If you care for patients with heart and vascular disease, the Cardiac-Vascular Nursing Certification (CV-BC™) from the American Nurses Credentialing Center (ANCC) shows that your specialty knowledge meets a national standard. The exam covers a lot of ground, from reading rhythm strips and Doppler findings to teaching a heart failure patient how to track daily weights. That breadth can feel intimidating at first.

In this guide, we’ll walk you through the exam format, each of the four content domains and their question counts, the official resources worth downloading, and the questions candidates ask most often.

What Is the ANCC CV-BC Exam?

The CV-BC is ANCC’s board certification for registered nurses who practice in cardiac-vascular nursing. It is an entry-level specialty credential, meaning it measures the knowledge and skills of an RN who has already built a couple of years of experience and at least 2,000 hours of cardiac-vascular practice. It is not an advanced practice (APRN) certification.

Cardiac-vascular nurses work across a wide range of settings: cardiac step-down and telemetry units, cardiovascular ICUs, cath and electrophysiology labs, vascular surgery units, heart failure clinics, and cardiac rehabilitation programs. The exam reflects that range. You’ll see questions on coronary artery disease, heart failure, dysrhythmias, peripheral arterial and venous disease, structural heart procedures, and cardiac and vascular surgery, all framed around the nursing process.

What Is the ANCC CV-BC Exam Format?

Here is the exam at a glance, based on the ANCC CV-BC certification page and the ANCC Certification Handbook:

  • Questions: 150 multiple-choice questions.
  • Scored vs. unscored: 125 scored questions and 25 unscored pretest questions. Pretest items are mixed in and look like every other question, so give each one your full effort.
  • Time: 3 hours to answer the questions. Plan for a longer appointment overall, since the handbook notes that check-in, instructions, and a tutorial add time.
  • Delivery: Computer-based testing at Prometric test centers. You can apply year-round and schedule within a 120-day testing window.
  • Passing score: A scaled score of 350 or higher on a scale of 0 to 500.
  • Results: After testing, you’ll receive an email with instructions for viewing your results online through Prometric’s Report Validation Portal. The handbook says results are typically available within 24 to 48 hours.

With 180 minutes for 150 questions, you have about 72 seconds per question. That’s comfortable for recall items but tighter for rhythm strip or hemodynamic questions, so timed practice is worth building into your plan.

What Content Outline Does the ANCC CV-BC Exam Use?

The current exam follows the CV-BC Test Content Outline, effective December 5, 2025. It organizes the 125 scored questions into four domains that follow the nursing process, with knowledge and skill statements under each one.

  • Domain I, Assessment and Diagnosis: 27 questions (22%)
  • Domain II, Planning and Implementation: 44 questions (35%)
  • Domain III, Evaluation and Modification: 23 questions (18%)
  • Domain IV, Patient and Community Education: 31 questions (25%)

Notice that the domains are organized by nursing process, not by disease. Heart failure, for example, can show up in all four: recognizing an S3 and crackles (Domain I), starting guideline-directed therapy (Domain II), spotting hyperkalemia after adding an ACE inhibitor (Domain III), and teaching sodium and fluid guidance (Domain IV).

Domain I: Assessment and Diagnosis (27 Questions, 22%)

This domain tests whether you can gather and make sense of cardiovascular data. It pairs core science with hands-on assessment and interpretation of diagnostics.

  • Knowledge: anatomy and physiology, pathophysiology, and nursing diagnosis identification.
  • Skill: patient interviews, including history, chief complaint, and social determinants of health.
  • Skill: cardiac-vascular assessment techniques and tools, such as Doppler and stroke scales.
  • Skill: collecting and interpreting data from diagnostic tests, laboratory results, and cardiac rhythms.

What questions look like: A stem gives you an ankle-brachial index, a troponin trend, or a 12-lead finding and asks what it most likely indicates or which finding needs follow-up first.

Domain II: Planning and Implementation (44 Questions, 35%)

This is the largest domain, with more than a third of scored questions. It covers what you do once you know what’s going on, guided by evidence and professional standards.

  • Evidence-based practice guidelines, such as ACC/AHA guidelines and quality measures.
  • Scope and standards of practice for cardiovascular nursing.
  • Legal and ethical considerations, including informed consent and advance directives.
  • Invasive and non-invasive procedures (peripheral, cardiac, and structural) and surgeries such as coronary or vascular bypass and transplant.
  • Pharmacologic, non-pharmacologic, and complementary therapies.
  • Risk-reduction measures such as venous thromboembolism prophylaxis and infection prevention.
  • Prioritization and care coordination with interdisciplinary teams and discharge planning.
  • Interventions such as targeted temperature management and cardioversion.

Study tip: Know pre- and post-procedure care for cardiac catheterization, PCI, TAVR, CABG, and peripheral revascularization, plus the major drug classes used in acute coronary syndrome, heart failure, and atrial fibrillation.

