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CCRN Certification Practice Test
Questions & Answers 2026-2027 |
Latest Exam Prep (Rationales)
Document Overview
This document provides 148 CCRN certification practice questions, each paired with its
correct answer and a detailed rationale. It covers critical care nursing, offering a
comprehensive resource for exam preparation. Students can utilize this material for in-
depth study and review to directly align with certification requirements.
100% Accurate Questions and Answers 100% Guarantee Pass - Verified by Experts
Expert-Verified
Verified Answers · Detailed Rationales · 148 Questions · September 2026
CCRN Certification Practice Test Questions & Answers 2026-2027 | Latest Exam Prep (Rationales) - Practice Questions Page 0
, Topics Covered
Section 1: Endocrine & Metabolic Disorders
Questions covering endocrine & Metabolic Disorders concepts.
Section 2: Cardiovascular Assessment & Management
Questions covering cardiovascular Assessment & Management concepts.
Section 3: Neurological & Spinal Cord Injury
Questions covering neurological & Spinal Cord Injury concepts.
Section 4: Respiratory System & Mechanical Ventilation
Questions covering respiratory System & Mechanical Ventilation concepts.
Section 5: Gastrointestinal & Hepatic Disorders
Questions covering gastrointestinal & Hepatic Disorders concepts.
Section 6: Patient & Family Education & Support
Questions covering patient & Family Education & Support concepts.
Questions
QUESTION 1 OF 148
A patient in hyperosolar hyperglycemic state (HHS) is being admitted with dehydration
and a serum glucose level of 836 mg/dL. Which of the following additional laboratory
findings should the nurse anticipate?
A. decreased BUN, decreased creatinine, and elevated serum osmolality
B. decreased BUN, decreased creatinine and decreased serum osmolality
C. decreased BUN, elevated creatinine and decreased serum osmolality
D. elevated BUN, elevated creatinine and elevated serum osmolality
Correct Answer: D. elevated BUN, elevated creatinine and elevated serum osmolality
Serum osmolality > 320 mOsm/kg distinguishes HHS from DKA
Rationale: Hyperosmolar hyperglycemic state (HHS) is characterized by profound dehydration, which leads to
hemoconcentration and elevated BUN and creatinine levels. The extreme hyperglycemia in HHS also causes a
significant increase in serum osmolality, often exceeding 320 mOsm/kg, which is a key diagnostic differentiator from
diabetic ketoacidosis. Therefore, elevated BUN, elevated creatinine, and elevated serum osmolality are anticipated
laboratory findings in a patient with HHS and severe hyperglycemia. This aligns with Serum osmolality > 320
mOsm/kg distinguishes HHS from DKA and elevated creatinine and elevated serum osmolality.
CCRN Certification Practice Test Questions & Answers 2026-2027 | Latest Exam Prep (Rationales) - Practice Questions Page 0
, QUESTION 2 OF 148
A patient with a four-year history of type 1 diabetes is admitted with influenza. The
patient is lethargic, responds to name and follows simple commands. Skin is dry, with
poor turgor. Which of the follow is the most likely cause of the patient's condition?
A. hyponatremia
B. hypoglycemia
C. ketosis
D. hypovolemia
Correct Answer: D. hypovolemia
Rationale: Influenza in a patient with type 1 diabetes can lead to dehydration due to fever, vomiting, and decreased
oral intake. Dry skin and poor turgor are classic signs of significant fluid volume deficit, indicating hypovolemia.
While hypoglycemia or ketosis can occur in diabetics, the prominent physical findings of dehydration point most
strongly to hypovolemia as the primary cause of the patient's lethargy and dry skin. This aligns with D. hypovolemia.
QUESTION 3 OF 148
The nurse is caring for a patient with hyper-calcemia. For which of the following
imbalances should the nurse observe?
A. hypokalemia
B. hypo-albumnemia
C. hyper-magnesmia
D. hyper-phosphatemia
Correct Answer: A. hypokalemia
Rationale: Hypercalcemia is often associated with hypokalemia due to shared mechanisms of renal tubular
reabsorption and effects on cellular potassium shifts. Elevated calcium levels can impair potassium reabsorption in the
distal tubules, leading to increased urinary potassium excretion and subsequent hypokalemia. Additionally, severe
hypercalcemia can cause a shift of potassium from the intracellular to extracellular space, which can mask or
exacerbate hypokalemia. This aligns with A. hypokalemia.
QUESTION 4 OF 148
Which of the following sings are characteristic of diabetes insipidus?
A. low urine output, low serum osmolality, hyponatremia and low urine sodium
B. elevated urine output, low serum osmolality, hyponatremia and low urine sodium
C. low urine output, low serum osmolality, hypernatremia and elevated urine sodium
D. elevated urine output, elevated serum osmolality, hypernatremia and low urine
sodium
Correct Answer: D. elevated urine output, elevated serum osmolality, hypernatremia and low urine
sodium
Rationale: Diabetes insipidus (DI) is characterized by the body's inability to conserve water, leading to excessive
thirst and the excretion of large volumes of dilute urine. This results in polyuria (elevated urine output) and polydipsia,
and if fluid intake cannot keep pace, it can lead to hypernatremia and a high serum osmolality due to free water loss.
