Adult CCRN Review Book 2025-2026 - CCRN Study Guide Secrets [7th Edition]
🫀 ADULT CCRN PRACTICE QUESTIONS (1–25)
CCRN Exam Style – 7th Edition
CARDIOVASCULAR SYSTEM
1. A client has the following hemodynamic values: CVP 3 mmHg, PAWP 4 mmHg, CO decreased.
Which condition is most likely?
A) Cardiogenic shock
B) Hypovolemic shock
C) Septic shock
D) Pulmonary embolism
Answer: B) Hypovolemic shock
Rationale: Low preload values (CVP, PAWP) with decreased CO indicate volume loss.
2. Which finding best indicates left ventricular failure?
A) Jugular vein distention
B) Peripheral edema
C) Pulmonary crackles
D) Hepatomegaly
Answer: C) Pulmonary crackles
Rationale: Left ventricular failure causes pulmonary congestion due to blood backing up into the
lungs.
3. A patient with acute MI develops hypotension, pulmonary edema, and low cardiac output. This
is consistent with:
A) Hypovolemic shock
B) Neurogenic shock
C) Cardiogenic shock
D) Septic shock
Answer: C) Cardiogenic shock
Rationale: Pump failure following MI leads to poor perfusion and pulmonary congestion.
4. Which medication is MOST appropriate to improve cardiac output in cardiogenic shock?
, A) Phenylephrine
B) Dobutamine
C) Propranolol
D) Furosemide
Answer: B) Dobutamine
Rationale: Dobutamine is an inotrope that increases myocardial contractility.
5. A PAWP of 22 mmHg indicates:
A) Dehydration
B) Normal preload
C) Left ventricular overload
D) Right ventricular failure
Answer: C) Left ventricular overload
Rationale: Elevated PAWP reflects increased left ventricular filling pressures.
PULMONARY / RESPIRATORY
6. Which ABG finding is expected in acute respiratory distress syndrome (ARDS)?
A) Respiratory alkalosis
B) Metabolic alkalosis
C) Hypoxemia refractory to oxygen
D) Hypercapnia only
Answer: C) Hypoxemia refractory to oxygen
Rationale: ARDS causes severe V/Q mismatch and shunting.
7. The BEST ventilator strategy for ARDS is:
A) High tidal volume
B) Low PEEP
C) Low tidal volume with PEEP
D) Hyperventilation
Answer: C) Low tidal volume with PEEP
Rationale: Lung-protective ventilation prevents volutrauma and improves oxygenation.
8. Which sign indicates impending respiratory failure?
A) Increased PaO₂
B) Decreased work of breathing
C) Rising PaCO₂ with fatigue
D) Tachypnea only
🫀 ADULT CCRN PRACTICE QUESTIONS (1–25)
CCRN Exam Style – 7th Edition
CARDIOVASCULAR SYSTEM
1. A client has the following hemodynamic values: CVP 3 mmHg, PAWP 4 mmHg, CO decreased.
Which condition is most likely?
A) Cardiogenic shock
B) Hypovolemic shock
C) Septic shock
D) Pulmonary embolism
Answer: B) Hypovolemic shock
Rationale: Low preload values (CVP, PAWP) with decreased CO indicate volume loss.
2. Which finding best indicates left ventricular failure?
A) Jugular vein distention
B) Peripheral edema
C) Pulmonary crackles
D) Hepatomegaly
Answer: C) Pulmonary crackles
Rationale: Left ventricular failure causes pulmonary congestion due to blood backing up into the
lungs.
3. A patient with acute MI develops hypotension, pulmonary edema, and low cardiac output. This
is consistent with:
A) Hypovolemic shock
B) Neurogenic shock
C) Cardiogenic shock
D) Septic shock
Answer: C) Cardiogenic shock
Rationale: Pump failure following MI leads to poor perfusion and pulmonary congestion.
4. Which medication is MOST appropriate to improve cardiac output in cardiogenic shock?
, A) Phenylephrine
B) Dobutamine
C) Propranolol
D) Furosemide
Answer: B) Dobutamine
Rationale: Dobutamine is an inotrope that increases myocardial contractility.
5. A PAWP of 22 mmHg indicates:
A) Dehydration
B) Normal preload
C) Left ventricular overload
D) Right ventricular failure
Answer: C) Left ventricular overload
Rationale: Elevated PAWP reflects increased left ventricular filling pressures.
PULMONARY / RESPIRATORY
6. Which ABG finding is expected in acute respiratory distress syndrome (ARDS)?
A) Respiratory alkalosis
B) Metabolic alkalosis
C) Hypoxemia refractory to oxygen
D) Hypercapnia only
Answer: C) Hypoxemia refractory to oxygen
Rationale: ARDS causes severe V/Q mismatch and shunting.
7. The BEST ventilator strategy for ARDS is:
A) High tidal volume
B) Low PEEP
C) Low tidal volume with PEEP
D) Hyperventilation
Answer: C) Low tidal volume with PEEP
Rationale: Lung-protective ventilation prevents volutrauma and improves oxygenation.
8. Which sign indicates impending respiratory failure?
A) Increased PaO₂
B) Decreased work of breathing
C) Rising PaCO₂ with fatigue
D) Tachypnea only
