AACN CCRN Quick Test Bank
Questions and Answers.
Which 12-lead ECG changes should be expected in a patient with ACS involving the
inferior wall?
a) ST segment elevation in leads II, III and all the precordial leads
b) ST segment elevation and deeply inverted T waves in leads II, III and AvF
c) ST segment elevation and deeply inverted T waves in leads V4-V6, I and aVL
d) ST segment depression and T wave elevation in leads II, III and AvL -
\Correct Answer: ST segment elevation and deeply inverted T waves in leads II, III and
AvF
An inferior wall MI is associated with changes in leads II, III and aVF. ST segment
elevation in leads V4-V6 and aVL are associated with an anterolateral MI. ST elevation
in leads II, III, and all of the precordial leads are consistent with a lateral wall MI. ACS is
not associated with changes in leads II, III and aVL. Leads I and aVL are the lateral
leads. ST segment depression is indicative of ischemia or an NSTEMI.
REF: Morton PG, Fontaine DK. 2018.
When teaching a family member to perform an aspect of patient care, the nurse should
understand that family members...
a) learn best if shown a complex procedure all at once.
b) are unaffected by the timing of teaching.
c) learn unrelated tasks first.
d) learn best if they perceive a need to learn. -
\Learn best if they percieve a need to learn;
Family members learn best if they perceive a need to learn. This is consistent with adult
learning theory. Establishing a "need to know" is an important first step for optimal
educational efforts. The timing of education is important for an optimal outcome to be
realized. Teaching unrelated tasks will not enhance learning and is a waste of the
family's and provider's time. Learners are goal-oriented and want to make a connection
between what they are being taught and the goal (skill or knowledge) needed to solve a
problem. If they recognize the relevance of the task, they are more likely to be
successful
Which may cause the development of fixed pupils?
a) hyperoxia
b) olfactory damage
c) hypothermia
d) opiates -
\Hypothermia;
, Hypothermia may cause fixed pupils. Hyperoxia (oxygen toxicity) does not result in fixed
pupils. However, hypoxia may cause wide and fixed pupils due to midbrain damage.
Opiates may cause pinpoint pupils, but they are not fixed. The olfactory nerve is
responsible for the sense of smell.REF: Morton PG, Fontaine DK. 2018.
Which places the older adult at greater risk for alcohol-induced disease? -
\Use of psychotropic drugs is a risk factor for older adults developing alcohol-induced
disease. This is due to the synergetic effects of psychotropic drugs and alcohol. Alcohol
enhances the sedative effects of frequently used psychotropic drugs. Older adults have
a slower metabolism, a smaller volume of body water, and a decrease in lean body
tissue associated with aging.
Following hip replacement surgery, an elderly patient with a history of diabetes, hepatic
insufficiency and alcohol abuse has a postoperative course complicated by the
development of a STAPHYLOCOCCUS infection at the surgical site. Which intervention
has the highest priority? a) Anticipate a return to the operating room.
b) Prepare the patient for wound closure.
c) Apply negative-pressure wound therapy.
d) Place the patient on strict isolation. -
\Anticipate a return to the operating room.
The patient has risk factors (elderly, diabetes, alcohol and liver disease) and signs
( Staph infection) of necrotizing fasciitis. Necrotic tissue must be completely excised and
explored to clean tissue and ensure the infection does not directly inoculate bone tissue.
Strict isolation is not required as necrotizing fasciitis is not contagious. Negative-
pressure wound therapy could be used once the wound has undergone debridement of
necrotic tissue. Local and systemic infection must be completely controlled before
wound closure is addressed.REF: Morton, P.G. & Fontaine, D.K. (2018).
A patient has heart failure secondary to ischemic cardiomyopathy and end-stage
coronary artery disease. Which agents would be the MOST beneficial? a) flecainide
(Tambocor) and hydralazine (Apresoline)
b) verapamil (Calan) and spironolactone (Aldactone)
c) digoxin (Lanoxin) and diltiazem (Cardizem)
d) carvedilol (Coreg) and lisinopril (Zestril) -
\Correct Answer: carvedilol (Coreg) and lisinopril (Zestril)
The patient has end-stage coronary artery disease causing systolic dysfunction. These
drugs decrease afterload and minimize remodeling that is associated with heart failure.
Calcium-channel blockers are contraindicated in heart failure. Digoxin may be used in
heart failure. Spironolactone is given to block the aldosterone effect. Hydralazine is an
alpha-blocker, which reduces afterload and is used in heart failure. Flecainide is
contraindicated with structural heart disease.
Which hemodynamic profile is MOST consistent with distributive shock?
