Structure of the exam

The pediatric CCRN exam is 150 questions, 25 of which are used for statistical analysis for future tests. This equates to 125 questions that are scored. The exam lasts 3 hours and candidates receive their test results immediately if you take the computer based exam.


The test is divided into clinical judgment, which is 80% (120 questions) of the exam, and professional caring and ethical practice, which is 20% of the exam. Clinical judgment is further divided into cardiovascular (15% - 22.5 questions), pulmonary (16% - 24 questions), endocrine/hematology/gastrointestinal/renal/integumentary (19% - 28.5 questions), musculoskeletal/neurology/psychosocial (16% - 24 questions), and multisystem (14% - 21 questions).


Professional caring and ethical practice is the remaining 20%, or 30 questions. Professional caring and ethical practice is based on a model created by the American Association of Critical Care Nurses (AACN) called the Synergy Model. The Synergy model discusses a set of patient characteristics and a set of nurse characteristics.


Synergy occurs when the patient characteristics match the nurse characteristics. Patient characteristics include resiliency, vulnerability, stability, complexity, resource availability, participation in care, participation in decision making, and predictability. Nurse characteristics include clinical judgment, advocacy/moral agency, caring practices, response to diversity, facilitation of learning, collaboration, systems thinking, and clinical inquiry.