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CCRN ADULT 58 AACN EXAM QUESTIONS AND ANSWERS(LATEST UPDATE 2022/2023)(A+ GRADING TEST)
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CCRN ADULT 58 AACN EXAM QUESTIONS AND ANSWERS(LATEST UPDATE 2022/2023)(A+ GRADING TEST)
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PASS CCRN 58 Exam Questions And100% Answers
Which vessel is used as a graft when the minimally invasive direct coronary artery
bypass grafting (MIDCABG) procedure is performed? Answer: The internal thoracic
(also called the internal mammary) artery is used for a MIDCABG.
Which drug has Class II and Class III properties? Answer: Sotalol has both Class II (i.e.,
β blockade) and Class III (i.e., potassium blockade) effects.
Which of the following is a diagnostic finding in hypovolemic shock caused by severe
diarrhea? Answer: The patient lost fluid, so the hematocrit would be increased because
the blood is hemoconcentrated. If the patient had lost blood, the hematocrit would be
decreased.
Platelet-activating factor, development of microclots, and activation of the fibrinolytic
system in septic shock set the stage for which of the following? Answer: DIC is initiated
by massive tissue and/or endothelial injury. Microclots develop that may cause ischemia
distal to the clots and may deplete clotting factors. These clots trigger the fibrinolytic
system, causing development of fibrin split products, which have their own
anticoagulant effect. Thus stable clots are broken down, and there is an inability to form
stable clots.
A 75-year-old woman is admitted with pneumonia. She is started on enteral feedings.
Over the last several hours, her urine output has been increasing. Which laboratory test
is most important at this time? Answer: SERUM GLUCOSE
An older patient with infection receiving high-glucose enteral feedings is at risk of
developing glucose intolerance and hyperglycemic hyperosmolar state (HHS). Close
monitoring of serum glucose and appropriate insulin administration by sliding scale will
prevent the development of HHS and the life-threatening dehydration that occurs.
A patient with severe hypertension most likely would have which of the following?
Answer: An S4 is associated with ventricular noncompliance. A patient with severe
hypertension would develop ventricular hypertrophy, which makes the ventricle
noncompliant.
Which is a normal oxygen consumption index (VO2I)? Answer: Approximately 150
ml/min/m2
Normal arterial oxygen saturation is 100%, and normal venous oxygen saturation is
75%. The tissues used 25%. The normal arterial oxygen content is 20 ml/dl, and normal
venous oxygen content is 15 ml/dl. The tissues used 25%. The normal oxygen delivery
(DO2) is 1000 ml/min, and normal VO2 is 250 ml/min. The tissues used 25%. The
normal DO2I is 600 ml/min/m2, so consider what is 25% of 600 ml/min/m2? The normal
VO2I is 150 ml/min/m2
, A 16-year-old girl with a history of type 1 diabetes mellitus (DM) is admitted to the
critical care unit. Her friend states that she has had a cold for the last few days. She is
now lethargic. Diabetic ketoacidosis causes dehydration by: Answer: glucose causing
an osmotic diuresis.
Remember that osmolality and osmotic pull are increased by the addition of solutes
such as sodium or glucose. The high serum glucose in diabetic ketoacidosis causes an
increase in osmotic pull in the renal tubules and an osmotic diuresis.
Which of the following statements is true regarding the use of patient-controlled
analgesia (PCA) in surgical patients? Answer: USE LESS MEDICATION
Patients who can control their own medication use less medication. Because the patient
is encouraged to take the drug at the onset of pain, less drug is required to control the
pain. PCA also combats patients' feelings of powerlessness because they are in control
of their analgesic use (within drug dosage limits).
According to the volume-pressure curve, initial small increases in intracranial volume in
a patient with no brain pathology would have which of the following effects on
intracranial pressure (ICP)? Answer: NO EFFECT
The brain is normally compliant and small increases in intracranial volume have no
effect on ICP. However, when the brain is injured and noncompliant, increases in
volume result in increases in pressure. As the end of the volume pressure-curve is
approached, even small increases in volume result in profound increase in ICP and
resultant herniation.
Which of the following type of drug would be prescribed after a myocardial infarction
(MI) to aid in prevention of remodeling? Answer: Angiotensin-converting enzyme (ACE)
inhibitors
In anterior MI, large inferior MI, or MI with heart failure, ACE inhibitors are indicated to
block the renin-angiotensin-aldosterone (RAA) system stimulated by renal
hypoperfusion. The RAA would cause retention of sodium and water leading to
ventricular dilation. When the ventricle heals after MI, it would heal in this dilated (i.e.,
spherical) shape.
Which vessel is used as a graft when the minimally invasive direct coronary artery
bypass grafting (MIDCABG) procedure is performed? Answer: The internal thoracic
(also called the internal mammary) artery is used for a MIDCABG.
A 64-year-old man is admitted for suspicion of stroke. To assess for muscle weakness,
the nurse asks the patient to hold his arms out in front of him. One arm drifts slightly
downward. This assessment finding is referred to as: Answer: PRONTOR DRIFT
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