Certification CCRN Critical care nursing
CCRN Critical Care Nursing Exam 2026/2027 – Latest
Comprehensive Practice Exam | 200 Questions &
Answers with Rationales
CCRN Critical Care Nursing — 200-Question Practice Examination
Questions 1–50
1. A patient with septic shock has a MAP of 55 mmHg despite adequate fluid resuscitation.
Which medication is the priority?
A. Dobutamine
B. Furosemide
C. Norepinephrine
D. Nitroglycerin
2. Which assessment finding is most concerning in a patient with increased intracranial
pressure (ICP)?
A. Headache
B. Nausea
C. Decreasing level of consciousness
D. Photophobia
3. A patient with acute respiratory distress syndrome (ARDS) is receiving mechanical
ventilation. Which intervention is most appropriate?
A. High tidal volumes
B. Low tidal-volume ventilation
C. Routine hyperventilation
D. Zero PEEP
,4. Which ECG finding is most characteristic of hyperkalemia?
A. Prolonged QT interval
B. U waves
C. Peaked T waves
D. ST elevation
5. A patient receiving heparin develops a platelet count that decreases substantially from
baseline. Which complication should the nurse suspect?
A. DIC
B. Thrombocytopenia from dilution
C. Heparin-induced thrombocytopenia
D. Hemophilia
6. Which finding is most consistent with cardiogenic shock?
A. Warm, flushed skin
B. Bounding pulses
C. Pulmonary congestion and hypotension
D. Increased urine output
7. A patient develops sudden dyspnea, hypotension, and unilateral absent breath sounds
after central-line placement. What complication is most likely?
A. Pulmonary edema
B. Pneumonia
C. Tension pneumothorax
D. Pleural effusion
8. Which medication is commonly used for symptomatic bradycardia?
A. Adenosine
B. Amiodarone
C. Atropine
D. Lidocaine
9. Which laboratory value is most useful for assessing oxygen-carrying capacity?
A. Sodium
B. Creatinine
C. Hemoglobin
D. Albumin
10. A patient with diabetic ketoacidosis is receiving IV insulin. Which electrolyte requires
particularly close monitoring?
A. Calcium
,B. Sodium
C. Potassium
D. Magnesium
11. Which finding is typical of left-sided heart failure?
A. Ascites
B. Peripheral edema only
C. Crackles and pulmonary congestion
D. Enlarged liver
12. A patient with acute ischemic stroke has difficulty swallowing. What is the nurse's
priority?
A. Give oral medications
B. Offer water
C. Keep the patient NPO until swallowing is assessed
D. Place the patient flat
13. Which intervention is appropriate for a patient experiencing autonomic dysreflexia?
A. Place the patient supine
B. Restrict fluids
C. Sit the patient upright and identify the trigger
D. Administer a sedative immediately
14. Which acid-base imbalance is expected with prolonged vomiting?
A. Respiratory acidosis
B. Metabolic acidosis
C. Respiratory alkalosis
D. Metabolic alkalosis
15. Which finding indicates worsening tissue perfusion in a critically ill patient?
A. Urine output 60 mL/hr
B. Warm extremities
C. Increasing serum lactate
D. Normal mentation
16. Which medication reverses opioid-induced respiratory depression?
A. Flumazenil
B. Protamine
C. Naloxone
D. Vitamin K
, 17. A patient develops wheezing, hypotension, and facial swelling after receiving an
antibiotic. What is the priority medication?
A. Diphenhydramine only
B. Hydrocortisone
C. Epinephrine
D. Furosemide
18. Which ventilator alarm requires immediate assessment?
A. Low battery
B. High-pressure alarm
C. Humidifier alarm
D. Low oxygen-cylinder alarm
19. Which assessment finding is most consistent with hypovolemic shock?
A. Bradycardia
B. Hypertension
C. Tachycardia with cool, clammy skin
D. Bounding pulses
20. A patient with acute pulmonary edema is severely dyspneic. Which position is most
appropriate?
A. Flat supine
B. Trendelenburg
C. High-Fowler's
D. Prone
21. Which laboratory finding is characteristic of disseminated intravascular coagulation
(DIC)?
A. Increased platelets
B. Decreased PT
C. Prolonged PT and aPTT
D. Increased fibrinogen
22. Which medication is an antidote for excessive warfarin effect?
A. Protamine sulfate
B. Naloxone
C. Vitamin K
D. Atropine
23. A patient with acute kidney injury has severe hyperkalemia and ECG changes. Which
treatment helps stabilize the cardiac membrane?
