CCRN Questions / CCRN EXAM LATEST ACTUAL EXAM
A 22-year-old man is admitted to the intensive care unit after a motor vehicle collision. There are lacerations on his face and head. The nurse observes a steady drip of clear fluid coming from his left ear. Which of the following is an appropriate ac...
CCRN Questions / CCRN
EXAM LATEST 2023-2024
ACTUAL EXAM
A 22-year-old man is admitted to the intensive care unit after a motor vehicle
collision. There are lacerations on his face and head. The nurse observes a
steady drip of clear fluid coming from his left ear. Which of the following is an
appropriate action to contain the drainage of cerebrospinal fluid (CSF)?
A.
Applying sterile ear packing
B.
Connecting low suction to the ear
,C.
Applying loose sterile dressing
D.
Leaving ear uncovered - ✔✔✔ANSWER-It is important not to obstruct CSF
flow because this could increase intracranial pressure. Introducing suction
could cause bleeding, infection, or further structural damage.
A 23-year-old man is admitted via the emergency department after a
motorcycle collision. His Glasgow Coma Scale score was 12 in the emergency
department, and it is still 12 upon his admission to the neurologic intensive
care unit. Both eyes are ecchymotic and swollen shut, and he has multiple
abrasions on his face. Which of the following is the most likely diagnosis?
,A 24-year-old woman is admitted with a closed head injury after a fall from a
cliff. She is less responsive and has a nonreactive dilated right pupil. These
signs suggest pressure in which area of the brain?
A.
Right hemisphere
B.
Left hemisphere
C.
Cerebellum
D.
Hypothalamus - ✔✔✔ANSWER-Right hemisphere
CN III controls pupil constriction. Hemispheric pressure on this nerve will
result in a dilated pupil on the same side as the pressure.
A 28-year-old woman is admitted to the critical care unit from the emergency
department with a diagnosis of asthma. Her initial arterial blood gases on a
28% Venturi mask are as follows:
pH 7.48
PaCO2 30 mm Hg
HCO3 24 mEq/L
, PaO2 64 mm Hg
Which of the following repeat arterial blood gases on 40% oxygen indicate that
the patient's condition is worsening?
A.
pH 7.48, PaCO2 30 mm Hg, PaO2 68 mm Hg
B.
pH 7.46, PaCO2 32 mm Hg, PaO2 61 mm Hg
C.
pH 7.40, PaCO2 40 mm Hg, PaO2 62 mm Hg
D.
pH 7.39, PaCO2 30 mm Hg, PaO2 60 mm Hg - ✔✔✔ANSWER-C.
pH 7.40, PaCO2 40 mm Hg, PaO2 62 mm Hg
The case study shows stage II asthma. Option c shows stage III asthma. The
patient is still breathing at a fast rate, but carbon dioxide is starting to be
retained as evidenced by the increase of the PaCO2 into normal range.
Options a and b are still stage II. Option d shows a respiratory alkalosis with a
metabolic acidosis because you would have expected the pH to be in an
alkalotic range with the PaCO2 of 30.
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