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CCRN Certification Exam Questions &
Answers 2026-2027 | Latest Critical
Care Review (Rationales)
Document Overview
This document provides 185 CCRN certification exam questions, each paired with its
correct answer and a detailed rationale. It covers critical care nursing principles, offering a
comprehensive resource for studying, reviewing, and preparing for certification. This
resource directly aligns with the exam's content, ensuring focused preparation.
100% Accurate Questions and Answers 100% Guarantee Pass - Verified by Experts
Expert-Verified
Verified Answers · Detailed Rationales · 185 Questions · September 2026
CCRN Certification Exam Questions & Answers 2026-2027 | Latest Critical Care Review (Rationales) - Practice Questions Page 0
, Topics Covered
Section 1: Cardiovascular Pathophysiology & Hemodynamics
Questions covering cardiovascular Pathophysiology & Hemodynamics concepts.
Section 2: Respiratory Critical Care & Ventilation
Questions covering respiratory Critical Care & Ventilation concepts.
Section 3: Shock & Hypoperfusion
Questions covering shock & Hypoperfusion concepts.
Section 4: Hematology & Coagulation
Questions covering hematology & Coagulation concepts.
Section 5: Renal & Fluid/Electrolyte Balance
Questions covering renal & Fluid/Electrolyte Balance concepts.
Section 6: Cardiac Arrhythmias & Conduction
Questions covering cardiac Arrhythmias & Conduction concepts.
Section 7: Pulmonary Hypertension & Embolism
Questions covering pulmonary Hypertension & Embolism concepts.
Section 8: Neurological Critical Care
Questions covering neurological Critical Care concepts.
Section 9: Pharmacology & Toxicology
Questions covering pharmacology & Toxicology concepts.
Section 10: Endocrine & Metabolic Disorders
Questions covering endocrine & Metabolic Disorders concepts.
Section 11: Critical Care Procedures & Monitoring
Questions covering critical Care Procedures & Monitoring concepts.
Section 12: Gastrointestinal & Hepatic Disorders
Questions covering gastrointestinal & Hepatic Disorders concepts.
Questions
QUESTION 1 OF 185
A 56 yr-old male is admitted to the ICU with a blood pressure of 225/135 and complains
of a headache and nausea. He reports he ran out of blood pressure meds three days ago,
but also appears to be confused to the date and situation. What is the most appropriate
treatment approach?
Correct Answer: Rapidly lower the diastolic pressure to 100 with IV antihypertensive meds, then continue
to gradually reduce the diastolic pressure to 85 with oral antihypertensive meds.
The maximum initial decrease should be no more than 25% reduction from initial presenting value. Reducing
the blood pressure too quickly can lead to cerebral edema or renal failure.
CCRN Certification Exam Questions & Answers 2026-2027 | Latest Critical Care Review (Rationales) - Practice Questions Page 0
, QUESTION 2 OF 185
A patient has sepsis, receives Lactated ringers 500ml IV bolus. Which finding indicate
that this intervention is having it's intended effect?
Correct Answer: ScvO2 of 72%
Early goal directed therapy for sepsis includes early fluid resuscitation at 30 ml/kg to maintain a CVP of 8-12
or 12-15 if mechanically ventilated, MAP greater than 65, ScvO2 greater than 70%, and urine output greater
than 0.5 kg/hr
Rationale: Early goal-directed therapy for sepsis aims to optimize tissue perfusion by ensuring adequate oxygen
delivery. An ScvO2 of 72% indicates improved mixed venous oxygen saturation, reflecting enhanced oxygen extraction
by tissues, which is a desired outcome of effective fluid resuscitation in sepsis. This finding aligns with the target ScvO2
greater than 70% as outlined in sepsis management guidelines, signifying successful restoration of hemodynamic
stability and oxygenation. This aligns with Early goal directed therapy for sepsis includes early fluid resuscitation at
30 ml/kg to maintain a CVP of 8-12 or 12-15 if mechanically ventilated, and urine output greater than 0.5 kg/hr and
MAP greater than 65.
QUESTION 3 OF 185
Values in Early compensated Hypovolemic shock?
Correct Answer: CO 4.0 L/min, HR 135, SV 65, SVR 1700, MAP 65
In hypovolemic states, circulating volume is depleted therefore preload and contractility are decreased which
leads to a decrease in SV and CO. HR and SV increase as compensatory measure to preserve CO, MAP and
cerebral perfusion.
