CCRN EXAM vc
Exam Solution vc
PASS the CCRN! Questions 2026 A+ GRADE ASSURED CO vc vc vc vc vc vc vc vc
MPLETE SOLUTIONS AND VERIFIED ANSWERS (4818F) vc vc vc vc vc
QUESTION 1 vc
A 56 yr- vc vc
old male is admitted to the ICU with a blood pressure of 225/135 and complains of a hea
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dache and nausea. He reports he ran out of blood pressure meds three days ago, but also
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appears to be confused to the date and situation. What is the most appropriate treatmen
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t approach?
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ANSWER
Rapidly lower the diastolic pressure to 100 with IV antihypertensive meds, then continue to gradually r
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educe the diastolic pressure to 85 with oral antihypertensive meds. The maximum initial decrease shoul
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d be no more than 25% reduction from initial presenting value. Reducing the blood pressure too quickly
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can lead to cerebral edema or renal failure.
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QUESTION 2 vc
A patient has sepsis, receives Lactated ringers 500ml IV bolus. Which finding indicate th
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at this intervention is having it's intended effect?
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ANSWER
ScvO2 of 72% Early goal directed therapy for sepsis includes early fluid resuscitation at 30 ml/kg to ma
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intain a CVP of 8-12 or 12- vc vc vc vc vc vc
15 if mechanically ventilated, MAP greater than 65, ScvO2 greater than 70%, and urine output greater t
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han 0.5 kg/hr vc vc
QUESTION 3 vc
72 male patient in ICU for 6 days on the ventilator for treatment of a COPD exacerbation.
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He has been receiving VTE prophylaxis and subcutaneous Heparin since admission. Tod
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ay his platelet count decreased significantly to 43,000 and was found to have new DVT o
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n his right upper extremity. What do you suspect is the most likely cause of these finding
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s?
,ANSWER
HIT The hallmark sign of HIT is a significant decrease in platelet count over a 24 hours period (>50%)
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within 5- vc
10 days of administering Heparin. The other hallmark sign is a new development of DVT despite being o
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n VTE prophylaxis.
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QUESTION 4 vc
TRALI:
ANSWER
is a complication from a blood transfusion reaction, which causes acute lung injury typically within 6 ho
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urs of a blood transfusion.
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QUESTION 5 vc
2 Hallmark signs of HIT:
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ANSWER
Decrease in platelet count over a 24 hr period. New development of DVT despite being on VTE prophyla
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xis.
QUESTION 6 vc
Values in Early compensated Hypovolemic shock?
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ANSWER
CO 4.0 L/min, HR 135, SV 65, SVR 1700, MAP 65 In hypovolemic states, circulating volume is depleted t
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herefore preload and contractility are decreased which leads to a decrease in SV and CO. HR and SV incr
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ease as compensatory measure to preserve CO, MAP and cerebral perfusion.
vc vc vc vc vc vc vc vc vc vc
QUESTION 7 vc
Post-renal failure values: vc vc
ANSWER
Urine output < 200; urine sodium 30; BUN: Creatinine ratio 15:1; urine specific gravity 1.010 BUN: Crea
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
tinine ratio is 15:1, but both the BUN & creatinine are elevated. Urine sodium is typically 1-40 mEq/L.
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QUESTION 8 vc
What to do in the event of HIT:
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ANSWER
,Stop Heparin and administer an alternative direct thrombin inhibitor.
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QUESTION 9 vc
Warfarin is contraindicated in HIT? T/F vc vc vc vc vc
ANSWER
True - vc
there is also no evidence that shows protamine, corticosteroids, and benadryl are effective treatments f
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or HIT vc
QUESTION 10 vc
Patients with right ventricular infarctions become preload dependent. Meds that decreas
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e preload should be avoided - which meds are these?
