ADULT CCRN LEAKED MULTISYSTEM 2026 EXAM
QUESTIONS WITH COMPLETE SOLUTIONS
GUARANTEED PASS
.
Which hemodynamic profile is MOST consistent with distributive
shock?
A) BP 75/50, CVP 8, PAOP 8, CI 2.5, SVR 1500, SvO2 68%
B) BP 84/42, CVP 3, PAOP 8, Cl 2.5, SVR 475, SvO2 52%
C) BP 88/44, CVP 15, PAOP 24, CI 1.5, SVR 1200, SVO2 47%
D) BP 85/40, CVP 12, PAOP 20, CI 2.0, SVR 1445, SvO2 50%
BP 84/42, CVP 3, PAOP 8, CI 2.5, SVR 475, Sv02 52%
In distributive shock types (e.g., anaphylactic or neurogenic), there is a
decrease in venous return, which causes a low CVP. Loss of vessel tone
results in a decreased SVR. A higher CVP indicates a high preload. The
Sv02 will be lower in shock states. A 90 kg patient with sepsis has a BP
82/40, HR 116, and a lactate of 5.6 mmol/L (elevated). Administration
of which should the nurse anticipate?
A) 0.9% sodium chloride 2700 mL
B) 5% dextrose in 0.45% sodium chloride 900 mL
C) 0.45% sodium chloride 1800 mL
D) 5% dextrose in lactated ringers 3500 mL
0.9% sodium chloride 2700 mL
At 30 mL/kg, 2700 mL of intravenous fluid is indicated. Either 0.9% sodium
chloride, lactated ringers or plasmaLyte may be administered.
A patient with acute onset of abdominal pain and a history of chronic
pain is admitted. Which question about chronic pain control is a
priority for the nurse to ask FIRST?
,A) What are your usual coping strategies?
B) What types of medications are you taking?
C) Can you point on this pain scale at your usual level?
D) How frequently do you take something for pain?
How frequently do you take something for pain?
Pain can be classified as acute or chronic. Acute pain implies tissue
damage that is usually from an identifiable cause that lasts for the healing
process, which is approximately 30 days. Chronic pain persists for more
than 3 to 6 months. A comprehensive initial assessment of pain, whenever
possible, is important in accurately evaluating pain and the details of prior
interventions. With the use of pharmacological approaches, the frequency
is a priority to determine. Then, the type of medication and the self-report of
pain level are expected to coincide with the reported frequency. Coping
strategies are important to complete individualized pain control while
hospitalized. For patients who wish to try nonpharmacologic pain control,
approaches include psychologic support, massage, acupuncture,
transcutaneous electrical nerve stimulation, distraction and cognitive-
behavioral therapy.
Ventilator-associated pneumonia (VAP) and ventilatorassociated
events (VAE) are BEST prevented with the implementation of
A) an assessment tool.
B) unit-based checklists.
C) unit-based nursing education.
D) evidence-based bundled care protocols.
evidence-based bundled care protocols.
The implementation of evidence-based bundled care protocols in
conjunction with a multidisciplinary approach has been effective in
decreasing the prevalence of ventilator-associated pneumonia (VAP) and
related events.
,A victim of an MVC is admitted with an acute intracranial bleed. The
patient
has hypotension and tachycardia. These findings are MOST
LIKELY the result
of
A) shock from multiple trauma.
B) increased intracranial pressure.
C) neurogenic shock.
D) extensive bleeding into the intracranial vault.
shock from multiple trauma.
This patient has risk factors for and manifestations of shock. The patient is
hypotensive and tachycardic. Patients with multiple traumas will typically
have hypovolemic shock, characterized by hypotension and tachycardia.
Extensive bleeding into the intracranial vault would result in increased
intracranial pressure, manifested, in part, by bradycardia. Neurogenic
shock is a type of distributive shock where the patient has bradycardia. An
increase in intracranial pressure is associated with bradycardia, which is
part of Cushing's triad.
Two hours after surgery, a patient begins to exhibit shivering of the
head and shoulders. T is 96.8 degrees F (36 degrees C). The patient is
covered with three blankets and has socks on the feet. What other
IMMEDIATE action should the nurse perform?
A) Wrap the head with a blanket, keeping the face exposed.
B) Turn up the temperature of the room thermostat.
C) Get an order for a heating blanket.
D) Wrap the hands with warm moist towels and plastic covers.
Wrap the head with a blanket, keeping the face exposed.
If the patient is unintentionally hypothermic, cover the patient's head with a
blanket or towel or an aluminum cap. This prevents heat loss. Shivering
, may exist in the absence of hypothermia (cutaneous vasodilation or non
thermoregulatory shivering); its cause is not known. Treatment may include
low doses of meperidine (Demerol).
Which mechanism contributes to hypotension in sepsis?
A) peripheral vasodilation
B) decreased vascular permeability
C) elevated afterload
D) increased cardiac contractility
peripheral vasodilation
In sepsis, proinflammatory mediators circulate in high amounts.
These mediators cause profound vasodilation and capillary leak, both of
which result in hypotension. SVR (afterload) is low in sepsis due to
vasodilation. Contractility is decreased in sepsis due to the release of
myocardial depressant factor, one of the pro-inflammatory mediators
released in sepsis.
A patient is admitted and has the following ABG results:
pH 7.30 pC02 31
mm Hg p02 73
mm Hg HCO3 19
mEq/L
Sa02 94%
Which should the nurse suspect as a likely cause?
