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ACCN CCRN PRACTICE TEST 1 QUESTIONS
WITH 100% CORRECT ANSWERS GRADE A
CERTIFIED 2025/26
After attending an educational session that reviewed drug dosing and provided a review of the
literature, the nurse would like to start using the admission weight to calculate drug dosing
during titration of vasoactive drugs rather than the current practice of using daily weights. What
would be the most effective next step for the nurse to take to implement this change?
(A) Begin the adaptation of the practice by using the admission weight for patients.
(B) Identify the key stakeholders related to the proposed change in practice.
(C) Ask the attending physician on rounds what her thoughts are about the practice.
(D) Discuss the educational session with nurse colleagues. - correct answer(B) Identify the key
stakeholders related to the proposed change in practice.
A patient presents with a productive cough, hypoxemia, a fever, hypotension, tachycardia, and
tachypnea. Hypoxemia was corrected with the administration of oxygen. Which of the following
should be done next?
(A) Administer antibiotics.
(B) Start a vasopressor.
(C) Collect a sputum culture.
(D) Initiate 0.9 normal saline. - correct answer(D) Initiate 0.9 normal saline.
A patient with a urinary tract infection presented with a temperature of 39°C (102.2°F), a heart
rate of 132 beats/minute, a respiratory rate of 24 breaths/minute, a BP of 78/49 (a MAP of 59
mmHg), and a lactate of 2.8 mmol/L. The patient received 2 L of 0.9 NS within 1 hour. The BP
is now 100/52 (the MAP is 68 mmHg), the heart rate is 118 beats/minute, the respiratory rate is
20 breaths/minute, and the lactate is 2.1 mmol/L. The patient requires treatment for:
(A) bacteremia.
(B) sepsis.
(C) SIRS.
(D) septic shock. - correct answer(B) sepsis.
A patient is 48 hours post aortic valve replacement. Which of the following would be a major
goal for this patient?
(A) diuretic therapy
(B) stabilizing the blood pressure
(C) prophylactic antibiotics
(D) preventing a thrombus - correct answer(D) preventing a thrombus
A patient with hypoxic encephalopathy has been opening his eyes to touch for the past 24 hours.
The patient now withdraws to painful stimuli, has developed unequal pupils, and has a positive
Babinski reflex. Which of the following interventions should the nurse anticipate?
(A) ventriculostomy, oxygen, steroids
1
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(B) sedation, vasopressin (Pitressin), thiazide diuretic
(C) osmotic diuretic, intubation, and monitor the pCO2
(D) lumbar puncture and increase the FiO2 - correct answer(C) osmotic diuretic, intubation, and
monitor the pCO2
A 19-year-old patient who was admitted with sickle cell crisis and acute kidney injury requests
to use a phone to update her friends on her condition. The nurse's best response would be to:
(A) explain to the patient that calls can be made when she is transferred out of the critical care
unit.
(B) allow the patient to make the calls in order to meet the patient's need for social support.
(C) explain to the patient that she needs to rest in order for the analgesic medication to take
effect.
(D) allow the patient to make the calls in order to reduce the patient's anxiety. - correct
answer(B) allow the patient to make the calls in order to meet the patient's need for social
support.
The unit quality council wants to reduce the number of CAUTIS. Which of the following
strategies has been demonstrated to reduce incidences of CAUTIS?
(A) Remove the indwelling urinary catheter on day 3 post-op.
(B) Place the drainage collection system on the patient's abdomen during transport.
(C) Assess the competency of the staff using a simulated environment.
(D) Avoid the use of intermittent straight catheterization. - correct answer(C) Assess the
competency of the staff using a simulated environment.
A patient has cardiogenic shock and cardiogenic pulmonary edema. Which of the following
therapies would be most effective for this patient?
(A) an intra-aortic balloon pump to increase coronary artery perfusion
(B) a beta blocker to increase cardiac contractility
(C) an alpha-adrenergic drug to increase coronary artery perfusion
(D) angiotensin-converting enzyme inhibitors to decrease afterload - correct answer(A) an intra-
aortic balloon pump to increase coronary artery perfusion
The care team is considering whether a patient is a candidate for hospice care. Which of the
following is a specific service provided by hospice care?
(A) advance care planning
(B) symptom management
(C) care for a terminal illness
(D) consideration of patient/family wishes - correct answer(C) care for a terminal illness
A patient has a history of chronic respiratory failure secondary to COPD and now has acute
respiratory failure secondary to pneumonia. Upon arrival at the critical care unit, his ABGs were
a pH of 7.29, a PaCO2 of 77, a PaO2 of 51, and an HCO3 of 31. He is receiving noninvasive
ventilation with settings that read as follows: FiO2 0.40, IPAP 12 cm, and EPAP 5 cm. After 1
hour of therapy, the patient's ABG results are a pH of 7.20, a PaCO2 of 89, a PaO2 of 48, and an
HCO3 of 32.
