100+ Free CCRN-K Neonatal Practice Questions

Pass your AACN CCRN-K Neonatal (Knowledge Professional) exam on the first try — instant access, no signup required.

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Same item bank as CCRN Neonatal (65.57% in 2024) Pass Rate

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Question 1

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A nurse educator is reviewing PDA management with NICU staff. Which finding most strongly indicates a hemodynamically significant PDA in a 3-day-old preterm infant?

Soft systolic murmur at the left sternal border

Widened pulse pressure with bounding peripheral pulses

Mild tachypnea resolving with prone positioning

Heart rate of 150 bpm during routine care

to track

Same family resources

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Practice Pages

AACN CCRN Neonatal Critical Care Nurse Practice200 questions AACN CCRN Pediatric Critical Care Nurse Practice200 questions CCRN Adult Critical Care Nurse Practice200 questions PCCN Progressive Care Certified Nurse Practice200 questions AACN ACCNS-AG Adult-Gerontology Acute Care CNS Practice100 questions AACN ACCNS-N Acute Care CNS Neonatal Practice100 questions

PCCN Pass Rate 2026: 79% + FREE 6-Week Study Plan13 min read FREE CCRN (Pediatric) Exam Guide 2026: Pass AACN PICU Cert26 min read CCRN Hardest Topics Ranked: What to Study First + 8-Week Plan (2026)14 min read FREE CCRN Study Guide 2026: 10-Week ICU Plan13 min read

2026 Statistics

Key Facts: CCRN-K Neonatal Exam

Same exam

Item bank shared with CCRN Neonatal

AACN CCRN-K Neonatal handbook

150

Total Items

AACN CCRN-K Neonatal handbook

125 + 25

Scored + Unscored

AACN CCRN-K Neonatal handbook

Exam Time

AACN CCRN-K Neonatal handbook

84/125

Passing Cut Score

AACN standard-setting (67.2%)

1,750 hrs

Influence-of-Care Hours / 2 Years

AACN CCRN-K Neonatal handbook

$255/$370

Member/Nonmember Fee

AACN CCRN-K Neonatal handbook

CCRN-K Neonatal uses the same 150-question (125 scored) neonatal item bank as CCRN Neonatal with a 84/125 (67.2%) cut score over 3 hours. Eligibility requires 1,750 hours influencing the care of acutely/critically ill neonatal patients within 2 years. Designed for educators, managers, CNS, quality leaders, and APRNs who do not meet direct-care bedside requirements but shape NICU practice. Certification valid 3 years; renew via CERPs or re-exam.

Sample CCRN-K Neonatal Practice Questions

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

1A nurse educator is reviewing PDA management with NICU staff. Which finding most strongly indicates a hemodynamically significant PDA in a 3-day-old preterm infant?

A.Soft systolic murmur at the left sternal border

B.Widened pulse pressure with bounding peripheral pulses

C.Mild tachypnea resolving with prone positioning

D.Heart rate of 150 bpm during routine care

Explanation: A widened pulse pressure (>25 mmHg) with bounding pulses reflects diastolic runoff from aorta to pulmonary artery and is the hallmark of a hemodynamically significant PDA. A soft murmur is common and nonspecific; mild positional tachypnea and a normal HR of 150 are not diagnostic. Educators should drill staff on pulse pressure and perfusion changes as early indicators.

2A CNS is teaching the team about ductal-dependent congenital heart disease. Which lesion requires PGE1 to maintain pulmonary blood flow?

A.Hypoplastic left heart syndrome

B.Coarctation of the aorta

C.Pulmonary atresia with intact ventricular septum

D.Total anomalous pulmonary venous return

Explanation: Pulmonary atresia depends on the ductus to deliver pulmonary blood flow. HLHS and coarctation are ductal-dependent for systemic flow. TAPVR is not ductal-dependent. Knowing which side the ductus supports drives oxygenation expectations and PGE1 monitoring.

3Which preductal/postductal SpO2 difference suggests right-to-left ductal shunting in a neonate with suspected PPHN?

A.Preductal 95%, postductal 94%

B.Preductal 88%, postductal 78%

C.Preductal 90%, postductal 92%

D.Preductal 100%, postductal 99%

Explanation: A preductal-postductal SpO2 gradient >5-10% with the lower value postductal indicates right-to-left shunting through the PDA, classic for PPHN. The other options show no clinically significant gradient.

