CCRN Certification Review Notes (Critical
Care Registered Nurse)
Candidate Name: __________________________
Certification: CCRN (Adult) – American Association of Critical-Care Nurses
Length: ~2,000 words
1. Overview of the CCRN Exam
The CCRN certification validates expertise in caring for acutely and critically ill patients. It is
offered by the AACN Certification Corporation and available in adult, pediatric, and neonatal
tracks.
Eligibility:
Current, unencumbered RN or APRN license.
At least 1,750 hours of direct bedside critical care experience in the last two years (875
in the most recent year).
Exam Structure (Adult CCRN):
150 multiple-choice questions (125 scored, 25 unscored).
, Duration: 3 hours.
Passing score: ~70–75% (scaled score 90).
Domains tested:
o Clinical Judgment (80%)
o Professional Caring and Ethical Practice (20%)
2. Core Clinical Content Areas
A. Cardiovascular System (≈17–21% of exam)
1. Hemodynamics
Key Parameters:
Measurement Normal Range Interpretation
High = fluid overload; Low =
CVP (Central Venous Pressure) 2–6 mmHg
hypovolemia
PAWP (Pulmonary Artery
8–12 mmHg Reflects left atrial pressure
Wedge Pressure)
CO: 4–8 L/min; CI: 2.5–4.0
CO/CI (Cardiac Output/Index) Decreased = poor perfusion
L/min/m²
SVR (Systemic Vascular High = vasoconstriction; Low =
800–1200 dynes/sec/cm⁵
Resistance) vasodilation
, Management Concepts:
Optimize preload, afterload, contractility, and heart rate.
Use inotropes (dobutamine), vasopressors (norepinephrine), or vasodilators
(nitroglycerin) as needed.
2. Cardiac Rhythms
Common Arrhythmias:
Atrial fibrillation: Irregular rhythm; risk of emboli → anticoagulation.
Ventricular tachycardia: Assess pulse; defibrillate if pulseless.
Ventricular fibrillation: CPR + defibrillation immediately.
Heart blocks:
o 1° AV = prolonged PR; monitor only.
o 3° AV = no atrial/ventricular coordination → pacemaker.
3. Myocardial Infarction
STEMI: Full-thickness damage; immediate PCI within 90 minutes.
NSTEMI: Partial occlusion; treat with antiplatelets and anticoagulants.
Monitor cardiac enzymes (troponin, CK-MB).
Administer MONA (Morphine, O₂, Nitrates, Aspirin) as indicated.
B. Respiratory System (≈14–18%)
Care Registered Nurse)
Candidate Name: __________________________
Certification: CCRN (Adult) – American Association of Critical-Care Nurses
Length: ~2,000 words
1. Overview of the CCRN Exam
The CCRN certification validates expertise in caring for acutely and critically ill patients. It is
offered by the AACN Certification Corporation and available in adult, pediatric, and neonatal
tracks.
Eligibility:
Current, unencumbered RN or APRN license.
At least 1,750 hours of direct bedside critical care experience in the last two years (875
in the most recent year).
Exam Structure (Adult CCRN):
150 multiple-choice questions (125 scored, 25 unscored).
, Duration: 3 hours.
Passing score: ~70–75% (scaled score 90).
Domains tested:
o Clinical Judgment (80%)
o Professional Caring and Ethical Practice (20%)
2. Core Clinical Content Areas
A. Cardiovascular System (≈17–21% of exam)
1. Hemodynamics
Key Parameters:
Measurement Normal Range Interpretation
High = fluid overload; Low =
CVP (Central Venous Pressure) 2–6 mmHg
hypovolemia
PAWP (Pulmonary Artery
8–12 mmHg Reflects left atrial pressure
Wedge Pressure)
CO: 4–8 L/min; CI: 2.5–4.0
CO/CI (Cardiac Output/Index) Decreased = poor perfusion
L/min/m²
SVR (Systemic Vascular High = vasoconstriction; Low =
800–1200 dynes/sec/cm⁵
Resistance) vasodilation
, Management Concepts:
Optimize preload, afterload, contractility, and heart rate.
Use inotropes (dobutamine), vasopressors (norepinephrine), or vasodilators
(nitroglycerin) as needed.
2. Cardiac Rhythms
Common Arrhythmias:
Atrial fibrillation: Irregular rhythm; risk of emboli → anticoagulation.
Ventricular tachycardia: Assess pulse; defibrillate if pulseless.
Ventricular fibrillation: CPR + defibrillation immediately.
Heart blocks:
o 1° AV = prolonged PR; monitor only.
o 3° AV = no atrial/ventricular coordination → pacemaker.
3. Myocardial Infarction
STEMI: Full-thickness damage; immediate PCI within 90 minutes.
NSTEMI: Partial occlusion; treat with antiplatelets and anticoagulants.
Monitor cardiac enzymes (troponin, CK-MB).
Administer MONA (Morphine, O₂, Nitrates, Aspirin) as indicated.
B. Respiratory System (≈14–18%)
