CCRN AACN Study Guide Questions with
Correct Answers
A patient in a hyperosmolar hyperglycemic state (HHS) is being admitted with
dehydration and a serum glucose level of 836 mg/dL. Which additional laboratory
findings should the nurse anticipate?
A. Decreased BUN, decreased creatinine, elevated serum osmolality
B. Elevated BUN, decreased creatinine, decreased serum osmolality
C. Decreased BUN, elevated creatinine, decreased serum osmolality
D. Elevated BUN, elevated creatinine, elevated serum osmolality
D. Elevated BUN, elevated creatinine, elevated serum osmolality
A patient with a history of bronchogenic carcinoma is admitted with respiratory failure.
The patient is intubated and on mechanical ventilation. The patient develops lethargy,
headache, slight confusion, and abdominal cramping. Urinary output is decreasing.
Significant lab data:
Serum Na+: 127 mEq/L
Serum osmolality: 270 mOsm/kg
Urine specific gravity: Elevated
Which INITIAL intervention should the nurse anticipate?
A. Collaboration with the oncologist for emergent chemotherapy
B. Administration of 3% saline
,C. Observation for central pontine myelinolysis
D. Initiation of fluid restriction
D. Initiation of fluid restriction
Which places the older adult at greater risk for alcohol-induced disease?
A. More rapid metabolism of alcohol
B. Larger volume of body water
C. Increase in lean body tissue
D. Use of psychotropic drugs
D. Use of psychotropic drugs
Which is an endpoint of volume resuscitation?
A. CVP 3 mm Hg
B. CI 2.4 L/min/m²
C. Oxygen consumption 250 mL/min
D. Base deficit 4 mmol/L
C. Oxygen consumption 250 mL/min
Which 12-lead ECG changes should be expected in a patient with ACS involving the
inferior wall?
A. ST segment elevation and deeply inverted T waves in leads V₄-V₆, I, and aVL
B. ST segment elevation in leads II, III, and all the precordial leads
C. ST segment elevation and deeply inverted T waves in leads II, III, and aVF
D. ST segment depression and T wave elevation in leads II, III, and aVL
,C. ST segment elevation and deeply inverted T waves in leads II, III, and aVF
The major effect of ARDS on lung tissue is:
A. Decreased capillary permeability
B. Increased functional residual capacity
C. Decreased compliance
D. Decreased alveolar surface tension
C. Decreased compliance
A patient with mitral regurgitation suddenly develops atrial fibrillation. BP is 118/74,
and HR is 156. The nurse should anticipate orders for:
A. Beta-blockers and vasopressors
B. Warfarin (Coumadin) and alpha-agonists
C. Beta-agonists and calcium-channel blockers
D. Cardiac glycosides and calcium-channel blockers
D. Cardiac glycosides and calcium-channel blockers
Which life-threatening dysrhythmia is MOST FREQUENTLY associated with heart
failure?
A. Bigeminy premature atrial contractions
B. Ventricular tachycardia
C. Second-degree AV block, Type II
D. Junctional tachycardia
B. Ventricular tachycardia
, A patient has heart failure secondary to ischemic cardiomyopathy and end-stage
coronary artery disease. Which agents would be the MOST beneficial?
A. Digoxin (Lanoxin) and diltiazem (Cardizem)
B. Carvedilol (Coreg) and lisinopril (Zestril)
C. Verapamil (Calan) and spironolactone (Aldactone)
D. Flecainide (Tambocor) and hydralazine (Apresoline)
C. Verapamil (Calan) and spironolactone (Aldactone)
When providing care to a patient with status epilepticus, the nurse should recognize
that usually:
A. It is a state of continuous seizures lasting more than 2 minutes.
B. The patient comes out of the postictal state between seizures.
C. It results from abrupt discontinuation of anti-seizure medications.
D. The cause of death is due to cerebral hemorrhage.
C. It results from abrupt discontinuation of anti-seizure medications.
A patient with a history of angina is admitted to the unit after surgical repair of an
abdominal aortic aneurysm (AAA). The patient is receiving a sodium nitroprusside
(Nipride) drip for severe postoperative hypertension. Twelve hours later, the patient
complains of back pain. Assessment at this time reveals:
BP: 80/60
HR: 120
UO: 20mL/hr
Correct Answers
A patient in a hyperosmolar hyperglycemic state (HHS) is being admitted with
dehydration and a serum glucose level of 836 mg/dL. Which additional laboratory
findings should the nurse anticipate?
