2024 CCRN EXAM QUESTIONS
WITH CORRECT ANSWERS
A 34-year-old man admitted with Pneumocystis carinii pneumonia asks the
nurse what protective measures he should use at home to prevent
transmission of human immunodeficiency virus (HIV) to family members. The
best response would include which of the following?
A.
Wear a mask to protect the family members.
B.
Use plastic eating utensils and paper plates.
C.
Launder clothing and linens separately.
D.
Clean up body secretion spills with a weak chlorine bleach solution. -
CORRECT-ANSWERSD - throw out the extremes and remember than body
secretions are the concern. I weak chlorine bleach will kill HIV
RA, RV, PA, and PAOP pressure normals?
What is a pressure for an optimally stretched wedge? - CORRECT-
ANSWERSSVC/RA = 0-6 mmHg (at this point inflate balloon with 1.5 mL of
air)
RV = 25/0 mmHg
PA = 15-30/5-15 mmHg
PAOP = 2-10 mmHg at 40-50 cm distance (if SCV/ IJ insertion)
somewhere in the ballpark of 12-20 mmHg
Which of the following accurately describes the normal difference between
the pulmonary artery diastolic pressure (PAd) and the pulmonary artery
occlusive pressure (PAOP)? - CORRECT-ANSWERSPAd should be 0-5mmHg
higher than the PAOP.
This to monitor in ethanol poisioning - CORRECT-ANSWERSethanol can cause
hypoglycemia - as well as monitor ethanol levels.
,How does heparin inhibit clotting - CORRECT-ANSWERSby neutralizing
circulating thrombin
Describe the difference between the s3 and s4 heart sounds - CORRECT-
ANSWERSs3 is the sound of rapid filling into an already distended ventricle
s4 is sound of atrial squeeze into a non-compliant ventricle (this non-
compliance is caused by ischemia)
Which of the following drugs is an alpha- and noncardioselective beta-
blocker?
A.
Propranolol (Inderal)
B.
Esmolol (Brevibloc)
C.
Carvedilol (Coreg)
D.
Metoprolol (Lopressor) - CORRECT-ANSWERScavedilol
describe the dolls eyes reflex - CORRECT-ANSWERSThe presence of dolls
eyes is a good thing. when the heard is turned from side to side the
brainstem has the ability to mantain the eyes looking forward regardless of
spine rotation. The absence of dolls eyes is a BAD thing. The eyes stay
midline following the head as it is turned.
What is Prinzmetal's angina - CORRECT-ANSWERSThere is ST segmant
elevation during periods of pain, but absence of EKG changes otherwise
A patient had a nephrectomy yesterday. She is being monitored closely for
indications of hypoventilation and atelectasis. Which of the following would
be the most appropriate treatment for this patient's hypoventilation?
A.
Suctioning of airway as needed
B.
Analgesics
C.
Bronchodilators
, D.
Antibiotics - CORRECT-ANSWERSFlank, thoracic, and high abdominal
incisions often are related to atelectasis because deep breathing is painful.
Adequate analgesia allows the patient to take deep breaths and perform
incentive spirometry with less discomfort.
B
What is the earliest sign of hepatic failure - CORRECT-
ANSWERShypoglycemia -
What is systems thinking - CORRECT-ANSWERSAn example of this is when
units are able to collaborate with one another to facilitate care and increase
efficiency. DO NOT CONFUSE SYSTEMS THINKING WITH COLLABORATION,
THEY WILL TRICK YOU.
Things to remember prior to testing - CORRECT-ANSWERSRead the answers
through and then read the question. Read carefully as to not miss the do
NOT and the DO questions.
A 42-year-old woman is admitted with "the worst headache I've ever had."
Computed tomography reveals an aneurysm in the circle of Willis.
Vasospasm may be treated with which of the following?
A.
Fluid administration
B.
Loop diuretics (e.g., furosemide)
C.
Antifibrinolytic (aminocaproic acid [Amicar])
D.
Osmotic diuretics (e.g., mannitol [Osmitrol]) - CORRECT-ANSWERSGive fluids
for treatment. Diuretics such as mannitol/lasix will excacerbate the problem
with a hypovolemic state. antifibrin may cause re-bleeding and is not
indicated for the treatment of vasospasm.
A patient with which of these conditions would have a normal serum lactate?
Why?
A.
Ventricular fibrillation
B.
, Cardiogenic shock
C.
Severe anemia
D.
Renal failure - CORRECT-ANSWERSRenal failure.
Do not confuse metabolic acidosis to always having an elevated serum
lactate. All 4 of these conditions will cause metabolic acidosis, however,
renal failure acidosis will be caused by urea build up. A, B, and C metabolic
acidosis will be caused by a decreased 02 delivery, a conversion of aerobic
to anaerobic metabolism, and a rising serum lactate.
A patient has had a large anterior myocardial infarction last month and
developed a ventricular aneurysm. He now has episodes of ventricular
tachycardia that are not prevented or converted with antidysrhythmic
agents. An implantable cardioverter-defibrillator (ICD) is implanted. Four
days after surgery he develops ventricular tachycardia. The ICD has
delivered three shocks but has not converted the rhythm. He is pulseless and
apneic. Cardiopulmonary resuscitation is in progress. What is the priority
action now?
A.
Administer epinephrine IV.
B.
Administer amiodarone.
C.
Defibrillate.
D.
Reset the ICD. - CORRECT-ANSWERSDefibrillate
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
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