CCRN LEAKED DEFINITIONS RETAKE ACTUAL ASSESSMENT
EXAM 2025 UPDATED QUESTIONS AND CORRECT R, Exams
of Nursing
The patient has been receiving enteral feeding and is now tachypenic. The SpO2 is 89% on 2L/
nc oxygen. Auscultation of the lungs reveals crackles over the right middle lobe. What is the
priority intervention?
a. call for a CXR
b. call anesthesia for insertion of an ETT
c. turn patient to the right side
d. increase FiO2 d. increase FiO2
The patient who has been receiving mechanical ventilation is also recieving a spontaneous
breathing trial (SBT). The ventilator setting include CPAP 10 cm H20, pressure support 5 cm H20,
and FiO2 0.30. The patient is experiencing increased work of breathing, and SpO2 is 0.95. What
intervention will most likely decrease the patient's work of breathing?
a. increasing the tidal volume
b. increasing the CPAP
c. increasing the FiO2
d. increasing the pressure support d. increasing the pressure support
The patient receiving mechanical ventilation is scheduled for a spontaneous breathing trial
(SBT). The patient's chest XR is improving. The LOC has decreased, and he now responds to
shaking rather than voice. The FiO2 is 40%, the resting minute ventilation is 8L/min, and the
RSBI is 108 breaths/min/L. What intervention is indicated at this time?
a. continue with the SBT as planned
b. hold the SBT because of the patient's minute volume
1|Page
,c. hold the SBT because of the FiO2 requirements
d. hold the SBT because of the change in the LOC ad because of the RSBI
d. Hold the SBT because of the change in the LOC ad because of the RSBI
RSBI should ideally be less than 105 breaths/min/L, and the patient's change in LOC needs to be
discussed with the provider before beginning an SBT
The patient was admitted with acute pancreatitis and has developed tachypnea, bilateral
crackles, and SpO2 of 84% despite an increase of FiO2 to 1.00 per non-rebreather mask. A CXR
shows bilateral "ground glass" appearance. The nurse anticipates which priority intervention?
a. initiation of non-invasive ventilation
b. mechanical ventilation with PEEP
c. initiation of a fibrinolytic for a massive pulmonary embolism
d. administration of diuretics for a pulmonary edema b. mechanical ventilation with PEEP
The patient has signs of ARDS as evidenced by refractory hypoxemia, the CXR, and the clinical
presentation. Non-invasive ventilation cannot provide the PEEP and full ventilatory support that
is required for the treatment of ARDS.
Which of the following ABGs is characteristic of acute respiratory failure?
a. pH 7.34; pCO2 34; HCO3 23; pO2 65 on room air
b. pH 7.33; pCO2 31; HCO3 22; pO2 79 on 2L/nc
c. pH 7.34; pCO2 55; HCO3 35; pO2 62 on RA
d. pH 7.33; pCO2 31; HCO3 22; pO2 62 on 50% 02 per mask d. pH 7.33; pCO2 31; HCO3
22; pO2 62 on 50% 02 per mask
A 60kg patient with status asthmaticus required intubation and mechanical ventilation. The
patient is sedated, and the ventilator setting include the following:
2|Page
,mode - assist control
FiO2 - 0.40
BR - 20/minute
Vt - 500 mL
PEEP - 0 cm H20
Which of these setting should the nurse question?
a. breath rate
b. tidal volume
c. mode
d. PEEP a. breath rate
The breath rate needs to be lowered to allow for a longer expiratory time. A patient with
asthma requires a longer expiratory time to prevent air trapping.
What physiologic factors of ARDS lead to refractory hypoxemia?
a. increased left heart pressure resulting in a pulmonary edema
b. damage to type II alveolar cells with increased surfactant production
c. alveolar collapse and decreased functional residual capacity (FRC)
d. increased compliance caused by decreased surfactant production c. alveolar collapse
and decreased functional residual capacity (FRC)
The arterial blood gases (ABG) results o the post-op patient with diabetes are reported as
follows: pH 7.30, PaCO2 51, PaO2 61, HCO3 25. Which interventions would address this
patient's acid-base status?
a. assess the electrolytes
3|Page
, b. increase the FiO2
c. administer naloxone (Narcan)
d. check the patient's blood sugar c. administer naloxone (Narcan)
The post-op patient who is receiving mechanical ventilation has a right-sided chest tube. Which
assessment would be necessitate notifying the provider?
a. peak airway pressure of 20 cm H20
b. development of bubbling in the water seal chamber
c. drainage of 40 mL over eight hours
d. tidaling with deep inspiration in the water seal chamber b. development of bubbling in the
water seal chamber
The patient who is receiving mechanical ventilation developed agitation, tachypnea, unequal
chest excursion, and diminished breath sounds on the right. The ventilatory high pressure alarm
is frequently sounding. The BP is elevated. What is the priority treatment for this patient?
a. right lung chest tube insertion
b. increase in FiO2
c. right lung needle aspiration
d. sedation a. right lung chest tube insertion
The patient has signs of a right-sided pneumothorax, and emergent placement of a chest tube is
needed
PEEP therapy is essential for a patient with ARDS. Which nursing intervention is appropriate for
a patient receiving PEEP therapy for the treatment of ARDS?
