PASS the CCRN! Questions &
Answers ( Latest 2025 )
A 56 yr-old male is admitted to the ICU with a blood
pressure of 225/135 and complains of a headache and
nausea. He reports he ran out of blood pressure meds
three days ago, but also appears to be confused to the
date and situation. What is the most appropriate
treatment approach? - CORRECT ANSWERS
✔✔Rapidly lower the diastolic pressure to 100 with IV
antihypertensive meds, then continue to gradually reduce
the diastolic pressure to 85 with oral antihypertensive
meds.
The maximum initial decrease should be no more than
25% reduction from initial presenting value. Reducing the
blood pressure too quickly can lead to cerebral edema or
renal failure.
A patient has sepsis, receives Lactated ringers 500ml IV
bolus. Which finding indicate that this intervention is
having it's intended effect? - CORRECT ANSWERS
✔✔ScvO2 of 72%
Early goal directed therapy for sepsis includes early fluid
resuscitation at 30 ml/kg to maintain a CVP of 8-12 or 12-
15 if mechanically ventilated, MAP greater than 65,
ScvO2 greater than 70%, and urine output greater than
0.5 kg/hr
,PASS the CCRN! Questions &
Answers ( Latest 2025 )
72 male patient in ICU for 6 days on the ventilator for
treatment of a COPD exacerbation. He has been receiving
VTE prophylaxis and subcutaneous Heparin since
admission. Today his platelet count decreased
significantly to 43,000 and was found to have new DVT on
his right upper extremity. What do you suspect is the
most likely cause of these findings? - CORRECT
ANSWERS ✔✔HIT
The hallmark sign of HIT is a significant decrease in
platelet count over a 24 hours period (>50%) within 5-10
days of administering Heparin. The other hallmark sign is
a new development of DVT despite being on VTE
prophylaxis.
TRALI: - CORRECT ANSWERS ✔✔is a complication
from a blood transfusion reaction, which causes acute
lung injury typically within 6 hours of a blood transfusion.
2 Hallmark signs of HIT: - CORRECT ANSWERS
✔✔Decrease in platelet count over a 24 hr period.
New development of DVT despite being on VTE
prophylaxis.
,PASS the CCRN! Questions &
Answers ( Latest 2025 )
Values in Early compensated Hypovolemic shock? -
CORRECT ANSWERS ✔✔CO 4.0 L/min, HR 135, SV 65,
SVR 1700, MAP 65
In hypovolemic states, circulating volume is depleted
therefore preload and contractility are decreased which
leads to a decrease in SV and CO. HR and SV increase as
compensatory measure to preserve CO, MAP and cerebral
perfusion.
Post-renal failure values: - CORRECT ANSWERS
✔✔Urine output < 200; urine sodium 30; BUN: Creatinine
ratio 15:1; urine specific gravity 1.010
BUN: Creatinine ratio is 15:1, but both the BUN &
creatinine are elevated. Urine sodium is typically 1-40
mEq/L.
What to do in the event of HIT: - CORRECT ANSWERS
✔✔Stop Heparin and administer an alternative direct
thrombin inhibitor.
Warfarin is contraindicated in HIT? T/F - CORRECT
ANSWERS ✔✔True - there is also no evidence that
, PASS the CCRN! Questions &
Answers ( Latest 2025 )
shows protamine, corticosteroids, and benadryl are
effective treatments for HIT
Patients with right ventricular infarctions become preload
dependent. Meds that decrease preload should be
avoided - which meds are these? - CORRECT ANSWERS
✔✔Morphine, Nitro, Beta blockers and diuretics.
Polymorphic ventricular tachycardia aka Torsades is
treated by? - CORRECT ANSWERS ✔✔Magnesium
Myocardial contusions generally impact which parts of the
heart? and what would the values be? - CORRECT
ANSWERS ✔✔Atria & right ventricle because of the
position of the heart in the chest.
