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PASS the CCRN! Questions and Correct Solutions (Latest Update 2024)
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PASS the CCRN! Questions and Correct Solutions (Latest Update 2024)
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PASS the CCRN! Questions and CorrectSolutions (Latest Update 2024)
A 56 yr-old male is admitted to the ICU with a blood pressure
of 225/135 and complains of a headache and nausea. He
reports he ran out of blood pressure meds three days ago,
but also appears to be confused to the date and situation.
What is the most appropriate treatment approach? - Correct
Answer ✅ Rapidly lower the diastolic pressure to 100 with IV
antihypertensive meds, then continue to gradually reduce the
diastolic pressure to 85 with oral antihypertensive meds.
The maximum initial decrease should be no more than 25%
reduction from initial presenting value. Reducing the blood
pressure too quickly can lead to cerebral edema or renal
failure.
A patient has sepsis, receives Lactated ringers 500ml IV
bolus. Which finding indicate that this intervention is having
it's intended effect? - Correct Answer ✅ ScvO2 of 72%
Early goal directed therapy for sepsis includes early fluid
resuscitation at 30 ml/kg to maintain a CVP of 8-12 or 12-15 if
mechanically ventilated, MAP greater than 65, ScvO2 greater
than 70%, and urine output greater than 0.5 kg/hr
,PASS the CCRN! Questions and Correct
Solutions (Latest Update 2024)
72 male patient in ICU for 6 days on the ventilator for
treatment of a COPD exacerbation. He has been receiving
VTE prophylaxis and subcutaneous Heparin since admission.
Today his platelet count decreased significantly to 43,000 and
was found to have new DVT on his right upper extremity.
What do you suspect is the most likely cause of these
findings? - Correct Answer ✅ HIT
The hallmark sign of HIT is a significant decrease in platelet
count over a 24 hours period (>50%) within 5-10 days of
administering Heparin. The other hallmark sign is a new
development of DVT despite being on VTE prophylaxis.
TRALI: - Correct Answer ✅ is a complication from a blood
transfusion reaction, which causes acute lung injury typically
within 6 hours of a blood transfusion.
2 Hallmark signs of HIT: - Correct Answer ✅ Decrease in
platelet count over a 24 hr period.
,PASS the CCRN! Questions and Correct
Solutions (Latest Update 2024)
New development of DVT despite being on VTE prophylaxis.
Values in Early compensated Hypovolemic shock? - Correct
Answer ✅ CO 4.0 L/min, HR 135, SV 65, SVR 1700, MAP 65
In hypovolemic states, circulating volume is depleted
therefore preload and contractility are decreased which leads
to a decrease in SV and CO. HR and SV increase as
compensatory measure to preserve CO, MAP and cerebral
perfusion.
Post-renal failure values: - Correct Answer ✅ Urine output
< 200; urine sodium 30; BUN: Creatinine ratio 15:1; urine
specific gravity 1.010
BUN: Creatinine ratio is 15:1, but both the BUN & creatinine
are elevated. Urine sodium is typically 1-40 mEq/L.
What to do in the event of HIT: - Correct Answer ✅ Stop
Heparin and administer an alternative direct thrombin
inhibitor.
, PASS the CCRN! Questions and Correct
Solutions (Latest Update 2024)
Warfarin is contraindicated in HIT? T/F - Correct Answer ✅
True - there is also no evidence that shows protamine,
corticosteroids, and benadryl are effective treatments for HIT
Patients with right ventricular infarctions become preload
dependent. Meds that decrease preload should be avoided -
which meds are these? - Correct Answer ✅ Morphine, Nitro,
Beta blockers and diuretics.
Polymorphic ventricular tachycardia aka Torsades is treated
by? - Correct Answer ✅ Magnesium
Myocardial contusions generally impact which parts of the
heart? and what would the values be? - Correct Answer ✅
Atria & right ventricle because of the position of the heart in
the chest.
PAOP 6, PA Pressure 40/24, RA Pressure 16
Neurogenic shock signs? - Correct Answer ✅ CVP: 3, CI:
2.5, SVR: 650, SBP: 88
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