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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