CCRN EXAM LATEST 2024 ACTUAL EXAM QUESTIONS AND
CORRECT DETAILED ANSWERS WITH RATIONALES
1. A patient with a history of congestive heart failure presents with dyspnea, orthopnea,
and pink, frothy sputum. Which of the following interventions is the priority?
a) Administering intravenous diuretics
b) Initiating oxygen therapy
c) Positioning the patient in high Fowler's position
d) Administering intravenous diuretics (✔️)
Rationale: Administering intravenous diuretics is the priority intervention as it reduces fluid
overload, thereby decreasing pulmonary congestion and improving respiratory function. High
Fowler’s position and oxygen therapy are also important but secondary to diuretics in this
scenario.
2. A patient with a history of atrial fibrillation is at risk for which of the following
complications?
a) Pulmonary embolism
b) Stroke
c) Myocardial infarction
d) Stroke (✔️)
Rationale: Atrial fibrillation increases the risk of blood clots forming in the atria, which can
dislodge and travel to the brain, causing a stroke. This is the most significant risk associated with
atrial fibrillation.
,3. A patient is being mechanically ventilated following a severe head injury. The nurse
notes that the patient’s PaCO2 is 55 mm Hg. What is the best nursing action?
a) Increase the tidal volume
b) Decrease the ventilator rate
c) Increase the respiratory rate
d) Increase the respiratory rate (✔️)
Rationale: A PaCO2 of 55 mm Hg indicates hypercapnia, which can increase intracranial
pressure. Increasing the respiratory rate will help to lower PaCO2 levels by enhancing
ventilation.
4. A patient with a myocardial infarction is experiencing chest pain. Which medication
should the nurse administer first?
a) Nitroglycerin
b) Morphine
c) Aspirin
d) Nitroglycerin (✔️)
Rationale: Nitroglycerin is a vasodilator that helps to decrease myocardial oxygen demand and
alleviate chest pain. It should be administered first, followed by other medications such as
morphine for pain and aspirin for antiplatelet effects.
,5. The nurse is assessing a patient who is post-cardiac surgery. Which finding would
indicate the need for immediate intervention?
a) Blood pressure of 110/70 mm Hg
b) Urine output of 20 mL/hr
c) Heart rate of 90 bpm
d) Urine output of 20 mL/hr (✔️)
Rationale: Urine output less than 30 mL/hr may indicate renal perfusion issues and possible
acute kidney injury, which requires immediate intervention.
6. A patient with acute respiratory distress syndrome (ARDS) is receiving mechanical
ventilation. Which of the following settings is most appropriate for this patient?
a) High tidal volume
b) Low tidal volume
c) High respiratory rate
d) Low tidal volume (✔️)
Rationale: Low tidal volume ventilation is preferred in ARDS to prevent ventilator-induced lung
injury by reducing overdistension of the alveoli.
7. A patient with septic shock is receiving norepinephrine. Which of the following is the
most important parameter to monitor?
, a) Heart rate
b) Blood pressure
c) Respiratory rate
d) Blood pressure (✔️)
Rationale: Norepinephrine is a vasopressor that increases blood pressure, which is critical to
monitor to ensure adequate perfusion without causing hypertension.
8. A patient with a history of COPD is admitted with an exacerbation. The nurse should
anticipate which of the following interventions?
a) Intravenous corticosteroids
b) Intravenous antibiotics
c) Supplemental oxygen
d) Supplemental oxygen (✔️)
Rationale: Supplemental oxygen is critical for managing COPD exacerbations, as it helps to
improve oxygenation. Corticosteroids and antibiotics may be used, but oxygen is the immediate
priority.
9. A patient is receiving a continuous infusion of heparin. The nurse notes that the patient's
aPTT is 90 seconds. What is the most appropriate nursing action?
a) Increase the heparin infusion rate
b) Continue the current rate of infusion
CORRECT DETAILED ANSWERS WITH RATIONALES
1. A patient with a history of congestive heart failure presents with dyspnea, orthopnea,
and pink, frothy sputum. Which of the following interventions is the priority?
a) Administering intravenous diuretics
b) Initiating oxygen therapy
c) Positioning the patient in high Fowler's position
d) Administering intravenous diuretics (✔️)
Rationale: Administering intravenous diuretics is the priority intervention as it reduces fluid
overload, thereby decreasing pulmonary congestion and improving respiratory function. High
Fowler’s position and oxygen therapy are also important but secondary to diuretics in this
scenario.
2. A patient with a history of atrial fibrillation is at risk for which of the following
complications?
a) Pulmonary embolism
b) Stroke
c) Myocardial infarction
d) Stroke (✔️)
Rationale: Atrial fibrillation increases the risk of blood clots forming in the atria, which can
dislodge and travel to the brain, causing a stroke. This is the most significant risk associated with
atrial fibrillation.
,3. A patient is being mechanically ventilated following a severe head injury. The nurse
notes that the patient’s PaCO2 is 55 mm Hg. What is the best nursing action?
a) Increase the tidal volume
b) Decrease the ventilator rate
c) Increase the respiratory rate
d) Increase the respiratory rate (✔️)
Rationale: A PaCO2 of 55 mm Hg indicates hypercapnia, which can increase intracranial
pressure. Increasing the respiratory rate will help to lower PaCO2 levels by enhancing
ventilation.
4. A patient with a myocardial infarction is experiencing chest pain. Which medication
should the nurse administer first?
a) Nitroglycerin
b) Morphine
c) Aspirin
d) Nitroglycerin (✔️)
Rationale: Nitroglycerin is a vasodilator that helps to decrease myocardial oxygen demand and
alleviate chest pain. It should be administered first, followed by other medications such as
morphine for pain and aspirin for antiplatelet effects.
,5. The nurse is assessing a patient who is post-cardiac surgery. Which finding would
indicate the need for immediate intervention?
a) Blood pressure of 110/70 mm Hg
b) Urine output of 20 mL/hr
c) Heart rate of 90 bpm
d) Urine output of 20 mL/hr (✔️)
Rationale: Urine output less than 30 mL/hr may indicate renal perfusion issues and possible
acute kidney injury, which requires immediate intervention.
6. A patient with acute respiratory distress syndrome (ARDS) is receiving mechanical
ventilation. Which of the following settings is most appropriate for this patient?
a) High tidal volume
b) Low tidal volume
c) High respiratory rate
d) Low tidal volume (✔️)
Rationale: Low tidal volume ventilation is preferred in ARDS to prevent ventilator-induced lung
injury by reducing overdistension of the alveoli.
7. A patient with septic shock is receiving norepinephrine. Which of the following is the
most important parameter to monitor?
, a) Heart rate
b) Blood pressure
c) Respiratory rate
d) Blood pressure (✔️)
Rationale: Norepinephrine is a vasopressor that increases blood pressure, which is critical to
monitor to ensure adequate perfusion without causing hypertension.
8. A patient with a history of COPD is admitted with an exacerbation. The nurse should
anticipate which of the following interventions?
a) Intravenous corticosteroids
b) Intravenous antibiotics
c) Supplemental oxygen
d) Supplemental oxygen (✔️)
Rationale: Supplemental oxygen is critical for managing COPD exacerbations, as it helps to
improve oxygenation. Corticosteroids and antibiotics may be used, but oxygen is the immediate
priority.
9. A patient is receiving a continuous infusion of heparin. The nurse notes that the patient's
aPTT is 90 seconds. What is the most appropriate nursing action?
a) Increase the heparin infusion rate
b) Continue the current rate of infusion
