CCRN Critical Care Registered Nurse
Exam With Actual Questions & Verified
Answers,Plus Rationales/Expert
Verified For Guaranteed Pass Graded
A+/2026 /Latest Update/Instant
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1. A 62-year-old man with acute MI develops hypotension and cold,
clammy skin. Which hemodynamic profile suggests cardiogenic shock?
A. Increased cardiac output, decreased SVR
B. Decreased cardiac output, increased SVR
C. Decreased cardiac output, decreased SVR
D. Increased cardiac output, increased SVR
Answer: B. Decreased cardiac output, increased SVR
Rationale: Cardiogenic shock causes low CO from pump failure;
systemic vasoconstriction raises SVR as compensation.
2. Best initial treatment for rapid atrial fibrillation with hypotension?
A. Amiodarone infusion
B. IV beta-blocker bolus
C. Synchronized cardioversion
D. Vagal maneuvers
Answer: C. Synchronized cardioversion
Rationale: Hemodynamic instability (hypotension) requires immediate
synchronized cardioversion.
3. A patient on mechanical ventilation with rising peak inspiratory
pressures and a sudden drop in tidal volume — most likely cause?
A. Increased secretions/airway obstruction
, B. Pulmonary embolism
C. Left ventricular failure
D. Hypovolemia
Answer: A. Increased secretions/airway obstruction
Rationale: Sudden rise in pressure and decreased delivered volume
suggests increased airway resistance or obstruction (secretions, kinked
tube).
4. For ARDS, which tidal volume strategy is recommended?
A. 10–12 mL/kg predicted body weight
B. 8–10 mL/kg actual body weight
C. 6 mL/kg predicted body weight
D. 12–15 mL/kg predicted body weight
Answer: C. 6 mL/kg predicted body weight
Rationale: Low tidal volume ventilation (~6 mL/kg PBW) reduces
ventilator-induced lung injury in ARDS.
5. A sudden decrease in EtCO2 from 35 to 5 mmHg during surgery suggests:
A. Hypoventilation
B. Pulmonary embolism or loss of circulation
C. Increased cardiac output
D. Hyperthermia
Answer: B. Pulmonary embolism or loss of circulation
Rationale: Sudden drop in EtCO2 indicates abrupt reduction in
pulmonary blood flow (e.g., PE, cardiac arrest).
6. Best next step for a rapid narrow-complex SVT in a stable awake patient?
A. Carotid massage if no carotid bruits
B. IV amiodarone
C. Immediate synchronized cardioversion
D. Start dopamine infusion
Answer: A. Carotid massage if no carotid bruits
Rationale: For stable SVT, vagal maneuvers (e.g., carotid sinus massage
if safe) are first-line.
7. In septic shock, recommended initial fluid bolus for hypotension?
A. 100 mL
, B. 500 mL
C. 30 mL/kg crystalloid
D. 3 L colloid only
Answer: C. 30 mL/kg crystalloid
Rationale: Early sepsis guidelines recommend initial fluid resuscitation
~30 mL/kg of crystalloid for hypotension or lactate ≥4 mmol/L.
8. Which vasopressor is first-line for septic shock?
A. Dopamine
B. Norepinephrine
C. Phenylephrine
D. Epinephrine
Answer: B. Norepinephrine
Rationale: Norepinephrine is preferred first-line vasopressor to restore
MAP in septic shock.
9. A central venous pressure (CVP) trending from 2 to 14 mmHg with rising
JVD and hypotension suggests:
A. Hypovolemia
B. Tension pneumothorax or cardiac tamponade
C. Pulmonary embolism
D. Sepsis with vasodilation
Answer: B. Tension pneumothorax or cardiac tamponade
Rationale: Rapidly increasing CVP with JVD and hypotension suggests
obstructive shock (tamponade, tension pneumothorax).
10.Which lab abnormality is most expected with tumor lysis syndrome?
A. Hypokalemia
B. Hyperkalemia, hyperphosphatemia, hypocalcemia, hyperuricemia
C. Hypophosphatemia and hypouricemia
D. Hyponatremia only
Answer: B. Hyperkalemia, hyperphosphatemia, hypocalcemia,
hyperuricemia
Rationale: Rapid cell lysis releases intracellular K and phosphate and
increases uric acid; Ca drops secondary to phosphate binding.
