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AACN CCRN-Adult Dumps

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Total 150 questions

CCRN (Adult) - Direct Care Eligibility Pathway Questions and Answers

Question 1

A patient was admitted 3 days ago for an overdose of acetaminophen (Tylenol). The patient is developing a decreasing level of consciousness. Which the following is the most likely finding?

Options:

A.

Cheyne-Stokes respirations

B.

splenomegaly

C.

decreased GFR

D.

increased INR

Question 2

A patient's blood culture report notes the presence of vancomycin resistant enterococcus. The nurse should place the patient in which type of isolation?

Options:

A.

droplet

B.

airborne

C.

contact

D.

protective

Question 3

Which of the following is the most common prerenal cause of acute tubular necrosis?

Options:

A.

shock

B.

blood transfusion reaction

C.

crush injury

D.

beta-hemolytic streptococcal infection

Question 4

Which of the following diagnostic procedures best pinpoints the location, size, and origin of a cerebral aneurysm?

Options:

A.

MRI

B.

cerebral angiography

C.

positron emission tomography (PET) scanning

D.

CT scanning

Question 5

The purpose of administering a sodium nitroprusside (Nipride) drip after a carotid endarterectomy is to

Options:

A.

promote myocardial contractility and thus enhance cerebral perfusion.

B.

increase coronary perfusion and thus increase cardiac output.

C.

decrease MAP and thus prevent hemorrhage at the operative site.

D.

increase afterload and thus promote vessel patency.

Question 6

A patient has experienced significant brain damage from an anoxic episode and has been unable to be weaned from ventilator support. The patient's spouse expresses ambivalence about stopping the ventilator now that it has been started. Which of the following statements is the nurse's most appropriate response?

Options:

A.

"When the patient no longer responds to treatment, it can be discontinued."

B.

"We can look at the hospital's policies regarding discontinuing therapy."

C.

"Perhaps you should talk with the rest of your family before making any decisions."

D.

"Maybe we shouldn't have been so quick to start the ventilator."

Question 7

A patient with a history of asthma presents with acute onset of dyspnea, a non-productive cough, and tachypnea. He is very anxious, restless, and tachycardic. Which of the following is a first-line drug for these symptoms?

Options:

A.

leukotriene inhibitor

B.

anticholinergic

C.

mast cell stabilizer

D.

beta-agonist

Question 8

An older adult patient is admitted with acute exacerbation of congestive heart failure. An echocardiogram indicates that EF is unchanged at 50%. The patient is most likely experiencing

Options:

A.

heart failure with reduced EF.

B.

heart failure with preserved EF.

C.

left ventricular failure.

D.

advanced heart failure.

Question 9

Which of the following serum laboratory results is most concerning to a nurse who is caring for a patient with a Stage Ill pressure ulcer on the coccyx?

Options:

A.

albumin 2.1 mg/dL

B.

hemoglobin 10.2 mg/dL

C.

WBC 6,000/mm3

D.

glucose 125 mg/dL

Question 10

For a patient with unstable angina, the major goal of treatment is to

Options:

A.

increase afterload.

B.

decrease myocardial contractility.

C.

increase preload.

D.

decrease myocardial O2 consumption.

Question 11

A patient is experiencing lower left quadrant pain with guarding, as well as abdominal distention and rigidity. KUB reveals free air in the abdominal

cavity. Vital signs are:

BP76/40

HR130

RR32

T101.7° F (38.7°C)

A nurse would suspect

Options:

A.

perforated bowel.

B.

paralytic ileus.

C.

appendicitis.

D.

acute pancreatitis.

Question 12

Which of the following signs is most frequently associated with meningitis?

Options:

A.

positive Trousseau's

B.

positive Cullen's

C.

positive Kernig's

D.

positive Babinski's

Question 13

Family members have been complaining about limited visiting hours. To facilitate a potential change in practice, a nurse should first

Options:

A.

schedule an interdisciplinary team meeting to discuss visiting hours.