Rationale: CO 4.0 L/min, HR 135, SV 65, SVR 1700, MAP 65 In hypovolemic states, circulating volume is depleted
therefore preload and contractility are decreased which leads to a decrease in SV and CO. HR and SV increase as
compensatory measure to preserve CO, MAP and cerebral perfusion., the body attempts to maintain cardiac output
(CO) and mean arterial pressure (MAP) despite reduced circulating volume. Heart rate (HR) increases significantly to
135 bpm, and stroke volume (SV) decreases to 65 mL, leading to a compensatory CO of 4.0 L/min and a MAP of 65
mmHg. Systemic vascular resistance (SVR) is elevated to 1700 dynes·sec/cm⁻⁵ as a compensatory mechanism to
preserve perfusion pressure.
QUESTION 4 OF 185
Patients with right ventricular infarctions become preload dependent. Meds that
decrease preload should be avoided - which meds are these?
Correct Answer: Morphine, Nitro, Beta blockers and diuretics.
Rationale: Right ventricular (RV) infarction impairs RV contractility, rendering the RV unable to adequately fill the
left ventricle; thus, RV stroke volume and systemic output are critically dependent on adequate preload. Medications
that reduce preload, such as morphine (vasodilator), nitroglycerin (venodilator), beta-blockers (decrease heart rate
and contractility), and diuretics (reduce circulating volume), will decrease RV filling pressures and consequentially
diminish cardiac output in these patients. Avoiding these agents helps maintain sufficient RV filling and preserve
systemic perfusion. This aligns with Morphine, Nitro, Beta blockers and diuretics., Beta blockers and diuretics. and
Morphine.
CCRN Certification Exam Questions & Answers 2026-2027 | Latest Critical Care Review (Rationales) - Practice Questions Page 0
, QUESTION 5 OF 185
Polymorphic ventricular tachycardia aka Torsades is treated by?
Correct Answer: Magnesium
Rationale: Torsades de Pointes, a polymorphic ventricular tachycardia, is often associated with a prolonged QT
interval and can be effectively treated with intravenous magnesium sulfate. Magnesium acts by stabilizing the cardiac
membrane and shortening the refractory period, thereby reducing the likelihood of early afterdepolarizations that
trigger this arrhythmia. This intervention is considered first-line therapy for Torsades, even in the absence of
documented hypomagnesemia.
QUESTION 6 OF 185
Myocardial contusions generally impact which parts of the heart? and what would the
values be?
Correct Answer: Atria & right ventricle because of the position of the heart in the chest.
PAOP 6, PA Pressure 40/24, RA Pressure 16
Rationale: Myocardial contusions, often resulting from blunt chest trauma, primarily affect the anterior and right-
sided structures of the heart due to their anterior position in the thoracic cavity. This anterior impact leads to
increased right ventricular preload and afterload, manifesting as elevated pulmonary artery occlusion pressure
(PAOP) and pulmonary artery systolic pressure, alongside a significantly increased right atrial (RA) pressure. The
given values (PAOP 6, PA Pressure 40/24, RA Pressure 16) reflect this pathophysiology, with the PAOP being relatively
low but the RA pressure and PA systolic pressure elevated, indicating impaired right ventricular function and potential
pulmonary hypertension secondary to the contusion. This aligns with Atria & right ventricle because of the position of
the heart in the chest..
QUESTION 7 OF 185
Neurogenic shock signs?
Correct Answer: CVP: 3, CI: 2.5, SVR: 650, SBP: 88
Neuro shock is associated with a loss of sympathetic tone causing extensive peripheral vasodilation. Clinical
signs and symptoms include hypotension, a low SVR, low CVP and low normal CI
Rationale: Neurogenic shock results from a loss of sympathetic tone, leading to widespread peripheral vasodilation
and a subsequent decrease in systemic vascular resistance (SVR). This vasodilation causes hypotension (low SBP),
reduced preload (low CVP), and a relative preservation of cardiac output (low normal CI) as the heart attempts to
compensate for decreased afterload. Therefore, the presented hemodynamic profile of CVP: 3, CI: 2.5, SVR: 650, and
SBP: 88 accurately reflects these characteristic findings. This aligns with Neuro shock is associated with a loss of
sympathetic tone causing extensive peripheral vasodilation. Clinical signs and symptoms include hypotension, low
CVP and low normal CI and a low SVR.
QUESTION 8 OF 185
What causes a larger than normal A wave on a PAOP?
Correct Answer: Mitral stenosis - causes increased left atrial pressure during atrial contraction.
Rationale: The 'A' wave on a pulmonary artery occlusion pressure (PAOP) tracing represents left atrial pressure
during atrial contraction (atrial systole). Mitral stenosis impedes blood flow from the left atrium to the left ventricle,
leading to increased left atrial pressure, which in turn causes a larger than normal 'A' wave. This reflects the increased
force required by the atrium to push blood across a narrowed mitral valve. This aligns with Mitral stenosis - causes
increased left atrial pressure during atrial contraction..
