CCRN test bank questions with correct answers

CCRN test bank questions with correct
answers

Which of the following would be the earliest auscultatory finding in left ventricular failure
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(LVF)?
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A. Crackles t




B. S3 t




C. Murmur of mitral regurgitation
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D. Pericardial friction rub - ANSWER: ➡ B. S3
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LVF would be the most subtle because early changes are usually subtle changes. Choose "S3."
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A patient with a triple-lumen subclavian catheter has been receiving total parenteral nutrition,
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maintenance fluids, and antibiotics by the catheter. He has been slightly confused. Suddenly he
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grasps the catheter and pulls it out. He then complains of shortness of breath, and his pulse
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oximetry indicates an SpO2 of 84%. How should this patient be positioned?
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A. Head down, left side
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t B. Head down, right side
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t C. Head of bed elevated, left side
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t D. Head of bed elevated, right side - ANSWER: ➡ A. Head down, left side
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Envision a big air bubble in the patient's heart. Think: what position would decrease the
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movement of the air embolism out of the right side of the heart. Chose "Head down, left side."
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Oxygen delivery (DO2) is the product of which of the following?
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,A.
PaO2, hemoglobin, mean arterial pressure
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t B.
SaO2, hemoglobin, cardiac output
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t C.
SvO2, cardiac index, SaO2
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t D.

PaO2, mean arterial pressure, SvO2 - ANSWER: ➡ B. SaO2, hemoglobin, cardiac output
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Oxygen is delivered from the arterial end, so choose an option that has SaO2
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Which of the following is the most significant complication of status asthmaticus?
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A.
Pulmonary embolism t




t B.
Acute respiratory failure
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t C.
Hypertension
t D.

Anaphylaxis - ANSWER: ➡ B. Acute respiratory failure t t tt t t t t




A 22-year-old man is admitted to the critical care unit after a motor vehicle collision. The
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emergency department nurse reports that he was unconscious at the scene of the accident, but
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he is now alert and oriented. Skull films show a linear fracture of the right temporal bone. He is at
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significant risk for:
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A.

,scalp hematoma. t




t B.
subdural hematoma. t




t C.
epidural hematoma. t




t D.

intracerebral hematoma. - ANSWER: ➡ C. epidural hematoma. t t t tt t t t




Linear fractures of the temporal bone frequently disrupt the middle meningeal artery and
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cause epidural hematoma. Patients with an epidural hematoma classically present with a short
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period of unconsciousness followed by a lucid interval and then rapid deterioration. An
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epidural hematoma is usually caused by arterial bleeding.
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A patient is admitted to the ICU after sustaining a concussion and blunt abdominal trauma to the
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right upper quadrant in a domestic dispute. The patient's vital signs are BP 145/86 mm Hg,
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pulse 86 beats/min, respiration 15 breaths/min, and temperature 98.8° F. The nurse is
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monitoring the patient's bowel sounds, abdominal tenderness, and abdominal girth
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frequently. Which of the following laboratory parameters is especially important for the nurse
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to closely monitor for bleeding in this patient?
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A.
Platelet count t




t B.
Protime
t C.
Hematocrit
t D.

Mean corpuscular volume - ANSWER: ➡ C. Hematocrit
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Common injuries resulting from blunt abdominal trauma can include injury to the liver, spleen,
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mesenteric vessels, pancreas, or kidneys. In a nonoperative approach to blunt abdominal
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, trauma, observation and monitoring include serial hematocrits to evaluate for intra-
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abdominal bleeding. The platelet count does not fluctuate unless there is a disease process (e.g.
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cirrhosis, leukemia) or significant blood loss. Protime is a monitor of coagulation status and can
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be prolonged without active bleeding. Mean corpuscular volume measures the average volume
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or size of a single RBC and is used in classifying anemias.
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Which of the following is associated with chest pain, confusion, and petechiae?
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A.
Dissecting aneurysm t




t B.
Fat embolism t




t C.
Pneumothorax
t D.

Myocardial infarction - ANSWER: ➡ B. Fat embolism t t t tt t t t




Chest pain, confusion, and petechiae are suggestive of a fat embolism, especially within the first
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48 to 72 hours after a long-bone fracture.
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The clincher is the petechiae. None of the other choices would cause petechiae.
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Which type of shock is most likely to be iatrogenic?
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A.
Hypovolemic
t B.
Cardiogenic
t C.