AACN Critical Care Registered
Nurse (CCRN) 2024 Exam
Review Questions and Answers
100% Pass
A 56 yr-old male is admitted to the ICU with a blood
pressure of 225/135 and complains of a headache and
nausea. He reports he ran out of blood pressure meds
three days ago, but also appears to be confused to the
date and situation. What is the most appropriate
treatment approach?
- Answer>> Rapidly lower the diastolic pressure to 100
with IV antihypertensive meds, then continue to
gradually reduce the diastolic pressure to 85 with oral
antihypertensive meds.
The maximum initial decrease should be no more than
25% reduction from initial presenting value. Reducing
the blood pressure too quickly can lead to cerebral
edema or renal failure.
,A patient has sepsis, receives Lactated ringers 500ml IV
bolus. Which finding indicate that this intervention is
having it's intended effect?
- Answer>> ScvO2 of 72%
Early goal directed therapy for sepsis includes early fluid
resuscitation at 30 ml/kg to maintain a CVP of 8-12 or
12-15 if mechanically ventilated, MAP greater than 65,
ScvO2 greater than 70%, and urine output greater than
0.5 kg/hr
72 male patient in ICU for 6 days on the ventilator for
treatment of a COPD exacerbation. He has been receiving
VTE prophylaxis and subcutaneous Heparin since
admission. Today his platelet count decreased
significantly to 43,000 and was found to have new DVT
on his right upper extremity. What do you suspect is the
most likely cause of these findings?
- Answer>> HIT
The hallmark sign of HIT is a significant decrease in
platelet count over a 24 hours period (>50%) within 5-10
,days of administering Heparin. The other hallmark sign
is a new development of DVT despite being on VTE
prophylaxis.
TRALI:
- Answer>> is a complication from a blood transfusion
reaction, which causes acute lung injury typically within
6 hours of a blood transfusion.
2 Hallmark signs of HIT:
- Answer>> Decrease in platelet count over a 24 hr
period.
New development of DVT despite being on VTE
prophylaxis.
Values in Early compensated Hypovolemic shock?
- Answer>> CO 4.0 L/min, HR 135, SV 65, SVR 1700, MAP
65
In hypovolemic states, circulating volume is depleted
therefore preload and contractility are decreased which
leads to a decrease in SV and CO. HR and SV increase as
, compensatory measure to preserve CO, MAP and cerebral
perfusion.
Post-renal failure values:
- Answer>> Urine output < 200; urine sodium 30; BUN:
Creatinine ratio 15:1; urine specific gravity 1.010
BUN: Creatinine ratio is 15:1, but both the BUN &
creatinine are elevated. Urine sodium is typically 1-40
mEq/L.
What to do in the event of HIT:
- Answer>> Stop Heparin and administer an alternative
direct thrombin inhibitor.
Warfarin is contraindicated in HIT? T/F
- Answer>> True - there is also no evidence that shows
protamine, corticosteroids, and benadryl are effective
treatments for HIT
Patients with right ventricular infarctions become
preload dependent. Meds that decrease preload should
Nurse (CCRN) 2024 Exam
Review Questions and Answers
100% Pass
A 56 yr-old male is admitted to the ICU with a blood
pressure of 225/135 and complains of a headache and
nausea. He reports he ran out of blood pressure meds
three days ago, but also appears to be confused to the
date and situation. What is the most appropriate
treatment approach?
- Answer>> Rapidly lower the diastolic pressure to 100
with IV antihypertensive meds, then continue to
gradually reduce the diastolic pressure to 85 with oral
antihypertensive meds.
The maximum initial decrease should be no more than
25% reduction from initial presenting value. Reducing
the blood pressure too quickly can lead to cerebral
edema or renal failure.
,A patient has sepsis, receives Lactated ringers 500ml IV
bolus. Which finding indicate that this intervention is
having it's intended effect?
- Answer>> ScvO2 of 72%
Early goal directed therapy for sepsis includes early fluid
resuscitation at 30 ml/kg to maintain a CVP of 8-12 or
12-15 if mechanically ventilated, MAP greater than 65,
ScvO2 greater than 70%, and urine output greater than
0.5 kg/hr
72 male patient in ICU for 6 days on the ventilator for
treatment of a COPD exacerbation. He has been receiving
VTE prophylaxis and subcutaneous Heparin since
admission. Today his platelet count decreased
significantly to 43,000 and was found to have new DVT
on his right upper extremity. What do you suspect is the
most likely cause of these findings?
- Answer>> HIT
The hallmark sign of HIT is a significant decrease in
platelet count over a 24 hours period (>50%) within 5-10
,days of administering Heparin. The other hallmark sign
is a new development of DVT despite being on VTE
prophylaxis.
TRALI:
- Answer>> is a complication from a blood transfusion
reaction, which causes acute lung injury typically within
6 hours of a blood transfusion.
2 Hallmark signs of HIT:
- Answer>> Decrease in platelet count over a 24 hr
period.
New development of DVT despite being on VTE
prophylaxis.
Values in Early compensated Hypovolemic shock?
- Answer>> CO 4.0 L/min, HR 135, SV 65, SVR 1700, MAP
65
In hypovolemic states, circulating volume is depleted
therefore preload and contractility are decreased which
leads to a decrease in SV and CO. HR and SV increase as
, compensatory measure to preserve CO, MAP and cerebral
perfusion.
Post-renal failure values:
- Answer>> Urine output < 200; urine sodium 30; BUN:
Creatinine ratio 15:1; urine specific gravity 1.010
BUN: Creatinine ratio is 15:1, but both the BUN &
creatinine are elevated. Urine sodium is typically 1-40
mEq/L.
What to do in the event of HIT:
- Answer>> Stop Heparin and administer an alternative
direct thrombin inhibitor.
Warfarin is contraindicated in HIT? T/F
- Answer>> True - there is also no evidence that shows
protamine, corticosteroids, and benadryl are effective
treatments for HIT
Patients with right ventricular infarctions become
preload dependent. Meds that decrease preload should