Domain III: Evaluation and Modification (23 Questions, 18%)

Evaluation is about noticing whether care is working and responding when it isn’t. It’s the smallest domain, but its questions tend to be high-stakes judgment calls.

  • Expected outcomes of treatment.
  • Drug interactions, both drug-drug and drug-food.
  • Recognition and treatment of adverse reactions and events.
  • Recognition and treatment of urgent and emergent conditions.

What questions look like: A patient on warfarin starts a new antibiotic, a post-cath patient develops back pain and hypotension, or a patient on amiodarone has a lengthening QT interval. You decide what the change means and what to do first.

Domain IV: Patient and Community Education (31 Questions, 25%)

A quarter of the exam focuses on teaching and prevention. Many candidates underestimate this domain because they don’t think of education as “clinical,” but ANCC weights it more heavily than evaluation.

  • Cardiac-vascular risk factors, such as ethnicity and smoking, and chronic disease management.
  • Education topics including procedures and medications.
  • Self-management strategies such as daily weights and blood pressure logs.
  • Community resources such as cardiac rehabilitation and anticoagulation clinics.
  • Individualized education planning, outpatient monitoring (remote telemetry, point-of-care testing), and health promotion (wellness counseling, health fairs).

Study tip: Be ready to pick the teaching point that matters most for safety, such as when to call the provider for weight gain or signs of bleeding on an anticoagulant, and to tailor teaching to health literacy and readiness to learn.

How Should You Use the Blueprint to Build a Study Plan?

The question counts give you a clear starting point for dividing your time.

  1. Take a mixed baseline. Answer a set of questions across all four domains before you start reviewing so you know where you actually stand.
  2. Weight your time. Domains II and IV together make up 60% of scored questions. Give them the most hours, especially if your baseline is weak there.
  3. Study by condition across domains. For each major condition, walk through assessment, treatment, evaluation, and teaching. This mirrors how ANCC structures the outline.
  4. Map every miss. Tag each missed question to a domain and a knowledge or skill statement. Patterns show up fast, such as drug interactions or post-procedure complications.
  5. Revisit with mixed, timed practice. In your final weeks, shift to mixed sets under time pressure to build pacing and recognition.

What Official ANCC CV-BC Resources Should You Use?

Commonly used CV-BC study textbooks:

  • Nursing: Scope and Standard of Practice (American Nurses Association), 5th Edition (ISBN 978-1558102156)
  • Neurovascular Nursing: Scope and Standards of Practice 1st Edition (ISBN 978-1953985644)
  • Manual of Perioperative Care in Adult Cardiac Surgery, 6th Edition (ISBN 978-1119582557)
  • Core Curriculum for Vascular Nursing: An Official Publication of the Society for Vascular Nursing (SVN), 2nd Edition (ISBN 978-1451192322)
  • Guide to the Code of Ethics for Nurses: With Interpretive Statements: Development, Interpretation, and Application, 2nd Edition (ISBN 978-1558106031)

Frequently Asked Questions About the ANCC CV-BC Exam

What score do I need to pass the CV-BC exam?
You need a scaled score of 350 or higher out of 500. Scaled scoring allows ANCC to account for small differences in difficulty between exam forms, so there’s no fixed number of questions you must answer correctly.

What is the CV-BC pass rate?
According to ANCC’s 2025 ANCC Certification Data, 1,120 candidates took the CV-BC exam for the first time in 2025, and 67% passed. That’s a solid reason to prepare deliberately rather than relying on clinical experience alone.

Did the CV-BC content outline change recently?
Yes. The current Test Content Outline took effect December 5, 2025. It uses four nursing-process domains: Assessment and Diagnosis, Planning and Implementation, Evaluation and Modification, and Patient and Community Education.

What happens if I don’t pass the CV-BC exam?
Per the handbook, you can retest 60 days after your last attempt, up to three attempts in any 12-month period. You’ll need to submit a retest application, meet the eligibility requirements in effect at that time, and pay the retest fee.

How much does the CV-BC exam cost?
ANCC lists the fee as $395 for non-members, $295 for ANA members, and $340 for members of the Society for Vascular Nursing or the Preventive Cardiovascular Nurses Association. Each fee includes a $140 non-refundable administrative fee.

How long is the CV-BC certification valid?
CV-BC certification is valid for five years. You can submit a renewal application up to one year before it expires. Renewal requires continuing education plus one additional professional development activity, and ANCC is introducing an updated renewal framework for applications submitted on or after February 1, 2027.

Start Preparing for the ANCC CV-BC Exam With Pocket Prep

Pocket Prep’s ANCC CV-BC practice questions give you 600 questions aligned to the four domains, each with a detailed explanation, plus a full-length mock exam to test your pacing. Use the Weakest Subject quiz to zero in on the domain that needs the most work, and let the Question of the Day keep you in the habit between longer sessions.

You’ve already built this knowledge at the bedside, and a consistent study plan will help you show it on exam day.