CCRN PRACTICE TEST 1 QUESTIONS AND ANSWERS
After attending an educational session that reviewed drug dosing and provided a review
of the literature, the nurse would like to start using the admission weight to calculate
drug dosing during titration of vasoactive drugs rather than the current practice of using
daily weights. What would be the most effective next step for the nurse to take to
implement this change?
(A) Begin the adaptation of the practice by using the admission weight for patients.
(B) Identify the key stakeholders related to the proposed change in practice.
(C) Ask the attending physician on rounds what her thoughts are about the practice.
(D) Discuss the educational session with nurse colleagues. - Answers -(B) Identify the
key stakeholders related to the proposed change in practice.
A patient presents with a productive cough, hypoxemia, a fever, hypotension,
tachycardia, and tachypnea. Hypoxemia was corrected with the administration of
oxygen. Which of the following should be done next?
(A) Administer antibiotics.
(B) Start a vasopressor.
(C) Collect a sputum culture.
(D) Initiate 0.9 normal saline. - Answers -(D) Initiate 0.9 normal saline.
A patient with a urinary tract infection presented with a temperature of 39°C (102.2°F), a
heart rate of 132 beats/minute, a respiratory rate of 24 breaths/minute, a BP of 78/49 (a
MAP of 59 mmHg), and a lactate of 2.8 mmol/L. The patient received 2 L of 0.9 NS
within 1 hour. The BP is now 100/52 (the MAP is 68 mmHg), the heart rate is 118
beats/minute, the respiratory rate is 20 breaths/minute, and the lactate is 2.1 mmol/L.
The patient requires treatment for:
(A) bacteremia.
(B) sepsis.
(C) SIRS.
(D) septic shock. - Answers -(B) sepsis.
A patient is 48 hours post aortic valve replacement. Which of the following would be a
major goal for this patient?
(A) diuretic therapy
(B) stabilizing the blood pressure
(C) prophylactic antibiotics
(D) preventing a thrombus - Answers -(D) preventing a thrombus
A patient with hypoxic encephalopathy has been opening his eyes to touch for the past
24 hours. The patient now withdraws to painful stimuli, has developed unequal pupils,
and has a positive Babinski reflex. Which of the following interventions should the nurse
anticipate?
(A) ventriculostomy, oxygen, steroids
(B) sedation, vasopressin (Pitressin), thiazide diuretic
(C) osmotic diuretic, intubation, and monitor the pCO2
,(D) lumbar puncture and increase the FiO2 - Answers -(C) osmotic diuretic, intubation,
and monitor the pCO2
A 19-year-old patient who was admitted with sickle cell crisis and acute kidney injury
requests to use a phone to update her friends on her condition. The nurse's best
response would be to:
(A) explain to the patient that calls can be made when she is transferred out of the
critical care unit.
(B) allow the patient to make the calls in order to meet the patient's need for social
support.
(C) explain to the patient that she needs to rest in order for the analgesic medication to
take effect.
(D) allow the patient to make the calls in order to reduce the patient's anxiety. - Answers
-(B) allow the patient to make the calls in order to meet the patient's need for social
support.
The unit quality council wants to reduce the number of CAUTIS. Which of the following
strategies has been demonstrated to reduce incidences of CAUTIS?
(A) Remove the indwelling urinary catheter on day 3 post-op.
(B) Place the drainage collection system on the patient's abdomen during transport.
(C) Assess the competency of the staff using a simulated environment.
(D) Avoid the use of intermittent straight catheterization. - Answers -(C) Assess the
competency of the staff using a simulated environment.
A patient has cardiogenic shock and cardiogenic pulmonary edema. Which of the
following therapies would be most effective for this patient?
(A) an intra-aortic balloon pump to increase coronary artery perfusion
(B) a beta blocker to increase cardiac contractility
(C) an alpha-adrenergic drug to increase coronary artery perfusion
(D) angiotensin-converting enzyme inhibitors to decrease afterload - Answers -(A) an
intra-aortic balloon pump to increase coronary artery perfusion
The care team is considering whether a patient is a candidate for hospice care. Which
of the following is a specific service provided by hospice care?
(A) advance care planning
(B) symptom management
(C) care for a terminal illness
(D) consideration of patient/family wishes - Answers -(C) care for a terminal illness
A patient has a history of chronic respiratory failure secondary to COPD and now has
acute respiratory failure secondary to pneumonia. Upon arrival at the critical care unit,
his ABGs were a pH of 7.29, a PaCO2 of 77, a PaO2 of 51, and an HCO3 of 31. He is
receiving noninvasive ventilation with settings that read as follows: FiO2 0.40, IPAP 12
cm, and EPAP 5 cm. After 1 hour of therapy, the patient's ABG results are a pH of 7.20,
a PaCO2 of 89, a PaO2 of 48, and an HCO3 of 32.
