The CNN (Certified Nephrology Nurse) is a nursing certification awarded by NNCC.
NNCC publishes the official exam outline, eligibility rules and fees — see NNCC's official page before you book.
In our 1020-card CNN deck the heaviest topics are Pathology (27%), Management (20%), Pharmacology (16%) — that is how this deck is weighted, not the official blueprint, so use it to plan practice and check NNCC's exam outline for the real weighting. This guide shows where the material gets hardest, which topics to practise first, and a 5-step plan built on active recall.
Start with the free CNN practice test
20 mixed questions with answers — find your weak topics before you plan around them →
Based on the 1020 flashcards in our CNN deck. Use it to budget study time, then confirm the official blueprint with the certifying body below.
| Topic | Cards | Share of deck | Practice |
|---|---|---|---|
| Pathology | 280 | 27% | Free questions → |
| Management | 200 | 20% | Free questions → |
| Pharmacology | 160 | 16% | Free questions → |
| Procedures | 120 | 12% | Free questions → |
| Basics | 110 | 11% | Free questions → |
| Diagnostics | 70 | 7% | Free questions → |
| Physiology | 60 | 6% | Free questions → |
| Assessment | 20 | 2% | Free questions → |
Our CNN cards carry difficulty ratings. The spread tells you how much of the deck is quick recall versus genuinely demanding:
0
Easy cards
0% of deck
509
Medium cards
50% of deck
511
Hard cards
50% of deck
These are genuine cards from the heaviest-weighted topics above. Answer each one before you reveal it — that is what active recall means in practice.
What specific physiological triggers stimulate the juxtaglomerular (JG) cells to release renin into the bloodstream?
Show answer →Renin release is triggered by three primary mechanisms: 1) Decreased perfusion pressure sensed by baroreceptors in the afferent arteriole; 2) Reduced sodium chloride delivery to the macula densa in the distal tubule; and 3) Sympathetic nervous system activation via beta-1 adrenergic receptors. Exam Tip: The NNCC often focuses on the macula densa's role as a chemical sensor for NaCl concentration, which is a key component of tubuloglomerular feedback. Renin is the rate-limiting step of the RAAS cascade, ultimately leading to systemic vasoconstriction and volume expansion.
Explain the role of Fibroblast Growth Factor 23 (FGF-23) in the hormonal regulation of Vitamin D and phosphorus in early CKD.
Show answer →FGF-23 is a phosphaturic hormone secreted by osteocytes in response to high phosphorus or high calcitriol. It acts on the kidney to increase phosphorus excretion and, importantly, suppresses the 1-alpha-hydroxylase enzyme. While this helps prevent hyperphosphatemia in early CKD, the resulting suppression of calcitriol production leads to early secondary hyperparathyroidism. Hard Exam Tip: FGF-23 levels rise long before serum phosphorus levels exceed the normal range, making it one of the earliest markers of CKD-MBD.
A patient on an ARB and Spironolactone develops a serum potassium of 6.2 mEq/L. What is the hormonal mechanism behind this complication?
Show answer →ARBs block Angiotensin II receptors, preventing the stimulation of the adrenal cortex to release aldosterone. Spironolactone is a mineralocorticoid receptor antagonist that directly blocks aldosterone's action in the distal tubule. Aldosterone is the primary hormone responsible for potassium secretion (excretion) into the tubular lumen via ROMK channels. Blocking this pathway leads to potassium retention. Exam Tip: The NNCC focuses on the triple whammy of RAAS inhibitors, potassium-sparing diuretics, and declining GFR as the primary risk for life-threatening hyperkalemia.
Eligibility, fees, question counts and the current blueprint live on the official NNCC site (linked below). Print the outline — it is the map for everything that follows.
These 3 topics alone account for roughly 63% of our 1020-card CNN deck. Time spent here pays off more than anywhere else.
Answer questions before flipping to the answer — that struggle is what builds retention. Start with the 30 free CNN cards, then work through the full deck one category at a time.
After a full pass, re-drill only the cards you missed. Small categories are quick wins — closing a weak topic can be an afternoon's work.
Our deck rates 511 cards as hard. If those feel comfortable in your final two weeks, you are studying above test level.
Put the plan into practice
Every topic in the table above, with progress tracking across devices.
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Try 30 free CNN cards firstWeight your time toward the biggest topics: in our 1020-card CNN deck, Pathology has 280 cards (27%), Management has 200 cards (20%), Pharmacology has 160 cards (16%). Always cross-check against the official NNCC exam outline.
Question counts, time limits and fees change — always confirm them in the official NNCC handbook (linked on this page). For practice, our CNN deck has 1020 question-and-answer flashcards covering the listed topics.
Difficulty is personal, but our deck's ratings give a sense of the spread: 0 easy, 509 medium and 511 hard cards. If the hard cards feel manageable, you are in good shape.
Try the 30 free CNN flashcards — no sign-up needed. If the format works for you, the full 1020-card deck is a one-time $7.
Eligibility rules, fees, question counts and passing standards are set by the certifying body and change over time. Always confirm them at the source before you apply or schedule your exam — our flashcards are practice material, not the official handbook.