AACN Certification CCRN/PCCN Critical Care Exam 1
|2026 COMPLETE QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED
A+||BRAND NEW VERSION!!
AACN - answer- : certify nurses; protect consumer by establishing high standards of professional
practice
CCRN - answer- : certification for nurses who provide care in critically ill adult, pediatric, or neonatal
populations
PCCN - answer- : certification for nurses who provide acute care in progressive care, telemetry, and
similar units
CNML - answer- : certification for critical care managers and leaders
Simple Face Mask - answer- : Flow rate should be set to at least 5 liter/min to prevent rebreathing CO2;
delivers flow rate @ 5 to 12 liters/min; provide concentration of 30% to 60%
Face Mask with Reservoirs - answer- : Provide concentration of 35% to 60% (partial) or 60% to 80%
(non-rebreather); may be used in patient with severe hypoxemia; non-rebreather has one way valve
Oral Airways (airway management) - answer- : Prevents tongue from falling back and obstructing
pharynx; for patient with depressed LOC; make ventilation of ambu bag easier; prevent unconscious
patient from biting and occluding ETT
,Nasopharyngeal Airways (airway management) - answer- : Also known as nasal airway or nasal trumpet;
not recommended for extended use as it can cause sinusitis or otitis;
Endotracheal Intubation (ETT) - answer- : can be inserted through mouth and nose; decrease ventilator-
associated pneumonia; used to establish airway, assist in secretion removal, provide mechanical
ventilation; protects airway from aspiration if patient have depressed cough/gag reflex
Procedure for Oral ETT - answer- : choose proper ETT size, usually between 7.5 to 9.0; tube is inserted
about 5 to 6 cm and cuff is inflated
Procedure for Naso ETT - answer- : done 2 ways: blind or direct visualization; naris is prepared with
vasocontricting agent to reduce bleeding and an anesthetic agent; position patient semi-Fowler, high
Fowler, or supine; Blind can only be done in patient who can spontaneously breath; correct placement is
28 cm (males) & 26 cm (females)
Verification of ETT Placement - answer- : auscultate epigastrium and lung fields and observe for bilateral
chest expansion; use a disposable ETCO2 detector, or a bulb aspiration device (ETCO2 will change from
purple to yellow); pulse oximetry (should not fall); portable chest radiograph; Tip of TT should be about
3 to 4 cm above the carina
Indications for Tracheostomy - answer- : long-term mechanical ventilation; long-term secretion
management; protecting airway from aspiration when cough/gag reflexes are impaired; bypassing upper
airway obstruction that prevents placement of ETT; reducing WOB associated with ETT
Advantages of Tracheostomy - answer- : shorter than ETT; airflow resistance is less than ETT; better
tolerated than ETT; requires less sedation or restraint use than ETT; allows patient to talk; makes oral
hygiene easier; permits oral intake
Percutaneous Dilatational Tracheostomy (PDT) - answer- : can be done @ bedside; ensure IV access line
are accessible for sedatives and analgesics; monitor physiological parameter Q15 minutes; complication
is accidental decannulation due to unsecured trachea and reinsertion may cause difficulty; oral
intubation may be required
Endotracheal Suctioning - answer- : Prevents complications such as hypoxemia, airway trauma,
infection, and ICP; stimulates cough reflex and promotes mobilization; indicated in presence of rhonchi;
, O2 desat; change in VS; dyspnea; restlessness; increased PIP; high-pressure vent alarms;
hyperoxygenate for 30 seconds;
Positive-Pressure Ventilation (Mechanical Ventilation) - answer- : forces air into lungs via artificial
airway; enlarges thoracic cavity; increases negative chest pressure, which results in flow of air into lungs
Tidal Volume (Vt) (ventilator setting) - answer- : amount of air delivered with each preset breath; ensure
that excessive stretch and pressure on lung tissue is avoided; set at 6 to 8 mL/kg of ideal body weight
and lower for obstructive airway disease; PIP should be below 40 cm H2O and Pplat should be below 30
cm H2O; goal is to achieve lowest Pplat while maintaining gas exchange
RR (ventilator setting) - answer- : frequency of breath (f); set to rates 14 to 20 bpm; when it is decreased
or mode of ventilation is changed, patient becomes capable of participating in ventilator work
Inspiratory-to-Expiratory Ratio (I:E) (ventilator setting) - answer- : set at 1:2 (33% inspiration; 66%
expiration); ratio of 1:3 or 1:4 may be needed in COPD patients to promote more complete exhalation
and reduce air trapping; reserve with noncompliant lungs (ie. ARDS)
Positive End-Expiratory Pressure (PEEP) - answer- : set at 5 to 20 cm H2O; allows airway to be held open
and improve oxygenation; mechanically vented patients receive 3 to 5 cm H2O; used to decrease high
FiO2; when applied, pressure reading does not return to zero at end of breath; adverse effects is ICP and
decrease in CO (decrease venous return, volutrauma, or barotrauma)
Nursing Management of PEEP - answer- : when level is increased, evaluate patient's hemodynamic
response; If client experienced decreased CO, ensure patient has adequate intravascular volume
(preload) and administer fluids. if that does not work, administer dobutamine (inotropic agent)
Auto-PEEP - answer- : the spontaneous development of PEEP due to gas trapping in lung from
insufficient expiratory time and incomplete exhalation, rapid RR, high VE demand, airflow obstruction,
inverse I:E ratio ventilation.
Peak Inspiratory Pressure (PIP) - answer- : the max pressure that occurs during inspiration; should never
be allowed to rise above 40 cm H2O, as it can cause ventilator-induced lung injury; monitor @ least Q4H
and with changes in patient's condition
|2026 COMPLETE QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED
A+||BRAND NEW VERSION!!