CCRN Certification Exam Questions & Answers 2026-2027 | Latest Critical Care Review (Rationales) - Practice Questions Page 0
CCRN Certification Exam Questions &
Answers 2026-2027 | Latest Critical
Care Review (Rationales)
Document Overview
This document provides 185 CCRN certification exam questions, each paired with its
correct answer and a detailed rationale. It covers critical care nursing principles, offering a
comprehensive resource for studying, reviewing, and preparing for certification. This
resource directly aligns with the exam's content, ensuring focused preparation.
100% Accurate Questions and Answers 100% Guarantee Pass - Verified by Experts
Expert-Verified
Verified Answers · Detailed Rationales · 185 Questions · September 2026
CCRN Certification Exam Questions & Answers 2026-2027 | Latest Critical Care Review (Rationales) - Practice Questions Page 0
, Topics Covered
Section 1: Cardiovascular Pathophysiology & Hemodynamics
Questions covering cardiovascular Pathophysiology & Hemodynamics concepts.
Section 2: Respiratory Critical Care & Ventilation
Questions covering respiratory Critical Care & Ventilation concepts.
Section 3: Shock & Hypoperfusion
Questions covering shock & Hypoperfusion concepts.
Section 4: Hematology & Coagulation
Questions covering hematology & Coagulation concepts.
Section 5: Renal & Fluid/Electrolyte Balance
Questions covering renal & Fluid/Electrolyte Balance concepts.
Section 6: Cardiac Arrhythmias & Conduction
Questions covering cardiac Arrhythmias & Conduction concepts.
Section 7: Pulmonary Hypertension & Embolism
Questions covering pulmonary Hypertension & Embolism concepts.
Section 8: Neurological Critical Care
Questions covering neurological Critical Care concepts.
Section 9: Pharmacology & Toxicology
Questions covering pharmacology & Toxicology concepts.
Section 10: Endocrine & Metabolic Disorders
Questions covering endocrine & Metabolic Disorders concepts.
Section 11: Critical Care Procedures & Monitoring
Questions covering critical Care Procedures & Monitoring concepts.
Section 12: Gastrointestinal & Hepatic Disorders
Questions covering gastrointestinal & Hepatic Disorders concepts.
Questions
QUESTION 1 OF 185
A 56 yr-old male is admitted to the ICU with a blood pressure of 225/135 and complains
of a headache and nausea. He reports he ran out of blood pressure meds three days ago,
but also appears to be confused to the date and situation. What is the most appropriate
treatment approach?
Correct Answer: Rapidly lower the diastolic pressure to 100 with IV antihypertensive meds, then continue
to gradually reduce the diastolic pressure to 85 with oral antihypertensive meds.
The maximum initial decrease should be no more than 25% reduction from initial presenting value. Reducing
the blood pressure too quickly can lead to cerebral edema or renal failure.
CCRN Certification Exam Questions & Answers 2026-2027 | Latest Critical Care Review (Rationales) - Practice Questions Page 0
, QUESTION 2 OF 185
A patient has sepsis, receives Lactated ringers 500ml IV bolus. Which finding indicate
that this intervention is having it's intended effect?
Correct Answer: ScvO2 of 72%
Early goal directed therapy for sepsis includes early fluid resuscitation at 30 ml/kg to maintain a CVP of 8-12
or 12-15 if mechanically ventilated, MAP greater than 65, ScvO2 greater than 70%, and urine output greater
than 0.5 kg/hr
Rationale: Early goal-directed therapy for sepsis aims to optimize tissue perfusion by ensuring adequate oxygen
delivery. An ScvO2 of 72% indicates improved mixed venous oxygen saturation, reflecting enhanced oxygen extraction
by tissues, which is a desired outcome of effective fluid resuscitation in sepsis. This finding aligns with the target ScvO2
greater than 70% as outlined in sepsis management guidelines, signifying successful restoration of hemodynamic
stability and oxygenation. This aligns with Early goal directed therapy for sepsis includes early fluid resuscitation at
30 ml/kg to maintain a CVP of 8-12 or 12-15 if mechanically ventilated, and urine output greater than 0.5 kg/hr and
MAP greater than 65.
QUESTION 3 OF 185
Values in Early compensated Hypovolemic shock?
Correct Answer: CO 4.0 L/min, HR 135, SV 65, SVR 1700, MAP 65
In hypovolemic states, circulating volume is depleted therefore preload and contractility are decreased which
leads to a decrease in SV and CO. HR and SV increase as compensatory measure to preserve CO, MAP and
cerebral perfusion.
