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Exam (elaborations)

2024 CCRN EXAM WITH CORRECT ANSWERS

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2024 CCRN EXAM WITH CORRECT ANSWERS

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  • September 14, 2024
  • 13
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • appropriate
  • CCRN
  • CCRN
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Elitaa
2024 CCRN EXAM WITH CORRECT
ANSWERS



Which of the following are symptoms of hypoglycemia?
(A) Tachycardia and trembling
(B) Bradycardia and diaphoresis
(C) Anxiety and flushed dry skin
(D) Flushed dry skin and tachycardia - CORRECT-ANSWERS(A) When the
blood glucose drops, sympathetic stimulation occurs, (Symptoms are masked
for the patient receiving beta-adrenergic blocker drugs). Flushed, dry skin is
a sign of hyperglycemia.

Which of the following is TRUE for a patient with a right-sided stroke who
develops increased intracranial pressure?
(A) pupils will change before level of consciousness, right-sided paralysis,
eyes deviated to the left, left pupil change
(B) pupils will change before level of consciousness, left-sided paralysis, eyes
deviated to the right, right pupil change
(C) level of consciousness will change before pupils, right-sided paralysis,
eyes deviated to the left, left pupil change.
(D) level of consciousness will change before pupils, left-sided paralysis, eyes
deviated to the right , right pupil change. - CORRECT-ANSWERS(D) Higher
brain centers (cerebral cortex) are the first to be affected by increased
intracranial pressure. Therefore, level of consciousness is the first sign (one
exception, epidural hematoma). Pupil changes are ipsilateral (same side as
the injury) due to compression of cranial nerve III against the transtentorial
notch. Motor changes are contralateral (opposite the side of injury) due to
motor fiber crossing in the brain stem.

Which of the following interventions would the nurse consider to be
inappropriate for the patient with increased intracranial pressure?
(A) maintaining oxygenation and normal PaCO2
(B) feeding the patient via an NGT
(C) administering 5% dextrose in water (D5W) at 75 ml/hour
(D) log roll when turning the patient - CORRECT-ANSWERS(C) 5% dextrose in
water is a hypotonic solution. When administered, it will cause movement of
the D5W into the brain cells, causing swelling and increased intracranial
pressure. The other 3 choices are acceptable interventions for the patient
with increased ICP.

, You know that research supports unrestricted access of a designated support
person to the patient, but your unit restricts all patient visitors to set times.
Your best response would be to:
(A) gather the facts and propose a policy change to your manager for the
unit
(B) tell patients/visitors that the unit's policy is outdated but there is nothing
you can do about it
(C) continue to follow the unit policy
(D) complain to colleagues about the unit's outdated policy. - CORRECT-
ANSWERS(A) The AACN Synergy Model supports patient advocacy.
Unrestricted access of a designated support person is evidence-based
practice included in the Patient Visitation AACN Practice Alert. Choice (A) is
an effective strategy for change.

Your patient has just consented to a bedside chest tube insertion and
requests that his wife be allowed to be present during the procedure. You
should:
(A) explain to the patient that this is against infection control practice
(B) tell the patient he will be able to see his wife as soon as the procedure is
completed
(C) tell the patient it would be too much for his wife to handle
(D) prepare the wife for what to expect and allow her to be present -
CORRECT-ANSWERS(D) The AACN Synergy Model supports caring practice
and family presence. An AACN practice alert indicates family presence may
improve patient outcome.

Which of the following laboratory findings are most specifically indicative of
disseminated intravascular coagulation (DIC) as the cause of bleeding?
(A) elevated fibrin split products and d-dimer
(B) prolonged PT, PTT, and bleeding time
(C) decreased platelet count
(D) decreased hemoglobin and hematocrit - CORRECT-ANSWERS(A) DIC is a
clotting problem, with massive coagulation. As clots break down, fibrin split
products are produced. Therefore with DIC, FSPs will be high. In fact, this is
the most specific test result for DIC. D-dimer is present due to the presence
of clots. While not specific for DIC, it is a good rule-out test.

A 29 year old female has been in the critical care unit for 2 days after a
motor vehicle crash and has developed acute tubular necrosis (ATN). She
was normotensive on admission. What would be the most likely cause of
ATN?
(A) hemorrhage
(B) rhabdomyolysis
(C) creatinine release
(D) cardiac dysthymias - CORRECT-ANSWERS(B) The motor vehicle crash
most likely resulted in a crash injury with destruction of skeletal muscle cells

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