CCRN Practice
Questions with
Accurate
Answers
A 28-year-old male patient is day 2 s/p closed head injury and T2-T5 compression fractures from a
motorcycle accident. He was wearing a helmet. The patient is mechanically ventilated and sedated. RASS
is -2. An indwelling urinary catheter is in place for strict I/O. Baseline VS: T 37.6 C, P 64, RR 18, BP
110/60. The monitor alarms, and the nurse discovers P 50, B/P 140/68, and the patient is diaphoretic.
What is the nurse's next appropriate action?
A) Administer the prescribed pain medication
B) Examine the urinary catheter tubing for obstruction
C) Increase the dose of sedation
D) Perform a focused neurologic exam correct answer B) Examine the urinary catheter tubing for
obstruction (Correct)
A 34-year-old patient with bacterial meningitis is sedated and intubated. A Ventriculostomy is in place,
but currently clamped. Intermittent ICP measurements are being monitored. The ICP is trending up from
6 to 17 mm Hg over the last 4 hours. The best initial intervention is to:
A) Assess sedation and bolus as needed
B) Open the Ventriculostomy to allow drainage
C) Elevate the head of the bed to 45°
D) Administer 1 g/kg of 20% Mannitol correct answer C) Elevate the head of the bed to 45° (Correct)
,A 45-year-old patient is scheduled to go to the cardiac cath lab in the morning for a coronary angiogram.
What will the nurse anticipate to prevent contrast induced nephropathy?
A) Acetylcysteine (Mucomyst) 1500 mg PO/NG q 12 hours x 6 doses
B) Lactated ringers at 100 ml/hour 12 hours before and after the procedure
C) Furosemide (Lasix) 20 mg IV q 6 hours x 4 doses
D) Mannitol 25% 0.5 grams/kg of body weight IV over 30 min correct answer B) Lactated ringers at 100
ml/hour 12 hours before and after the procedure (Correct)
A 52-year-old man has had a renal transplant. Two weeks after surgery he complains of having the "flu."
Rejection of transplanted organs occurs due to the function of which of the following?
A) Cellular immunity
B) Humoral immunity
C) Delayed hypersensitivity reaction
D) Complement cascade correct answer A) Cellular immunity (Correct)
A 55-year-old female presents to the ED anxious and SOB. Her 12 lead ECG reveals a STEMI. Which of
the following findings suggests an absolute contraindication for thrombolytic therapy?
A) Dull chest pain, ST elevation in V4, V5, V6, new left bundle branch block |
B) History of cholecystectomy 2 weeks ago, ST elevation in V3, V4, V5 |
C) Sudden onset severe chest and back pain, uncontrolled BP 195/115, ST elevation II, III, aVF, and a new
diastolic murmur over the left sternal border
D) Left arm pain, BP 180/100 easily controlled on antihypertensive meds, ST elevation in V1, V2 V3
correct answer C) Sudden onset severe chest and back pain, uncontrolled BP 195/115, ST elevation II, III,
aVF, and a new diastolic murmur over the left sternal border (Correct)
A 56 year old patient presents with substernal chest pain radiating to her left arm. A 12 lead EKG reveals
ST segment elevation in leads II, III and AVF. You would expect reciprocal changes in which leads?
A) V4-V6
,B) I, AVL
C) AVR, AVL, V1
D) V3, V4 correct answer B) I, AVL (Correct)
A 60 year old female patient had an Anterior wall MI yesterday. She now complains of new chest pain
and dizziness. On auscultation you hear a new systolic murmur. You suspect:
A) Acute tricuspid regurgitation
B) Ventricular outflow obstruction
C) Acute aortic stenosis
D) Acute papillary muscle rupture correct answer D) Acute papillary muscle rupture (Correct)
A 62-year old female was being treated for pneumonia for 5 days and now presents to the ED with
dyspnea and tachypnea requiring intubation and mechanical ventilation. Her CXR reveals bilateral
patchy infiltrates with multiple areas of consolidation. Crackles are auscultated throughout her lung
fields and she is requiring 100% FiO2. PaO2 per ABG is 48. Calculation of the P/F ratio indicates which
condition?
