CCRN practice questions, CCRN practice tests and CCRN exam prep for the AACN critical care certification

The CCRN (Adult) is a computer-based exam administered for AACN Certification Corporation at PSI test centers and by live remote proctoring. You get 150 items in total: 125 that count toward your score and 25 unscored pretest items that AACN uses to trial future questions. The pretest items are scattered through the exam with no marking of any kind, so there is no way to spot them and no reason to try. The time limit is three hours, which works out to about 72 seconds per item, and most candidates finish with time left over. Passing takes 83 correct answers out of the 125 scored items, roughly 66.4%. That cut score is not folklore: AACN publishes it, and the current value took effect on November 12, 2025. The exam is offered year round rather than in windows, and you get your pass or fail result at the test center as soon as you finish.

• 150 items total: 125 scored plus 25 unscored pretest items
• Three hours, about 72 seconds per item
• Pass with 83 of 125 correct, roughly 66.4%
• Cut score effective November 12, 2025, published by AACN

AACN splits the CCRN into two categories, and the split is lopsided on purpose. Clinical Judgment is 80% of the exam, about 100 of the 125 scored items, and it is organized by body system. Professional Caring and Ethical Practice is the other 20%, about 25 items, built on AACN's Synergy Model: advocacy and moral agency, caring practices, collaboration, systems thinking, response to diversity, clinical inquiry and facilitation of learning. The Exam Handbook test plan breaks Clinical Judgment down by system, and the shape of it surprises people who assume the CCRN is a cardiac exam. Cardiovascular is the largest single system at roughly 18%, but the combined endocrine, hematology, gastrointestinal, renal and integumentary group is larger still at about 20%. Pulmonary runs about 17%, multisystem about 14%, and the musculoskeletal, neurological and psychosocial group about 13%.

• Clinical Judgment: 80% of the exam, about 100 scored items
• Professional Caring and Ethical Practice: 20%, about 25 items
• Cardiovascular about 18%, but endocrine/heme/GI/renal/integumentary is about 20%
• Pulmonary about 17%, multisystem about 14%, MSK/neuro/psychosocial about 13%

You need an unencumbered RN or APRN license and a specific number of hours in the direct care of acutely or critically ill adult patients. AACN gives you two pathways and you only need to satisfy one. The two-year option asks for 1,750 hours in the previous two years, with 875 of those in the most recent year. The five-year option asks for 2,000 hours in the previous five years, with 144 of those in the most recent year. The five-year route exists for nurses whose bedside time is now intermittent, such as educators, rapid response staff and managers who still take assignments. Note what the hours have to be: direct care of acutely or critically ill adult patients. Charge shifts, orientation of new staff and time spent in non-critical areas do not count toward the total, and AACN audits a share of applications, so keep a record you could actually produce.

• Two-year path: 1,750 hours in two years, 875 in the most recent year
• Five-year path: 2,000 hours in five years, 144 in the most recent year
• Hours must be direct care of acutely or critically ill adult patients
• Applications are audited, so document your hours as you go

AACN publishes its exam statistics, which puts the CCRN in a small group of credentials where you can check the difficulty against the regulator rather than a prep vendor. The 2025 first-time pass rate for CCRN (Adult) was 72.02% across 17,151 candidates. In 2024 it was 72.74% across 19,483 candidates. In 2023 it was 81.20%. That nine-point drop between 2023 and 2024 is the single most useful fact about this exam right now, and almost no study advice written before 2024 accounts for it. Roughly one in four experienced critical care nurses now fails on the first attempt. The comparison across AACN's other exams is worth knowing too: PCCN came in at 70.10% in 2025 and CSC at 52.20%, so the CCRN is not the hardest thing AACN administers, but it is no longer the near-formality some units still treat it as.

• 2025 first-time pass rate: 72.02% on 17,151 candidates
• 2024: 72.74%. 2023: 81.20%. The exam got harder to pass.
• About one in four first-time candidates now fails
• For comparison, PCCN was 70.10% and CSC 52.20% in 2025

The exam fee is $260 for AACN members and $375 for nonmembers. AACN membership costs less than the $115 gap, so joining first and then registering is cheaper than registering as a nonmember, which is the one piece of arithmetic every candidate should do before paying. If you do not pass, you are eligible for a discounted retest fee, and that discount stays available until you pass. You may sit the CCRN up to four times in any 12-month period. Certification runs for three years, and you renew either by retaking the exam or through Renewal by Synergy CERPs, which requires a minimum of 100 continuing education recognition points across the three-year period. Many hospitals reimburse the exam fee on a pass and pay a certification differential on top, so check your own tuition and certification policy before you pay out of pocket.

• Exam fee: $260 AACN members, $375 nonmembers
• Discounted retest fee, available until you pass
• Up to four attempts in any 12-month period
• Certification lasts three years: retake, or renew with 100 CERPs

The trap for experienced nurses is assuming the exam tests what the unit tests. It does not. Your unit gives you a population, a set of protocols and a physician group whose habits you know. The CCRN tests the whole adult critical care population against AACN's test plan, including systems you may go months without touching. A cardiac ICU nurse who can run a balloon pump in her sleep still loses points on endocrine emergencies and GI bleeds, and that group is 20% of the exam. So start by working questions across every system rather than reading a review book front to back. Question practice tells you where the gaps actually are, which is almost never where you expect. Then review with intent: for each miss, write down what the item was testing and why the answer you picked looked correct, because it did look correct at the time. Do not neglect the Professional Caring 20%. It is 25 items, it is the section most people skip, and Synergy Model questions are learnable in a way that pathophysiology is not.

• Work questions across every system, not just your own unit's population
• Endocrine, heme, GI, renal and integumentary is about 20% and gets neglected
• Review every miss: what was it testing, why did your answer look right
• The Professional Caring 20% is 25 free-ish items if you study the Synergy Model