CCRN Actual Exam Questions With Reviewed 100%
Correct Detailed Answers & Rationale
Guaranteed Pass!!Current Update
(Verified Pass)
1. The physician has prescribed mannitol for a patient with intracranial
hypertension. Which of the following is an important consideration when
administering mannitol?
A. The drug must be protected from light.
B. The drug must be administered through an in-line filter.
C. The drug must be administered into a central venous catheter.
D. The drug must be refrigerated. - ANSWER B. The drug must be
administered through an in-line filter.
2. If a patient with a normal pH and temperature has a PaO2 of 60 mm Hg, his
arterial oxygen saturation (SaO2) is closest to which of the following values?
A. 75%
B. 90%
C. 95%
D. 99% - ANSWER B. 90%
One way to remember this is to consider what level concerns you. At an SaO2 of
less than 90%, we get concerned because we are no longer on the horizontal end
of the oxyhemoglobin dissociation curve. This means that there will be significant
desaturation for every drop in the PaO2 of even 1 mm Hg because we are on the
vertical limb of the curve. Note how significantly the saturation dropped between
the PaO2 of 60 mm Hg and 40 mm Hg.
,3. 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 intravenous solution most
appropriate for fluid replacement would be:
A. 5% dextrose in water (D5W).
B. normal saline.
C. lactated Ringer solution.
D. 10% dextrose in water (D10W). - ANSWER A. 5% dextrose in water
(D5W).
D5W is an isotonic solution while in the bottle, but when it is administered, the
dextrose is quickly metabolized, leaving free water. The patient in this case has
indications of diabetes insipidus. Patients with diabetes insipidus lose more water
than sodium, and they need to be treated with more water than sodium. Saline
and lactated Ringer solution would contribute to the hypernatremia. D10W could
cause a hypertonic diuresis.
4. A 76-year-old man is admitted with complaints of sudden, sharp, "tearing"
chest pain radiating to the shoulders, neck, and back. He has been in apparent
good health except for a history of hypertension. Vital signs are blood
pressure, 180/96 mm Hg; heart rate, 90 beats/min; and respiratory rate, 26
breaths/min. He is dyspneic, and his electrocardiogram shows nonspecific ST-T
wave changes. Which of the following would not be an important aspect of
care for this patient?
, A. Control his blood pressure.
B. Provide adequate analgesia.
C. Initiate fibrinolytic therapy.
D. Prepare the patient for surgery. - ANSWER C. Initiate fibrinolytic
therapy.
Fibrinolytic therapy is contraindicated if dissecting thoracic aortic aneurysm is
suspected. All of the other interventions are appropriate.
5. Which of the following interventions would be helpful in prevention of
aspiration in a patient receiving enteral feedings?
A. Check for gastric residuals every 4 hours.
B. Use a small-bore duodenal feeding tube.
C. Use a high-fat feeding.
D. Add blue food coloring to the enteral feeding. - ANSWER B. Use a small-
bore duodenal feeding tube.
A tube that is placed below the pylorus would decrease the risk of aspiration
6. Which of the following would not cause an elevated creatine kinase-
muscle/brain (CK-MB)?
A. Myocarditis
B. Heart failure
C. Myocardial infarction
D. Post cardiotomy - ANSWER B. Heart failure
, Any injury to the myocardium would cause elevation of cardiac isoenzymes.
Myocarditis, myocardial infarction, and cardiotomy cause injury to the
myocardium.
7. The ability of the brain contents to be shifted to prevent intracranial
hypertension when intracranial volume increases is referred to as:
A. compensation.
B. autoregulation.
C. normalization.
D. feedback. - ANSWER A. compensation.
Remember the difference between compensation and autoregulation.
Compensation relates to intracranial volumes and resultant pressure.
Autoregulation relates to the ability of the cerebral vessels to change size to
normalize blood flow
8. Which of the following is not a therapeutic effect of nifedipine when used for
angina?
A. Decreased preload.
B. Decreased afterload.
C. Decreased contractility.
D. Relieve vasospasm. - ANSWER C. Decreased contractility.
Nifedipine decreases myocardial oxygen consumption by dilating veins and
arteries, thereby decreasing preload and afterload. Nifedipine also decreases
vasospasm and potential for vasospasm. Unlike diltiazem and verapamil,
nifedipine does not significantly decrease contractility.
