CCRN EXAM LATEST 2023-2024 ACTUAL EXAM QUESTIONS
AND CORRECT DETAILED ANSWERS WITH
RATIONALES|ALREADY GRADED A+|BRAND NEW!!
The patient is receiving heparin infusion for the treatment of
pulmonary embolism. There has been a 60% decrease in the platelet
count and no clinical change. Which of the following is indicated? -
ANSWER--Discontinue heparin and being argatroban.
The patient most likely has HIT. Exposure to heparin needs to
discontinued and a direct thrombin inhibitor started for continued
anticoagulation.
The patient with oat cell carcinoma has the following clinical
findings: low urine output, low serum osmolality, hyponatremia, and
elevated urine sodium. The nurse anticipates which of the following
as part of the treatment plan? - ANSWER--Phenytoin (Dilantin), 3%
saline.
The patient has signs of SIADH which results in production of
excessive ADH. Dilantin will inhibit ADH secretion and 3% saline
will increase serum sodium.
Peep therapy and mechanical ventilation are ordered for the patient
with acute respiratory failure. Which of the following is a possible
complication? - ANSWER--Barotrauma
The addition of positive end-expiratory pressure will increase
alveolar recruitment, prevent atelectasis and improve oxygenation.
However, the increase in intrathoracic pressure may lead to
pneumothorax or subcutaneous emphysema.
The postoperative thoracic surgery patient has bubbling in the
water seal drainage chamber of the chest tube. Which of the
, CCRN EXAM LATEST 2023-2024 ACTUAL EXAM QUESTIONS
AND CORRECT DETAILED ANSWERS WITH
RATIONALES|ALREADY GRADED A+|BRAND NEW!!
following interventions is indicated? - ANSWER--avoid high airway
pressures
Bubbling in the water seal chamber is due to a pleural air leak, and
high airway pressure will either prevent resolution of the current
air leak or make it worse.
Which clinical sign might patients with both systolic and diastolic
heart failure have in common? - ANSWER--Lung crackles
Both a problem with systolic (ejection problem) and diastolic (filling
problem) will increase left heart pressure and cause cardiogenic
pulmonary edema (lung crackles).
Which of the following is most likely to result in a low Sv02?
A. Hypotermia
B. Fever
C. Severe sepsis - ANSWER--Fever
Fever increases metabolic rate and consumption, which may lead to
a drop in mixed venous oxygen saturation.
The nurse needs to assess adequacy of the tubing/catheter system
for the arterial line. Which of the following interventions will best
assess this? - ANSWER--Perform a square wave test
The patient requires fluid resuscitation and 8 units of PRBC's status
post traumatic injury. Which of the following interventions is most
appropriate? - ANSWER--Warm blood products and crystalloids
, CCRN EXAM LATEST 2023-2024 ACTUAL EXAM QUESTIONS
AND CORRECT DETAILED ANSWERS WITH
RATIONALES|ALREADY GRADED A+|BRAND NEW!!
Warming fluids and blood needed for traumatic injury will prevent
hypothermia and its related adverse effects.
Which of the following therapies should be avoided for the patient
with cardiogenic shock? - ANSWER--high dose vasopressors
Vasopressors increase left ventricular after load, which would
increase myocardial work of a failing heart.
The patient is status post repair of an aneurysm for subarachnoid
hemorrhage. Which of the following interventions is indicated to
prevent vasospasm? - ANSWER--Nimodipine (Nimotop)
is a calcium channel blocker that is started immediately post-op to
prevent arterial spasm of the brain.
The patient presents with a rigid abdomen, rebound tenderness, and
a free air in the peritoneum seen on KUB x-ray. Which of the
following should the nurse anticipate? - ANSWER--Powell
perforation; provide fluids, prepare for surgery.
The clinical signs are those of bowel perforation.
Which is the priority treatment for the pt with DKA who presents
with hyperglycemia, ketosis, and normal serum potassium? -
ANSWER--replace potassium
The patient with DKA will have a low pH and metabolic acidosis. In a
state of metabolic acidosis, hydrogen ions move into the
intracellular space. In exchange, potassium leaves the intracellular
, CCRN EXAM LATEST 2023-2024 ACTUAL EXAM QUESTIONS
AND CORRECT DETAILED ANSWERS WITH
RATIONALES|ALREADY GRADED A+|BRAND NEW!!
space. The movement of K into the extracellular space results in
hyperkalemia.
Which of the following is a systemic effect of the therapeutic
hypothermia during the cooling phase? - ANSWER--Hyperglycemia
secondary to insulin resistance.
During the cooling phase of clinical hypothermia there is typically
insulin resistance. Additionally, during the phase there is
vasoconstriction, decreased neutrophil production and during
rewarming, rebound hyperkalemia may occur (not during the
cooling phase).
The patient presented to the ED with a history of palpitations and
dyspnea, persisting on and off for one week. The heart monitor
shows trail fibrillation with rapid ventricular response, blood
pressure 112/70. Treatment will most likely include: - ANSWER--
CCB and anticoagulation
The patient history seems to be one of intermittent atrail fibrillation
over the past week. Controlling rate and addressing potential left
atrial clot formation are priority treatments.
Which of the following clinical findings would you expect to find in
the patient with septic shock? - ANSWER--Lactate 8, SvO2 85
Elevated lactate is evidence of anaerobic metabolism and elevated
Sv02 is evidence of decreased oxygen utilization at the cellular level
- both definitive for septic shock.
