CCRN Complete Exam Study Guide (Questions
and Verified Answers) Expert Graded A+ |
Brand New Version <Latest Edition>
1. The nurse is caring for a patient with acute inferior wall MI, post-coronary
artery stent deployment, For optimal care of the patient, the nurse should: -
ANSWER Continuously monitor the patient in lead II
It is best practice to monitor the patient status post PCI with stent, in the lead
that was most abnormal during the acute occlusion.
2. Which of the following is most likely to result in a low Sv02?
A. Hypotermia
B. Fever
C. Severe sepsis - ANSWER Fever
Fever increases metabolic rate and consumption, which may lead to a drop in
mixed venous oxygen saturation.
3. The nurse needs to assess adequacy of the tubing/catheter system for the
arterial line. Which of the following interventions will best assess this? -
ANSWER Perform a square wave test
4. The patient requires fluid resuscitation and 8 units of PRBC's status post
traumatic injury. Which of the following interventions is most appropriate? -
ANSWER Warm blood products and crystalloids
,Warming fluids and blood needed for traumatic injury will prevent hypothermia
and its related adverse effects.
5. Which of the following therapies should be avoided for the patient with
cardiogenic shock? - ANSWER high dose vasopressors
Vasopressors increase left ventricular after load, which would increase
myocardial work of a failing heart.
6. The patient is status post repair of an aneurysm for subarachnoid
hemorrhage. Which of the following interventions is indicated to prevent
vasospasm? - ANSWER Nimodipine (Nimotop)
7. The patient presents with a rigid abdomen, rebound tenderness, and a free air
in the peritoneum seen on KUB x-ray. Which of the following should the
nurse anticipate? - ANSWER Powell perforation; provide fluids, prepare for
surgery.
The clinical signs are those of bowel perforation.
8. Which is the priority treatment for the pt with DKA who presents with
hyperglycemia, ketosis, and normal serum potassium? - ANSWER replace
potassium
The patient with DKA will have a low pH and metabolic acidosis. In a state of
metabolic acidosis, hydrogen ions move into the intracellular space. In
exchange, potassium leaves the intracellular space. The movement of K into the
extracellular space results in hyperkalemia.
,9. Which of the following is a systemic effect of the therapeutic hypothermia
during the cooling phase? - ANSWER Hyperglycemia secondary to insulin
resistance.
During the cooling phase of clinical hypothermia there is typically insulin
resistance. Additionally, during the phase there is vasoconstriction, decreased
neutrophil production and during rewarming, rebound hyperkalemia may occur
(not during the cooling phase).
10.The patient presented to the ED with a history of palpitations and dyspnea,
persisting on and off for one week. The heart monitor shows trail fibrillation
with rapid ventricular response, blood pressure 112/70. Treatment will most
likely include: - ANSWER CCB and anticoagulation
The patient history seems to be one of intermittent atrail fibrillation over the
past week. Controlling rate and addressing potential left atrial clot formation are
priority treatments.
11.The ECG demonstrates ST elevation in leads II, III and aVF. The nurse
needs to monitor the patient closely for which of the following? - ANSWER
Complication likely to occur after an acute inferior wall MI include
bradycardia secondary to ischemia to the SA and/or AV node, and papillary
muscle rupture or dysfunction due to the anatomical distance between the
RCA and the papillary muscle.
12.Which of the following hemodynamic profiles would benefit from the
aggressive fluid administration, pressers and antibiotics therapy?
a. RAP: 1mm Hg; PAOP: 4 mmHg; SVR: 1800 dynes/sec; CO:
2L/min
, b. RAP: 5; PAOP: 7; SVR: 400; CO; 8L - ANSWER B. the
hemodynamic profile of RAP 5, PAOP 7, SVR 400 is typical
of septic shock, and choice B would be the best approach.
13.Which of the following is indicative of a mixed acid-base disorder?
A. pH 7.18; PaCO2 25; PaO2 64; HCO3 11
B. pH 7.33; PaCO2 29; PaO2 72; HCO3 15 - ANSWER The decrease in
PaCO2 is evidence of respiratory alkalosis and the decreased HCO3 is
evidenced of a metabolic acidosis. The pt with severe sepsis or septic
shock may present with this mixed acid-base disorder.
14.The patient with a temporary pacemaker develops pacemaker malfunction.
The oriented is instructed to reposition the patient to try and correct the
problem. The cardiac monitor most likely demonstrates? - ANSWER
Failure to capture (pacemaker without a QRS) may be corrected by
repositioning the patient to the side.
15.The patient with diastolic heart develops SVT, heart rate 220/min. The most
dangerous hemodynamic effect is a decrease in: - ANSWER coronary artery
perfusion.