A) nasogastric suctioning
B) starvation
C) seizures D) tetany
starvation
QUESTIONS WITH COMPLETE SOLUTIONS
GUARANTEED PASS
.
Which hemodynamic profile is MOST consistent with distributive
shock?
A) BP 75/50, CVP 8, PAOP 8, CI 2.5, SVR 1500, SvO2 68%
B) BP 84/42, CVP 3, PAOP 8, Cl 2.5, SVR 475, SvO2 52%
C) BP 88/44, CVP 15, PAOP 24, CI 1.5, SVR 1200, SVO2 47%
D) BP 85/40, CVP 12, PAOP 20, CI 2.0, SVR 1445, SvO2 50%
BP 84/42, CVP 3, PAOP 8, CI 2.5, SVR 475, Sv02 52%
In distributive shock types (e.g., anaphylactic or neurogenic), there is a
decrease in venous return, which causes a low CVP. Loss of vessel tone
results in a decreased SVR. A higher CVP indicates a high preload. The
Sv02 will be lower in shock states. A 90 kg patient with sepsis has a BP
82/40, HR 116, and a lactate of 5.6 mmol/L (elevated). Administration
of which should the nurse anticipate?
A) 0.9% sodium chloride 2700 mL
B) 5% dextrose in 0.45% sodium chloride 900 mL
C) 0.45% sodium chloride 1800 mL
D) 5% dextrose in lactated ringers 3500 mL
0.9% sodium chloride 2700 mL
At 30 mL/kg, 2700 mL of intravenous fluid is indicated. Either 0.9% sodium
chloride, lactated ringers or plasmaLyte may be administered.
A patient with acute onset of abdominal pain and a history of chronic
pain is admitted. Which question about chronic pain control is a
priority for the nurse to ask FIRST?
,A) What are your usual coping strategies?
B) What types of medications are you taking?
C) Can you point on this pain scale at your usual level?
D) How frequently do you take something for pain?
How frequently do you take something for pain?
Pain can be classified as acute or chronic. Acute pain implies tissue
damage that is usually from an identifiable cause that lasts for the healing
process, which is approximately 30 days. Chronic pain persists for more
than 3 to 6 months. A comprehensive initial assessment of pain, whenever
possible, is important in accurately evaluating pain and the details of prior
interventions. With the use of pharmacological approaches, the frequency
is a priority to determine. Then, the type of medication and the self-report of
pain level are expected to coincide with the reported frequency. Coping
strategies are important to complete individualized pain control while
hospitalized. For patients who wish to try nonpharmacologic pain control,
approaches include psychologic support, massage, acupuncture,
transcutaneous electrical nerve stimulation, distraction and cognitive-
behavioral therapy.
Ventilator-associated pneumonia (VAP) and ventilatorassociated
events (VAE) are BEST prevented with the implementation of
A) an assessment tool.
B) unit-based checklists.
C) unit-based nursing education.
D) evidence-based bundled care protocols.
evidence-based bundled care protocols.
The implementation of evidence-based bundled care protocols in
conjunction with a multidisciplinary approach has been effective in
decreasing the prevalence of ventilator-associated pneumonia (VAP) and
related events.
,A victim of an MVC is admitted with an acute intracranial bleed. The
patient
has hypotension and tachycardia. These findings are MOST
LIKELY the result
of
A) shock from multiple trauma.
B) increased intracranial pressure.
C) neurogenic shock.
D) extensive bleeding into the intracranial vault.
shock from multiple trauma.
This patient has risk factors for and manifestations of shock. The patient is
hypotensive and tachycardic. Patients with multiple traumas will typically
have hypovolemic shock, characterized by hypotension and tachycardia.
Extensive bleeding into the intracranial vault would result in increased
intracranial pressure, manifested, in part, by bradycardia. Neurogenic
shock is a type of distributive shock where the patient has bradycardia. An
increase in intracranial pressure is associated with bradycardia, which is
part of Cushing's triad.
Two hours after surgery, a patient begins to exhibit shivering of the
head and shoulders. T is 96.8 degrees F (36 degrees C). The patient is
covered with three blankets and has socks on the feet. What other
IMMEDIATE action should the nurse perform?
A) Wrap the head with a blanket, keeping the face exposed.
B) Turn up the temperature of the room thermostat.
C) Get an order for a heating blanket.
D) Wrap the hands with warm moist towels and plastic covers.
Wrap the head with a blanket, keeping the face exposed.
If the patient is unintentionally hypothermic, cover the patient's head with a
blanket or towel or an aluminum cap. This prevents heat loss. Shivering
, may exist in the absence of hypothermia (cutaneous vasodilation or non
thermoregulatory shivering); its cause is not known. Treatment may include
low doses of meperidine (Demerol).
Which mechanism contributes to hypotension in sepsis?
A) peripheral vasodilation
B) decreased vascular permeability
C) elevated afterload
D) increased cardiac contractility
peripheral vasodilation
In sepsis, proinflammatory mediators circulate in high amounts.
These mediators cause profound vasodilation and capillary leak, both of
which result in hypotension. SVR (afterload) is low in sepsis due to
vasodilation. Contractility is decreased in sepsis due to the release of
myocardial depressant factor, one of the pro-inflammatory mediators
released in sepsis.
A patient is admitted and has the following ABG results:
pH 7.30 pC02 31
mm Hg p02 73
mm Hg HCO3 19
mEq/L
Sa02 94%
Which should the nurse suspect as a likely cause?
A) nasogastric suctioning
B) starvation
C) seizures D) tetany
starvation
