*Original post released 11/19/2020
If you’re a nurse in the ICU setting and are either studying for or have passed your critical care (CCRN) exam, this article is for you! Unlike the cardiac surgery certification (CSC), the cardiac medicine certification (CMC) can be earned by nurses taking care of non-surgical cardiac patients. In other words, this means you don’t have to be a CVICU nurse to become specialty certified with the CMC! I have a medical ICU (MICU) background and routinely care for patients with cardiac issues, post-MI patients, cardiogenic shock patients, and those requiring vasoactive titratable medications. If that sounds like you too, then, by all means, pursue certification! Certification is a great way to motivate yourself to learn, test your knowledge, prove a baseline level of knowledge to current and future employers, and make yourself more marketable as a nurse. I recently accepted a CVICU nursing position while only having my CCRN certification and decided to take this exam to not only validate my own choice to take that job but also to prove to my new colleagues my dedication to cardiac nursing.
This article will discuss eligibility criteria, exam review resources, and general tips/pointers to help you prepare for the exam and approach it more confidently. By the time you’ve read this, it is my hope that you feel like you have a solid plan of action, ample pre-reviewed quality resource suggestions, and the confidence to approach cardiac certification no matter what point you’re at in your career. Throughout this article, you’ll find multiple “hot” words that have been hyperlinked to take you to the exact resources I’ll be discussing. Be sure to check them out for more information! (Trust me, no one is paying me to promote their items)
To be eligible to sit for the CMC examination, you need to currently hold a valid clinical nursing specialty certification by a nationally accredited organization (Ex: CCRN). This exam gives you a subspecialty certification; it is not a primary certification. If you’ve been practicing for two years or less, you’ll need 1,750 hours of direct care of acutely/critically ill adult cardiac patients (these do NOT have to be specifically cardiac surgical patients). If you’ve been practicing a little over two years, 875 of those required hours have to be accrued within the most recent year prior to submitting your application. If you’ve been a registered nurse for five years, you’re required to have 2,000 hours experience of which 1,000 are direct care for critically ill adult cardiac patients. Moreover, 144 of those hours must have been accrued in the most recent year prior to submitting your application.
Ultimately, you’ll have to “sign” an honor statement that states that you’ve met these requirements. You’ll also be required to provide contact information of a colleague/supervisor who can verify the validity of your experience in case of audit. The cost of the for AACN members is (currently) $135 and for non-members $225. My suggestion is to check with your facility to see if they have vouchers for these certification exams or if they offer a reimbursement program. There’s no need for you to pay for this exam if you don’t have to! Plus, they likely won’t issue a voucher or approve reimbursement unless you meet the minimum eligibility criteria anyway; it can serve as an extra step in eligibility verification if you’re unsure. In addition to this, your organization may also have a subscription or have purchased review materials in bulk…meaning less out-of-pocket cost to you. However, I have found this to be less true of the subspecialty certifications as compared to initial certifications like the CCRN.
Exam Review Resources
Now that we’re on the subject of test review materials, let’s discuss some of the most common resources, their costs, and how well I *personally* felt each prepared me for the exam. These are not discussed in any particular order; however, I will discuss resources from the same company together. Let me preface this by saying how difficult it is to actually find resources for this exam, so there aren’t many to discuss anyway.
Nicole Kupchik’s CMC Review Course and Book: The cost of these resources can be quite hefty depending on what you purchase. The book itself is $59.99, the course itself is $159, or you can bundle them both for $199. In my honest opinion, the material covered in her resources for this exam is fairly vague for the level of understanding you’ll be required to have to answer the exam questions. I would save your money here and put it towards a different resource. I did find her hemodynamics course quite helpful in understanding and interpreting data from PA catheters. Coming from a MICU background, my exposure to PA catheters was nearly non-existent. The hemodynamic course she offers is $179 (however, you may be able to message her on IG or through their website’s contact page to see if she has any sales/promotions available; I’ve done that for every course I purchased through her company). You definitely don’t need that course to be able to pass though.
