1.1 Current Exam Facts

Current Exam Facts for AACN CCRN (Neonatal)

Quick Answer: AACN Certification Corporation's CCRN (Neonatal) exam is 150 multiple-choice items—125 scored plus 25 unscored pretest items—in 3 hours. The cut score is 84 of 125 scored items effective November 12, 2025. Computer-based fees are $260 for AACN members and $375 for nonmembers.

The CCRN (Neonatal) credential is a specialty certification issued by AACN Certification Corporation for registered nurses and APRNs who care for acutely and critically ill neonatal patients. It is not a license. Your state board RN or APRN license remains the legal authority to practice. CCRN (Neonatal) documents that you met this certification body's practice-hour rules and passed its neonatal examination.

CCRN Neonatal practice questionsPractice questions with detailed explanations

What the neonatal credential covers

NICU postings that say "CCRN preferred" mean the neonatal specialty when the census is neonates. Adult CCRN and pediatric CCRN are separate credentials with separate test plans. A nurse who previously certified in adults, or who floated from a PICU, still sits a neonatal-specific exam: transitional circulation, congenital heart disease in the first days of life, necrotizing enterocolitis, germinal-matrix hemorrhage, thermoregulation of the extremely low-birth-weight infant, and family systems around a hospitalized newborn.

adult CCRN study guideFree exam prep with practice questions & AI tutor

Format: 150 items, 3 hours, 80/20 split

The current examination is a computer-based test (CBT). You will see 150 four-option multiple-choice questions. 125 of those items are scored. 25 are unscored pretest items that AACN Certification Corporation uses to try out future questions. You are not told which screens are pretest. Treat every item as if it counts.

Scored content follows a two-part framework published in the Neonatal CCRN Test Plan (exams taken on or after November 12, 2025):

1. Clinical Judgment — 80% — patient problems in cardiovascular, respiratory, endocrine/hematology/GI/renal/integumentary, musculoskeletal/neurologic/behavioral, and multisystem domains.
2. Professional Caring and Ethical Practice — 20% — Synergy Model nurse characteristics beyond the Clinical Judgment bucket: advocacy/moral agency, caring practices, clinical inquiry, collaboration, facilitation of learning, response to diversity, and systems thinking.

Three hours for 150 items is 72 seconds per question if you spend the entire clock and never review. NICU stems are often dense: gestational age, day of life, current weight, ventilator mode, a blood gas, and a "priority action" close. A workable plan is roughly 60–70 seconds per item so you keep 15–20 minutes to return to marked questions. If you burn three minutes on the first congenital-heart stem, you will steal time from later multisystem items that carry as much weight.

You typically receive pass/fail on screen when you finish the CBT. A detailed score report is emailed within 24 hours, broken out by test-plan area. That report is the document to use if you must retake; it is more useful than a global feeling that "respiratory was hard."

Cut score: 84 of 125 from November 12, 2025

For exams taken on or after November 12, 2025, the passing standard is 84 correct scored items out of 125. That integer is the operational rule. 84/125 is about 67% of scored items, which is why a casual plan to "get 70 percent" is imprecise. Eighty-three scored items correct is a fail even if the last hour felt strong.

AACN Certification Corporation and PSI set the standard with a modified Angoff method. Neonatal subject-matter experts estimate how a just-qualified CCRN (Neonatal) nurse would perform on each item. Those ratings are aggregated and reviewed with the testing vendor to produce the cut. A revised Neonatal CCRN Test Plan, drawn from a 2024 study of practice, also took effect for exams on or after that November date.

If your notes still list cardiovascular at 5% and respiratory at 21%, you are looking at the pre-November 2025 weights. Those figures are retired for current testers. This guide uses the current Neonatal CCRN Test Plan in the CCRN Exam Handbook – Direct Care, July 2026.

Current test-plan domain weights

Clinical Judgment (80%) is subdivided into five patient-problem clusters. Professional Caring is a separate 20%. Together they total 100% of scored content.

Approximate item counts are a study aid (weight × 125, rounded). PSI does not promise that every form contains exactly those integers. Pretest items can appear in any area.

The three heaviest buckets are each 20%: the combined endocrine–heme–GI–renal–skin cluster, Multisystem, and Professional Caring. Respiratory at 15% is next. Cardiovascular at 10% is still high-stakes because transitional physiology and congenital heart disease are conceptually heavy, but it should not consume 40% of your calendar. MSK/Neuro/Behavioral at 13% includes IVH, seizures, and family-crisis items that night-shift nurses sometimes postpone until "later"—later is 13% of the exam.

Fees, confirmation email, and scheduling

From the July 2026 handbook and the current neonatal certification pages:

Member pricing requires an active AACN membership at the time you apply. After AACN Certification Corporation approves the application, you receive a confirmation email, then you schedule with PSI. You may test at a PSI Testing Center or by Live Remote Proctoring if you meet PSI's room, camera, identification, and workspace rules. Remote proctoring is often attractive to night-shift NICU nurses; it does not shorten the exam or simplify the stems. A second monitor, a clinical badge buddy with dose charts, or a family member walking through the room will typically stop a remote session.

The eligibility window is normally 90 days from the confirmation date. The July 2026 Direct Care handbook currently also notes a 180-day window. Read the dates in your confirmation email and the handbook edition in force when you apply. Do not copy a coworker's 90-day window from a 2023 application and assume it still governs your file.

First-time pass rates

AACN publishes first-time pass rates for CCRN (Neonatal):

A 2025 first-time pass rate of 60.29% means roughly two of five first-time testers did not meet the cut. The 2023 rate of 72.20% is useful history, not a forecast. Treat older "I passed with two weeks of flashcards" stories as entertainment. Plan to earn 84 scored items on a form that can mix a 24-week septic infant with a systems-thinking item in the same hour.

How to use this independent guide

Work domain-by-domain in proportion to the weights above. After a cluster, use independent practice at /practice/ccrn-neonatal to check whether you can apply the physiology, not whether you memorized a paragraph. Official documents remain the authority for fees, windows, and eligibility:

• CCRN Exam Handbook – Direct Care (July 2026 PDF)
• CCRN (Neonatal) Direct Care
• CCRN (Neonatal) Knowledge Professional