100+ Free CCRN-K (Adult) Practice Questions

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Question 1

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An adult ICU patient with anterior STEMI has new-onset crackles, JVD, and a SBP of 78/50 mmHg with cool extremities. The Knowledge Professional reviewing the case would expect the bedside team to recognize this pattern as which shock state?

Hypovolemic shock

Cardiogenic shock

Distributive (septic) shock

Obstructive shock from PE

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2026 Statistics

Key Facts: CCRN-K (Adult) Exam

150

Total Items

AACN CCRN handbook

125 + 25

Scored + Unscored

AACN CCRN handbook

Exam Time

AACN CCRN handbook

Passing Cut Score

AACN cut score update (effective 2025-11-12)

80/20

Clinical Judgment / Professional Caring

AACN CCRN test plan

$255/$370

Member/Nonmember Fee

AACN CCRN handbook

AACN's adult CCRN-K uses the same exam content as adult CCRN: 150 total items with 125 scored and 25 unscored, delivered in 3 hours. The framework is Clinical Judgment 80% and Professional Caring & Ethical Practice 20%. Within Clinical Judgment, AACN weights Cardiovascular 13%, Respiratory 12%, Endocrine/Hematology/Immunology/GI-Renal-GU/Integumentary 21%, Musculoskeletal/Neurological/Behavioral-Psychosocial 18%, and Multisystem 16%. Cut score is 83 of 125 scored items. CCRN-K differs from CCRN only by eligibility pathway: candidates document hours influencing (not directly providing) acute/critical care.

Sample CCRN-K (Adult) Practice Questions

Try these sample questions to test your CCRN-K (Adult) exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1An adult ICU patient with anterior STEMI has new-onset crackles, JVD, and a SBP of 78/50 mmHg with cool extremities. The Knowledge Professional reviewing the case would expect the bedside team to recognize this pattern as which shock state?

A.Hypovolemic shock

B.Cardiogenic shock

C.Distributive (septic) shock

D.Obstructive shock from PE

Explanation: Anterior STEMI plus new pulmonary congestion, JVD, hypotension, and cool extremities reflects pump failure — cardiogenic shock. CCRN/CCRN-K candidates must distinguish this from distributive (warm), hypovolemic (no congestion), and obstructive shock (e.g., RV strain on echo).

2A patient with NSTEMI is on a heparin infusion. Platelets fall from 220 to 78 (×10^9/L) on day 5 with a new line-tip clot. The MOST appropriate action consistent with CCRN/CCRN-K standards is:

A.Continue heparin and transfuse platelets

B.Stop heparin, avoid platelet transfusion, and start a non-heparin anticoagulant

C.Restart heparin at a lower dose after platelets recover

D.Switch to LMWH and continue therapy

Explanation: This is heparin-induced thrombocytopenia (HIT) with thrombosis. All heparin (including LMWH) must be stopped, platelet transfusion avoided unless bleeding, and a non-heparin anticoagulant (argatroban/bivalirudin) started.

3Which finding on a 12-lead ECG most strongly suggests an inferior STEMI with right ventricular involvement?

A.ST elevation in V1–V4

B.ST elevation in II, III, aVF with ST elevation in V4R

C.ST depression in I and aVL only

D.Q waves in V5 and V6

Explanation: Inferior STEMI with RV involvement shows ST elevation in II, III, aVF and ST elevation in right-sided lead V4R. CCRN-K educators should reinforce the use of right-sided leads when inferior MI is suspected.

4A patient with acute decompensated heart failure has SBP 92/60, lactate 4.2, and is on dobutamine. The MOST appropriate hemodynamic monitoring goal is:

A.MAP > 90 mmHg regardless of perfusion

B.Adequate cardiac index and resolving lactate with MAP ≥ 65

C.CVP > 20 mmHg as the primary endpoint

D.PAOP < 6 mmHg in all patients

Explanation: Goals in cardiogenic shock are improving cardiac index/perfusion (lactate clearance) with MAP ≥ 65 mmHg. Static numbers like CVP are unreliable; PAOP targets vary by patient.

5A patient develops new sustained monomorphic VT at a rate of 180 with SBP of 70 and altered mentation. The CCRN-level priority action is:

A.Administer IV amiodarone bolus only

B.Synchronized cardioversion

C.Defibrillation at 200 J biphasic

D.Vagal maneuvers

Explanation: Unstable monomorphic VT with a pulse requires synchronized cardioversion. Defibrillation is reserved for pulseless VT/VF; antiarrhythmics follow stabilization.

6Which intervention BEST reduces mortality in an adult cardiogenic shock patient with refractory hypotension despite inotropes?

A.Adding a second inotrope at maximum dose

B.Early mechanical circulatory support evaluation (IABP, Impella, VA-ECMO)

C.Aggressive fluid loading to CVP 18

D.High-dose corticosteroids

Explanation: Refractory cardiogenic shock requires early mechanical circulatory support evaluation. Adding inotropes increases myocardial oxygen demand without addressing pump failure.

7A nurse manager auditing acute MI care notes that door-to-balloon times exceed 90 minutes. Which AACN-aligned QI step is MOST appropriate?

