Certified Critical Care Registered Nurse (CCRN) Final Exam Questions & Answers

Certified Critical Care Registered Nurse (CCRN) Final Exam Questions & Answers-A patient in hyperosolar hyperglycemic state (HHS) is being admitted with dehydration and a serum glucose level of 836 mg/dL. Which of the following additional laboratory findings should the nurse anticipate? A. decreased BUN, decreased creatinine, and elevated serum osmolality B. decreased BUN, decreased creatinine and decreased serum osmolality C. decreased BUN, elevated creatinine and decreased serum osmolality D. elevated BUN, elevated creatinine and elevated serum osmolality - D. elevated BUN, elevated creatinine and elevated serum osmolality Serum osmolality 320 mOsm/kg distinguishes HHS from DKA On the fifth day post-admission, a patient with Q waves in V1, V2, and V3 develops hypotension, tachycardia, and a pan-systolic murmur that is loudest at the lower left sternal border. This patient most likely developed A. idiopathic hypertrophic cardiomyopathy B. inferior wall infarction C. cardiac tamponade D. a ruptured inter-ventricular septum - D. a ruptured inter-ventricular septum (septal wall MI) A patient with a history of chronic pain, asthma, diabetes, and heavy alcohol intake is now experiencing cognitive impairment from medications. Assessment: awake but confused, BP 155/82, HR 84, RR 16 and SpO2 95% on RA. This patient is at high risk for A. Intubation B. needing long-term psychiatric care C. attempting suicide D. over-sedation by staff - C. attempting suicide (chronic medical illness, heavy alcohol intake, and chronic pain) Which of the following 12-lead ECG changes should be expected in a patient with acute coronary syndrome involving the inferior wall? A. ST segment elevation and deeply inverted T waves in leads V4-V6, I and aVL B. ST segment elevation in leads II, III, and all precordial leads C. ST segment elevation and deeply inverted T waves in leads II, III, aVF D. ST segment depression and T wave elevation in leads II, III, aVL - C. ST segment elevation and deeply inverted T waves in leads II, III, aVF The major effect of acute lung injury (ALI) on the lung tissue is A. decreased capillary permeability B. increased function residual capacity (FRC) C. decreased compliance D. decreased alveolar surface tension - C. decreased compliance (related to the alteration of lung endothelium and vascular tissue. Results in stiffness and fluid filled non-aerated airways) A patient with mitral regurgitation suddenly develops atrial fibrillation with a rate of 156. BP is 118/74. The nurse should anticipate medication orders for A. beta-blockers and vasopressors B. warfarin (Coumadin) and alpha-agonists C. beta-agonists and calcium-channel blockers D. cardiac glycosides and calcium channel blockers - D. cardiac glycosides (digoxin) and calcium channel blockers Which of the following pulmonary artery catheter findings would be anticipated in a patient with chronic emphysema? A. increased CVP B. decreased CI C. increased SV D. decreased PAOP - A. increased CVP (emphysema can cause cor pulmonale secondary to increased pressure) A patient is admitted complaining of chest pain and nausea. The ECG monitor reveals secondary AV block, Type II. These findings are probably a result of occlusion of which of the following coronary arteries? A. left anterior descending B. left circumflex C. posterior descending D. right - A. left anterior descending (LAD supplies blood to the septum)