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
Answer(s): D
Takotsubo cardiomyopathy, also known as stress-induced cardiomyopathy or "broken heart syndrome," is characterized by transient left ventricular dysfunction often precipitated by significant emotional or physical stress. The key findings of chest pain and ST elevation without significant coronary artery disease, along with left ventricular dysfunction and apical ballooning observed on imaging, are classic for takotsubo cardiomyopathy. This condition is often reversible and is associated with a temporary reduction in the heart's pumping ability, indicated by the reduced ejection fraction (EF) of 35%.
=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
A patient is admitted with a femoral shaft fracture and an oblique fracture of three ribs on the right side. The patient suddenly reports shortness of breath. Assessment reveals new-onset headache, central and peripheral cyanosis, and petechiae of the neck and anterior chest wall. Available data are:The nurse should suspect the development of
The patient's clinical presentation and recent history of femoral shaft and rib fractures are highly suggestive of a fat embolism syndrome (FES). FES typically occurs after long bone fractures and is characterized by sudden onset of respiratory distress, neurological symptoms, and petechial rash, which aligns with the new-onset headache, central and peripheral cyanosis, and petechiae of the neck and anterior chest wall observed in this patient. The fat emboli originate from the bone marrow and enter the bloodstream, traveling to the lungs and other organs, leading to respiratory and systemic symptoms.
=CCRN (Adult) Certification Review Course Online: Pulmonary Embolism and Fat Embolism. 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
Which of the following intubated patients is most at risk for developing ventilator-associated pneumonia (VAP)?
Answer(s): A
Among the options, the 68-year-old patient with COPD and dialysis-dependent renal disease is at the highest risk for developing VAP. This is due to multiple risk factors including advanced age, chronic obstructive pulmonary disease (COPD), which predisposes to poor lung function and clearance of secretions, and the immunocompromised state from dialysis-dependent renal disease. The patient's higher body weight can also contribute to complications in mobility and ventilation management, further increasing the risk of VAP.
=CCRN (Adult) Certification Review Course Online: Infectious Disease and Pulmonary Infections. 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
A patient is admitted with a traumatic brain injury. During assessment, a nurse notes increased urinary output from the catheter. Which of the following should the nurse suspect?
Answer(s): B
brain injury (TBI) is most suggestive of central diabetes insipidus (DI). This condition is caused by damage to the hypothalamus or pituitary gland, leading to insufficient secretion of antidiuretic hormone (ADH). The result is an inability to concentrate urine, leading to polyuria (excessive urine output) and potentially significant dehydration and electrolyte imbalances if not managed appropriately.
=CCRN (Adult) Certification Review Course Online: Neurological Disorders and Endocrine Emergencies.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
A physician tries three times to insert a central line, then says, "I think I can get it this time." A nurse should
When a physician has attempted to insert a central line multiple times without success, the nurse's responsibility includes ensuring patient safety and advocating for the patient. Continued attempts by the same physician may increase the risk of complications, such as infection or trauma. Therefore, the nurse should suggest that another physician, possibly one with more experience or skill in central line insertion, perform the procedure.
AACN Adult CCRN Certification Review Course, AACN CCRN Exam Handbook.
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.