CCRN LEAKED DEFINITIONS RETAKE
ACTUAL ASSESSMENT EXAM 2025
UPDATED QUESTIONS AND CORRECT R,
Exams of Nursing
In patients with dilated cardiomyopathy, which of the following intracardiac pressure changes
would be seen?
A. decreased L atrial pressure, increased R atrial pressure
B. normal L atrial pressure, decrease R atrial pressure
C. elevated L atrial pressure, decreased R atrial pressure
D. decreased L atrial pressure, normal R atrial pressure C
A 16 year old female is admitted with +3 edema and a positive Homans sign on the L leg. She
states she smokes "on occasion". During the medical history assessment the nurse should
inquire about:
A. birth control use
B. alcohol use
C. sexual activity
D. illicit drug use A
A patient admitted following blunt chest trauma reports stabbing substernal pain and shortness
of breath. On exam, the nurse notes a crunching noise that is synchronous with the patient's
heartbeat. Findings are most likely due to:
A. pneumothorax
B. pneumoperitoneum
C. pneumomediastinum
D. pneumopericardium C
A 4 year old patient was just admitted for asthma exacerbation and is receiving continuous
albuterol (Proventil) at 5mg/hr. Assessment reveals an absence of breath sounds bilaterally,
lethargy, inability to speak. Data are:
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,HR 65, RR 10, SpO2 85%
The nurse recognizes this an:
A. an expected assessment requiring ongoing monitoring
B. a concerning finding requiring administration of methylprednisolone (Solumedrol)
C. a life threatening emergency requiring endotracheal intubation
D. an acute deterioration requiring an increase in continuous albuterol (Proventil) dose C
An infant is admitted after an unsuccessful reduction of an intussusception. Further assessment
reveals abdominal distention, fever, and hypoactive bowel sounds. The nurse should
immediately notify the provider if the patient has:
A. projectile vomiting
B. clay colored stools
C. sustained tachycardia
D. abdominal erythema C
An acutely ill infant is born to a Vietnamese family. The father asks a few questions about the
infant's condition, and the mother asks none. Both parents appear to be proficient in English.
Which is the MOST USEFUL resource for a nurse caring for this infant?
A. classes conducted by the primary nurse as the need arises
B. information about the cultural backgrounds represented in the community
C. an interpreter who is proficient is the parents' language
D. ongoing classes addressing the cultural needs of the community C
Which of the following are expected findings in a patient admitted in the early stage of septic
shock?
A. pale and mottled skin, weak pulses and narrow pulse pressure
B. flushed skin, weak pulses, and narrow pulse pressure
C. flushes skin, bounding pulses, and wide pulse pressure
D. pale and mottled skin, bounding pulses, and wide pulse pressure C
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,The authority of a surrogate to speak for a patient should be based on which of the following
conditions?
A. the patient has specifically conveyed wishes to the surrogate regarding current or similar
circumstances
B. the surrogate is a family member and has recently lived with the patient
C. the family has designated the surrogate as the most knowledgeable individual regarding the
patient's wishes
D. the patient indicates to the nursing staff that the surrogate should speak on the patient's
behalf A
A child has the following physical findings: decreased tissue perfusion, lethargy, acidosis, and
oliguria. The hemodynamic status remains unstable after 3 fluid boluses. The NEXT intervention
should be:
A. a vasodilator to decrease after load
B. diuretics to minimize vascular congestion
C. sodium bicarb administration to reverse acidosis
D. inotropic agents to increase myocardial contractility D
An 8 month old recovering from TET repair remains intubated. Data are:
HR 148, SpO2 90%, cap refill 4 seconds, arterial BP 84/53
The nurse anticipates:
A. administering sedation
B. increasing inotropic support
C. decreasing FiO2
D. suctioning the ETT A
A patient who is ventilator-dependent has been hospitalized. the provider has indicated that the
patient will be discharged home in one week with a tracheostomy and gastrostomy. In order to
determine the discharge needs of the patient, the nurse should arrange:
A. home nursing care for the first few days following discharge
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, B. an outreach educator to determine the learning needs of the family
C. a social worker to meet with the family and assess the adequacy of the home environment
D. a multidisciplinary care conference prior to discharge C
A child being treated for DKA becomes lethargic, is difficult to arouse and has vomited twice in
the past hour. These symptoms indicate:
A. increased ICP
B. exhaustion due to lack of sleep
C. the development of hypoglycemia
D. decreased intestinal motility A
A child presents with blood in the urine. A review of the medical records show multiple
admissions for the same symptom. No etiology has been found. The patient is symptomatic only
when the caregiver is present. The nurse suspects that the diagnosis will be:
A. Munchausen syndrome by proxy
B. sexual abuse
C. non-accidental trauma
D. physical abuse A
Which method is BEST to update a family that primarily speaks Spanish?
A. give the family the operative consent written in Spanish
B. use hand gestures to point to key things such as the patient and the surgeon
C. have the patient's sibling provide interpretation for the family
D. utilize a medical interpreter either in person or on the telephone D
Which statement by the post-cardiac surgery patient should indicate to the nurse that
additional teaching is required?
