DEH 2300 : CCRN-PCCN Review Study Guide. Questions and Answers. Rationales Provided.
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Course
DEH 2300 - CCRN
Institution
Valencia College
DEH 2300 : CCRN-PCCN Review Study Guide. Questions and Answers. Rationales Provided.
CCRN-PCCN Review:
Questions, Answers, Rationale & Strategies
Synergy
1. After cardiac surgery, a patient who is a Jehovah’s Witness had an HCT of 18% and
accumulated chest-tube drainage of 1800cc in the...
Stephanie Maillie, MSN, RN, CCRN, PCCN, CCNS
maillies@einstein.edu
Clinical Nurse Specialist
Medical ICU and Medical Progressive Care Unit
and
Barbara Pope, MSN, RN, CCRN, PCCN, CCNS
popeb@einstein.edu
Critical Care Clinical Educator
Albert Einstein Healthcare Network
Philadelphia, PA
Content Description
In response to frequent requests for more practice with sample questions and answers, this
session will be dedicated to fulfilling that request. We will present sample questions and include
a discussion of rationale for correct and incorrect answers. Strategies for clues to correct
answers will also be given. Sample questions will begin with subject-specific examples in the
topics of cardiac, pulmonary, neuro, GI, renal, endocrine, hematologic, multisystem, synergy,
and behavioral. The session will conclude with a “potpourri” of questions from all topics tested
in the CCRN, PCCN, CCNS, CMC and CSC certification exams. The participant will leave with
a plan for successful completion of the exam.
Learning Objectives
At the end of this session, the participant will be able to:
1. Analyze questions and identify clues to correct answer
2. Explore rationales for correct and incorrect answers
3. Develop a plan for successful certification
References
NOTE: Please refer to outline for references pertaining to this session.
Synergy
1. After cardiac surgery, a patient who is a Jehovah’s Witness had an HCT of 18% and
accumulated chest-tube drainage of 1800cc in the first 3 hours. The most appropriate action
would be to:
A. Begin continuous-circuit autotransfusion
B. Administer donated directed PRBCs
C. Administer donated autologous whole blood
D. Administer 500cc of albumin
2. An alert patient is emergently intubated during an episode of pulmonary edema. When family
members come to visit the patient, they cry out, “Talk to me; talk to me!” The nurse should
tell the family that:
A. They must not excite the patient while visiting
B. Communication is not a priority at this time
C. The patient is too exhausted to converse with them
D. The breathing tube temporarily prevents the patient from speaking
Cardiac
3. The heart sound most often associated with heart failure is:
A. An S3
B. A pericardial friction rub
C. An S4
D. A systolic ejection murmur
4. A patient is admitted with acute decompensated heart failure. The physician orders that the
patient receive nesiritide (Natrecor) for volume overload refractory to loop diuretics. The
nurse would closely monitor the patient for which side effect of nesiritide?
A. Hypokalemia
B. Hypotension
C. Ventricular dysrhythmia
D. Nausea/vomiting
5. The nurse should be alert for complications associated with embolic phenomena in which
group of patients regardless of their disease stage?
A. Patients with dilated cardiomyopathy
B. Patients with hypertrophic cardiomyopathy
C. Patients with restrictive cardiomyopathy
D. Patients with myocarditis
, 6. Which of the following physiologic changes occurs as direct result of cardiogenic shock?
A. Increase in capacitance
B. Increase in afterload
C. Decrease in preload
D. Decrease in SVR
Pulmonary
7. A young patient is admitted to the ICU after a motorcycle accident involving the center
median of the freeway in which she sustained blunt head and chest trauma. Within minutes of
arrival on the unit, the patient complains of dysphasia and is coughing. She develops upper
airway obstruction unrelieved by oxygen, becomes cyanotic, and has palpable subcutaneous
emphysema near the sternal notch.
For which of the following interventions should the nurse prepare?
A. Intubation and mechanical ventilation
B. Fiberoptic bronchoscopy
C. Emergent tracheostomy
D. Initiation of cardiac compressions for CPR
8. The nurse maintains an adequate water level in the water-seal chamber of a chest tube
drainage system because the waterseal:
A. Controls the suction level of the chest tube system
B. Controls the rate of drainage from the pleural cavity
C. Prevents air and pleural fluid from reentering the pleural cavity
D. Determines the amount of drainage from the pleural cavity
Neuro
9. Anna is an ICU patient with new-onset grand mal seizures. While at her bedside, you witness
a seizure. What should your first action be?
A. Hit the Code Blue Button
B. Hold the patient down to prevent injury
C. Insert an oral airway and call for help
D. Roll Anna to her right side and protect the airway
10. Jason M., an 80 year old African American male, as had a left temporal cerebral vascular
accident due to uncontrolled hypertension. As the critical care nurse you know Jason is likely to
have which of the following deficits?
A. Receptive Aphasia
B. Motor Deficits
C. Balance deficits
D. Expressive Aphasia
GI
11. Mr. Smith, is a 46 year old male who is frequently admitted to your ICU and step down for
alcohol withdrawal syndrome. Most recently he spent the last week in the ICU for alcohol-
induced coma and was transferred to Medical Step Down 2 days ago. Just prior to being
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