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CCRN QUESTIONS 2024 exam with verified answers
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CCRN QUESTIONS 2024 exam with verified answers
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CCRN QUESTIONS 2024 exam withverified answers
The nurse is caring for a patient with acute inferior wall MI, post-coronary artery stent
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deployment, For optimal care of the patient, the nurse should: - ANSWER: ➡ Continuously
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monitor the patient in lead II
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It is best practice to monitor the patient status post PCI with stent, in the lead that was most
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abnormal during the acute occlusion.
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The ECG demonstrates ST elevation in leads II, III and aVF. The nurse needs to monitor the
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patient closely for which of the following? - ANSWER: ➡ Complication likely to occur after an
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acute inferior wall MI include bradycardia secondary to ischemia to the SA and/or AV node, and
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papillary muscle rupture or dysfunction due to the anatomical distance between the RCA and
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the papillary muscle.
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Which of the following hemodynamic profiles would benefit from the aggressive fluid
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administration, pressers and antibiotics therapy?
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a. RAP: 1mm Hg; PAOP: 4 mmHg; SVR: 1800 dynes/sec; CO: 2L/min
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b. RAP: 5; PAOP: 7; SVR: 400; CO; 8L - ANSWER: ➡ B. the hemodynamic profile of RAP 5, PAOP 7,
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SVR 400 is typical of septic shock, and choice B would be the best approach.
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Which of the following is indicative of a mixed acid-base disorder?
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A. pH 7.18; PaCO2 25; PaO2 64; HCO3 11
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,B. pH 7.33; PaCO2 29; PaO2 72; HCO3 15 - ANSWER: ➡ The decrease in PaCO2 is evidence of
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respiratory alkalosis and the decreased HCO3 is evidenced of a metabolic acidosis. The pt with
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severe sepsis or septic shock may present with this mixed acid-base disorder.
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The patient with a temporary pacemaker develops pacemaker malfunction. The oriented is
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instructed to reposition the patient to try and correct the problem. The cardiac monitor most
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likely demonstrates? - ANSWER: ➡ Failure to capture (pacemaker without a QRS) may be
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corrected by repositioning the patient to the side.
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The patient with diastolic heart develops SVT, heart rate 220/min. The most dangerous
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hemodynamic effect is a decrease in: - ANSWER: ➡ coronary artery perfusion.
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Diastolic heart failure results in a problem with left ventricular FILLING secondary to
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ventricular thickening, and contractility and ejection are maintained in diastolic failure. The
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rapid heart rate will decrease filling time, worsen left ventricular filling and because coronary
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artery perfusion occurs during diastole, this arrhythmia may be life-threatening.
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The patient is receiving heparin infusion for the treatment of pulmonary embolism. There has
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been a 60% decrease in the platelet count and no clinical change. Which of the following is
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indicated? - ANSWER: ➡ Discontinue heparin and being argatroban.
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The patient most likely has HIT. Exposure to heparin needs to discontinued and a direct
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thrombin inhibitor started for continued anticoagulation.
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The patient with oat cell carcinoma has the following clinical findings: low urine output, low
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serum osmolality, hyponatremia, and elevated urine sodium. The nurse anticipates which of
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the following as part of the treatment plan? - ANSWER: ➡ Phenytoin (Dilantin), 3% saline.
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The patient has signs of SIADH which results in production of excessive ADH. Dilantin will
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inhibit ADH secretion and 3% saline will increase serum sodium.
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Peep therapy and mechanical ventilation are ordered for the patient with acute respiratory
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failure. Which of the following is a possible complication? - ANSWER: ➡ Barotrauma
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,The addition of positive end-expiratory pressure will increase alveolar recruitment, prevent
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atelectasis and improve oxygenation. However, the increase in intrathoracic pressure may lead
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to pneumothorax or subcutaneous emphysema.
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The postoperative thoracic surgery patient has bubbling in the water seal drainage chamber of
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the chest tube. Which of the following interventions is indicated? - ANSWER: ➡ avoid high
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airway pressures
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Bubbling in the water seal chamber is due to a pleural air leak, and high airway pressure will
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either prevent resolution of the current air leak or make it worse.
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Which clinical sign might patients with both systolic and diastolic heart failure have in
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common? - ANSWER: ➡ Lung crackles
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Both a problem with systolic (ejection problem) and diastolic (filling problem) will increase
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left heart pressure and cause cardiogenic pulmonary edema (lung crackles).
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Which of the following is most likely to result in a low Sv02?
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A. Hypotermia
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B. Fever
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C. Severe sepsis - ANSWER: ➡ Fever
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Fever increases metabolic rate and consumption, which may lead to a drop in mixed venous
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oxygen saturation.
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The nurse needs to assess adequacy of the tubing/catheter system for the arterial line. Which of
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the following interventions will best assess this? - ANSWER: ➡ Perform a square wave test
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, The patient requires fluid resuscitation and 8 units of PRBC's status post traumatic injury.
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Which of the following interventions is most appropriate? - ANSWER: ➡ Warm blood products
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and crystalloids
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Warming fluids and blood needed for traumatic injury will prevent hypothermia and its related
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adverse effects.
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Which of the following therapies should be avoided for the patient with cardiogenic shock? -
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ANSWER: ➡ high dose vasopressors
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Vasopressors increase left ventricular after load, which would increase myocardial work of a t t t t t t t t t t t t
failing heart.
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The patient is status post repair of an aneurysm for subarachnoid hemorrhage. Which of the
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following interventions is indicated to prevent vasospasm? - ANSWER: ➡ Nimodipine
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(Nimotop)
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is a calcium channel blocker that is started immediately post-op to prevent arterial spasm of the
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brain.
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The patient presents with a rigid abdomen, rebound tenderness, and a free air in the
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peritoneum seen on KUB x-ray. Which of the following should the nurse anticipate? - ANSWER:
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➡ Powell perforation; provide fluids, prepare for surgery.
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The clinical signs are those of bowel perforation.
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Which is the priority treatment for the pt with DKA who presents with hyperglycemia, ketosis,
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and normal serum potassium? - ANSWER: ➡ replace potassium
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The patient with DKA will have a low pH and metabolic acidosis. In a state of metabolic acidosis,
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hydrogen ions move into the intracellular space. In exchange, potassium leaves the
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intracellular space. The movement of K into the extracellular space results in hyperkalemia.
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