AACN’s Review Course and Practice Exam Booklet: The review course published by the AACN is by far the MOST comprehensive study tool you could hope to use for CMC exam preparation! Word of caution… these videos are rough. And by rough, I mean dry, unexciting, and dull. The presenters tend to be monotone, and the videos range anywhere from 20 minutes to 2.5 hours in length. With that being said, it is highly important that you give yourself enough time to make it through all the videos AND still have time to get in those crucial practice exam questions. I passed my CCRN at the end of July and spent two of the next three months actively studying while working full time as a COVID ICU nurse. It will be worth it in the end though, because there were definitely 15 or more questions I would have missed if I didn’t watch their videos. The course costs $150 for non-members or $135 for members. A steep investment, but highly worth it. It also provides you with CEs and an extra 100 practice questions at the end of the program.
The AACN also published their own practice exam booklet that contains 100 questions similar to those you’ll see on the exam. This booklet costs $13 for non-members or $10 for members. This might be a good tool to use to evaluate your progress with studying the cardiac content. I’d suggest using it towards the half way point or end of the time you’ve set aside to prep for the exam. The booklet also contains rationales for you to review afterwards. This is a cheap option to utilize for additional practice questions; however, I have some additional suggestions in the next paragraphs that may be more lucrative both in content and cost.
Cardio Nursing Education Associates Questions: The professionals who put together the AACN review course have their own website with their own exam resources! For the CMC exam, they offer a digital question bank that you can take with you anywhere with wifi. It contains over 1,300 questions with answers and rationales. They also make a printed book version of the the review questions, so you don’t need to purchase both; choose whichever format will help you learn and retain information the best. For the digital option, you can choose 6 months ($70) of access or a year ($101.50).
I definitely preferred the CNEA’s review questions over all others because they were challenging and most similar to those I saw on the actual CMC exam. The physical book of review questions can be found on their website or on amazon for $70. I highly suggest this resource! It also contains another full-length practice exam at the end, so you can test your knowledge and gauge your overall improvement with the material.
You can also do what I did and review the cardiovascular sections of your CCRN prep materials. I also utilized the cardiovascular ICU questions from the Pass CCRN question bank online. You can check out my CCRN article for more information about that resource here.
General Tips & Pointers
There are a total of 90 questions on this exam, 15 of which will not count for or against your grade. You’ll need to get a minimum score of 54/75 (~72%) to pass and you’ll be given two hours to answer the exam in its entirety. Another thing to keep in mind, you won’t know which 15 questions are being “thrown out.” This means it’s incredibly important to treat each question as if it contributes to your score.
Take your time during the exam and read each question very carefully. If time is a major crutch for you, practice with those full length exams in a timed setting prior to your exam date. If the question provides you with labs and/or hemodynamic values, try to anticipate what state the patient is in (Ex: septic, hypovolemic, cardiogenic shock, etc.) as well as what interventions they would need or might be contraindicated. Treat each answer option as a true or false statement. Even if you can eliminate one or two of the responses, that still increases your likelihood of selecting the correct answer by 25-50%!
If you’ve just recently taken the CCRN, submit your application for the CMC now and set a date for 1-2 months after you’ve been cleared to take it. Setting a date will not only help motivate you more, but sitting for the exam so soon after the CCRN will help promote retention of that cardiovascular-related nursing knowledge and critical thinking skills for testing purposes. Make sure you review the AACN’s test plan to understand where your areas of weakness are. If you are short on time, hone in on those weak areas most. For instance, coming from my MICU background, I knew that my knowledge of ventricular assist devices (Ex: Impellas, IABPs, VADs) and CABG surgery was weak. And, yes, there will be questions about post-CABG patients in the 3-5 day post op period. I also knew I needed to brush up on my pacemaker/ICD and targeted temperature management knowledge.
Once you evaluate what content areas you’re strong and weak in, make sure you’re also expanding on the knowledge you already have and push yourself to grow. I found that even on the areas I felt comfortable with, there was always room to learn more. You may think you know the information about a certain topic well, but trust me when I say that there’s nearly always SO much more to know. One way to test your knowledge development is to take a baseline exam, mid-way exam, and a final exam to gauge your progression and identify persistently weak areas of knowledge.
Well, I hope this has been an informative article about the CMC certification exam. I know you’ll do amazing on this exam, and I can’t wait to see your photo holding up the results page that says “PASS!” It is doable, even if you don’t come from a cardiovascular nursing specialty background. You are more than capable of acing this exam!