CCRN PRACTICE QUESTIONS
A 35-12 months-antique female underwent a mitral valve alternative. Her chest tube output
has been approximately 125 mL/hr for the final three hours, and now the drainage has
ceased suddenly. The immediately assessment exhibits a good sized decrease in BP, RAP
12, PAP 30/15 , PAOP thirteen. What different facts would suggest the improvement of
cardiac tamponade?
A. Increased venous oxygen saturation (SvO2)
B. Decreased UO
C. Muffled heart sounds
D. New holosystolic murmur at the sternum - ANS-C
Muffled coronary heart sounds are a conventional finding in cardiac tamponade. Remember
the traditional indications of cardiac tamponade known as Beck's triad: muffled heart sounds,
jugular venous distention, and hypotension. Even although urine output is a touchy indicator
of cardiac output and in cardiac tamponade a decreased stroke extent results in a decreased
cardiac output, by the point a nurse might note the decreased urine output, the patient may
also have already had a cardiopulmonary arrest. The SvO2 simply would lower due to the
decrease in cardiac output. New holosystolic murmur at the decrease left sternal border is a
sign of ventricular septal rupture.
A forty-year-vintage affected person has been admitted to the important care unit after
sustaining a couple of injuries from a cave-in accident this morning. X-ray verify multiple
fractures, together with the left femur. During the afternoon he was taken to surgical
treatment for inner fixation of the left femur. It is now 10 pm, and the patient is complaining of
excessive throbbing pain in his thigh. The patient received 5 mg of morphine sulfate IV 30
minutes ago. The anterior left thigh is company to touch, and the pain increases whilst the
patient flexes his left leg. The nurse must suspect which of the subsequent?
A. Normal ache associated with fractured femur
B. Abnormal pain related to compartment syndrome
C. Abnormal pain related to infection
D. Abnormal pain related to lumbosacral plexus harm - ANS-B. Abnormal pain related to
compartment syndrome
A 52-12 months-old man is admitted to the vital care unit with a prognosis of an acute MI.
EKG indicates ST elevation and T wave inversion in leads V2, V3, and V4. His history
includes HTN, 80 percent-years of smoking, COPD, and HLD.
An IV and fibrinolytic remedy have been initiated inside the ED. Which of the subsequent
might now not be an indication of a hit reperfusion?
A. Pain cessation
B. Absence of creatine kinase (CK) enzyme elevation
C. Reversal of ST section elevation with return of ST segment to baseline
D. Short runs of ventricular tachycardia - ANS-B. Absence of creatine kinase (CK) enzyme
elevation
,A fifty two-yr-old female arrives in the ED. Started out having fluttering in her chest about 1
hour in the past and now could be having chest ache. She has a records of HTN. The EKG
monitor suggests paroxysmal atrial tachycardia with HR 150, BP 130/88. Verapamil five mg
is given through gradual IV push. What would be a appropriate healing final results?
A. Decrease in blood stress
B. Decrease in heart charge
C. Change in rhythm to atrial fibrillation
D. A lower inside the fluttering feeling in her chest - ANS-B. Decrease in coronary heart
charge
A 55-12 months-antique guy had a coronary heart transplant 10 hours ago. Present
assessment consists of bloodless, clammy skin, jugular venous distention, bilateral crackles,
and tachycardia. Vital signs and symptoms are temperature ninety eight.6° F, BP 80/60, HR
a hundred and twenty and RR 24 . Mediastinal tube drainage is about 50 mL/hr. He is
diagnosed with decreased cardiac contractility. Which of the subsequent could be the correct
treatment for this affected person?
A. Beta-adrenergic stimulant (e.G., dobutamine)
B. Diuretic (e.G., furosemide)
C. Normal saline bolus
D. Antibiotics - ANS-A. Beta-adrenergic stimulant (e.G., dobutamine)
A fifty five-yr-antique guy with a long records of alcoholism maintains to drink alcohol and
now has alcoholic cardiomyopathy, a shape of dilated cardiomyopathy. Which of the
subsequent might this patient now not be expected to obtain?
