Updated July 2026 · 10 min read
The CCRN is achievable with the right preparation strategy. Most nurses who fail do so because they used the wrong resources, not because they lacked the knowledge. Here is how to study efficiently and pass on your first attempt.
The CCRN (Adult) consists of 150 multiple-choice questions (25 are pretest items that do not count toward your score). You have 3 hours. The passing score is approximately 87 out of 125 scored questions. The exam is weighted heavily toward cardiovascular, pulmonary, and multisystem content — together these account for over 50% of the scored questions.
AACN requires 1,750 direct care hours in an acute/critical care setting within the past 2 years to be eligible, with 875 of those in the most recent year before application.
Pass CCRN! by Robin Dennison is the most commonly cited preparation resource among nurses who pass on first attempt. The book integrates content review with practice questions in a way that builds retention. Available on Amazon, it is worth the cost of a physical copy for annotation.
AACN's own practice questions (available at aacn.org) are the most representative of actual exam item style. The AACN also sells a comprehensive review book. Official resources should form the backbone of your preparation.
Board Vitals, UWorld (if you already have a subscription from nursing school), and Laura Gasparis Vonfrolio's CCRN review videos are all effective supplements. Video content is best for cardiovascular hemodynamics, which is the topic most nurses find hardest to learn from text alone.
Random YouTube videos, unvetted Quizlet decks, and generic NCLEX-style question banks do not match the CCRN's depth or style. Time spent on them is largely wasted.
| Week | Focus | Daily Time |
|---|---|---|
| 1 | Cardiovascular I: Hemodynamic monitoring, pressors, shock states | 60-90 min |
| 2 | Cardiovascular II: Dysrhythmias, ACS, heart failure, IABP | 60-90 min |
| 3 | Pulmonary: ARDS, ventilator management, respiratory failure | 60-90 min |
| 4 | Neurological: ICP, stroke, seizures, TBI | 60-90 min |
| 5 | Multisystem: Sepsis, MODS, burns, trauma | 60-90 min |
| 6 | Renal, endocrine, GI: AKI, DKA, liver failure | 60-90 min |
| 7 | Full practice exams: 150 questions x2, review every wrong answer | 3-4 hrs/session |
| 8 | Targeted review of weak areas only, light review Day 6-7 | 60 min |
Cardiovascular is the single most important content area. Master hemodynamic profiles for each shock state (cardiogenic vs. distributive vs. obstructive vs. hypovolemic), PA catheter values, and vasoactive drug mechanisms. Know the waveforms cold.
Pulmonary is second. Ventilator modes (AC, SIMV, PSV, APRV), ARDS Berlin criteria, prone positioning indications, and weaning parameters are all heavily tested. Know your P/F ratios.
Dysrhythmia recognition appears throughout the exam. You need to identify and state the treatment for at least 15 dysrhythmias rapidly and correctly.
Pharmacology is embedded throughout every system. Know the mechanism, indication, titration parameters, and critical side effects of: norepinephrine, vasopressin, epinephrine, dobutamine, milrinone, sodium nitroprusside, heparin, and the common sedation agents.
Related: CCRN tips and full study schedule · ICU specialties comparison · CRNA prerequisites checklist
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