A.Wait for individual chart audits during annual review

B.Use rapid-cycle PDSA with the cath lab and ED on handoff bottlenecks

C.Reassign nurses from the ICU to ED triage

D.Eliminate ECG repeat protocols

Explanation: AACN/CCRN-K Knowledge Professional roles emphasize systems-level QI. Rapid-cycle PDSA targeting handoff steps is the standard improvement approach.

8A patient on amiodarone develops a QTc of 540 ms and new torsades de pointes. The FIRST-line treatment is:

A.IV magnesium sulfate

B.IV potassium 40 mEq bolus

C.IV procainamide

D.Defibrillation followed by epinephrine

Explanation: IV magnesium 1–2 g is first-line for torsades, regardless of serum magnesium level. Withdrawal of QT-prolonging drugs and overdrive pacing may follow.

9On a pulmonary artery catheter, a patient has CVP 4, PAOP 6, CI 1.8, SVR 1900. This profile is MOST consistent with:

A.Septic shock

B.Cardiogenic shock

C.Hypovolemic shock

D.Neurogenic shock

Explanation: Low CVP/PAOP, low CI, and high SVR reflect hypovolemia. Cardiogenic shock has high filling pressures; septic shock has low SVR.

10An adult patient with new bradycardia (HR 38) and SBP 80 fails atropine. The next BEST intervention is:

A.High-dose epinephrine push 1 mg

B.Transcutaneous pacing

C.Adenosine 6 mg rapid push

D.Synchronized cardioversion

Explanation: Per ACLS adult bradycardia algorithm, transcutaneous pacing (or dopamine/epinephrine infusion) follows atropine failure in unstable bradycardia.

About the CCRN-K (Adult) Exam

CCRN-K is the Knowledge Professional pathway of AACN's adult CCRN credential, designed for nurses who influence the care of acutely/critically ill adults but do not primarily provide direct bedside care, including educators, managers, advanced beginners moving away from bedside, and quality leaders. The exam validates the same body of knowledge as adult CCRN.

Questions

150 scored questions

Time Limit

3 hours

Passing Score

83 out of 125 scored items

Exam Fee

$255 AACN members / $370 non-members (AACN Certification Corporation / PSI)

CCRN-K (Adult) Exam Content Outline

13%

Cardiovascular

Hemodynamics, perfusion, shock states, dysrhythmias, ACS priorities, and vasoactive-response monitoring concepts the Knowledge Professional must teach and oversee

12%

Respiratory

Gas exchange, ventilator management concepts, oxygenation/ventilation failure patterns, and escalation triggers for nurses influencing adult acute/critical care

21%

Endocrine, Hematology/Immunology, GI, Renal/GU, Integumentary

Cross-system instability, metabolic derangements, renal/GU critical care, and immunologic/hematologic complications

18%

Musculoskeletal, Neurological, Behavioral/Psychosocial

Neurocritical changes, behavioral instability, safety-centered ICU decisions, and mobility-related ICU risk management

16%

Multisystem

Sepsis, multi-organ dysfunction, complex resuscitation priorities, and integrated critical-care escalation planning

20%

Professional Caring & Ethical Practice

Advocacy, collaboration, goals-of-care alignment, end-of-life support, ethical/legal ICU decision-making, and AACN Synergy Model concepts emphasized in Knowledge Professional roles

How to Pass the CCRN-K (Adult) Exam

What You Need to Know

Passing score: 83 out of 125 scored items
Exam length: 150 questions
Time limit: 3 hours
Exam fee: $255 AACN members / $370 non-members

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

CCRN-K (Adult) Study Tips from Top Performers

1Train high-frequency ICU decision patterns: shock recognition, perfusion trends, and escalation timing — concepts Knowledge Professionals must teach and audit

2Use ABG/hemodynamic combined drills rather than isolated system memorization

3Prioritize first-action reasoning in unstable scenarios; CCRN-K rewards sequence and safety under pressure

4Build timed blocks around adult CCRN weighting so cardiovascular and respiratory decision-making gets repeated exposure

5Practice communication and ethical-care scenarios, especially goals-of-care conflict, end-of-life transitions, and coaching staff through difficult cases

Frequently Asked Questions

What is the difference between CCRN-K and CCRN?

AACN's CCRN-K and adult CCRN use the same exam content. CCRN-K (Knowledge Professional) is for nurses who influence the care of acutely/critically ill adults (educators, managers, quality leaders) rather than primarily providing direct bedside care.

How many questions are on the adult CCRN-K exam?

AACN's adult CCRN handbook applies to CCRN-K and lists 150 items total: 125 scored and 25 unscored.

How long is the CCRN-K exam?

AACN lists a 3-hour exam appointment for adult CCRN-K testing.

What score is needed to pass CCRN-K?

AACN's current cut score notice sets adult CCRN/CCRN-K passing at 83 correct out of 125 scored items (effective November 12, 2025).

What is the adult CCRN-K exam fee?

AACN's handbook lists $255 for AACN members and $370 for non-members for initial application.

Who is eligible for CCRN-K?

RNs/APRNs with a current unrestricted license who document either 1,750 hours in 2 years or 2,000 hours in 5 years influencing the care of acutely/critically ill adult patients.

What patient population does adult CCRN-K cover?

Adult CCRN-K focuses on acutely/critically ill adult patients and emphasizes the knowledge base needed to teach, lead, or oversee ICU-level care.