CCRN-Adult Critical Care Nursing Exam 2026/2027 |
Practice Questions And Answers 2026/2027 | Complete
Questions And Answers (Verified Answers) | Exam Prep
Comprehensive Exam Guide 2026&2027
1. A patient with septic shock remains hypotensive after receiving an appropriate initial
fluid bolus. Which intervention should the critical care nurse anticipate next?
A. Administer a loop diuretic
B. Initiate norepinephrine infusion
C. Restrict all intravenous fluids
D. Administer oral antihypertensive medication
Answer: B
Norepinephrine is the preferred first-line vasopressor for persistent hypotension in septic
shock after adequate fluid resuscitation because it increases vascular tone and mean arterial
pressure.
2. A mechanically ventilated patient suddenly develops severe dyspnea, hypotension, and
absent breath sounds on the right side. What is the nurse's priority action?
A. Increase the PEEP
B. Administer a sedative
C. Prepare for immediate treatment of tension pneumothorax
D. Obtain a routine sputum culture
Answer: C
Sudden unilateral absent breath sounds with hypotension in a ventilated patient strongly
suggests tension pneumothorax. Immediate decompression is prioritized over waiting for
diagnostic imaging.
3. Which hemodynamic finding is most consistent with left ventricular failure?
A. Increased pulmonary artery wedge pressure
B. Decreased systemic vascular resistance only
C. Increased right atrial pressure with clear lungs
D. Increased cardiac index with low filling pressures
Answer: A
Left ventricular failure causes blood to back up into the pulmonary circulation, producing an
elevated pulmonary artery wedge pressure.
,4. A patient with acute pulmonary edema is severely dyspneic and has an oxygen saturation
of 82%. Which intervention should the nurse perform first?
A. Place the patient flat
B. Encourage oral fluids
C. Administer a sedative
D. Position the patient upright and provide oxygen support
Answer: D
Upright positioning improves lung expansion and reduces venous return, while oxygen
support addresses the immediate life-threatening hypoxemia.
5. A patient receiving unfractionated heparin develops a platelet count decrease of more
than 50% from baseline on day 7 of therapy. Which complication should the nurse
suspect?
A. Disseminated intravascular coagulation
B. Heparin-induced thrombocytopenia
C. Vitamin K deficiency
D. Immune thrombocytopenia unrelated to heparin
Answer: B
A platelet decrease of more than 50% occurring several days after heparin exposure is highly
concerning for heparin-induced thrombocytopenia, which carries a significant risk of
thrombosis.
6. A patient with acute myocardial infarction develops hypotension, jugular venous
distention, and clear lung sounds. Which complication is most likely?
A. Right ventricular infarction
B. Acute left ventricular failure
C. Pulmonary edema
D. Mitral stenosis
Answer: A
Right ventricular infarction impairs right-sided pumping, producing systemic venous
congestion and hypotension while pulmonary congestion may remain absent.
7. Which ECG finding is most characteristic of acute myocardial ischemia?
A. Prolonged QT interval
B. Widened QRS complex
C. ST-segment depression
D. Shortened PR interval
Answer: C
,ST-segment depression can indicate myocardial ischemia, particularly when it occurs in
anatomically appropriate leads and correlates with clinical symptoms.
8. A patient develops ventricular fibrillation and becomes unresponsive with no pulse.
What should the nurse do immediately?
A. Administer oral amiodarone
B. Obtain a 12-lead ECG
C. Begin synchronized cardioversion
D. Initiate CPR and prepare for immediate defibrillation
Answer: D
Pulseless ventricular fibrillation is a shockable cardiac arrest rhythm. High-quality CPR and
immediate unsynchronized defibrillation are priorities.
9. A patient with atrial fibrillation has a ventricular rate of 168/min, blood pressure of
78/42 mmHg, and altered mental status. Which treatment should the nurse anticipate?
A. Synchronized cardioversion
B. Oral beta-blocker administration
C. Observation for spontaneous conversion
D. Fluid restriction
Answer: A
Atrial fibrillation causing hemodynamic instability requires synchronized cardioversion
because the rapid rhythm is compromising circulation.
