CCRN TEST BANK QUESTIONS
ANSWERS AND RATIONALES GRADED
A+ 2024 UPDATED(ACTUAL EXAM).
Which of the following would be the earliest auscultatory finding in left
ventricular failure (LVF)?
A. Crackles
B. S3
C. Murmur of mitral regurgitation
D. Pericardial friction rub - Precise answer B. S3
LVF would be the most subtle because early changes are usually subtle
changes. Choose "S3."
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 - Precise 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."
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 - Precise answer B. SaO2,
hemoglobin, cardiac output
Oxygen is delivered from the arterial end, so choose an option that has
SaO2
Which of the following is the most significant complication of status
asthmaticus?
A.
Pulmonary embolism
B.
Acute respiratory failure
C.
Hypertension
D.
Anaphylaxis - Precise answer B. Acute respiratory failure
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. - Precise 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.
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 - Precise 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.
Which of the following is associated with chest pain, confusion, and
petechiae?
A.
Dissecting aneurysm
B.
Fat embolism
C.
Pneumothorax
D.
, Myocardial infarction - Precise 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.
Which type of shock is most likely to be iatrogenic?
A.
Hypovolemic
B.
Cardiogenic
C.
Septic
D.
Neurogenic - Precise 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.
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.
ANSWERS AND RATIONALES GRADED
A+ 2024 UPDATED(ACTUAL EXAM).
Which of the following would be the earliest auscultatory finding in left
ventricular failure (LVF)?
A. Crackles
B. S3
C. Murmur of mitral regurgitation
D. Pericardial friction rub - Precise answer B. S3
LVF would be the most subtle because early changes are usually subtle
changes. Choose "S3."
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 - Precise 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."
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 - Precise answer B. SaO2,
hemoglobin, cardiac output
Oxygen is delivered from the arterial end, so choose an option that has
SaO2
Which of the following is the most significant complication of status
asthmaticus?
A.
Pulmonary embolism
B.
Acute respiratory failure
C.
Hypertension
D.
Anaphylaxis - Precise answer B. Acute respiratory failure
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. - Precise 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.
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 - Precise 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.
Which of the following is associated with chest pain, confusion, and
petechiae?
A.
Dissecting aneurysm
B.
Fat embolism
C.
Pneumothorax
D.
, Myocardial infarction - Precise 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.
Which type of shock is most likely to be iatrogenic?
A.
Hypovolemic
B.
Cardiogenic
C.
Septic
D.
Neurogenic - Precise 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.
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.
