CCRN Exam Adult Practice Test 2025 Official Study Guide [PDF]

Last Updated on April 13, 2025

CCRN Exam Adult Practice Test 2025 Official Study Guide [PDF]. AACN Certification Corporation administers the examination. Try our free CCRN (Certified Critical Care Registered Nurse) Adult exam questions and answers online.

CCRN® is a registered trademark of AACN Certification Corporation, which neither sponsors nor endorses this product. The CCRN (Certified Critical Care Registered Nurse) exam is administered by the American Association of Critical-Care Nurses (AACN) to recognize nurses with specialized knowledge and skills in critical care nursing.

Table of Contents

CCRN Exam Adult Practice Test

This is the first of two 150-question comprehensive practice tests. The pretest and questions within each chapter focused more on “facts.” The questions on each final comprehensive practice test require application, evaluation, and analysis of knowledge. By practicing more, you can score at least 80% on these comprehensive practice tests before taking the Adult CCRN exam.

CCRN Exam Adult Pre Test

Certified Critical Care Registered Nurse
CCRN Exam Adult Pre-Test
Total Items: 25
Time Limit: 25 Minutes

1. Which of the following are symptoms of hypoglycemia?

(A) tachycardia and trembling

(B) bradycardia and diaphoresis

(D) flushed, dry skin and tachycardia

2. Which of the following is TRUE for a patient who has had a right-sided stroke and develops increased intracranial pressure?

(A) The pupils will change before the level of consciousness does, there will be right-sided paralysis, the eyes will be deviated to the left, and there will be a left pupil change.

(B) The pupils will change before the level of consciousness does, there will be left-sided paralysis, the eyes will be deviated to the right, and there will be a right pupil change.

(C) The level of consciousness will change before there will be pupil changes, there will be right-sided paralysis, the eyes will be deviated to the left, and there will be a left pupil change.

(D) The level of consciousness will change before there will be pupil changes, there will be left-sided paralysis, the eyes will be deviated to the right, and there will be a right pupil change.

3. A patient status-post head trauma has an ICP of 32 mmHg. Which of the following interventions is contraindicated for this patient?

(A) Provide enteral feeding via a nasal tube.

(B) Elevate the head of bed 30–45 degrees.

(D) Avoid hypotonic intravenous solutions.

4. Which of the following is associated with mitral regurgitation?

(A) systolic murmur, sinus bradycardia

(B) diastolic murmur, heart failure

(D) diastolic murmur, complete heart block

5. A nurse knows that research supports a patient having unrestricted access to his or her designated support person (according to the patient’s wishes). However, the nurse’s unit restricts all patient visitors to set times. The nurse’s best response would be to:

(A) gather the facts and propose a policy change to the manager for the unit.

(B) tell patients/visitors that the unit’s policy is outdated but there is nothing that can be done about it.

(D) complain to colleagues about the unit’s outdated policy.

6. Nitrate therapy is indicated for the treatment of unstable angina and acute heart failure because it:

(A) decreases preload and increases myocardial O2 demand.

(B) increases preload and increases myocardial O2 demand.

(D) decreases preload and decreases myocardial O2 demand.

7. A patient post-op CABG had a sudden decrease in mediastinal chest tube drainage with hypotension, narrowing pulse pressure, and respiratory variation on the arterial waveform (pulsus paradoxus). What other signs or symptoms would the nurse anticipate that this patient might exhibit?

(A) muffled heart sounds

(B) decreased central venous pressure and increased pulmonary artery occlusion pressure

(D) ripping mid-scapular back pain

8. A patient has just consented to a bedside chest tube insertion and requests that his wife be allowed to be present during the procedure. The nurse should:

(A) explain to the patient that this is against infection control practices.

(B) tell the patient he will be able to see his wife as soon as the procedure is completed.

(D) prepare the wife for what to expect and allow her to be present.

9. ECG changes associated with ST-elevation myocardial infarction (STEMI) that affect the lateral wall would include changes in which of the following leads?

(A) II, III, aVF

(B) V1, V2, V3

(D) V5, V6, I, aVL

10. Which of the following laboratory findings are most specifically indicative of disseminated intravascular coagulation (DIC) as the cause of bleeding?

