- How CCRN Testing Is Administered in 2026
- PSI Test Centers: What to Expect
- PSI Live Remote Proctoring: Requirements and Process
- PSI Center vs. Remote: Side-by-Side Comparison
- Registration, Fees, and Scheduling
- The 150-Question Format and What's Actually on the Exam
- Allocating Prep Time by Domain Weight
- A Domain-Driven Prep Timeline
- Frequently Asked Questions
- CCRN exams are delivered through PSI at 300+ U.S. test centers or via PSI Live Remote Proctoring from your home.
- The exam fee is $250 for AACN members and $365 for non-members; joining before registering can save $115.
- The revised CCRN exam launched November 12, 2025-any prep materials predating that update may be outdated.
- Cardiovascular and Professional Caring and Ethical Practice are each weighted at 17%, making them your two highest-priority domains.
How CCRN Testing Is Administered in 2026
The CCRN certification-formally the Certification in Acute/Critical Care Nursing-is administered by the AACN Certification Corporation, the credentialing arm of the American Association of Critical-Care Nurses. Since 2020, AACN Certification Corporation has partnered with PSI Services as its exclusive testing vendor, and that partnership continues through 2026.
Candidates have two distinct delivery options: sitting at a physical PSI testing center (more than 300 locations across the United States) or completing the exam through PSI Live Remote Proctoring, which streams to a live proctor via your own computer. Neither option changes the exam content, the question count, or the time limit-but the choice significantly affects logistics, technology requirements, and test-day experience.
The revised CCRN exams launched on November 12, 2025. If you have study guides, question banks, or flashcard decks purchased before that date, verify their alignment with the current blueprint before relying on them heavily.
PSI Test Centers: What to Expect
PSI operates more than 300 testing centers nationwide, meaning most candidates can find a location within reasonable driving distance. These are dedicated, controlled testing environments staffed by PSI employees who check identification, administer a security screening, and supervise the exam floor.
The Check-In Process
Arrive at least 15-30 minutes before your appointment. You will need to present a valid, government-issued photo ID whose name matches exactly what you entered when registering with AACN Certification Corporation. Personal items-phones, watches, wallets, food, and notes-are stored in a locker before you enter the exam room. PSI staff will photograph you and may conduct a palm-vein scan for biometric verification at some locations.
The testing room contains individual workstations with partitions. You will receive scratch paper or an erasable notepad and a marker; these stay in the room. The timer appears on-screen and begins once you start the exam, not when you sit down.
Locating a PSI Center Near You
The AACN Certification Corporation's candidate handbook directs test-takers to the PSI scheduling portal to search available sites by zip code. Availability varies by region; urban areas typically offer multiple nearby sites with frequent open appointments, while rural candidates may need to plan further in advance or travel to a larger city. Schedule as soon as your application is approved to secure your preferred date and location, since high-demand windows-especially spring and fall-fill quickly.
PSI Live Remote Proctoring: Requirements and Process
Remote proctoring through PSI allows you to take the CCRN exam from a private room in your home or office. A live PSI proctor-not an AI system-monitors you via your webcam and microphone throughout the exam. This is not a recorded, asynchronous review; someone is watching in real time.
Technical Requirements
PSI publishes specific system requirements on its candidate support page, and these should be verified close to your exam date since they are subject to change. Generally, you will need a desktop or laptop computer (tablets and Chromebooks are typically not permitted), a stable broadband internet connection, a functioning webcam and microphone, and a supported operating system and browser. Run PSI's compatibility checker well before test day-not the night before.
Room and Environment Rules
Your testing space must be private with a closed door, clear of any other people for the entire exam duration, and free of notes, books, dual monitors, and non-permitted technology. The proctor will conduct a 360-degree room scan via your webcam before the exam begins. Your desk must be clear except for the testing computer. Any violation observed by the proctor can result in immediate exam termination and forfeiture of your fee.
Key Takeaway
Remote proctoring eliminates travel time but introduces technical risk. Run PSI's system check at least one week before your exam date using the exact computer, network, and room you plan to use on test day. Do not attempt remote proctoring on a work-managed laptop with restrictive IT security settings unless you have confirmed compatibility.
Scheduling Remote vs. In-Center
Remote proctoring often offers more flexible appointment windows, including early mornings and weekends, and availability is not constrained by physical seat capacity. This can be an advantage for candidates in areas with limited PSI centers or those with rigid work schedules.
