- CSC stands for Cardiac Surgery (Adult), an AACN Certification Corporation credential for critical-care RNs.
- The exam has 90 multiple-choice questions (75 scored, 15 unscored) in a 2-hour, closed-book format.
- Passing requires 55 of 75 scored questions correct under the version tested through November 18, 2026.
- Therapeutic Interventions and Complications together make up 76% of the current test plan.
What "CSC" Actually Stands For
When people search "what is a CSC," they're usually running into the letters in a very different context - software companies, government service centers, or other unrelated acronyms. On this site, CSC means one thing only: Cardiac Surgery (Adult), a nursing subspecialty certification for RNs who care for adult patients during the first 48 hours after cardiac surgery. It is not a general nursing license, not a hospital job title, and not related to any other industry's use of the same three letters.
The certification exists because the immediate postoperative window after cardiac surgery is uniquely high-risk. Hemodynamics can shift quickly, chest tubes and temporary pacing wires need vigilant management, and complications can escalate within minutes. CSC certification is a way for a nurse to formally demonstrate mastery of that narrow but demanding clinical window.
If you landed here from a different search intent, you may also want our companion explainers - What Is CSC?, CSC Meaning, and What Does CSC Stand For? - which cover the same identity question from slightly different angles.
Who Grants the CSC Credential
The CSC credential is awarded by AACN Certification Corporation, the credentialing arm of the American Association of Critical-Care Nurses (AACN). This is the same organization that certifies other critical-care subspecialties, but CSC is its own distinct credential with its own eligibility pathway, its own exam blueprint, and its own renewal cycle.
Who Can Sit for the CSC Exam
Candidates need an unencumbered U.S. RN or APRN license and must already hold a current, nationally accredited clinical nursing specialty certification. From there, AACN offers two ways to qualify on practice hours:
- Two-year route: 1,750 hours caring for acutely or critically ill adults within the previous 2 years, with at least 875 of those hours in the most recent year. Of the total, 875 hours must specifically involve adults in the first 48 hours after cardiac surgery.
- Five-year route: 2,000 qualifying adult acute/critical-care hours across the previous 5 years, including at least 144 hours in the latest year. Of the total, 1,000 hours must involve the first-48-hours postoperative population.
Applicants also need to identify a clinical supervisor or an RN/physician colleague who can verify their eligible practice hours if their application is audited. For a full breakdown of both pathways and how to document them, see CSC Requirements 2026: Eligibility, Prerequisites & How to Qualify.
Exam Format, Scoring, and Fees
The CSC exam is a closed-book test administered at PSI test centers or via Live Remote Proctoring. It consists of 90 multiple-choice questions - 75 scored and 15 unscored - delivered in a 2-hour window. You won't know which questions are unscored, so every question deserves full attention.
The current passing cut is 55 of 75 scored questions, based on the January 31, 2022 version of the exam, which remains in effect through November 18, 2026. Initial exam fees are $150 for AACN members and $240 for nonmembers. For a line-by-line cost comparison, visit CSC Certification Cost 2026: Complete Pricing Breakdown, and for a deeper look at what the score threshold means for your prep, read CSC Passing Score 2026: Exactly What You Need to Pass.
Key Takeaway
Because a new test-plan version launches for exams on or after November 19, 2026, always match your practice test blueprint and passing-score expectations to your actual scheduled test date - check CSC Exam Dates 2026: Testing Windows, Deadlines & Scheduling before you commit to a study plan.
The Four CSC Exam Domains
The current CSC test plan (valid through November 18, 2026) is built around four content domains. Weight distribution matters enormously here - two domains alone account for 76% of the exam.
Domain 1: Procedures (11%)
Covers the surgical and bedside procedures relevant to the postoperative cardiac surgery patient - from the operative approach itself to bedside interventions performed during recovery.
- Understand what was done in the OR and how it shapes early postop expectations
- Know indications for common bedside procedures in this population
Domain 2: Complications (33%)
Focuses on recognizing and responding to the complications most likely to occur in the first 48 hours after cardiac surgery - arrhythmias, bleeding, tamponade, low cardiac output, and neurological events among them.
