovascular; Tumors; Immune/Infection; Seizures; Pediatric and Developmental; and Chronic Neurological. The second topic, Interventions, deals with: Basic Physiological; Complex Physiological; Behavioral; Family and Culture; Safety; and Health System. The time allotted to take the test is four hours.[4]

Test Environment

It is recommended to arrive at least half an hour before the exam is scheduled to begin. This allows time to locate and check in to the testing center. The CNRN is computer-based, and proctored by Iso-Quality Testing centers. For admission, a printed confirmation of the test, and the user ID and Passcode are required.[5]

Test Content

  • Sample CNRN Practice Questions
  1. The most accurate statement concerning patient age and treatment outcomes for cerebral aneurysm is:
    A. For all accepted types of treatment, outcomes are not correlated with age.
    B. Above age 65, there is a higher incidence of negative treatment outcomes, even though the surgical complication rate is the same.
    C. Above age 65, the incidence of negative treatment outcomes and the incidence of surgical complications are both higher.
    D. Only ultra-soft coils have an acceptable success rate in patients over age 65.
  2. The MOST COMMON source of infection leading to brain abscesses is
    A. Direct CNS invasion from otitis media and mastoiditis
    B. Sinusitis
    C. Hematogenous spread from distant infected sites, such as pneumonia, lung abscess, or bacterial endocarditis
    D. Accidental trauma and surgical injury
  3. The MOST common cause and radial nerve injury is:
    A. A fractured humerus
    B. A fractured radius
    C. A fractured ulna
    D. Shoulder dislocation
  4. Many histologically benign brain tumors prove to be fatal because:
    A. They undergo malignant transformation
    B. They are in locations that are surgically inaccessible, so they continue to grow
    C. They constitute a seizure focus, and the patient succumbs in status epilepticus
  5. All of the following are risk factors for spina bifida EXCEPT:
    A. Pre-pregnancy maternal obesity
    B. Maternal diabetes
    C. Birth trauma
    D. Maternal folic acid deficiency
  6. Dietary management of a patient with hypokalemic periodic paralysis includes:
    A. Avoidance of caffeine
    B. Avoidance of high-protein meals
    C. Avoidance of high-carbohydrate meals
    D. Calcium supplementation
  7. The MOST COMMON natural history of degenerative disc disease without radiculopathy in lumbar spine is:
    A. Gradual, steady worsening pain over time without other symptoms
    B. Relentless spread to adjacent discs
    C. Gradual improvement over time
    D. Gradual development of radiculopathy and/or instability over time
  8. The MOST practical system of communication that can be implemented by the nurse for a patient with locked-in syndrome is:
    A. A simple system of eye blinks and other eye movements to correlate with simple responses, such as "yes" and "no"
    B. Functional muscular stimulation using electrodes to stimulate the muscles of speech
    C. A laptop computer driven by the patient's eye movements
    D. A spelling board
  9. Which of the following is the MOST likely contraindication preventing a 70-year-old lacunar stroke patient with diabetes from receiving a fibrinolytic infusion?
    A. History of ischemic stroke 2 years earlier.
    B. Daily use of (low-dose) aspirin 160 mg.
    C. Acute uncontrolled hypertension (200/120)
    D. Platelet count of 130,000

More free CNRN practice test questions.


Scores on the CNRN are based on candidates' answers to 200 scored multiple-choice items. Twenty or more additional unscored pretest items which are being assessed for future use are also included on the examination.[1]

The CNRN examination's content is divided into seven categories of disorders and six categories of interventions. It is not clear exactly how many questions are dedicated to disorders and how many are dedicated to interventions, but overall, the content on the exam is distributed as follows:

Distribution of questions on the CNRN[1]
Disorders Interventions
Category  % of
Category  % of
Trauma 18% Basic Physiological 20%
Cerebrovascular 26% Complex Physiological 36%
Tumors 13% Behavioral 15%
Immune/Infection 11% Family and Culture 9%
Seizures 9% Safety 11%
Pediatric and Developmental 8% Health System 9%
Chronic Neurological 15%
Total 100% Total 100%

Candidates' scores are scaled to account for slightly different levels of difficulty between versions of the CNRN exam. In this way, scores can be compared fairly between candidates who took different versions of the test.

The ABNN does not appear to publish specific passing scores for the CNRN exam. However, in 2013, the passing rate for the CNRN exam was 84%.[6] The content outline of the examination has been revised since then, however.[1]

Recent Developments

The current content outline of the CNRN examination is based on a role delineation study which was conducted by the ABNN from 2013 to 2014.[1][6] As of early 2015, pass rate statistics are not yet available for this version of the exam.


  1. ^ a b c d e f g h i j k l m n ABNN - Certified Neuroscience Registered Nurse (CNRN) 2015 Candidate Handbook January 29 2015
  2. ^ AANN - ABNN Certification January 29 2015
  3. ^ ABNN - Request for Exam Accommodation Form January 29 2015
  4. ^ CNRN Candidate Handbook 14 July 2014
  5. ^ CNRN Candidate Handbook 14 July 2014
  6. ^ a b AANN - 2013 AANN Annual Report January 29 2015