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CCRN ADULT EXAM PREP 2026 | 500+ VERIFIED Q&A |
ICU NURSING MASTERY | NGN RATIONALES
A patient who is 72 hours postoperative repair of a bowel obstruction suddenly
demonstrates shortness of breath and his respiratory rate increases from 22 to 45/min. His
SpO2 went from 95% to 88% acutely. An arterial blood gas sample obtained while the
patient is receiving oxygen via a nasal cannula at 6L/min reveals the following results:
pH 7.40
pCO2 27
pO2 50
A chest x-ray is obtained and a "ground-glass-like appearance" is reported. Auscultation of
the lungs reveals diffuse crackles that were not present previously.
Your patient just received 10 units of banked blood for a GI bleed. You know this will affect
the oxyhemoglobin dissociation curve by:
A. Shifting it to the right
B. Causing a plateau in the curve
C. Shifting it to the left
D. Causing no change in the curve
C. Shifting it to the left
A patient who is 72 hours postoperative repair of a bowel obstruction suddenly
demonstrates shortness of breath and his respiratory rate increases from 22 to 45/min. His
,2|Page
SpO2 went from 95% to 88% acutely. An arterial blood gas sample obtained while the
patient is receiving oxygen via a nasal cannula at 6L/min reveals the following results:
pH 7.40
pCO2 27
pO2 50
A chest x-ray is obtained and a "ground-glass-like appearance" is reported. Auscultation of
the lungs reveals diffuse crackles that were not present previously.
Your patient is currently on a ventilator with the following settings: AC, FiO2 100%, Rate
of 12, Tidal Volume 450, PEEP of 5. His arterial blood gas results are the following: pH
7.36, PaCO2 43, PaO2 56, HCO3 28. Which ventilator parameter do you anticipate
changing?
A. Decrease the FiO2
B. Increase the tidal volume
C. Increase the PEEP
D. Increase the rate
C. Increase the PEEP
ARDS is characterized by which of the following:
A. Refractory hypercarbia
B. Increase in surfactant
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C. Increased lung compliance
D. Shunting
D. Shunting
Rationale: ARDS is characterized by refractory hypoxia, shunting, decreased lung compliance,
and decreased surfactant.
A 42 y/o woman with a 6 month history of worsening anxiety, heat intolerance, and weight
loss presents to the emergency department. Which of the following are indicators of
hyperthyroidism?
A. Constipation, lower body temperature, and edema
B. High T3 and T4 and low TSH.
C. Depression, dementia, and reflex changes
D. Low T3 and T4 and high TSH
B. High T3 and T4 and low TSH.
Rationale: Constipation, lower body temperature, edema, depression, dementia, reflex changes,
low T3, low T4, high TSH are all indicators of hypothyroidism.
An elderly man with Type 2 DM comes into the emergency department after spending all
day in the mall shopping with his wife. He tells you that his heart is racing and he is sweaty
and shaky. What is the best course of action for the nurse?
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A. Give the patient a candy bar and drink regular soda then check his BG.
B. Check his blood glucose level and obtain an ECG.
C. Check his blood glucose and inject NPH insulin if he's hyperglycemic.
D. Give the patient 4 glucose tablets and then check his blood glucose.
B. Check his blood glucose level and obtain an ECG.
Successful treatment of DKA revolves around:
A. Correction of orthostatic hypotension with electrolytes
B. Administration of fluids, electrolytes and insulin
C. Gradually decreasing a patient's excessive fluid volume from hyperosmolality
D. Administration of glucagon to elevate plasma blood levels
B. Administration of fluids, electrolytes and insulin
What is the Somogyi phenomenon generally attributed?
A. Prolonged hyperglycemia that has led to neurological damage and impaired
counterregulatory response
B. Cyclic rise in blood glucose associated with increased need for insulin
C. Nocturnal food ingestion
D. Counter-regulatory response to severe hypoglycemia
D. Counter-regulatory response to severe hypoglycemia
The serum potassium (K+) of a patient with DKA is 5.4 mEq/l. What changes would the
nurse expect to see on an EKG?
