The Medical-Surgical Nursing Certification Board (MSNCB) encourages certification for all registered nurses who provide care in a medical-surgical setting. Initial certification is achieved through successful testing by written examination. The certification examination is based on Benner's Nursing Model. Questions on the examination fall within the seven domains of nursing practice: Helping Role, Teaching-Coaching Function, Diagnostic and Patient Monitoring, Effective Management of Rapidly Changing Situations, Administering and Monitoring Therapeutic Interventions and Regimens, Monitoring and Ensuring the Quality of Health Care Practices, and Organizational and Work Role Competencies.