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Critical Care · AACN

CCRN practice questions, built for nurses.

Prepare for the Critical Care Registered Nurse exam with 720+ blueprint-aligned questions across all six AACN domains — weighted to the official AACN test plan, with a dashboard that shows exactly where to focus and a full exam simulation when you're ready.

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720+QUESTIONS
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About the CCRN exam

The CCRN certifies registered nurses who provide direct care to acutely and critically ill adult patients in ICU, CCU, trauma, and critical-care transport settings — spanning the major body systems and multisystem problems.

Exam at a glance

Credentialing bodyAACN Certification Corporation
Format150 items (125 scored)
Time3 hours
DeliveryPSI centers / online proctored
Official detailsAACN ↗

What CertifyRN gives you

Question bank720+ questions
Clinical exhibitsECG, waveforms & ABGs
Blueprint matchAll 6 domains, weighted
Weak-spot dashboardPer-domain tracking
Exam simulationReal timing + conditions
PricingFree to start · subscription

Domain breakdown

Your practice mix mirrors the official AACN CCRN test plan, so you study in the same proportions the exam tests.

Cardiovascular13%
Respiratory12%
Endocrine / Hematology / GI / Renal / Integumentary21%
Neurological / Musculoskeletal / Behavioral18%
Multisystem16%
Professional Caring & Ethical Practice20%

Read the strips, waveforms & labs

CCRN tests interpretation, not recall. CertifyRN questions put the actual exhibit in front of you — a rhythm strip, a hemodynamic waveform, an ABG panel — and ask what you'd do next, the way the real exam does.

ECG & rhythm strips

Identify the lethal rhythm and pick the intervention — defibrillate, pace, or push the drug.

Hemodynamic waveforms

Read arterial and PA-catheter tracings — wedge, CVP, CO/CI — and titrate accordingly.

pH7.28
PaCO₂58
HCO₃26

ABG & lab panels

Interpret the acid–base picture from real values and choose the next correction.

Increase PEEP
Prone the patient
Give a fluid bolus

Single-best-answer

Every item is a focused ICU decision with four options — the exact CCRN format.

Exhibits are illustrative of the question style. The CCRN® exam is multiple-choice; CertifyRN mirrors that format.

Study smarter, not just harder

Free CCRN study guides — no login needed. Learn the Synergy Model, drill acid–base and hemodynamics, and walk in on test day knowing exactly what to expect.

Why nurses choose CertifyRN

Target your weak spots

A domain dashboard shows exactly where you're losing points, so study time goes where it counts.

Practice like the real thing

Full exam simulation mirrors the real CCRN timing and conditions — no surprises on test day.

Study anywhere

Progress syncs across all your devices instantly, so you can practice on any break.

All-access.
One subscription unlocks every CertifyRN exam — the full CCRN bank, exam simulation, and your readiness dashboard. Monthly or annual, cancel anytime.

Try 5 CCRN questions

Tap an answer to check it. Want the full bank? Start practicing free ›

1. A patient in cardiogenic shock after a large anterior MI has a cardiac index of 1.6 L/min/m2, a high systemic vascular resistance, and pulmonary congestion. Which intervention most directly addresses the primary problem?
AAggressive crystalloid bolus to raise preload
BAn inotrope such as dobutamine to improve contractility
CA pure alpha-agonist to raise blood pressure
DImmediate beta-blockade to lower heart rate
Correct: An inotrope such as dobutamine to improve contractility.
Rationale

Cardiogenic shock after a large anterior MI is a pump-failure problem — low cardiac output (index 1.6) against a high afterload. An inotrope such as dobutamine improves contractility and raises output, which most directly addresses the failing pump.

Why the other options are wrong

A crystalloid bolus adds volume and worsens the existing pulmonary congestion. A pure alpha-agonist raises afterload against an already failing pump. Immediate beta-blockade further lowers an output that is already dangerously low.

2. A patient in diabetic ketoacidosis has a serum potassium of 3.1 mEq/L on arrival, and an insulin infusion is ordered. What is the priority before starting insulin?
AStart the insulin infusion immediately as ordered
BGive a bicarbonate drip to correct the acidosis first
CReplace potassium and hold insulin until it exceeds 3.3 mEq/L
DSwitch to subcutaneous insulin to slow the potassium shift
Correct: Replace potassium and hold insulin until it exceeds 3.3 mEq/L.
Rationale

Insulin drives potassium into cells. With a serum potassium of 3.1 mEq/L, giving insulin first can trigger dangerous hypokalemia and arrhythmias, so potassium is replaced and insulin held until it exceeds 3.3 mEq/L.

Why the other options are wrong

Starting the infusion immediately pushes potassium even lower. A bicarbonate drip is not first-line in DKA and does nothing about the potassium risk. Subcutaneous insulin still shifts potassium into cells — changing the route doesn't remove the hypokalemia hazard.

