Cisco®
CompTIA
Checkpoint
ISC
EC-Council
EXIN
Fortinet
ITIL®
Juniper
Microsoft
VMware
Avaya
SAP
Google
Salesforce
Amazon
Palo Alto Networks
ISC2
All Vendors
  2. Home
  3. Exams
  4. AACN
  5. CCRN

Free AACN CCRN Exam Questions (page: 3)

Page 3 of 20
PDF with 150 Questions

A patient who is confused and dyspneic is admitted with ABG values that reveal hypoxemi

  1. Results from insertion of a pulmonary artery catheter are:
    PAP 38/18 mm Hg
    PAOP 10 mm Hg
    CI 3.5 L/min/m2
    These values are most indicative of
  2. hypovolemia.
  3. hypervolemia.
  4. pulmonary dysfunction.
  5. left ventricular failure.

Answer(s): C

Explanation:

The patient's ABG values show hypoxemia, which is a low level of oxygen in the blood. This can be caused by various pulmonary disorders that impair gas exchange, such as pneumonia, pulmonary edema, pulmonary embolism, or acute respiratory distress syndrome (ARDS). The patient's PAP (pulmonary artery pressure) is elevated, indicating increased resistance in the pulmonary circulation. This can also result from pulmonary dysfunction, as the lungs become stiff and inflamed, or from pulmonary hypertension, which is a chronic condition that affects the small arteries in the lungs. The patient's PAOP (pulmonary artery occlusion pressure) is normal, suggesting that the left ventricle is not failing and that the patient is not hypovolemic or hypervolemic. The patient's CI (cardiac index) is also normal, indicating adequate cardiac output. Therefore, the most likely cause of the patient's hypoxemia and dyspnea is pulmonary dysfunction.


Reference:

AACN. (2023). CCRN (Adult) Exam Handbook. Retrieved from [CCRN Exam Handbook], p. 18. AACN. (2023). CCRN (Adult) Exam Blueprint. Retrieved from [CCRN Exam Blueprint], p. 2.



A patient with end-stage COPD who has failed multiple mechanical ventilation weaning trials communicates a desire to discontinue mechanical ventilation and be extubated.
Which of the following is a nurse's best response?

  1. Advocate with the care team for a withdrawal of treatment plan.
  2. Encourage the patient to continue with current medications and attempts to wean.
  3. Explore the patient's reasons for the request and understanding of potential consequences.
  4. Refer the patient's request to the healthcare facility's ethics committee for review.

Answer(s): C

Explanation:

The nurse's best response is to explore the patient's reasons for the request and understanding of potential consequences, as this demonstrates respect for the patient's autonomy and dignity, as well as provides an opportunity to assess the patient's decision-making capacity, goals of care, and preferences for end-of-life care. The nurse should also provide emotional support, education, and symptom management to the patient and family. Advocating with the care team for a withdrawal of treatment plan, encouraging the patient to continue with current medications and attempts to wean, or referring the patient's request to the healthcare facility's ethics committee for review are not appropriate responses, as they may undermine the patient's right to self-determination, impose the nurse's own values or beliefs, or delay the implementation of the patient's wishes.


Reference:

AACN. (2023). CCRN (Adult) Exam Handbook. Retrieved from [CCRN Exam Handbook], p. 19. AACN. (2023). CCRN (Adult) Exam Blueprint. Retrieved from [CCRN Exam Blueprint], p. 2. AACN. (2020). Practice Recommendations for End-of-Life Care in the Intensive Care Unit. Retrieved from [Practice Recommendations], p. 14-15.
NICE. (2019). End of life care for adults: service delivery. Retrieved from [NICE Guidance], p. 4.



A patient has gained 8 kg in the past week. Serum sodium is 115 mEq/L, CVP is 20 mm Hg, and serum osmolality is decreased. The patient has just experienced a generalized tonic-clonic seizure. In this situation, which of the following IV solutions should a nurse be prepared to administer?

  1. 3% sodium chloride
  2. 0.45% sodium chloride
  3. 0.9% sodium chloride
  4. 5% dextrose with 0.25% sodium chloride

Answer(s): A

Explanation:

The patient has signs of severe hyponatremia, which is a low level of sodium in the blood. Hyponatremia can cause cerebral edema, which can lead to seizures, confusion, coma, and death. The patient needs a hypertonic solution, which is a fluid that has a higher concentration of solutes than the blood, to draw water out of the brain cells and restore the normal sodium level. 3% sodium chloride is a hypertonic solution that can be used to treat severe hyponatremia. 0.45% sodium chloride, 0.9% sodium chloride, and 5% dextrose with 0.25% sodium chloride are all hypotonic solutions, which are fluids that have a lower concentration of solutes than the blood, and would worsen the patient's condition by adding more water to the blood and the brain.


