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Want a feel for the real CCRN before you pay for anything? Start here. Below are
sample Adult CCRN questions written in the same style as the AACN exam
— single best answer, scenario-driven, with a rationale that explains why
the right answer is right and the others are traps. Work each one before you read the answer.
Unlock 590+ CCRN practice questions across 4 full-length simulators — $19.99 lifetime →
How close are these to the actual CCRN?
Per the AACN CCRN Exam Handbook, the Adult CCRN is 150 questions
(125 scored, 25 unscored) over 3 hours. About 80% tests Clinical Judgment across body
systems, and 20% tests Professional Caring and the Synergy Model. The samples below mirror
that mix — mostly bedside judgment, with one Synergy-style item so you see both.
Sample CCRN questions
- A patient 2 days post anterior STEMI develops new crackles to the mid-lung
fields, an S3, and a drop in SpO2 to 88% on 2 L. What is your priority action?- A. Increase the nasal cannula to 6 L
- B. Sit the patient upright and notify the provider for suspected acute heart failure
- C. Administer a 500 mL fluid bolus
- D. Draw a troponin and wait for results
Answer: B. The S3, new crackles, and falling saturation point to
left-ventricular failure with flash pulmonary edema — common after a large anterior
infarct. Upright positioning plus rapid escalation is the priority; a fluid bolus (C) would
worsen the congestion, and waiting on labs (D) delays care. - An intubated ARDS patient on volume-control ventilation has a plateau pressure
of 34 cmH2O. Which change best protects the lungs?- A. Increase tidal volume to improve ventilation
- B. Reduce tidal volume toward 6 mL/kg of predicted body weight
- C. Increase the respiratory rate to 35
- D. Switch to pressure support
Answer: B. Lung-protective ventilation keeps plateau pressure under
30 cmH2O, and the lever for that is a lower tidal volume (~6 mL/kg PBW). A higher
tidal volume (A) raises the plateau further; an unstable patient with a plateau of 34 is not
ready for pressure support (D). - A septic patient remains hypotensive (MAP 58) after a 30 mL/kg crystalloid
bolus. Per Surviving Sepsis principles, what comes next?- A. A second 30 mL/kg bolus
- B. Start norepinephrine to target a MAP of at least 65
- C. Start dopamine
- D. Give a unit of packed red cells
Answer: B. When fluids alone don’t restore perfusion, norepinephrine is
the first-line vasopressor to reach a MAP of 65 or higher. Dopamine (C) is no longer
preferred; transfusion (D) isn’t indicated without a hemoglobin trigger. - A monitor shows a regular wide-complex tachycardia at 180 with a palpable pulse
and a blood pressure of 132/80. What is the appropriate first step?- A. Immediate unsynchronized defibrillation
- B. Synchronized cardioversion without delay
- C. Assess, obtain a 12-lead, and consider adenosine or antiarrhythmics for stable VT
- D. Begin chest compressions
Answer: C. The patient is stable (good pressure, perfusing), so you have
time to work the rhythm up rather than shock it. Defibrillation (A) is for pulseless rhythms;
compressions (D) are wrong in a patient with a pulse. - Which finding most strongly suggests your sedated, ventilated patient is in pain
rather than simply under-sedated?- A. A RASS of −1
- B. A rising Critical-Care Pain Observation Tool (CPOT) score with grimacing and
ventilator dyssynchrony - C. A stable heart rate
- D. Closed eyes
Answer: B. Pain in a patient who can’t self-report is assessed with a
validated behavioral tool such as CPOT; grimacing plus dyssynchrony is a classic signal.
This item also reflects the Synergy Model’s focus on responding to the patient’s actual needs. - A patient with DKA has a potassium of 3.2 mEq/L. What should happen before
starting the insulin infusion?- A. Start insulin immediately to close the anion gap
- B. Replace potassium first, because insulin will drive it lower
- C. Give sodium bicarbonate
- D. Restrict all IV fluids
Answer: B. Insulin shifts potassium into cells, so starting it with a K
of 3.2 can cause dangerous hypokalemia. Replace potassium first and hold insulin until it’s
at least 3.3–3.5 mEq/L.
How did you do?
If a few of those felt shaky, that’s exactly what practice is for — the real exam
rewards pattern recognition you build by working hundreds of these. Our full bank gives you
590+ CCRN questions across 4 timed simulators, each with the same kind of rationale, plus a
free 30-question sample test you can take right now without paying.
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).