2024 /2025 | © copyright | This work may not be copied for profit gain Excel!
Kassi - CCRN Questions and Correct
Answers | Latest Update
A patient in hyperosmolar hyperglycemic state (HHS) is being admitted with dehydration
and a serum glucose level of 836 mg/dL. Which of the following additional laboratory
findings should the nurse anticipate?
a. decreased BUN, decreased creatinine, and elevated serum osmolality
b. elevated BUN, decreased creatinine, and decreased serum osmolality
c. decreased BUN, elevated creatinine, and decreased serum osmolality
d. elevated BUN, elevated creatinine, and elevated serum osmolality
-:- d. elevated BUN, elevated creatinine, and elevated serum osmolality
Rationale: Typical presentation of HHS includes elevations in BUN and creatinine levels
resulting from hypovolemia. Serum osmolality >320 mOsm/kg distinguishes HHS from DKA.
On the fifth day post-admission, a patient with Q waves if V1, V2, and V3 develops
hypotension, tachycardia, and a pansystolic murmur that is loudest at the lower left sternal
border. This patient has MOST LIKELY developed
1|P a g e | G r a d e A + | 2 0 2 0 2 5
,2024 /2025 | © copyright | This work may not be copied for profit gain Excel!
a. idiopathic hypertrophic cardiomyopathy
b. inferior wall myocardial infarction
c. cardiac tamponade
d. a ruptured interventricular septum
-:- d. a ruptured interventricular septum
Rationale: Q waves in V1 and V2 indicate septal wall MI, which puts the patient at risk for
septal wall rupture. Pansystolic murmur at the left sternal border is consistent with a
ruptured interventricular septum
A patient with a history of chronic pain, asthma, diabetes and heavy alcohol intake is now
experiencing cognitive impairment from medications. Assessment: awake but confused, BP
155/82, HR 84, RR 16 and SpO2 95% on RA. This patient is at high risk for
a. intubation
b. needing long-term psychiatric care
c. attempting suicide
d. oversedation by staff
2|P a g e | G r a d e A + | 2 0 2 0 2 5
,2024 /2025 | © copyright | This work may not be copied for profit gain Excel!
-:- c. attempting suicide
Rationale: The risk factors listed for suicide are part of the Suicide Risk Assessment -
chronic medical illness, heavy alcohol intake and chronic pain.
Which of the following 12-lead ECG changes should be expected in a patient with ACS
involving the inferior wall?
a. ST segment elevation and deeply inverted T waves in leads V4-V6, I and aVL
b. ST segment elevation in leads II, III and all the precordial leads
c. ST segment elevation and deeply inverted T waves in leads II, III and aVF
d. ST segment depression and T wave elevation in leads II, III and aVL
-:- c. ST segment elevation and deeply inverted T waves in leads II, III and aVF
Rationale: An anterior wall MI is associated with changes in leads II, III and aVF
a. anterolateral MI
b. lateral MI
d. ACS not associated with these changes
3|P a g e | G r a d e A + | 2 0 2 0 2 5
, 2024 /2025 | © copyright | This work may not be copied for profit gain Excel!
The major effect of acute lung injury (ALI) on the lung tissue is
a. decreased capillary permeability
b. increased functional residual capacity (FRC)
c. decreased compliance
d. decreased alveolar surface tension
-:- c. decreased compliance
Rationale: It is related to alteration of lung endothelium and vascular tissue. Pathophysiologic
changes in lung vascular tissue and increased lung edema contribute to the decrease in
compliance. The end result is stiffness of the fluid-filled non-aerated airways.
A patient with mitral regurgitation suddenly develops atrial fibrillation with rate of 156. BP is
118/74. The nurse should anticipate medication orders for
a. beta-blockers and vasopressors
b. warfarin (Coumadin) and alpha-agonists
4|P a g e | G r a d e A + | 2 0 2 0 2 5
Kassi - CCRN Questions and Correct
Answers | Latest Update
A patient in hyperosmolar hyperglycemic state (HHS) is being admitted with dehydration
and a serum glucose level of 836 mg/dL. Which of the following additional laboratory
findings should the nurse anticipate?
a. decreased BUN, decreased creatinine, and elevated serum osmolality
b. elevated BUN, decreased creatinine, and decreased serum osmolality
c. decreased BUN, elevated creatinine, and decreased serum osmolality
d. elevated BUN, elevated creatinine, and elevated serum osmolality
-:- d. elevated BUN, elevated creatinine, and elevated serum osmolality
Rationale: Typical presentation of HHS includes elevations in BUN and creatinine levels
resulting from hypovolemia. Serum osmolality >320 mOsm/kg distinguishes HHS from DKA.
On the fifth day post-admission, a patient with Q waves if V1, V2, and V3 develops
hypotension, tachycardia, and a pansystolic murmur that is loudest at the lower left sternal
border. This patient has MOST LIKELY developed
1|P a g e | G r a d e A + | 2 0 2 0 2 5
,2024 /2025 | © copyright | This work may not be copied for profit gain Excel!
a. idiopathic hypertrophic cardiomyopathy
b. inferior wall myocardial infarction
c. cardiac tamponade
d. a ruptured interventricular septum
-:- d. a ruptured interventricular septum
Rationale: Q waves in V1 and V2 indicate septal wall MI, which puts the patient at risk for
septal wall rupture. Pansystolic murmur at the left sternal border is consistent with a
ruptured interventricular septum
A patient with a history of chronic pain, asthma, diabetes and heavy alcohol intake is now
experiencing cognitive impairment from medications. Assessment: awake but confused, BP
155/82, HR 84, RR 16 and SpO2 95% on RA. This patient is at high risk for
a. intubation
b. needing long-term psychiatric care
c. attempting suicide
d. oversedation by staff
2|P a g e | G r a d e A + | 2 0 2 0 2 5
,2024 /2025 | © copyright | This work may not be copied for profit gain Excel!
-:- c. attempting suicide
Rationale: The risk factors listed for suicide are part of the Suicide Risk Assessment -
chronic medical illness, heavy alcohol intake and chronic pain.
Which of the following 12-lead ECG changes should be expected in a patient with ACS
involving the inferior wall?
a. ST segment elevation and deeply inverted T waves in leads V4-V6, I and aVL
b. ST segment elevation in leads II, III and all the precordial leads
c. ST segment elevation and deeply inverted T waves in leads II, III and aVF
d. ST segment depression and T wave elevation in leads II, III and aVL
-:- c. ST segment elevation and deeply inverted T waves in leads II, III and aVF
Rationale: An anterior wall MI is associated with changes in leads II, III and aVF
a. anterolateral MI
b. lateral MI
d. ACS not associated with these changes
3|P a g e | G r a d e A + | 2 0 2 0 2 5
, 2024 /2025 | © copyright | This work may not be copied for profit gain Excel!
The major effect of acute lung injury (ALI) on the lung tissue is
a. decreased capillary permeability
b. increased functional residual capacity (FRC)
c. decreased compliance
d. decreased alveolar surface tension
-:- c. decreased compliance
Rationale: It is related to alteration of lung endothelium and vascular tissue. Pathophysiologic
changes in lung vascular tissue and increased lung edema contribute to the decrease in
compliance. The end result is stiffness of the fluid-filled non-aerated airways.
A patient with mitral regurgitation suddenly develops atrial fibrillation with rate of 156. BP is
118/74. The nurse should anticipate medication orders for
a. beta-blockers and vasopressors
b. warfarin (Coumadin) and alpha-agonists
4|P a g e | G r a d e A + | 2 0 2 0 2 5