3. Two days after a pericardial effusion was identified, a patient becomes acutely hypotensive with distended neck veins and muffled heart sounds. Systolic pressure falls 14 mmHg during inspiration and the monitor shows low-voltage QRS complexes. Which action does the nurse anticipate?
ALay the patient flat and restrict intravenous fluids
BPrepare for emergent pericardiocentesis to relieve the tamponade
CPrepare for immediate synchronized cardioversion
DApply high-flow oxygen and continue routine monitoring
Correct: Prepare for emergent pericardiocentesis to relieve the tamponade.
Rationale

Hypotension, jugular venous distension, and muffled heart sounds (Beck's triad), together with pulsus paradoxus — an inspiratory drop in systolic pressure greater than 10 mmHg — and low-voltage QRS, point to cardiac tamponade. The compressed heart cannot fill, so removing the pericardial fluid by pericardiocentesis is the definitive, life-saving intervention.

Why the other options are wrong

Lying flat and restricting fluids further lowers preload and worsens this obstructive shock — the filling-limited heart needs volume while drainage is arranged. Cardioversion treats unstable tachyarrhythmias, not a mechanical filling problem with an organized rhythm. Oxygen and monitoring alone ignore an immediately reversible cause that requires drainage.

4. A patient on room air has an ABG showing pH 7.30, PaCO2 58 mmHg, PaO2 52 mmHg, and HCO3 27 mEq/L. The patient is drowsy with shallow respirations. Which interpretation best fits this picture?
AAcute hypercapnic respiratory failure with hypoxemia
BChronic compensated hypercapnia with stable gas exchange
CPrimary metabolic acidosis from tissue hypoperfusion
DRespiratory alkalosis from compensatory hyperventilation
Correct: Acute hypercapnic respiratory failure with hypoxemia.
Rationale

Respiratory failure is defined by hypercapnia above 45 with hypoxemia below 60, and a low pH marks the process as acute rather than chronic. The depressed level of consciousness reflects the rising PaCO2 driving CNS depression.

Why the other options are wrong

A chronic compensated picture would show a near-normal pH with renal bicarbonate retention, which the acidotic pH rules out. A primary metabolic process would lower the bicarbonate rather than leave it slightly elevated. The gases show acidosis with CO2 retention, not the alkalosis of hyperventilation.

5. A patient with worsening dyspnea has the pulmonary artery tracing shown. Which conclusion is supported?
0 20 40 60 80 mmHg PA 62/30 (41)
AThe transducer requires releveling
BThe catheter has migrated into the wedge
CThe tracing shows an overdamped system
DPulmonary hypertension is present
Correct: Pulmonary hypertension is present.
Rationale

A mean pulmonary artery pressure above 25 mmHg defines pulmonary hypertension, and this tracing reads 41. The morphology is entirely normal, with a preserved upstroke and dicrotic notch, so the abnormality is in the scale rather than the shape. Reading contour alone and skipping the axis is the error this tracing is designed to expose.

Why the other options are wrong

A leveling error shifts all pressures together without preserving a normal contour at a plausibly elevated range. A wedged catheter shows a damped atrial waveform with a fall in mean pressure, not an elevated pulsatile tracing. Overdamping blunts the waveform and narrows the pulse pressure, which is not seen here.

The same tracing, labeled

In the app, every waveform question can show a labeled version once you have answered.

0 20 40 60 80 mmHg PA 62/30 (41) systolic 62 contour normal — the SCALE is raised diastolic 30

CCRN prep — frequently asked

Are these CCRN practice questions free?

Yes. You can practice CCRN questions for free to start. The full 720+ question bank and exam simulation are included with an all-access CertifyRN subscription (monthly or annual, cancel anytime).

How many CCRN practice questions are included?

The CCRN bank has 720+ blueprint-aligned questions distributed across all six AACN domains in line with the official test plan, so your practice mix mirrors the real exam blueprint.

Do the questions follow the current AACN CCRN test plan?

Yes. Questions are weighted to the official test plan: Cardiovascular 13%, Respiratory 12%, Endocrine / Hematology / GI / Renal / Integumentary 21%, Neurological / Musculoskeletal / Behavioral 18%, Multisystem 16%, and Professional Caring and Ethical Practice 20%.

Is CertifyRN affiliated with AACN?

No. CertifyRN is an independent study resource and is not affiliated with, endorsed by, or sponsored by AACN Certification Corporation. CCRN is a registered trademark of its respective owner.

How does the weak-spot dashboard work?

As you practice, CertifyRN tracks performance by domain and shows which areas need the most work, so your study targets your weakest domains first. Full exam simulation mirrors real testing conditions.

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CertifyRN is an independent study resource and is not affiliated with, endorsed by, or sponsored by the American Association of Critical-Care Nurses (AACN) or the AACN Certification Corporation. CCRN® is a registered trademark of its respective owner, used here for identification only. CertifyRN provides original practice materials and does not reproduce official exam content.