Questions and Answers.
Which 12-lead ECG changes should be expected in a patient with ACS involving the
inferior wall?
a) ST segment elevation in leads II, III and all the precordial leads
b) ST segment elevation and deeply inverted T waves in leads II, III and AvF
c) ST segment elevation and deeply inverted T waves in leads V4-V6, I and aVL
d) ST segment depression and T wave elevation in leads II, III and AvL -
\Correct Answer: ST segment elevation and deeply inverted T waves in leads II, III and
AvF
An inferior wall MI is associated with changes in leads II, III and aVF. ST segment
elevation in leads V4-V6 and aVL are associated with an anterolateral MI. ST elevation
in leads II, III, and all of the precordial leads are consistent with a lateral wall MI. ACS is
not associated with changes in leads II, III and aVL. Leads I and aVL are the lateral
leads. ST segment depression is indicative of ischemia or an NSTEMI.
REF: Morton PG, Fontaine DK. 2018.
When teaching a family member to perform an aspect of patient care, the nurse should
understand that family members...
a) learn best if shown a complex procedure all at once.
b) are unaffected by the timing of teaching.
c) learn unrelated tasks first.
d) learn best if they perceive a need to learn. -
\Learn best if they percieve a need to learn;
Family members learn best if they perceive a need to learn. This is consistent with adult
learning theory. Establishing a "need to know" is an important first step for optimal
educational efforts. The timing of education is important for an optimal outcome to be
realized. Teaching unrelated tasks will not enhance learning and is a waste of the
family's and provider's time. Learners are goal-oriented and want to make a connection
between what they are being taught and the goal (skill or knowledge) needed to solve a
problem. If they recognize the relevance of the task, they are more likely to be
successful
Which may cause the development of fixed pupils?
a) hyperoxia
b) olfactory damage
c) hypothermia
d) opiates -
\Hypothermia;
, Hypothermia may cause fixed pupils. Hyperoxia (oxygen toxicity) does not result in fixed
pupils. However, hypoxia may cause wide and fixed pupils due to midbrain damage.
Opiates may cause pinpoint pupils, but they are not fixed. The olfactory nerve is
responsible for the sense of smell.REF: Morton PG, Fontaine DK. 2018.
Which places the older adult at greater risk for alcohol-induced disease? -
\Use of psychotropic drugs is a risk factor for older adults developing alcohol-induced
disease. This is due to the synergetic effects of psychotropic drugs and alcohol. Alcohol
enhances the sedative effects of frequently used psychotropic drugs. Older adults have
a slower metabolism, a smaller volume of body water, and a decrease in lean body
tissue associated with aging.
Following hip replacement surgery, an elderly patient with a history of diabetes, hepatic
insufficiency and alcohol abuse has a postoperative course complicated by the
development of a STAPHYLOCOCCUS infection at the surgical site. Which intervention
has the highest priority? a) Anticipate a return to the operating room.
b) Prepare the patient for wound closure.
c) Apply negative-pressure wound therapy.
d) Place the patient on strict isolation. -
\Anticipate a return to the operating room.
The patient has risk factors (elderly, diabetes, alcohol and liver disease) and signs
( Staph infection) of necrotizing fasciitis. Necrotic tissue must be completely excised and
explored to clean tissue and ensure the infection does not directly inoculate bone tissue.
Strict isolation is not required as necrotizing fasciitis is not contagious. Negative-
pressure wound therapy could be used once the wound has undergone debridement of
necrotic tissue. Local and systemic infection must be completely controlled before
wound closure is addressed.REF: Morton, P.G. & Fontaine, D.K. (2018).
A patient has heart failure secondary to ischemic cardiomyopathy and end-stage
coronary artery disease. Which agents would be the MOST beneficial? a) flecainide
(Tambocor) and hydralazine (Apresoline)
b) verapamil (Calan) and spironolactone (Aldactone)
c) digoxin (Lanoxin) and diltiazem (Cardizem)
d) carvedilol (Coreg) and lisinopril (Zestril) -
\Correct Answer: carvedilol (Coreg) and lisinopril (Zestril)
The patient has end-stage coronary artery disease causing systolic dysfunction. These
drugs decrease afterload and minimize remodeling that is associated with heart failure.
Calcium-channel blockers are contraindicated in heart failure. Digoxin may be used in
heart failure. Spironolactone is given to block the aldosterone effect. Hydralazine is an
alpha-blocker, which reduces afterload and is used in heart failure. Flecainide is
contraindicated with structural heart disease.
Which hemodynamic profile is MOST consistent with distributive shock?