What is the correct evaluation of this data?
, (A) Alveolar hyperventilation is getting worse; the BiPAP settings need adjustment.
(B) Metabolic acidosis is worse; the FiO, needs to be increased.
(C) Alveolar hypoventilation is getting worse; the patient needs to be intubated.
(D) The pH is acceptable for a patient with COPD; continue the current therapy. -
Answers -(C) Alveolar hypoventilation is getting worse; the patient needs to be
intubated.
Which of the following is true regarding plateau pressure?
(A) It is a pressure that is used to calculate static compliance and reflects pressure in
the lungs.
(B) It is a pressure that is used to calculate vital capacity and reflects pressure in the
lungs.
(C) It is a pressure that is used to calculate dynamic compliance and reflects pressure in
the airways.
(D) It is a pressure that is used to measure tidal volume and reflects pressure in the
airways. - Answers -(A) It is a pressure that is used to calculate static compliance and
reflects pressure in the lungs.
A patient is admitted with a salicylate overdose. Which of the following treatments is
most effective for this patient?
(A) N-acetylcysteine, support the airway, fluids
(B) gastric lavage, an antidote, fluids
(C) activated charcoal, urine alkalinization, dialysis
(D) support the airway, gastric lavage, ethanol - Answers -(C) activated charcoal, urine
alkalinization, dialysis
Which of the following patients who have sustained multiple trauma is most likely how to
have a poor outcome based on patient characteristics?
(A) the college graduate
(B) the owner of a successful business
(C) the married man
(D) the homeless man - Answers -(D) the homeless man
Which of the following is an appropriate strategy to use when providing mechanical
ventilation to a patient with status asthmaticus?
(A) Provide a long inspiratory time and a short expiratory time.
(B) Utilize a PEEP setting of 10-15 cm.
(C) Use a lower respiratory rate.
(D) Set the tidal volume to 10-12 mL/kg. - Answers -(C) Use a lower respiratory rate.
Which of the following complications might the RN expect for a patient with an acute
inferior MI?
(A) new onset 2nd-degree Type II heart block
(B) acute LV failure
(C) reciprocal changes (ST depression) in leads V3-V5
After attending an educational session that reviewed drug dosing and provided a review
of the literature, the nurse would like to start using the admission weight to calculate
drug dosing during titration of vasoactive drugs rather than the current practice of using
daily weights. What would be the most effective next step for the nurse to take to
implement this change?
(A) Begin the adaptation of the practice by using the admission weight for patients.
(B) Identify the key stakeholders related to the proposed change in practice.
(C) Ask the attending physician on rounds what her thoughts are about the practice.
(D) Discuss the educational session with nurse colleagues. - Answers -(B) Identify the
key stakeholders related to the proposed change in practice.
A patient presents with a productive cough, hypoxemia, a fever, hypotension,
tachycardia, and tachypnea. Hypoxemia was corrected with the administration of
oxygen. Which of the following should be done next?
(A) Administer antibiotics.
(B) Start a vasopressor.
(C) Collect a sputum culture.
(D) Initiate 0.9 normal saline. - Answers -(D) Initiate 0.9 normal saline.
A patient with a urinary tract infection presented with a temperature of 39°C (102.2°F), a
heart rate of 132 beats/minute, a respiratory rate of 24 breaths/minute, a BP of 78/49 (a
MAP of 59 mmHg), and a lactate of 2.8 mmol/L. The patient received 2 L of 0.9 NS
within 1 hour. The BP is now 100/52 (the MAP is 68 mmHg), the heart rate is 118
beats/minute, the respiratory rate is 20 breaths/minute, and the lactate is 2.1 mmol/L.
The patient requires treatment for:
(A) bacteremia.
(B) sepsis.
(C) SIRS.
(D) septic shock. - Answers -(B) sepsis.
A patient is 48 hours post aortic valve replacement. Which of the following would be a
major goal for this patient?
(A) diuretic therapy
(B) stabilizing the blood pressure
(C) prophylactic antibiotics
(D) preventing a thrombus - Answers -(D) preventing a thrombus
A patient with hypoxic encephalopathy has been opening his eyes to touch for the past
24 hours. The patient now withdraws to painful stimuli, has developed unequal pupils,
and has a positive Babinski reflex. Which of the following interventions should the nurse
anticipate?