PSI Center vs. Remote: Side-by-Side Comparison
| Factor | PSI Testing Center | PSI Live Remote Proctoring |
|---|---|---|
| Location | 300+ physical U.S. sites | Your home or private office |
| Proctor Type | On-site PSI staff | Live remote PSI proctor via webcam |
| ID Verification | In-person; photo and biometric scan | Webcam; ID held up to camera |
| Technology Risk | Low; PSI manages all equipment | Higher; depends on your hardware and internet |
| Scheduling Flexibility | Limited to center hours and seat availability | Often more flexible; wider time windows |
| Travel Required | Yes | No |
| Permitted Materials | PSI-provided scratch paper only | Nothing on desk; no scratch paper unless PSI provides digital whiteboard |
| Interruptions | Controlled environment | You are responsible for preventing interruptions |
Registration, Fees, and Scheduling
Before you can schedule a PSI appointment, AACN Certification Corporation must approve your application. The eligibility requirements for the CCRN are specific and non-negotiable: you must hold a current, unencumbered RN or APRN license in the United States, and you must meet one of two clinical hour pathways:
- Primary pathway: 1,750 hours of direct care of acutely or critically ill patients within the past two years, with at least 875 of those hours in the most recent year.
- Alternative pathway: 5 years of experience with a minimum of 2,000 total hours, including at least 144 hours in the most recent year.
Once AACN Certification Corporation approves your application, you receive an Authorization to Test (ATT) letter with instructions to schedule through PSI. Your ATT has an expiration window, so schedule your exam promptly after receiving it.
Fee Structure
The exam fee depends on your AACN membership status at the time of application-not at the time of payment. AACN membership costs money, but for many candidates the $115 savings ($365 non-member vs. $250 member) more than offsets a year of membership dues. If you need to retest, the retest fee is $180 for members and $285 for non-members-again a meaningful gap.
The 150-Question Format and What's Actually on the Exam
The CCRN is a 150-question, multiple-choice exam delivered on computer. Of those 150 items, 125 are scored and 25 are unscored pretest items embedded throughout the exam. You will not know which questions are pretest items, so treat every question as scored. The time limit is 3 hours, and passing requires correctly answering at least 83 of the 125 scored items.
The questions are scenario-based and clinically grounded. Expect patient vignettes that present hemodynamic data, ventilator settings, lab values, rhythm strips, or medication drips and ask you to prioritize, interpret, or intervene. The CCRN does not test isolated fact recall the way some nursing school exams do-it tests clinical reasoning under realistic conditions.
For group testing situations, AACN Certification Corporation also offers a paper-based exam format, though the vast majority of individual candidates test via computer at a PSI center or remotely.
To build the kind of clinical reasoning these questions demand, consistent practice with timed, case-style questions is essential. CCRN Exam Prep's full practice test suite is built around the current 2025-2026 blueprint and mirrors the scenario format you will encounter on test day.
Allocating Prep Time by Domain Weight
The CCRN blueprint is not evenly distributed. Two domains each carry 17% of the exam-the highest weighting-and understanding them in depth is non-negotiable for passing.
Domain 1: Cardiovascular (17%)
The single largest clinical domain. Candidates must master hemodynamic monitoring (PA catheters, arterial lines, CVP interpretation), dysrhythmia recognition and management, heart failure pathophysiology, acute coronary syndromes, cardiogenic shock, and vasoactive medication pharmacology. Expect rhythm strips and hemodynamic scenario questions.
- 12-lead ECG interpretation and STEMI recognition
- IABP and temporary pacemaker management
- Afterload, preload, and contractility in the critically ill
- Vasopressor and inotrope selection and titration
Domain 10: Professional Caring and Ethical Practice (17%)
Tied with Cardiovascular as the highest-weighted domain, this section covers the Synergy Model for Patient Care, ethical decision-making, advocacy, collaboration, and clinical judgment. Many candidates underestimate this domain because it feels less "clinical," but it accounts for a significant portion of the exam. See our detailed guide on CCRN Domain 10: Professional Caring and Ethical Practice 2026 for a full breakdown of what this domain actually tests.
