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CCRN Certification Questions &
Answers 2026-2027 | Comprehensive
Critical Care Exam (Rationales)
Document Overview
This document provides 92 critical care nursing exam questions, each with its correct
answer and detailed explanations. It covers comprehensive critical care topics with the aid
of diagrams and images. This resource is ideal for studying, reviewing, and preparing for
CCRN certification.
100% Accurate Questions and Answers 100% Guarantee Pass - Verified by Experts
Expert-Verified
Verified Answers · Detailed Rationales · 92 Questions · September 2026
CCRN Certification Questions & Answers 2026-2027 | Comprehensive Critical Care Exam (Rationales) - Practice Questions Page 0
, Topics Covered
Section 1: Cardiovascular Assessment & Pathophysiology Q 1-20
Questions covering cardiovascular Assessment & Pathophysiology concepts.
Section 2: Respiratory & Pulmonary Management Q 21-40
Questions covering respiratory & Pulmonary Management concepts.
Section 3: Neurological & Head Trauma Management Q 41-53
Questions covering neurological & Head Trauma Management concepts.
Section 4: Critical Care Pharmacology & Hemodynamics Q 54-67
Questions covering critical Care Pharmacology & Hemodynamics concepts.
Section 5: Electrolyte & Acid-Base Balance Q 68-71
Questions covering electrolyte & Acid-Base Balance concepts.
Section 6: Professional & Systems Issues Q 72-81
Questions covering professional & Systems Issues concepts.
Section 7: Gastrointestinal & Renal Systems Q 82-92
Questions covering gastrointestinal & Renal Systems concepts.
Questions
QUESTION 1 OF 92
A patient has had a large anterior myocardial infarction last month and developed a
ventricular aneurysm. He now has episodes of ventricular tachycardia that are not
prevented or converted with antidysrhythmic agents. An implantable cardioverter-
defibrillator (ICD) is implanted. Four days after surgery he develops ventricular
tachycardia. The ICD has delivered three shocks but has not converted the rhythm. He
is pulseless and apneic. Cardiopulmonary resuscitation is in progress. What is the
priority action now?
A.
Administer epinephrine IV.
B.
Administer amiodarone.
C.
Defibrillate.
D.
Reset the ICD.
Correct Answer: Defibrillate
Rationale: In a pulseless and apneic patient experiencing refractory ventricular tachycardia despite ICD shocks,
immediate external defibrillation is the priority action to restore organized electrical activity. This approach
supersedes pharmacologic interventions or ICD manipulation when advanced life support protocols for cardiac arrest
are invoked. The goal is to deliver a countershock to terminate the lethal arrhythmia and allow for spontaneous
circulation. This aligns with Defibrillate.
CCRN Certification Questions & Answers 2026-2027 | Comprehensive Critical Care Exam (Rationales) - Practice Questions Page 0
, QUESTION 2 OF 92
An extra heart sound preceding S1 is most likely an S4 if the stethoscope's:
A.
diaphragm is over the apex.
B.
bell is over the aortic area.
C.
diaphragm is over the aortic area.
D.
bell is over the apex.
Correct Answer: bell is over the apex.
S3 and S4 are low pitched, so choose options with the bell being used. S3 and S4 are heard at the mitral area
(i.e., apex) unless the right ventricular is affected, and then they are heard in the tricuspid area.
Low-Pitched is best heard with Bell
QUESTION 3 OF 92
The mean QRS axis of ventricular tachycardia is most likely to be:
A.
normal or left axis deviation.
B.
right axis deviation or indeterminate axis.
C.
right axis deviation or left axis deviation.
D.
left axis deviation or indeterminate axis.
Correct Answer: left axis deviation or indeterminate axis.
Ventricular tachycardia is most likely to be left axis deviation of −30 or greater or indeterminate axis,
whereas aberrancy is more likely to be normal axis or right axis deviation.
