AACN Certification CCRN/PCCN Critical Care Exam 1
NEWEST 2026 COMPLETE QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED ANSWERS) |ALREADY
GRADED A+||BRAND NEW VERSION!!
AACN - answer-: certify nurses; protect consumer by establishing high standards of professional practice
CCRN - answer-: certification for nurses who provide care in critically ill adult, pediatric, or neonatal
populations
PCCN - answer-: certification for nurses who provide acute care in progressive care, telemetry, and
similar units
CNML - answer-: certification for critical care managers and leaders
Positive End-Expiratory Pressure (PEEP) - answer-: set at 5 to 20 cm H2O; allows airway to be held open
and improve oxygenation; mechanically vented patients receive 3 to 5 cm H2O; used to decrease high
FiO2; when applied, pressure reading does not return to zero at end of breath; adverse effects is ICP and
decrease in CO (decrease venous return, volutrauma, or barotrauma)
Nursing Management of PEEP - answer-: when level is increased, evaluate patient's hemodynamic
response; If client experienced decreased CO, ensure patient has adequate intravascular volume
(preload) and administer fluids. if that does not work, administer dobutamine (inotropic agent)
Auto-PEEP - answer-: the spontaneous development of PEEP due to gas trapping in lung from
insufficient expiratory time and incomplete exhalation, rapid RR, high VE demand, airflow obstruction,
inverse I:E ratio ventilation.
,Peak Inspiratory Pressure (PIP) - answer-: the max pressure that occurs during inspiration; should never
be allowed to rise above 40 cm H2O, as it can cause ventilator-induced lung injury; monitor @ least Q4H
and with changes in patient's condition
Volume Ventilation - answer-: Tidal volume is constant for every breath delivered by ventilator; set to
allow airflow into lungs until preset volume has been reached; PIP varies in this mode; has two types:
assist/control (A/C) and synchronized intermittent mandatory ventilation (SIMV)
Assist/Control (A/C) Ventilation (volume ventilation) - answer-: for patient who can breathe
spontaneously; delivers preset number of breaths of a preset tidal volume; when patient initiates a
breath, ventilator delivers one as well; indicated it patient whose respiratory muscles are too weak or
unable to perform WOB;
Disadvantage of Assist/Control (A/C) Ventilation (volume ventilation) - answer-: respiratory alkalosis
may develop; treated or prevented by providing sedation or analgesia prn or changing to SIMV; patient
may rely on this instead of attempting to initiate spontaneous breathing.
Nursing Management of Assist/Control (A/C) Ventilation (volume ventilation) - answer-: monitor total
RR, EVt, PIP; monitor synchronization with the ventilator, and acid-base status
Synchronized Intermittent Mandatory Ventilation (SIMV) (volume ventilation) - answer-: delivers a set of
number of breaths of a set tidal volume; tidal volume is variable and depends on patient's effort; helps
prevent respiratory muscle weakness because patient helps with WOB; Indicated when patient is
allowed to breathe at their RR, hyperventilation during A/C mode, and to wean patients from
mechanical ventilation
Nursing management of SIMV - answer-: monitor total RR to see if patient initiates spontaneous
breaths; adequate spontaneous Vt is 5 to 7 mL/kg of ideal body weight; rising total RR means that
patients is getting tired (can lead to atelectasis); monitor EVt to ensure Vt is being delivered; assess PIP
and ABGs
Pressure Ventilation - answer-: Set to allow air to flow into lungs until present inspiratory pressure (PIP)
has been reached; tidal volume is variable; can be reliably controlled for each breath the ventilator
delivers; May cause hypoventilation and respiratory acidosis; monitor EVt
, Continuous Positive Airway Pressure (CPAP) (pressure ventilation) - answer-: applied throughout
respiratory cycle to spontaneously breathing patient; no mandatory breaths or other ventilatory
assistance given; patient perform all WOB; provides pressure @ end expiratory; used as mode of
weaning; same as PEEP; monitor EVt; set alarm to detect low EVt and apnea; administered via nasal or
face mask;
Pressure Support (PS) (pressure ventilation) - answer-: changes patient's spontaneous respiratory
activity by the delivery of a preset amount of inspiratory positive pressure; used as a stand-alone or in
combination with other modes; changes patient's spontaneous tidal volume and decrease WOB
associated with artificial airway; typical levels are 6 to 12 cm H2O; monitor EVt (if inadequate, increase