4A quality leader is auditing care for infants with HLHS pre-Norwood. Which target is most appropriate for room-air oxygen saturation?

A.95-100%

B.85-90%

C.75-85%

D.60-70%

Explanation: In HLHS pre-stage 1 palliation, SpO2 of 75-85% reflects balanced Qp:Qs ~1. Higher saturations indicate pulmonary overcirculation and systemic hypoperfusion; lower saturations indicate inadequate pulmonary blood flow. Educators must reinforce avoiding high FiO2.

5Indomethacin therapy for PDA closure is most likely to be contraindicated in which scenario?

A.Gestational age 28 weeks

B.Platelet count 60,000/mm3

C.Birth weight 1,200 g

D.Day-of-life 5

Explanation: Thrombocytopenia (<50,000-100,000/mm3 per institutional protocol) is a contraindication to indomethacin due to bleeding risk and platelet dysfunction. Other contraindications include active bleeding, NEC, renal failure, and ductal-dependent lesions.

6A neonate with d-transposition of the great arteries is cyanotic with SpO2 65%. The most life-saving intervention prior to surgical repair is:

A.Increasing FiO2 to 1.0

B.Balloon atrial septostomy

C.Initiating high-frequency oscillatory ventilation

D.Administering surfactant

Explanation: In d-TGA, parallel circulations require mixing. Balloon atrial septostomy (Rashkind) creates an ASD allowing oxygenated and deoxygenated blood to mix, dramatically improving systemic oxygenation until arterial switch surgery. Increasing FiO2 has limited effect without mixing.

7Which assessment finding suggests coarctation of the aorta in a 5-day-old infant?

A.Bounding femoral pulses

B.Differential cyanosis with pink upper body and blue lower body

C.Stronger upper-extremity pulses than lower-extremity pulses

D.Continuous machinery murmur

Explanation: Coarctation classically presents with stronger upper-extremity pulses (preductal) than weaker lower-extremity pulses (postductal). Differential cyanosis would suggest ductal-dependent shunting; bounding femoral pulses would be inconsistent with coarctation; a machinery murmur is associated with PDA.

8A nurse manager reviews surfactant administration competencies. The primary therapeutic effect of exogenous surfactant in RDS is:

A.Reducing pulmonary vascular resistance

B.Decreasing alveolar surface tension

C.Increasing pulmonary capillary perfusion

D.Stimulating fetal lung fluid clearance

Explanation: Surfactant reduces alveolar surface tension, improving compliance, preventing atelectasis, and increasing FRC. PVR changes and fluid clearance are secondary or unrelated effects.

9Which finding indicates the most likely complication after surfactant administration?

A.Improved chest rise within 2 minutes

B.Sudden drop in SpO2 with bradycardia

C.Increased lung compliance on the ventilator

D.Decreased work of breathing

Explanation: During surfactant instillation, transient airway obstruction causes desaturation and bradycardia. After dosing, rapid lung compliance changes can lead to overventilation and pneumothorax if vent settings are not weaned. Improved chest rise, compliance, and decreased WOB are positive outcomes.

10Bronchopulmonary dysplasia (BPD) severity at 36 weeks PMA is most strongly associated with which long-term outcome?

A.Increased risk of asthma and recurrent respiratory infections

B.Improved lung function compared with non-BPD peers

C.No long-term respiratory implications

D.Decreased risk of pulmonary hypertension

Explanation: BPD survivors have increased rates of reactive airway disease, recurrent respiratory infections, exercise intolerance, and pulmonary hypertension. Educators should reinforce long-term follow-up needs.

About the CCRN-K Neonatal Exam

CCRN-K Neonatal is the Knowledge Professional pathway for nurses who influence the care of acutely/critically ill neonatal patients (educators, managers, CNS, quality leaders, APRNs). The exam content is identical to CCRN Neonatal: Clinical Judgment (80%) — Cardiovascular (5%), Respiratory (21%), Endocrine/Hematology/GI/Renal/Integumentary (27%), Neuro/Musculoskeletal/Psychosocial (13%), Multisystem (14%); plus Professional Caring and Ethical Practice (20%). Differs from CCRN Neonatal only by eligibility pathway — non-bedside influence-of-care hours instead of direct-care hours.