AACN - answer- : certify nurses; protect consumer by establishing high standards of professional
practice
CCRN - answer- : certification for nurses who provide care in critically ill adult, pediatric, or neonatal
populations
PCCN - answer- : certification for nurses who provide acute care in progressive care, telemetry, and
similar units
CNML - answer- : certification for critical care managers and leaders
Simple Face Mask - answer- : Flow rate should be set to at least 5 liter/min to prevent rebreathing CO2;
delivers flow rate @ 5 to 12 liters/min; provide concentration of 30% to 60%
Face Mask with Reservoirs - answer- : Provide concentration of 35% to 60% (partial) or 60% to 80%
(non-rebreather); may be used in patient with severe hypoxemia; non-rebreather has one way valve
Oral Airways (airway management) - answer- : Prevents tongue from falling back and obstructing
pharynx; for patient with depressed LOC; make ventilation of ambu bag easier; prevent unconscious
patient from biting and occluding ETT
,Nasopharyngeal Airways (airway management) - answer- : Also known as nasal airway or nasal trumpet;
not recommended for extended use as it can cause sinusitis or otitis;
Endotracheal Intubation (ETT) - answer- : can be inserted through mouth and nose; decrease ventilator-
associated pneumonia; used to establish airway, assist in secretion removal, provide mechanical
ventilation; protects airway from aspiration if patient have depressed cough/gag reflex
Procedure for Oral ETT - answer- : choose proper ETT size, usually between 7.5 to 9.0; tube is inserted
about 5 to 6 cm and cuff is inflated
Procedure for Naso ETT - answer- : done 2 ways: blind or direct visualization; naris is prepared with
vasocontricting agent to reduce bleeding and an anesthetic agent; position patient semi-Fowler, high
Fowler, or supine; Blind can only be done in patient who can spontaneously breath; correct placement is
28 cm (males) & 26 cm (females)
Verification of ETT Placement - answer- : auscultate epigastrium and lung fields and observe for bilateral
chest expansion; use a disposable ETCO2 detector, or a bulb aspiration device (ETCO2 will change from
purple to yellow); pulse oximetry (should not fall); portable chest radiograph; Tip of TT should be about
3 to 4 cm above the carina
Indications for Tracheostomy - answer- : long-term mechanical ventilation; long-term secretion
management; protecting airway from aspiration when cough/gag reflexes are impaired; bypassing upper
airway obstruction that prevents placement of ETT; reducing WOB associated with ETT
Advantages of Tracheostomy - answer- : shorter than ETT; airflow resistance is less than ETT; better
tolerated than ETT; requires less sedation or restraint use than ETT; allows patient to talk; makes oral
hygiene easier; permits oral intake
Percutaneous Dilatational Tracheostomy (PDT) - answer- : can be done @ bedside; ensure IV access line
are accessible for sedatives and analgesics; monitor physiological parameter Q15 minutes; complication
is accidental decannulation due to unsecured trachea and reinsertion may cause difficulty; oral
intubation may be required
Endotracheal Suctioning - answer- : Prevents complications such as hypoxemia, airway trauma,
infection, and ICP; stimulates cough reflex and promotes mobilization; indicated in presence of rhonchi;
, O2 desat; change in VS; dyspnea; restlessness; increased PIP; high-pressure vent alarms;
hyperoxygenate for 30 seconds;
Positive-Pressure Ventilation (Mechanical Ventilation) - answer- : forces air into lungs via artificial
airway; enlarges thoracic cavity; increases negative chest pressure, which results in flow of air into lungs
Tidal Volume (Vt) (ventilator setting) - answer- : amount of air delivered with each preset breath; ensure
that excessive stretch and pressure on lung tissue is avoided; set at 6 to 8 mL/kg of ideal body weight
and lower for obstructive airway disease; PIP should be below 40 cm H2O and Pplat should be below 30
cm H2O; goal is to achieve lowest Pplat while maintaining gas exchange
RR (ventilator setting) - answer- : frequency of breath (f); set to rates 14 to 20 bpm; when it is decreased
or mode of ventilation is changed, patient becomes capable of participating in ventilator work
Inspiratory-to-Expiratory Ratio (I:E) (ventilator setting) - answer- : set at 1:2 (33% inspiration; 66%
expiration); ratio of 1:3 or 1:4 may be needed in COPD patients to promote more complete exhalation
and reduce air trapping; reserve with noncompliant lungs (ie. ARDS)
Positive End-Expiratory Pressure (PEEP) - answer- : set at 5 to 20 cm H2O; allows airway to be held open
and improve oxygenation; mechanically vented patients receive 3 to 5 cm H2O; used to decrease high
FiO2; when applied, pressure reading does not return to zero at end of breath; adverse effects is ICP and
decrease in CO (decrease venous return, volutrauma, or barotrauma)
Nursing Management of PEEP - answer- : when level is increased, evaluate patient's hemodynamic
response; If client experienced decreased CO, ensure patient has adequate intravascular volume
(preload) and administer fluids. if that does not work, administer dobutamine (inotropic agent)
Auto-PEEP - answer- : the spontaneous development of PEEP due to gas trapping in lung from
insufficient expiratory time and incomplete exhalation, rapid RR, high VE demand, airflow obstruction,
inverse I:E ratio ventilation.
Peak Inspiratory Pressure (PIP) - answer- : the max pressure that occurs during inspiration; should never
be allowed to rise above 40 cm H2O, as it can cause ventilator-induced lung injury; monitor @ least Q4H
and with changes in patient's condition
