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CCRN test bank EXAM with complete solutions 2024_2025
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CCRN test bank EXAM with complete solutions 2024_2025
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CCRN test bank EXAM with completesolutions 2024/2025
Which of the following would be the earliest auscultatory finding in left
ventricular failure (LVF)?
A. Crackles
B. S3
C. Murmur of mitral regurgitation
D. Pericardial friction rub - ANSWER-B. S3
LVF would be the most subtle because early changes are usually subtle changes.
Choose "S3."
A patient with a triple-lumen subclavian catheter has been receiving total
parenteral nutrition, maintenance fluids, and antibiotics by the catheter. He has
been slightly confused. Suddenly he grasps the catheter and pulls it out. He then
complains of shortness of breath, and his pulse oximetry indicates an SpO2 of
84%. How should this patient be positioned?
A. Head down, left side
B. Head down, right side
C. Head of bed elevated, left side
D. Head of bed elevated, right side - ANSWER-A. Head down, left side
Envision a big air bubble in the patient's heart. Think: what position would
decrease the movement of the air embolism out of the right side of the heart.
Chose "Head down, left side."
Oxygen delivery (DO2) is the product of which of the following?
,A.
PaO2, hemoglobin, mean arterial pressure
B.
SaO2, hemoglobin, cardiac output
C.
SvO2, cardiac index, SaO2
D.
PaO2, mean arterial pressure, SvO2 - ANSWER-B. SaO2, hemoglobin, cardiac
output
Oxygen is delivered from the arterial end, so choose an option that has SaO2
Which of the following is the most significant complication of status
asthmaticus?
A.
Pulmonary embolism
B.
Acute respiratory failure
C.
Hypertension
D.
Anaphylaxis - ANSWER-B. Acute respiratory failure
A 22-year-old man is admitted to the critical care unit after a motor vehicle
collision. The emergency department nurse reports that he was unconscious at
the scene of the accident, but he is now alert and oriented. Skull films show a
linear fracture of the right temporal bone. He is at significant risk for:
A.
scalp hematoma.
B.
subdural hematoma.
C.
epidural hematoma.
D.
intracerebral hematoma. - ANSWER-C. epidural hematoma.
,Linear fractures of the temporal bone frequently disrupt the middle meningeal
artery and cause epidural hematoma. Patients with an epidural hematoma
classically present with a short period of unconsciousness followed by a lucid
interval and then rapid deterioration. An epidural hematoma is usually caused by
arterial bleeding.
A patient is admitted to the ICU after sustaining a concussion and blunt
abdominal trauma to the right upper quadrant in a domestic dispute. The patient's
vital signs are BP 145/86 mm Hg, pulse 86 beats/min, respiration 15 breaths/min,
and temperature 98.8° F. The nurse is monitoring the patient's bowel sounds,
abdominal tenderness, and abdominal girth frequently. Which of the following
laboratory parameters is especially important for the nurse to closely monitor for
bleeding in this patient?
A.
Platelet count
B.
Protime
C.
Hematocrit
D.
Mean corpuscular volume - ANSWER-C. Hematocrit
Common injuries resulting from blunt abdominal trauma can include injury to the
liver, spleen, mesenteric vessels, pancreas, or kidneys. In a nonoperative
approach to blunt abdominal trauma, observation and monitoring include serial
hematocrits to evaluate for intra-abdominal bleeding. The platelet count does not
fluctuate unless there is a disease process (e.g. cirrhosis, leukemia) or significant
blood loss. Protime is a monitor of coagulation status and can be prolonged
without active bleeding. Mean corpuscular volume measures the average volume
or size of a single RBC and is used in classifying anemias.
Which of the following is associated with chest pain, confusion, and petechiae?
A.
Dissecting aneurysm
B.
Fat embolism
C.
Pneumothorax
D.
, Myocardial infarction - ANSWER-B. Fat embolism
Chest pain, confusion, and petechiae are suggestive of a fat embolism, especially
within the first 48 to 72 hours after a long-bone fracture.
The clincher is the petechiae. None of the other choices would cause petechiae.
Which type of shock is most likely to be iatrogenic?
A.
Hypovolemic
B.
Cardiogenic
C.
Septic
D.
Neurogenic - ANSWER-C. Septic
Iatrogenic means caused by treatment or diagnostic procedures or medically
induced. Septic shock is the type of shock most likely to be iatrogenic.
Significant contributors include immunosuppressive medications and therapies
and invasive procedures.
A patient had a craniotomy 2 days ago for removal of a tumor. He is awake and
talking to the nurse and demonstrates no neurologic deficit. Blood pressure is
110/80 mm Hg, pulse is 92 beats/min, and respiratory rate is 22 breaths/min. Urine
outputs have been approximately 60 ml/hr over the last 2 days, but he has had a
recent change. He has had 300 to 400 ml/hr of urine output over the last several
hours. The urine has a specific gravity of 1.002. The nurse checks his serum
glucose and finds that it is 100 mg/dl. The cause of hypernatremia in this patient
is:
A.
sodium retention.
B.
water loss.
C.
water gain.
D.
aldosterone excess. - ANSWER-B. water loss
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