CCRN Practice Test 2025/2026 – Critical Care Registered Nurse
CCRN PRACTICE TEST 2025/2026
Critical Care Registered Nurse – AACN Certification Examination
175 Total Questions (150 Scored + 25 Pretest) | 3 Hours
42 Practice Questions with Correct Answers and Evidence-Based Rationales
Instructions: This practice test covers all major content domains of the AACN CCRN examination blueprint
for 2025/2026. Each multiple-choice question has one best answer. The correct answer is displayed in bold
cyan blue. A detailed evidence-based rationale is provided for each question to support clinical judgment and
exam preparation.
Domain Questions Exam Weight Score
Cardiovascular 9 25–30% ____
Pulmonary 6 15–20% ____
Renal 4 10–15% ____
Neurological 5 10–15% ____
Endocrine 3 5–10% ____
Gastrointestinal 3 5–10% ____
Hematology & 4 5–10% ____
Immunology
Multisystem/Trauma/ 4 10–15% ____
Toxicology
Professional Caring & 2 Integrated ____
Ethical Practice
Multisystem/ 2 5–10% ____
Pharmacology
Total 42 100% ____
Cardiovascular
1. A patient with a pulmonary artery catheter (PAC/Swan-Ganz) has the following hemodynamic values:
CVP 12 mmHg, PAP 45/25 mmHg, PAWP/PCWP 18 mmHg, CO 3.2 L/min, SVR 1800 dynes/sec/cm ⁻⁵.
Which type of shock is this patient most likely experiencing?
A. Hypovolemic shock B. Cardiogenic shock
C. Distributive shock D. Obstructive shock
Correct Answer: B
Rationale: The elevated PAWP/PCWP (18 mmHg, normal 6–12) indicates increased left ventricular filling
pressures, consistent with cardiogenic shock. The elevated SVR (1800, normal 800–1200) reflects compensatory
vasoconstriction. The low cardiac output (3.2 L/min, normal 4–8) confirms pump failure. Hypovolemic shock
would show low PAWP; distributive shock would show low SVR; obstructive shock would show equalization of
diastolic pressures.
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, CCRN Practice Test 2025/2026 – Critical Care Registered Nurse
2. A patient arrives to the ICU after a cardiac arrest with return of spontaneous circulation (ROSC). The
interprofessional team initiates Targeted Temperature Management (TTM). Which temperature range is
recommended per AHA/ACLS guidelines for post-cardiac arrest care?
A. 32°C–34°C (89.6°F–93.2°F) B. 36°C (96.8°F) or 32–36°C
C. 35°C–37°C (95°F–98.6°F) D. 30°C–32°C (86°F–89.6°F)
Correct Answer: B
Rationale: Current AHA guidelines (2020 and beyond) recommend TTM at either 36°C (96.8°F) or within the
range of 32–36°C for at least 24 hours in comatose adult patients after ROSC from cardiac arrest. The earlier
strict 32–34°C range has been updated based on evidence showing comparable outcomes at 36°C with fewer
complications.
3. A critical care nurse is caring for a patient receiving a continuous dobutamine infusion for acute
decompensated heart failure. Which adverse effect requires the most immediate intervention?
A. Tachycardia with new onset chest pain B. Mild headache
C. Decreased appetite D. Peripheral vasodilation with warm extremities
Correct Answer: A
Rationale: Dobutamine is a beta-1 agonist that increases myocardial contractility and heart rate. Tachycardia
with new chest pain may indicate increased myocardial oxygen demand leading to ischemia or extension of an
infarction. This requires immediate intervention, potentially including dose reduction, analgesics, or anti-
ischemic therapy. The other options are less urgent side effects.
4. A patient in the ICU develops sudden onset hypotension (BP 70/40), jugular venous distension, and
muffled heart sounds. Which intervention should the nurse prepare for FIRST?
A. Fluid bolus of 1 L normal saline B. Pericardiocentesis
C. Emergent intubation D. Administration of vasopressors
Correct Answer: B
Rationale: This presentation (hypotension, JVD, muffled heart sounds) is Beck’s Triad, the classic presentation of
cardiac tamponade. The first intervention is pericardiocentesis to remove pericardial fluid and relieve the
pressure on the heart. While vasopressors and fluids may temporarily support blood pressure, they do not address
the underlying cause. Tamponade is a mechanical obstruction requiring drainage.
5. A patient with an Intra-Aortic Balloon Pump (IABP) has the following arterial waveform. The balloon
inflation is set to trigger on the Dicrotic Notch. The nurse notes that the augmented diastolic pressure is
lower than the previous reading. Which complication should the nurse suspect?
A. Limb ischemia B. Balloon rupture
C. Hemolysis D. Balloon migration
Correct Answer: B
Rationale: A sudden decrease in augmented diastolic pressure suggests balloon rupture or a leak in the balloon.
