A patient is admitted for acute benzodiazepine overdose. Nursing interventions should include administration of
Answer(s): B
Flumazenil is a benzodiazepine antagonist that can reverse the effects of benzodiazepine overdose. It acts by competitively inhibiting the activity at the benzodiazepine receptor, thus reversing sedation and other effects caused by benzodiazepines. Sodium bicarbonate, naloxone, and osmotic diuretics are not appropriate treatments for benzodiazepine overdose.
AACN Adult CCRN Certification Review Course, AACN CCRN Exam Handbook.
A patient who sustained a C4 fracture requests to be taken off the ventilator 3 days after the initial injury, indicating, "I can't live hooked to this machine." The nurse's best response to this patient would be,
Answer(s): A
The best response is to assess the patient's feelings and understanding of their condition and prognosis. This response opens a dialogue and allows the nurse to provide education and emotional support based on the patient's specific concerns. Other responses may provide false reassurance or imply assumptions about the patient's future without first understanding their current emotional state and concerns.
Which of the following assessment findings would be found in a patient with pulmonary hypertension?
Answer(s): D
Pulmonary hypertension leads to increased pressure in the pulmonary circulation, which can cause right ventricular hypertrophy and failure. This results in systemic venous congestion, presenting as distended neck veins. Crackles, rhonchi, and pink frothy sputum are more indicative of pulmonary edema or other respiratory conditions rather than pulmonary hypertension.
Assessment of a patient admitted with excruciating back pain reveals:Appropriate therapy should include
The patient's vital signs indicate hypertensive urgency or emergency (BP 190/100, HR 126), with a differential radial pulse, suggesting aortic dissection. Nitroprusside is a potent vasodilator used in the management of hypertensive crises and can help reduce blood pressure and the shear force on the aortic wall, which is crucial in managing aortic dissection. Nitroglycerin, diltiazem, and digoxin are not appropriate first-line therapies for this condition.
A caloric irrigation test of the oculovestibular reflex is performed on a patient who is comatose following a hypoxic brain injury. When cold water is introduced into the left ear, nystagmus occurs with slow deviation of the eyes toward the left, followed by faster eye deviation to the right. This pattern is indicative of a
Answer(s): C
The caloric irrigation test, also known as the oculovestibular reflex test, is used to assess brainstem function in patients, especially those who are comatose. In this test, cold water is introduced into the ear canal, which should induce a predictable response if the brainstem is intact. The normal response to cold water irrigation is nystagmus with slow deviation of the eyes toward the side of the cold water (in this case, the left) and a fast phase of eye movement (nystagmus) away from the side of the cold water (to the right). This indicates that the brainstem pathways are functioning properly.
=American Association of Critical-Care Nurses (AACN). (2024). CCRN Exam Handbook. Retrieved from AACN CCRN Exam HandbookAdult CCRN/CCRN-E/CCRN-K Certification Review Course Online. AACN
Post your Comments and Discuss AACN CCRN exam prep with other Community members:
Our website is free, but we have to fight against AI bots and content theft. We're sorry for the inconvenience caused by these security measures. You can access the rest of the CCRN content, but please register or login to continue.