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AACN Certification Corporation

CCRN® (Adult) Certification

The specialty credential for nurses caring for critically ill adults — from the ICU and step-down unit to the cath lab and flight team.

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Questions150 multiple-choice (125 scored, 25 unscored pretest)
Time3 hours — about 72 seconds per question
Blueprint80% clinical judgment · 20% professional caring and ethical practice
WhereAt home by Live Remote Proctoring, or at a PSI test center
Fee$260 AACN members · $375 non-members · retest $185 / $290
Who sits itRNs or APRNs with 1,750 direct-care hours with acutely/critically ill adults in 2 years (875 in the last year), or 2,000 hours in 5 years (144 in the last year)
ResultsOn screen when you finish; detailed score report by email within 24 hours

About the exam

The CCRN (Adult) is AACN's certification for nurses who provide direct care to acutely and critically ill adult patients. It shows you can recognize subtle deterioration, interpret hemodynamics, rhythms and labs, and manage complex, multisystem illness at the bedside.

The exam is built on the AACN Synergy Model. 80% tests clinical judgment across body systems — cardiovascular, respiratory, the endocrine, hematology, GI, renal and skin group, neuro and behavioral health, and multisystem problems like shock and sepsis. The other 20% tests professional caring and ethical practice: advocacy, collaboration, systems thinking and caring for diverse patients and families.

AACN revised the exam in November 2025 after its 2024 practice study. Cardiovascular and respiratory content shrank a little; neurological and multisystem content grew, with new topics such as cardiac infections, neurogenic shock, tumor lysis syndrome and skin failure.

How we track your progress

Every blueprint domain moves through five levels as you study:

  1. Not startedNo questions answered in this domain yet.
  2. Getting startedFirst questions answered — not enough yet to judge.
  3. DevelopingAt least 5 answered and 50% or better on your recent questions.
  4. ProficientAt least 15 answered and 70% or better on your recent questions.
  5. Exam readyAt least 25 answered, 80% or better recently, and holding up on hard questions.

The exam blueprint

AACN Adult CCRN Test Plan, revised exam launched November 12, 2025 — 125 scored items: 80% clinical judgment across 5 body-system areas, 20% professional caring and ethical practice. Tap a domain to see its topics.

1 Cardiovascular 13% of the exam
Acute coronary syndromesAortic aneurysm and dissectionCardiac infections (endocarditis, pericarditis, myocarditis)Cardiac surgery and post-op careCardiogenic shock and mechanical circulatory supportCardiomyopathiesDysrhythmiasHeart failureHypertensive crisisStructural and valvular heart diseaseVascular disorders and peripheral vascular insufficiencyHemodynamic monitoring

58 practice questions in this domain so far

2 Respiratory 12% of the exam
Acute respiratory distress syndrome (ARDS)Acute respiratory failureAcute respiratory infectionsPulmonary embolismChronic lung disease exacerbations (COPD, asthma)Mechanical ventilation and its complicationsPleural abnormalities (pneumothorax, effusion)Pulmonary edema and pulmonary hypertensionPulmonary hemorrhageThoracic traumaAirway management and oxygenation

54 practice questions in this domain so far

3 Endocrine, Hematology, Immunology, GI, Renal and Integumentary 21% of the exam
Diabetic emergencies (DKA, HHS, hypoglycemia)Thyroid, adrenal and pituitary disorders (including SIADH and DI)Coagulopathies (DIC, HIT, thrombocytopenia)Anemia, transfusion and transfusion reactionsImmune compromise and oncologic emergencies (including tumor lysis syndrome)GI hemorrhageHepatic failure and cirrhosisAcute pancreatitisBowel obstruction, ischemia and perforationAcute kidney injury and renal replacement therapyElectrolyte imbalancesPressure injuries, wounds and skin failure

95 practice questions in this domain so far

4 Musculoskeletal, Neurological, Behavioral and Psychosocial 18% of the exam
Fractures, rhabdomyolysis and compartment syndromeAcute ischemic and hemorrhagic strokeTraumatic brain injury and increased ICPSpinal cord injury and neurogenic shockSeizures and status epilepticusEncephalopathy and brain deathNeuromuscular disorders (myasthenia gravis, Guillain-Barré)Delirium and dementiaAgitation, sedation and restraintSubstance use and withdrawalSuicidal behavior, anxiety, depression and PTSD

81 practice questions in this domain so far

5 Multisystem 16% of the exam
Acid-base imbalanceSepsis and septic shockShock states (hypovolemic, distributive, obstructive)Multiple organ dysfunction syndromeBurnsTrauma and massive transfusionToxic ingestions and overdoseThermoregulation and post-arrest carePain managementEnd-of-life and palliative care

72 practice questions in this domain so far

6 Professional Caring and Ethical Practice 20% of the exam
Advocacy and moral agencyCaring practicesResponse to diversityFacilitation of learningCollaborationSystems thinkingClinical inquiry

90 practice questions in this domain so far

What you get when you access this exam

Free with your QuizMe account.