Rationale: Ventricular tachycardia originates in the ventricles, leading to abnormal depolarization that typically
results in a leftward shift of the QRS axis (greater than -30 degrees) or an indeterminate axis due to the chaotic nature
of ventricular conduction. In contrast, supraventricular tachycardia with aberrant conduction usually maintains a
more normal or rightward QRS axis as the depolarization follows a more typical pathway through the ventricles.
Therefore, left axis deviation or an indeterminate axis is the most likely finding for ventricular tachycardia. This aligns
with Ventricular tachycardia is most likely to be left axis deviation of −30 or greater or indeterminate axis, whereas
aberrancy is more likely to be normal axis or right axis deviation. and left axis deviation or indeterminate axis..
CCRN Certification Questions & Answers 2026-2027 | Comprehensive Critical Care Exam (Rationales) - Practice Questions Page 0
, QUESTION 4 OF 92
A 30-year-old man is in the surgical intensive care unit after exploratory laparotomy
performed after he sustained a gunshot wound to the abdomen. He now has developed
a pancreatic fistula. Which acid-base imbalance is this patient at risk for developing?
A.
Respiratory acidosis
B.
Metabolic acidosis
C.
Respiratory alkalosis
D.
Metabolic alkalosis
Correct Answer: Metabolic acidosis
The stomach is acidic, but the gastrointestinal tract below the stomach is alkaline. Pancreatic secretions are
rich in bicarbonate, and these losses would cause metabolic acidosis.
Rationale: Pancreatic secretions are alkaline due to a high bicarbonate content, and significant losses from a fistula
lead to a depletion of body bicarbonate. This loss of bicarbonate results in a reduction of the body's buffering capacity,
causing a metabolic acidosis. Therefore, a pancreatic fistula places the patient at risk for developing metabolic
acidosis. This aligns with but the gastrointestinal tract below the stomach is alkaline. Pancreatic secretions are rich in
bicarbonate, and these losses would cause metabolic acidosis. and The stomach is acidic.
CCRN Certification Questions & Answers 2026-2027 | Comprehensive Critical Care Exam (Rationales) - Practice Questions Page 0
CCRN Certification Questions &
Answers 2026-2027 | Comprehensive
Critical Care Exam (Rationales)
Document Overview
This document provides 92 critical care nursing exam questions, each with its correct
answer and detailed explanations. It covers comprehensive critical care topics with the aid
of diagrams and images. This resource is ideal for studying, reviewing, and preparing for
CCRN certification.
100% Accurate Questions and Answers 100% Guarantee Pass - Verified by Experts
Expert-Verified
Verified Answers · Detailed Rationales · 92 Questions · September 2026
CCRN Certification Questions & Answers 2026-2027 | Comprehensive Critical Care Exam (Rationales) - Practice Questions Page 0
, Topics Covered
Section 1: Cardiovascular Assessment & Pathophysiology Q 1-20
Questions covering cardiovascular Assessment & Pathophysiology concepts.
Section 2: Respiratory & Pulmonary Management Q 21-40
Questions covering respiratory & Pulmonary Management concepts.
Section 3: Neurological & Head Trauma Management Q 41-53
Questions covering neurological & Head Trauma Management concepts.
Section 4: Critical Care Pharmacology & Hemodynamics Q 54-67
Questions covering critical Care Pharmacology & Hemodynamics concepts.
Section 5: Electrolyte & Acid-Base Balance Q 68-71
Questions covering electrolyte & Acid-Base Balance concepts.
Section 6: Professional & Systems Issues Q 72-81
Questions covering professional & Systems Issues concepts.
Section 7: Gastrointestinal & Renal Systems Q 82-92
Questions covering gastrointestinal & Renal Systems concepts.
Questions
QUESTION 1 OF 92
A patient has had a large anterior myocardial infarction last month and developed a
ventricular aneurysm. He now has episodes of ventricular tachycardia that are not
prevented or converted with antidysrhythmic agents. An implantable cardioverter-
defibrillator (ICD) is implanted. Four days after surgery he develops ventricular
tachycardia. The ICD has delivered three shocks but has not converted the rhythm. He
is pulseless and apneic. Cardiopulmonary resuscitation is in progress. What is the
priority action now?