B.

begin a literature search on family visitation practices.

C.

consult with medical staff to change visiting hours.

D.

draft a new policy regarding visitation practices for the unit.

Question 14

A patient with a sodium level of 114 mEq/L is most likely to develop

Options:

A.

tetany.

B.

flaccid paralysis.

C.

seizures.

D.

cardiac arrhythmias.

Question 15

An unconscious patient in hepatic failure secondary to alcoholism becomes acutely hypoglycemic. Glucagon administration is contraindicated for this patient because glucagon

Options:

A.

interferes with lactulose (Cephulac) therapy.

B.

produces additional sedative effects.

C.

is ineffective when hepatocytes are damaged.

D.

causes rebound hyperglycemia.

Question 16

A patient is admitted for acute benzodiazepine overdose. Nursing interventions should include administration of

Options:

A.

sodium bicarbonate.

B.

flumazenil (Romazicon).

C.

naloxone (Narcan).

D.

osmotic diuretics.

Question 17

A patient presents with fever and chills, is diaphoretic, and reports experiencing abdominal and intermittent left shoulder pain for the past week. An

ultrasound shows an enlarged spleen. Vital signs are:

BP 106/59

HR 118

RR 23

T101.2° F (38.4° C)

When reviewing the lab report, which of the following findings is most significant to this presentation?

Options:

A.

positive blood cultures

B.

PLT 150,000/mm3

C.

WBC less than 500/mm3

D.

Hct 39%

Question 18

A patient who is confused and dyspneic is admitted with ABG values that reveal hypoxemia. Results from insertion of a pulmonary artery catheter are:

PAP 38/18 mm Hg

PAOP10 mm Hg

CI 3.5 L/min/m2

These values are most indicative of

Options:

A.

hypovolemia.

B.

hypervolemia.

C.

pulmonary dysfunction.

D.

left ventricular failure.

Question 19

A patient is 2 days post MI. The patient was stable until this morning, when severe chest discomfort developed. Assessment reveals:

BP70/palpable

HR122

RR38

PAOP28 mm Hg, with large V waves

CI1.6 L/min/m2

Cool, clammy skin

Inspiratory crackles throughout the lung field

Loud blowing holosystolic murmur at the apex

The patient's present clinical status is most likely a result of

Options:

A.

papillary muscle rupture.

B.

cardiac tamponade.

C.

acute aortic insufficiency.

D.

ventricular septal defect.

Question 20

Which of the following suggests acute peripheral arterial insufficiency?

Options:

A.

positive Homans' sign

B.

capillary refill time less than 2 sec

C.

weak equal bilateral pedal pulses

D.

sudden, severe pain at rest

Question 21

A nurse admits a patient awaiting surgery for an unstable pelvic fracture following a fall in which no other injuries were sustained. The nurse should prioritize

Options:

A.

transportation to radiology for an MRI.

B.

type and crossmatch PRBC prior to surgery.

C.

placement of a binder across the patient's hips.

D.

administration of a sedative to reduce movement.

Question 22

A patient underwent bariatric surgery for weight loss 3 days ago. The patient appears anxious, restless, and reports increased abdominal pain over the last 24 hours. The nurse palpates mild subcutaneous crepitus over the neck. Vital signs are:

BP 106/64

HR 128

RR 27

T 100.4° F (38°C)

Which action should the nurse anticipate?

Options:

A.

Obtain labs.

B.

Administer a 1000 mL bolus of normal saline.

C.

Provide broad spectrum antibiotics.

D.

Prepare the patient for surgery.

Question 23

An older adult patient has been in the unit for 60 hours. The patient has received benzodiazepines for agitation, opioids for persistent pain, and bronchodilators. The patient reports that there is too much noise, and they cannot get peace and quiet. The nurse should evaluate for

Options:

A.

sleep disturbances.

B.

an anxiety disorder.

C.

situational depression.

D.

acute manic episodes.