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ANSWER
Morphine, Nitro, Beta blockers and diuretics. vc vc vc vc vc
QUESTION 11 vc
Polymorphic ventricular tachycardia aka Torsades is treated by? vc vc vc vc vc vc vc
ANSWER
Magnesium
QUESTION 12 vc
Myocardial contusions generally impact which parts of the heart? and what would the va
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lues be? vc
ANSWER
Atria & right ventricle because of the position of the heart in the chest. PAOP 6, PA Pressure 40/24, RA
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Pressure 16 vc
QUESTION 13 vc
Neurogenic shock signs? vc vc
ANSWER
CVP: 3, CI: 2.5, SVR: 650, SBP: 88 Neuro shock is associated with a loss of sympathetic tone causing exte
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
nsive peripheral vasodilation. Clinical signs and symptoms include hypotension, a low SVR, low CVP and
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low normal CI
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, QUESTION 14 vc
What causes a larger than normal A wave on a PAOP?
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ANSWER
Mitral stenosis - causes increased left atrial pressure during atrial contraction.
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QUESTION 15 vc
Pulmonary HTN will result in what? vc vc vc vc vc
ANSWER
Elevated PA pressures but have no impact on PAOP.
vc vc vc vc vc vc vc vc
QUESTION 16 vc
Infective Endocarditis can cause what kind of impairment?
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ANSWER
Neurologic impairment. One of the risks of infective endocarditis is the bacterial strand breaking in the
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
heart and throwing bacterial emboli forward into the lungs from the right side of the heart or to the bra
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
in/body from the left side of the heart.
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QUESTION 17 vc
Neurologic impairment could be a sign? vc vc vc vc vc
ANSWER
Embolic ischemic stroke.
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QUESTION 18 vc
Post bariatric surgery should avoid what kind of meds?
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ANSWER
Extended release meds due to absorption concerns post-operatively
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QUESTION 19 vc
Chlorpropamide is a what? vc vc vc
ANSWER
Exam Solution vc
PASS the CCRN! Questions 2026 A+ GRADE ASSURED CO vc vc vc vc vc vc vc vc
MPLETE SOLUTIONS AND VERIFIED ANSWERS (4818F) vc vc vc vc vc
QUESTION 1 vc
A 56 yr- vc vc
old male is admitted to the ICU with a blood pressure of 225/135 and complains of a hea
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
dache and nausea. He reports he ran out of blood pressure meds three days ago, but also
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc v
appears to be confused to the date and situation. What is the most appropriate treatmen
c vc vc vc vc vc vc vc vc vc vc vc vc vc vc
t approach?
vc
ANSWER
Rapidly lower the diastolic pressure to 100 with IV antihypertensive meds, then continue to gradually r
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
educe the diastolic pressure to 85 with oral antihypertensive meds. The maximum initial decrease shoul
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
d be no more than 25% reduction from initial presenting value. Reducing the blood pressure too quickly
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
can lead to cerebral edema or renal failure.
vc vc vc vc vc vc vc vc
QUESTION 2 vc
A patient has sepsis, receives Lactated ringers 500ml IV bolus. Which finding indicate th
vc vc vc vc vc vc vc vc vc vc vc vc vc
at this intervention is having it's intended effect?
vc vc vc vc vc vc vc
ANSWER
ScvO2 of 72% Early goal directed therapy for sepsis includes early fluid resuscitation at 30 ml/kg to ma
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
intain a CVP of 8-12 or 12- vc vc vc vc vc vc
15 if mechanically ventilated, MAP greater than 65, ScvO2 greater than 70%, and urine output greater t
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
han 0.5 kg/hr vc vc
QUESTION 3 vc
72 male patient in ICU for 6 days on the ventilator for treatment of a COPD exacerbation.
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc v
He has been receiving VTE prophylaxis and subcutaneous Heparin since admission. Tod
c vc vc vc vc vc vc vc vc vc vc vc
ay his platelet count decreased significantly to 43,000 and was found to have new DVT o
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
n his right upper extremity. What do you suspect is the most likely cause of these finding
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
s?
,ANSWER
HIT The hallmark sign of HIT is a significant decrease in platelet count over a 24 hours period (>50%)
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
within 5- vc
10 days of administering Heparin. The other hallmark sign is a new development of DVT despite being o
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
n VTE prophylaxis.
vc vc
QUESTION 4 vc
TRALI:
ANSWER
is a complication from a blood transfusion reaction, which causes acute lung injury typically within 6 ho
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
urs of a blood transfusion.
vc vc vc vc
QUESTION 5 vc
2 Hallmark signs of HIT:
vc vc vc vc
ANSWER
Decrease in platelet count over a 24 hr period. New development of DVT despite being on VTE prophyla
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
xis.