- Pattern-recognition questions testing early warning signs
- Prioritization of which complication to address first
Domain 3: Therapeutic Interventions (43%)
The single largest domain on the exam. Covers the interventions - pharmacologic, mechanical, and procedural - used to stabilize and support the postoperative cardiac surgery patient.
- Vasoactive drips, temporary pacing, and mechanical circulatory support
- Titration decisions based on evolving hemodynamics
Domain 4: Monitoring and Diagnostics (13%)
Tests interpretation of hemodynamic data, labs, imaging, and rhythm strips specific to the first 48 postoperative hours.
- Correlating monitoring trends with underlying pathology
- Choosing the next diagnostic step based on a clinical picture
Mapping a Study Plan to the Domains
Because Therapeutic Interventions and Complications together make up 76% of the exam, your study time should mirror that imbalance rather than splitting evenly across four domains. A simple way to structure a multi-week plan:
Therapeutic Interventions
- Drip titration logic and mechanical support indications
- Practice questions weighted toward the 43% domain
Complications
- Recognition and prioritization scenarios
- Cross-reference with interventions from weeks 1-2
Monitoring & Diagnostics, then Procedures
- Hemodynamic and lab interpretation drills
- Lighter review of the smallest-weighted domain
Full-length timed practice
- Simulate the 90-question, 2-hour format
- Review missed items by domain, not just overall score
This is one framework, not the only one - techniques like spaced repetition on high-yield complications or short focused review blocks can be layered in as needed. For a more detailed, week-by-week walkthrough, see CSC Study Guide 2026: How to Pass on Your First Attempt, and if you're still calibrating how much time to budget, How Hard Is the CSC Exam? Complete Difficulty Guide 2026 and CSC Pass Rate 2026: What the Data Shows both put the exam's difficulty in context. You can also build domain-specific timed drills using the practice tests at CSC Exam Prep.
Keeping the CSC Credential Active
CSC certification lasts 3 years. To renew, you need your qualifying license and base certification still active, plus 432 first-48-hours postoperative adult cardiac-surgery practice hours during the 3-year cycle, including at least 144 hours in the latest year. On top of the hours requirement, you choose one of two paths:
- CERP path: 25 relevant Category A Clinical Judgment CERPs, at a renewal fee of $75 (member) / $130 (nonmember).
- Exam path: Retake the renewal exam for $125 (member) / $170 (nonmember).
Planning renewal early - rather than scrambling in the final months of the 3-year window - keeps both the hours and continuing-education tracking manageable.
Who Hires Nurses With a CSC
CSC certification signals expertise in the highest-acuity phase of cardiac surgical recovery, so it's most valued in units where that first 48-hour window is the daily reality:
- Cardiac surgery ICUs and cardiovascular ICUs
- Cardiothoracic surgical step-down and recovery units
- Hospitals with active adult cardiac surgery programs seeking specialty-certified staff for postoperative care teams
Because the credential is specific to a clinical population rather than a broad specialty, it tends to matter most to hiring managers and charge nurses staffing cardiac surgery recovery, rather than as a generic nursing credential. For how this translates into compensation and job search terms, see CSC Salary Guide 2026: Complete Earnings Analysis, Is the CSC Certification Worth It? Complete ROI Analysis 2026, and CSC Jobs.
Frequently Asked Questions
No. On this site, CSC refers exclusively to AACN Certification Corporation's Cardiac Surgery (Adult) credential. Other fields use the same three letters for entirely unrelated certifications, but none of those facts apply here.
The exam has 90 multiple-choice questions - 75 scored and 15 unscored - administered in a 2-hour, closed-book format at PSI test centers or via Live Remote Proctoring.
Under the current test plan (in effect through November 18, 2026), you need 55 of the 75 scored questions correct.
Therapeutic Interventions, at 43% of the current exam, is the single largest domain, followed closely by Complications at 33%. Together they represent 76% of the test plan.
Yes. For exams administered on or after November 19, 2026, the weighting shifts to Procedures 9%, Complications 37%, Therapeutic Interventions 43%, and Monitoring and Diagnostics 11%. Match your study plan to your actual test date.