- CCI's 2025 CNAMB results: 78.6% first-time pass rate, 83.3% retake rate, 78.9% overall.
- Passing requires a scaled score of 620 on a 200-800 scale, not a raw percentage.
- Intraoperative Care is the single heaviest domain at 20% of the exam.
- The current nine-domain outline runs through 2026 before an eight-domain version launches in 2027.
The 2025 CNAMB Results, By the Numbers
Anyone researching the Certified Ambulatory Surgery Nurse credential eventually asks the same question: how many people actually pass? The Competency & Credentialing Institute (CCI), which owns and administers CNAMB, publishes annual pass rate data, and the 2025 figures give a clear picture. Across 76 candidates, the overall pass rate was 78.9%. Broken out further, first-time candidates passed at 78.6%, while candidates retaking the exam passed at 83.3%.
Those numbers matter for two reasons. First, they confirm the exam is passable for well-prepared perioperative nurses - it isn't a credential with a razor-thin success rate. Second, the gap between first-time and retake performance suggests that failure is often about exam-specific preparation gaps, not a lack of clinical competence. Candidates who fail once and come back tend to close those gaps and pass at a higher rate the second time.
First-Time vs. Retake Pass Rates
The 4.7-point gap between first-attempt (78.6%) and retake (83.3%) pass rates is worth sitting with. It implies that a meaningful share of candidates who don't pass on attempt one are close - close enough that targeted review, rather than a complete overhaul of clinical knowledge, gets them across the 620 threshold on the second try.
CCI's retake policy reinforces this pattern. Because the retake fee is $175 (compared to the $400 initial application, which includes the first attempt), the credentialing body has effectively built a lower-friction path back into the exam for candidates who need a second shot. There's a mandatory 30-day minimum between attempts, which gives just enough runway to rework weak domains without losing momentum. For a full breakdown of how the $400 fee, $175 retake, and renewal costs stack up, see the CNAMB Certification Cost 2026: Complete Pricing Breakdown.
Key Takeaway
If you don't pass on your first attempt, don't panic and don't restart your entire study plan. Focus your 30-day gap on the two or three domains that cost you the most points - the 2025 data suggests that targeted retake preparation works.
How the 620 Scaled Score Actually Works
CNAMB isn't scored as a raw percentage of correct answers. The exam uses a scaled score on a 200-800 range, and the passing threshold is 620. Of the 200 total questions on the exam, only 185 are scored; the remaining 15 are unscored pretest items CCI uses to evaluate future questions. You won't know which 15 are unscored, so every question deserves your full attention.
Because scaled scoring adjusts for slight variations in item difficulty across exam forms, you can't reverse-engineer "how many questions I can miss" with certainty. That's precisely why understanding the passing standard conceptually - rather than chasing a specific missed-question count - matters. The CNAMB Passing Score 2026: Exactly What You Need to Pass guide walks through what a 620 scaled score means in practice and how CCI's scoring model differs from a simple percentage cutoff.
Domain Weighting and Where Candidates Lose Points
The current CNAMB exam blueprint spans nine content domains, and they are not weighted equally. Understanding the weighting is one of the most concrete ways to convert study time into pass-rate improvement, because it tells you exactly where points are concentrated.
Domain 3: Intraoperative Care (20%)
This is the single largest domain on the exam, accounting for one-fifth of scored content. Candidates must be fluent in intraoperative monitoring, positioning, sterile technique, and the immediate management of the surgical patient under anesthesia.
- Highest point value of any domain - under-preparing here has an outsized effect on your scaled score
- Draws heavily on the same competencies verified by the 500-hour intraoperative experience requirement
Domain 1: Preoperative Patient Assessment and Diagnosis (14%)
Covers pre-admission screening, risk stratification, and the clinical judgment needed to determine a patient's readiness for ambulatory surgery.
- Second-highest weighting on the current blueprint
- Pairs closely with Domain 2's plan-of-care content
Domain 2 & Domain 4: Preoperative Plan of Care and Communication (12% each)
These two domains carry equal weight and often overlap in exam vignettes - a scenario testing care planning frequently also tests how that plan is communicated to the patient, family, or surgical team.
Domain 5: Postoperative/Transfer of Care (10%)
Focuses on discharge readiness, handoff communication, and recognizing complications before a patient transitions out of the ambulatory setting.
Domain 9: Professional Accountability (10%)
Covers scope of practice, ethics, and regulatory responsibilities specific to ambulatory surgical nursing.
Domain 8: Management of Personnel, Services, and Materials (9%)
Tests leadership and resource-management competencies relevant to charge-nurse and coordinator roles common in ambulatory surgery centers.
Domain 6: Instrument Processing and Supply Management (8%) & Domain 7: Emergency Situations (5%)
The two lowest-weighted domains still appear regularly and shouldn't be skipped - Emergency Situations in particular tests high-stakes scenarios that candidates sometimes underestimate because of its smaller point share.