A. "I will use antibacterial soap on my incision"
B. "I will let you know if any drainage around my incision gets thick"
C. "I am looking forward to being able to drive my new car next week"
D. "I can't wait for the two day to occur so I can take a shower" C
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ACTUAL ASSESSMENT EXAM 2025
UPDATED QUESTIONS AND CORRECT R,
Exams of Nursing
In patients with dilated cardiomyopathy, which of the following intracardiac pressure changes
would be seen?
A. decreased L atrial pressure, increased R atrial pressure
B. normal L atrial pressure, decrease R atrial pressure
C. elevated L atrial pressure, decreased R atrial pressure
D. decreased L atrial pressure, normal R atrial pressure C
A 16 year old female is admitted with +3 edema and a positive Homans sign on the L leg. She
states she smokes "on occasion". During the medical history assessment the nurse should
inquire about:
A. birth control use
B. alcohol use
C. sexual activity
D. illicit drug use A
A patient admitted following blunt chest trauma reports stabbing substernal pain and shortness
of breath. On exam, the nurse notes a crunching noise that is synchronous with the patient's
heartbeat. Findings are most likely due to:
A. pneumothorax
B. pneumoperitoneum
C. pneumomediastinum
D. pneumopericardium C
A 4 year old patient was just admitted for asthma exacerbation and is receiving continuous
albuterol (Proventil) at 5mg/hr. Assessment reveals an absence of breath sounds bilaterally,
lethargy, inability to speak. Data are:
1|Page
,HR 65, RR 10, SpO2 85%
The nurse recognizes this an:
A. an expected assessment requiring ongoing monitoring
B. a concerning finding requiring administration of methylprednisolone (Solumedrol)
C. a life threatening emergency requiring endotracheal intubation
D. an acute deterioration requiring an increase in continuous albuterol (Proventil) dose C
An infant is admitted after an unsuccessful reduction of an intussusception. Further assessment
reveals abdominal distention, fever, and hypoactive bowel sounds. The nurse should
immediately notify the provider if the patient has:
A. projectile vomiting
B. clay colored stools
C. sustained tachycardia
D. abdominal erythema C
An acutely ill infant is born to a Vietnamese family. The father asks a few questions about the
infant's condition, and the mother asks none. Both parents appear to be proficient in English.
Which is the MOST USEFUL resource for a nurse caring for this infant?
A. classes conducted by the primary nurse as the need arises
B. information about the cultural backgrounds represented in the community
C. an interpreter who is proficient is the parents' language
D. ongoing classes addressing the cultural needs of the community C
Which of the following are expected findings in a patient admitted in the early stage of septic
shock?
A. pale and mottled skin, weak pulses and narrow pulse pressure
B. flushed skin, weak pulses, and narrow pulse pressure
C. flushes skin, bounding pulses, and wide pulse pressure
D. pale and mottled skin, bounding pulses, and wide pulse pressure C
2|Page
,The authority of a surrogate to speak for a patient should be based on which of the following
conditions?
A. the patient has specifically conveyed wishes to the surrogate regarding current or similar
circumstances
B. the surrogate is a family member and has recently lived with the patient
C. the family has designated the surrogate as the most knowledgeable individual regarding the
patient's wishes
D. the patient indicates to the nursing staff that the surrogate should speak on the patient's
behalf A
A child has the following physical findings: decreased tissue perfusion, lethargy, acidosis, and
oliguria. The hemodynamic status remains unstable after 3 fluid boluses. The NEXT intervention
should be:
A. a vasodilator to decrease after load
B. diuretics to minimize vascular congestion
C. sodium bicarb administration to reverse acidosis
D. inotropic agents to increase myocardial contractility D
An 8 month old recovering from TET repair remains intubated. Data are:
HR 148, SpO2 90%, cap refill 4 seconds, arterial BP 84/53
The nurse anticipates:
A. administering sedation
B. increasing inotropic support
C. decreasing FiO2
D. suctioning the ETT A
A patient who is ventilator-dependent has been hospitalized. the provider has indicated that the
patient will be discharged home in one week with a tracheostomy and gastrostomy. In order to
determine the discharge needs of the patient, the nurse should arrange:
A. home nursing care for the first few days following discharge
3|Page
, B. an outreach educator to determine the learning needs of the family
C. a social worker to meet with the family and assess the adequacy of the home environment
D. a multidisciplinary care conference prior to discharge C
A child being treated for DKA becomes lethargic, is difficult to arouse and has vomited twice in
the past hour. These symptoms indicate:
A. increased ICP
B. exhaustion due to lack of sleep
C. the development of hypoglycemia
D. decreased intestinal motility A
A child presents with blood in the urine. A review of the medical records show multiple
admissions for the same symptom. No etiology has been found. The patient is symptomatic only
when the caregiver is present. The nurse suspects that the diagnosis will be:
A. Munchausen syndrome by proxy
B. sexual abuse
C. non-accidental trauma
D. physical abuse A
Which method is BEST to update a family that primarily speaks Spanish?
A. give the family the operative consent written in Spanish
B. use hand gestures to point to key things such as the patient and the surgeon
C. have the patient's sibling provide interpretation for the family
D. utilize a medical interpreter either in person or on the telephone D
Which statement by the post-cardiac surgery patient should indicate to the nurse that
additional teaching is required?
A. "I will use antibacterial soap on my incision"
B. "I will let you know if any drainage around my incision gets thick"
C. "I am looking forward to being able to drive my new car next week"
D. "I can't wait for the two day to occur so I can take a shower" C
4|Page
