CMC exam guide
About the Cardiac Medicine Certification (CMC) exam
CMC is an adult cardiac medicine subspecialty certification for specialty-certified nurses who provide direct care to acutely and critically ill adult cardiac patients. This guide uses AACN's revised test plan for examinations taken on or after November 19, 2026. Use the diagnostic to identify gaps in condition recognition, therapeutic management, monitoring, and diagnostic interpretation, then build a study plan around the four official domains.
MedPorium is an independent education platform and is not affiliated with or endorsed by AACN Certification Corporation. Exam details can change; confirm them with the official source before applying.
CMC exam format at a glance
- Questions
- 90
- 75 scored; 15 unscored
- Time
- 2 hours
- Delivery
- Computer-based through PSI at a testing center or by live remote proctoring
Knowledge to review for the CMC exam
These foundations support the practical tasks in the official examination matrix.
Cardiac assessment and clinical judgment
- Physical and psychosocial assessment, 12-lead ECG, continuous rhythm interpretation, perfusion, and invasive or noninvasive hemodynamics
- Acute coronary syndromes, heart failure, dysrhythmias, cardiomyopathy, valvular disease, tamponade, arrest, and hypertensive emergencies
- Aortic, arterial, venous, and post-intervention vascular conditions with rapid recognition of deterioration and complications
Therapies, procedures, and devices
- Cardiac and peripheral catheterization, PCI, structural intervention, pericardiocentesis, grafts, stents, and thrombolysis
- Temporary and durable mechanical circulatory support, pacing, CRT, implanted or wearable defibrillators, ablation, cardioversion, and defibrillation
- Cardiovascular pharmacology, respiratory support, renal replacement, targeted temperature management, rehabilitation, palliative care, and end-of-life care
Monitoring, diagnostics, and coordinated care
- Echocardiography, ECG, laboratory testing, stress testing, cardiac CT and MRI, radiography, ABG, SvO2 or ScvO2, pulse oximetry, and capnography
- Perioperative and periprocedural care, sedation monitoring, vascular access, prevention of hospital-acquired conditions, and response evaluation
- Patient and caregiver education, shared goals, interdisciplinary planning, cardiac rehabilitation, and health-related social needs
CMC examination matrix
The percentages below are the approximate exam-score weights published by AACN Certification Corporation. Use them to allocate study time, then adjust for your own weak areas.
21%
Cardiovascular Conditions
Recognize and manage acute and chronic adult cardiac and vascular conditions, hemodynamic deterioration, arrest, and post-intervention complications.
- Assess acute coronary syndromes, including STEMI, NSTEMI, unstable angina, and spontaneous coronary artery dissection
- Recognize tamponade, cardiomyopathy, dysrhythmia, heart failure, hypertensive crisis, inflammation or infection, pericardial effusion, pulmonary edema, syncope, valvular disease, and cardiac arrest
- Assess acute arterial occlusion, acute venous thrombosis, aortic aneurysm or dissection, dyslipidemia, and vascular complications after intervention
- Connect assessment and monitoring findings with the safest immediate nursing action and threshold for escalation
21%
Non-Cardiovascular Conditions
Integrate respiratory, endocrine, hematologic, neurologic, renal, multisystem, and psychosocial problems that alter cardiac presentation or management.
- Recognize pulmonary embolus, respiratory failure, ARDS, pleural abnormalities, pulmonary hypertension, and sleep apnea
- Manage diabetes, metabolic syndrome, thyroid disorders, anemia, coagulopathy, stroke, and delirium in the cardiac population
- Assess AKI, CKD, fluid, electrolyte, and acid-base disturbances and their effects on cardiac therapy
- Differentiate shock, MODS, non-cardiac chest pain, and substance-use concerns from primary cardiac problems while coordinating appropriate care
44%
Therapeutic Interventions
The dominant domain covers cardiac and vascular procedures, cardiovascular pharmacology, electrophysiology, respiratory and renal support, rehabilitation, and end-of-life therapies.
- Manage right and left heart catheterization, PCI, pericardiocentesis, structural heart intervention, peripheral or carotid intervention, grafts, stents, and catheter-directed thrombolysis
- Support IABP, temporary and durable VADs, temporary or permanent pacing, CRT, ICDs, wearable defibrillators, ablation, cardioversion, and defibrillation
- Monitor antidysrhythmics, anticoagulants, antiplatelets, diuretics, inotropes, thrombolytics, vasoactive agents, beta-blockers, lipid therapy, pulmonary vasodilators, sedation, RAS inhibitors, MRAs, SGLT2 inhibitors, and calcium-channel blockers
- Manage oxygen delivery, noninvasive and mechanical ventilation, chest tubes, renal replacement therapy, targeted temperature management, cardiac rehabilitation, palliative care, and end-of-life care
14%
Monitoring and Diagnostics
Perform, interpret, and integrate cardiovascular monitoring and diagnostic findings to recognize instability, guide therapy, and detect complications.
