2023 Edition

CCRN Practice Test

Take this free CCRN practice test to get a sample of the types of questions on the actual Critical Care Registered Nurse certification exam.

The CCRN exam is a 3 hour exam covering 150 multiple choice questions. The CCRN exams focus on three general populations: adult, pediatric and neonatal patients.  Within the three general populations, the following subject categories are covered: Cardiovascular, Respiratory, Endocrine, Hematology / Immunity, Neurology, Gastrointestinal, Renal, Multisystem, Mental Health and Professional Care and Ethical Practice. Each exam is age specific and a large percentage of each test focuses on clinical judgment. A smaller percentage of each test covers professional caring and ethical practice, which can address any age in the life span, in any of the tests.

For complete practice, check out the CCRN Practice Exam Kit with 750 questions and fully explained answers.  CCRN FAQ's V



1. A 47-year-old male has been admitted to the CCU from the emergency room with a history of sudden diaphoresis, nausea, vomiting and radiating pain down his left arm. He reports no significant medical history, and has been a two PPD smoker since his early twenties. His admitting diagnosis is UA/NSTEMI and he is being prepped for cardiac catheterization for possible angioplasty with stent placement. What type of medication orders might the nurse see prior to his procedure?
2. Agnes is a 65-year-old white female who has a history of pulmonary fibrosis with steroid use for the past two years with concomitant hypertension. She has been on oxygen therapy at 4L per nasal cannula for the past 3 years. Recently, her first great-grandchild was born, and she decided to quit smoking. Three days ago, she experienced nausea and dizziness and was admitted to the CCU with a diagnosis of acute myocardial infarction. During shift change, Agnes' low blood pressure alarm sounds. Upon assessment, she is diaphoretic and has severe dyspnea. What is the most likely cause of her symptoms?


3. Norman is a 65-year-old paraplegic who resides in a nursing home. He presents with a 3-day history of increased temperature, productive cough, and increased weakness. His caregiver states that he had developed a decubitis ulcer, and has not been able to tolerate sitting in his wheelchair, so has been in bed for the past week. Bibasilar crackles are audible on auscultation, with overall diminished breath sounds bilaterally. Obvious respiratory distress is apparent with tachypnea, suprasternal retractions and use of accessory muscles. Vitals: T-100.2F, HR-120, RR-28, BP 104/50, O2 Sat on RA - 88%. An initial chest x-ray reveals the "spine sign" and a normal cardiac silhouette. What is the most likely cause of Norman's condition?
4. What does the finding of "spine sign" on Norman's chest x-ray indicate?


5. If a patient is suspected of having an episode of acute hypoglycemia, which of the following is NOT the most appropriate first intervention?
6. Marilyn is a Type I diabetic who has been admitted to the unit after a severe hypoglycemic episode in which she lost consciousness. She states that she has had many episode of hypoglycemia, but just does not seem to know when they are coming on anymore. What is the term for this phenomenon?

Hematology / Immunology

7. Of the following, which is included in the etiology of idiopathic thrombocytopenic purpura (ITP)?
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8. Of the following, which is NOT a consideration when administering IVIg therapy?


9. What is the most common site of rupture of a cerebral aneurysm with resulting subarachnoid hemorrhage (SAH)?
10. Donna is a 43-year-old teacher who was admitted 6 days ago with a ruptured middle cerebral artery (MCA) aneurysm with subarachnoid hemorrhage (SAH). She underwent surgery for aneurysm clipping 12 hours after admission, and has had an excellent post-operative course. However, this morning, she complained of a severe headache, became acutely confused and quickly progressed to unresponsiveness. What is the likely cause for Donna's change of status?


11. Matthew is a 26-year-old who has been admitted to the ICU following a motor vehicle accident. Upon assessment, it is noted that he has a positive Cullen sign. What does this indicate?
12. If bowel sounds are audible when auscultating Matthew's lungs, what injury may he have sustained?


13. If a patient sustains acute renal failure (ARF) secondary to cardiogenic shock, what type of renal failure is this considered?
14. The RIFLE classification system provides a definition and classification system for acute renal failure (ARF). What does the "R" in the RIFLE acronym refer to?


15. Andrew is a 47-year-old with advanced amyotrophic lateralizing sclerosis (ALS). He requires total assistance for positioning, bathing and mobility. His swallowing is impaired, so he takes nothing by mouth and receives nutrition through tube feedings via a gastrostomy tube. Based on his current condition, what type of asphyxia may Andrew be most susceptible to?
16. Ramona is a 21-year-old who has been admitted to the ICU after suffering an anaphylactic reaction during dinner due to peanut sauce in a dish that the host didn't tell her about. She was stabilized in the emergency room with IV epinephrine and IV diphenhydramine. However, 4 hours after being admitted to the ICU she becomes anxious, develops hives and begins to have difficulty breathing. What is the most likely cause for Ramona's symptoms?

Behavior / Psychological

17. Madge is a 91-year-old nursing home resident with a history of dementia and atrial fibrillation who has been admitted to the ICU for treatment of pneumonia. As you are performing her bed bath, you note bruising around her breasts and genital area. What potential issue should be of major concern in Madge's situation?
18. Jerry is a 55-year-old veteran who has been admitted after a motor vehicle accident with multiple injuries. His friend reported that he had been using synthetic marijuana prior to the accident, and that he also sees a psychiatrist at the VA hospital for an unknown diagnosis. He stated that Jerry sometimes gets "hyper" for no reason, starts "ranting" and becomes violent. Of the following, which general psychiatric disorder is characterized by a pattern of aggression or violence which includes irritability, agitation, and violent behavior during manic or psychotic episodes?

Professional Caring and Ethical Practice

19. Emily has been admitted to the ICU after being found unconscious on the street. She was found to be in diabetic ketoacidosis (DKA) with a blood sugar of 785. Emily is homeless, has had multiple admissions for DKA, and could benefit from use of an insulin pump, but says she has been repeatedly told, "Those are for rich people." What ethical principle supports Emily's right to have an insulin pump?
20. Tonya is a 44-year-old with a history of substance abuse who has been admitted to the ICU status-post left lateral thoracotomy. She has been clean and sober for 14 years, and discussed her status with her physician prior to her surgery. When she arrives from the operating room, she is in a great deal of pain. Post-operative pain management orders are for acetaminophen only. When you ask the surgeon for an opioid for pain management, he states, "She's an addict. She doesn't need anything for pain." What should your first response be?

Quality starts with who wrote the material.
Our practice exam writer
Sarah Morris
, RN, MSN, CCRN, is an adjunct instructor in the nursing program at The College of the Canyons. She also works in the neuro/trauma ICU at the UCLA Medical Center. Sarah has been in nursing for over ten years and a CCRN for over seven years.

Brynn Knibbe
, RN, BSN, CCRN, has lectured at the University of Arizona BSN-MSN program on advanced CCRN level topics and precepted and mentored many nurse graduates in the ICU setting. She works in an intensive care unit at the Cleveland Clinic.

Shamin Hampton
, RN, MSN, CCRN, worked as a critical care clinical unit leader in a hospital in Charlotte, North Carolina. She has worked in critical care for over ten years and is now an NP.

Sue Montgomery
is a medical writer who worked as a CCRN for six years. As a CCRN, she served as a staff nurse, clinical leader, preceptor and assistant nurse manager. She has been an RN for over 28 years.