CCRN ADULT EXAM PREP 2026 | 500+ VERIFIED Q&A |
ICU NURSING MASTERY | NGN RATIONALES
A patient who is 72 hours postoperative repair of a bowel obstruction suddenly
demonstrates shortness of breath and his respiratory rate increases from 22 to 45/min. His
SpO2 went from 95% to 88% acutely. An arterial blood gas sample obtained while the
patient is receiving oxygen via a nasal cannula at 6L/min reveals the following results:
pH 7.40
pCO2 27
pO2 50
A chest x-ray is obtained and a "ground-glass-like appearance" is reported. Auscultation of
the lungs reveals diffuse crackles that were not present previously.
Your patient just received 10 units of banked blood for a GI bleed. You know this will affect
the oxyhemoglobin dissociation curve by:
A. Shifting it to the right
B. Causing a plateau in the curve
C. Shifting it to the left
D. Causing no change in the curve
C. Shifting it to the left
A patient who is 72 hours postoperative repair of a bowel obstruction suddenly
demonstrates shortness of breath and his respiratory rate increases from 22 to 45/min. His
,2|Page
SpO2 went from 95% to 88% acutely. An arterial blood gas sample obtained while the
patient is receiving oxygen via a nasal cannula at 6L/min reveals the following results:
pH 7.40
pCO2 27
pO2 50
A chest x-ray is obtained and a "ground-glass-like appearance" is reported. Auscultation of
the lungs reveals diffuse crackles that were not present previously.
Your patient is currently on a ventilator with the following settings: AC, FiO2 100%, Rate
of 12, Tidal Volume 450, PEEP of 5. His arterial blood gas results are the following: pH
7.36, PaCO2 43, PaO2 56, HCO3 28. Which ventilator parameter do you anticipate
changing?
A. Decrease the FiO2
B. Increase the tidal volume
C. Increase the PEEP
D. Increase the rate
C. Increase the PEEP
ARDS is characterized by which of the following:
A. Refractory hypercarbia
B. Increase in surfactant
,3|Page
C. Increased lung compliance
D. Shunting
D. Shunting
Rationale: ARDS is characterized by refractory hypoxia, shunting, decreased lung compliance,
and decreased surfactant.
A 42 y/o woman with a 6 month history of worsening anxiety, heat intolerance, and weight
loss presents to the emergency department. Which of the following are indicators of
hyperthyroidism?
A. Constipation, lower body temperature, and edema
B. High T3 and T4 and low TSH.
C. Depression, dementia, and reflex changes
D. Low T3 and T4 and high TSH
B. High T3 and T4 and low TSH.
Rationale: Constipation, lower body temperature, edema, depression, dementia, reflex changes,
low T3, low T4, high TSH are all indicators of hypothyroidism.
An elderly man with Type 2 DM comes into the emergency department after spending all
day in the mall shopping with his wife. He tells you that his heart is racing and he is sweaty
and shaky. What is the best course of action for the nurse?
, 4|Page
A. Give the patient a candy bar and drink regular soda then check his BG.
B. Check his blood glucose level and obtain an ECG.
C. Check his blood glucose and inject NPH insulin if he's hyperglycemic.
D. Give the patient 4 glucose tablets and then check his blood glucose.
B. Check his blood glucose level and obtain an ECG.
Successful treatment of DKA revolves around:
A. Correction of orthostatic hypotension with electrolytes
B. Administration of fluids, electrolytes and insulin
C. Gradually decreasing a patient's excessive fluid volume from hyperosmolality
D. Administration of glucagon to elevate plasma blood levels
B. Administration of fluids, electrolytes and insulin
What is the Somogyi phenomenon generally attributed?
A. Prolonged hyperglycemia that has led to neurological damage and impaired
counterregulatory response
B. Cyclic rise in blood glucose associated with increased need for insulin
C. Nocturnal food ingestion
D. Counter-regulatory response to severe hypoglycemia
D. Counter-regulatory response to severe hypoglycemia
The serum potassium (K+) of a patient with DKA is 5.4 mEq/l. What changes would the
nurse expect to see on an EKG?