Question 24

A patient underwent a successful percutaneous coronary intervention to the left anterior descending coronary artery. The patient suddenly begins to complain of dyspnea, jaw pain, and chest tightness. The bedside monitor displays sinus tachycardia and ST segment elevation in lead V2. The patient's neck veins are flat and BP is 152/98. Which of the following is the most likely cause of the patient's symptoms?

Options:

A.

pulmonary hypertension

B.

coronary artery occlusion

C.

vasovagal reaction

D.

cardiac tamponade

Question 25

A patient who underwent bowel resection surgery due to small bowel rupture is tachycardic and hypotensive. A nurse calls the on-call surgical resident and reports the findings. No new orders are received. The nurse should continue to monitor the patient and

Options:

A.

notify the charge nurse during nightly rounds.

B.

inform the clinical manager in the morning.

C.

initiate the rapid response team.

D.

consult the nearest nursing colleague.

Question 26

A nurse has responded to a rapid response call on a medical-surgical floor in the hospital. The nurse finds the patient with the following data:

BP72/30

HR132

RR24

T102.3° F (39.0° C)

SpO295%

Ph7.13

PaCO234 mm Hg

PaO288 mm Hg

HCO3 14 mEq/L

Na+ 142 mEq/L

The nurse should anticipate an order to administer which of the following?

Options:

A.

8.4% sodium bicarbonate

B.

phenylephrine (Neo-Synephrine)

C.

0.9% sodium chloride

D.

amiodarone (Cordarone)

Question 27

A patient who recently lost their spouse is admitted following an emergent cardiac catheterization. The procedure report states chest pain and ST elevation, no significant coronary artery disease, left ventricular dysfunction with apical ballooning, and an EF of 35%. These findings are consistent for

Options:

A.

arrhythmogenic right ventricular cardiomyopathy.

B.

non ischemic cardiomyopathy.

C.

hypertrophic cardiomyopathy.

D.

takotsubo cardiomyopathy.

Question 28

A patient who sustained acute head trauma exhibited intermittent unconsciousness prior to admission. The patient is disoriented initially and exhibits rapid deterioration in neurological status shortly after admission. X-rays reveal a right temporal bone fracture, and a diagnosis of epidural hematoma is made. The deterioration in the patient's condition is most likely associated with

Options:

A.

arterial bleeding.

B.

venous bleeding.

C.

clot formation.

D.

intracranial aneurysm.

Question 29

A patient with cardiogenic shock for several days has been managed aggressively with vasopressor and inotrope therapies. Which of the following indicates organ dysfunction from hypoperfusion?

Options:

A.

decreased insulin requirements and abdominal pain

B.

elevated creatinine and fever

C.

abdominal pain and elevated creatinine

D.

fever and decreased insulin requirements

Question 30

Following a splenectomy, a patient is most at risk for

Options:

A.

sepsis.

B.

pulmonary embolism.

C.

hypertension.

D.

wound dehiscence.

Question 31

A patient admitted with a diagnosis of pneumonia has a temperature of 103.2° F (39.5° C) and copious pulmonary secretions. ABG results drawn on room air are:

The nurse should expect that hemoglobin's affinity for oxygen in this patient to be

Options:

A.

unchanged.

B.

unpredictable.

C.

increased.

D.

decreased.

Question 32

A physician tries three times to insert a central line, then says, "I think I can get it this time." A nurse should

Options:

A.

suggest that another physician insert the line.

B.

administer an analgesic.

C.

allow the physician to try again.

D.

start a peripheral line.

Question 33

A patient admits to a nurse that he has struggled with depression and feelings of isolation and abandonment since moving into a nursing home last year,

but he has recently started taking an anti-depressant. The patient states, "Sometimes it takes everything I've got just to go on each day." Which of the

following is the nurse's best initial response?

Options:

A.

"You sound like you've been really unhappy. Have you thought about harming yourself?"

B.

"Those feelings should resolve when the medication you've started has a chance to take effect."

