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The Adult CCRN measures two things: your clinical judgment at the bedside, and how you
practice as a professional. Here’s how AACN weights the exam — and what
changed in the November 2025 revision.
The two domains
| Domain | Weight |
|---|---|
| Clinical Judgment (across body systems) | 80% |
| Professional Caring & Ethical Practice (Synergy Model) | 20% |
Clinical Judgment (80%): organized by body system
The 80% is spread across body systems plus multisystem problems, with
Cardiovascular the single largest area (about 17%). The areas tested:
- Cardiovascular — the largest single section
- Pulmonary
- Neurological
- Multisystem (sepsis, shock, fluid and
electrolyte imbalance, rhabdomyolysis, and more) - Gastrointestinal
- Renal/Genitourinary
- Endocrine
- Hematology/Immunology
- Integumentary and Musculoskeletal
- Behavioral/Psychosocial
Professional Caring & Ethical Practice (20%): the Synergy Model
This fifth of the exam is built on the AACN Synergy Model — the idea that the best
outcomes happen when a nurse’s competencies match a patient’s needs. Expect items on
advocacy and moral agency, caring practices, collaboration, systems thinking, response to
diversity, facilitation of learning, and clinical inquiry.
What changed in November 2025?
AACN revised the Adult CCRN exam on November 12, 2025. Cardiovascular
and Respiratory question counts decreased slightly, while Multisystem and Neurological
increased. New topics include cardiac infection and inflammatory disease, pericardiocentesis,
fluid and electrolyte imbalances, rhabdomyolysis, adult failure to thrive, and
obesity-related complications. If your study material predates the change, plug those gaps.
Unlock 590+ CCRN practice questions across 4 full-length simulators — $19.99 lifetime →
Sources & references
The exam facts on this page are drawn from official certifying-body materials, reviewed 2026-06-18 by the DrCertifications exam-prep team (10+ years in exam preparation and publishing).