PRACTICE TEST 1 CCRN (PASS CCRN
QUESTIONS AND ANSWERS
What is vasogenic cerebral edema? Correct Answer: Vasogenic cerebral edema is an increase in
extracellular fluid caused by a breakdown of the blood-brain barrier with the resultant increase in
vascular permeability. This cerebral edema begins locally and becomes more generalized. Common
causes are trauma (including surgical trauma), tumors, hemorrhage, and abscesses
What ventilator parameter indicates fluid volume excess? Correct Answer: An A:a gradient greater
than 10 mm Hg is a reflection of a diffusion defect. Note that the process of diffusion is between A
(alveolus) and (a) arterial blood. An increase in intraalveolar fluid dilutes and inactivates surfactant,
causing alveolar collapse (decreasing vital capacity) and decreases lung compliance. Peak
inspiratory pressure increases reflect a decrease in lung compliance
What does autonomy refer to? Correct Answer: The patient's right to make decisions for themselves
What does beneficence mean? Correct Answer: Obligation to do good
What does nonmaleficence mean? Correct Answer: Obligation to do no harm
What does fidelity mean? Correct Answer: the obligation to abide by agreements and responsibilities
What does veracity mean? Correct Answer: The obligation to tell the truth
What are Diagnosis-Related groups? Correct Answer: DRGs constitute a prospective payment
program for Medicare patients. Payment is based on primary and secondary diagnosis, primary and
secondary procedures, age, and length of hospitalization
BNP is secreted in response to? Correct Answer: Ventricular wall stretch
What are omnious signs in a patient with status asthmaticus? Correct Answer: A normalization or
increase in the PaCO2. This patient is still tachypneic, and if ventilation is normal, PaCO2 should be
decreased. The other ominous sign in this patient would be absence of wheezing or rhonchi, because
they would indicate that ventilation is insufficient to cause these noises.
What problems arise from losses from the GI tract? Correct Answer: Any loss results in hypokalemia.
Vomiting results in loss of acidic contents, whereas losses below the pylorus result is alkalitic losses
leading to metabolic acidosis. Fluid is sequestered in the intestine leading to hypovolemia, which
could cause hypovolemic shock.
Actual problems are worse than potential problems!! Correct Answer:
How can you differentiate the cause of jaundice? Correct Answer: An increase in direct bilirubin is
associated with biliary obstruction because direct bilirubin is conjugated. An increase in indirect
bilirubin is associated with hepatic disease or excessive hemolysis because indirect bilirubin is
unconjugated
, What antihypertensive meds work best in African american patients? Correct Answer: African-
Americans do not respond well to angiotensin-converting enzyme inhibitors (e.g., captopril
[Capoten]), but they do respond well to an angiotensin II blocker (valsartan [Diovan]). Of the beta-
blockers, labetalol works best. Of the calcium channel blockers, diltiazem works best
What lab values define acute respiratory failure? Correct Answer: 50-50!
PaO2<50 and/or PaCO2>50
Hyperkalemia can cause what? Correct Answer: Diarrhea-increases gastric motility
Flaccid paralysis- partially depolarizes muscle cells, prevents further depolarization
Every 1 inch increase in abdominal girth equates to how much blood accumulation in the abdomen
Correct Answer: 500-1000mL
What pacing method would be used in a patient in atrial fib? Correct Answer: VVI- you don't want to
sense or pace the atria.
1st letter-paced chamber
2nd letter-chamber sensed
What is the difference between an anaphylactic and anaphylactoid reaction? Correct Answer:
Anaphylactoid reaction is clinically indistinguishable from anaphylactic reaction but does not require
previous exposure to the antigen. Anaphylactoid reaction is not IgE mediated, and direct activation
and degranulation of mast cells are thought to be triggered by the complement system. Anaphylactic
reaction requires previous exposure to the antigen and is IgE mediated
Mitral stenosis is associated with what? Correct Answer: Pinkish discoloration of the cheeks. It is a
diastolic murmur
What murmur is associated with widened pulse pressure? Correct Answer: Aortic regurg
What murmur is associated with narrowed pulse pressure? Correct Answer: Mitral regurg
What lead changes are associated with left ventricle hyperthrophy? Correct Answer: Strain pattern in
V5 and V6 (asymmetric T wave inversion)
When the depth of the S wave in lead V1 or V2 plus the height of the R wave in lead V5 or V6 is 35
mm or greater, this constitutes voltage
What lead changes are associated with right ventricle hypertrophy? Correct Answer: strain pattern in
V1 and V2. Prominent R wave in V1 reverse progression of the R wave across the precordium.
