The CNN (Certified Nephrology Nurse) credential is awarded by the Nephrology Nursing Certification Commission (NNCC) to registered nurses specializing in kidney disease care. Whether you work in hemodialysis, peritoneal dialysis, or kidney transplant nursing, earning your CNN demonstrates clinical expertise and commitment to nephrology practice. This free printable PDF lets you study anytime — no internet required.
Our CNN practice test PDF covers every major domain tested on the actual NNCC examination: kidney anatomy and physiology, chronic kidney disease (CKD) staging and management, hemodialysis nursing, peritoneal dialysis nursing, transplant nursing, and acute kidney injury (AKI) management. Print the PDF, quiz yourself with a pen, and review rationales to lock in the knowledge you need to pass.
Questions test your understanding of nephron structure and function, glomerular filtration rate (GFR), the renin-angiotensin-aldosterone system (RAAS), tubular reabsorption and secretion, acid-base regulation, erythropoietin production, activation of vitamin D, and fluid and electrolyte regulation. Normal GFR is 90–120 mL/min and is the cornerstone of CKD staging.
CKD is staged 1 through 5 based on GFR, with Stage 5D indicating dialysis dependence. Common causes include diabetic nephropathy, hypertension, and glomerulonephritis. Complications you must know include anemia of CKD (EPO deficiency with iron deficiency management), CKD-mineral and bone disorder (CKD-MBD) requiring phosphate binders and dietary phosphorus restriction, potassium restriction, fluid management, and vascular access selection — including AV fistula, AV graft, and tunneled catheter care and assessment.
HD prescription components include Kt/V target ≥ 1.2, blood flow rate, dialysate flow rate, and treatment time. Nurses must assess vascular access by confirming bruit and thrill, master cannulation techniques, and manage anticoagulation with UFH or enoxaparin. Intradialytic complications include hypotension (most common), muscle cramps, arrhythmias, headache, and the life-threatening air embolism — each requiring specific nursing interventions. Ultrafiltration calculation is also high-yield.
The exam tests CAPD versus APD (cycler) differences, PD prescription parameters (dwell time, fill volume, dextrose concentration), and weekly Kt/V adequacy ≥ 1.7. PD complications include peritonitis — the most serious, presenting with cloudy effluent — catheter exit site and tunnel infections, ultrafiltration failure, and encapsulating peritoneal sclerosis. Patient education for home PD is a recurring topic.
Immunosuppression regimens include calcineurin inhibitors (tacrolimus, cyclosporine), antimetabolites (mycophenolate mofetil), and corticosteroids. You must distinguish hyperacute, acute, and chronic rejection and differentiate rejection signs from infection signs. Opportunistic infections post-transplant — CMV, Pneumocystis jirovecii pneumonia (PJP), and BK virus — are tested, along with food safety education and medication adherence counseling.
KDIGO AKI staging, pre-renal versus intrinsic versus post-renal causes, and CRRT modalities (CVVH, CVVHD, CVVHDF) with nursing management are all high-yield. Electrolyte and fluid monitoring, medication dose adjustments in AKI, and indications for emergent dialysis using the AEIOU mnemonic (Acidosis, Electrolytes, Ingestion, Overload, Uremia) round out this domain.
Prefer to study on screen? Our interactive CNN practice test gives you instant feedback on every answer, detailed rationales, and a running score so you know exactly where to focus. Combine the online tests with this printable PDF for a complete study approach — use the PDF for offline review and paper-based self-testing, then reinforce weak areas with the adaptive online questions.