PAOP 6, PA Pressure 40/24, RA Pressure 16
Neurogenic shock signs? - CORRECT ANSWERS
✔✔CVP: 3, CI: 2.5, SVR: 650, SBP: 88
Neuro shock is associated with a loss of sympathetic tone
causing extensive peripheral vasodilation. Clinical signs
Answers ( Latest 2025 )
A 56 yr-old male is admitted to the ICU with a blood
pressure of 225/135 and complains of a headache and
nausea. He reports he ran out of blood pressure meds
three days ago, but also appears to be confused to the
date and situation. What is the most appropriate
treatment approach? - CORRECT ANSWERS
✔✔Rapidly lower the diastolic pressure to 100 with IV
antihypertensive meds, then continue to gradually reduce
the diastolic pressure to 85 with oral antihypertensive
meds.
The maximum initial decrease should be no more than
25% reduction from initial presenting value. Reducing the
blood pressure too quickly can lead to cerebral edema or
renal failure.
A patient has sepsis, receives Lactated ringers 500ml IV
bolus. Which finding indicate that this intervention is
having it's intended effect? - CORRECT ANSWERS
✔✔ScvO2 of 72%
Early goal directed therapy for sepsis includes early fluid
resuscitation at 30 ml/kg to maintain a CVP of 8-12 or 12-
15 if mechanically ventilated, MAP greater than 65,
ScvO2 greater than 70%, and urine output greater than
0.5 kg/hr
,PASS the CCRN! Questions &
Answers ( Latest 2025 )
72 male patient in ICU for 6 days on the ventilator for
treatment of a COPD exacerbation. He has been receiving
VTE prophylaxis and subcutaneous Heparin since
admission. Today his platelet count decreased
significantly to 43,000 and was found to have new DVT on
his right upper extremity. What do you suspect is the
most likely cause of these findings? - CORRECT
ANSWERS ✔✔HIT
The hallmark sign of HIT is a significant decrease in
platelet count over a 24 hours period (>50%) within 5-10
days of administering Heparin. The other hallmark sign is
a new development of DVT despite being on VTE
prophylaxis.
TRALI: - CORRECT ANSWERS ✔✔is a complication
from a blood transfusion reaction, which causes acute
lung injury typically within 6 hours of a blood transfusion.
2 Hallmark signs of HIT: - CORRECT ANSWERS
✔✔Decrease in platelet count over a 24 hr period.
New development of DVT despite being on VTE
prophylaxis.
,PASS the CCRN! Questions &
Answers ( Latest 2025 )
Values in Early compensated Hypovolemic shock? -
CORRECT ANSWERS ✔✔CO 4.0 L/min, HR 135, SV 65,
SVR 1700, MAP 65
In hypovolemic states, circulating volume is depleted
therefore preload and contractility are decreased which
leads to a decrease in SV and CO. HR and SV increase as
compensatory measure to preserve CO, MAP and cerebral
perfusion.
Post-renal failure values: - CORRECT ANSWERS
✔✔Urine output < 200; urine sodium 30; BUN: Creatinine
ratio 15:1; urine specific gravity 1.010
BUN: Creatinine ratio is 15:1, but both the BUN &
creatinine are elevated. Urine sodium is typically 1-40
mEq/L.
What to do in the event of HIT: - CORRECT ANSWERS
✔✔Stop Heparin and administer an alternative direct
thrombin inhibitor.
Warfarin is contraindicated in HIT? T/F - CORRECT
ANSWERS ✔✔True - there is also no evidence that
, PASS the CCRN! Questions &
Answers ( Latest 2025 )
shows protamine, corticosteroids, and benadryl are
effective treatments for HIT
Patients with right ventricular infarctions become preload
dependent. Meds that decrease preload should be
avoided - which meds are these? - CORRECT ANSWERS
✔✔Morphine, Nitro, Beta blockers and diuretics.
Polymorphic ventricular tachycardia aka Torsades is
treated by? - CORRECT ANSWERS ✔✔Magnesium
Myocardial contusions generally impact which parts of the
heart? and what would the values be? - CORRECT
ANSWERS ✔✔Atria & right ventricle because of the
position of the heart in the chest.
PAOP 6, PA Pressure 40/24, RA Pressure 16
Neurogenic shock signs? - CORRECT ANSWERS
✔✔CVP: 3, CI: 2.5, SVR: 650, SBP: 88
Neuro shock is associated with a loss of sympathetic tone
causing extensive peripheral vasodilation. Clinical signs
