AACN Exams

The Role of AACN in Critical Care

The American Association of Critical-Care Nurses (AACN) established its credentialing arm in 1976. Since then, it has become the primary certification body for nurses working in high-acuity environments. Over 138,000 acute and critical care nurses currently hold an AACN credential.

In intensive care units, clinical margins are thin. Employers need proof that a nurse can manage complex, unstable patients requiring advanced interventions. The CCRN credential provides that verification. It separates general nursing experience from verified critical care competence. Hospitals pursuing or maintaining Magnet Recognition - a nursing excellence designation - track the percentage of their staff holding credentials like the CCRN, making it an asset for hiring and clinical ladder advancement.

CCRN: CCRN (Adult) - Direct Care Eligibility Pathway

The CCRN: CCRN (Adult) - Direct Care Eligibility Pathway targets nurses who provide direct bedside care to acutely or critically ill adult patients.

Before a candidate can sit for the exam, the AACN enforces strict clinical hour prerequisites. You must hold an unencumbered RN or APRN license and verify either 1,750 hours of direct critical care in the past two years (with 875 hours accrued in the most recent year) or 2,000 hours in the past five years (with 144 in the most recent year). A clinical supervisor or professional colleague must verify these hours.

The computer-based exam runs for three hours and contains 150 multiple-choice questions. Only 125 questions count toward your final score; the remaining 25 are unscored items used to evaluate future test material.

The test plan divides into two distinct sections. Clinical Judgment makes up 80% of the exam. This domain tests your ability to assess and intervene across specific body systems. Cardiovascular and pulmonary topics dominate this section, but it also covers endocrine, hematology, gastrointestinal, renal, and neurological disorders. The remaining 20% covers Professional Caring and Ethical Practice. This section evaluates systems thinking, clinical inquiry, and patient advocacy.

Pass rates hover around 72%, reflecting the technical depth expected of candidates.

Market Demand and Evolving Standards

Hiring managers in specialized units treat the CCRN as a benchmark. Job postings for cardiothoracic ICUs, trauma centers, and rapid response teams frequently list the credential as strongly preferred. Flight nursing and critical care transport roles, such as those at Air Methods, often require it outright.

The AACN updates the exam every few years based on a national practice analysis. The organization recently announced that revised CCRN exams will launch on November 12, 2025. These changes stem from a 2024 study of practice, ensuring the test questions continue to match the precise clinical realities of a modern intensive care unit.