For a domain-by-domain breakdown with sample content and study priorities, the CNAMB Exam Domains 2026: Complete Guide to All 9 Content Areas goes deeper than the summary above. If you're still assessing whether these domains reflect a difficult exam relative to your clinical background, How Hard Is the CNAMB Exam? Complete Difficulty Guide 2026 puts the domain weighting in context alongside the 78.9% overall pass rate.
Exam Format, Timing, and Testing Conditions
Pass rate data doesn't exist in a vacuum - it's shaped by exam logistics. CNAMB is delivered by PSI, either at a physical testing center or via Remote Secure Proctored Exam, and candidates have 3 hours and 45 minutes to answer 200 multiple-choice questions.
| Testing Detail | What Applies |
|---|---|
| Total questions | 200 (185 scored, 15 unscored pretest) |
| Time allotted | 3 hours 45 minutes |
| Passing standard | Scaled score of 620 (200-800 scale) |
| Test-center break | One 10-minute break |
| Remote exam break | No break |
| Retake wait period | 30-day minimum between attempts |
The break policy is worth planning around. Test-center candidates get one 10-minute break during the 3 hours 45 minutes, while remote candidates get none. If you're considering the Remote Secure Proctored Exam for convenience, factor the no-break format into your pacing strategy - nearly four hours without a pause is a different endurance test than the same exam with a scheduled break.
Eligibility and scheduling windows also shape when candidates sit for the exam. Testing is offered continuously, but the first attempt must occur within 90 days of eligibility approval, and the full eligibility period lasts 12 months. Details on scheduling these windows are covered in CNAMB Exam Dates 2026: Testing Windows, Deadlines & Scheduling, and the full eligibility pathway - including the 2,400-hour and 500-intraoperative-hour requirements - is laid out in CNAMB Requirements 2026: Eligibility, Prerequisites & How to Qualify.
Why the 2027 Blueprint Change Matters Now
The nine-domain outline described above remains in effect through 2026. Starting in 2027, CCI moves to a new eight-domain outline with 175 scored questions and 25 unscored items, replacing the current 185-scored/15-unscored split. If you're planning to sit in 2026, this transition doesn't change your preparation - but it does mean the pass rate data discussed in this article, including the 2025 first-time and retake figures, reflects the current nine-domain structure rather than the version that will exist afterward.
How to Improve Your Odds Before Test Day
Given that Intraoperative Care alone accounts for a fifth of the scored exam, and that Preoperative Patient Assessment and Diagnosis adds another 14%, more than a third of the exam sits inside just two domains. A study plan that allocates time proportional to domain weight - rather than spreading effort evenly across all nine areas - directly targets where the exam concentrates its questions.
Intraoperative Care and Preoperative Assessment
- Review intraoperative monitoring, positioning, and sterile technique (Domain 3, 20%)
- Work through pre-admission screening and risk assessment scenarios (Domain 1, 14%)
Care Planning, Communication, and Postop Transfer
- Connect plan-of-care content with communication scenarios (Domains 2 & 4, 12% each)
- Study discharge readiness and handoff protocols (Domain 5, 10%)
Accountability, Management, and Lower-Weight Domains
- Cover professional accountability and scope-of-practice questions (Domain 9, 10%)
- Review personnel/materials management and instrument processing (Domains 8 & 6)
- Don't skip Emergency Situations (Domain 7, 5%) despite its smaller share
A structured, timed practice environment also matters because the real exam gives you 3 hours and 45 minutes with limited or no break, depending on delivery method. Rehearsing under similar time pressure with full-length practice sets on our CNAMB practice test platform helps you calibrate pacing before you're facing the clock for real. For a more complete week-by-week study framework tied to these domain weights, see the CNAMB Study Guide 2026: How to Pass on Your First Attempt.
It's also worth stepping back and asking whether the credential fits your career goals before you invest the $400 application fee and months of preparation. The Is the CNAMB Certification Worth It? Complete ROI Analysis 2026 article and the practice questions available at CNAMB Exam Prep can both help you make that call with clearer expectations about what the exam actually tests.
FAQ
CCI reported a 78.9% overall pass rate across 76 candidates in 2025, with first-time candidates passing at 78.6% and retake candidates at 83.3%.
Yes. In the 2025 data, retake candidates passed at 83.3%, higher than the 78.6% first-time rate, suggesting many candidates who fail initially are close to the passing standard and improve with targeted review.
You need a scaled score of 620 on a 200-800 scale. This is not the same as a raw percentage of correct answers, since CCI adjusts scores for question difficulty across exam forms.
The exam includes 200 multiple-choice questions - 185 scored and 15 unscored pretest items - administered over 3 hours and 45 minutes at a PSI testing center or via Remote Secure Proctored Exam.
The current nine-domain outline and its associated pass rate data apply through 2026. Starting in 2027, CCI shifts to an eight-domain outline with 175 scored and 25 unscored questions, which may produce different pass rate patterns going forward.