What is the correct evaluation of this data?
2
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(A) Alveolar hyperventilation is getting worse; the BiPAP settings need adjustment.
(B) Metabolic acidosis is worse; the FiO, needs to be increased.
(C) Alveolar hypoventilation is getting worse; the patient needs to be intubated.
(D) The pH is acceptable for a patient with COPD; continue the current therapy. - correct
answer(C) Alveolar hypoventilation is getting worse; the patient needs to be intubated.
Which of the following is true regarding plateau pressure?
(A) It is a pressure that is used to calculate static compliance and reflects pressure in the lungs.
(B) It is a pressure that is used to calculate vital capacity and reflects pressure in the lungs.
(C) It is a pressure that is used to calculate dynamic compliance and reflects pressure in the
airways.
(D) It is a pressure that is used to measure tidal volume and reflects pressure in the airways. -
correct answer(A) It is a pressure that is used to calculate static compliance and reflects pressure
in the lungs.
A patient is admitted with a salicylate overdose. Which of the following treatments is most
effective for this patient?
(A) N-acetylcysteine, support the airway, fluids
(B) gastric lavage, an antidote, fluids
(C) activated charcoal, urine alkalinization, dialysis
(D) support the airway, gastric lavage, ethanol - correct answer(C) activated charcoal, urine
alkalinization, dialysis
Which of the following patients who have sustained multiple trauma is most likely how to have a
poor outcome based on patient characteristics?
(A) the college graduate
(B) the owner of a successful business
(C) the married man
(D) the homeless man - correct answer(D) the homeless man
Which of the following may be a reason to use restraints for a patient?
(A) The patient is screaming obscenities.
(B) The patient is spitting.
(C) The patient is pulling at his central venous catheter.
(D) The patient has an endotracheal tube. - correct answer(C) The patient is pulling at his central
venous catheter.
A patient has acute right ventricular infarct and RV failure. Which of the following is an
indication that this patient's condition has improved?
(A) The PAOP has decreased.
(B) The RA pressure has decreased.
(C) The RV pressure has increased.
(D) The PA diastolic pressure has decreased. - correct answer(B) The RA pressure has
decreased.
3
ACCN CCRN PRACTICE TEST 1 QUESTIONS
WITH 100% CORRECT ANSWERS GRADE A
CERTIFIED 2025/26
After attending an educational session that reviewed drug dosing and provided a review of the
literature, the nurse would like to start using the admission weight to calculate drug dosing
during titration of vasoactive drugs rather than the current practice of using daily weights. What
would be the most effective next step for the nurse to take to implement this change?
(A) Begin the adaptation of the practice by using the admission weight for patients.
(B) Identify the key stakeholders related to the proposed change in practice.
(C) Ask the attending physician on rounds what her thoughts are about the practice.
(D) Discuss the educational session with nurse colleagues. - correct answer(B) Identify the key
stakeholders related to the proposed change in practice.
A patient presents with a productive cough, hypoxemia, a fever, hypotension, tachycardia, and
tachypnea. Hypoxemia was corrected with the administration of oxygen. Which of the following
should be done next?
(A) Administer antibiotics.
(B) Start a vasopressor.
(C) Collect a sputum culture.
(D) Initiate 0.9 normal saline. - correct answer(D) Initiate 0.9 normal saline.
A patient with a urinary tract infection presented with a temperature of 39°C (102.2°F), a heart
rate of 132 beats/minute, a respiratory rate of 24 breaths/minute, a BP of 78/49 (a MAP of 59
mmHg), and a lactate of 2.8 mmol/L. The patient received 2 L of 0.9 NS within 1 hour. The BP
is now 100/52 (the MAP is 68 mmHg), the heart rate is 118 beats/minute, the respiratory rate is
20 breaths/minute, and the lactate is 2.1 mmol/L. The patient requires treatment for:
(A) bacteremia.
(B) sepsis.
(C) SIRS.
(D) septic shock. - correct answer(B) sepsis.
A patient is 48 hours post aortic valve replacement. Which of the following would be a major
goal for this patient?
(A) diuretic therapy
(B) stabilizing the blood pressure
(C) prophylactic antibiotics
(D) preventing a thrombus - correct answer(D) preventing a thrombus
A patient with hypoxic encephalopathy has been opening his eyes to touch for the past 24 hours.
The patient now withdraws to painful stimuli, has developed unequal pupils, and has a positive
Babinski reflex. Which of the following interventions should the nurse anticipate?