(A) elevated fibrin split products and D-dimer

(B) prolonged PT, PTT, and bleeding time

(D) decreased hemoglobin and hematocrit

11. A 29-year-old female has been in the critical care unit for 2 days after a motor vehicle crash, and she has developed acute tubular necrosis (ATN). She was normotensive upon admission. What would be the most likely cause of her ATN?

(A) hemorrhage

(B) rhabdomyolysis

(D) cardiac dysrhythmias

12. A patient with chronic kidney disease presented to the ED with complaints of shortness of breath and mouth twitching after missing two dialysis sessions. The nurse noted carpopedal spasm when the BP cuff was inflated. In addition to treatment of heart failure, which of the following would the nurse expect might need to be administered?

(A) calcium gluconate (to correct hypocalcemia)

(B) potassium (to correct hypokalemia)

(D) magnesium hydroxide (to correct hypermagnesemia)

13. A patient with a history of opioid and alcohol abuse is admitted for treatment of cellulitis. The patient has flushed, slightly moist skin and is slow to respond to verbal stimuli. The affected arm is edematous and hard to the touch, with yellow exudates noted from puncture wounds on the skin. The patient’s vital signs are as follows: temperature is 102°F (38.9°C); BP is 88/50; heart rate is 120 beats/minute; respiratory rate is 26 breaths/minute. The nurse should anticipate orders for:

(A) antibiotic and crystalloid administration.

(B) antipyretic and dopamine administration.

(D) colloid administration followed by norepinephrine administration.

14. A patient with a history of hyperlipidemia and alcohol abuse reports left upper quadrant abdominal pain. The patient’s vital signs are as follows: temperature is 101°F (38.3°C); BP is 85/50; heart rate is 110 beats/minute; respiratory rate is 24 breaths/minute. Which of the following lab values should the nurse anticipate?

(A) decreased serum amylase level and increased WBC count

(B) decreased hematocrit (HCT) and increased lipase level

(D) increased LDH and increased SGOT (AST)

15. A patient is admitted with diabetic ketoacidosis (DKA). The arterial blood gas (ABG) on room air shows:

The ABG demonstrates:

(A) compensated metabolic alkalosis.

(B) compensated respiratory acidosis.

(D) uncompensated metabolic acidosis.

16. What is the recommended initial position to improve oxygenation for a patient with unilateral pneumonia?

(A) Trendelenburg position

(B) supine position

(D) side lying on unaffected side

17. A patient is admitted with a respiratory infection. The patient has shortness of breath with a frequent productive cough and is expectorating light-green sputum. Vital signs are stable, except for the temperature, which is 39°C, and an increased respiratory rate. The nurse should anticipate which of the following ABG results?

(A) respiratory acidosis

(B) respiratory alkalosis

(D) metabolic alkalosis

18. A patient has been receiving mechanical ventilation for 2 days, but the nurse notices that there is no order for nutrition. The nurse’s best response would be to:

(A) insert a feeding tube and begin enteral nutritional therapy.

(B) complain about the physician’s practice patterns to her colleagues.

(D) assume it is the physician’s responsibility for the nutritional plan of care.

19. Which of the following critically ill patients is most at risk for development of a pressure injury?

(A) the 66-year-old patient receiving three vasopressors

(B) the patient receiving mechanical ventilation

(D) the patient with Guillain-Barré syndrome

20. In a patient with acute lung injury (ALI), which of the following contributes to the development of atelectasis?

(A) loss of surfactant and interstitial fluid accumulation

(B) increased pulmonary vascular resistance and hypoxemia

(D) mucosal edema and mucus plugging

21. All of the following are features of an acute subarachnoid hemorrhage EXCEPT for:

(A) a sudden explosive headache.

(B) nuchal rigidity.

(D) pinpoint pupils.

22. A patient is status-post inferior wall ST-elevation myocardial infarction (STEMI), with a right ventricular infarction and right ventricular failure. Which of the following data would be consistent with this patient’s condition? Note that PAP = pulmonary artery pressure, PAOP = pulmonary artery occlusion pressure, and CVP = central venous pressure.

(A) elevated PAP; elevated PAOP; elevated CVP; ST elevation in II, III, and aVF; crackles bilaterally

(B) elevated PAP; elevated PAOP; elevated CVP; ST elevation in V2–V6; clear lungs

(D) normal PAP; elevated PAOP; elevated CVP; ST elevation in V2–V6; crackles bilaterally

23. Which of the following hemodynamic profiles would best exemplify that seen in septic shock? Note that PAP = pulmonary artery pressure, PAOP = pulmonary artery occlusion pressure, CVP = central venous pressure, and SVR = systemic vascular resistance.

