CCRN Exam Blueprint 2026: The New Test Plan and 83 of 125 to Pass
The November 2025 test plan took weight off cardiovascular and respiratory and gave it to neurological, psychosocial and multisystem care. The cut score stayed at 83 of 125.
- 150 (125 scored)Questions
- 3hTime
- 6Sections
- YesWeights published
- 83/125 correctPass mark
- $260-$375Fee
Table of Contents
The whole paper in one bar
The Adult CCRN test plan for exams taken on and after 12 November 2025 is the exam guide AACN publishes for CCRN (Adult) certification in acute/critical care nursing, restated so you can see the shape of the paper before you read a word of the detail. The bar below is the entire syllabus: 6 sections, in the order the certifying body lists them.
- §1 Cardiovascular — 13%
- §2 Respiratory — 12%
- §3 Endocrine, Hematology/Immunology, GI, Renal/GU, Integumentary — 21%
- §4 Musculoskeletal, Neurological, Behavioral/Psychosocial — 18%
- §5 Multisystem — 16%
- §6 Professional Caring & Ethical Practice — 20%
Those percentages are AACN’s own, not an estimate. That matters more than it sounds: most pages ranking for this query quote weightings the certifying body never published.
The syllabus, section by section
Each block below is one section of the official outline. The bullets are the sub-objectives AACN publishes underneath it — the actual scope statement, not a summary of it.
Cardiovascular
- Acute coronary syndrome, heart failure, cardiomyopathy and cardiogenic shock
- Dysrhythmias and conduction system defects (prolonged QT, Wolff-Parkinson-White)
- Aortic aneurysm, dissection and rupture; hypertensive crisis
- Cardiac tamponade, cardiac trauma, cardiac infection and inflammatory disease
- Structural heart defects, including valvular disease; arterial and venous stenosis
- Cardiac surgery, cardiac/vascular catheterization and vascular interventions (stents, fem-pop bypass, carotid endarterectomy)
- Nursing actions: rhythm interpretation, hemodynamic monitoring, mechanical circulatory support, temporary pacing, pericardiocentesis
Respiratory
- ARDS, acute respiratory failure and acute pulmonary edema
- Acute pulmonary embolus, pulmonary hypertension and pulmonary hemorrhage
- Pneumonia and other acute infections; COPD, asthma and status asthmaticus
- Mechanical ventilation complications
- Pleural space abnormalities: pneumothorax, hemothorax, empyema, effusions
- Thoracic and airway trauma; thoracic surgery
- Nursing actions: airway management, NIPPV and high-flow, prone positioning, RSI, chest tubes, tracheostomy
Endocrine, Hematology/Immunology, GI, Renal/GU, Integumentary
- Endocrine: DKA, HHS, diabetes insipidus, SIADH, adrenal insufficiency, thyroid disorders
- Hematology: anemia, coagulopathies (ITP, DIC, HIT), myelosuppression, transfusion reactions (TRALI, TACO)
- Immunology and oncology: autoimmune disorders (lupus, myasthenia gravis, Guillain-Barré), tumor lysis syndrome
- GI: acute GI hemorrhage, pancreatitis, bowel infarction or obstruction, abdominal compartment syndrome
- Hepatic failure and liver disease, malnutrition, GI surgery (Whipple, esophagectomy)
- Renal/GU: AKI and ATN, chronic kidney disease, urosepsis; hemodialysis, CRRT, peritoneal dialysis
- Integumentary: pressure injury, necrotizing fasciitis, cellulitis, IV infiltration, wounds
Musculoskeletal, Neurological, Behavioral/Psychosocial
- Musculoskeletal: compartment syndrome, fractures, trauma, deconditioning and early mobility
- Stroke, traumatic brain injury and acute spinal cord injury
- Seizures, encephalopathy, brain death, neurological storming, neurogenic shock
- Neurosurgery and spinal surgery; ICP monitoring and ventricular drains; neuroendovascular procedures
- Neuromuscular disorders, space-occupying lesions, neurologic infections, hydrocephalus
- Delirium, agitation and aggression; de-escalation and behavioral emergencies
- Mood disorders, PTSD, post-intensive care syndrome, substance use, self-harm and suicidal ideation
Multisystem
- Sepsis, SIRS, MODS and shock states (distributive, obstructive)
- Acid-base, fluid and electrolyte imbalances; rhabdomyolysis
- Healthcare-associated infections and other infectious diseases
- Toxic ingestion, inhalation and exposure; burns; submersion injury; thermoregulation
- Palliative and end-of-life care, pain, sleep disruption
- Life-threatening maternal/fetal complications (eclampsia, HELLP syndrome, placental abruption)
- Transplant history, obesity-related complications, failure to thrive, anoxic injury
- Nursing actions: ECMO, targeted temperature management, intra-abdominal pressure monitoring, organ donation
Professional Caring & Ethical Practice
- Advocacy and moral agency
- Caring practices
- Clinical inquiry
- Collaboration
- Facilitation of learning
- Response to diversity
- Systems thinking
This post covers CCRN (Adult). Pediatric and Neonatal CCRN are separate exams with their own test plans and weights, and Neonatal's cut score is 84, not 83. All three share the frame: 150 four-option items in 3 hours, of which 125 are scored and 25 are unscored pretest items you cannot identify, split 80% Clinical Judgment and 20% Professional Caring & Ethical Practice. The 20% covers the other seven nurse competencies in the AACN Synergy Model, not body systems; Clinical Judgment is the eighth. AACN is moving to generic drug names only; until that finishes, some items still show trade names too. There is no penalty for guessing.
