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CCRN TEST EXAM QUESTIONS AND CORRECT VERIFIED
SOLUTIONS LATEST UPDATE THIS YEAR – JUST RELEASED
CCRN TEST EXAM
EXAM COVERAGE
Cardiovascular emergencies, acute coronary syndromes, dysrhythmias, heart failure,
shock, and cardiac surgery.
Respiratory failure, ARDS, pulmonary embolism, mechanical ventilation, COPD, asthma,
and pulmonary complications.
Endocrine emergencies including DKA, HHS, SIADH, diabetes insipidus, thyroid disorders,
and adrenal insufficiency.
Hematologic and immunologic disorders including anemia, DIC, HIT, transfusion
complications, and immune disorders.
Gastrointestinal and hepatic critical illness including GI hemorrhage, pancreatitis, liver
failure, and abdominal emergencies.
Renal and genitourinary disorders including acute kidney injury, electrolyte disturbances,
acid-base abnormalities, and renal replacement therapy.
Neurologic emergencies including stroke, seizures, traumatic brain injury, intracranial
hypertension, and neurosurgical conditions.
Multisystem critical illness including sepsis, septic shock, MODS, systemic inflammatory
responses, and toxicologic emergencies.
Critical-care pharmacology, hemodynamic monitoring, laboratory interpretation,
procedures, complications, and prioritization.
Professional caring, ethical practice, advocacy, collaboration, communication, diversity,
and patient-centered critical-care decision-making.
QUESTIONS
1. A patient with an acute inferior myocardial infarction suddenly develops hypotension, clear
lung sounds, and elevated jugular venous pressure. Which intervention is most appropriate
initially?
A. Administer a rapid intravenous fluid bolus
B. Administer intravenous furosemide
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C. Increase positive end-expiratory pressure
D. Give an additional vasodilator
Answer: A
Rationale: Inferior infarction involving the right ventricle can produce preload-dependent
hypotension. Carefully administered intravenous fluid can improve right ventricular filling and
cardiac output.
2. A mechanically ventilated patient with severe ARDS has worsening hypoxemia despite
appropriate oxygen therapy and lung-protective ventilation. Which intervention should the
nurse anticipate?
A. Routine reduction of PEEP
B. Immediate discontinuation of mechanical ventilation
C. Prone positioning
D. Administration of a large crystalloid bolus
Answer: C
Rationale: Prone positioning can improve ventilation-perfusion matching and oxygenation in
severe ARDS when used with appropriate lung-protective strategies.
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3. A patient receiving an intravenous heparin infusion develops a platelet count decrease of
more than 50 percent several days after therapy begins. Which complication should the nurse
suspect?
A. Disseminated intravascular coagulation
B. Heparin-induced thrombocytopenia
C. Immune thrombocytopenic purpura
D. Thrombotic thrombocytopenic purpura
Answer: B
Rationale: A significant platelet reduction occurring several days after heparin exposure strongly
suggests HIT, which paradoxically increases the risk of thrombosis.
4. A patient with septic shock remains hypotensive after appropriate fluid resuscitation. Which
medication is generally considered the preferred initial vasopressor?
A. Dopamine
B. Phenylephrine
C. Epinephrine
D. Norepinephrine
Answer: D
Rationale: Norepinephrine is generally the preferred first-line vasopressor for persistent
hypotension in septic shock after adequate fluid resuscitation.
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5. A patient with diabetic ketoacidosis has a serum potassium of 2.8 mEq/L before insulin
therapy begins. What should the nurse anticipate first?
A. Starting an insulin infusion immediately
B. Administering potassium replacement
C. Administering intravenous sodium bicarbonate routinely
D. Restricting all intravenous fluids
Answer: B
Rationale: Insulin shifts potassium intracellularly and can precipitate dangerous hypokalemia.
Significant hypokalemia should be corrected before insulin is initiated.
6. Which assessment finding most strongly suggests cardiac tamponade in a critically ill patient
after cardiac surgery?
A. Hypertension with bounding pulses
B. Pulmonary crackles and frothy sputum
C. Hypotension, muffled heart sounds, and elevated jugular venous pressure
D. Bradycardia with widened pulse pressure
Answer: C
Rationale: Hypotension, elevated venous pressure, and muffled heart sounds are classic
findings associated with cardiac tamponade.
