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CCRN Questions 2024 with verified answers
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CCRN Questions 2024 with verified answers
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CCRN Questions 2024 with verified answersA patient has had a large anterior myocardial infarction last month and developed a ventricular
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aneurysm. He now has episodes of ventricular tachycardia that are not prevented or converted
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with antidysrhythmic agents. An implantable cardioverter-defibrillator (ICD) is implanted.
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Four days after surgery he develops ventricular tachycardia. The ICD has delivered three
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shocks but has not converted the rhythm. He is pulseless and apneic. Cardiopulmonary
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resuscitation is in progress. What is the priority action now?
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A.
Administer epinephrine IV. t t
t B.
Administer amiodarone. t
t C.
Defibrillate.
t D.
Reset the ICD. - ANSWER: ➡ Defibrillate
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A 28-year-old woman is admitted to the critical care unit from the emergency department with
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a diagnosis of asthma. Her initial arterial blood gases on a 28% Venturi mask are as follows:
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t pH 7.48 t t
t PaCO2 30 mm Hg t t t t
t HCO3 24 mEq/L t t t
t PaO2 64 mm Hg t t t t
,Which of the following repeat arterial blood gases on 40% oxygen indicate that the patient's
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condition is worsening?
t t t
A.
pH 7.48, PaCO2 30 mm Hg, PaO2 68 mm Hg
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t B.
pH 7.46, PaCO2 32 mm Hg, PaO2 61 mm Hg
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t C.
pH 7.40, PaCO2 40 mm Hg, PaO2 62 mm Hg
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t D.
pH 7.39, PaCO2 30 mm Hg, PaO2 60 mm Hg - ANSWER: ➡ C.
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pH 7.40, PaCO2 40 mm Hg, PaO2 62 mm Hg
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The case study shows stage II asthma. Option c shows stage III asthma. The patient is still
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breathing at a fast rate, but carbon dioxide is starting to be retained as evidenced by the increase
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of the PaCO2 into normal range. Options a and b are still stage II. Option d shows a respiratory
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alkalosis with a metabolic acidosis because you would have expected the pH to be in an alkalotic
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range with the PaCO2 of 30.
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A patient experiencing alcohol withdrawal syndrome describes the swirls in the wallpaper as
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being worms. This is an example of which of the following?
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A.
Delusion
t B.
Hallucination
,t C.
Illusion
t D.
Visual impairment - ANSWER: ➡ C.
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Illusion
An illusion is a misperception or misinterpretation of an actual external stimulus. Illusions and
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hallucinations (a perception that has no actual external stimulus) are common during alcohol
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withdrawal syndrome.
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A patient arrives in the emergency department with multiple gunshot wounds. He requires
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massive transfusion for blood loss from chest and abdominal wounds. The electrocardiogram
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should be observed closely for changes indicative of which of the following?
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A.
Atrioventricular block t
t B.
Hyperkalemia
t C.
Hypercalcemia
t D.
Hypomagnesemia - ANSWER: ➡ Hyperkalemia t t tt t
, Banked blood is high in potassium because of hemolysis. Look for tall, peaked T waves and
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widening of the QRS complex. Other considerations with massive transfusion of banked blood
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are hypocalcemia, hypothermia, and decreased tissue oxygen delivery caused by decreased
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levels of 2,3-diphosphoglycerate.
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A 65-year-old woman reports severe dyspnea 2 days after abdominal surgery. She is
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transferred to the critical care unit. On 5 L of oxygen by nasal cannula, her arterial blood gases
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are as follows:
t t t
t pH 7.39
t t
t PaCO2 35 mm Hg t t t t
t HCO3 19 mEq/L t t t
t PaO2 40 mm Hg t t t t
t Arterial oxygen saturation 75% t t t t
Why does this patient have hypoxemia without hypercapnia?
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A.
Because carbon dioxide is more diffusible than oxygen
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t B.
Because carbon dioxide has more driving pressure t t t t t t
t C.
Because carbon dioxide is less diffusible than oxygen
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t D.
Because carbon dioxide excretion by the kidney is increased - ANSWER: ➡ Because carbon
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dioxide is more diffusible than oxygen
t t t t t t
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