CCRN Professional Caring and Ethical Practice Questions
Updated October 30, 2026
Professional Caring and Ethical Practice is a fifth of the CCRN (Adult) exam, about 25 of the 125 scored questions. That is more than cardiovascular (13%) or respiratory (12%), and it is easy to underprepare for because it does not look like clinical content. The questions are built on the AACN Synergy Model and are set at the bedside: a family in conflict, a patient who needs an interpreter, a colleague who will not listen, a unit practice that needs to change.
The 12 questions below are original, written for this page in the style of the real exam. They are independent practice and are not official AACN material.
Professional Caring and Ethics on the CCRN at a glance
| Item | Details |
|---|---|
| Share of the exam | 20% of the scored questions, about 25 of 125 |
| Basis | The nurse competencies of the AACN Synergy Model |
| Split by competency | AACN does not publish weights for each competency on the Adult exam |
| Question style | Bedside and unit scenarios, four choices, one best answer |
The seven competencies tested
| Competency | What it looks like on the exam |
|---|---|
| Advocacy and moral agency | Acting on the patient’s behalf, honoring their wishes, resolving ethical concerns |
| Caring practices | Comfort, vigilance and a therapeutic environment for patients and families |
| Response to diversity | Recognizing culture, spiritual beliefs, language, values and other differences, and building them into care |
| Facilitation of learning | Teaching patients, families and staff, formally and informally |
| Collaboration | Working with the rest of the team, including raising concerns |
| Systems thinking | Using resources across the unit and the health system for the patient |
| Clinical inquiry | Questioning practice and bringing evidence into it |
Clinical judgment, the eighth Synergy competency, is the other 80% of the exam. The Synergy Model’s core idea is that care works best when the nurse’s competencies match the patient’s needs and characteristics, such as resiliency, vulnerability, stability and participation in decisions.
Tips for these questions
- The patient’s own wishes come first. A patient with decision-making capacity, or a documented directive or health care agent, outranks the loudest family member.
- Use the right channel. Qualified interpreters, ethics consultation, case management and the chain of command are usually better answers than handling it alone.
- Address safety before paperwork. After an error, assess and protect the patient first, then report.
- Pick the active, respectful choice. Answers that avoid the issue, deceive or overrule without discussion are rarely right.
CCRN professional caring and ethics practice questions
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A patient with end-stage COPD who has decision-making capacity tells the team he does not want to be intubated if his breathing worsens. His daughter insists that everything be done. Which action by the nurse is MOST appropriate?Answer: BA patient with capacity has the right to refuse treatment, and the nurse's role is to uphold that choice while helping the family understand it. A family meeting with the team supports both the patient's wishes and the daughter. Overriding or postponing the conversation fails the patient.
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The provider needs to discuss a high-risk procedure with a patient who speaks only Vietnamese. The patient's 16-year-old grandson offers to translate. Which action is BEST?Answer: AConsent and other complex discussions require a qualified medical interpreter, who translates accurately and keeps the content confidential. Family members, especially minors, and untrained staff may leave out or soften information and place an unfair burden on the relative.
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The family of a dying patient asks to hold a prayer ritual at the bedside that involves several relatives and quiet singing. The patient is in a shared room. Which response is MOST appropriate?Answer: CResponse to diversity means learning what matters to the family and adapting care to honor it within safety limits. Asking about the ritual and arranging privacy respects the patient's beliefs and supports the family at the end of life, while a blanket refusal or redirection ignores them.
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A patient's wife will help manage her husband's new tracheostomy at home. After teaching suctioning, which method BEST confirms that she understands?Answer: DTeach-back and return demonstration show what the learner actually understands and can do, so gaps can be corrected before discharge. A question such as whether she has questions often gets a yes or no that hides misunderstanding, and handouts and videos do not check learning.
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A nurse tells the resident that a postoperative patient's lactate has risen and urine output has fallen for 3 hours. The resident says to keep watching. An hour later the patient is more tachycardic and confused. Which action should the nurse take NEXT?Answer: BWhen a patient is deteriorating and the first response is not enough, the nurse advocates by escalating through the chain of command or calling the rapid response team, giving a clear, structured report. Waiting longer risks harm, and acting outside an order is not appropriate.
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A patient being discharged from the ICU to home cannot afford a new anticoagulant and has no prescription coverage. Which action BEST reflects systems thinking?Answer: CSystems thinking means using resources across the health system to meet the patient's needs. Case management and social work can find assistance programs, coverage or an affordable alternative so the patient can follow the plan safely. Skipping doses or taking unit stock are unsafe, and delaying discharge does not solve the problem.
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An ICU nurse notices that central line infections on the unit have risen over the last quarter. Which action BEST reflects clinical inquiry?Answer: DClinical inquiry means questioning current practice and comparing it with the best evidence, then using what is found to guide a change. Reminders and borrowed protocols are not based on a review of the evidence or the unit's own data.
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A patient goes into cardiac arrest while his wife is in the room. She asks to stay during the resuscitation. Which response is MOST appropriate?Answer: AAn AACN practice alert supports offering family presence during resuscitation, with a staff member assigned to support the family member. Families who choose to be present often find it helps them understand that everything was done and helps them grieve.
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A nurse realizes that a heparin infusion has been running at twice the ordered rate for 2 hours. The patient has no visible bleeding. Which action should the nurse take FIRST?Answer: DPatient safety comes first: stop the excess dose by correcting the rate and assess for harm, then notify the provider, who may order labs or a reversal. Reporting through the facility system and disclosure to the patient and family follow, but they come after the patient is protected.
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A nurse feels moral distress caring for a patient whose family insists on aggressive treatment that the team believes is only prolonging suffering. Which action is MOST appropriate?Answer: AMoral distress is best addressed by speaking up through proper channels. An ethics consultation brings the team and family together to clarify goals and values. Avoidance and silence leave the distress and the conflict unresolved, and a private judgment to the family undermines the team.
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The ICU is full and the emergency department is holding a critically ill patient. The charge nurse must choose one patient to transfer to the step-down unit. Which patient is the MOST appropriate choice?Answer: BThe most stable, predictable patient is the best choice to move to a lower level of care. The others have active or recent instability: ongoing chest pain on a titrated drip, a new extubation with heavy secretions, and an active bleed needing transfusion.
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A patient on a ventilator has a documented health care power of attorney naming her partner, who is not a legal relative. The patient's siblings arrive and say they should make the decisions. Which action is MOST appropriate?Answer: CA legally designated health care agent speaks for the patient when she cannot, regardless of family ties. The nurse upholds that choice while keeping the siblings informed and supported. Sharing or handing over the decision would go against the patient's documented wishes.
Keep practicing
Our Professional Caring and Ethics practice exam has 25 questions, the same share as the real exam, and the full practice exams mix all six areas into 125 scored questions with 83 to pass. Start from the home page.
Next, try the multisystem questions, or read how CCRN scoring works and the CCRN exam guide.
Pass the CCRN exam on your first try
- All 338 questions across every area of the 2025 Adult CCRN test plan
- A rationale for every answer, including why the tempting choice is wrong
- Unlimited full 125-question practice exams, scored like the real one (83 to pass)