ICU scenarios aligned to the blueprint

Every question is tagged to one of the 6 CCRN areas and its topics — rhythms, hemodynamics, vent settings, labs and what you do first.

Exam-critical hints

Reveal the critical-care pearl that unlocks the question — the waveform clue, the pressure that matters, the lab trend. Every answer comes with the full rationale.

Adaptive testing

Questions steer toward your weakest areas, weighted by how much each counts on the real exam, and get harder as you get stronger.

Timed practice exams

Blueprint-weighted exams at the real pace — 150 questions in 3 hours — with a live pacing indicator and a full review.

Flashcards, case simulations and guides

120 flashcards, 8 unfolding ICU cases where the chart updates with every decision, and interactive illustrated guides you explore hotspot by hotspot.

Progress for every blueprint area

Each area moves from Not started to Getting started, Developing, Proficient and Exam ready — so you know exactly what to study next.

Test at home or at a center

AACN offers the CCRN two ways, both delivered by PSI. Once your application is approved you have a 90-day window to test.

At home — Live Remote Proctoring

  • A live PSI proctor watches through your webcam for the whole exam.
  • Use your own Windows PC or Mac with a webcam, microphone and steady internet — not a tablet, Chromebook or locked-down work computer.
  • Run PSI's system check well before exam day, and again on the same network the day before.
  • Test alone in a quiet, private room with a clear desk: no phone, notes, smartwatch or second monitor.
  • You'll show the room and your desk on camera before you start.

At a PSI test center

  • Arrive about 30 minutes early for check-in.
  • Bring current government-issued photo ID with the same name as your application.
  • Phones, bags, watches and notes go in a locker.
  • Fewer moving parts: no home tech check, no room scan, no worries about your Wi-Fi.

Exam-day game plan

How to walk in ready — and how to pace 150 questions in 3 hours.

Pacing checkpoints

Hit these and you finish with time to revisit your flagged questions. Our timed practice exams run at this same pace.

38questions0:45
75questions1:30
113questions2:15
150questions3:00

The week before

  • Take one full-length timed practice exam 3–5 days out, then rest.
  • Spend your last sessions on the heaviest areas — the endocrine/heme/GI/renal group (21%), Professional Caring (20%) and neuro/behavioral (18%) — plus anything still below Proficient.
  • Review rhythm strips, hemodynamic profiles of each shock state, ABG interpretation and vent troubleshooting.
  • At home? Run PSI's system check and set up your room.

Exam morning

  • Eat a real breakfast with protein; go easy on caffeine.
  • Test center: arrive 30 minutes early with your ID. Home: log in early, restart your computer and close every other program.
  • Use the restroom right before you start.

During the exam

  • Read the whole stem and find the cue: first, priority, most concerning, best indicator.
  • Think in physiology: what is the pressure, the flow, the oxygen delivery doing — and what fixes the cause, not just the number?
  • Professional Caring questions reward the Synergy answer: advocate, collaborate, include the family, respect the patient's values.
  • Pick your best answer, flag it and move on. Revisit flags at the end.
  • Answer every question — there's no penalty for guessing.
  • 25 questions are unscored pretest items you can't identify.

Keep your head

  • A few nerves sharpen focus. If you freeze, take three slow breaths and reread the stem.
  • You're measured against a fixed standard, not other test-takers.
  • Change an answer only when you find a real reason in the stem.

Keeping your CCRN

  • Certification lasts 3 years.
  • Renew with 100 Synergy CERPs across categories A, B and C, or by passing the current exam.
  • Renewal also requires recent practice hours caring for acutely/critically ill patients — check AACN's renewal handbook for the exact numbers.
  • If you can't meet the requirements, AACN offers an inactive status for up to 3 years.

Official sources and further reading

Ready to start?

450 questions and scenarios across the blueprint — and growing.

Enroll free

CCRN® is a registered trademark of the AACN Certification Corporation. QuizMe and thinQtank Learning are not affiliated with or endorsed by AACN or PSI. Exam details are summarized from AACN's published handbook and test plan; fees and rules change — always confirm at aacn.org before you apply. We don't state a passing score; our Exam ready level asks for 80% or better.