CCRN (Adult) - Direct Care Eligibility Pathway (CCRN-Adult) Free Practice Test

Question 1

The nurse is caring for a trauma patient with a severe head injury and subsequent Traumatic Brain Injury (TBI). The patient currently has a blood pressure of 143/75, a mean arterial pressure of 98 and an Intracranial Pressure (ICP) measurement of 29 mm Hg, monitored via an intraventricular catheter.
What is the patient's Cerebral Perfusion Pressure (CPP)?

A. 69 mm Hg

B. 127 mm Hg

C. 114 mm Hg

D. 45 mm Hg

Correct Answer: A

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Question 2

Which of the following is the MOST important reason for treating ventilator-associated pneumonia (VAP) in the critical care setting?

A. It increases the risk that other critically ill patients will develop pneumonias

B. It is not reimbursed by Medicare or Medicaid

C. It increases morbidity and mortality

D. It increases length of stay and hospital costs

Correct Answer: C

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Question 3

Which of the following is the federal law that requires healthcare institutions receiving Medicare or Medicaid funds to inform patients of their legal rights to make healthcare decisions and execute advance directives?

A. National Mental Health Act (NMHA)

B. Mental Health Systems Act (MHSA)

C. Patient Safety and Quality Improvement Act (PSQIA)

D. The Patient Self Determination Act (PSDA)

Correct Answer: D

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Question 4

Which of the following is LEAST LIKELY to be caused by blunt chest trauma?

A. Aortic disruption

B. Beck's triad

C. Flail chest

D. Cushing's triad

Correct Answer: D

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Question 5

Analyze and interpret the ABG results:
* pH: 7.50
* PaCO2: 44 mmHg
* HCO3: 33 mEq/L

A. Normal ABG

B. Partially compensated respiratory alkalosis

C. Acute (uncompensated) metabolic alkalosis

D. Fully compensated metabolic acidosis

Correct Answer: C

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Question 6

The critical care nurse is caring for a patient with MODS who is not expected to survive and will likely never be a candidate for ventilatory weening. The patient's wife, however, does not want care to be withdrawn, stating that she would like everything possible done to save him. The patient is unable to express his wishes and does not have an advanced directive. Which of the following statements made by the nurse to the patient's wife is most appropriate?

A. We will do everything we can, but don't be surprised if he doesn't make it.

B. Withdrawing care is the best option for your husband at this point.

C. As long as he is alive, there is still hope that he could pull through this.

D. You are causing him distress and prolonging his death by not discontinuing care.

Correct Answer: B

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Question 7

Which of the following is MOST LIKELY to cause idiopathic pulmonary fibrosis?

A. Occupational exposure to pulmonary irritants

B. Connective tissue disorders

C. Chemotherapeutic agents

D. Familial factors

Correct Answer: D

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Question 8

Which of the following statements made about aortic dissection by a student nurse requires correction by the critical care nurse?

A. "Aortic dissection can decrease hemoglobin and hematocrit."

B. "Aortic dissection is not life-threatening if it does not rupture."

C. "Aortic dissection occurs when the inner wall of the aorta is disrupted."

D. "Aortic dissection can cause dyspnea or extremity weakness."

Correct Answer: B

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Question 9

The nurse is caring for a patient with irreversible Multiple Organ Dysfunction Syndrome (MODS).
According to the updated international sepsis care guidelines, the nurse should request a palliative care consult as early as possible, but no later than within:

A. 72 hours of ICU admission

B. 12 hours of ICU admission

C. 24 hours of ICU admission

D. 96 hours of ICU admission

Correct Answer: A

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Question 10

A patient with a past diagnosis of schizoaffective disorder is admitted to the critical care unit with diabetes insipidus. As the admission nurse, priorities would include all of the following EXCEPT:

A. review all preadmission medications

B. ask the patient if he knows why he is in the hospital

C. hold all psychiatric medications until the patient's blood glucose is under control

D. contact the patient's psychiatrist with permission from the patient or the patient's guardian

Correct Answer: C

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Question 11

A critical care nurse is caring for a patient with diabetic ketoacidosis (DKA). Which of the following interventions performed in the care of this patient is an example of systems thinking, a core nurse competency as defined in the Synergy Model for Patient Care?

A. Developing a better method of ensuring that blood glucose monitors on the unit are always charged

B. Collaborating with a dietitian to ensure the patient has meals that meet with his preferences while also being healthy

C. Teaching the patient how and when to access the healthcare system in the future

D. Recognizing that the patient has an unmet need for potassium level monitoring

Correct Answer: A

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Question 12

A 69-year-old female presented to the emergency department with diaphoresis and severe dyspne a. A pulse oximeter revealed 85% oxygen saturation. Oxygen at 4 L/min was started via nasal cannula, and an ECG was performed and showed left ventricular hypertrophy and a Left Bundle Branch Block (LBBB). Her chest x-ray showed an enlarged cardiac silhouette and bilateral infiltrates. The nurse secured IV access, and the patient was started on a dobutamine drip and given IV furosemide.
The PRIMARY purpose of starting the dobutamine infusion and administering the furosemide is to:

A. increase myocardial contractility and reduce ventricular afterload

B. increase myocardial contractility and increase ventricular afterload

C. increase myocardial contractility and reduce ventricular preload

D. reduce myocardial contractility and increase ventricular preload

Correct Answer: C

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Question 13

Which of the following is the primary carrier of oxygen to body tissues?

A. Hematocrit

B. White blood cells

C. Hemoglobin

D. Red blood cells

Correct Answer: C

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Question 14

A normal Ejection Fraction (EF) is usually over:

A. 80%

B. 50%

C. 70%

D. 60%

Correct Answer: D

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Question 15

The nurse is instructing a student in how to recognize shock. Which of the following statements by the student indicates understanding?

A. Hypotension will occur in all but one type of shock.

B. Lactic acid levels are better indicators of shock than hypotension.

C. Hypotension in shock should always initially be treated by administering IV boluses.

D. Hypotension is a concern once the MAP is less than 55 mm Hg.

Correct Answer: B

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AACN CCRN (Adult) - Direct Care Eligibility Pathway (CCRN-Adult) Free Practice Test