- CSC is 90 questions (75 scored, 15 unscored) in 2 hours; you need 55 of 75 to pass.
- Therapeutic Interventions (43%) and Complications (33%) together make up 76% of the current blueprint.
- The current test plan applies through November 18, 2026; weights shift on November 19, 2026.
- Eligibility runs on hours: 1,750 in 2 years or 2,000 in 5 years, with a large chunk tied to the first 48 postoperative hours.
Quick Facts at a Glance
This is the one-page version of everything a Cardiac Surgery (Adult) (CSC) candidate needs pinned above their desk. It's not a substitute for deep review - that's what a full CSC Study Guide 2026: How to Pass on Your First Attempt is for - but it's the fastest way to confirm you have the numbers, domains, and mechanics locked in before test day.
- Credentialing body: AACN Certification Corporation (the credentialing arm of the American Association of Critical-Care Nurses)
- Focus population: Adults in the first 48 hours after cardiac surgery
- Testing venue: PSI test centers or Live Remote Proctoring; closed-book
- Question count: 90 total - 75 scored, 15 unscored - 2 hours
- Passing cut: 55 of 75 scored questions
- Certification term: 3 years
The Four Domains, One Table
Everything on the CSC blueprint sits under four domains. Two of them - Therapeutic Interventions and Complications - dominate the exam, so your review time should mirror that imbalance. For a deeper walkthrough of each domain's subtopics, see the CSC Exam Domains 2026: Complete Guide to All 4 Content Areas.
| Domain | Current Weight (through Nov 18, 2026) |
|---|---|
| Procedures | 11% |
| Complications | 33% |
| Therapeutic Interventions | 43% |
| Monitoring and Diagnostics | 13% |
Key Takeaway
Therapeutic Interventions and Complications combine for 76% of the current exam. If you only had time to master two domains, these are the two.
Eligibility Snapshot
Before you can even schedule a seat, you need a qualifying license and clinical hours documented on one of two tracks. Full details, including audit documentation, live in the CSC Requirements 2026: Eligibility, Prerequisites & How to Qualify guide, but here's the compressed version.
Baseline Requirement
You must hold an unencumbered U.S. RN or APRN license and a current, nationally accredited clinical nursing specialty certification.
Two-Year Practice Route
1,750 hours caring for acutely or critically ill adults within the previous 2 years, with 875 of those hours in the most recent year.
- 875 of the total hours must involve adults during the first 48 hours after cardiac surgery.
Five-Year Practice Route
2,000 qualifying adult acute/critical-care hours within the previous 5 years, with 144 of those hours in the most recent year.
- 1,000 of the total hours must involve the first-48-hours postoperative cardiac-surgery population.
Whichever route you choose, be ready to name a clinical supervisor or an RN/physician colleague who can verify your hours if your application is audited. This isn't optional paperwork - treat it as part of your application timeline, not an afterthought.
Exam Format & Scoring
The CSC exam is 90 multiple-choice questions - 75 scored and 15 unscored - delivered over 2 hours, closed-book, at a PSI test center or via Live Remote Proctoring. You won't know which questions are unscored, so treat every item as if it counts.
The passing cut is 55 of 75 scored questions correct. That threshold, along with the domain weights above, reflects the January 31, 2022 exam version, which remains applicable through November 18, 2026. If you're benchmarking your own practice-test performance against that cut score, the CSC Passing Score 2026: Exactly What You Need to Pass breakdown walks through what that ratio means in practice.
Fees & Renewal Math
Budgeting for CSC involves two separate fee schedules: the initial exam and the renewal cycle three years later. A full cost breakdown, including how member status changes the math, is in the CSC Certification Cost 2026: Complete Pricing Breakdown article.
- Initial exam fee: $150 AACN member / $240 nonmember
- Certification term: 3 years
- Renewal hour requirement: 432 first-48-hours postoperative adult cardiac-surgery practice hours during the 3-year cycle, including 144 in the latest year
- Renewal path 1 (CERPs): 25 relevant Category A Clinical Judgment CERPs - fee $75 member / $130 nonmember
- Renewal path 2 (exam): Retake the renewal exam - fee $125 member / $170 nonmember
Renewal also requires that you still hold the qualifying license and your base certification, so lapses elsewhere in your credentialing stack can complicate a CSC renewal even if your hours are solid.