- Interpret invasive and noninvasive hemodynamics, ECG and continuous rhythm data, laboratory results, pulse oximetry, EtCO2, ABG, SvO2, and ScvO2
- Integrate echocardiography, cardiac stress testing, cardiac CT or MRI, and radiography with the clinical picture
- Use remote dysrhythmia and pulmonary artery sensor data to identify urgent changes and coordinate follow-up
- Perform physical and psychosocial assessment, trend treatment response, and communicate findings during perioperative and periprocedural care
How to use this CMC diagnostic
The 15 questions sample all four revised CMC domains, with the largest share focused on Therapeutic Interventions. A short set cannot represent every disease, procedure, medication, device, or diagnostic finding in the plan. Review every rationale, classify each gap as assessment, interpretation, prioritization, intervention, complication recognition, response monitoring, education, or escalation, and follow with larger mixed sets. If your examination is scheduled before November 19, 2026, confirm the applicable plan with AACN.
High-yield CMC study priorities
Priority 1
Put nearly half of study time into interventions
Therapeutic Interventions represents 44% of the revised plan. Study each therapy through indication, preparation, expected response, nursing surveillance, device or medication complication, immediate response, education, and escalation rather than memorizing disconnected lists.
Priority 2
Pair every condition with hemodynamics
Cardiovascular and non-cardiovascular conditions each contribute 21%. Practise distinguishing similar presentations by perfusion, filling pressure, rhythm, oxygenation, ventilation, laboratory, and imaging patterns, then select the safest next action.
Priority 3
Build medication-device-procedure cases
Use integrated scenarios that combine vasoactive or guideline-directed therapy with catheterization, structural intervention, pacing, mechanical support, pulmonary vasodilation, ventilation, or renal replacement. Include contraindications, interactions, alarms, bleeding, ischemia, and post-procedure complications.
Priority 4
Do not treat diagnostics as a small add-on
Monitoring and Diagnostics contributes 14% but also drives decisions throughout the other domains. Rehearse serial ECGs, hemodynamic waveforms, echo findings, gases, capnography, laboratory trends, stress testing, remote monitoring, and multimodality imaging in context.
CMC exam FAQ
How many questions are on the CMC exam?
AACN's August 2026 CMC Exam Handbook lists 90 multiple-choice questions: 75 scored items and 15 unscored items used to collect performance data for future examinations.
How long is the CMC exam?
AACN lists a two-hour testing time for the CMC examination.
How is the revised CMC test plan weighted?
For examinations taken on or after November 19, 2026, the plan assigns 21% to Cardiovascular Conditions, 21% to Non-Cardiovascular Conditions, 44% to Therapeutic Interventions, and 14% to Monitoring and Diagnostics.
When does this CMC test plan take effect?
The supplied AACN test plan applies to examinations taken on or after November 19, 2026. Candidates testing before that date should use the prior plan and verify the applicable outline with AACN.
Who is eligible for CMC certification?
AACN requires a current, unencumbered U.S. RN or APRN license, a qualifying nationally accredited clinical nursing specialty certification, and the required direct-care practice hours with acutely or critically ill adult and adult cardiac patients. Candidates should verify all current requirements with AACN before applying.
Is the CMC exam entirely clinical judgment?
Yes. AACN describes the CMC exam as 100% Clinical Judgment because candidates must already hold a qualifying specialty certification that tests professional caring and ethical practice competencies.
Can the CMC exam be taken remotely?
AACN describes computer-based testing at a PSI Testing Center or through live remote proctoring from a suitable private location.
Does this diagnostic predict whether I will pass?
No. A 15-question diagnostic is a low-confidence baseline, not a validated pass prediction. Use it to identify review priorities and confirm the test plan that applies to your exam date with AACN.
Is MedPorium affiliated with AACN?
No. MedPorium is an independent education platform and is not affiliated with or endorsed by AACN or AACN Certification Corporation.
Review and official source
Clinical reviewer: H. D. Myers
Exam format and matrix information were checked against the AACN CMC Adult certification page. Source reviewed October 11, 2026.
Ready to check your CMC knowledge?
Take the free 15-question practice test to identify strengths and topics that need more review.