10. Which assessment finding most strongly suggests cardiac tamponade?
A. Hypertension and bounding pulses
B. Bradycardia with pulmonary crackles
C. Hypotension, jugular venous distention, and muffled heart sounds
D. Increased urine output and peripheral vasodilation
Answer: C
The combination of hypotension, elevated venous pressure, and muffled heart sounds is
classic for cardiac tamponade and reflects impaired ventricular filling from pericardial
pressure.
11. A patient with cardiogenic shock has a cardiac index of 1.7 L/min/m². Which finding
would the nurse expect?
A. Warm skin and bounding pulses
B. Decreased systemic perfusion
C. Increased urine output
D. Markedly reduced lactate production
, Answer: B
A low cardiac index indicates inadequate forward blood flow and therefore reduced tissue
perfusion, commonly manifested by cool extremities, oliguria, altered mentation, and
elevated lactate.
12. A patient receiving norepinephrine through a peripheral IV reports severe pain at the
infusion site. The site is pale and cool. What is the nurse's priority?
A. Increase the infusion rate
B. Flush the IV rapidly
C. Apply a tight pressure dressing
D. Stop the infusion and manage suspected extravasation according to protocol
Answer: D
Pain, pallor, and coolness suggest vasopressor extravasation. The infusion should be stopped
and the institution's extravasation protocol followed to limit tissue injury.
13. Which laboratory value is most useful for evaluating the severity and trend of tissue
hypoperfusion in septic shock?
A. Serum lactate
B. Total cholesterol
C. Hemoglobin A1c
D. Serum calcium alone
Answer: A
Elevated lactate can reflect impaired oxygen utilization or delivery and is useful for assessing
the severity and trajectory of shock when interpreted with the overall clinical picture.
14. A patient with severe asthma develops increasing fatigue, a decreasing respiratory rate,
and rising PaCO₂. What does this change indicate?
A. Improving ventilation
B. Resolution of bronchospasm
C. Impending respiratory failure
D. Normal compensation
Answer: C
In severe asthma, a rising PaCO₂ after earlier hypocapnia can indicate worsening ventilatory
failure and respiratory muscle fatigue.
15. A patient with COPD exacerbation is receiving oxygen therapy. Which principle is most
appropriate?
A. Withhold oxygen until arterial blood gases are obtained
B. Provide controlled oxygen while monitoring respiratory status and gas exchange
Practice Questions And Answers 2026/2027 | Complete
Questions And Answers (Verified Answers) | Exam Prep
Comprehensive Exam Guide 2026&2027
1. A patient with septic shock remains hypotensive after receiving an appropriate initial
fluid bolus. Which intervention should the critical care nurse anticipate next?
A. Administer a loop diuretic
B. Initiate norepinephrine infusion
C. Restrict all intravenous fluids
D. Administer oral antihypertensive medication
Answer: B
Norepinephrine is the preferred first-line vasopressor for persistent hypotension in septic
shock after adequate fluid resuscitation because it increases vascular tone and mean arterial
pressure.
2. A mechanically ventilated patient suddenly develops severe dyspnea, hypotension, and
absent breath sounds on the right side. What is the nurse's priority action?
A. Increase the PEEP
B. Administer a sedative
C. Prepare for immediate treatment of tension pneumothorax
D. Obtain a routine sputum culture
Answer: C
Sudden unilateral absent breath sounds with hypotension in a ventilated patient strongly
suggests tension pneumothorax. Immediate decompression is prioritized over waiting for
diagnostic imaging.
3. Which hemodynamic finding is most consistent with left ventricular failure?
A. Increased pulmonary artery wedge pressure
B. Decreased systemic vascular resistance only
C. Increased right atrial pressure with clear lungs
D. Increased cardiac index with low filling pressures
Answer: A
Left ventricular failure causes blood to back up into the pulmonary circulation, producing an
elevated pulmonary artery wedge pressure.
,4. A patient with acute pulmonary edema is severely dyspneic and has an oxygen saturation
of 82%. Which intervention should the nurse perform first?
A. Place the patient flat
B. Encourage oral fluids
C. Administer a sedative
D. Position the patient upright and provide oxygen support
Answer: D
Upright positioning improves lung expansion and reduces venous return, while oxygen
support addresses the immediate life-threatening hypoxemia.
5. A patient receiving unfractionated heparin develops a platelet count decrease of more
than 50% from baseline on day 7 of therapy. Which complication should the nurse
suspect?