A) Status Asthmaticus
B) Acute Respiratory Distress Syndrome (ARDS)
C) Acute pulmonary embolism (PE)
D) Chronic Obstructive Pulmonary Disease (COPD) correct answer B) Acute Respiratory Distress
Syndrome (ARDS) (Correct)
A 65-year-old male is admitted to the ICU with SIADH resultant from a brain tumor in his frontal lobe.
Serum sodium is 115 mEq/L. What is the priority of nursing care for the patient?
A) Fluid restriction
B) Sodium replacement to 140 mEq/L
C) Administration of diuretics
D) Maintaining a safe environment correct answer D) Maintaining a safe environment (Correct)
, A 68-year-old patient presents to your unit 9 days after a 3 vessel CABG complaining of chest pain. A 12-
lead ECG reveals non-specific ST elevation in leads V1 â€" V6. Cardiac enzymes are not elevated. He
states the pain is better when he sits up and leans forward. This scenario is most consistent with:
A) Acute inferior wall MI
B) Post-operative cardiac tamponade
C) Pleural effusions
D) Pericarditis correct answer D) Pericarditis (Correct)
A 68-year-old patient with COPD presents with SOB. He is given a nebulizer treatment, but remains SOB.
ABG results are: pH 7.22, PaCO2 74, PaO2 103, HCO3 30. This ABG confirms:
A) Uncompensated metabolic acidosis
B) Partially compensated metabolic alkalosis
C) Partially compensated respiratory acidosis (Correct)
D) Compensated respiratory alkalosis correct answer C) Partially compensated respiratory acidosis
(Correct)
A 72-year-old male patient is mechanically ventilated. His respiratory rate is 20. The ventilator is set to
deliver 12 BPM at a set volume. The volume of the remaining 8 breaths varies. What is the mode of
ventilation described?
A) Airway Pressure Release Ventilation (APRV)
B) Controlled Mandatory Ventilation (CMV)
C) Continuous Positive Airway Pressure (CPAP)
D) Synchronized Intermittent Mandatory Ventilation (SIMV) (Correct) correct answer D) Synchronized
Intermittent Mandatory Ventilation (SIMV) (Correct)
A critically ill patient has a stage III pressure ulcer involving a large amount of tissue loss and exudate.
The nurse should anticipate management to include:
Questions with
Accurate
Answers
A 28-year-old male patient is day 2 s/p closed head injury and T2-T5 compression fractures from a
motorcycle accident. He was wearing a helmet. The patient is mechanically ventilated and sedated. RASS
is -2. An indwelling urinary catheter is in place for strict I/O. Baseline VS: T 37.6 C, P 64, RR 18, BP
110/60. The monitor alarms, and the nurse discovers P 50, B/P 140/68, and the patient is diaphoretic.
What is the nurse's next appropriate action?
A) Administer the prescribed pain medication
B) Examine the urinary catheter tubing for obstruction
C) Increase the dose of sedation
D) Perform a focused neurologic exam correct answer B) Examine the urinary catheter tubing for
obstruction (Correct)
A 34-year-old patient with bacterial meningitis is sedated and intubated. A Ventriculostomy is in place,
but currently clamped. Intermittent ICP measurements are being monitored. The ICP is trending up from
6 to 17 mm Hg over the last 4 hours. The best initial intervention is to:
A) Assess sedation and bolus as needed
B) Open the Ventriculostomy to allow drainage
C) Elevate the head of the bed to 45°
D) Administer 1 g/kg of 20% Mannitol correct answer C) Elevate the head of the bed to 45° (Correct)
,A 45-year-old patient is scheduled to go to the cardiac cath lab in the morning for a coronary angiogram.
What will the nurse anticipate to prevent contrast induced nephropathy?
A) Acetylcysteine (Mucomyst) 1500 mg PO/NG q 12 hours x 6 doses
B) Lactated ringers at 100 ml/hour 12 hours before and after the procedure
C) Furosemide (Lasix) 20 mg IV q 6 hours x 4 doses
D) Mannitol 25% 0.5 grams/kg of body weight IV over 30 min correct answer B) Lactated ringers at 100
ml/hour 12 hours before and after the procedure (Correct)
A 52-year-old man has had a renal transplant. Two weeks after surgery he complains of having the "flu."
Rejection of transplanted organs occurs due to the function of which of the following?
