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Exam Code: CCRN-Neonatal
Exam Name: Critical Care Register Nurse (Neonatal)
Total Questions: 150 multiple-choice questions.
Scored Questions: 125 scored, 25 unscored
Time Allotted: 3 hours
Passing Score: 84 correct answers out of the 125 scored questions.

Cardiovascular
- Acquired cardiac conditions
- Alteration in the transition to extrauterine life(e.g., PDA, PFO, PPHN)
- Cardiac tamponade
- Congenital heart defects
- Dysrhythmias
- Heart failure (e.g., high output, congestive,secondary)
- Hemodynamic instability
- Surgery
Respiratory
- Acute respiratory distress and/or failure
- Alteration in the transition to extrauterine life(e.g., surfactant deficiency, secondary apnea)
- Apnea of prematurity
- Aspiration (e.g., meconium, secretions, milk,gastric contents)
- Chronic conditions (e.g., CLD/BPD, PIE)
- Congenital anomalies (e.g., CDH, TEF-EA,choanal atresia, tracheal malacia/stenosis/atresia, CPAM, chylothorax)
- Infection (bacterial, viral, and fungal)
- Pleural space abnormalities (e.g.,pneumothorax, hemothorax, empyema,pleural effusions)
- Pulmonary hemorrhage
- Pulmonary hypertension (e.g., PPHN,structural failure)
- Respiratory distress syndrome (RDS)
- Surgery
- Transient tachypnea of the newborn (TTN)
Endocrine, Hematology/Immunology, GI, Renal/GU, Integumentary
- Endocrine
- Adrenal disorders
- Calcium homeostatis disorders
- Glucose homeostasis (hypo- andhyperglycemia)
- Metabolism disorders (e.g., glucose,protein, fat)
- Thyroid disorders
- Hematology and Immunology
- Blood cell disorders (e.g., anemias,polycythemia, sickle cell disease,leukopenia)
- Coagulopathies (e.g., DIC,thrombocytopenias, hemorrhagic diseaseof the newborn, factor deficiencies)
- Hemolytic disease of the newborn (e.g., Rhincompatibilities, ABO incompatibilities)
- Gastrointestinal
- Abnormalities - congenital or acquired (e.g.,omphalocele, gastroschisis, malrotation/volvulus, imperforate anus, Hirschsprungdisease, intussusception, pyloric stenosis,atresias)
- Gastroesophageal reflux
- Hepatic failure (e.g., portal hypertension,biliary atresia, cholestasis)
- Necrotizing enterocolitis (NEC)
- Nutritional conditions
- Intolerance (e.g., feeding, proteinabsorption, milk allergy)
- Malabsorption
- Surgery
- Renal and Genitourinary
- Conditions - congenital and acquired (e.g.,hypospadias, polycystic kidney disease,hydronephrosis, bladder exstrophy, posterior urethral valves, ambiguousgenitalia, AKI, CKD)
- Infections
- Surgery
- Integumentary
- Complications related to neonatal skin (e.g.,injury, transepidermal water loss, contactdermatitis)
- Congenital abnormalities(e.g., epidermolysis bullosa, skin tags,hemangiomas)
- Diaper dermatitis
- Infection (bacterial, viral, and fungal)
- IV infiltration/extravasation
- Skin conditions associated with gestationalage
- Wounds (non-surgical and surgical)
Psychosocial
- Musculoskeletal
- Acquired conditions (e.g., osteopenia,fractures, brachial plexus injury, infection)
- Congenital conditions (e.g., craniofacial,limb, muscle, spine, osteogenesisimperfecta)
- Neurological
- Congenital abnormalities (e.g., AVmalformation, myelomeningocele,encephalocele, hydrocephalus)
- Hemorrhage (e.g., extracranial, intracranial,intraventricular)
- Infection (bacterial, viral, and fungal)
- Ischemic insult (e.g., stroke, periventricularleukomalacia, HIE)
- Seizures
- State dysregulation (e.g., stress, pain,agitation)
- Surgery
- Behavioral and Psychosocial
- Alterations in family systems (e.g.,engagement, resource limitations, caregiverconfidence, PTSD, postpartum mooddisorder)
- Abuse/neglect/maltreatment
- Families in crisis (e.g., grief, lack of coping,violent behavioral escalation, obstructionof care)
- Culture/communication/language
Multisystem
- Acid-base and fluid/electrolyte imbalance
- Birth trauma
- Conditions requiring advanced therapy(e.g., ECMO, CRRT, dialysis, therapeutichypothermia)
- Delay in growth and/or developmentalmilestones
- Genetic conditions
- Metabolic
- Syndromes (e.g., Turner, Noonan, BeckwithWiedemann, Prader-Willi, Angelman,CHARGE)
- Trisomies (13, 18, 21)
- Healthcare-acquired conditions (e.g., CAUTI,CLABSI, VAE, HAPI, PIVIE, MDRO)
- Hydrops fetalis
- Hyperbilirubinemia
- Infant of a diabetic mother (IDM)
- Life-threatening maternal/fetal complications(e.g., eclampsia, HELLP syndrome, maternalfetal transfusion, placental abruption, placenta previa)
- 1Multi-organ failure
- Sensory impairment (e.g., retinopathy ofprematurity, glaucoma, congenital hearingimpairment)
- Sepsis (early and late onset)
- Sequences (e.g., VACTERL, Pierre Robin)
- Shock states (e.g., hypovolemic, septic,cardiogenic, obstructive)
- Terminal conditions (e.g., end-of-life, palliativecare, death and dying)
- Thermoregulation
- Toxin/drug exposure (e.g., withdrawal frommaternal or iatrogenic substances, fetal alcoholspectrum syndrome)
General
- Anticipate and recognize signs and systems ofevolving patient condition
- Assess and monitor based on patient's gestationalage
- Identify and monitor normal and abnormaldiagnostic test results (e.g., labs, radiology,pathology)
- Implement interventions to keep the neonatessafe (e.g., transport, security, safe sleep, safe infanthandling, infection prevention)
- Manage equipment and/or devices relevant topatient care
- Manage patients receiving enteral/oral andparenteral medications based on gestational age andweight
- Provide age-appropriate developmental care
- Provide care for families considering equity, diversity,and inclusion
- Provide pre- intra- and post-operative/proceduralcare
- Recognize indications for advanced therapies andfollow protocols
- Recognize signs and systems of emergencies, initiateinterventions, and seek assistance as needed
- Recognize the impact of genetics on postnatal care
- Cardiovascular
- Identify, interpret and monitor cardiac rhythms
- Recognize normal fetal circulation and transition toextrauterine life
- Recognize signs and symptoms of hemodynamicinstability
- Recognize indications for and manage patients with/requiring:
- congenital cardiovascular abnormalities
- hemodynamic monitoring (non-invasive andinvasive)
- patent ductus arteriosus (PDA)
- pharmacologic and mechanic cardioversion
- vascular access (e.g., PIVS, UVC, UAC, Midline,PICC, tunneled, non-tunneled)
- Respiratory
- Interpret blood gas results
- Manage medications and monitor patients requiringrapid sequence intubation (RSI)
- Prevent complications related to respiratory support
- Recognize indications for and manage patients with/requiring:
- alternative airways (e.g., endotracheal tube,laryngeal mask airway (LMA))
- assisted ventilation (traditional and highfreqency)
- chest tubes
- congenital respiratory/pulmonaryabnormalities
- non-invasive positive pressure ventilation(e.g., CPAP, NIPPV, high-flow nasal cannula)
- respiratory monitoring devices (e.g., SP02,SV02, ETC02)
- therapeutic gases (e.g., oxygen, nitric oxide,heliox, CO2)
- thoracentesis
- tracheostomy
- Hematology and Immunology
- Recognize indications for and manage patients with/requiring:
- bleeding disorders and other bloodpathophysiology
- blood conservation techniques
- congenital hematology/immunologyabnormalities
- transfusion of blood products
- Neurological
- Implement strategies for neurologic protection/promotion
- Recognize indications for and manage patients with/requiring:
- congenital neurological abnormailities
- neurologic monitoring devices and drains (e.g.,ICP, ventricular drain)
- pain (non-pharmacologic and pharmacologic)
- sedation (e.g., procedural, intermittent,continuous)
- therapeutic hypothermia
- Integumentary
- Recognize indications for, and manage patients with/requiring:
- altered skin integrity based on gestational age
- congenital integumentary abnormalities
- infiltration/extravasation
- preventative and therapeutic intervention(e.g., neonatal skin care, humidity, bathing,adhesives)
- therapeutic devices (e.g., wound VACs, pressurereduction surfaces, ostomy device)
- Gastrointestinal
- Recognize indications for and manage patients with/requiring:
- congenital GI abnormalities
- enteral and parenteral nutrition
- enteral tubes (gastic and post-pyloric)
- feeding diffulties and disorders
- lactation support
- necrotizing enterocolities (NEC)
- peritoneal drains
- transition to oral feedings
- Renal and Genitourinary
- Recognize indications for and manage patients with/requiring:
- congenital renal and genitourinaryabnormalities
- fluid/electrolyte management
- diagnostic procedures (e.g., renal biopsy,ultrasound)
- Multisystem
- Follow protocol for newborn screening (e.g., car seattesting, metabolic, hearing and congenital heartdisease)
- Recognize the impact of developmental physiologyon postnatal care
- Promote thermoregulation based on gestational age
- Recognize indications for and manage patients with/requiring:
- birth trauma
- early and late onset sepsis
- acid-base and fluid/electrolyte management
- palliative and end of life care
- toxin/drug exposure (e.g., withdrawal frommaternal or iatrogenic substances, fetal alcoholspectrum syndrome)
- Behavioral and Psychosocial
- Faciliate progressive family involvement in care
- Recognize indications of stress and provide supportto family
- Respond to behavioral emergencies (e.g., nonviolentcrisis intervention, de-escalation techniques)
- Provide care for diverse families (e.g., cultural,spiritual, LGBTQ+ community)
- Recognize the impacts of social determinants ofhealth
- Facilitate trauma informed care for families