Exam With Actual Questions & Verified
Answers,Plus Rationales/Expert
Verified For Guaranteed Pass Graded
A+/2026 /Latest Update/Instant
Download Pdf
1. A 62-year-old man with acute MI develops hypotension and cold,
clammy skin. Which hemodynamic profile suggests cardiogenic shock?
A. Increased cardiac output, decreased SVR
B. Decreased cardiac output, increased SVR
C. Decreased cardiac output, decreased SVR
D. Increased cardiac output, increased SVR
Answer: B. Decreased cardiac output, increased SVR
Rationale: Cardiogenic shock causes low CO from pump failure;
systemic vasoconstriction raises SVR as compensation.
2. Best initial treatment for rapid atrial fibrillation with hypotension?
A. Amiodarone infusion
B. IV beta-blocker bolus
C. Synchronized cardioversion
D. Vagal maneuvers
Answer: C. Synchronized cardioversion
Rationale: Hemodynamic instability (hypotension) requires immediate
synchronized cardioversion.
3. A patient on mechanical ventilation with rising peak inspiratory
pressures and a sudden drop in tidal volume — most likely cause?
A. Increased secretions/airway obstruction
, B. Pulmonary embolism
C. Left ventricular failure
D. Hypovolemia
Answer: A. Increased secretions/airway obstruction
Rationale: Sudden rise in pressure and decreased delivered volume
suggests increased airway resistance or obstruction (secretions, kinked
tube).
4. For ARDS, which tidal volume strategy is recommended?
A. 10–12 mL/kg predicted body weight
B. 8–10 mL/kg actual body weight
C. 6 mL/kg predicted body weight
D. 12–15 mL/kg predicted body weight
Answer: C. 6 mL/kg predicted body weight
Rationale: Low tidal volume ventilation (~6 mL/kg PBW) reduces
ventilator-induced lung injury in ARDS.
5. A sudden decrease in EtCO2 from 35 to 5 mmHg during surgery suggests:
A. Hypoventilation
B. Pulmonary embolism or loss of circulation
C. Increased cardiac output
D. Hyperthermia
Answer: B. Pulmonary embolism or loss of circulation
Rationale: Sudden drop in EtCO2 indicates abrupt reduction in
pulmonary blood flow (e.g., PE, cardiac arrest).
6. Best next step for a rapid narrow-complex SVT in a stable awake patient?
A. Carotid massage if no carotid bruits
B. IV amiodarone
C. Immediate synchronized cardioversion
D. Start dopamine infusion
Answer: A. Carotid massage if no carotid bruits
Rationale: For stable SVT, vagal maneuvers (e.g., carotid sinus massage
if safe) are first-line.
7. In septic shock, recommended initial fluid bolus for hypotension?
A. 100 mL
, B. 500 mL
C. 30 mL/kg crystalloid
D. 3 L colloid only
Answer: C. 30 mL/kg crystalloid
Rationale: Early sepsis guidelines recommend initial fluid resuscitation
~30 mL/kg of crystalloid for hypotension or lactate ≥4 mmol/L.
8. Which vasopressor is first-line for septic shock?
A. Dopamine
B. Norepinephrine
C. Phenylephrine
D. Epinephrine
Answer: B. Norepinephrine
Rationale: Norepinephrine is preferred first-line vasopressor to restore
MAP in septic shock.
9. A central venous pressure (CVP) trending from 2 to 14 mmHg with rising
JVD and hypotension suggests:
A. Hypovolemia
B. Tension pneumothorax or cardiac tamponade
C. Pulmonary embolism
D. Sepsis with vasodilation
Answer: B. Tension pneumothorax or cardiac tamponade
Rationale: Rapidly increasing CVP with JVD and hypotension suggests
obstructive shock (tamponade, tension pneumothorax).
10.Which lab abnormality is most expected with tumor lysis syndrome?
A. Hypokalemia
B. Hyperkalemia, hyperphosphatemia, hypocalcemia, hyperuricemia
C. Hypophosphatemia and hypouricemia
D. Hyponatremia only
Answer: B. Hyperkalemia, hyperphosphatemia, hypocalcemia,
hyperuricemia
Rationale: Rapid cell lysis releases intracellular K and phosphate and
increases uric acid; Ca drops secondary to phosphate binding.
