QUIZ CCRN-ADULT - CCRN (ADULT) - DIRECT CARE ELIGIBILITY PATHWAY–TRUSTABLE POSITIVE FEEDBACK

Quiz CCRN-Adult - CCRN (Adult) - Direct Care Eligibility Pathway–Trustable Positive Feedback

Quiz CCRN-Adult - CCRN (Adult) - Direct Care Eligibility Pathway–Trustable Positive Feedback

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AACN CCRN (Adult) - Direct Care Eligibility Pathway Sample Questions (Q33-Q38):

NEW QUESTION # 33
A patient is admitted with an acute anterior wall MI. Initial hemodynamic readings are:

The nurse anticipates initiating a plan of care for

  • A. right ventricular infarct.
  • B. pulmonary hypertension.
  • C. cardiogenic shock.
  • D. volume overload.

Answer: C

Explanation:
The hemodynamic readings provided (BP 80/60, HR 110, CVP 20 mm Hg, PAOP 26 mm Hg, CO 2.1 L/min, CI 1.3 L/min/m², PAP 42/32 mm Hg, SVR 1762 dynes/sec/cm) suggest cardiogenic shock. This condition is characterized by low cardiac output and index, elevated filling pressures (CVP and PAOP), and systemic vascular resistance. Cardiogenic shock often occurs following an acute anterior wall myocardial infarction (MI) due to extensive damage to the myocardium, leading to impaired contractility and inadequate tissue perfusion.References: = CCRN Exam Handbook, page 12


NEW QUESTION # 34
In order to meet the spiritual needs of critically ill patients and their families, which of the following should the nurse understand regarding chaplain services?

  • A. The chaplain may be of a specific denomination, but the chaplain provides resources to patients of many faiths and beliefs.
  • B. A chaplain's visit will not benefit a patient who is comatose or non-communicative.
  • C. It would be inappropriate for the hospital chaplain to document in the medical record.
  • D. The service should be provided only when specifically requested by the patient or family.

Answer: A

Explanation:
Chaplain services in hospitals are designed to address the spiritual needs of patients and their families, regardless of their specific faith or belief system. While a chaplain may belong to a particular denomination, they are trained to provide support and resources to people of various faiths and spiritual beliefs. This approach helps ensure that all patients receive appropriate spiritual care, which can be a crucial part of holistic care in critical situations. References: = CCRN Exam Handbook, AACN Adult CCRN Certification Review Course


NEW QUESTION # 35
A patient is admitted for hypertensive crisis. As a nurse is starting a peripheral IV, the patient appears increasingly anxious as the catheter is about to be inserted. The patient threatens to harm the nurse if the catheter insertion causes pain. Which of the following is the nurse's best action?

  • A. Ask another staff member to distract the patient during insertion.
  • B. Engage the patient in a conversation and encourage him to verbalize his feelings.
  • C. Tell the patient to remain still in a stern, authoritative voice.
  • D. Physically restrain the patient during the performance of the procedure.

Answer: B

Explanation:
When a patient exhibits anxiety and threats of harm, it is crucial to de-escalate the situation through verbal communication and engagement. By encouraging the patient to verbalize their feelings, the nurse can address the patient's fears and anxieties, reducing the likelihood of aggression. This approach promotes a therapeutic nurse-patient relationship and ensures the safety of both the patient and healthcare staff. References: = CCRN Exam Handbook, AACN Adult CCRN Certification Review Course


NEW QUESTION # 36
A nurse is caring for a patient who had a gastric bypass procedure 2 days ago. A physician has ordered a gastric tube to be placed due to increased abdominal distention. The nurse realizes that this procedure will most likely need to be done

  • A. under fluoroscopy.
  • B. with a guide wire.
  • C. using ultrasound.
  • D. by two nurses.

Answer: A

Explanation:
After gastric bypass surgery, the altered anatomy of the gastrointestinal tract makes it challenging to place a gastric tube. Performing the procedure under fluoroscopy provides real-time imaging guidance, ensuring correct placement and reducing the risk of complications, such as perforation or misplacement.References: = CCRN Exam Handbook, page 45


NEW QUESTION # 37
The water retention associated with SIADH is characterized by

  • A. fluid intake greater than UO, increased serum osmolality and sodium, and severe (4+) pitting edema.
  • B. fluid intake greater than UO, weight gain, and increased urine osmolality and sodium.
  • C. UO greater than fluid intake and severe (4+) pitting edema.
  • D. UO greater than fluid intake, extreme weight gain, and mild (2+) pitting edema.

Answer: B

Explanation:
The syndrome of inappropriate antidiuretic hormone (SIADH) is characterized by excessive release of antidiuretic hormone (ADH), leading to water retention. This results in fluid intake being greater than urine output (UO), weight gain due to fluid retention, and concentrated urine with increased osmolality and sodium levels. SIADH does not typically present with severe pitting edema or increased serum osmolality and sodium.
References: =
* CCRN (Adult) Certification Review Course Online: Endocrine Emergencies.
* American Association of Critical-Care Nurses (AACN). (2024). CCRN Exam Handbook. Retrieved from AACN CCRN Exam Handbook
* Adult CCRN/CCRN-E/CCRN-K Certification Review Course Online. AACN


NEW QUESTION # 38
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