PS); promotes conditioning of respiratory muscles; used for COPD
Pressure Assist/Control (P-A/C) (pressure ventilation) - answer-: RR is set; every breath is changed by a
set amount of inspiratory pressure; if patient triggers additional breaths beyond mandatory breaths,
they are augmented by set amount of inspiratory pressure; typical pressure ranges from 15 to 25 cm
H2O; for ARDS or with high PIP; reduces risk of barotrauma; monitor total RR to see if patient is initiating
spontaneous breaths; monitor EVt for adequacy of volume
Pressure-controlled inverse-ratio ventilation (PC-IRV) (pressure ventilation) - answer-: set to provide
longer inspiratory times; increase MAP, open and stabilize alveoli; for noncompliant lungs (ARDS) and
when oxygenation is not adequate even with high FiO2, PEEP, or positioning; patient must be sedated
and may be paralyzed to prevent dysynchrony & oxygen desaturation
Airway Pressure-Release Ventilation (APRV) - answer-: provides two levels of CPAP, one during
inspiration and one during expiration; Allow unrestricted spontaneous breathing; starts at elevated
pressure (P-high), followed by low pressure (P-low); lowers PIP: alternatives to V-A/C or P-A/C
What to do When Mechanical Ventilator Alarm Sounds - answer-: check if patient is disconnected from
vent; if not, assess patient for distress, adequate ventilation and oxygenation; assess LOC, HR, color, etc;
If patient is in acute distress, disconnect the patient from ventilator and manually ventilate with ambu
bag while another RN figure out the problem
High Peak Pressure Causes and Intervention - answer-: vent is set 10 cm H2O above average PIP and
pressure increases in circuit can cause it; assess for kinks, anxiety and level of sedation, patient
biting/gagging on tube; observe for coughing; auscultate lung sounds if suctioning or bronchodilator is
needed; empty water from water traps if needed; assess for pulmonary pathology getting worse; call
MD/RT
NEWEST 2026 COMPLETE QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED ANSWERS) |ALREADY
GRADED A+||BRAND NEW VERSION!!
AACN - answer-: certify nurses; protect consumer by establishing high standards of professional practice
CCRN - answer-: certification for nurses who provide care in critically ill adult, pediatric, or neonatal
populations
PCCN - answer-: certification for nurses who provide acute care in progressive care, telemetry, and
similar units
CNML - answer-: certification for critical care managers and leaders
Positive End-Expiratory Pressure (PEEP) - answer-: set at 5 to 20 cm H2O; allows airway to be held open
and improve oxygenation; mechanically vented patients receive 3 to 5 cm H2O; used to decrease high
FiO2; when applied, pressure reading does not return to zero at end of breath; adverse effects is ICP and
decrease in CO (decrease venous return, volutrauma, or barotrauma)
Nursing Management of PEEP - answer-: when level is increased, evaluate patient's hemodynamic
response; If client experienced decreased CO, ensure patient has adequate intravascular volume
(preload) and administer fluids. if that does not work, administer dobutamine (inotropic agent)
Auto-PEEP - answer-: the spontaneous development of PEEP due to gas trapping in lung from
insufficient expiratory time and incomplete exhalation, rapid RR, high VE demand, airflow obstruction,
inverse I:E ratio ventilation.
,Peak Inspiratory Pressure (PIP) - answer-: the max pressure that occurs during inspiration; should never
be allowed to rise above 40 cm H2O, as it can cause ventilator-induced lung injury; monitor @ least Q4H
and with changes in patient's condition
Volume Ventilation - answer-: Tidal volume is constant for every breath delivered by ventilator; set to
allow airflow into lungs until preset volume has been reached; PIP varies in this mode; has two types:
assist/control (A/C) and synchronized intermittent mandatory ventilation (SIMV)
Assist/Control (A/C) Ventilation (volume ventilation) - answer-: for patient who can breathe
spontaneously; delivers preset number of breaths of a preset tidal volume; when patient initiates a
breath, ventilator delivers one as well; indicated it patient whose respiratory muscles are too weak or
unable to perform WOB;
Disadvantage of Assist/Control (A/C) Ventilation (volume ventilation) - answer-: respiratory alkalosis
may develop; treated or prevented by providing sedation or analgesia prn or changing to SIMV; patient
may rely on this instead of attempting to initiate spontaneous breathing.