QUESTION 6 vc
Values in Early compensated Hypovolemic shock?
vc vc vc vc vc
ANSWER
CO 4.0 L/min, HR 135, SV 65, SVR 1700, MAP 65 In hypovolemic states, circulating volume is depleted t
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
herefore preload and contractility are decreased which leads to a decrease in SV and CO. HR and SV incr
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
ease as compensatory measure to preserve CO, MAP and cerebral perfusion.
vc vc vc vc vc vc vc vc vc vc
QUESTION 7 vc
Post-renal failure values: vc vc
ANSWER
Urine output < 200; urine sodium 30; BUN: Creatinine ratio 15:1; urine specific gravity 1.010 BUN: Crea
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
tinine ratio is 15:1, but both the BUN & creatinine are elevated. Urine sodium is typically 1-40 mEq/L.
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
QUESTION 8 vc
What to do in the event of HIT:
vc vc vc vc vc vc vc
ANSWER
,Stop Heparin and administer an alternative direct thrombin inhibitor.
vc vc vc vc vc vc vc vc
QUESTION 9 vc
Warfarin is contraindicated in HIT? T/F vc vc vc vc vc
ANSWER
True - vc
there is also no evidence that shows protamine, corticosteroids, and benadryl are effective treatments f
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
or HIT vc
QUESTION 10 vc
Patients with right ventricular infarctions become preload dependent. Meds that decreas
vc vc vc vc vc vc vc vc vc vc
e preload should be avoided - which meds are these?
vc vc vc vc vc vc vc vc vc
ANSWER
Morphine, Nitro, Beta blockers and diuretics. vc vc vc vc vc
QUESTION 11 vc
Polymorphic ventricular tachycardia aka Torsades is treated by? vc vc vc vc vc vc vc
ANSWER
Magnesium
QUESTION 12 vc
Myocardial contusions generally impact which parts of the heart? and what would the va
vc vc vc vc vc vc vc vc vc vc vc vc vc
lues be? vc
ANSWER
Atria & right ventricle because of the position of the heart in the chest. PAOP 6, PA Pressure 40/24, RA
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
Pressure 16 vc
QUESTION 13 vc
Neurogenic shock signs? vc vc
ANSWER
CVP: 3, CI: 2.5, SVR: 650, SBP: 88 Neuro shock is associated with a loss of sympathetic tone causing exte
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
nsive peripheral vasodilation. Clinical signs and symptoms include hypotension, a low SVR, low CVP and
vc vc vc vc vc vc vc vc vc vc vc vc vc vc v
low normal CI
c vc vc
, QUESTION 14 vc
What causes a larger than normal A wave on a PAOP?
vc vc vc vc vc vc vc vc vc vc
ANSWER
Mitral stenosis - causes increased left atrial pressure during atrial contraction.
vc vc vc vc vc vc vc vc vc vc
QUESTION 15 vc
Pulmonary HTN will result in what? vc vc vc vc vc
ANSWER
Elevated PA pressures but have no impact on PAOP.
vc vc vc vc vc vc vc vc
QUESTION 16 vc
Infective Endocarditis can cause what kind of impairment?
vc vc vc vc vc vc vc
ANSWER
Neurologic impairment. One of the risks of infective endocarditis is the bacterial strand breaking in the
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
heart and throwing bacterial emboli forward into the lungs from the right side of the heart or to the bra
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
in/body from the left side of the heart.
vc vc vc vc vc vc vc
QUESTION 17 vc
Neurologic impairment could be a sign? vc vc vc vc vc
ANSWER
Embolic ischemic stroke.
vc vc
QUESTION 18 vc
Post bariatric surgery should avoid what kind of meds?
vc vc vc vc vc vc vc vc
ANSWER
Extended release meds due to absorption concerns post-operatively
vc vc vc vc vc vc vc
QUESTION 19 vc
Chlorpropamide is a what? vc vc vc
ANSWER
