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2024 CCRN PRACTICE TEST 1EXAM WITH CORRECT ANSWERS
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2024 CCRN PRACTICE TEST 1EXAM WITH CORRECT ANSWERS
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2024 CCRN PRACTICE TEST 1EXAMWITH CORRECT ANSWERS
Which of the following would warrant an immediate call to the neurosurgeon
postoperatively?
(A) ICP 15 mmHg, cerebral perfusion pressure 100 mmHg
(B) a temperature increase to 39.8°C from 37.2°C
(C) a urine output of 100 mL in the past hour and a urine specific gravity of
1.010
(D) the patient arouses with voice and was previously aroused with shaking -
A patient with abdominal trauma is experiencing acute left shoulder pain.
Which of the following might cause this symptom?
(A) diaphragmatic irritation
(B) ruptured bladder
(C) liver contusion
(D) ruptured kidney -
A nursing measure designed to optimize the
cerebral perfusion pressure (CPP) involves:
(A) turning the patient every hour.
(B) preventing the MAP from becoming greater than 65 mmHg.
(C) maintaining the PaCO, at less than 30 mmHg.
(D) maintaining a neutral head position. -
The physician orders intubation and mechanical ventilation for a patient with
asthma. The patient's respiratory rate is 28 breaths/minute, and she is
currently receiving 3 L/nasal cannula oxygen. Which of the following arterial
blood gases best supports the decision to place an endotracheal tube?
(A) pH 7.41; PaCO2 39 mmHg; PaO2 83 mmHg
(B) pH 7.50; PaCO, 29 mmHg; PaO2 72 mmHg
(C) pH 7.46; PaCO, 33 mmHg; PaO2 62 mmHg
(D) pH 7.36; PaCO2 41 mmHg; PaO2 62 mmHg -
A 22-year-old male patient, with a known history of Wolff-Parkinson-White
(WPW) syndrome, developed preexcited atrial fibrillation (AF) at a rate of 170
beats/ minute. The nurse should anticipate the administration of which of the
following medications?
(A) adenosine (Adenocard)
(B) diltiazem (Cardizem)
(C) esmolol (Brevibloc)
,(D) digoxin (Lanoxin) -
Which of the following patients will most likely need hemodialysis?
(A) the patient with a BUN of 88 mg/dL and a creatinine of 3.8 mg/dL
(B) the patient with metabolic alkalosis and hypokalemia
(C) the patient with an aspirin overdose, a BUN of 15 mg/dL, and a creatinine
of 1.5 mg/dL
(D) the patient with a serum potassium of 5.8 mEq/L and a normal ECG -
A type 2 diabetic patient presents with a serum glucose of 1,050 mg/dL and
negative ketones. Which of the following is the priority intervention for this
patient?
(A) insulin
(B) bicarbonate
(C) potassium
(D) fluid replacement -
A patient with acute pancreatitis has the following assessment:
Vital signs: Temperature 37°C, BP 98/65, heart rate 110 beats/minute,
respiratory rate 28 breaths/minute, SpO2 89%, FiO2 of 2 L/nasal cannula
Labs: WBC count 19,000, hemoglobin 9.0 g/dL, hematocrit 40%, Na+ 145
mEq/L, K+ 3.0 mEq/L, Ca++ 7.8 mEq/L, glucose
220 mg/dL
Assessment: Lungs with left lower lobe crackles, abdomen with Cullen's sign
Which of the following additional conditions (along with pancreatitis) does
this patient most likely have, and what intervention is needed?
(A) hemorrhagic shock, stress hyperglycemia, hypoxemia; the patient needs
blood
(B) hypovolemic shock, diabetes, sepsis; the patient needs antibiotics
(C) SIRS, hemorrhagic pancreatitis, MODS; the patient needs fluids
(D) dehydration, ARDS, stress hyperglycemia; the patient needs
intubation -
A patient who is receiving intracranial pressure monitoring has sustained A-
waves on the intracranial pressure (ICP) monitor. Which of the following
interventions is contraindicated for this patient?
(A) Discontinue opiate and sedating drugs.
(B) Administer mannitol.
(C) Infuse isotonic solutions.
(D) Drain CSF from the ventricular catheter. -
A patient arrives in the critical care unit 4 hours postpartum with bleeding
that is thought to be secondary to severe uterine atony. Her blood pressure
is 78/40, her heart rate is 140 beats/minute, and her respiratory rate is 30
breaths/minute. Her hemoglobin is 11.2 g/dL. Which of the following
interventions is appropriate?