Reference:

AACN. (2023). CCRN (Adult) Exam Handbook. Retrieved from [CCRN Exam Handbook], p. 18. AACN. (2023). CCRN (Adult) Exam Blueprint. Retrieved from [CCRN Exam Blueprint], p. 2. AACN. (2020). Practice Alert: Hyponatremia. Retrieved from [Practice Alert], p. 1-2. Lewis, S. L., Bucher, L., Heitkemper, M. M., Harding, M. M., Kwong, J., & Roberts, D. (2017). Medical- surgical nursing: Assessment and management of clinical problems (11th ed.). St. Louis, MO: Elsevier.
Retrieved from [Textbook], p. 303-304.



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

  1. ruptured abdominal viscus.
  2. ruptured diaphragm.
  3. flail chest.
  4. mediastinal shift.

Answer(s): B

Explanation:

The patient's findings are consistent with a ruptured diaphragm, which is a tear in the muscle that separates the chest and abdominal cavities. A blunt chest trauma can cause a sudden increase in intra-abdominal pressure, which can rupture the diaphragm and allow abdominal organs to herniate into the thorax. This can cause dyspnea, hypotension, shoulder pain, and bowel sounds over the lower thorax. A ruptured abdominal viscus would cause peritonitis, which would present with abdominal pain, distension, fever, and signs of sepsis. A flail chest would cause paradoxical chest movement, respiratory distress, and cyanosis. A mediastinal shift would cause tracheal deviation, decreased breath sounds, and jugular venous distension.


Reference:

AACN. (2023). CCRN (Adult) Exam Handbook. Retrieved from [CCRN Exam Handbook], p. 18.

AACN. (2023). CCRN (Adult) Exam Blueprint. Retrieved from [CCRN Exam Blueprint], p. 2. BCEN. (2020). Trauma Certified Registered Nurse (TCRN) Examination Content Outline. Retrieved from [TCRN Exam Content Outline], p. 8.
Lewis, S. L., Bucher, L., Heitkemper, M. M., Harding, M. M., Kwong, J., & Roberts, D. (2017). Medical- surgical nursing: Assessment and management of clinical problems (11th ed.). St. Louis, MO: Elsevier.
Retrieved from [Textbook], p. 1789-1790.



The goal of PEEP therapy in acute lung injury (ALI) is to

  1. decrease PAP.
  2. decrease airway resistance.
  3. increase cardiac output.
  4. reduce physiologic shunting.

Answer(s): D

Explanation:

The goal of PEEP therapy in acute lung injury (ALI) is to reduce physiologic shunting, which is the perfusion of blood through unventilated or collapsed alveoli. This results in hypoxemia and impaired gas exchange. PEEP therapy increases the end-expiratory pressure and prevents alveolar collapse, thus improving ventilation and oxygenation. PEEP therapy does not necessarily decrease PAP (pulmonary artery pressure), decrease airway resistance, or increase cardiac output. In fact, PEEP therapy may have adverse effects on these parameters, such as increasing intrathoracic pressure, reducing venous return, and decreasing cardiac output.


Reference:

AACN. (2023). CCRN (Adult) Exam Handbook. Retrieved from [CCRN Exam Handbook], p. 18. AACN. (2023). CCRN (Adult) Exam Blueprint. Retrieved from [CCRN Exam Blueprint], p. 2. AACN. (2020). Practice Alert: Acute Lung Injury/Acute Respiratory Distress Syndrome. Retrieved from [Practice Alert], p. 1-2.
Lewis, S. L., Bucher, L., Heitkemper, M. M., Harding, M. M., Kwong, J., & Roberts, D. (2017). Medical- surgical nursing: Assessment and management of clinical problems (11th ed.). St. Louis, MO: Elsevier.
Retrieved from [Textbook], p. 1908-1910.



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

  1. droplet
  2. airborne
  3. contact
  4. protective

Answer(s): C

Explanation:

The nurse should place the patient in contact isolation, which is a type of precaution used to prevent the transmission of microorganisms that are spread by direct or indirect contact with the patient or the patient's environment. Contact isolation requires the use of gloves and gowns when entering the patient's room, as well as dedicated patient-care equipment and proper hand hygiene. Vancomycin resistant enterococcus (VRE) is a type of bacteria that is resistant to the antibiotic vancomycin and can cause infections in various sites, such as the urinary tract, bloodstream, or wounds. VRE can be spread by contact with contaminated surfaces, equipment, or hands.