Questions

150 scored questions

Time Limit

3 hours

Passing Score

84 out of 125 scored items (67.2%)

Exam Fee

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

CCRN-K Neonatal Exam Content Outline

Cardiovascular

PDA, congenital heart defects (TOF, TGA, HLHS), heart failure, dysrhythmias, hemodynamic monitoring

21%

Respiratory

RDS, BPD, MAS, PPHN, apnea, mechanical ventilation, surfactant therapy, iNO, HFOV, air leak syndromes

27%

Endocrine/Hematology/GI/Renal/Integumentary

Hypoglycemia, thyroid disorders, polycythemia, hyperbilirubinemia, NEC, feeding intolerance, renal agenesis, skin integrity, thermoregulation

13%

Neurologic/Musculoskeletal/Psychosocial

IVH, HIE, therapeutic hypothermia, seizures, neural tube defects, brachial plexus injury, NAS, family support, developmental care

14%

Multisystem

Sepsis, shock, DIC, birth asphyxia, congenital infections, metabolic disorders, pharmacology, transfusions

20%

Professional Caring & Ethical Practice

AACN Synergy Model, advocacy, collaboration, cultural competence, family-centered care, ethics, end-of-life, research, QI leadership

How to Pass the CCRN-K Neonatal Exam

What You Need to Know

Passing score: 84 out of 125 scored items (67.2%)
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 Neonatal Study Tips from Top Performers

1Use the same Core Curriculum for Neonatal Intensive Care Nursing (AWHONN/NANN) used by bedside CCRN Neonatal candidates

2Stay sharp on bedside protocols you may not perform daily — surfactant strategy, iNO, HFOV, therapeutic hypothermia

3Master neonatal-specific normal values: vital signs, lab values, weight-based dosing calculations

4Review congenital heart defect pathophysiology and pre/post-operative care (PDA, TOF, TGA, HLHS)

5Understand IVH grading, HIE management, and developmental-care principles for educator/manager scenarios

6Practice family-centered care, ethics, and Synergy Model application — the 20% Professional Practice domain matters even more in influencer roles

Frequently Asked Questions

What is the difference between CCRN-K Neonatal and CCRN Neonatal?

Both certifications use the same neonatal critical-care exam content, blueprint weights, and 84/125 passing score. CCRN Neonatal is for direct-care bedside RNs (1,750 direct-care hours required). CCRN-K Neonatal is the Knowledge Professional pathway for nurses who influence neonatal critical-care practice — educators, managers, CNS, quality leaders, APRNs — without meeting bedside-hour requirements.

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

The CCRN-K Neonatal exam contains 150 questions total, with 125 scored and 25 unscored pretest items. You have 3 hours to complete the computer-based exam at a PSI testing center or via remote proctored delivery. The item bank is shared with CCRN Neonatal.

What score is needed to pass CCRN-K Neonatal?

The CCRN-K Neonatal passing score is 84 correct out of 125 scored items (67.2%), effective November 12, 2025 per AACN's standard-setting process — identical to CCRN Neonatal because the exam content is shared.

What are the CCRN-K Neonatal eligibility requirements?

You need a current unrestricted RN/APRN license plus either (Option 1) 1,750 hours influencing the care of acutely/critically ill neonatal patients in the previous 2 years (875 in the most recent year), or (Option 2) 2,000 such hours in the previous 5 years (144 in the most recent year). Qualifying roles include educators, managers, CNS, quality/research leaders, and APRNs who shape NICU practice.

How is the CCRN-K Neonatal exam organized?

CCRN-K Neonatal follows the AACN Synergy Model framework with Clinical Judgment (80%) and Professional Caring/Ethical Practice (20%). The largest clinical domain is Endocrine/Hematology/GI/Renal/Integumentary (27%), followed by Respiratory (21%) and Multisystem (14%). The exam blueprint matches CCRN Neonatal exactly.

How long is CCRN-K Neonatal certification valid?

CCRN-K Neonatal certification is valid for 3 years. Renewal options include: (1) Completing 100 CERPs (Continuing Education Recognition Points) with 60 in Category A and 10 each in Categories B and C, or (2) Passing the exam again. Renewal hour requirements may be met via knowledge-professional practice.

What is the best way to study for CCRN-K Neonatal?

Use the same study plan as CCRN Neonatal — the item bank is identical. Prioritize high-weight clinical areas: Endocrine/Heme/GI/Renal (27%), Respiratory (21%), and Multisystem (14%). Knowledge professionals often benefit from staying current on bedside protocols (NRP, surfactant strategy, ventilation modes, NEC management) even if their day-to-day work is teaching, leading, or quality improvement. Plan 3-6 months of preparation.