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CCRN CRITICAL CARE REGISTERED NURSE LATEST EXAM TEST BANK NEWEST 2024 COMPLETE QUESTIONS AND ANSWERS

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CCRN CRITICAL CARE REGISTERED NURSE LATEST EXAM TEST BANK NEWEST 2024 COMPLETE QUESTIONS AND ANSWERS

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  • June 16, 2024
  • 55
  • 2023/2024
  • Exam (elaborations)
  • Questions & answers

Subjects

  • ccrn critical care
  • ccrn critical care registered nurse latest exam
  • ccrn critical care registered nurse

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  • CCRN CRITICAL CARE
  • CCRN CRITICAL CARE

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CCRN CRITICAL CARE REGISTERED NURSE
LATEST EXAM TEST BANK NEWEST 2024
COMPLETE QUESTIONS AND ANSWERS

What is the first thing assessed if a patient has a suspected
TBI?
Level of consciousness
What are the 5 levels of LOC and what are the characteristics
of each one?
1. Alert = Awake and easily aroused
2. Lethargic = Drowsy, drifts asleep when not stimulated.
3. Obtunded = Sleeps most times, difficult to arouse, stimulated
with loud noise, shaking, or non-painful touch
4. Stuporous = Need persistent/continuous loud noise or pain for
arousal; responds to stimuli
5. Comatose = No response to any stimulation
What is hyperarousal in LOC?
An agitated/delusional state
What is noxious stimulation and what are 4 examples?
Painful stimulation
1. Sternal rub = rubbing fist on its sternum
2. Supraorbital = putting pressure above its eyes
3. Trapezius pinch = pinch btw neck and shoulders
4. Mandibular pressure = pushing at the angle of jaw
What are the 4 H's that negate/invalidate the neuro exam?
1. Hypotension
2. Hypoxia
3. Hypoglycemia
4. Hypothermia
What is the Glasgow Coma Scale (GCS) used for?
To assess patients with altered levels of consciousness
What are the 3 things assessed for in the GCS? What are the
ranges for mild, moderate, and severe?

,3 things = eyes, verbal, and motor function
1. Mild = 13-15
2. Moderate = 9-12
3. Severe = <8
When assessing a pts motor functioning in a neuro
assessment what are the 5 things that are looked at?
1. Noxious stimulation
2. Strenght (scale 1-5)
3. Lateral comparison
4. Withdrawal & Localization
5. Posturing
What is posturing in a motor assessment?
Motor responses of upper extremities and how they respond to
painful stimuli
What are the 4 types of posturing in a motor assessment?
1. Localization = moving extremities towards the stimulation
2. Decorticate = abnormal flexion, arm curled and flexed
3. Decerebrate = abnormal extension, arm extended & straight
(internal rotation of shoulder)
4. No response to stimuli
What is the difference between contralateral and ipsilateral
affect?
Contralateral = Responses that affect the opposite side of the
brain: motor
Ipsilateral = Responses that affect the same side of the brain:
pupils
What 3 things are looked at about the eyes/pupils in an neuro
assessment?
1. Size
2. Reaction
3. Equality
What are the 2 best assessment indicators of neurologic
status?
#1 = LOC
#2 = Eyes/pupils

,What is the Doll's eyes assessment test and which cranial
nerve is this?
Turning head & looking for motor movements of eyes. Used for
ruling out brain death
Cranial nerve 3: occulomotor reflex
What is the normal & abnormal findings of a Doll's eye
assessment?
Normal = eyes move when head turned & brain stem is intact
(positive finding)
Abnormal = eyes stay fixated when head turned & need to
continue brain death assessment (negative finding)
What does Cushing's triad indicate? What are 3 effects on
the vital signs?
Late sign of increased ICP on brain stem
1. Increased systolic BP
2. Decreased HR
3. Decreased RR
What are 4 common physical assessment findings that rule
out brain death?
1. Gag reflex
2. Breathing over vent
3. Opening eyes
4. Responding to stimuli
What is a TCD and what is it used for?
Transcranial Doppler
Evaluation of cerebral blood flow with ultrasound
What is the caloric test and what are the normal/abnormal
responses?
Ice water is put in a syringe and irrigated into ear, a form of
painful stimuli
Normal response = jerking eye movement (nystagmus) on same
side of stimuli
Abnormal response = jerking eye movement on opposite side of
stimuli or no movement
What is the apnea test and how does it work?

, Test to see if they have a respiratory response
1. Pt has normal CO2 levels
2. Pre-oxygenate with 100% O2 for 10 mins
3. Disconnect vent, continue O2
4. Observe for respirations
5. After 10 mins, draw ABG, & connect vent
What are the parameters for passing and failing the apnea
test?
Pass: if pt initiate own breathe
Fail: doesn't initiate own breathe (apneic)
and CO2 >60 (supports brain death)
What is ICP?
Intracranial pressure: how much internal pressure is being
generated by the brain, blood, and cerebral spinal fluid (CSF) that
exert pressure on the skull bones
What are the 3 things maintain the balance of the ICP?
1. Brain (80%)
2. CSF (10%)
3. Blood (10%)
What is the normal range of ICP and what is the treatment
threshold?
Normal range = 0-15mmHg
Treatment threshold = >22mmHg
What is CPP and how is it calculated?
Cerebral Perfusion Pressure = O2 delivery to the brain
Calculation: MAP-ICP=CPP
What is the normal range of CPP?
60-70
What is CBF? Following a TBI blood flow decreased by 50%
in ____ & _____
CBF = Cerebral blood flow
1. 1st 24 hours
2. Week 2 following injury
What is auto regulation in a TBI?

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