What the weightings really mean
A percentage in an exam guide is a promise about how many questions get drawn from a section, not about how hard those questions are. On a paper of roughly 125 items, Endocrine, Hematology/Immunology, GI, Renal/GU, Integumentary at 21% is worth about 26 questions and Respiratory at 12% is worth about 15. No single section decides the result on its own here - the largest is 21% of the paper - so the result is decided by how few sections you leave weak, not by how well you master one.
The trap is treating that arithmetic as permission to skip. Weightings are the floor of what a section costs you, because the low-weight sections on almost every blueprint are the ones that supply context for questions filed under a different heading. You lose those marks in the heavy section and never find out why.
Reading the verbs in the objectives
The verb at the front of each sub-objective is the part candidates skim and examiners take literally. It sets the depth you are tested at, and it is the difference between recognising a term and being asked to choose between two answers that both look right.
| Verb | What a question at that depth looks like |
|---|---|
| Recall / Recognise | The minority of items. Which finding fits tamponade, which electrolyte drives the ECG change, which pathophysiologic change explains the breath sounds. AACN says its questions test remembered facts as well as applied knowledge. |
| Apply / Anticipate | A patient, a set of numbers and 'the nurse anticipates which...'. AACN's own sample asks for the drug combination that best improves remodeling in heart failure with an ejection fraction of 20%. |
| Analyse / Prioritise | The stems capitalise MOST LIKELY, highest PRIORITY and IMMEDIATE. Several options are correct actions; only one comes first for this patient's vital signs, labs and trend. |
| Advocate / Collaborate | The Professional Caring items. An ethical conflict, a frightened family or a team disagreement, answered through the Synergy competencies rather than unit habit. |
AACN writes most items at the application and analysis levels of a condensed Bloom's taxonomy. The handbook pairs the test plan with a 'Testable Nursing Actions' list: the conditions tell you what can appear, and the actions tell you what you will be asked to do about it.
Study it in this order, not the syllabus order
Exam guides are written to describe what a candidate must know, not to teach it. The published order is almost never the order that builds knowledge fastest. This is the sequence that front-loads the material everything else depends on.
| Order | Why here |
|---|---|
| 1. Cardiovascular | 13%, about 16 items. Rhythms, hemodynamics and shock physiology come first because Multisystem and several other groups assume them. |
| 2. Respiratory | 12%, about 15 items. ARDS, ventilation and oxygenation. With step 1 it completes the physiology behind sepsis and shock. |
| 3. Multisystem | 16%, about 20 items. Sepsis, shock states, MODS, acid-base and electrolytes apply steps 1 and 2 directly. |
| 4. Endocrine, Hematology/Immunology, GI, Renal/GU, Integumentary | 21%, about 26 items, the largest group. DKA and HHS, DIC and HIT, GI bleeding, AKI and CRRT reuse the fluid and electrolyte work from step 3. |
| 5. Musculoskeletal, Neurological, Behavioral/Psychosocial | 18%, about 22-23 items, up from 14% in the 2020 plan. Stroke, TBI, ICP, delirium, PICS and de-escalation. |
| 6. Professional Caring & Ethical Practice | 20%, 25 items. Quickest once the clinical content is in place. Drill it as scenario questions and answer from the Synergy Model. |
Clinical Judgment is 100 of the 125 scored items, and its five groups run from 12% to 21%, so none is safe to skip. Professional Caring sits last only because it is quickest to learn; at 25 items it outweighs every body-system group except the endocrine-to-integumentary one. Read the handbook's two Synergy Model pages on day one.