Must-Know Clinical Topics by Domain
The domain names are abstract until you map them to bedside reality. Here's how experienced test-takers translate each domain into study targets.
Procedures (11%)
Understand the surgical approaches and mechanical circulatory support devices patients arrive with, not how to perform the surgery itself.
- CABG, valve repair/replacement, and combined procedures
- Cardiopulmonary bypass physiology and off-pump considerations
- Mechanical circulatory support basics (IABP, temporary VADs)
Complications (33%)
This domain rewards pattern recognition - knowing which complication a given combination of vitals, labs, and timing points to.
- Low cardiac output syndrome and tamponade
- Dysrhythmias specific to the postop cardiac surgery window
- Bleeding, coagulopathy, and reoperation triggers
- Renal, neurologic, and infectious complications in the acute phase
Therapeutic Interventions (43%)
The largest domain by far - expect the exam to lean heavily on your ability to select and titrate the right intervention for a given clinical picture.
- Vasoactive and inotropic drip management
- Temporary pacing and rhythm management
- Chest tube and drainage management
- Ventilator weaning and extubation readiness in the postop period
Monitoring and Diagnostics (13%)
Smaller in weight but still tested through waveform interpretation and lab-trend questions rather than simple recall.
- Hemodynamic waveform and pressure interpretation
- Lab trend recognition (lactate, potassium, hemoglobin)
- Chest x-ray and echo findings relevant to early postop status
A Tight Final-Week Cram Map
If your review calendar is already built, skip this. If you need a simple last-mile structure, weight your remaining hours the same way the exam weights its domains - Therapeutic Interventions and Complications first, Procedures and Monitoring and Diagnostics last.
Therapeutic Interventions
- Drip titration scenarios and pacing decision trees
- Practice questions weighted toward this domain since it's 43% of the exam
Complications
- Build a complication-by-timeline chart (hour 0-12, 12-24, 24-48)
- Drill dysrhythmia and low output syndrome recognition
Procedures + Monitoring and Diagnostics
- Review surgical approaches and device basics
- Practice waveform and lab-trend interpretation
Full timed practice + weak-area review
- Simulate the 90-question, 2-hour format
- Revisit whichever domain is scoring lowest
For a longer-horizon version of this plan with more built-in review cycles, the CSC Study Guide 2026: How to Pass on Your First Attempt lays out a fuller sequence, and you can pressure-test your pacing with timed sets on the CSC practice test platform.
What Changes on November 19, 2026
The domain weights and passing cut described above apply to the January 31, 2022 exam version, valid through November 18, 2026. Starting November 19, 2026, AACN shifts the blueprint:
| Domain | Current Weight | Weight Effective Nov 19, 2026 |
|---|---|---|
| Procedures | 11% | 9% |
| Complications | 33% | 37% |
| Therapeutic Interventions | 43% | 43% |
| Monitoring and Diagnostics | 13% | 11% |
FAQ
On this site, CSC refers exclusively to Cardiac Surgery (Adult), the AACN Certification Corporation credential for nurses caring for adults in the first 48 hours after cardiac surgery. Other fields use the same three letters for unrelated credentials, so double-check the sponsoring body whenever you see "CSC" elsewhere.
90 multiple-choice questions total - 75 scored and 15 unscored - administered in 2 hours at a PSI test center or via Live Remote Proctoring.
You need 55 of the 75 scored questions correct under the current exam version, which applies through November 18, 2026.
Therapeutic Interventions, at 43% of the current blueprint, followed by Complications at 33%. Together they account for 76% of the exam.
CSC certification lasts 3 years. Renewal requires your qualifying license, your base certification, 432 first-48-hours postoperative adult cardiac-surgery hours in the cycle (with 144 in the latest year), and either 25 Category A Clinical Judgment CERPs or the renewal exam.
Keep this page bookmarked as your quick-reference sheet, but pair it with real question practice - the numbers above only become useful once you've seen them applied to scenario-based items on a full CSC practice test.