A) Cellular immunity
B) Humoral immunity
C) Delayed hypersensitivity reaction
D) Complement cascade correct answer A) Cellular immunity (Correct)
A 55-year-old female presents to the ED anxious and SOB. Her 12 lead ECG reveals a STEMI. Which of
the following findings suggests an absolute contraindication for thrombolytic therapy?
A) Dull chest pain, ST elevation in V4, V5, V6, new left bundle branch block |
B) History of cholecystectomy 2 weeks ago, ST elevation in V3, V4, V5 |
C) Sudden onset severe chest and back pain, uncontrolled BP 195/115, ST elevation II, III, aVF, and a new
diastolic murmur over the left sternal border
D) Left arm pain, BP 180/100 easily controlled on antihypertensive meds, ST elevation in V1, V2 V3
correct answer C) Sudden onset severe chest and back pain, uncontrolled BP 195/115, ST elevation II, III,
aVF, and a new diastolic murmur over the left sternal border (Correct)
A 56 year old patient presents with substernal chest pain radiating to her left arm. A 12 lead EKG reveals
ST segment elevation in leads II, III and AVF. You would expect reciprocal changes in which leads?
A) V4-V6
,B) I, AVL
C) AVR, AVL, V1
D) V3, V4 correct answer B) I, AVL (Correct)
A 60 year old female patient had an Anterior wall MI yesterday. She now complains of new chest pain
and dizziness. On auscultation you hear a new systolic murmur. You suspect:
A) Acute tricuspid regurgitation
B) Ventricular outflow obstruction
C) Acute aortic stenosis
D) Acute papillary muscle rupture correct answer D) Acute papillary muscle rupture (Correct)
A 62-year old female was being treated for pneumonia for 5 days and now presents to the ED with
dyspnea and tachypnea requiring intubation and mechanical ventilation. Her CXR reveals bilateral
patchy infiltrates with multiple areas of consolidation. Crackles are auscultated throughout her lung
fields and she is requiring 100% FiO2. PaO2 per ABG is 48. Calculation of the P/F ratio indicates which
condition?
A) Status Asthmaticus
B) Acute Respiratory Distress Syndrome (ARDS)
C) Acute pulmonary embolism (PE)
D) Chronic Obstructive Pulmonary Disease (COPD) correct answer B) Acute Respiratory Distress
Syndrome (ARDS) (Correct)
A 65-year-old male is admitted to the ICU with SIADH resultant from a brain tumor in his frontal lobe.
Serum sodium is 115 mEq/L. What is the priority of nursing care for the patient?
A) Fluid restriction
B) Sodium replacement to 140 mEq/L
C) Administration of diuretics
D) Maintaining a safe environment correct answer D) Maintaining a safe environment (Correct)
, A 68-year-old patient presents to your unit 9 days after a 3 vessel CABG complaining of chest pain. A 12-
lead ECG reveals non-specific ST elevation in leads V1 â€" V6. Cardiac enzymes are not elevated. He
states the pain is better when he sits up and leans forward. This scenario is most consistent with:
A) Acute inferior wall MI
B) Post-operative cardiac tamponade
C) Pleural effusions
D) Pericarditis correct answer D) Pericarditis (Correct)
A 68-year-old patient with COPD presents with SOB. He is given a nebulizer treatment, but remains SOB.
ABG results are: pH 7.22, PaCO2 74, PaO2 103, HCO3 30. This ABG confirms:
A) Uncompensated metabolic acidosis
B) Partially compensated metabolic alkalosis
C) Partially compensated respiratory acidosis (Correct)
D) Compensated respiratory alkalosis correct answer C) Partially compensated respiratory acidosis
(Correct)
A 72-year-old male patient is mechanically ventilated. His respiratory rate is 20. The ventilator is set to
deliver 12 BPM at a set volume. The volume of the remaining 8 breaths varies. What is the mode of
ventilation described?
A) Airway Pressure Release Ventilation (APRV)
B) Controlled Mandatory Ventilation (CMV)
C) Continuous Positive Airway Pressure (CPAP)
D) Synchronized Intermittent Mandatory Ventilation (SIMV) (Correct) correct answer D) Synchronized
Intermittent Mandatory Ventilation (SIMV) (Correct)
A critically ill patient has a stage III pressure ulcer involving a large amount of tissue loss and exudate.
The nurse should anticipate management to include:
