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CCRN ADULT MOST FAILED EXAMS QUESTIONS ITH CORRECT ANSWERS 2022/2023 UPDATE
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CCRN ADULT MOST FAILED EXAMS QUESTIONS ITH CORRECT ANSWERS 2022/2023 UPDATE
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CCRN ADULT MOST FAILED EXAMSQUESTIONS WITH CORRECT ANSWERS
2022/2023 UPDATE
Ashman phenomenon is a predisposition for aberrancy when which of the following
occurs?
A.
A long P-P interval is followed by a short P-P interval.
B.
A short P-P interval is followed by a long P-P interval.
C.
A short R-R interval is followed by a long R-R interval.
D.
A long R-R interval is followed by a short R-R interval. - Answer D
Ashman phenomenon occurs when a short cycle follows a long cycle. Refractory
periods are related to cycle length. When a short cycle follows a long cycle, the QRS
complex that ends the short cycle interrupts the long refractory period of the long cycle.
That beat is likely to be conducted aberrantly.
* Which is a normal oxygen consumption index (VO2I)?
A.
Approximately 50 ml/min/m2
B.
Approximately 100 ml/min/m2
C.
Approximately 150 ml/min/m2
D.
Approximately 200 ml/min/m2 - Answer C
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.
* Increasing the driving pressure of oxygen increases blood oxygenation. Driving
pressure of oxygen is affected by which two factors?
A.
Compliance and resistance
,B.
Oxygen concentration and barometric pressure
C.
Hemoglobin and arterial oxygen saturation (SaO2)
D.
Cardiac output and systemic vascular resistance - Answer B
The driving pressure of oxygen across the alveolar-capillary membrane is affected by
the concentration of the gas (FiO2) and the barometric pressure (760 mm Hg at sea
level). Therefore blood oxygenation is increased by increasing the FiO2 or by increasing
the pressure, such as with a hyperbaric chamber or the addition of continuous positive
airway pressure or positive end-expiratory pressure.Compliance and resistance affect
the work of breathing. Hemoglobin and SaO2 affect the CaO2 (content of oxygen in the
arterial blood). Cardiac output and systemic vascular resistance affect blood pressure.
Emergency decompression of a tension pneumothorax includes needle puncture at
which of the following locations?
A.
Fifth intercostal space at the midclavicular line on the affected side
B.
Second intercostal space at the midclavicular line on the affected side
C.
Second intercostal space at the midaxillary line on the affected side
D.
Fifth intercostal space at the midaxillary line on the affected side - Answer B
Emergency decompression of a tension pneumothorax is performed by insertion of a
large-bore needle into the thorax at the second intercostal space at the midclavicular
line.
* Which of the following statements about colloids is correct?
A.
They are classified as hypotonic, hypertonic, and isotonic.
B.
They increase interstitial and intracellular volume.
C.
They increase intravascular colloidal oncotic pressure.
D.
They are the first-line treatment in fluid resuscitation. - Answer C
Colloids increase intravascular colloidal oncotic pressure and pull fluid from the
interstitial space into the intravascular space. Current research has not found a benefit
of colloids over crystalloids in fluid resuscitation, and colloids are much more expensive.
,A 52-year-old patient with a history of alcoholism is admitted with massive esophageal
bleeding. The patient has had several blood transfusions. The toxic effects of citrate in
stored blood are caused by a fall in which electrolyte?
A.
Calcium
B.
Sodium
C.
Potassium
D.
Phosphorus - Answer A
Calcium binds with the citrate that reduces the ionized calcium level and causes tetany.
Possible interventions for the most clinically significant intracranial pressure (ICP)
waves include any of the following except:
A.
administration of mannitol.
B.
repositioning of the patient.
C.
initiation of hyperventilation therapy.
D.
drainage of cerebrospinal fluid (CSF) via an intraventricular catheter. - Answer B
When patients have elevation in ICP, it is important not to do anything that might
increase the ICP further. Mannitol administration and CSF drainage are methods that
are often used to reduce acute increases in ICP. Hyperventilation therapy might be
used to cause cerebral vasoconstriction in a time of crisis but should not be used
routinely. Repositioning the patient may increase the ICP. Avoid anything that may
increase ICP, especially in times of crisis.
"Administration of mannitol," "initiation of hyperventilation therapy," and "drainage of
cerebrospinal fluid (CSF) via an intraventricular catheter" all cause the loss of volume
from the head. Mannitol decreases cerebral edema, hyperventilation causes cerebral
vessel constriction and decrease in blood volume in the head, and CSF drainage
reduces the volume of CSF in the head. Repositioning the patient may increase ICP.
Also note that repositioning the patient is a general statement versus the other more
specific options. Choose "repositioning of the patient" as an intervention that should not
be initiated.
A 72-year-old man arrived in the emergency department after 4 hours of substernal pain
radiating to the left arm. He has a 100 pack-year history of cigarette smoking, chronic
obstructive pulmonary disease, and intermittent claudication. His electrocardiogram on
, admission shows sinus tachycardia with a rate of 120 beats/min and ST segment
elevation in leads I, AVL, and V3 to V6. Vital signs include blood pressure, 150/84 mm
Hg; respiratory rate, 15 breaths/min; functional oxygen saturation (SpO2), 95%; and
temperature, 38.3° C (100.9° F). An S4 is noted during cardiac auscultation. This sound
indicates:
A.
atrial contraction and propulsion of blood into a noncompliant ventricle.
B.
inflammation of the pericardium.
C.
opening of a defective semilunar valve.
D.
rapid ventricular filling into an already distended ventricle. - Answer A
An S4 occurs during the end of diastole when the atria contract but the ventricle is
noncompliant. An S4 occurs in myocardial ischemia, infarction, and hypertrophy. Most
patients with an acute myocardial infarction have an S4 for the first 48 hours.
* Which of the following are the two clinical hallmarks of acute respiratory distress
syndrome?
A.
Increased lung compliance and pulmonary edema
B.
Increased functional residual capacity and decreased compliance
C.
Refractory hypoxemia and decreased lung compliance
D.
Refractory hypoxemia and increased functional residual capacity - Answer C
Intra-alveolar fluid and damage to type II pneumocytes result in a decrease in the
amount and effectiveness of surfactant. This causes alveolar collapse (decreased
functional residual capacity), pulmonary edema, decrease in lung compliance, and
massive intrapulmonary shunt. Intrapulmonary shunt causes severe hypoxemia that is
refractory to oxygen therapy.
An aortic tear commonly is associated with which of the following?
A.
Acceleration-deceleration injury
B.
Barotrauma
C.
Penetrating injury of the chest wall
D.
Blunt force injury to the chest wall - Answer A
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