CCRN Critical Care Nursing Exam 2026/2027 – Latest
Comprehensive Practice Exam | 200 Questions &
Answers with Rationales
CCRN Critical Care Nursing — 200-Question Practice Examination
Questions 1–50
1. A patient with septic shock has a MAP of 55 mmHg despite adequate fluid resuscitation.
Which medication is the priority?
A. Dobutamine
B. Furosemide
C. Norepinephrine
D. Nitroglycerin
2. Which assessment finding is most concerning in a patient with increased intracranial
pressure (ICP)?
A. Headache
B. Nausea
C. Decreasing level of consciousness
D. Photophobia
3. A patient with acute respiratory distress syndrome (ARDS) is receiving mechanical
ventilation. Which intervention is most appropriate?
A. High tidal volumes
B. Low tidal-volume ventilation
C. Routine hyperventilation
D. Zero PEEP
,4. Which ECG finding is most characteristic of hyperkalemia?
A. Prolonged QT interval
B. U waves
C. Peaked T waves
D. ST elevation
5. A patient receiving heparin develops a platelet count that decreases substantially from
baseline. Which complication should the nurse suspect?
A. DIC
B. Thrombocytopenia from dilution
C. Heparin-induced thrombocytopenia
D. Hemophilia
6. Which finding is most consistent with cardiogenic shock?
A. Warm, flushed skin
B. Bounding pulses
C. Pulmonary congestion and hypotension
D. Increased urine output
7. A patient develops sudden dyspnea, hypotension, and unilateral absent breath sounds
after central-line placement. What complication is most likely?
A. Pulmonary edema
B. Pneumonia
C. Tension pneumothorax
D. Pleural effusion
8. Which medication is commonly used for symptomatic bradycardia?
A. Adenosine
B. Amiodarone
C. Atropine
D. Lidocaine
9. Which laboratory value is most useful for assessing oxygen-carrying capacity?
A. Sodium
B. Creatinine
C. Hemoglobin
D. Albumin
10. A patient with diabetic ketoacidosis is receiving IV insulin. Which electrolyte requires
particularly close monitoring?
A. Calcium
,B. Sodium
C. Potassium
D. Magnesium
11. Which finding is typical of left-sided heart failure?
A. Ascites
B. Peripheral edema only
C. Crackles and pulmonary congestion
D. Enlarged liver
12. A patient with acute ischemic stroke has difficulty swallowing. What is the nurse's
priority?
A. Give oral medications
B. Offer water
C. Keep the patient NPO until swallowing is assessed
D. Place the patient flat
13. Which intervention is appropriate for a patient experiencing autonomic dysreflexia?
A. Place the patient supine
B. Restrict fluids
C. Sit the patient upright and identify the trigger
D. Administer a sedative immediately
14. Which acid-base imbalance is expected with prolonged vomiting?
A. Respiratory acidosis
B. Metabolic acidosis
C. Respiratory alkalosis
D. Metabolic alkalosis
15. Which finding indicates worsening tissue perfusion in a critically ill patient?
A. Urine output 60 mL/hr
B. Warm extremities
C. Increasing serum lactate
D. Normal mentation
16. Which medication reverses opioid-induced respiratory depression?
A. Flumazenil
B. Protamine
C. Naloxone
D. Vitamin K
, 17. A patient develops wheezing, hypotension, and facial swelling after receiving an
antibiotic. What is the priority medication?
A. Diphenhydramine only
B. Hydrocortisone
C. Epinephrine
D. Furosemide
18. Which ventilator alarm requires immediate assessment?
A. Low battery
B. High-pressure alarm
C. Humidifier alarm
D. Low oxygen-cylinder alarm
19. Which assessment finding is most consistent with hypovolemic shock?
A. Bradycardia
B. Hypertension
C. Tachycardia with cool, clammy skin
D. Bounding pulses
20. A patient with acute pulmonary edema is severely dyspneic. Which position is most
appropriate?
A. Flat supine
B. Trendelenburg
C. High-Fowler's
D. Prone
21. Which laboratory finding is characteristic of disseminated intravascular coagulation
(DIC)?
A. Increased platelets
B. Decreased PT
C. Prolonged PT and aPTT
D. Increased fibrinogen
22. Which medication is an antidote for excessive warfarin effect?
A. Protamine sulfate
B. Naloxone
C. Vitamin K
D. Atropine
23. A patient with acute kidney injury has severe hyperkalemia and ECG changes. Which
treatment helps stabilize the cardiac membrane?
