Keep Calm & Pass the CCRN Exam

• The CCRN exam can be grueling and should not be taken lightly, but it is achievable with appropriate preparation. 
• Realistically, you only need to get eighty-seven of the remaining questions correct to pass. 
• Either way, this test prep is more than memorization and regurgitation. It requires application of what has been learned at the bedside combined with knowledge. 

CCRN is a registered trademark that signifies board certification of a critical care nurse. These highly trained and certified nurses work in many arenas including ICU, ED, and on neonate, pediatric, and adult transport teams.  

The American Association of Critical Care Nurses (AACN) endorses this CCRN certification. Securing and maintaining this highly regarded certification benefits patients, institutions, and the individual nurse. Qualifying to sit for the exam requires an unencumbered RN or APRN license and a minimum of 1750 direct critical care bedside hours over two years.  

The CCRN exam can be grueling and should not be taken lightly, but it is achievable with appropriate preparation. Remember you have been practicing for the test for the last 1750 hours over the preceding two years.  

The test is 150 questions in length, but twenty-five of those are not graded. Realistically, you only need to get eighty-seven of the remaining questions correct to pass. All the questions are multiple choice giving you the valuable tool – process of elimination.  

The test is divided into two general areas – Clinical Judgment and Caring/Ethical Practice with clinical judgment comprising the lion’s share of the test at 80%. You are allotted three hours to complete the exam. The recent passing rate is approximately 72% – not bad odds.  

Often the difference between success and failure on examinations is dependent on finely tuned test taking skills. Studies have concluded that those with well-defined test taking skills exhibit improved attitudes regarding tests, display decreased anxiety levels, and achieve better overall. There are multiple pathways to choose from when prepping for the CCRN. Some prefer to take a review course while others prefer to self-prepare. Either way, this test prep is more than memorization and regurgitation. It requires application of what has been learned at the bedside combined with knowledge.  

CCRN Exam Preparation

First, start by setting a schedule. This means pick your target test date, circle it on the calendar, call the test center and secure it. This is imperative because it keeps you honest and moving forward. It takes away the option to procrastinate. Having a test date will motivate and inspire you to develop a study schedule and stick to it.  

Next, break the test down into sections and focus on that topic, specifically cardiovascular and respiratory. These two areas account for more than 32% of the of all the questions – so spend a hefty portion of study time there.

The endocrine, gastrointestinal, renal, and integumentary systems make up 20% of the test with musculoskeletal, neurology, and psychosocial accounting for another 14%. Slow and steady study and preparation beats cramming.  

Third, utilize multiple modalities. Flashcards are a great study instrument. Research supports repetition as an effective learning formula. They engage visual and tactile learning styles – read the card & flip the card. They are compact and portable making them invaluable to the busy nurse.  

Interestingly, you engage in a competition with yourself, which increases your retention of the material. Finally, practice makes perfect. Do as many practice questions as possible. Study guides, websites, AACN practice exams are all providers of questions. 

CCRN Exam Test-Taking Strategies

Start the testing drill the night before by assuring a good night’s sleep. Fuel up in the morning with a well-balanced breakfast and allow ample travel time to the test site. Today is not the day to increase anxiety by running late.  

As the computer loads your exam, remember test taking strategies are an important part of the process. Step one is to read the question and deduce what it is asking.  

Key Words

One effective technique is to spot key words or phrases such as “first”, “always”, “best”, and “initial”. These words will help you focus your attention on what the author of the question is looking for.  

For example, if a question asks what your first response to a trauma patient is, it is telegraphing that all the answers are correct, and you will have to determine what is the “first” thing to do.  

Frequently, these questions utilizing “first” or “initial” will offer an option including airway, breathing, or circulation. It is a fair bet; this will be your answer.  

Process of Elimination

Another question answering technique is the process of elimination. Sometimes one option is obviously unrelated. Eliminate incorrect choices and select from what you have left. Remember medicine seldom has “always” or “never” options. Shun answers that include these descriptors.  

Grouping also works well as a testing strategy. When three of the four answers are related or comparable, the answer is likely to be the one that is unrelated or different.  

Scenario Questions

The most challenging type questions on the CCRN exam are scenario questions. By the time you read the whole scenario, you have forgotten what the question was asking.  

The approach to these type questions is to read the question first, then the scenario, and wrap up by rereading the question. Now reread the scenario again excluding as much of the superfluous information as possible.  

The goal is to be left with a simple question that can be solved by a trimmed down scenario.  

Other CCRN Exam Considerations

Remember to utilize the bookmark function. Marking a question to return to is a good testing tactic. With three hundred questions, it is odds-on that you may encounter information in the remaining questions that helps you answer bookmarked questions.  

Battle apprehensive or uneasy feelings – remember you are not expected to know every answer. Celebrate the ones you are confident in and move on. Do not fall into the trap of picking the first correct answer you come across.  

Remember to read all the answers before selecting one. When you see a question that references the “gold standard”, know that this means the most proven, effective, and safe routine, not the common approach.  

Probably, most importantly, is to recall your priority as an advocate for your patient and this concept is the “Gold Standard” of a CCRN practice. When a question offers options that facilitate patient care, you will commonly see words such as “encourage”, “reinforce”, and “nurture”.  

Finally, follow your gut. Once you complete a question, move forward, do not second guess your answer.  

The Bottom Line

CCRN certification serves many purposes, but most importantly studies have shown that it grows a nurse’s confidence exponentially. Certified nurses feel empowered. They know their skill, knowledge and judgment are respected and celebrated by patients and institutions.  

The AACN recognizes March 19 as Certified Nurses Day annually to honor Gretta Madden-Styles the first researcher to discuss standards necessary for credentialling. 

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