Nursing Management of Assist/Control (A/C) Ventilation (volume ventilation) - answer-: monitor total
RR, EVt, PIP; monitor synchronization with the ventilator, and acid-base status
Synchronized Intermittent Mandatory Ventilation (SIMV) (volume ventilation) - answer-: delivers a set of
number of breaths of a set tidal volume; tidal volume is variable and depends on patient's effort; helps
prevent respiratory muscle weakness because patient helps with WOB; Indicated when patient is
allowed to breathe at their RR, hyperventilation during A/C mode, and to wean patients from
mechanical ventilation
Nursing management of SIMV - answer-: monitor total RR to see if patient initiates spontaneous
breaths; adequate spontaneous Vt is 5 to 7 mL/kg of ideal body weight; rising total RR means that
patients is getting tired (can lead to atelectasis); monitor EVt to ensure Vt is being delivered; assess PIP
and ABGs
Pressure Ventilation - answer-: Set to allow air to flow into lungs until present inspiratory pressure (PIP)
has been reached; tidal volume is variable; can be reliably controlled for each breath the ventilator
delivers; May cause hypoventilation and respiratory acidosis; monitor EVt
, Continuous Positive Airway Pressure (CPAP) (pressure ventilation) - answer-: applied throughout
respiratory cycle to spontaneously breathing patient; no mandatory breaths or other ventilatory
assistance given; patient perform all WOB; provides pressure @ end expiratory; used as mode of
weaning; same as PEEP; monitor EVt; set alarm to detect low EVt and apnea; administered via nasal or
face mask;
Pressure Support (PS) (pressure ventilation) - answer-: changes patient's spontaneous respiratory
activity by the delivery of a preset amount of inspiratory positive pressure; used as a stand-alone or in
combination with other modes; changes patient's spontaneous tidal volume and decrease WOB
associated with artificial airway; typical levels are 6 to 12 cm H2O; monitor EVt (if inadequate, increase
PS); promotes conditioning of respiratory muscles; used for COPD
Pressure Assist/Control (P-A/C) (pressure ventilation) - answer-: RR is set; every breath is changed by a
set amount of inspiratory pressure; if patient triggers additional breaths beyond mandatory breaths,
they are augmented by set amount of inspiratory pressure; typical pressure ranges from 15 to 25 cm
H2O; for ARDS or with high PIP; reduces risk of barotrauma; monitor total RR to see if patient is initiating
spontaneous breaths; monitor EVt for adequacy of volume
Pressure-controlled inverse-ratio ventilation (PC-IRV) (pressure ventilation) - answer-: set to provide
longer inspiratory times; increase MAP, open and stabilize alveoli; for noncompliant lungs (ARDS) and
when oxygenation is not adequate even with high FiO2, PEEP, or positioning; patient must be sedated
and may be paralyzed to prevent dysynchrony & oxygen desaturation
Airway Pressure-Release Ventilation (APRV) - answer-: provides two levels of CPAP, one during
inspiration and one during expiration; Allow unrestricted spontaneous breathing; starts at elevated
pressure (P-high), followed by low pressure (P-low); lowers PIP: alternatives to V-A/C or P-A/C
What to do When Mechanical Ventilator Alarm Sounds - answer-: check if patient is disconnected from
vent; if not, assess patient for distress, adequate ventilation and oxygenation; assess LOC, HR, color, etc;
If patient is in acute distress, disconnect the patient from ventilator and manually ventilate with ambu
bag while another RN figure out the problem
High Peak Pressure Causes and Intervention - answer-: vent is set 10 cm H2O above average PIP and
pressure increases in circuit can cause it; assess for kinks, anxiety and level of sedation, patient
biting/gagging on tube; observe for coughing; auscultate lung sounds if suctioning or bronchodilator is
needed; empty water from water traps if needed; assess for pulmonary pathology getting worse; call
MD/RT