A. Disseminated intravascular coagulation
B. Heparin-induced thrombocytopenia
C. Vitamin K deficiency
D. Immune thrombocytopenia unrelated to heparin
Answer: B
A platelet decrease of more than 50% occurring several days after heparin exposure is highly
concerning for heparin-induced thrombocytopenia, which carries a significant risk of
thrombosis.
6. A patient with acute myocardial infarction develops hypotension, jugular venous
distention, and clear lung sounds. Which complication is most likely?
A. Right ventricular infarction
B. Acute left ventricular failure
C. Pulmonary edema
D. Mitral stenosis
Answer: A
Right ventricular infarction impairs right-sided pumping, producing systemic venous
congestion and hypotension while pulmonary congestion may remain absent.
7. Which ECG finding is most characteristic of acute myocardial ischemia?
A. Prolonged QT interval
B. Widened QRS complex
C. ST-segment depression
D. Shortened PR interval
Answer: C
,ST-segment depression can indicate myocardial ischemia, particularly when it occurs in
anatomically appropriate leads and correlates with clinical symptoms.
8. A patient develops ventricular fibrillation and becomes unresponsive with no pulse.
What should the nurse do immediately?
A. Administer oral amiodarone
B. Obtain a 12-lead ECG
C. Begin synchronized cardioversion
D. Initiate CPR and prepare for immediate defibrillation
Answer: D
Pulseless ventricular fibrillation is a shockable cardiac arrest rhythm. High-quality CPR and
immediate unsynchronized defibrillation are priorities.
9. A patient with atrial fibrillation has a ventricular rate of 168/min, blood pressure of
78/42 mmHg, and altered mental status. Which treatment should the nurse anticipate?
A. Synchronized cardioversion
B. Oral beta-blocker administration
C. Observation for spontaneous conversion
D. Fluid restriction
Answer: A
Atrial fibrillation causing hemodynamic instability requires synchronized cardioversion
because the rapid rhythm is compromising circulation.
10. Which assessment finding most strongly suggests cardiac tamponade?
A. Hypertension and bounding pulses
B. Bradycardia with pulmonary crackles
C. Hypotension, jugular venous distention, and muffled heart sounds
D. Increased urine output and peripheral vasodilation
Answer: C
The combination of hypotension, elevated venous pressure, and muffled heart sounds is
classic for cardiac tamponade and reflects impaired ventricular filling from pericardial
pressure.
11. A patient with cardiogenic shock has a cardiac index of 1.7 L/min/m². Which finding
would the nurse expect?
A. Warm skin and bounding pulses
B. Decreased systemic perfusion
C. Increased urine output
D. Markedly reduced lactate production
, Answer: B
A low cardiac index indicates inadequate forward blood flow and therefore reduced tissue
perfusion, commonly manifested by cool extremities, oliguria, altered mentation, and
elevated lactate.
12. A patient receiving norepinephrine through a peripheral IV reports severe pain at the
infusion site. The site is pale and cool. What is the nurse's priority?
A. Increase the infusion rate
B. Flush the IV rapidly
C. Apply a tight pressure dressing
D. Stop the infusion and manage suspected extravasation according to protocol
Answer: D
Pain, pallor, and coolness suggest vasopressor extravasation. The infusion should be stopped
and the institution's extravasation protocol followed to limit tissue injury.
13. Which laboratory value is most useful for evaluating the severity and trend of tissue
hypoperfusion in septic shock?
A. Serum lactate
B. Total cholesterol
C. Hemoglobin A1c
D. Serum calcium alone
Answer: A
Elevated lactate can reflect impaired oxygen utilization or delivery and is useful for assessing
the severity and trajectory of shock when interpreted with the overall clinical picture.
14. A patient with severe asthma develops increasing fatigue, a decreasing respiratory rate,
and rising PaCO₂. What does this change indicate?
A. Improving ventilation
B. Resolution of bronchospasm
C. Impending respiratory failure
D. Normal compensation
Answer: C
In severe asthma, a rising PaCO₂ after earlier hypocapnia can indicate worsening ventilatory
failure and respiratory muscle fatigue.
15. A patient with COPD exacerbation is receiving oxygen therapy. Which principle is most
appropriate?
A. Withhold oxygen until arterial blood gases are obtained
B. Provide controlled oxygen while monitoring respiratory status and gas exchange