Blood may enter the catheter, visible as blood in the gas tubing. This is a medical emergency requiring immediate
IABP removal. Limb ischemia would present with cool, pale, pulseless extremity. Hemolysis would show
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CCRN PRACTICE TEST 2025/2026
Critical Care Registered Nurse – AACN Certification Examination
175 Total Questions (150 Scored + 25 Pretest) | 3 Hours
42 Practice Questions with Correct Answers and Evidence-Based Rationales
Instructions: This practice test covers all major content domains of the AACN CCRN examination blueprint
for 2025/2026. Each multiple-choice question has one best answer. The correct answer is displayed in bold
cyan blue. A detailed evidence-based rationale is provided for each question to support clinical judgment and
exam preparation.
Domain Questions Exam Weight Score
Cardiovascular 9 25–30% ____
Pulmonary 6 15–20% ____
Renal 4 10–15% ____
Neurological 5 10–15% ____
Endocrine 3 5–10% ____
Gastrointestinal 3 5–10% ____
Hematology & 4 5–10% ____
Immunology
Multisystem/Trauma/ 4 10–15% ____
Toxicology
Professional Caring & 2 Integrated ____
Ethical Practice
Multisystem/ 2 5–10% ____
Pharmacology
Total 42 100% ____
Cardiovascular
1. A patient with a pulmonary artery catheter (PAC/Swan-Ganz) has the following hemodynamic values:
CVP 12 mmHg, PAP 45/25 mmHg, PAWP/PCWP 18 mmHg, CO 3.2 L/min, SVR 1800 dynes/sec/cm ⁻⁵.
Which type of shock is this patient most likely experiencing?
A. Hypovolemic shock B. Cardiogenic shock
C. Distributive shock D. Obstructive shock
Correct Answer: B
Rationale: The elevated PAWP/PCWP (18 mmHg, normal 6–12) indicates increased left ventricular filling
pressures, consistent with cardiogenic shock. The elevated SVR (1800, normal 800–1200) reflects compensatory
vasoconstriction. The low cardiac output (3.2 L/min, normal 4–8) confirms pump failure. Hypovolemic shock
would show low PAWP; distributive shock would show low SVR; obstructive shock would show equalization of
diastolic pressures.
Page 1
, CCRN Practice Test 2025/2026 – Critical Care Registered Nurse
2. A patient arrives to the ICU after a cardiac arrest with return of spontaneous circulation (ROSC). The
interprofessional team initiates Targeted Temperature Management (TTM). Which temperature range is
recommended per AHA/ACLS guidelines for post-cardiac arrest care?
A. 32°C–34°C (89.6°F–93.2°F) B. 36°C (96.8°F) or 32–36°C
C. 35°C–37°C (95°F–98.6°F) D. 30°C–32°C (86°F–89.6°F)
Correct Answer: B
Rationale: Current AHA guidelines (2020 and beyond) recommend TTM at either 36°C (96.8°F) or within the
range of 32–36°C for at least 24 hours in comatose adult patients after ROSC from cardiac arrest. The earlier
strict 32–34°C range has been updated based on evidence showing comparable outcomes at 36°C with fewer
complications.
3. A critical care nurse is caring for a patient receiving a continuous dobutamine infusion for acute
decompensated heart failure. Which adverse effect requires the most immediate intervention?
A. Tachycardia with new onset chest pain B. Mild headache
C. Decreased appetite D. Peripheral vasodilation with warm extremities
Correct Answer: A
Rationale: Dobutamine is a beta-1 agonist that increases myocardial contractility and heart rate. Tachycardia
with new chest pain may indicate increased myocardial oxygen demand leading to ischemia or extension of an
infarction. This requires immediate intervention, potentially including dose reduction, analgesics, or anti-
ischemic therapy. The other options are less urgent side effects.
4. A patient in the ICU develops sudden onset hypotension (BP 70/40), jugular venous distension, and
muffled heart sounds. Which intervention should the nurse prepare for FIRST?
A. Fluid bolus of 1 L normal saline B. Pericardiocentesis
C. Emergent intubation D. Administration of vasopressors
Correct Answer: B
Rationale: This presentation (hypotension, JVD, muffled heart sounds) is Beck’s Triad, the classic presentation of
cardiac tamponade. The first intervention is pericardiocentesis to remove pericardial fluid and relieve the
pressure on the heart. While vasopressors and fluids may temporarily support blood pressure, they do not address
the underlying cause. Tamponade is a mechanical obstruction requiring drainage.
5. A patient with an Intra-Aortic Balloon Pump (IABP) has the following arterial waveform. The balloon
inflation is set to trigger on the Dicrotic Notch. The nurse notes that the augmented diastolic pressure is
lower than the previous reading. Which complication should the nurse suspect?
A. Limb ischemia B. Balloon rupture
C. Hemolysis D. Balloon migration
Correct Answer: B
Rationale: A sudden decrease in augmented diastolic pressure suggests balloon rupture or a leak in the balloon.
Blood may enter the catheter, visible as blood in the gas tubing. This is a medical emergency requiring immediate
IABP removal. Limb ischemia would present with cool, pale, pulseless extremity. Hemolysis would show
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