ACCN CCRN EXAM WITH 100% CORRECT ANSWERS GRADE A CERTIFIED 2025/26

what causes S4 - correct answercauses by atrial contraction of blood into a noncompliant ventricle associate with myocardial ischemia, infarction, hypertension, ventricle hypertrophy and aortic stenosis normal pule pressure - correct answer40-60 mmHg (systolic-diastolic=pulse pressure) narrowing pulse pressure - correct answera decrease in systolic blood pressure with little change or even an increase in diastolic blood pressure most often seen with hypovolemia or a severe drop in cardiac output systolic blood pressure - correct answeris an indirect measurement of cardiac output and stoke volume widening pulse pressure - correct answera decrease in diastolic pressure with little change to the systolic pressure can indicate vasodilation or a drop is SVR diastolic blood pressure - correct answerin an indirect measurement of systemic vascular resistance (SVR) when are coronary arteries perfused - correct answerduring diastole systole - correct answerejection, high pressure the semilunar valves (pulmonic and aortic) are OPEN the AV valves (mitral and tricuspid) are CLOSED diastole - correct answerfilling, low pressure the semilunar valves (pulmonic and aortic) are CLOSED the AV valves (mitral and tricuspid) are OPEN diastole taken 1/3 longer than systole because the chambers need time for filling this is why blood pressure drops during tacharrhythmias, there is no time for filling and therefore less output OPEN AV valves - correct answerdiastole CLOSE AV valves - correct answersystole OPEN semilunar valves - correct answersystole CLOSE semilunar valves - correct answerdiastole mitral insufficiency occurs when the mitral valves is close. When is the mitral valves closed? - correct answersystole mitral stenosis occurs when the mitral valves is open. When is the mitral valve open? - correct answerdiastole aortic insufficiency occurs when the aortic valves is closed. When is the aortic valves closed? - correct answerdiastole aortic stenosis occurs when the aortic valves is open. When is the aortic valves open? - correct answersystole stenosis - correct answeropen insufficiency - correct answerclosure The nursing staff is resisting being assigned to a disruptive patient. An appropriate resolution would be to A. ask the provider to transfer the patient. B. rotate the patient assignment among staff. C. confront the family and demand an end to the behavior. D. hold a nursing team conference to discuss care needs. - correct answerD. hold a nursing team conference to discuss care needs. A patient with unstable angina has an IABP inserted. Hemodynamics are: HR 148 (sinus tachycardia) MAP 40 mm Hg PAOP 25 mm Hg CI 1.4 L/min/m^2 Which of the following should be included in this patient's plan of care? A. checking timing of the IABP, decreasing balloon to 1:2 frequency B. obtaining an echocardiogram and administering furosemide (Lasix) C. infusing dobutamine (Dobutrex) and obtaining a 12-lead ECG D. administering adenosine (Adenocard) rapidly and checking results of Hgb and Hct - correct answerA. checking timing of the IABP, decreasing balloon to 1:2 frequency The family of a critically ill patient wishes to spend the night, which is contrary to visiting policy. The nurse's BEST action would be to A. adhere to the visiting policy. B. allow the family to stay in the room. C. obtain a motel room near the hospital where the family can spend the night. D. allow one or two family members to stay and evaluate the patient's response. - correct answerD. allow one or two family members to stay and evaluate the patient's response. A patient with a recent myocardial infarction suddenly develops a loud systolic murmur. The MOST LIKELY cause is which of the following? A. pulmonary embolism B. congestive heart failure C. ruptured papillary muscle D. increased systemic vascular resistance - correct answerC. ruptured papillary muscle Members of the nursing staff are developing written patient education materials for a group of patients with diverse reading abilities. It would be MOST EFFECTIVE for the staff to A. design individual handouts for each patient. B. develop a computer-based education series. C. write the materials at a fourth-grade reading level. D. limit text and provide color pictures. - correct answerC. write the materials at a fourth-grade reading level. A patient who is 72 hours postoperative repair of a ruptured abdominal aortic aneurysm (AAA) suddenly becomes dyspneic with an increased respiratory rate from 24 to 40. An ABG sample obtained while the patient is receiving oxygen at 6 L/min via nasal cannula reveals the following results: pH 7.50 pCO2 31 mm Hg pO2 48 mm Hg A chest x-ray is obtained and a "ground-glass- like appearance" is reported. Lung auscultation bilaterally reveals basilar crackles that were not previously present. The nurse should suspect that the patient has developed A. a pulmonary embolus. B. bacterial pneumonia. C. chronic obstructive pulmonary disease. D. acute respiratory distress syndrome. - correct answerD. acute respiratory distress syndrome. A patient on mechanical ventilation is post- operative day 5 for spinal injury sustained playing college football. He was unusually disengagedthe previous day. Today he is agitated, combative during care and forgot his family was at the bedside an hour ago. Other physiological factors ruled out. The nurse should recognize the patient is MOST LIKELY experiencing A. acute dementia. B. acute delirium. C. alcohol withdrawal. D. steroid withdrawal. - correct answerB. acute delirium. A patient who is one day post-gastroplasty has a sudden onset of restlessness, dyspnea and chest pain. His heart rate is 122, and auscultation of heart sound reveals an increased intensity of a pulmonary S2. The MOST LIKELY cause is A. aspiration pneumonia. B. a spontaneous pneumothorax. C. a pleural effusion. D. a pulmonary embolus. - correct answerD. a pulmonary embolus.