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(Solved) BARRONS CCRN EXAM LATEST 2022/2023 Questions and Answers Test Bank
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(Solved) BARRONS CCRN EXAM LATEST 2022/2023 Questions and Answers Test Bank-Which of the following ventilator settings is most likely to decrease the work of breathing?
A
assist-control
B
pressure support
C
tidal volume
D
CPAP
{{Ans- Answer: B
Pressure support senses the beginning of the patient's spontaneous inspiration and provides a set
pressure to assist the inspiratory effort. The primary purpose of the ventilator settings listed in
choices (A), (C), and (D) is not to decrease the work of breathing.
-A nurse is caring for a patient with an acute inferior wall MI, post coronary artery stent deployment. For
optimal care of this patient, the nurse should:
Select single answer choice.
A
administer an analgesic for acute back pain.clearYou selected.
B
apply a pressure dressing to the groin.clearYou did not select.
C
continuously monitor the patient in lead II.
D
maintain the patient in a supine position.
{{Ans- Answer: C
It is best practice to continuously monitor a patient, who is post coronary artery stent deployment, in
the lead that was most abnormal during the acute occlusion. Lead II would most likely meet this
criterion for a patient with an inferior wall MI. The remaining interventions are NOT indicated for a
patient who is post coronary artery stent deployment.
-A patient with aortic regurgitation will have which of the following upon auscultation?
Select single answer choice.
A
a diastolic murmur, loudest at the fifth intercostal space, midclavicular
a systolic murmur, loudest at the apex of the heart
C
a diastolic murmur, loudest at the second intercostal space, right sternal border
,D
a systolic murmur, loudest at the base of the heart
{{Ans- Answer: C
Aortic insufficiency (regurgitation) is the backflow of blood during the time when the aortic valve
should be closed. The aortic valve is closed during diastole; therefore, this patient has a diastolic
murmur. The aortic area of auscultation is at the base of the heart: the second intercostal space, right
sternal border.
-A patient has acute kidney injury with fluid overload, and continuous renal replacement therapy (CRRT)
has been ordered. Which of the following would indicate the need for CRRT rather than intermittent
hemodialysis?
Select single answer choice.
A
hyperkalemia
B.
a MAP of 45 mmHg
C
acidosis
D
severe hypoxemia
{{Ans- Answer: B
Hemodynamic instability, such as hypotension, is the indication for CRRT since it does not cause the
rapid fluid shifts that are seen with intermittent hemodialysis. The remaining choices are not
indications for CRRT.
-Which of the following patients, who are all receiving mechanical ventilation, is most likely a candidate
for a spontaneous awakening trial?
Select single answer choice.
A
a patient who is receiving PRN morphine
B
a patient who is receiving a propofol infusion
C
a patient who is receiving 100% oxygen and 20 cm H2O pressure of PEEP
D
a patient who is receiving a vecuronium (Norcuron) infusion
{{Ans- Answer: B
A spontaneous awakening trial should be considered for a patient who is receiving a continuous
infusion of a sedating drug and/or an analgesic drug and who meets the hemodynamic criteria. A
patient who is receiving a propofol infusion is a potential candidate for a spontaneous awakening trial
,as long as the hemodynamic criteria are met. A patient who is receiving PRN morphine may be a
candidate for a spontaneous breathing trial, but that patient does not require an infusion to be
stopped in order to be awakened. The remaining 2 choices do not meet the criteria for performing
either a spontaneous awakening trial or a spontaneous breathing trial.
-While the code team is performing resuscitative efforts, many of the patient's family members start to
cry and pray, while other family members lie down on the floor in the corner of the room. Which of the
following demonstrates the best action for the nurse to take at this time?
Select single answer choice.
A
Ensure that a member of the code team serves as a family presence facilitator and clearly communicates
the treatment strategies to the family.
B
Call security to escort the family members to the waiting room due to their disruptive behavior.
C
Encourage the family members to leave the patient care area because they are extre mely distressed.
D
Ask the family members to leave the patient care area because they may suffer anxiety from remaining
in the room.
{{Ans- Answer: A
It is important to offer families the opportunity to witness the efforts of the health care team during a
patient's cardiopulmonary resuscitation. Research suggests that allowing family members to stay with
a patient during this time may decrease their rates of post-traumatic stress disorder, depression, and
anxiety related to the event. If the family interferes with the code team's ability to provide care to the
patient, it may be necessary to have security remove the family; however, this scenario does not state
that the family members are interfering with the code team's efforts, so choice (B) is incorrect. The
remaining 2 choices do not allow the family to grieve in a way that may be natural to them.
-Cardiogenic shock secondary to left ventricular failure will generally result in:
Select single answer choice.
A
decreased afterload.
B
a narrow pulse pressure.
C
decreased preload.
D
a widening pulse pressure.
{{Ans- Answer: B
, The systolic pressure decreases due to a drop in the cardiac output; however, the diastolic pressure
either stays the same or increases due to a compensatory increase in the systemic vascular resistance.
The remaining choices are not found in the presence of cardiogenic shock.
-Massive atelectasis occurs in the presence of acute respiratory distress syndrome (ARDS). What are the
2 causes of the atelectasis that is typical of ARDS?
Select single answer choice.
A
a surfactant deficiency and pulmonary edema
B
increased pulmonary vascular resistance and increased pulmonary compliance
C
increased pulmonary compliance and pulmonary edema
D
mucus plugs and bronchospasm
{{Ans- Answer: A
ARDS destroys Type II alveolar cells, which results in decreased surfactant production. ARDS also
results in capillary leak at normal left-sided heart pressures, which results in pulmonary edema. Both
a surfactant deficiency and pulmonary edema lead to atelectasis. The remaining choices are not
correct because increased pulmonary compliance and mucus plugs are not features of ARDS.
-A patient was admitted with an acute inferior wall STEMI. The physician advises the nurse to monitor
the patient for signs of right ventricular (RV) infarction. Which of the following are signs of RV
infarction?
Select single answer choice.
A
S4 heart sound, lung crackles
B
hypotension, flat neck veins
C
hypertension, a systolic murmur
D
distended neck veins, clear lungs
{{Ans- Answer: D
If the RV contractility decreases, the pressure that is proximal to the right ventricle (which is the right
atrial pressure) increases, resulting in distended neck veins. As the right heart fails, the left heart
preload decreases, and the lungs are clear.
-Which of the following is an effect of hypothermia?
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