The urine, being dilute, will have a low osmolality and low urine sodium concentration as the kidneys are unable to
reabsorb sodium effectively in the absence of ADH action. This aligns with hypernatremia and low urine sodium and
elevated serum osmolality.
CCRN Certification Practice Test Questions & Answers 2026-2027 | Latest Exam Prep (Rationales) - Practice Questions Page 0
, QUESTION 5 OF 148
Procainamide is associated with
Correct Answer: QT prolongation, which can lead to development of Torsades de Pointes
Rationale: Procainamide is a Class IA antiarrhythmic agent that prolongs the QRS duration and QT interval by
blocking sodium channels and potassium channels. Prolongation of the QT interval represents delayed ventricular
repolarization, increasing the risk of early afterdepolarizations and subsequent polymorphic ventricular tachycardia,
specifically Torsades de Pointes. Therefore, procainamide's association with QT prolongation directly links it to the
potential development of this life-threatening arrhythmia. This aligns with which can lead to development of Torsades
de Pointes.
QUESTION 6 OF 148
A patient with DKA is admitted. Since admission, the patient's glucose levels have been
400-500 mg/dL, and regular insulin has been administered on a sliding dosage scale.
Given these findings, the most appropriate initial nursing intervention is to
A. consult with the physician about changing the regiment to regular insulin via
continuous drip
B. arrange for nutritional consult to enhance adherence to an ADA diet
C. consult with the physician about increasing the max dosage of regular insulin on a
sliding scale
D. request eval of a diabetes educator
Correct Answer: A. consult with the physician about changing the regiment to regular insulin via
continuous drip
(goal is to achieve blood glucose lowering by 50-75 mg/dL/hr)
Rationale: Diabetic ketoacidosis (DKA) management requires aggressive glucose lowering with insulin to resolve
hyperglycemia and acidosis. Continuous intravenous infusion of regular insulin is the standard of care for DKA to
achieve predictable and controlled blood glucose reduction, typically aiming for 50-75 mg/dL per hour. When glucose
levels remain persistently high despite a sliding scale, transitioning to a continuous drip allows for more precise
titration and effective management of this critical condition. This aligns with consult with the physician about
changing the regiment to regular insulin via continuous drip and (goal is to achieve blood glucose lowering by 50-75
mg/dL/hr).
CCRN Certification Practice Test Questions & Answers 2026-2027 | Latest Exam Prep (Rationales) - Practice Questions Page 0
CCRN Certification Practice Test
Questions & Answers 2026-2027 |
Latest Exam Prep (Rationales)
Document Overview
This document provides 148 CCRN certification practice questions, each paired with its
correct answer and a detailed rationale. It covers critical care nursing, offering a
comprehensive resource for exam preparation. Students can utilize this material for in-
depth study and review to directly align with certification requirements.
100% Accurate Questions and Answers 100% Guarantee Pass - Verified by Experts
Expert-Verified
Verified Answers · Detailed Rationales · 148 Questions · September 2026
CCRN Certification Practice Test Questions & Answers 2026-2027 | Latest Exam Prep (Rationales) - Practice Questions Page 0
, Topics Covered
Section 1: Endocrine & Metabolic Disorders
Questions covering endocrine & Metabolic Disorders concepts.
Section 2: Cardiovascular Assessment & Management
Questions covering cardiovascular Assessment & Management concepts.
Section 3: Neurological & Spinal Cord Injury
Questions covering neurological & Spinal Cord Injury concepts.
Section 4: Respiratory System & Mechanical Ventilation
Questions covering respiratory System & Mechanical Ventilation concepts.
Section 5: Gastrointestinal & Hepatic Disorders
Questions covering gastrointestinal & Hepatic Disorders concepts.
Section 6: Patient & Family Education & Support
Questions covering patient & Family Education & Support concepts.
Questions
QUESTION 1 OF 148
A patient in hyperosolar hyperglycemic state (HHS) is being admitted with dehydration
and a serum glucose level of 836 mg/dL. Which of the following additional laboratory
findings should the nurse anticipate?
A. decreased BUN, decreased creatinine, and elevated serum osmolality
B. decreased BUN, decreased creatinine and decreased serum osmolality
C. decreased BUN, elevated creatinine and decreased serum osmolality
D. elevated BUN, elevated creatinine and elevated serum osmolality
Correct Answer: D. elevated BUN, elevated creatinine and elevated serum osmolality
Serum osmolality > 320 mOsm/kg distinguishes HHS from DKA
Rationale: Hyperosmolar hyperglycemic state (HHS) is characterized by profound dehydration, which leads to
hemoconcentration and elevated BUN and creatinine levels. The extreme hyperglycemia in HHS also causes a
significant increase in serum osmolality, often exceeding 320 mOsm/kg, which is a key diagnostic differentiator from
diabetic ketoacidosis. Therefore, elevated BUN, elevated creatinine, and elevated serum osmolality are anticipated
laboratory findings in a patient with HHS and severe hyperglycemia. This aligns with Serum osmolality > 320
mOsm/kg distinguishes HHS from DKA and elevated creatinine and elevated serum osmolality.