Reference:

AACN. (2023). CCRN (Adult) Exam Handbook. Retrieved from [CCRN Exam Handbook], p. 18. AACN. (2023). CCRN (Adult) Exam Blueprint. Retrieved from [CCRN Exam Blueprint], p. 2. CDC. (2019). Guidelines for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings. Retrieved from [CDC Guidelines], p. 69-70. CDC. (2019). Vancomycin-resistant Enterococci (VRE) and the Clinical Laboratory. Retrieved from [CDC Fact Sheet], p. 1-2.



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:

-BP
-HR 132
-RR 24
-T 102.3° F (39.0° C)
-SpO2 95%
-Ph 7.13
-PaCO2 34 mm Hg
-PaO2 88 mm Hg
-HCO3 14 mEq/L
-Na+ 142 mEq/L

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

  1. 8.4% sodium bicarbonate
  2. phenylephrine (Neo-Synephrine)
  3. 0.9% sodium chloride
  4. amiodarone (Cordarone)

Answer(s): B

Explanation:

The patient's data indicate that the patient is in shock, which is a life-threatening condition characterized by inadequate tissue perfusion and organ dysfunction. The patient has a low blood pressure, a high heart rate, a fever, and a metabolic acidosis, which suggest that the patient may have septic shock, which is caused by a severe infection that triggers a systemic inflammatory response. The nurse should anticipate an order to administer phenylephrine (Neo-Synephrine), which is a vasopressor agent that constricts the blood vessels and increases the blood pressure and tissue perfusion. Phenylephrine is recommended as a first-line agent for septic shock by the Surviving Sepsis Campaign guidelines.
8.4% sodium bicarbonate is not indicated for the treatment of septic shock, as it may worsen the acid-base balance and increase the risk of complications.
0.9% sodium chloride is a normal saline solution that may be used for fluid resuscitation, but it may not be sufficient to restore the blood pressure and may cause fluid overload, hyperchloremia, and kidney injury.
Amiodarone (Cordarone) is an antiarrhythmic drug that is used to treat ventricular tachycardia or fibrillation, but it is not effective for septic shock and may cause hypotension, bradycardia, and other adverse effects.


Reference:

Surviving Sepsis Campaign. (2020). Surviving Sepsis Campaign: Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (COVID-19). Retrieved from 1, p. 16. Marik, P. E., & Bellomo, R. (2013). A rational approach to fluid therapy in sepsis. British Journal of Anaesthesia, 110(3), 323-329. Retrieved from 2, p. 327. Semler, M. W., & Rice, T. W. (2019). Saline versus balanced crystalloids for intravenous fluid therapy in the emergency department: study protocol for a cluster-randomized, multiple-crossover trial.
Trials, 20(1), 1-10. Retrieved from 3, p. 2-3.
Lexicomp Online. (2021). Amiodarone. Retrieved from 4, p. 1-2.



Which of the following is most indicative of successful treatment for salicylate poisoning?

  1. osmotic diuresis
  2. decrease in gastric pH
  3. decrease in CPK
  4. alkalinization of urine

Answer(s): D

Explanation:



Alkalinization of urine is one of the main goals of treatment for salicylate poisoning, as it enhances the renal excretion of salicylate and reduces its reabsorption. Alkalinization of urine can be achieved by administering intravenous sodium bicarbonate and maintaining adequate hydration and urine output. Alkalinization of urine can be monitored by measuring the urine pH, which should be above 7.5. Osmotic diuresis, decrease in gastric pH, and decrease in CPK are not indicative of successful treatment for salicylate poisoning. Osmotic diuresis may occur as a result of salicylate toxicity, but it does not improve the elimination of salicylate. Decrease in gastric pH may impair the absorption of salicylate, but it does not affect the elimination of salicylate. Decrease in CPK may reflect the resolution of rhabdomyolysis, which is a possible complication of salicylate poisoning, but it does not reflect the clearance of salicylate.


Reference:

Salicylate (aspirin) poisoning: Management - UpToDate1, p. 1-2. Salicylate poisoning - Symptoms, diagnosis and treatment | BMJ Best Practice US2, p. 4-5.



Viewing page 3 of 20
Viewing questions 17 - 24 out of 150 questions



Post your Comments and Discuss AACN CCRN exam prep with other Community members:

CCRN Exam Discussions & Posts