- AACN Synergy Model: eight patient characteristics and eight nurse competencies
- Ethical principles applied to ICU scenarios (autonomy, beneficence, justice)
- End-of-life care, informed consent, and surrogate decision-making
- Conflict resolution and interprofessional collaboration
The remaining domains round out the blueprint:
| Domain | Weight | Key Focus Areas |
|---|---|---|
| Respiratory | 15% | Mechanical ventilation, ABG interpretation, ARDS, status asthmaticus |
| Neurology | 12% | ICP monitoring, stroke, seizures, sedation assessment |
| Multisystem | 12% | Sepsis, MODS, trauma, toxicology, burns |
| Endocrine, Hematology, and Immunology | 8% | DKA, HHS, DIC, transfusion reactions, immunosuppression |
| Renal and Genitourinary | 6% | AKI, CRRT, electrolyte emergencies |
| Gastrointestinal | 6% | GI hemorrhage, hepatic failure, acute pancreatitis |
| Behavioral and Psychosocial | 4% | ICU delirium, substance withdrawal, crisis communication |
| Musculoskeletal and Integumentary | 3% | Compartment syndrome, pressure injury, rhabdomyolysis |
A Domain-Driven Prep Timeline
Generic study schedules rarely work for the CCRN because the exam's content is unevenly weighted and deeply clinical. The timeline below sequences domains by weight and conceptual complexity, not alphabetically. Most candidates need 8-12 weeks of structured preparation depending on their clinical background and weekly study hours available.
Cardiovascular (17%) - Your Highest-Stakes Domain
- Review hemodynamic parameters and PA catheter waveforms
- Practice rhythm strip interpretation daily using timed sets
- Map each vasopressor and inotrope to its receptor profile and clinical indication
- Run baseline practice questions at CCRN Exam Prep to identify specific weak spots
Respiratory (15%) + Neurology (12%)
- Master vent mode selection: AC, SIMV, PS, PRVC, and their weaning implications
- Practice ABG interpretation with mixed disorders
- Review ICP waveforms, Monroe-Kellie doctrine, and cerebral perfusion pressure
- Connect sedation scoring (RASS, CAM-ICU) to neurological and behavioral domains simultaneously
Multisystem (12%) + Domain 10: Professional Caring and Ethical Practice (17%)
- Work through sepsis bundle components and surviving sepsis guidelines
- Study MODS organ failure cascade and trauma priorities
- Dedicate at least three sessions exclusively to the Synergy Model-this is heavily tested
- Read full-length ethical scenario questions; practice eliminating answers that ignore patient autonomy
Endocrine/Hematology/Immunology (8%) + Renal (6%) + GI (6%)
- Build comparison charts: DKA vs. HHS; prerenal vs. intrinsic AKI vs. postrenal
- Review CRRT modes and anticoagulation during renal replacement
- Focus GI study on upper GI bleed management, hepatic encephalopathy grading, and Ranson criteria
Behavioral/Psychosocial (4%) + Musculoskeletal/Integumentary (3%) + Full Review
- Cover ICU delirium prevention bundles (ABCDEF bundle) and alcohol withdrawal scoring
- Review compartment syndrome assessment and fasciotomy indications
- Take full 150-question timed practice exams to simulate test day pacing
- Revisit any domain where practice test accuracy remains below your target threshold
For additional detail on scheduling your exam and understanding what PSI testing locations look like in practice, bookmark CCRN Testing Centers: PSI Locations and Remote Options 2026 as a reference you can return to as your test date approaches.
The CCRN is widely recognized by Magnet-designated hospitals as a marker of clinical excellence, and many critical care units actively recruit and retain CCRN-certified nurses. If you are preparing for your exam, consistent practice with questions that mirror the current blueprint is the most direct path to confidence on test day. Start with a full-length practice exam at CCRN Exam Prep to benchmark your readiness across all ten domains before you commit to a test date.
Frequently Asked Questions
Yes. Once AACN Certification Corporation approves your application and issues your Authorization to Test, you schedule directly through the PSI portal. At that point you select either a physical test center location or the remote proctoring option. The choice is made during scheduling, not during the application process, so you have flexibility up until you book your appointment.
No, there is a mandatory waiting period between attempts. You must wait a specified interval before reapplying, and your retest fee will be $180 if you are an AACN member or $285 if you are a non-member. The AACN Certification Corporation candidate handbook specifies the exact retake policy and any limits on the number of attempts per eligibility period. Review it before scheduling your first attempt so you understand the full timeline.
Yes. The 25 pretest items are embedded throughout the 150-question exam and are indistinguishable from the 125 scored items. AACN Certification Corporation uses these unscored questions to evaluate new items for future exam versions. Because you cannot identify which questions are pretest items, you should approach every question with the same focus and effort as if it were scored.
Your membership status is determined at the time of application, which is when the fee is assessed. If you are a member when you submit your application, you pay the member rate of $250. Membership status at the time of your actual test date does not change the fee you already paid. However, you should verify this with AACN Certification Corporation directly if your membership expires between application and test date.
Yes. The exam blueprint, question count, time limit, passing score, and content are identical regardless of delivery method. PSI administers the same exam whether you are sitting at a physical testing center workstation or logging in from your home. The only differences are the logistical and environmental factors described in this article.