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Certified Addictions Registered Nurse (CARN) Examination
The Certified Addictions Registered Nurse (CARN) Examination is a 150-question multiple-choice computer-based certification exam (about 25 of the items are unscored pilot questions) owned by the Addictions Nursing Certification Board, with applications and testing services run by C-NET and delivery at PSI test centers; candidates get 3 hours, need 75% of the scored items to pass, receive scores immediately on completion, and earn a CARN certification valid for four years.
Official exam siteJump to prep options ↓
Questions150 multiple-choice questions, of which about 25 are experimental/pilot questions that are not scored (about 125 scored items)
Testing time3 hours
ScoringA passing score requires correctly answering 75% of the CARN test items; the passing standard is set by the Angoff Procedure (criterion-referenced, not norm-referenced)
Exam feeUSD 300 standard examination fee; USD 250 with a membership discount requiring proof of membership in ASAN, IntNSA USA, or NOVA; fees are listed on the C-NET website and are subject to change at the discretion of the ANCB
Prep options
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Exam overview
What to know before choosing your prep
- Who runs it
- ANCB
- Category
- Specialty Nursing Certification
- Current version
- CARN Examination Handbook revised 1/2026; current ANCB test specifications (blueprint) implemented 2026, derived from the Role Delineation Study that is repeated approximately every five years
- Where it applies
- International / multi-country
- Exam languages
- English
- Score scale
- Percentage of correctly answered test items (75% required to pass); no scaled score published — passing score reports show the total score only, failing reports show the total score plus sub-scores in all major areas of concentration
- Testing provider
- PSI Services LLC (C-NET's global testing partner; C-NET administers applications and testing services on behalf of ANCB)
- Format
- Computer-based multiple-choice test administered at PSI testing locations; single-best-answer items with no penalty for guessing; scores available immediately at the testing facility
- Availability
- Year-round computer-based testing with no application deadlines; applications processed in approximately two weeks; once approved and registered with PSI, candidates have a 90-day testing window to schedule and sit the examination (one optional 90-day extension available for a fee)
- Results
- Scores available immediately upon completion at the testing facility; passing score reports show the total score only, failing score reports include the total score plus sub-scores in all major areas of concentration
- Credential validity
- CARN certification is valid for four (4) years from passing, provided the individual maintains a current RN license; renewal is by recertification (60 points of credit plus 2,000 hours of addictions nursing experience within the past four years) or by re-passing the examination before expiration
- Remote testing
- Not available
Exam structure
One 150-item multiple-choice section whose items are distributed across five domains of practice — Perform a biopsychosocial SUD assessment (15%), Assess acute care needs of SUD patients (20%), Develop and implement an individualized plan of care (15%), Educate and promote behavioral change (15%), and Care management, treatment, and evaluation throughout the recovery continuum including special populations (35%) — crossed with seven patient-problem categories: opioid use disorder (27%), alcohol use disorders (25%), medication misuse (10%), co-occurring psychiatric/comorbid medical disorders (12%), stimulant use disorders (15%), cannabinoids and other hallucinogens (6%), and tobacco use disorder (5%)
Where rules vary
A single uniform examination used in the United States and Canada; ANCB states it is currently certifying nurses in both countries. Licensure eligibility requires an RN license verified via NCLEX or CGFNS/WES/ERES equivalency.
Eligibility
Current RN license (via NCLEX or equivalency verified by CGFNS, WES, or ERES; unrestricted in every jurisdiction of practice); at least 2,000 hours (one year) of addictions-related nursing experience within the three years before applying; 30 continuing-education contact hours earned within three years with at least 51% specific to addictions nursing; upload of a matching government-issued photo ID; nurses with restricted licenses in monitoring programs need a supporting letter from the program (surrendered licenses or agreement violations make candidates ineligible)
Retake policy
Candidates who do not pass receive an automated retake/rescheduling link emailed no sooner than 30 days after the last test date; each link may be used once, with new links issued after each unsuccessful attempt for up to one year from the original application submission, after which a new application and fee are required