CCRN Neonatal Exam

The CCRN Neonatal exam will test a nurse’s knowledge of handling critically ill neonatal patients. A neonatal critical care nurse will undergo extensive training to be able to work with these tiny patients. Although a CCRN Neonatal certification may not be required for these jobs, the certification can enhance a neonatal nurse’s resume. A CCRN certification gives the doctors and the parents of the patient confidence that the infant is receiving the most competent nursing care possible.

The format for this CCRN exam is similar to the CCRN Pediatric and Adult exams. The Neonatal exam will ask 150 questions that measure your knowledge about critical judgment, professional caring, and ethical practices. However, only 125 of the questions will count towards your score. The other 25 questions are used for testing purposes. They may eventually be included on future exams. You will not know which questions count towards your overall score, so you must try to do your best on every question.

The majority of the exam questions (80%) will test your understanding and knowledge about critical judgment. These questions will only ask you about health issues specific to neonatal patients.

Prepare to answer questions about the following categories and topics:

  • Pulmonary (24%) – Acute respiratory failure, apnea, transient tachypnea, congenital abnormalities, respiratory infections including croup, and bronchopulmonary dysplasia
  • Cardiovascular (10%) – Heart failure, cardiogenic shock, structural heart defects, dysrhythmias, and hypovolemic shock
  • Neurology (10%) – Birth injuries, intracranial hemorrhage, congenital neurological abnormalities, brain death, seizure disorders, neuromuscular disorders, and neurosurgery
  • Multisystem (10%) – Low birth weight, asphyxia, septic shock, toxin overdose, and maternal fetal complications including HELLP syndrome, eclampsia, and placenta previa
  • Behavioral and Psychosocial (7%) – Stress as a result of low birth weight, abuse, delays in development, and substance dependence issues as a result of maternal drug and alcohol abuse
  • Gastrointestinal (6%) – GI abnormalities, malnutrition, bowel obstruction or perforation, hepatic failure, GI surgeries, and gastro esophageal reflux
    Hematology and Immunology (6%) – Coagulopathies, anemia, and pathological hyperbilirubinemia
  • Endocrine (3%) – Neonatal hypoglycemia and metabolism
  • Renal (5%) – Renal failure and electrolyte imbalances

*Note: According to the AACN’s website, and the CCRN testing handbook, say that the clinical judgment portion of the exam is 80%. Its figures, however, add up to the 81%. The figures listed above are found at

You will also receive questions testing your understanding of ethical practices in the nursing profession and professional caring issues. These questions will be broad and will not necessarily focus only on neonatal patients. Questions will test your understanding of the following topics:dreamstime_17890402

  • Collaboration (4%)
  • Caring Practices (4%)
  • Facilitation of Learning (3%)
  • Advocacy and Moral Agency (3%)
  • Clinical Inquiry (2%)
  • Systems Thinking (2%)
  • Response to Diversity (2%)

The American Association of Critical Care Nurses has decided that you must earn a score of at least 88 to pass the exam. Your score will not be based on the percentage of questions you answered correctly. It will be a raw score. Remember, it is important to attempt to answer each question. You are not penalized for incorrect answers.