CCRN CERTIFICATION PRACTICE
EXAM 2024/2025 LATEST TEST BANK
WITH 500 PRACTICE QUESTIONS AND
CORRECT ANSWERS FOR THE CCRN
ADULT CERTIFICATION TEST
A patient arrives in the emergency department with multiple gunshot wounds. He
requires massive transfusion for blood loss from chest and abdominal wounds. The
electrocardiogram should be observed closely for changes indicative of which of
the following?
A.
Atrioventricular block
B.
Hyperkalemia
C.
Hypercalcemia
D.
Hypomagnesemia - ANSWER-Hyperkalemia
Banked blood is high in potassium because of hemolysis. Look for tall, peaked T
waves and widening of the QRS complex. Other considerations with massive
transfusion of banked blood are hypocalcemia, hypothermia, and decreased tissue
oxygen delivery caused by decreased levels of 2,3-diphosphoglycerate.
pg. 1
,A 52-year-old woman developed an epidural hematoma after being in a motor
vehicle collision. She has had a craniotomy to evacuate the clot, and an
intraventricular catheter was placed during surgery. Which of the following is
important in caring for the patient with an intracranial pressure (ICP) monitoring
system?
A.
Use heparin to maintain integrity of the line.
B.
Use preservative-free isotonic saline.
C.
Use a flush system.
D.
Use a pressure bag. - ANSWER-ICP monitoring systems are closed systems. A
flush system with heparin and a pressure bag with an intermittent flush device is
appropriate for vascular pressure monitoring (e.g., arterial catheters and pulmonary
artery catheters) but not for intracranial pressure monitoring systems. Preservatives
in saline vials can cause meningeal irritation or brain tissue necrosis. Only
preservative-free saline should be used to prime the system.
A 68-year-old woman is admitted with ischemic stroke. When the bottom of her
foot is stroked, the great toe moves upward and the other toes fan out. This finding
indicates which of the following?
A.
Upper motor neuron lesion
pg. 2
,B.
Lower motor neuron lesion
C.
Brainstem lesion
D.
Normal finding - ANSWER-A
Upper do to stroke, and the babinski reflex is an UMN lesion always
Your patient is in hepatic failure caused by chronic liver disease. She has ascites
and severe peripheral edema. She is anorectic and vomiting and has developed
metabolic alkalosis and hypokalemia. Which of the following would not be
included in this patient's management?
A.
Diuretics
B.
Potassium supplements
C.
Antiemetics
D.
Diet high in protein - ANSWER-Diuretics would worsen the metabloc alkolis and
hypokalemia. The patient with liver failure does not have the appropriate proteins
pg. 3
, to pull water from the tissues into the vascular bed, thus diuretics would lose their
effect in this situation. A diet high in protein would only be contraindicated if the
patient had a decrease in mental status from the liver failure ( H ammonia levels)
A 34-year-old man admitted with Pneumocystis carinii pneumonia asks the nurse
what protective measures he should use at home to prevent transmission of human
immunodeficiency virus (HIV) to family members. The best response would
include which of the following?
A.
Wear a mask to protect the family members.
B.
Use plastic eating utensils and paper plates.
C.
Launder clothing and linens separately.
D.
Clean up body secretion spills with a weak chlorine bleach solution. - ANSWER-D
- throw out the extremes and remember that body secretions are the concern. Weak
chlorine bleach will kill HIV
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?
pg. 4
EXAM 2024/2025 LATEST TEST BANK
WITH 500 PRACTICE QUESTIONS AND
CORRECT ANSWERS FOR THE CCRN
ADULT CERTIFICATION TEST
A patient arrives in the emergency department with multiple gunshot wounds. He
requires massive transfusion for blood loss from chest and abdominal wounds. The
electrocardiogram should be observed closely for changes indicative of which of
the following?
A.
Atrioventricular block
B.
Hyperkalemia
C.
Hypercalcemia
D.
Hypomagnesemia - ANSWER-Hyperkalemia
Banked blood is high in potassium because of hemolysis. Look for tall, peaked T
waves and widening of the QRS complex. Other considerations with massive
transfusion of banked blood are hypocalcemia, hypothermia, and decreased tissue
oxygen delivery caused by decreased levels of 2,3-diphosphoglycerate.
pg. 1
,A 52-year-old woman developed an epidural hematoma after being in a motor
vehicle collision. She has had a craniotomy to evacuate the clot, and an
intraventricular catheter was placed during surgery. Which of the following is
important in caring for the patient with an intracranial pressure (ICP) monitoring
system?
A.
Use heparin to maintain integrity of the line.
B.
Use preservative-free isotonic saline.
C.
Use a flush system.
D.
Use a pressure bag. - ANSWER-ICP monitoring systems are closed systems. A
flush system with heparin and a pressure bag with an intermittent flush device is
appropriate for vascular pressure monitoring (e.g., arterial catheters and pulmonary
artery catheters) but not for intracranial pressure monitoring systems. Preservatives
in saline vials can cause meningeal irritation or brain tissue necrosis. Only
preservative-free saline should be used to prime the system.
A 68-year-old woman is admitted with ischemic stroke. When the bottom of her
foot is stroked, the great toe moves upward and the other toes fan out. This finding
indicates which of the following?
A.
Upper motor neuron lesion
pg. 2
,B.
Lower motor neuron lesion
C.
Brainstem lesion
D.
Normal finding - ANSWER-A
Upper do to stroke, and the babinski reflex is an UMN lesion always
Your patient is in hepatic failure caused by chronic liver disease. She has ascites
and severe peripheral edema. She is anorectic and vomiting and has developed
metabolic alkalosis and hypokalemia. Which of the following would not be
included in this patient's management?
A.
Diuretics
B.
Potassium supplements
C.
Antiemetics
D.
Diet high in protein - ANSWER-Diuretics would worsen the metabloc alkolis and
hypokalemia. The patient with liver failure does not have the appropriate proteins
pg. 3
, to pull water from the tissues into the vascular bed, thus diuretics would lose their
effect in this situation. A diet high in protein would only be contraindicated if the
patient had a decrease in mental status from the liver failure ( H ammonia levels)
A 34-year-old man admitted with Pneumocystis carinii pneumonia asks the nurse
what protective measures he should use at home to prevent transmission of human
immunodeficiency virus (HIV) to family members. The best response would
include which of the following?
A.
Wear a mask to protect the family members.
B.
Use plastic eating utensils and paper plates.
C.
Launder clothing and linens separately.
D.
Clean up body secretion spills with a weak chlorine bleach solution. - ANSWER-D
- throw out the extremes and remember that body secretions are the concern. Weak
chlorine bleach will kill HIV
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?
pg. 4
