Change ahead : Revised CMC test plan from AACN’s 2025 study of practice · AACN
CMC review, weighted to the revised test plan
Study guide · revised test plan · AACN reading list
Procedures and drugs together make up 44% of the revised exam, so a review that starts with diagnoses spends its freshest weeks on the smaller half. This plan starts with devices and drugs, then conditions, then monitoring, and lists what the November 2026 plan added.
Where the scored questions sit
About 33 of the 75 scored questions come from Section III, about 16 from each conditions section and 10 or 11 from monitoring (our arithmetic from the published shares).
Therapeutic Interventions
44%
Before Nov 19, 2026:39%21%
Before Nov 19, 2026:23%21%
Before Nov 19, 2026:23%14%
Before Nov 19, 2026:16%
Heaviest first; bars on one scale[1]
Source: CMC test plan, pp. 1–2.
Six weeks, procedures and drugs first
- Weeks 1–2, procedures and devices: catheterization and PCI aftercare, structural procedures, balloon pumps and VADs, pacing, ICDs and ablation, chest drains, renal replacement, temperature control (procedures and devices).
- Week 3, drugs: the revised list of 15 drug classes, up from 7, with heart failure therapy and antiarrhythmics first (pharmacology).
- Week 4, cardiac conditions: acute coronary syndromes and SCAD, heart failure, valves, arrest, aortic disease (Section I).
- Week 5, the rest of the body: kidney, lung, thyroid, blood and delirium in a cardiac patient (Section II).
- Week 6, numbers and a timed run: hemodynamics, gases and imaging (Section IV), then the practice test against a clock.
Six weeks suits a nurse already working with cardiac patients. Add a week to whichever section your unit rarely shows you, often durable VADs or pulmonary vasodilators.
Lines the November 2026 plan added
Tick these off if your review book was written for the older plan (test plan):
- SCAD, now inside acute coronary syndromes
- Cardiac arrest as a condition of its own
- Delirium, next to stroke under neurology
- ARDS as a separate respiratory line
- Fluid and acid-base imbalance, added to the electrolyte line
- Temporary and durable VADs, replacing the LVAD-only line
- Pleural chest tubes and drains and oxygen delivery devices
- Cardiac rehabilitation, beside palliative and end-of-life care
- Eight more drug classes, among them beta-blockers, renin-angiotensin inhibitors (ACE, ARB, ARNI), MRAs, SGLT2 inhibitors, pulmonary vasodilators, and sedation and analgesia
- Cardiac MRI and CT
- Renamed, not new: mixed venous gases are now venous blood gases (SvO2, ScvO2), hyperlipidemia is dyslipidemia
- Taken out: adrenal disorders
The reading list behind the items
The board checks its items against a published bibliography. The list for exams on and after November 19, 2026, linked from the announcement of the revised exam, includes:
- AHA 2025 Guidelines Update for CPR and Emergency Cardiovascular Care, for arrest and post-arrest care.
- Kern's Cardiac Catheterization Handbook, 7th edition.
- Cardiovascular Nursing Practice by Jacobson, Marzlin and Webner, 3rd edition.
- AACN Procedure Manual for Progressive and Critical Care, 8th edition (2024), for device and line care.
- AACN Essentials of Critical-Care Nursing by Burns and Delgado, 5th edition (2025).
Older review books are still useful; check them against the guidelines that changed answers after they were printed: heart failure (AHA/ACC/HFSA, 2022), atrial fibrillation (ACC/AHA/ACCP/HRS, 2023) and acute coronary syndromes (ACC/AHA, 2025).
Five decisions worth drilling
- Balloon pump timing: what late deflation does to afterload (devices).
- Heart failure drug holds: the potassium and kidney limits for an MRA, the washout before an ARNI (GDMT).
- Rate control in HFrEF: which calcium channel blockers to avoid (drug traps).
- Nitrates: the hypotension, right ventricular infarction and PDE-5 inhibitor checks (conditions).
- HIT: what stopping all heparin includes (non-cardiac conditions).
Generic names on test day
Drugs on the exam are shifting to generic names alone (handbook, PDF p. 6). Make drug cards generic-first: sacubitril/valsartan, not the brand on the box.
Ten-minute sets for a cardiac review
Practice on your phone
Rules, fees and practice for this exam
- CMCAACN cardiac medicine subspecialty: format, revised plan, fees, who qualifies
- CMC practice testPractice questions on the revised plan, each option explained
- CMC exam factsOld and new test plans, booking, scoring, pass rates, retakes, renewal
- CMC costMember and non-member fees, retest, renewal, whether dues pay back
- CMC eligibilitySpecialty certification, license and two cardiac hour routes
Planning a cardiac medicine review
Are older cardiac medicine review books still worth using?
Yes. The board says current study materials remain relevant for the revised exam. Work through the checklist of added lines above, and update any drug or arrest content against the newer guidelines.
How many weeks does a cardiac medicine review take?
The board gives no figure. Six weeks fits a nurse who already cares for cardiac patients every shift; give more time to the devices and drugs your unit rarely uses.
Is ECG interpretation on the exam?
Yes. The revised plan lists the ECG under monitoring and diagnostics and lists the 12-lead ECG, recorded and read by the nurse, among its testable nursing actions (test plan, p. 3).
Sources
all read Nov 11, 2026