FIRST PUBLISH OCTOBER 2024
ccrn aacn practice questions with correct answers
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 and significant lab data includes
Serum Na+ 127
Serum osmolality 270
urine specific gravity elevated - Ans:✔✔-Initiation of fluid restriction -
this pt has risk factors signs and symptoms of SIADH
fluid restriction slows glomerular filtration and blood flow enhances proximal reabsorption of sodium
and water increases aldosterone secretion and enhances distal tubule sodium reabsorption. chemo may
alleviate some of the water retention caused by some cancers but non will completely inhibit ADH
secretions. three percent saline administration in severe case only
A pt is being admitted in HHS with dehydration and a serum glucose level of 836 mg/dl. Which additional
laboratory findings should the nurse anticipate? - Ans:✔✔-> elevated BUN > Elevated creatinine
>elevated osmolality
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FIRST PUBLISH OCTOBER 2024
HHNS - Hyperosmolar hyperglycemic nonketonic state
A 49 year old patient male recently admitted with an inferiors wall MI resulting from 100% occlusion of
the right coronary artery (RCA). The 12 lead ECG reveals ST elevation in leads 11, 111, and aVf. you would
expect to see reciprocal changes in which leads? - Ans:✔✔-1 and aVL the RCA perfuses the inferior wall
and the mirror image or reciprocal changes would be seen in the the high lateral wall, which is reflected
in leads 1 and avl on the 12 lead ECG. Lead v1 and v2 correlate with the septal area, lead v 3 and v4
correlate with the anterior area of the heart
a patient is admitted following a MVA , Lab data reveal elevated creatinine phosphokinase and
myoglobin. What should the nurse anticipate? - Ans:✔✔-Rhabdomyolysis -MVA is a risk factor for
rhabdomyolysis and lab data consistent with condition
a patient is admitted with pulmonary hypertension. What should lead the nurse to suspect pulmonary
fibrosis - Ans:✔✔-dyspnea at rest
a patient is admitted 2 days ago with a large subdural hematoma has a rectal temp of 104. the fever is
treated with iv acetaminophen and ice packs. Two hours later the fever increased to 104.9 what should
the nurse be most concerned for .... - Ans:✔✔-central nervous system ischemia - the patient most likely
has a neurogenic fever due to injury of the hypothalamus
A patient is at greatest risk for developing critical illness polyneuropathy? a patient with - Ans:✔✔-
Lactate of 4.6 - sepsis has a strong link to the development of critical illness polyneuropathy
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