(A) ventriculostomy, oxygen, steroids
(B) sedation, vasopressin (Pitressin), thiazide diuretic
(C) osmotic diuretic, intubation, and monitor the pCO2
,(D) lumbar puncture and increase the FiO2 - Answers -(C) osmotic diuretic, intubation,
and monitor the pCO2
A 19-year-old patient who was admitted with sickle cell crisis and acute kidney injury
requests to use a phone to update her friends on her condition. The nurse's best
response would be to:
(A) explain to the patient that calls can be made when she is transferred out of the
critical care unit.
(B) allow the patient to make the calls in order to meet the patient's need for social
support.
(C) explain to the patient that she needs to rest in order for the analgesic medication to
take effect.
(D) allow the patient to make the calls in order to reduce the patient's anxiety. - Answers
-(B) allow the patient to make the calls in order to meet the patient's need for social
support.
The unit quality council wants to reduce the number of CAUTIS. Which of the following
strategies has been demonstrated to reduce incidences of CAUTIS?
(A) Remove the indwelling urinary catheter on day 3 post-op.
(B) Place the drainage collection system on the patient's abdomen during transport.
(C) Assess the competency of the staff using a simulated environment.
(D) Avoid the use of intermittent straight catheterization. - Answers -(C) Assess the
competency of the staff using a simulated environment.
A patient has cardiogenic shock and cardiogenic pulmonary edema. Which of the
following therapies would be most effective for this patient?
(A) an intra-aortic balloon pump to increase coronary artery perfusion
(B) a beta blocker to increase cardiac contractility
(C) an alpha-adrenergic drug to increase coronary artery perfusion
(D) angiotensin-converting enzyme inhibitors to decrease afterload - Answers -(A) an
intra-aortic balloon pump to increase coronary artery perfusion
The care team is considering whether a patient is a candidate for hospice care. Which
of the following is a specific service provided by hospice care?
(A) advance care planning
(B) symptom management
(C) care for a terminal illness
(D) consideration of patient/family wishes - Answers -(C) care for a terminal illness
A patient has a history of chronic respiratory failure secondary to COPD and now has
acute respiratory failure secondary to pneumonia. Upon arrival at the critical care unit,
his ABGs were a pH of 7.29, a PaCO2 of 77, a PaO2 of 51, and an HCO3 of 31. He is
receiving noninvasive ventilation with settings that read as follows: FiO2 0.40, IPAP 12
cm, and EPAP 5 cm. After 1 hour of therapy, the patient's ABG results are a pH of 7.20,
a PaCO2 of 89, a PaO2 of 48, and an HCO3 of 32.
What is the correct evaluation of this data?
, (A) Alveolar hyperventilation is getting worse; the BiPAP settings need adjustment.
(B) Metabolic acidosis is worse; the FiO, needs to be increased.
(C) Alveolar hypoventilation is getting worse; the patient needs to be intubated.
(D) The pH is acceptable for a patient with COPD; continue the current therapy. -
Answers -(C) Alveolar hypoventilation is getting worse; the patient needs to be
intubated.
Which of the following is true regarding plateau pressure?
(A) It is a pressure that is used to calculate static compliance and reflects pressure in
the lungs.
(B) It is a pressure that is used to calculate vital capacity and reflects pressure in the
lungs.
(C) It is a pressure that is used to calculate dynamic compliance and reflects pressure in
the airways.
(D) It is a pressure that is used to measure tidal volume and reflects pressure in the
airways. - Answers -(A) It is a pressure that is used to calculate static compliance and
reflects pressure in the lungs.
A patient is admitted with a salicylate overdose. Which of the following treatments is
most effective for this patient?
(A) N-acetylcysteine, support the airway, fluids
(B) gastric lavage, an antidote, fluids
(C) activated charcoal, urine alkalinization, dialysis
(D) support the airway, gastric lavage, ethanol - Answers -(C) activated charcoal, urine
alkalinization, dialysis
Which of the following patients who have sustained multiple trauma is most likely how to
have a poor outcome based on patient characteristics?
(A) the college graduate
(B) the owner of a successful business
(C) the married man
(D) the homeless man - Answers -(D) the homeless man
Which of the following is an appropriate strategy to use when providing mechanical
ventilation to a patient with status asthmaticus?
(A) Provide a long inspiratory time and a short expiratory time.
(B) Utilize a PEEP setting of 10-15 cm.
(C) Use a lower respiratory rate.
(D) Set the tidal volume to 10-12 mL/kg. - Answers -(C) Use a lower respiratory rate.
Which of the following complications might the RN expect for a patient with an acute
inferior MI?
(A) new onset 2nd-degree Type II heart block
(B) acute LV failure
(C) reciprocal changes (ST depression) in leads V3-V5