What organ system is the most common to fail in severe sepsis? Correct Answer: Hematologic-
coagulopathies are common in severe sepsis
What are the early signs of hypoglycemia? Correct Answer: The early signs of hypoglycemia are
mediated by the sympathetic nervous system, which acts to mobilize glucose stores (tachycardia,
tachypnea, diaphoresis). Later signs of hypoglycemia are related to low glucose levels in the brain
(neuroglycopenia)
**Early signs can be masked in pts taking beta-blockers
QUESTIONS AND ANSWERS
What is vasogenic cerebral edema? Correct Answer: Vasogenic cerebral edema is an increase in
extracellular fluid caused by a breakdown of the blood-brain barrier with the resultant increase in
vascular permeability. This cerebral edema begins locally and becomes more generalized. Common
causes are trauma (including surgical trauma), tumors, hemorrhage, and abscesses
What ventilator parameter indicates fluid volume excess? Correct Answer: An A:a gradient greater
than 10 mm Hg is a reflection of a diffusion defect. Note that the process of diffusion is between A
(alveolus) and (a) arterial blood. An increase in intraalveolar fluid dilutes and inactivates surfactant,
causing alveolar collapse (decreasing vital capacity) and decreases lung compliance. Peak
inspiratory pressure increases reflect a decrease in lung compliance
What does autonomy refer to? Correct Answer: The patient's right to make decisions for themselves
What does beneficence mean? Correct Answer: Obligation to do good
What does nonmaleficence mean? Correct Answer: Obligation to do no harm
What does fidelity mean? Correct Answer: the obligation to abide by agreements and responsibilities
What does veracity mean? Correct Answer: The obligation to tell the truth
What are Diagnosis-Related groups? Correct Answer: DRGs constitute a prospective payment
program for Medicare patients. Payment is based on primary and secondary diagnosis, primary and
secondary procedures, age, and length of hospitalization
BNP is secreted in response to? Correct Answer: Ventricular wall stretch
What are omnious signs in a patient with status asthmaticus? Correct Answer: A normalization or
increase in the PaCO2. This patient is still tachypneic, and if ventilation is normal, PaCO2 should be
decreased. The other ominous sign in this patient would be absence of wheezing or rhonchi, because
they would indicate that ventilation is insufficient to cause these noises.
What problems arise from losses from the GI tract? Correct Answer: Any loss results in hypokalemia.
Vomiting results in loss of acidic contents, whereas losses below the pylorus result is alkalitic losses
leading to metabolic acidosis. Fluid is sequestered in the intestine leading to hypovolemia, which
could cause hypovolemic shock.
Actual problems are worse than potential problems!! Correct Answer:
How can you differentiate the cause of jaundice? Correct Answer: An increase in direct bilirubin is
associated with biliary obstruction because direct bilirubin is conjugated. An increase in indirect
bilirubin is associated with hepatic disease or excessive hemolysis because indirect bilirubin is
unconjugated
, What antihypertensive meds work best in African american patients? Correct Answer: African-
Americans do not respond well to angiotensin-converting enzyme inhibitors (e.g., captopril
[Capoten]), but they do respond well to an angiotensin II blocker (valsartan [Diovan]). Of the beta-
blockers, labetalol works best. Of the calcium channel blockers, diltiazem works best
What lab values define acute respiratory failure? Correct Answer: 50-50!
PaO2<50 and/or PaCO2>50
Hyperkalemia can cause what? Correct Answer: Diarrhea-increases gastric motility
Flaccid paralysis- partially depolarizes muscle cells, prevents further depolarization
Every 1 inch increase in abdominal girth equates to how much blood accumulation in the abdomen
Correct Answer: 500-1000mL
What pacing method would be used in a patient in atrial fib? Correct Answer: VVI- you don't want to
sense or pace the atria.
1st letter-paced chamber
2nd letter-chamber sensed
What is the difference between an anaphylactic and anaphylactoid reaction? Correct Answer:
Anaphylactoid reaction is clinically indistinguishable from anaphylactic reaction but does not require
previous exposure to the antigen. Anaphylactoid reaction is not IgE mediated, and direct activation
and degranulation of mast cells are thought to be triggered by the complement system. Anaphylactic
reaction requires previous exposure to the antigen and is IgE mediated
Mitral stenosis is associated with what? Correct Answer: Pinkish discoloration of the cheeks. It is a
diastolic murmur
What murmur is associated with widened pulse pressure? Correct Answer: Aortic regurg
What murmur is associated with narrowed pulse pressure? Correct Answer: Mitral regurg
What lead changes are associated with left ventricle hyperthrophy? Correct Answer: Strain pattern in
V5 and V6 (asymmetric T wave inversion)
When the depth of the S wave in lead V1 or V2 plus the height of the R wave in lead V5 or V6 is 35
mm or greater, this constitutes voltage
What lead changes are associated with right ventricle hypertrophy? Correct Answer: strain pattern in
V1 and V2. Prominent R wave in V1 reverse progression of the R wave across the precordium.
What organ system is the most common to fail in severe sepsis? Correct Answer: Hematologic-
coagulopathies are common in severe sepsis
What are the early signs of hypoglycemia? Correct Answer: The early signs of hypoglycemia are
mediated by the sympathetic nervous system, which acts to mobilize glucose stores (tachycardia,
tachypnea, diaphoresis). Later signs of hypoglycemia are related to low glucose levels in the brain
(neuroglycopenia)
**Early signs can be masked in pts taking beta-blockers