(A) ventriculostomy, oxygen, steroids
1
(B) sedation, vasopressin (Pitressin), thiazide diuretic
(C) osmotic diuretic, intubation, and monitor the pCO2
(D) lumbar puncture and increase the FiO2 - correct answer(C) osmotic diuretic, intubation, and
monitor the pCO2
A 19-year-old patient who was admitted with sickle cell crisis and acute kidney injury requests
to use a phone to update her friends on her condition. The nurse's best response would be to:
(A) explain to the patient that calls can be made when she is transferred out of the critical care
unit.
(B) allow the patient to make the calls in order to meet the patient's need for social support.
(C) explain to the patient that she needs to rest in order for the analgesic medication to take
effect.
(D) allow the patient to make the calls in order to reduce the patient's anxiety. - correct
answer(B) allow the patient to make the calls in order to meet the patient's need for social
support.
The unit quality council wants to reduce the number of CAUTIS. Which of the following
strategies has been demonstrated to reduce incidences of CAUTIS?
(A) Remove the indwelling urinary catheter on day 3 post-op.
(B) Place the drainage collection system on the patient's abdomen during transport.
(C) Assess the competency of the staff using a simulated environment.
(D) Avoid the use of intermittent straight catheterization. - correct answer(C) Assess the
competency of the staff using a simulated environment.
A patient has cardiogenic shock and cardiogenic pulmonary edema. Which of the following
therapies would be most effective for this patient?
(A) an intra-aortic balloon pump to increase coronary artery perfusion
(B) a beta blocker to increase cardiac contractility
(C) an alpha-adrenergic drug to increase coronary artery perfusion
(D) angiotensin-converting enzyme inhibitors to decrease afterload - correct answer(A) an intra-
aortic balloon pump to increase coronary artery perfusion
The care team is considering whether a patient is a candidate for hospice care. Which of the
following is a specific service provided by hospice care?
(A) advance care planning
(B) symptom management
(C) care for a terminal illness
(D) consideration of patient/family wishes - correct answer(C) care for a terminal illness
A patient has a history of chronic respiratory failure secondary to COPD and now has acute
respiratory failure secondary to pneumonia. Upon arrival at the critical care unit, his ABGs were
a pH of 7.29, a PaCO2 of 77, a PaO2 of 51, and an HCO3 of 31. He is receiving noninvasive
ventilation with settings that read as follows: FiO2 0.40, IPAP 12 cm, and EPAP 5 cm. After 1
hour of therapy, the patient's ABG results are a pH of 7.20, a PaCO2 of 89, a PaO2 of 48, and an
HCO3 of 32.
What is the correct evaluation of this data?
2
(A) Alveolar hyperventilation is getting worse; the BiPAP settings need adjustment.
(B) Metabolic acidosis is worse; the FiO, needs to be increased.
(C) Alveolar hypoventilation is getting worse; the patient needs to be intubated.
(D) The pH is acceptable for a patient with COPD; continue the current therapy. - correct
answer(C) Alveolar hypoventilation is getting worse; the patient needs to be intubated.
Which of the following is true regarding plateau pressure?
(A) It is a pressure that is used to calculate static compliance and reflects pressure in the lungs.
(B) It is a pressure that is used to calculate vital capacity and reflects pressure in the lungs.
(C) It is a pressure that is used to calculate dynamic compliance and reflects pressure in the
airways.
(D) It is a pressure that is used to measure tidal volume and reflects pressure in the airways. -
correct answer(A) It is a pressure that is used to calculate static compliance and reflects pressure
in the lungs.
A patient is admitted with a salicylate overdose. Which of the following treatments is most
effective for this patient?
(A) N-acetylcysteine, support the airway, fluids
(B) gastric lavage, an antidote, fluids
(C) activated charcoal, urine alkalinization, dialysis
(D) support the airway, gastric lavage, ethanol - correct answer(C) activated charcoal, urine
alkalinization, dialysis
Which of the following patients who have sustained multiple trauma is most likely how to have a
poor outcome based on patient characteristics?
(A) the college graduate
(B) the owner of a successful business
(C) the married man
(D) the homeless man - correct answer(D) the homeless man
Which of the following may be a reason to use restraints for a patient?
(A) The patient is screaming obscenities.
(B) The patient is spitting.
(C) The patient is pulling at his central venous catheter.
(D) The patient has an endotracheal tube. - correct answer(C) The patient is pulling at his central
venous catheter.
A patient has acute right ventricular infarct and RV failure. Which of the following is an
indication that this patient's condition has improved?
(A) The PAOP has decreased.
(B) The RA pressure has decreased.
(C) The RV pressure has increased.
(D) The PA diastolic pressure has decreased. - correct answer(B) The RA pressure has
decreased.
3