AND CORRECT DETAILED ANSWERS WITH
RATIONALES|ALREADY GRADED A+|BRAND NEW!!
The patient is receiving heparin infusion for the treatment of
pulmonary embolism. There has been a 60% decrease in the platelet
count and no clinical change. Which of the following is indicated? -
ANSWER--Discontinue heparin and being argatroban.
The patient most likely has HIT. Exposure to heparin needs to
discontinued and a direct thrombin inhibitor started for continued
anticoagulation.
The patient with oat cell carcinoma has the following clinical
findings: low urine output, low serum osmolality, hyponatremia, and
elevated urine sodium. The nurse anticipates which of the following
as part of the treatment plan? - ANSWER--Phenytoin (Dilantin), 3%
saline.
The patient has signs of SIADH which results in production of
excessive ADH. Dilantin will inhibit ADH secretion and 3% saline
will increase serum sodium.
Peep therapy and mechanical ventilation are ordered for the patient
with acute respiratory failure. Which of the following is a possible
complication? - ANSWER--Barotrauma
The addition of positive end-expiratory pressure will increase
alveolar recruitment, prevent atelectasis and improve oxygenation.
However, the increase in intrathoracic pressure may lead to
pneumothorax or subcutaneous emphysema.
The postoperative thoracic surgery patient has bubbling in the
water seal drainage chamber of the chest tube. Which of the
, CCRN EXAM LATEST 2023-2024 ACTUAL EXAM QUESTIONS
AND CORRECT DETAILED ANSWERS WITH
RATIONALES|ALREADY GRADED A+|BRAND NEW!!
following interventions is indicated? - ANSWER--avoid high airway
pressures
Bubbling in the water seal chamber is due to a pleural air leak, and
high airway pressure will either prevent resolution of the current
air leak or make it worse.
Which clinical sign might patients with both systolic and diastolic
heart failure have in common? - ANSWER--Lung crackles
Both a problem with systolic (ejection problem) and diastolic (filling
problem) will increase left heart pressure and cause cardiogenic
pulmonary edema (lung crackles).
Which of the following is most likely to result in a low Sv02?
A. Hypotermia
B. Fever
C. Severe sepsis - ANSWER--Fever
Fever increases metabolic rate and consumption, which may lead to
a drop in mixed venous oxygen saturation.
The nurse needs to assess adequacy of the tubing/catheter system
for the arterial line. Which of the following interventions will best
assess this? - ANSWER--Perform a square wave test
The patient requires fluid resuscitation and 8 units of PRBC's status
post traumatic injury. Which of the following interventions is most
appropriate? - ANSWER--Warm blood products and crystalloids
, CCRN EXAM LATEST 2023-2024 ACTUAL EXAM QUESTIONS
AND CORRECT DETAILED ANSWERS WITH
RATIONALES|ALREADY GRADED A+|BRAND NEW!!
Warming fluids and blood needed for traumatic injury will prevent
hypothermia and its related adverse effects.
Which of the following therapies should be avoided for the patient
with cardiogenic shock? - ANSWER--high dose vasopressors
Vasopressors increase left ventricular after load, which would
increase myocardial work of a failing heart.
The patient is status post repair of an aneurysm for subarachnoid
hemorrhage. Which of the following interventions is indicated to
prevent vasospasm? - ANSWER--Nimodipine (Nimotop)
is a calcium channel blocker that is started immediately post-op to
prevent arterial spasm of the brain.
The patient presents with a rigid abdomen, rebound tenderness, and
a free air in the peritoneum seen on KUB x-ray. Which of the
following should the nurse anticipate? - ANSWER--Powell
perforation; provide fluids, prepare for surgery.
The clinical signs are those of bowel perforation.
Which is the priority treatment for the pt with DKA who presents
with hyperglycemia, ketosis, and normal serum potassium? -
ANSWER--replace potassium
The patient with DKA will have a low pH and metabolic acidosis. In a
state of metabolic acidosis, hydrogen ions move into the
intracellular space. In exchange, potassium leaves the intracellular
, CCRN EXAM LATEST 2023-2024 ACTUAL EXAM QUESTIONS
AND CORRECT DETAILED ANSWERS WITH
RATIONALES|ALREADY GRADED A+|BRAND NEW!!
space. The movement of K into the extracellular space results in
hyperkalemia.
Which of the following is a systemic effect of the therapeutic
hypothermia during the cooling phase? - ANSWER--Hyperglycemia
secondary to insulin resistance.
During the cooling phase of clinical hypothermia there is typically
insulin resistance. Additionally, during the phase there is
vasoconstriction, decreased neutrophil production and during
rewarming, rebound hyperkalemia may occur (not during the
cooling phase).
The patient presented to the ED with a history of palpitations and
dyspnea, persisting on and off for one week. The heart monitor
shows trail fibrillation with rapid ventricular response, blood
pressure 112/70. Treatment will most likely include: - ANSWER--
CCB and anticoagulation
The patient history seems to be one of intermittent atrail fibrillation
over the past week. Controlling rate and addressing potential left
atrial clot formation are priority treatments.
Which of the following clinical findings would you expect to find in
the patient with septic shock? - ANSWER--Lactate 8, SvO2 85
Elevated lactate is evidence of anaerobic metabolism and elevated
Sv02 is evidence of decreased oxygen utilization at the cellular level
- both definitive for septic shock.
