CCRN EXAM CRAM TEST BANK SOLVED QUESTIONS 100 PERCENT CORRECT ANSWERS
CCRN EXAM CRAM Final Study Guide 2026/2027
Questions and Answers Verified Solutions Latest
Update
Question:
A patient with a triple-lumen subclavian catheter has been receiving total parenteral nutrition,
maintenance fluids, and antibiotics by the catheter. He has been slightly confused. Suddenly he
grasps the catheter and pulls it out. He then complains of shortness of breath, and his pulse oximetry
indicates an SpO2 of 84%. How should this patient be positioned? A. Head down, left side B. Head
down, right side C. Head of bed elevated, left side D. Head of bed elevated, right side
Answer:
A. Head down, left side Envision a big air bubble in the patient's heart. Think: what position would
decrease the movement of the air embolism out of the right side of the heart. Chose "Head down,
left side."
Question:
Oxygen delivery (DO2) is the product of which of the following? A. PaO2, hemoglobin, mean
arterial pressure B. SaO2, hemoglobin, cardiac output C. SvO2, cardiac index, SaO2 D. PaO2, mean
arterial pressure, SvO2
Answer:
B. SaO2, hemoglobin, cardiac output Oxygen is delivered from the arterial end, so choose an option
that has SaO2
Question:
Which of the following is the most significant complication of status asthmaticus? A. Pulmonary
embolism B. Acute respiratory failure C. Hypertension D. Anaphylaxis
Answer:
B. Acute respiratory failure
,Question:
A 22-year-old man is admitted to the critical care unit after a motor vehicle collision. The
emergency department nurse reports that he was unconscious at the scene of the accident, but he is
now alert and oriented. Skull films show a linear fracture of the right temporal bone. He is at
significant risk for: A. scalp hematoma. B. subdural hematoma. C. epidural hematoma. D.
intracerebral hematoma.
Answer:
C. epidural hematoma. Linear fractures of the temporal bone frequently disrupt the middle
meningeal artery and cause epidural hematoma. Patients with an epidural hematoma classically
present with a short period of unconsciousness followed by a lucid interval and then rapid
deterioration. An epidural hematoma is usually caused by arterial bleeding.
Question:
A patient is admitted to the ICU after sustaining a concussion and blunt abdominal trauma to the
right upper quadrant in a domestic dispute. The patient's vital signs are BP 145/86 mm Hg, pulse 86
beats/min, respiration 15 breaths/min, and temperature 98.8° F. The nurse is monitoring the patient's
bowel sounds, abdominal tenderness, and abdominal girth frequently. Which of the following
laboratory parameters is especially important for the nurse to closely monitor for bleeding in this
patient? A. Platelet count B. Protime C. Hematocrit D. Mean corpuscular volume
Answer:
C. Hematocrit Common injuries resulting from blunt abdominal trauma can include injury to the
liver, spleen, mesenteric vessels, pancreas, or kidneys. In a nonoperative approach to blunt
abdominal trauma, observation and monitoring include serial hematocrits to evaluate for
intra-abdominal bleeding. The platelet count does not fluctuate unless there is a disease process (e.g.
cirrhosis, leukemia) or significant blood loss. Protime is a monitor of coagulation status and can be
prolonged without active bleeding. Mean corpuscular volume measures the average volume or size
of a single RBC and is used in classifying anemias.
Question:
Which of the following is associated with chest pain, confusion, and petechiae? A. Dissecting
aneurysm B. Fat embolism C. Pneumothorax D. Myocardial infarction
Answer:
B. Fat embolism Chest pain, confusion, and petechiae are suggestive of a fat embolism, especially
within the first 48 to 72 hours after a long-bone fracture. The clincher is the petechiae. None of the
,other choices would cause petechiae.
Question:
Which type of shock is most likely to be iatrogenic? A. Hypovolemic B. Cardiogenic C. Septic D.
Neurogenic
Answer:
C. Septic Iatrogenic means caused by treatment or diagnostic procedures or medically induced.
Septic shock is the type of shock most likely to be iatrogenic. Significant contributors include
immunosuppressive medications and therapies and invasive procedures.
Question:
A patient had a craniotomy 2 days ago for removal of a tumor. He is awake and talking to the nurse
and demonstrates no neurologic deficit. Blood pressure is 110/80 mm Hg, pulse is 92 beats/min, and
respiratory rate is 22 breaths/min. Urine outputs have been approximately 60 ml/hr over the last 2
days, but he has had a recent change. He has had 300 to 400 ml/hr of urine output over the last
several hours. The urine has a specific gravity of 1.002. The nurse checks his serum glucose and
finds that it is 100 mg/dl. The cause of hypernatremia in this patient is: A. sodium retention. B.
water loss. C. water gain. D. aldosterone excess.
Answer:
B. water loss This case is an example of diabetes insipidus, which is caused by a lack of antidiuretic
hormone (ADH). ADH causes water retention in the renal tubules but not sodium retention, so
eliminate sodium retention. A lack of ADH causes water loss not water gain, so eliminate water
gain. Diabetes insipidus does not have anything to do with aldosterone. The hypernatremia is a
concentration effect caused by water loss. This sometimes is called hypovolemic hypernatremia.