a. monitor for possible barotrauma
b. decrease PEEP if hypotension develops
c. titrate PEEP down when hypoxemia is corrected, and then decrease the FiO2
4|Page
EXAM 2025 UPDATED QUESTIONS AND CORRECT R, Exams
of Nursing
The patient has been receiving enteral feeding and is now tachypenic. The SpO2 is 89% on 2L/
nc oxygen. Auscultation of the lungs reveals crackles over the right middle lobe. What is the
priority intervention?
a. call for a CXR
b. call anesthesia for insertion of an ETT
c. turn patient to the right side
d. increase FiO2 d. increase FiO2
The patient who has been receiving mechanical ventilation is also recieving a spontaneous
breathing trial (SBT). The ventilator setting include CPAP 10 cm H20, pressure support 5 cm H20,
and FiO2 0.30. The patient is experiencing increased work of breathing, and SpO2 is 0.95. What
intervention will most likely decrease the patient's work of breathing?
a. increasing the tidal volume
b. increasing the CPAP
c. increasing the FiO2
d. increasing the pressure support d. increasing the pressure support
The patient receiving mechanical ventilation is scheduled for a spontaneous breathing trial
(SBT). The patient's chest XR is improving. The LOC has decreased, and he now responds to
shaking rather than voice. The FiO2 is 40%, the resting minute ventilation is 8L/min, and the
RSBI is 108 breaths/min/L. What intervention is indicated at this time?
a. continue with the SBT as planned
b. hold the SBT because of the patient's minute volume
1|Page
,c. hold the SBT because of the FiO2 requirements
d. hold the SBT because of the change in the LOC ad because of the RSBI
d. Hold the SBT because of the change in the LOC ad because of the RSBI
RSBI should ideally be less than 105 breaths/min/L, and the patient's change in LOC needs to be
discussed with the provider before beginning an SBT
The patient was admitted with acute pancreatitis and has developed tachypnea, bilateral
crackles, and SpO2 of 84% despite an increase of FiO2 to 1.00 per non-rebreather mask. A CXR
shows bilateral "ground glass" appearance. The nurse anticipates which priority intervention?
a. initiation of non-invasive ventilation
b. mechanical ventilation with PEEP
c. initiation of a fibrinolytic for a massive pulmonary embolism
d. administration of diuretics for a pulmonary edema b. mechanical ventilation with PEEP
The patient has signs of ARDS as evidenced by refractory hypoxemia, the CXR, and the clinical
presentation. Non-invasive ventilation cannot provide the PEEP and full ventilatory support that
is required for the treatment of ARDS.
Which of the following ABGs is characteristic of acute respiratory failure?
a. pH 7.34; pCO2 34; HCO3 23; pO2 65 on room air
b. pH 7.33; pCO2 31; HCO3 22; pO2 79 on 2L/nc
c. pH 7.34; pCO2 55; HCO3 35; pO2 62 on RA
d. pH 7.33; pCO2 31; HCO3 22; pO2 62 on 50% 02 per mask d. pH 7.33; pCO2 31; HCO3
22; pO2 62 on 50% 02 per mask
A 60kg patient with status asthmaticus required intubation and mechanical ventilation. The
patient is sedated, and the ventilator setting include the following:
2|Page
,mode - assist control
FiO2 - 0.40
BR - 20/minute
Vt - 500 mL
PEEP - 0 cm H20
Which of these setting should the nurse question?
a. breath rate
b. tidal volume
c. mode
d. PEEP a. breath rate
The breath rate needs to be lowered to allow for a longer expiratory time. A patient with
asthma requires a longer expiratory time to prevent air trapping.
What physiologic factors of ARDS lead to refractory hypoxemia?
a. increased left heart pressure resulting in a pulmonary edema
b. damage to type II alveolar cells with increased surfactant production
c. alveolar collapse and decreased functional residual capacity (FRC)
d. increased compliance caused by decreased surfactant production c. alveolar collapse
and decreased functional residual capacity (FRC)
The arterial blood gases (ABG) results o the post-op patient with diabetes are reported as
follows: pH 7.30, PaCO2 51, PaO2 61, HCO3 25. Which interventions would address this
patient's acid-base status?
a. assess the electrolytes
3|Page
, b. increase the FiO2
c. administer naloxone (Narcan)
d. check the patient's blood sugar c. administer naloxone (Narcan)
The post-op patient who is receiving mechanical ventilation has a right-sided chest tube. Which
assessment would be necessitate notifying the provider?
a. peak airway pressure of 20 cm H20
b. development of bubbling in the water seal chamber
c. drainage of 40 mL over eight hours
d. tidaling with deep inspiration in the water seal chamber b. development of bubbling in the
water seal chamber
The patient who is receiving mechanical ventilation developed agitation, tachypnea, unequal
chest excursion, and diminished breath sounds on the right. The ventilatory high pressure alarm
is frequently sounding. The BP is elevated. What is the priority treatment for this patient?
a. right lung chest tube insertion
b. increase in FiO2
c. right lung needle aspiration
d. sedation a. right lung chest tube insertion
The patient has signs of a right-sided pneumothorax, and emergent placement of a chest tube is
needed
PEEP therapy is essential for a patient with ARDS. Which nursing intervention is appropriate for
a patient receiving PEEP therapy for the treatment of ARDS?
a. monitor for possible barotrauma
b. decrease PEEP if hypotension develops
c. titrate PEEP down when hypoxemia is corrected, and then decrease the FiO2
4|Page
