For RNs Practicing in Multiple Areas of Nephrology

Certified Nephrology Nurse® (CNN®)

Three Easy Steps to Certification

  • The applicant must hold a full and unrestricted license as a registered nurse in the United States, or its territories.
  • The applicant must have completed a minimum of 3,000 hours of experience in multiple areas of nephrology nursing within the three (3) years prior to application. If the applicant is working in an outpatient hemodialysis facility, at least 750 hours (25%) of the 3,000 hours of experience must also include one or more of the following:
    • Home hemodialysis.
    • Home peritoneal dialysis.
    • Inpatient acute kidney injury on kidney replacement therapy.
    • Inpatient critical care on kidney replacement therapy.
    • CKD management NOT on kidney replacement therapy.
    • Kidney transplant.
    • Apheresis.
  • The applicant must possess a baccalaureate degree in nursing or a master’s degree in nursing.
  • The applicant must have completed thirty (30) contact hours of approved continuing education credit in nephrology nursing within three (3) years prior to submitting the exam application.

    Continuing education must be approved by one of the following:
    • Organizations accredited by the American Nurses’ Credentialing Center – Commission on Accreditation (ANCC-COA) the credentialing body of the American Nurses Association.
    • The American Association of Critical-Care Nurses (AACN).
    • The Council of Continuing Education.
    • All State Boards of Nursing.

Please be aware that although programs may meet requirements set forth by other state boards of nursing, they may not meet the Nephrology Nursing Certification Commission criteria.

The CNN exam consists of 150 questions and must be completed in three (3) hours. You must receive a standard score of 95 to pass the examination; this is achieved by answering 70% of the test questions correctly.

Download the Exam Application Forms

Standard Fees

Fee Name Amount
Exam Fee
One-time Retake
CBT 90-day Extension
Exam Application Processing Fee (Non-refundable, included in exam fee)
Expedited Review
Late Fee
Incomplete Application Fee
Returned Check/Cancelled Payment Fee
Duplicate Wallet Card or Certificate
Certification Validation Letter (Except to State Boards of Nursing)

Reduced Fees for Partner* Members

Fee Name Amount
Exam Fee
One-Time Retake
Late Fee

*Current partner organizations include the American Nephrology Nurses Association, the American Society of Nephrology, the National Kidney Foundation, and the Nurses Organization of Veterans Affairs.

  • Download our Certification Preparation Guide.
  • Determine the content of the examination from the test blueprint.
  • Read the test specifications to determine which content areas have the most "weight," because those will have the highest number of questions.
  • Review the exam reference list to familiarize yourself with material that will be included on the test.
  • Focus on areas with which you are least familiar.
  • Take the Online Practice Exam (see info below)
  • Learning strategies:
    • complete a certification review course offered by a national nephrology organization such as ANNA, NKF or ASN.
    • check with your local nephrology organizations chapter regarding upcoming certification review opportunities.
    • systematically review a nephrology nursing reference textbook.
    • participate in a study group.
    • spend a day with a colleague working in an area you need to learn about.
  • Listen to the directions given prior to the examination and follow them exactly.
  • Each month, NNCC poses a question of the month for each credential. Review the questions posed for this credential including the correct answer, rationale and reference information here:
  • Caution: Test preparation websites offering alternative and/or shortcuts to test preparation should be avoided. Exam content is confidential and is not shared with any individuals involved in test preparation activities. "Tricks of testing" and "short cut methods for test preparation" are specifically avoided when creating this exam. We test candidates on content and not on their "test taking skills." If you have any questions about the best methods to prepare please call us at 888.884.6622. Our goal is that each exam candidate best use their time and money to reach the end result of demonstrating their excellence in nephrology nursing care through certification.

The purpose of the CNN Practice Test is to allow candidates for the CNN examination to practice with a test similar in content and format to the actual CNN examination. However, no questions on the CNN Practice Test will be on the actual CNN examination. Taking the CNN Practice Test is not required and does not guarantee a similar result on the CNN examination.

The fee for the test is $50. The CNN Practice Test contains 50 multiple-choice questions available in two modes: Practice Mode provides the correct answer and rationale after each question, while Test Mode holds the results until the end of the test. Both modes at the end of the test provide a Score Report which displays your score and breakdown of percentage correct in each area of the test blueprint.