(A) PAP 20/4; PAOP 3; CVP 0; SVR 1,400

(B) PAP 22/6; PAOP 5; CVP 1; SVR 600

(D) PAP 55/25; PAOP 15; CVP 10; SVR 1,200

24. Which of the following patients is least likely to return to a normal level of functioning after discharge?

(A) the 70-year-old who was admitted with septic shock and is receiving chemotherapy

(B) the 75-year-old who was admitted for a scheduled coronary artery bypass graft procedure

(D) the 65-year-old who was admitted with an acute MI and a history of diabetes

25. Which of the following statements is TRUE?

(A) Delirium is a permanent condition.

(B) A patient who develops delirium has an increased risk of mortality.

(D) A patient with dementia cannot develop delirium.

Your score is

CCRN Adult Exam Format

Exam Format Here are some essential facts about the Adult CCRN exam that you should be familiar with: This exam is developed and administered by the AACN Certification Corporation, a certification organization for the American Association of Critical-Care Nurses (AACN®).

Test Name	CCRN® Adult
Administered by	AACN®
Test Mode	Computer Based Test
Total Items	150 multiple-choice
Time Limit	3 hours
Passing point/cut score	Decided by the Score Evaluation Committee (SEC)
Certification Validity	3 years

This computerized test consists of 150 multiple-choice questions, of which only 125 will be scored. Note that 25 of the questions on your exam will be validated by the AACN for future tests, but you will not know which questions are scored versus which ones are in the validation process.

You will have 3 hours to complete the exam. Rarely do test-takers not have enough time to complete this test. However, pace yourself and remain aware of the time. This test is designed to measure your command of the common body of knowledge needed to function effectively in an acute/critical care setting

Adult CCRN Test Plan

1. CLINICAL JUDGMENT (80%)

A. Cardiovascular (17%)
B. Respiratory (15%)
C. Endocrine/Hematology/Gastrointestinal/ Renal/Integumentary (20%)
D. Musculoskeletal/Neurological/ Psychosocial (14%)
E. Multisystem (14%)

2. PROFESSIONAL CARING & ETHICAL PRACTICE (20%)

A. Advocacy/Moral Agency
B. Caring Practices
C. Response to Diversity
D. Facilitation of Learning
E. Collaboration
F. Systems Thinking
G. Clinical Inquiry

Benefits of Certification

Benefits of Certification Before you learn more about the Adult CCRN exam and begin your review, you may ask yourself the following questions: What is critical care certification, and what are the benefits of accreditation? Why bother to undertake this professional challenge?

Certification is a process by which a nongovernmental agency validates, based upon predetermined standards, a nurse’s qualifications and knowledge for practicing in a defined functional or clinical area of nursing. Achieving certification in your specialty nursing practice is a major professional achievement.

Exam Results

After you complete the exam, the computer will notify you whether you passed. Within 24 hours, you will receive an email with the number of correct answers that you achieved, what the passing score was for that exam, and a score for each test content area (e.g., Cardiovascular, Respiratory, etc.) with the corresponding raw score you achieved for each area.

This will allow you to see which content areas you did the best on and which areas you need to improve. You might be nervous while waiting to find out whether you passed the exam, but the feeling is exhilarating when you do!

Tips

Review those topics again within the chapter for any practice questions you answered incorrectly. Ensure you understand where you went wrong when answering the question. Then, take a second attempt at the end-of-chapter practice questions until you get at least 80% of them correct. As you try a second time and improve your score, you will build the confidence you need to succeed!

Remember: Your clinical experience will be an advantage. However, you should not rely totally on your unit practice patterns, which may sometimes vary from correct answers as determined by the AACN.

Recertification

The Adult CCRN certification period is 3 years. When it is time for you to renew your Adult CCRN credential, there are specific requirements that you must meet, including

Maintaining a current RN or APRN licensure
Completing 432 hours of direct care of acute/critically ill patients over the 3 years, with 144 of those hours within 12 months of the renewal date
Completing the required Continuing Education Recognition Points (CERPs) or retaking and passing the Adult CCRN exam

AACN Certification Corporation’s APRN certifications are recognized for licensure in all U.S. states and territories.