CCRN TEST EXAM QUESTIONS AND CORRECT VERIFIED
SOLUTIONS LATEST UPDATE THIS YEAR – JUST RELEASED
CCRN TEST EXAM
EXAM COVERAGE
Cardiovascular emergencies, acute coronary syndromes, dysrhythmias, heart failure,
shock, and cardiac surgery.
Respiratory failure, ARDS, pulmonary embolism, mechanical ventilation, COPD, asthma,
and pulmonary complications.
Endocrine emergencies including DKA, HHS, SIADH, diabetes insipidus, thyroid disorders,
and adrenal insufficiency.
Hematologic and immunologic disorders including anemia, DIC, HIT, transfusion
complications, and immune disorders.
Gastrointestinal and hepatic critical illness including GI hemorrhage, pancreatitis, liver
failure, and abdominal emergencies.
Renal and genitourinary disorders including acute kidney injury, electrolyte disturbances,
acid-base abnormalities, and renal replacement therapy.
Neurologic emergencies including stroke, seizures, traumatic brain injury, intracranial
hypertension, and neurosurgical conditions.
Multisystem critical illness including sepsis, septic shock, MODS, systemic inflammatory
responses, and toxicologic emergencies.
Critical-care pharmacology, hemodynamic monitoring, laboratory interpretation,
procedures, complications, and prioritization.
Professional caring, ethical practice, advocacy, collaboration, communication, diversity,
and patient-centered critical-care decision-making.
QUESTIONS
1. A patient with an acute inferior myocardial infarction suddenly develops hypotension, clear
lung sounds, and elevated jugular venous pressure. Which intervention is most appropriate
initially?
A. Administer a rapid intravenous fluid bolus
B. Administer intravenous furosemide
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C. Increase positive end-expiratory pressure
D. Give an additional vasodilator
Answer: A
Rationale: Inferior infarction involving the right ventricle can produce preload-dependent
hypotension. Carefully administered intravenous fluid can improve right ventricular filling and
cardiac output.
2. A mechanically ventilated patient with severe ARDS has worsening hypoxemia despite
appropriate oxygen therapy and lung-protective ventilation. Which intervention should the
nurse anticipate?
A. Routine reduction of PEEP
B. Immediate discontinuation of mechanical ventilation
C. Prone positioning
D. Administration of a large crystalloid bolus
Answer: C
Rationale: Prone positioning can improve ventilation-perfusion matching and oxygenation in
severe ARDS when used with appropriate lung-protective strategies.
, Page 3 of 129
3. A patient receiving an intravenous heparin infusion develops a platelet count decrease of
more than 50 percent several days after therapy begins. Which complication should the nurse
suspect?
A. Disseminated intravascular coagulation
B. Heparin-induced thrombocytopenia
C. Immune thrombocytopenic purpura
D. Thrombotic thrombocytopenic purpura
Answer: B
Rationale: A significant platelet reduction occurring several days after heparin exposure strongly
suggests HIT, which paradoxically increases the risk of thrombosis.
4. A patient with septic shock remains hypotensive after appropriate fluid resuscitation. Which
medication is generally considered the preferred initial vasopressor?
A. Dopamine
B. Phenylephrine
C. Epinephrine
D. Norepinephrine
Answer: D
Rationale: Norepinephrine is generally the preferred first-line vasopressor for persistent
hypotension in septic shock after adequate fluid resuscitation.
, Page 4 of 129
5. A patient with diabetic ketoacidosis has a serum potassium of 2.8 mEq/L before insulin
therapy begins. What should the nurse anticipate first?
A. Starting an insulin infusion immediately
B. Administering potassium replacement
C. Administering intravenous sodium bicarbonate routinely
D. Restricting all intravenous fluids
Answer: B
Rationale: Insulin shifts potassium intracellularly and can precipitate dangerous hypokalemia.
Significant hypokalemia should be corrected before insulin is initiated.
6. Which assessment finding most strongly suggests cardiac tamponade in a critically ill patient
after cardiac surgery?
A. Hypertension with bounding pulses
B. Pulmonary crackles and frothy sputum
C. Hypotension, muffled heart sounds, and elevated jugular venous pressure
D. Bradycardia with widened pulse pressure
Answer: C
Rationale: Hypotension, elevated venous pressure, and muffled heart sounds are classic
findings associated with cardiac tamponade.