You will have access to the test for 90 days. Several scrambled versions of the same 50 questions are offered for retesting. Your credit card payment will be processed on-line and you will be granted immediate access to the CNN Practice Test.

To purchase the CNN Practice Exam, please read the Terms of Agreement and click the appropriate button below.

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Return to the CNN Practice Test

Online Practice Exam

Fee Name Amount
Online Practice Exam

Core References

  • Bodin, S.M. (Ed.) (2022). Contemporary Nephrology Nursing, 4th ed.  Pitman, NJ: ANNA.

    More Info and Purchase Here

  • Centers for Medicare and Medicaid Services (CMS). End-Stage Kidney Disease Program Interpretive Guidance Version 1.1

    View Online

  • Counts, C.S. (Ed.) (2020). Core Curriculum for Nephrology Nursing, 7th ed.  Pitman, NJ: ANNA.

    More Info and Purchase Here

  • Gomez, N. (Ed.) (2022). Nephrology Nursing Scope and Standards of Practice, 9th ed. Pitman, NJ: ANNA.

    More Info and Purchase Here

  • Kallenbach, J.Z. (2016). Review of hemodialysis for Nurses and Dialysis Personnel, 9th ed.  St. Louis, MO: Elsevier/Mosby.
  • Wilson, B.A., Shannon, M.T., & Shields, K.M. (2017). Pearson Nurse’s Drug Guide 2017. Hoboken, NJ: Pearson Education, Inc. (you may consult any similar current nurse’s drug guide)

Emotional Preparation

  • Moderate anxiety is normal and may be helpful - you may be more alert and open to learning; however too much anxiety is detrimental and will interfere with learning and test-taking.
  • Study and prepare for the examination so that you feel confident.
  • Think positively - you possess a wealth of experience and the examination will allow you to demonstrate that knowledge.
  • Use anxiety-reducing strategies:
    • relaxation response.
    • guided imagery.
    • exercise.
    • prayer.
  • Even though some test takers may finish the exam early, use as much of the allotted time as you need to think through and answer the questions.

Physical Preparation

  • Get a good night's sleep.
  • Eat before the examination - those gray cells will have glucose available when you're answering questions.
  • Gather all the materials you need to take the test the night before the exam:
    • government-issued photo ID.
    • nursing license.
    • examination permit.
    • sweater or jacket in case the room is cool.
  • Allow plenty of time to arrive early.
  • If you are distracted by other candidates during the test or leaving to use the rest room, select a seat at the front of the room where you will be less likely to notice the other candidates.

Tips on Answering Examination Questions

  • Read the questions carefully and focus on key words in the question such as "first", "most likely", "most important", "best". These words are usually printed in boldface type to attract your attention.
  • As you read the question, anticipate the correct answer.
  • Read each of the four choices carefully. Even if the first option sounds correct, read all options before choosing the answer.
  • Do not "read into" the question. Answer the question based only on the information presented, even if you think the answer is too obvious or too easy.
  • Do not be afraid to change an answer. Research has shown that more often than not, test takers change answers to the correct one.
  • Do not spend too much time on any one question. Make a note of the questions of which you are uncertain and return to them later if you have time.
  • If you are unsure about one of the content areas, you may find it helpful to complete the other areas first and leave the problem area for last.
  • "With new technologies and research, the field of nephrology nursing continues to evolve. My certification keeps me in touch with new trends and issues so I can better serve my patients. I encourage every professional nephrology nurse to get certified."

    Maggie Dorsaint‎, CNN
  • "...validates my professional expertise." 

    Mary, RN, CNN, NE-BC
  • "Having my certification as a Certified Nephrology Nurse highly magnifies my knowledge and experience..."

    Sheree Mullen, BSN RN CCM CNN
  • "Certification means the achievement of a level of professionalism in your chosen specialty. In addition, it shows that you are dedicated to your patients and colleagues."

    Madeline, BSN RN CNN
  • "I've had great job opportunities. It has motivated me to become a better leader and inspire more nurses to become certified..."

    Rebecca Rodriguez Nevarez, MSN RN CNN