A.
Administer epinephrine IV.
B.
Administer amiodarone.
C.
Defibrillate.
D.
Reset the ICD.
Correct Answer: Defibrillate
Rationale: In a pulseless and apneic patient experiencing refractory ventricular tachycardia despite ICD shocks,
immediate external defibrillation is the priority action to restore organized electrical activity. This approach
supersedes pharmacologic interventions or ICD manipulation when advanced life support protocols for cardiac arrest
are invoked. The goal is to deliver a countershock to terminate the lethal arrhythmia and allow for spontaneous
circulation. This aligns with Defibrillate.
CCRN Certification Questions & Answers 2026-2027 | Comprehensive Critical Care Exam (Rationales) - Practice Questions Page 0
, QUESTION 2 OF 92
An extra heart sound preceding S1 is most likely an S4 if the stethoscope's:
A.
diaphragm is over the apex.
B.
bell is over the aortic area.
C.
diaphragm is over the aortic area.
D.
bell is over the apex.
Correct Answer: bell is over the apex.
S3 and S4 are low pitched, so choose options with the bell being used. S3 and S4 are heard at the mitral area
(i.e., apex) unless the right ventricular is affected, and then they are heard in the tricuspid area.
Low-Pitched is best heard with Bell
QUESTION 3 OF 92
The mean QRS axis of ventricular tachycardia is most likely to be:
A.
normal or left axis deviation.
B.
right axis deviation or indeterminate axis.
C.
right axis deviation or left axis deviation.
D.
left axis deviation or indeterminate axis.
Correct Answer: left axis deviation or indeterminate axis.
Ventricular tachycardia is most likely to be left axis deviation of −30 or greater or indeterminate axis,
whereas aberrancy is more likely to be normal axis or right axis deviation.
Rationale: Ventricular tachycardia originates in the ventricles, leading to abnormal depolarization that typically
results in a leftward shift of the QRS axis (greater than -30 degrees) or an indeterminate axis due to the chaotic nature
of ventricular conduction. In contrast, supraventricular tachycardia with aberrant conduction usually maintains a
more normal or rightward QRS axis as the depolarization follows a more typical pathway through the ventricles.
Therefore, left axis deviation or an indeterminate axis is the most likely finding for ventricular tachycardia. This aligns
with Ventricular tachycardia is most likely to be left axis deviation of −30 or greater or indeterminate axis, whereas
aberrancy is more likely to be normal axis or right axis deviation. and left axis deviation or indeterminate axis..
CCRN Certification Questions & Answers 2026-2027 | Comprehensive Critical Care Exam (Rationales) - Practice Questions Page 0
, QUESTION 4 OF 92
A 30-year-old man is in the surgical intensive care unit after exploratory laparotomy
performed after he sustained a gunshot wound to the abdomen. He now has developed
a pancreatic fistula. Which acid-base imbalance is this patient at risk for developing?
A.
Respiratory acidosis
B.
Metabolic acidosis
C.
Respiratory alkalosis
D.
Metabolic alkalosis
Correct Answer: Metabolic acidosis
The stomach is acidic, but the gastrointestinal tract below the stomach is alkaline. Pancreatic secretions are
rich in bicarbonate, and these losses would cause metabolic acidosis.
Rationale: Pancreatic secretions are alkaline due to a high bicarbonate content, and significant losses from a fistula
lead to a depletion of body bicarbonate. This loss of bicarbonate results in a reduction of the body's buffering capacity,
causing a metabolic acidosis. Therefore, a pancreatic fistula places the patient at risk for developing metabolic
acidosis. This aligns with but the gastrointestinal tract below the stomach is alkaline. Pancreatic secretions are rich in
bicarbonate, and these losses would cause metabolic acidosis. and The stomach is acidic.
CCRN Certification Questions & Answers 2026-2027 | Comprehensive Critical Care Exam (Rationales) - Practice Questions Page 0