Correct Detailed Answers & Rationale
Guaranteed Pass!!Current Update
(Verified Pass)
1. The physician has prescribed mannitol for a patient with intracranial
hypertension. Which of the following is an important consideration when
administering mannitol?
A. The drug must be protected from light.
B. The drug must be administered through an in-line filter.
C. The drug must be administered into a central venous catheter.
D. The drug must be refrigerated. - ANSWER B. The drug must be
administered through an in-line filter.
2. If a patient with a normal pH and temperature has a PaO2 of 60 mm Hg, his
arterial oxygen saturation (SaO2) is closest to which of the following values?
A. 75%
B. 90%
C. 95%
D. 99% - ANSWER B. 90%
One way to remember this is to consider what level concerns you. At an SaO2 of
less than 90%, we get concerned because we are no longer on the horizontal end
of the oxyhemoglobin dissociation curve. This means that there will be significant
desaturation for every drop in the PaO2 of even 1 mm Hg because we are on the
vertical limb of the curve. Note how significantly the saturation dropped between
the PaO2 of 60 mm Hg and 40 mm Hg.
,3. 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 intravenous solution most
appropriate for fluid replacement would be:
A. 5% dextrose in water (D5W).
B. normal saline.
C. lactated Ringer solution.
D. 10% dextrose in water (D10W). - ANSWER A. 5% dextrose in water
(D5W).
D5W is an isotonic solution while in the bottle, but when it is administered, the
dextrose is quickly metabolized, leaving free water. The patient in this case has
indications of diabetes insipidus. Patients with diabetes insipidus lose more water
than sodium, and they need to be treated with more water than sodium. Saline
and lactated Ringer solution would contribute to the hypernatremia. D10W could
cause a hypertonic diuresis.
4. A 76-year-old man is admitted with complaints of sudden, sharp, "tearing"
chest pain radiating to the shoulders, neck, and back. He has been in apparent
good health except for a history of hypertension. Vital signs are blood
pressure, 180/96 mm Hg; heart rate, 90 beats/min; and respiratory rate, 26
breaths/min. He is dyspneic, and his electrocardiogram shows nonspecific ST-T
wave changes. Which of the following would not be an important aspect of
care for this patient?
, A. Control his blood pressure.
B. Provide adequate analgesia.
C. Initiate fibrinolytic therapy.
D. Prepare the patient for surgery. - ANSWER C. Initiate fibrinolytic
therapy.
Fibrinolytic therapy is contraindicated if dissecting thoracic aortic aneurysm is
suspected. All of the other interventions are appropriate.
5. Which of the following interventions would be helpful in prevention of
aspiration in a patient receiving enteral feedings?
A. Check for gastric residuals every 4 hours.
B. Use a small-bore duodenal feeding tube.
C. Use a high-fat feeding.
D. Add blue food coloring to the enteral feeding. - ANSWER B. Use a small-
bore duodenal feeding tube.
A tube that is placed below the pylorus would decrease the risk of aspiration
6. Which of the following would not cause an elevated creatine kinase-
muscle/brain (CK-MB)?
A. Myocarditis
B. Heart failure
C. Myocardial infarction
D. Post cardiotomy - ANSWER B. Heart failure
, Any injury to the myocardium would cause elevation of cardiac isoenzymes.
Myocarditis, myocardial infarction, and cardiotomy cause injury to the
myocardium.
7. The ability of the brain contents to be shifted to prevent intracranial
hypertension when intracranial volume increases is referred to as:
A. compensation.
B. autoregulation.
C. normalization.
D. feedback. - ANSWER A. compensation.
Remember the difference between compensation and autoregulation.
Compensation relates to intracranial volumes and resultant pressure.
Autoregulation relates to the ability of the cerebral vessels to change size to
normalize blood flow
8. Which of the following is not a therapeutic effect of nifedipine when used for
angina?
A. Decreased preload.
B. Decreased afterload.
C. Decreased contractility.
D. Relieve vasospasm. - ANSWER C. Decreased contractility.
Nifedipine decreases myocardial oxygen consumption by dilating veins and
arteries, thereby decreasing preload and afterload. Nifedipine also decreases
vasospasm and potential for vasospasm. Unlike diltiazem and verapamil,
nifedipine does not significantly decrease contractility.
