CCRN-NEONATAL Practice Test (15 Questions)

10%

Cardiovascular

Recognize neonatal cardiovascular transition, congenital and acquired disease, rhythm disturbances, heart failure, tamponade, hemodynamic instability, and surgical needs.

• Assess altered transition to extrauterine life, including PDA, PFO, and persistent pulmonary hypertension
• Recognize congenital heart defects, acquired cardiac conditions, heart failure, tamponade, dysrhythmias, and hemodynamic instability
• Interpret cardiac rhythms and monitor invasive or noninvasive hemodynamic data
• Support neonatal vascular access, pharmacologic or mechanical cardioversion, PDA management, and perioperative cardiac care

15%

Respiratory

Assess and manage neonatal respiratory transition, distress or failure, apnea, aspiration, congenital anomalies, infection, pulmonary vascular disease, pleural emergencies, and respiratory support.

• Recognize RDS, TTN, surfactant deficiency, secondary apnea, apnea of prematurity, aspiration, pulmonary hemorrhage, and PPHN
• Assess BPD or other chronic disease, infection, congenital airway or pulmonary anomalies, and pleural-space abnormalities
• Interpret blood gases and manage artificial airways, CPAP, NIPPV, high-flow support, conventional or high-frequency ventilation, and respiratory monitors
• Prevent support-related complications and assist with rapid-sequence intubation, chest tubes, thoracentesis, tracheostomy, and therapeutic gases

20%

Endocrine, Hematology/Immunology, GI, Renal/GU, Integumentary

Integrate neonatal endocrine and metabolic balance, hematology, gastrointestinal and feeding disorders, renal or genitourinary disease, and gestational-age-specific skin care.

• Manage adrenal, calcium, glucose, metabolic, and thyroid disorders in relation to gestational age and weight
• Recognize anemia, polycythemia, leukopenia, coagulopathy, hemolytic disease, immune abnormalities, and blood-product needs
• Assess congenital or acquired GI abnormalities, reflux, hepatic failure, NEC, feeding intolerance, malabsorption, nutrition, enteral access, and lactation needs
• Monitor congenital or acquired renal and GU conditions, infection, AKI, CKD, fluids, electrolytes, diagnostics, and surgical needs
• Prevent and manage transepidermal water loss, infection, dermatitis, congenital skin disease, infiltration or extravasation, wounds, adhesives, humidity, and therapeutic devices

13%

Musculoskeletal, Neurological, Behavioral/Psychosocial

Manage neonatal musculoskeletal and neurologic conditions, pain and state regulation, while supporting family systems, safeguarding, communication, and crisis needs.

• Assess acquired or congenital bone, limb, muscle, craniofacial, spine, infection, and birth-related musculoskeletal conditions
• Recognize congenital neurologic abnormalities, hemorrhage, infection, ischemic injury, hydrocephalus, seizures, and surgical needs
• Provide neuroprotection and support neurologic monitoring, drains, pain care, sedation, therapeutic hypothermia, and state regulation
• Recognize maltreatment, caregiver stress, postpartum mood disorder, PTSD, resource limitations, grief, crisis, communication barriers, and obstruction of care

20%

Multisystem

Integrate whole-neonate priorities across sepsis, shock, organ failure, genetic and maternal-fetal conditions, development, thermoregulation, advanced therapies, screening, and end-of-life care.

• Recognize acid-base or fluid and electrolyte imbalance, early- or late-onset sepsis, shock states, multi-organ failure, hydrops, hyperbilirubinemia, and birth trauma
• Assess genetic and metabolic conditions, syndromes, trisomies, sequences, developmental delay, sensory impairment, and the infant of a diabetic mother
• Respond to life-threatening maternal-fetal complications, healthcare-acquired conditions, thermoregulation problems, and maternal or iatrogenic drug exposure
• Support ECMO, CRRT, dialysis, therapeutic hypothermia, newborn screening, palliative care, end-of-life care, and family needs

20%

Professional Caring & Ethical Practice

Apply AACN Synergy Model nursing competencies to advocate for neonates and families, collaborate, teach, inquire, respond to diversity, and improve care within complex systems.

• Demonstrate advocacy and moral agency and deliver compassionate, trauma-informed, developmentally supportive caring practices
• Use clinical inquiry and evidence to improve neonatal critical-care practice
• Collaborate with families and the interprofessional team and communicate safely during procedures, transport, and transitions
• Facilitate learning, support health literacy and family participation, use qualified interpreters, and respond appropriately to diversity
• Apply systems thinking to safety, infection prevention, equipment, resources, quality improvement, ethical conflict, and coordinated care