Rationale: CO 4.0 L/min, HR 135, SV 65, SVR 1700, MAP 65 In hypovolemic states, circulating volume is depleted
therefore preload and contractility are decreased which leads to a decrease in SV and CO. HR and SV increase as
compensatory measure to preserve CO, MAP and cerebral perfusion., the body attempts to maintain cardiac output
(CO) and mean arterial pressure (MAP) despite reduced circulating volume. Heart rate (HR) increases significantly to
135 bpm, and stroke volume (SV) decreases to 65 mL, leading to a compensatory CO of 4.0 L/min and a MAP of 65
mmHg. Systemic vascular resistance (SVR) is elevated to 1700 dynes·sec/cm⁻⁵ as a compensatory mechanism to
preserve perfusion pressure.
QUESTION 4 OF 185
Patients with right ventricular infarctions become preload dependent. Meds that
decrease preload should be avoided - which meds are these?
Correct Answer: Morphine, Nitro, Beta blockers and diuretics.
Rationale: Right ventricular (RV) infarction impairs RV contractility, rendering the RV unable to adequately fill the
left ventricle; thus, RV stroke volume and systemic output are critically dependent on adequate preload. Medications
that reduce preload, such as morphine (vasodilator), nitroglycerin (venodilator), beta-blockers (decrease heart rate
and contractility), and diuretics (reduce circulating volume), will decrease RV filling pressures and consequentially
diminish cardiac output in these patients. Avoiding these agents helps maintain sufficient RV filling and preserve
systemic perfusion. This aligns with Morphine, Nitro, Beta blockers and diuretics., Beta blockers and diuretics. and
Morphine.
CCRN Certification Exam Questions & Answers 2026-2027 | Latest Critical Care Review (Rationales) - Practice Questions Page 0
, QUESTION 5 OF 185
Polymorphic ventricular tachycardia aka Torsades is treated by?
Correct Answer: Magnesium
Rationale: Torsades de Pointes, a polymorphic ventricular tachycardia, is often associated with a prolonged QT
interval and can be effectively treated with intravenous magnesium sulfate. Magnesium acts by stabilizing the cardiac
membrane and shortening the refractory period, thereby reducing the likelihood of early afterdepolarizations that
trigger this arrhythmia. This intervention is considered first-line therapy for Torsades, even in the absence of
documented hypomagnesemia.
QUESTION 6 OF 185
Myocardial contusions generally impact which parts of the heart? and what would the
values be?
Correct Answer: Atria & right ventricle because of the position of the heart in the chest.
PAOP 6, PA Pressure 40/24, RA Pressure 16
Rationale: Myocardial contusions, often resulting from blunt chest trauma, primarily affect the anterior and right-
sided structures of the heart due to their anterior position in the thoracic cavity. This anterior impact leads to
increased right ventricular preload and afterload, manifesting as elevated pulmonary artery occlusion pressure
(PAOP) and pulmonary artery systolic pressure, alongside a significantly increased right atrial (RA) pressure. The
given values (PAOP 6, PA Pressure 40/24, RA Pressure 16) reflect this pathophysiology, with the PAOP being relatively
low but the RA pressure and PA systolic pressure elevated, indicating impaired right ventricular function and potential
pulmonary hypertension secondary to the contusion. This aligns with Atria & right ventricle because of the position of
the heart in the chest..
QUESTION 7 OF 185
Neurogenic shock signs?
Correct Answer: CVP: 3, CI: 2.5, SVR: 650, SBP: 88
Neuro shock is associated with a loss of sympathetic tone causing extensive peripheral vasodilation. Clinical
signs and symptoms include hypotension, a low SVR, low CVP and low normal CI
Rationale: Neurogenic shock results from a loss of sympathetic tone, leading to widespread peripheral vasodilation
and a subsequent decrease in systemic vascular resistance (SVR). This vasodilation causes hypotension (low SBP),
reduced preload (low CVP), and a relative preservation of cardiac output (low normal CI) as the heart attempts to
compensate for decreased afterload. Therefore, the presented hemodynamic profile of CVP: 3, CI: 2.5, SVR: 650, and
SBP: 88 accurately reflects these characteristic findings. This aligns with Neuro shock is associated with a loss of
sympathetic tone causing extensive peripheral vasodilation. Clinical signs and symptoms include hypotension, low
CVP and low normal CI and a low SVR.
QUESTION 8 OF 185
What causes a larger than normal A wave on a PAOP?
Correct Answer: Mitral stenosis - causes increased left atrial pressure during atrial contraction.
Rationale: The 'A' wave on a pulmonary artery occlusion pressure (PAOP) tracing represents left atrial pressure
during atrial contraction (atrial systole). Mitral stenosis impedes blood flow from the left atrium to the left ventricle,
leading to increased left atrial pressure, which in turn causes a larger than normal 'A' wave. This reflects the increased
force required by the atrium to push blood across a narrowed mitral valve. This aligns with Mitral stenosis - causes
increased left atrial pressure during atrial contraction..
CCRN Certification Exam Questions & Answers 2026-2027 | Latest Critical Care Review (Rationales) - Practice Questions Page 0