What changed, and how to spot the next change
The Adult test plan changed for exams taken on and after 12 November 2025, replacing the March 2020 plan after AACN's 2024 study of practice. The 80/20 split is unchanged; the weight moved inside Clinical Judgment. Cardiovascular fell from 17% to 13% and Respiratory from 15% to 12%. Musculoskeletal, Neurological and Behavioral/Psychosocial rose from 14% to 18%, Multisystem from 14% to 16% and the endocrine-to-integumentary group from 20% to 21%. The cut score stayed at 83 of 125. AACN's first-time pass rates were 81.2% in 2023, 72.74% in 2024 and 72.02% in 2025. The exam costs $260 for AACN members and $375 for everyone else; a retest is $185 or $290. Certification lasts three years. Renewal needs 432 practice hours, 144 of them in the final year, plus 100 Synergy CERPs or a pass on the exam.
Two habits keep you from studying a retired outline. First, open the official exam guide and look for its revision date before you buy anything — courses and question banks lag a syllabus change by months, and the cheapest ones never catch up. Second, re-check it the week you book. A revision announced after you started studying is still a revision you sit.
Turn the syllabus into questions
Reading an outline tells you the shape of the paper. Answering questions tells you which sections you would actually lose marks on. Start free, then $5.99 unlocks the full CCRN bank.
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What are the CCRN exam blueprint areas and their weightings?
Clinical Judgment is 80%: Cardiovascular 13%, Respiratory 12%, Endocrine/Hematology-Immunology/GI/Renal-GU/Integumentary 21%, Musculoskeletal/Neurological/Behavioral-Psychosocial 18% and Multisystem 16%. Professional Caring & Ethical Practice is 20%. These are AACN's Adult CCRN figures for exams taken on and after 12 November 2025. On 125 scored items that is roughly 16, 15, 26, 22-23, 20 and 25 questions.
What is the passing score for the CCRN exam?
83 correct answers out of 125 scored items, AACN's published cut score for CCRN (Adult) effective 12 November 2025. That works out at about 66%, but AACN sets the cut score as a raw number, not a percentage, and it can change when forms are re-equated. The 25 pretest items do not count. Your report shows correct answers by content area, but only the total decides the result.
What clinical hours count for CCRN (Adult) eligibility?
You need a current, unencumbered US RN or APRN licence plus either 1,750 hours of direct care of acutely or critically ill adult patients in the past two years, with 875 in the most recent year, or 2,000 hours over five years, with 144 in the most recent year. The hours must match the exam's patient population, and most must be with critically ill patients. Orientation hours spent shadowing another nurse do not count.
How much does the CCRN exam cost in total?
$260 for AACN members and $375 for non-members. One year of AACN membership is $78, so joining first costs $338 in total and still saves $37. A retest is $185 or $290, and you can sit the same exam up to four times in a rolling 12 months. An eligibility extension costs $100. Renewal by CERPs every three years is $150 for members or $230 for non-members.
Sources
Every section title, sub-objective and number on this page comes from the certifying body:
- https://www.aacn.org/-/media/aacn-website/certification/get-certified/handbooks/ccrnexamhandbook.pdf
- https://www.aacn.org/~/media/aacn-website/certification/get-certified/ccrn-ccrne-ccrnk-adult-test-plan.pdf
- https://www.aacn.org/certification/preparation-tools-and-handbooks/exam-stats-and-scores
- https://www.aacn.org/newsroom/revised-ccrn-exams-launch-nov-12-2025
- https://www.aacn.org/-/media/aacn-website/certification/get-certified/handbooks/certpolicyhndbk.pdf
- https://www.aacn.org/-/media/aacn-website/certification/cert-renewal/renew-handbooks/ccrnrenewalhandbook.pdf
Checked October 9, 2026. Exam guides are revised without notice — confirm against AACN before you build a study plan around this page.