A. Decreased BUN, decreased creatinine, elevated serum osmolality
B. Elevated BUN, decreased creatinine, decreased serum osmolality
C. Decreased BUN, elevated creatinine, decreased serum osmolality
D. Elevated BUN, elevated creatinine, elevated serum osmolality
D. Elevated BUN, elevated creatinine, elevated serum osmolality
A patient with a history of bronchogenic carcinoma is admitted with respiratory failure.
The patient is intubated and on mechanical ventilation. The patient develops lethargy,
headache, slight confusion, and abdominal cramping. Urinary output is decreasing.
Significant lab data:
Serum Na+: 127 mEq/L
Serum osmolality: 270 mOsm/kg
Urine specific gravity: Elevated
Which INITIAL intervention should the nurse anticipate?
A. Collaboration with the oncologist for emergent chemotherapy
B. Administration of 3% saline
,C. Observation for central pontine myelinolysis
D. Initiation of fluid restriction
D. Initiation of fluid restriction
Which places the older adult at greater risk for alcohol-induced disease?
A. More rapid metabolism of alcohol
B. Larger volume of body water
C. Increase in lean body tissue
D. Use of psychotropic drugs
D. Use of psychotropic drugs
Which is an endpoint of volume resuscitation?
A. CVP 3 mm Hg
B. CI 2.4 L/min/m²
C. Oxygen consumption 250 mL/min
D. Base deficit 4 mmol/L
C. Oxygen consumption 250 mL/min
Which 12-lead ECG changes should be expected in a patient with ACS involving the
inferior wall?
A. ST segment elevation and deeply inverted T waves in leads V₄-V₆, I, and aVL
B. ST segment elevation in leads II, III, and all the precordial leads
C. ST segment elevation and deeply inverted T waves in leads II, III, and aVF
D. ST segment depression and T wave elevation in leads II, III, and aVL
,C. ST segment elevation and deeply inverted T waves in leads II, III, and aVF
The major effect of ARDS on lung tissue is:
A. Decreased capillary permeability
B. Increased functional residual capacity
C. Decreased compliance
D. Decreased alveolar surface tension
C. Decreased compliance
A patient with mitral regurgitation suddenly develops atrial fibrillation. BP is 118/74,
and HR is 156. The nurse should anticipate orders for:
A. Beta-blockers and vasopressors
B. Warfarin (Coumadin) and alpha-agonists
C. Beta-agonists and calcium-channel blockers
D. Cardiac glycosides and calcium-channel blockers
D. Cardiac glycosides and calcium-channel blockers
Which life-threatening dysrhythmia is MOST FREQUENTLY associated with heart
failure?
A. Bigeminy premature atrial contractions
B. Ventricular tachycardia
C. Second-degree AV block, Type II
D. Junctional tachycardia
B. Ventricular tachycardia
, A patient has heart failure secondary to ischemic cardiomyopathy and end-stage
coronary artery disease. Which agents would be the MOST beneficial?
A. Digoxin (Lanoxin) and diltiazem (Cardizem)
B. Carvedilol (Coreg) and lisinopril (Zestril)
C. Verapamil (Calan) and spironolactone (Aldactone)
D. Flecainide (Tambocor) and hydralazine (Apresoline)
C. Verapamil (Calan) and spironolactone (Aldactone)
When providing care to a patient with status epilepticus, the nurse should recognize
that usually:
A. It is a state of continuous seizures lasting more than 2 minutes.
B. The patient comes out of the postictal state between seizures.
C. It results from abrupt discontinuation of anti-seizure medications.
D. The cause of death is due to cerebral hemorrhage.
C. It results from abrupt discontinuation of anti-seizure medications.
A patient with a history of angina is admitted to the unit after surgical repair of an
abdominal aortic aneurysm (AAA). The patient is receiving a sodium nitroprusside
(Nipride) drip for severe postoperative hypertension. Twelve hours later, the patient
complains of back pain. Assessment at this time reveals:
BP: 80/60
HR: 120
UO: 20mL/hr