C.

"I understand how you feel. We all get that way when we're depressed."

D.

"Have you talked to anyone about what is bothering you?"

Question 34

A patient with a history of alcohol abuse has been admitted for progressive dyspnea and leg swelling. Assessment findings include:

BP155/90

HR85

CVP12 mm Hg

Which of the following tests will provide the most definitive diagnosis?

Options:

A.

echocardiogram

B.

pro-BNP

C.

chest x-ray

D.

liver function panel

Question 35

Treatment of cerebral vasospasm includes administration of

Options:

A.

lorazepam (Ativan).

B.

propranolol (Inderal).

C.

nimodipine (Nimotop).

D.

pentobarbital (Nembutal).

Question 36

The first priority in management of an acute GI hemorrhage is

Options:

A.

monitoring of serial Hgb and Hct.

B.

fluid resuscitation.

C.

pain relief.

D.

Sengstaken-Blakemore tube insertion.

Question 37

Which of the following is a sign of brain death?

Options:

A.

positive vestibulo-ocular reflex

B.

negative apnea test

C.

positive cough reflex

D.

negative cold caloric test

Question 38

A patient post-surgical externalized ventricular drain placement has treatment orders that include continuous cerebrospinal fluid (CSF) drainage at 10 mm

Hg. Which of the following should the nurse anticipate with an increase in the ICP above 25 mm Hg?

Options:

A.

a decrease in the pulse pressure

B.

a change in CSF drainage from clear to pink

C.

the amplitude of P2 greater than P1 on the waveform morphology

D.

an increase in the cerebral perfusion pressure from 65 to 70

Question 39

A patient lying on the left side in Trendelenburg position is in the correct position for postural drainage of which of the following lobes of the lungs?

Options:

A.

left upper

B.

left lower

C.

right lower

D.

right upper

Question 40

A patient who experienced a blunt chest trauma in an automobile crash is admitted with multiple rib fractures. The patient is dyspneic and hypotensive and is reporting left shoulder pain. On auscultation, a nurse notes that bowel sounds can be heard over the lower left thorax. These findings are consistent with

Options:

A.

ruptured abdominal viscus.

B.

ruptured diaphragm.

C.

flail chest.

D.

mediastinal shift.

Question 41

An unconscious patient presents with the following laboratory values:

Appropriate management of this patient should include

Options:

A.

IV hydration.

B.

hemodialysis.

C.

intubation.

D.

osmotic diuresis.

Question 42

A patient is admitted with anaphylactic shock secondary to a blood transfusion. The patient's spouse asks the nurse to explain how blood can cause a low blood pressure. The nurse responds that with anaphylactic shock the

Options:

A.

heart muscle weakens and is unable to pump effectively.

B.

peripheral blood vessels dilate, and this creates a maldistribution of volume.

C.

kidneys excrete large amounts of urine dropping the blood pressure.

D.

autonomic nervous system is disrupted dropping blood pressure.

Question 43

Appropriate outcomes for a patient with status asthmaticus include

Options:

A.

increased PaCO2 and decreased FEV1.

B.

decreased peak flow rates and decreased wheezing.

C.

paradoxical breathing and increased FEV1.

D.

normal PaCO2 and increased FEV1.

Question 44

A patient's IV with norepinephrine (Levophed) infusing is red, swollen, and the IV pump is alarming. A nurse should anticipate

Options:

A.

administering phentolamine (Regitine).

B.

providing a warm compress.

C.

lowering the extremity below heart level.

D.

removing the IV immediately.

Question 45

A patient reported to have smoked crack cocaine is brought to the hospital by paramedics and admitted in an agitated state. On the way to the hospital, the patient had a generalized seizure. The toxicology screen is positive for cocaine. Which of the following is most appropriate to administer?

Options:

A.

naloxone (Narcan)

B.

ipecac

C.

lorazepam (Ativan)

D.

activated charcoal

Page: 1 / 11
Total 150 questions