,(A) This patient has lost 1,500-2,000 mL of blood and is at a high risk for DIC.
Initiate fluid resuscitation, transfuse blood, and check the coagulation profile.
(B) The patient has lost 500-1,000 mL of blood and is at a high risk for septic
shock. Initiate fluid resuscitation, give pressors, and obtain blood cultures.
(C) The patient has lost 250-500 mL of blood and is at a high risk for a
pulmonary embolism. Initiate fluid resuscitation, get a chest CT scan, and
obtain a D-dimer.
(D) The patient has lost over 2,000 mL of blood and is at a high risk for
uterine rupture. Initiate fluid resusci -
The decision has been made to wean a patient from the ventilator. Which of
the Tot following would be an indication to stop the weaning trial?
(A) the development of a paradoxical breathing pattern with accessory
muscle use
(B) the patient remains disoriented with demonstrations of mild anxiety and
agitation
(C) a productive cough with activation of the ventilator alarm within the first
5 minutes of the weaning trial
(D) an increase in heart rate from 82 beats/minute to 96 beats/minute within
the first 5 minutes of the weaning trial -
A patient presents with a blood pressure of 232/129 and acute chest pain.
Which of the following would be the agent of choice to use for this patient?
(A) nicardipine (Cardene)
(B) labetalol (Normodyne)
(C) nitroprusside (Nipride)
(D) diltiazem (Cardizem) -
Which of the following findings would be expected during chest auscultation
of a patient with systolic heart failure?
(A) an S4 heart sound at the apex of the heart
(B) a systolic murmur at the apex of the heart
(C) a diastolic murmur at the left sternal border
(D) an S3 heart sound at the apex of the heart -
After attending an educational session that reviewed drug dosing and
provided a review of the literature, the nurse would like to start using the
admission weight to calculate drug dosing during titration of vasoactive
drugs rather than the current practice of using daily weights. What would be
the most effective next step for the nurse to take to implement this change?
(A) Begin the adaptation of the practice by using the admission weight for
patients.
(B) Identify the key stakeholders related to the proposed change in practice.
, (C) Ask the attending physician on rounds what her thoughts are about the
practice.
(D) Discuss the educational session with nurse colleagues. - (B) Identify the
key stakeholders related to the proposed change in practice.
A patient presents with a productive cough, hypoxemia, a fever,
hypotension, tachycardia, and tachypnea. Hypoxemia was corrected with the
administration of oxygen. Which of the following should be done next?
(A) Administer antibiotics.
(B) Start a vasopressor.
(C) Collect a sputum culture.
(D) Initiate 0.9 normal saline. - (D) Initiate 0.9 normal saline.
A patient with a urinary tract infection presented with a temperature of 39°C
(102.2°F), a heart rate of 132 beats/minute, a respiratory rate of 24
breaths/minute, a BP of 78/49 (a MAP of 59 mmHg), and a lactate of 2.8
mmol/L. The patient received 2 L of 0.9 NS within 1 hour. The BP is now
100/52 (the MAP is 68 mmHg), the heart rate is 118 beats/minute, the
respiratory rate is 20 breaths/minute, and the lactate is 2.1 mmol/L. The
patient requires treatment for:
(A) bacteremia.
(B) sepsis.
(C) SIRS.
(D) septic shock. - (B) sepsis.
A patient is 48 hours post aortic valve replacement. Which of the following
would be a major goal for this patient?
(A) diuretic therapy
(B) stabilizing the blood pressure
(C) prophylactic antibiotics
(D) preventing a thrombus - (D) preventing a thrombus
A patient with hypoxic encephalopathy has been opening his eyes to touch
for the past 24 hours. The patient now withdraws to painful stimuli, has
developed unequal pupils, and has a positive Babinski reflex. Which of the
following interventions should the nurse anticipate?
(A) ventriculostomy, oxygen, steroids
(B) sedation, vasopressin (Pitressin), thiazide diuretic
(C) osmotic diuretic, intubation, and monitor the pCO2
(D) lumbar puncture and increase the FiO2 - (C) osmotic diuretic, intubation,
and monitor the pCO2
A 19-year-old patient who was admitted with sickle cell crisis and acute
kidney injury requests to use a phone to update her friends on her condition.
The nurse's best response would be to:
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