16.Diastolic heart failure results in a problem with left ventricular FILLING
secondary to ventricular thickening, and contractility and ejection are
maintained in diastolic failure. The rapid heart rate will decrease filling time,
worsen left ventricular filling and because coronary artery perfusion occurs
during diastole, this arrhythmia may be life-threatening.
and Verified Answers) Expert Graded A+ |
Brand New Version <Latest Edition>
1. The nurse is caring for a patient with acute inferior wall MI, post-coronary
artery stent deployment, For optimal care of the patient, the nurse should: -
ANSWER Continuously monitor the patient in lead II
It is best practice to monitor the patient status post PCI with stent, in the lead
that was most abnormal during the acute occlusion.
2. Which of the following is most likely to result in a low Sv02?
A. Hypotermia
B. Fever
C. Severe sepsis - ANSWER Fever
Fever increases metabolic rate and consumption, which may lead to a drop in
mixed venous oxygen saturation.
3. The nurse needs to assess adequacy of the tubing/catheter system for the
arterial line. Which of the following interventions will best assess this? -
ANSWER Perform a square wave test
4. The patient requires fluid resuscitation and 8 units of PRBC's status post
traumatic injury. Which of the following interventions is most appropriate? -
ANSWER Warm blood products and crystalloids
,Warming fluids and blood needed for traumatic injury will prevent hypothermia
and its related adverse effects.
5. Which of the following therapies should be avoided for the patient with
cardiogenic shock? - ANSWER high dose vasopressors
Vasopressors increase left ventricular after load, which would increase
myocardial work of a failing heart.
6. The patient is status post repair of an aneurysm for subarachnoid
hemorrhage. Which of the following interventions is indicated to prevent
vasospasm? - ANSWER Nimodipine (Nimotop)
7. The patient presents with a rigid abdomen, rebound tenderness, and a free air
in the peritoneum seen on KUB x-ray. Which of the following should the
nurse anticipate? - ANSWER Powell perforation; provide fluids, prepare for
surgery.
The clinical signs are those of bowel perforation.
8. Which is the priority treatment for the pt with DKA who presents with
hyperglycemia, ketosis, and normal serum potassium? - ANSWER replace
potassium
The patient with DKA will have a low pH and metabolic acidosis. In a state of
metabolic acidosis, hydrogen ions move into the intracellular space. In
exchange, potassium leaves the intracellular space. The movement of K into the
extracellular space results in hyperkalemia.
,9. Which of the following is a systemic effect of the therapeutic hypothermia
during the cooling phase? - ANSWER Hyperglycemia secondary to insulin
resistance.
During the cooling phase of clinical hypothermia there is typically insulin
resistance. Additionally, during the phase there is vasoconstriction, decreased
neutrophil production and during rewarming, rebound hyperkalemia may occur
(not during the cooling phase).
10.The patient presented to the ED with a history of palpitations and dyspnea,
persisting on and off for one week. The heart monitor shows trail fibrillation
with rapid ventricular response, blood pressure 112/70. Treatment will most
likely include: - ANSWER CCB and anticoagulation
The patient history seems to be one of intermittent atrail fibrillation over the
past week. Controlling rate and addressing potential left atrial clot formation are
priority treatments.
11.The ECG demonstrates ST elevation in leads II, III and aVF. The nurse
needs to monitor the patient closely for which of the following? - ANSWER
Complication likely to occur after an acute inferior wall MI include
bradycardia secondary to ischemia to the SA and/or AV node, and papillary
muscle rupture or dysfunction due to the anatomical distance between the
RCA and the papillary muscle.
12.Which of the following hemodynamic profiles would benefit from the
aggressive fluid administration, pressers and antibiotics therapy?
a. RAP: 1mm Hg; PAOP: 4 mmHg; SVR: 1800 dynes/sec; CO:
2L/min
, b. RAP: 5; PAOP: 7; SVR: 400; CO; 8L - ANSWER B. the
hemodynamic profile of RAP 5, PAOP 7, SVR 400 is typical
of septic shock, and choice B would be the best approach.
13.Which of the following is indicative of a mixed acid-base disorder?
A. pH 7.18; PaCO2 25; PaO2 64; HCO3 11
B. pH 7.33; PaCO2 29; PaO2 72; HCO3 15 - ANSWER The decrease in
PaCO2 is evidence of respiratory alkalosis and the decreased HCO3 is
evidenced of a metabolic acidosis. The pt with severe sepsis or septic
shock may present with this mixed acid-base disorder.
14.The patient with a temporary pacemaker develops pacemaker malfunction.
The oriented is instructed to reposition the patient to try and correct the
problem. The cardiac monitor most likely demonstrates? - ANSWER
Failure to capture (pacemaker without a QRS) may be corrected by
repositioning the patient to the side.
15.The patient with diastolic heart develops SVT, heart rate 220/min. The most
dangerous hemodynamic effect is a decrease in: - ANSWER coronary artery
perfusion.
16.Diastolic heart failure results in a problem with left ventricular FILLING
secondary to ventricular thickening, and contractility and ejection are
maintained in diastolic failure. The rapid heart rate will decrease filling time,
worsen left ventricular filling and because coronary artery perfusion occurs
during diastole, this arrhythmia may be life-threatening.