A. Angiotensin-converting enzyme inhibitors
B. Cardiac transplant referral
C. Diuretics
D. Inotropes - ANS-B. Cardiac transplant referral
A 57-year-old man was admitted to the critical care unit with a diagnosis of anteroseptal MI.
A PA catheter become inserted, and preliminary readings had been inside regular limits. BP
140/92, HR 110 and everyday, RR 24. Breath sounds same and clean. Three hrs after
admission, the pt becomes restless with cool, faded pores and skin. Now BP one hundred
ten/seventy two, HR 120, RR 28 and worked. Crackles are audible on the lung bases BL.
The patient is given furosemide (Lasix) at eight am. At 9 am, the PAOP drops to eight, with a
drop in BP. Which of the following will be the most suitable intervention at the moment?
A. Administer saline bolus.
B. Decrease dobutamine drip price.
C. Increase nitroglycerin drip charge.
D. Replace potassium. - ANS-A. Administer saline bolus.
A 61-yr-vintage man is admitted to the crucial care unit from the cath lab. He has simply had
a PCI and stent insertion to the RCA. His leg is immobilized, and the HOB 30 levels. Six
hours later the patient is stressed and complaining of lower back pain. The femoral sheath is
undamaged inside the right femoral location, and there is no evidence of bleeding or
hematoma. Neck veins are flat with the HOB 30 stages, and coronary heart sounds are
regular. Vital signs are BP 80/50, HR a hundred and twenty, and RR 24. Which of the
subsequent is the concern issue for patient schooling for this affected person?
, A. The need for life-style changes to decelerate the atherosclerotic technique
B. To avoid magnetic resonance imaging
C. The want for taking a platelet aggregation inhibitor day by day
D. How to take nitroglycerin - ANS-C. The want for taking a platelet aggregation inhibitor
day by day
A 65-yr-old black man comes to the ER with court cases of headache. His admission BP
220/one hundred fifty. A nitroprusside (Nipride) drip is initiated. Which of the subsequent
could no longer be an essential component of care for a patient receiving nitroprusside?
A. Closely assessing the patient for scientific indicators of hypoxia
B. Monitoring the patient's blood strain each 1-2 mins till it stabilizes and dosage is
established
C. Checking the patient's serum glucose every 6 hours
D. Monitoring the affected person for symptoms of thiocyanate poisoning - ANS-C.
Checking the patient's serum glucose every 6 hours
A sixty seven-yr-vintage woman with risky angina is admitted to the cardiac unit. She has a
records of DM and reviews having had chest ache intermittently for 4 days. The EKG
suggests nonspecific ST modifications. Which of the following research is most diagnostic in
identifying a MI in this affected person?
A. Elevated creatine kinase-myocardial bound (CK-MB)
B. Elevated creatine kinase-muscle type (CK-MM)
C. Elevated troponin I
D. Lactate dehydrogenase 1 (LDH-1) greater than LDH-2 - ANS-C. Elevated troponin I
A 70-year-vintage woman, weighing 50 kg, involves the ED complaining of chest pain and
shortness of breath. EKG shows ventricular tachycardia HR a hundred and fifty. Which
treatment is suitable in this example?
A. Amiodarone (Cordarone) IV
B. Verapamil HCl (Calan) IV
C. Defibrillation starting at two hundred J
D. Synchronized cardioversion beginning at a hundred J - ANS-D.
Synchronized cardioversion starting at a hundred J
A ninety-12 months-old affected person is admitted with acute respiratory misery. Vital signs
and symptoms are blood stress 92/sixty six mm Hg, coronary heart rate 132 beats/min and
everyday rhythm, and respiratory fee 36 breaths/min and labored. Auscultation of breath
sounds well-knownshows crackles to the scapular degree bilaterally. Which of the
subsequent is the most probably pathophysiologic trouble in this affected person?
