2024 CCRN EXAM QUESTIONS
WITH CORRECT ANSWERS
Which of the following sign or symptom is most specific to a small-bowel
obstruction? - CORRECT-ANSWERSVomiting of fecal matter
Remember that time is muscle, so reperfusion is the priority. Also remember
an actual problem (decreased contractility) takes priority over a potential
problem (dysrhythmias) T/F? - CORRECT-ANSWERSTrue
patient returns to the critical care unit after insertion of a transvenous
pacemaker. There are pacing spikes not followed by a QRS. Which of the
following is a method to facilitate capture during pacing? - CORRECT-
ANSWERSIncrease milliamperage
Consider that failure to capture occurs when the electricity from the
pacemaker does not cause depolarization of the ventricle (or atria if an atrial
pacemaker). It would be logical to consider using more electricity (i.e.,
milliamperage).
Which of the following statements about colloids is correct? - CORRECT-
ANSWERSThey increase intravascular colloidal oncotic pressure.
She has had a craniotomy to evacuate the clot, and an intraventricular
catheter was placed during surgery. While the nurse is monitoring the
patient's intracranial pressure (ICP), the pressure climbs to 40 mm Hg but
returns to 15 mm Hg almost immediately. This describes which of the
following? - CORRECT-ANSWERSB wave
Normal ICP has a pressure of 5 to 15 mm Hg. An elevation of ICP to 20 to 50
mm Hg occurring every 30 seconds to 2 minutes is a B wave. An elevation of
ICP to 50 to 100 mm Hg lasting longer than 2 minutes is an A wave. An
elevation of ICP to 20 to 25 mm Hg every 4 to 8 minutes is a C wave.
What three things tell you heart catheter has flipped back into right
ventricle? - CORRECT-ANSWERSThree things tell you that the catheter has
flipped back into the right ventricle: drop in diastolic pressure, loss of dicrotic
notch, and initiation of ventricular ectopy.
,Which of the following is the preferred lead for ST segment monitoring for a
patient with a suspected left anterior descending (LAD) artery occlusion? -
CORRECT-ANSWERSV3
Normal osmolality of body fluids? - CORRECT-ANSWERS275-295
Normal urine osmolality? - CORRECT-ANSWERS1.010 - 1.020
What is the biggest danger to hyponatremia? - CORRECT-ANSWERSSeizure
What is the dilute urine range of DI? - CORRECT-ANSWERS1.001 - 1.005
Treatment of DI? - CORRECT-ANSWERSGive ADH (Pitressin, DDAVP)
Characteristics of DKA? - CORRECT-ANSWERSBlood sugar: >250
Elevated potassium in the presence of acidosis, although total body
potassium is low, it decreases as acidosis is corrected
Younger/Type 1 diabetes
Insulin production: No
Breathing pattern: Kussmaul
Tx for DKA: - CORRECT-ANSWERSInsulin, fluids
0.9 saline, 0.45 saline (if sodium high and B/P normal or high)
Decrease blood sugar by 50-100 mg/hr
Add dextrose to IV fluids after serum glucose reaches - 250mg
Continue insulin infusion until acidosis is resolved
Characteristics of HHNK: - CORRECT-ANSWERSOlder
Type 2 diabetes
Pancreatitis
>600 blood sugar
Insulin production: Yes
Serum K: Often elevated due to insulin deficiency
, Tx for HHNK: - CORRECT-ANSWERSFluids, insulin
0.9 saline
Decrease blood sugar by 50-100mg/hr
Add dextrose to IV fluids
Definitive test for DIC: - CORRECT-ANSWERSFSP
Normal: <10
Fibrinogen is 200-400
Tx for DIC: - CORRECT-ANSWERSEliminate the cause
Vit K
Platelets
FFP (Fresh frozen plasma)
Cryoprecipitate
Heparin (low dose) is controversial so may not see it on test.
S&S of HIT: - CORRECT-ANSWERSPlatelets < 150,000 or drop 30% to 50%
Early sign - PETECHIAE
Clots may lead to PE, MI, stroke, amputation
Tx for HIT: - CORRECT-ANSWERSStop HEPARIN (fractionated as well as
unfractionated)
Test for presence of heparin antibodies, ELISA, but do not wait for test results
to stop heparin and start treatment
Start warfarin
Platelets < 10,000, monitor for changes in LOC (intracranial bleed)
What is decreased in Cardiogenic shock: - CORRECT-ANSWERSBP
CI/CO
SvO2
Everything else is increased: RAP/PAOP/PAP/SVR/PVR
What is increased in hypovolemic shock? - CORRECT-ANSWERSSVR
Everything else is decreased
What is increased in Septic shock (early)? -
CORRECT-ANSWERSCO/CI/SV/SvO2
WITH CORRECT ANSWERS
Which of the following sign or symptom is most specific to a small-bowel
obstruction? - CORRECT-ANSWERSVomiting of fecal matter
Remember that time is muscle, so reperfusion is the priority. Also remember
an actual problem (decreased contractility) takes priority over a potential
problem (dysrhythmias) T/F? - CORRECT-ANSWERSTrue
patient returns to the critical care unit after insertion of a transvenous
pacemaker. There are pacing spikes not followed by a QRS. Which of the
following is a method to facilitate capture during pacing? - CORRECT-
ANSWERSIncrease milliamperage
Consider that failure to capture occurs when the electricity from the
pacemaker does not cause depolarization of the ventricle (or atria if an atrial
pacemaker). It would be logical to consider using more electricity (i.e.,
milliamperage).