Question:
A patient is admitted with unstable angina. He has a long history of hypertension and coronary
artery disease. The nurse notes a split S2on expiration and a single S2 on inspiration during cardiac
auscultation. Blood pressure is 150/88 mm Hg, and heart rate is 88 beats/min. On the
electrocardiogram, there is a normal-appearing P wave in front of each QRS complex, the PR
interval measures 0.2 second consistently, and the QRS complexes measure 0.14 second. They are
positive in V5 and V6 and negative in V1 and V2. These findings most likely indicate which of the
following? A. Left bundle branch block (LBBB) B. Right bundle branch block (RBBB) C.
Third-degree atrioventricular block D. Ventricular tachycardia
, Answer:
A. Left bundle branch block (LBBB) Features of LBBB described here are a QRS complex greater
than 0.12 second in duration and a QRS complex that is positive in leads V5 and V6 (consider these
left ventricular leads) and negative in leads V1 and V2 (consider these right ventricular leads).
LBBB causes a paradoxical splitting of S2. This means that it is split on expiration but not on
inspiration. This is paradoxical because it is opposite of a normal physiologic split of S2, which is
split on inspiration but not split on expiration
Question:
Which of the following is not an indication for mechanical ventilation in patients with asthma? A.
Respiratory alkalosis B. Cardiopulmonary arrest C. Respiratory muscle fatigue D. Hypercapnia and
respiratory acidosis
Answer:
A. Respiratory alkalosis Respiratory alkalosis is seen early in asthma because of hyperventilation.
Question:
A patient exhibiting nystagmus, ataxia, unsteady gait, and problems with rapid, alternating
movements probably has a lesion in the: A. frontal lobe. B. pituitary gland. C. cerebellum. D.
brainstem.
Answer:
C. cerebellum The pituitary is an endocrine gland that controls release of hormones within the body,
so eliminate "pituitary gland." The brainstem contains the cardiac and respiratory centers,
temperature, and other basic drives, so eliminate "brainstem." The frontal lobe controls voluntary
motor function and behavior, so eliminate "frontal lobe." The cerebellum controls balance and
coordination. Associate bellum with ballerina, who must balance to dance. Choose "cerebellum."
Question:
Which route would be preferred for the rapid administration of fluids in hypovolemic shock? A.
Central venous catheter B. Large-gauge, short peripheral catheter C. Needle inserted into saline lock
D. Large-gauge, long peripheral catheter
Answer:
CCRN EXAM CRAM Final Study Guide 2026/2027
Questions and Answers Verified Solutions Latest
Update
Question:
A patient with a triple-lumen subclavian catheter has been receiving total parenteral nutrition,
maintenance fluids, and antibiotics by the catheter. He has been slightly confused. Suddenly he
grasps the catheter and pulls it out. He then complains of shortness of breath, and his pulse oximetry
indicates an SpO2 of 84%. How should this patient be positioned? A. Head down, left side B. Head
down, right side C. Head of bed elevated, left side D. Head of bed elevated, right side
Answer:
A. Head down, left side Envision a big air bubble in the patient's heart. Think: what position would
decrease the movement of the air embolism out of the right side of the heart. Chose "Head down,
left side."
Question:
Oxygen delivery (DO2) is the product of which of the following? A. PaO2, hemoglobin, mean
arterial pressure B. SaO2, hemoglobin, cardiac output C. SvO2, cardiac index, SaO2 D. PaO2, mean
arterial pressure, SvO2
Answer:
B. SaO2, hemoglobin, cardiac output Oxygen is delivered from the arterial end, so choose an option
that has SaO2
Question:
Which of the following is the most significant complication of status asthmaticus? A. Pulmonary
embolism B. Acute respiratory failure C. Hypertension D. Anaphylaxis
Answer:
B. Acute respiratory failure
,Question:
A 22-year-old man is admitted to the critical care unit after a motor vehicle collision. The
emergency department nurse reports that he was unconscious at the scene of the accident, but he is
now alert and oriented. Skull films show a linear fracture of the right temporal bone. He is at
significant risk for: A. scalp hematoma. B. subdural hematoma. C. epidural hematoma. D.
intracerebral hematoma.
Answer:
C. epidural hematoma. Linear fractures of the temporal bone frequently disrupt the middle
meningeal artery and cause epidural hematoma. Patients with an epidural hematoma classically
present with a short period of unconsciousness followed by a lucid interval and then rapid
deterioration. An epidural hematoma is usually caused by arterial bleeding.