CCRN Certification Practice Test Questions & Answers 2026-2027 | Latest Exam Prep (Rationales) - Practice Questions Page 0
, QUESTION 2 OF 148
A patient with a four-year history of type 1 diabetes is admitted with influenza. The
patient is lethargic, responds to name and follows simple commands. Skin is dry, with
poor turgor. Which of the follow is the most likely cause of the patient's condition?
A. hyponatremia
B. hypoglycemia
C. ketosis
D. hypovolemia
Correct Answer: D. hypovolemia
Rationale: Influenza in a patient with type 1 diabetes can lead to dehydration due to fever, vomiting, and decreased
oral intake. Dry skin and poor turgor are classic signs of significant fluid volume deficit, indicating hypovolemia.
While hypoglycemia or ketosis can occur in diabetics, the prominent physical findings of dehydration point most
strongly to hypovolemia as the primary cause of the patient's lethargy and dry skin. This aligns with D. hypovolemia.
QUESTION 3 OF 148
The nurse is caring for a patient with hyper-calcemia. For which of the following
imbalances should the nurse observe?
A. hypokalemia
B. hypo-albumnemia
C. hyper-magnesmia
D. hyper-phosphatemia
Correct Answer: A. hypokalemia
Rationale: Hypercalcemia is often associated with hypokalemia due to shared mechanisms of renal tubular
reabsorption and effects on cellular potassium shifts. Elevated calcium levels can impair potassium reabsorption in the
distal tubules, leading to increased urinary potassium excretion and subsequent hypokalemia. Additionally, severe
hypercalcemia can cause a shift of potassium from the intracellular to extracellular space, which can mask or
exacerbate hypokalemia. This aligns with A. hypokalemia.
QUESTION 4 OF 148
Which of the following sings are characteristic of diabetes insipidus?
A. low urine output, low serum osmolality, hyponatremia and low urine sodium
B. elevated urine output, low serum osmolality, hyponatremia and low urine sodium
C. low urine output, low serum osmolality, hypernatremia and elevated urine sodium
D. elevated urine output, elevated serum osmolality, hypernatremia and low urine
sodium
Correct Answer: D. elevated urine output, elevated serum osmolality, hypernatremia and low urine
sodium
Rationale: Diabetes insipidus (DI) is characterized by the body's inability to conserve water, leading to excessive
thirst and the excretion of large volumes of dilute urine. This results in polyuria (elevated urine output) and polydipsia,
and if fluid intake cannot keep pace, it can lead to hypernatremia and a high serum osmolality due to free water loss.
The urine, being dilute, will have a low osmolality and low urine sodium concentration as the kidneys are unable to
reabsorb sodium effectively in the absence of ADH action. This aligns with hypernatremia and low urine sodium and
elevated serum osmolality.
CCRN Certification Practice Test Questions & Answers 2026-2027 | Latest Exam Prep (Rationales) - Practice Questions Page 0
, QUESTION 5 OF 148
Procainamide is associated with
Correct Answer: QT prolongation, which can lead to development of Torsades de Pointes
Rationale: Procainamide is a Class IA antiarrhythmic agent that prolongs the QRS duration and QT interval by
blocking sodium channels and potassium channels. Prolongation of the QT interval represents delayed ventricular
repolarization, increasing the risk of early afterdepolarizations and subsequent polymorphic ventricular tachycardia,
specifically Torsades de Pointes. Therefore, procainamide's association with QT prolongation directly links it to the
potential development of this life-threatening arrhythmia. This aligns with which can lead to development of Torsades
de Pointes.
QUESTION 6 OF 148
A patient with DKA is admitted. Since admission, the patient's glucose levels have been
400-500 mg/dL, and regular insulin has been administered on a sliding dosage scale.
Given these findings, the most appropriate initial nursing intervention is to
A. consult with the physician about changing the regiment to regular insulin via
continuous drip
B. arrange for nutritional consult to enhance adherence to an ADA diet
C. consult with the physician about increasing the max dosage of regular insulin on a
sliding scale
D. request eval of a diabetes educator
Correct Answer: A. consult with the physician about changing the regiment to regular insulin via
continuous drip
(goal is to achieve blood glucose lowering by 50-75 mg/dL/hr)
Rationale: Diabetic ketoacidosis (DKA) management requires aggressive glucose lowering with insulin to resolve
hyperglycemia and acidosis. Continuous intravenous infusion of regular insulin is the standard of care for DKA to
achieve predictable and controlled blood glucose reduction, typically aiming for 50-75 mg/dL per hour. When glucose
levels remain persistently high despite a sliding scale, transitioning to a continuous drip allows for more precise
titration and effective management of this critical condition. This aligns with consult with the physician about
changing the regiment to regular insulin via continuous drip and (goal is to achieve blood glucose lowering by 50-75
mg/dL/hr).
CCRN Certification Practice Test Questions & Answers 2026-2027 | Latest Exam Prep (Rationales) - Practice Questions Page 0