Which of the following statements about colloids is correct? - CORRECT-
ANSWERSThey increase intravascular colloidal oncotic pressure.
She has had a craniotomy to evacuate the clot, and an intraventricular
catheter was placed during surgery. While the nurse is monitoring the
patient's intracranial pressure (ICP), the pressure climbs to 40 mm Hg but
returns to 15 mm Hg almost immediately. This describes which of the
following? - CORRECT-ANSWERSB wave
Normal ICP has a pressure of 5 to 15 mm Hg. An elevation of ICP to 20 to 50
mm Hg occurring every 30 seconds to 2 minutes is a B wave. An elevation of
ICP to 50 to 100 mm Hg lasting longer than 2 minutes is an A wave. An
elevation of ICP to 20 to 25 mm Hg every 4 to 8 minutes is a C wave.
What three things tell you heart catheter has flipped back into right
ventricle? - CORRECT-ANSWERSThree things tell you that the catheter has
flipped back into the right ventricle: drop in diastolic pressure, loss of dicrotic
notch, and initiation of ventricular ectopy.
,Which of the following is the preferred lead for ST segment monitoring for a
patient with a suspected left anterior descending (LAD) artery occlusion? -
CORRECT-ANSWERSV3
Normal osmolality of body fluids? - CORRECT-ANSWERS275-295
Normal urine osmolality? - CORRECT-ANSWERS1.010 - 1.020
What is the biggest danger to hyponatremia? - CORRECT-ANSWERSSeizure
What is the dilute urine range of DI? - CORRECT-ANSWERS1.001 - 1.005
Treatment of DI? - CORRECT-ANSWERSGive ADH (Pitressin, DDAVP)
Characteristics of DKA? - CORRECT-ANSWERSBlood sugar: >250
Elevated potassium in the presence of acidosis, although total body
potassium is low, it decreases as acidosis is corrected
Younger/Type 1 diabetes
Insulin production: No
Breathing pattern: Kussmaul
Tx for DKA: - CORRECT-ANSWERSInsulin, fluids
0.9 saline, 0.45 saline (if sodium high and B/P normal or high)
Decrease blood sugar by 50-100 mg/hr
Add dextrose to IV fluids after serum glucose reaches - 250mg
Continue insulin infusion until acidosis is resolved
Characteristics of HHNK: - CORRECT-ANSWERSOlder
Type 2 diabetes
Pancreatitis
>600 blood sugar
Insulin production: Yes
Serum K: Often elevated due to insulin deficiency
, Tx for HHNK: - CORRECT-ANSWERSFluids, insulin
0.9 saline
Decrease blood sugar by 50-100mg/hr
Add dextrose to IV fluids
Definitive test for DIC: - CORRECT-ANSWERSFSP
Normal: <10
Fibrinogen is 200-400
Tx for DIC: - CORRECT-ANSWERSEliminate the cause
Vit K
Platelets
FFP (Fresh frozen plasma)
Cryoprecipitate
Heparin (low dose) is controversial so may not see it on test.
S&S of HIT: - CORRECT-ANSWERSPlatelets < 150,000 or drop 30% to 50%
Early sign - PETECHIAE
Clots may lead to PE, MI, stroke, amputation
Tx for HIT: - CORRECT-ANSWERSStop HEPARIN (fractionated as well as
unfractionated)
Test for presence of heparin antibodies, ELISA, but do not wait for test results
to stop heparin and start treatment
Start warfarin
Platelets < 10,000, monitor for changes in LOC (intracranial bleed)
What is decreased in Cardiogenic shock: - CORRECT-ANSWERSBP
CI/CO
SvO2
Everything else is increased: RAP/PAOP/PAP/SVR/PVR
What is increased in hypovolemic shock? - CORRECT-ANSWERSSVR
Everything else is decreased
What is increased in Septic shock (early)? -
CORRECT-ANSWERSCO/CI/SV/SvO2