Question:
A patient is admitted to the ICU after sustaining a concussion and blunt abdominal trauma to the
right upper quadrant in a domestic dispute. The patient's vital signs are BP 145/86 mm Hg, pulse 86
beats/min, respiration 15 breaths/min, and temperature 98.8° F. The nurse is monitoring the patient's
bowel sounds, abdominal tenderness, and abdominal girth frequently. Which of the following
laboratory parameters is especially important for the nurse to closely monitor for bleeding in this
patient? A. Platelet count B. Protime C. Hematocrit D. Mean corpuscular volume
Answer:
C. Hematocrit Common injuries resulting from blunt abdominal trauma can include injury to the
liver, spleen, mesenteric vessels, pancreas, or kidneys. In a nonoperative approach to blunt
abdominal trauma, observation and monitoring include serial hematocrits to evaluate for
intra-abdominal bleeding. The platelet count does not fluctuate unless there is a disease process (e.g.
cirrhosis, leukemia) or significant blood loss. Protime is a monitor of coagulation status and can be
prolonged without active bleeding. Mean corpuscular volume measures the average volume or size
of a single RBC and is used in classifying anemias.
Question:
Which of the following is associated with chest pain, confusion, and petechiae? A. Dissecting
aneurysm B. Fat embolism C. Pneumothorax D. Myocardial infarction
Answer:
B. Fat embolism Chest pain, confusion, and petechiae are suggestive of a fat embolism, especially
within the first 48 to 72 hours after a long-bone fracture. The clincher is the petechiae. None of the
,other choices would cause petechiae.
Question:
Which type of shock is most likely to be iatrogenic? A. Hypovolemic B. Cardiogenic C. Septic D.
Neurogenic
Answer:
C. Septic Iatrogenic means caused by treatment or diagnostic procedures or medically induced.
Septic shock is the type of shock most likely to be iatrogenic. Significant contributors include
immunosuppressive medications and therapies and invasive procedures.
Question:
A patient had a craniotomy 2 days ago for removal of a tumor. He is awake and talking to the nurse
and demonstrates no neurologic deficit. Blood pressure is 110/80 mm Hg, pulse is 92 beats/min, and
respiratory rate is 22 breaths/min. Urine outputs have been approximately 60 ml/hr over the last 2
days, but he has had a recent change. He has had 300 to 400 ml/hr of urine output over the last
several hours. The urine has a specific gravity of 1.002. The nurse checks his serum glucose and
finds that it is 100 mg/dl. The cause of hypernatremia in this patient is: A. sodium retention. B.
water loss. C. water gain. D. aldosterone excess.
Answer:
B. water loss This case is an example of diabetes insipidus, which is caused by a lack of antidiuretic
hormone (ADH). ADH causes water retention in the renal tubules but not sodium retention, so
eliminate sodium retention. A lack of ADH causes water loss not water gain, so eliminate water
gain. Diabetes insipidus does not have anything to do with aldosterone. The hypernatremia is a
concentration effect caused by water loss. This sometimes is called hypovolemic hypernatremia.
Question:
A patient is admitted with unstable angina. He has a long history of hypertension and coronary
artery disease. The nurse notes a split S2on expiration and a single S2 on inspiration during cardiac
auscultation. Blood pressure is 150/88 mm Hg, and heart rate is 88 beats/min. On the
electrocardiogram, there is a normal-appearing P wave in front of each QRS complex, the PR
interval measures 0.2 second consistently, and the QRS complexes measure 0.14 second. They are
positive in V5 and V6 and negative in V1 and V2. These findings most likely indicate which of the
following? A. Left bundle branch block (LBBB) B. Right bundle branch block (RBBB) C.
Third-degree atrioventricular block D. Ventricular tachycardia
, Answer:
A. Left bundle branch block (LBBB) Features of LBBB described here are a QRS complex greater
than 0.12 second in duration and a QRS complex that is positive in leads V5 and V6 (consider these
left ventricular leads) and negative in leads V1 and V2 (consider these right ventricular leads).
LBBB causes a paradoxical splitting of S2. This means that it is split on expiration but not on
inspiration. This is paradoxical because it is opposite of a normal physiologic split of S2, which is
split on inspiration but not split on expiration
Question:
Which of the following is not an indication for mechanical ventilation in patients with asthma? A.
Respiratory alkalosis B. Cardiopulmonary arrest C. Respiratory muscle fatigue D. Hypercapnia and
respiratory acidosis
Answer:
A. Respiratory alkalosis Respiratory alkalosis is seen early in asthma because of hyperventilation.
Question:
A patient exhibiting nystagmus, ataxia, unsteady gait, and problems with rapid, alternating
movements probably has a lesion in the: A. frontal lobe. B. pituitary gland. C. cerebellum. D.
brainstem.
Answer:
C. cerebellum The pituitary is an endocrine gland that controls release of hormones within the body,
so eliminate "pituitary gland." The brainstem contains the cardiac and respiratory centers,
temperature, and other basic drives, so eliminate "brainstem." The frontal lobe controls voluntary
motor function and behavior, so eliminate "frontal lobe." The cerebellum controls balance and
coordination. Associate bellum with ballerina, who must balance to dance. Choose "cerebellum."
Question:
Which route would be preferred for the rapid administration of fluids in hypovolemic shock? A.
Central venous catheter B. Large-gauge, short peripheral catheter C. Needle inserted into saline lock
D. Large-gauge, long peripheral catheter
Answer:
