CSC Cardiac Surgery Certification

CSC certification at a glance

CSC — Cardiac Surgery Certification — recognizes RNs who deliver direct care to acutely/critically ill adult cardiac surgery patients in the first 48 hours postoperatively. The credential is issued by the AACN Certification Corporation, the certification arm of the American Association of Critical-Care Nurses. CSC is a subspecialty: it attaches to an existing nationally accredited clinical specialty certification — typically CCRN or PCCN — so it cannot be a candidate's first certification.

The CSC scope is post-op cardiac surgery care — coronary artery bypass grafting (CABG), valve repair and replacement, the MAZE procedure, and related vascular surgery, plus the bleeding, hemodynamic, pulmonary, and renal complications that follow. If your unit is a cardiothoracic surgery ICU, cardiovascular surgical ICU, open-heart recovery, or a PACU receiving fresh post-op hearts, CSC matches your day-to-day practice. CMC, the sibling subspecialty, covers acutely ill adult cardiac patients in cardiac medicine rather than the surgical first 48 hours.

Am I eligible for the CSC exam?

Yes — if you hold an active, unencumbered U.S. RN or APRN license, a current nationally accredited clinical nursing specialty certification (the CSC attaches to it), and you meet one of two clinical-practice-hour options.

AACN sets the hours specifically around adult cardiac surgery patients within the first 48 hours postoperatively. Hours must be completed in a U.S.- or Canada-based facility (or a comparable acute/critical-care setting) and must be verifiable by your clinical supervisor or a professional colleague if you are selected for audit.

You are eligible if…

• You hold an active, unencumbered U.S. RN or APRN license.
• You already hold a current nationally accredited clinical specialty certification (such as CCRN or PCCN) for the CSC to attach to.
• Two-Year Option: 1,750 hours of direct care of acutely/critically ill adult patients over the previous two years (875 in the most recent year), of which 875 hours were in adult cardiac surgery patients within the first 48 hours postoperatively.
• Five-Year Option: at least 2,000 hours over the previous five years (144 in the most recent year), of which 1,000 hours were in adult cardiac surgery patients within the first 48 hours postoperatively.

CSC exam blueprint — four domains

The CSC blueprint is four domains. Therapeutic Interventions (36%) and Complications (31%) together carry about two-thirds of the exam — most of your study time should live there. Procedures (19%) and Monitoring and Diagnostics (15%) round out the form.

The weighting reflects the bedside reality of the first 48 post-op hours: managing chest tubes, vasoactive drips, temporary pacing, ventilation, and tight glycemic control (interventions), then recognizing and responding to bleeding, tamponade, low cardiac output, dysrhythmias, and renal or pulmonary decline (complications). Candidates who know the surgical procedures but underprepare for complication recognition tend to lose the most points.

Cost, scheduling, and renewal fees

AACN delivers the CSC exam through its testing service, PSI, at PSI test centers, with a paper option also available. After AACN approves your application, you receive scheduling instructions — book your seat promptly to stay inside the testing window. Computer-based candidates receive a pass/fail score report at the end of the exam.

Renewal

CSC certification is valid for three years, beginning the first day of the month you passed the exam. Pathway 1 — Renewal by Synergy CERPs: earn 25 Category A Clinical Judgment CERPs within the three-year cycle and maintain continued clinical practice (432 hours of direct care of adult postoperative cardiac patients, with 144 hours in the most recent 12 months).

Pathway 2 — Renewal by Examination: retake and pass the current CSC exam. Because CSC attaches to an underlying CCRN or PCCN, most nurses sync the CSC renewal with that base credential. A lapsed CSC must be earned again by exam — there is no grace period.

How hard is the CSC exam?

The CSC passing standard is a cut score of 55 correct out of 75 scored items, in effect since 2022-01-31. The passing score is a raw number, not a percentage, set through the modified-Angoff method with PSI psychometricians. The 15 unscored pretest items do not count toward your result.

AACN reported a 52.2% first-time pass rate in 2025 (1,184 candidates tested), down from 51.3% in 2024 and 69.7% in 2023. The sharp drop from the high-60s to the low-50s likely reflects content updates following AACN's 2020 National Practice Analysis of Cardiac Surgery Nurses. The CSC is now one of AACN's harder subspecialty exams — structured, complication-focused preparation matters.

An 8-week CSC study plan

Eight weeks is enough for most cardiac surgery RNs who already hold CCRN or PCCN — roughly 60 to 100 total study hours across the four blueprint domains. Weight your time toward Therapeutic Interventions and Complications (about two-thirds of the exam), and finish with a full-length timed practice run plus a targeted review of weak areas.

How CSC candidates actually fail — and how to avoid it

Sample CSC question

This item mirrors AACN's scenario format for the post-op cardiac surgery patient: a short clinical stem and four plausible options where only one is best. Try it before reading the rationale.

Key CSC terms every candidate should know

These terms surface across CSC exam items. Review them until the definitions feel automatic — scenario stems often hinge on recognizing which post-op syndrome or intervention applies.

CSC vs. CMC, CCRN, PCCN

CSC sits alongside its sibling AACN credentials. The most common mix-up is CSC versus CMC — both are AACN cardiac subspecialty add-ons with the identical 90-item format, but they cover different patients.

Take CSC if most of your shift is fresh post-op cardiac surgery patients in their first 48 hours. Take CMC instead if your cardiac patients are medical rather than surgical. Either way, you must already hold a CCRN, PCCN, or another accredited specialty certification first — CSC and CMC are subspecialty add-ons, not standalone credentials.

Frequently asked questions about the CSC exam

Trusted sources

All figures on this page are verified against the following primary sources. Fees, blueprint weights, cut scores, and renewal rules shift on AACN's revision cycle — always verify numeric facts against the current AACN CSC Exam Handbook before relying on them for application decisions.

• AACN Certification Corporation — CSC (Adult) Get Certified page: eligibility, initial fees ($145 member / $235 non-member)
• AACN — Certification Exam Statistics and Cut Scores: CSC pass rates (2023 69.7%, 2024 51.3%, 2025 52.2%), 90 items / 75 scored, cut score 55 (effective 2022-01-31)
• AACN — CSC (Adult) Certification Renewal page: 3-year cycle, 25 Category A Clinical Judgment CERPs, 432/144 practice hours, renewal-by-exam fees
• AACN — CSC Exam Handbook: test plan, four-domain blueprint (Therapeutic Interventions 36%, Complications 31%, Procedures 19%, Monitoring and Diagnostics 15%), sample questions
• AACN — Frequently Asked Questions About CMC and CSC Certification: CSC vs CMC scope and the subspecialty add-on rule
• AACN — 2020 National Practice Analysis of Cardiac Surgery Nurses (Study of Practice): basis for current exam content

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