Should I Sit for My Critical Care Registered Nurse Certification?

ccrn certification with nurse

A question many nurses working in critical care ask themselves is whether or not to sit for the CCRN certification. I certainly did, and for me, the answer was yes. Before deciding if it is right for you, it is important to understand the value of a certification. Certification exams serve to demonstrate mastery in a field or specialty; both to one’s self and the rest of the world. The CCRN exam is difficult, and rightfully so – its aim is to show the world your expertise in caring for critically ill patients.

The Exam

The CCRN exam is administered by the American Association of Critical-Care Nurses (AACN). On the AACN website, you will find guidelines to prepare for the test, eligibility requirements, and testing center locations, amongst other useful information.

The CCRN exam costs $335 but is reduced to $230 for AACN members. Here’s my first big tip: join the AACN. Membership costs $78/year but ends up saving you $95 on the cost of the test. In addition to these savings, membership also grants you access to a wealth of free continuing education opportunities, three critical care journal subscriptions, and access to a community of like-minded professionals across the country with whom you can discuss and learn about your chosen specialty.

How to Prepare

It is important to understand how you study and learn best – I recommend employing a number of methods to help keep the process from getting stale.

Review Courses

Review courses are very beneficial. Many larger hospitals put them on for staff, but there are also professional speakers who tour and put on workshops. Some of these speakers even sell recordings of their workshops (ever wish you could click rewind during a live presentation?)


There are a number of books and online courses available to you as well, including one from the AACN. I found these two to be the most useful.

AACN Certification and Core Review for High Acuity and Critical Care 6th Edition

This book provides a good assessment for critical care nurses. Within it, you will find three sample 200-question CCRN Practice Exams that will help you evaluate your preparedness for your upcoming exam. Each question comes with detailed references and rationales to help you understand why you answered it correctly or incorrectly.

Cost: Approximately $118.

PASS CCRN®!, 4th Edition, Authors: Robin Dennison Robin Dennison

This book is known to be a different approach to preparing for the exam. It helps identify new study techniques and learning strategies and is notoriously accurate. Because it is broken down by sections found on the exam. Many readers find it easy to identify trouble areas for more targeted study.

Cost: Approximately $68.

Live Workshops

Personally, I preferred live workshops because I found it to be more engaging and fun rather than studying from books. I chose a speaker who had a dry wit and penchant for memorable stories and pneumonic devices that were easily relatable. I even found myself chuckling during the test when I was able to answer a question by remembering one of her stories. Speakers have YouTube videos that you can view to determine if they are the right match for you. Another tip is to remember you are part of a multidisciplinary team; coworkers such as respiratory therapists and doctors can be useful resources to explain concepts familiar to them.

If you are researching speakers, check to see if they have a YouTube channel or videos posted that you can view to determine if they are the right match for you. Another tip is to remember you are part of a multidisciplinary team; coworkers such as respiratory therapists and doctors can be useful resources to explain concepts familiar to them.

Pace Your Review

The best tip I can give about preparing for the CCRN exam is to approach it as you would train for a big race. Think of your brain as a muscle that must be conditioned before it can reach its peak performance. You wouldn’t consider running a marathon without building up to it, why would you expect to be able to fly through a test without building up your brain endurance.

When taking practice questions, many people will do a few at a time that pertains to the system they are studying, and maybe take one or two practice tests to judge their progress. However, you will find that sitting down to answer 150 questions in a row can be mentally exhausting. I know that the first time I sat down to take a practice test it took me nearly three hours; I kept wanting to get up and stretch or walk away. In order to correct this, I took one full practice test (150 questions) a day for seven days leading up to my testing date.

What I noticed amazed me, each day I took less and less time to complete the test, and by the end of the week, it was no struggle at all to sit and focus for that period. I also recommend taking CCRN practice tests online, because the actual exam will be taken on a computer and the closer your preparation is to the actual conditions, the less stress you will likely feel in the testing center.

How the CCRN Exam is Broken Up

It is important to consider the makeup of the exam when planning your study time. CCRN is made up of 80% clinical questions and 20% professional practice. The AACN follows the synergy model, which I found logical and did not feel the need to spend much of my study time focusing on. If you frame the question in terms of what a kind compassionate nurse would do in the best interest of their patient, it became clear how to answer.

For the clinical questions, the breakdown is:

  • 18% Cardiovascular (or 27 questions)
  • 17% pulmonary (26)
  • 20% Endocrine/Hematology/Gastrointestinal/Renal/Integumentary (30)
  • 13% Musculoskeletal/Neurology/Psychosocial (20)
  • 14%Multisystem (21)

These numbers may seem intimidating on their face, but I found it helpful to break them into the number of questions. While the third category (Endocrine/Hematology/Gastrointestinal/Renal/Integumentary) has 30 potential questions, it is important to remember that it covers five body systems, so in reality, it will likely be six questions about each of those systems. Looking at it this way is easier to see where the bulk of one’s time should be spent studying. In addition, I found it to be a helpful reminder when I was stressing out about obscure conditions to remind myself that it was unlikely to come up as one of the six questions.

Managing Stress

The final piece of advice I can offer is about managing stress. Some stress is good and can help us to focus, but taking this exam will be stressful enough so it is important to avoid unnecessary stress before the exam.

  • Make sure you know where the testing center is and how to get there before leaving that morning
  • Leave extra drive time in case of traffic or accidents
  • Eat a good breakfast before the exam, your brain will be working hard so give it plenty of good fuel
  • Get a good night’s sleep the night before, make sure if you work off shifts you are not scheduled right before the exam so you are rested

Passing the CCRN exam is an accomplishment to be proud of, prepare yourself in the best way by taking the time to thoroughly prepare yourself mentally and emotionally.

Author, Ari NewmanAri Newman has been a nurse for 13 years, working in emergency departments in Cleveland, Ohio, and Las Vegas, Nevada.  He also spent time recovering open heart patients in the CardioVascular ICU a the Cleveland Clinic before moving to Nursing Education and Professional Development department.  He now focuses on the education of new and experienced ICU nurses, working to expand their knowledge and improve the level of care delivered to their patients.

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