A. Acute myocardial infarction
B. Mild heart failure
C. Massive pulmonary embolus
D. Acute pulmonary edema - ANS-D.
Acute pulmonary edema
A patient arrives to the ED with a knife sticking out of his chest. He is solid at this time
however complaining of ache at the knife insertion website online. The medical doctor is
busy resuscitating another affected person. What need to be completed?
A 35-12 months-antique female underwent a mitral valve alternative. Her chest tube output
has been approximately 125 mL/hr for the final three hours, and now the drainage has
ceased suddenly. The immediately assessment exhibits a good sized decrease in BP, RAP
12, PAP 30/15 , PAOP thirteen. What different facts would suggest the improvement of
cardiac tamponade?
A. Increased venous oxygen saturation (SvO2)
B. Decreased UO
C. Muffled heart sounds
D. New holosystolic murmur at the sternum - ANS-C
Muffled coronary heart sounds are a conventional finding in cardiac tamponade. Remember
the traditional indications of cardiac tamponade known as Beck's triad: muffled heart sounds,
jugular venous distention, and hypotension. Even although urine output is a touchy indicator
of cardiac output and in cardiac tamponade a decreased stroke extent results in a decreased
cardiac output, by the point a nurse might note the decreased urine output, the patient may
also have already had a cardiopulmonary arrest. The SvO2 simply would lower due to the
decrease in cardiac output. New holosystolic murmur at the decrease left sternal border is a
sign of ventricular septal rupture.
A forty-year-vintage affected person has been admitted to the important care unit after
sustaining a couple of injuries from a cave-in accident this morning. X-ray verify multiple
fractures, together with the left femur. During the afternoon he was taken to surgical
treatment for inner fixation of the left femur. It is now 10 pm, and the patient is complaining of
excessive throbbing pain in his thigh. The patient received 5 mg of morphine sulfate IV 30
minutes ago. The anterior left thigh is company to touch, and the pain increases whilst the
patient flexes his left leg. The nurse must suspect which of the subsequent?
A. Normal ache associated with fractured femur
B. Abnormal pain related to compartment syndrome
C. Abnormal pain related to infection
D. Abnormal pain related to lumbosacral plexus harm - ANS-B. Abnormal pain related to
compartment syndrome
A 52-12 months-old man is admitted to the vital care unit with a prognosis of an acute MI.
EKG indicates ST elevation and T wave inversion in leads V2, V3, and V4. His history
includes HTN, 80 percent-years of smoking, COPD, and HLD.
An IV and fibrinolytic remedy have been initiated inside the ED. Which of the subsequent
might now not be an indication of a hit reperfusion?
A. Pain cessation
B. Absence of creatine kinase (CK) enzyme elevation
C. Reversal of ST section elevation with return of ST segment to baseline
D. Short runs of ventricular tachycardia - ANS-B. Absence of creatine kinase (CK) enzyme
elevation
,A fifty two-yr-old female arrives in the ED. Started out having fluttering in her chest about 1
hour in the past and now could be having chest ache. She has a records of HTN. The EKG
monitor suggests paroxysmal atrial tachycardia with HR 150, BP 130/88. Verapamil five mg
is given through gradual IV push. What would be a appropriate healing final results?
A. Decrease in blood stress
B. Decrease in heart charge
C. Change in rhythm to atrial fibrillation
D. A lower inside the fluttering feeling in her chest - ANS-B. Decrease in coronary heart
charge
A 55-12 months-antique guy had a coronary heart transplant 10 hours ago. Present
assessment consists of bloodless, clammy skin, jugular venous distention, bilateral crackles,
and tachycardia. Vital signs and symptoms are temperature ninety eight.6° F, BP 80/60, HR
a hundred and twenty and RR 24 . Mediastinal tube drainage is about 50 mL/hr. He is
diagnosed with decreased cardiac contractility. Which of the subsequent could be the correct
treatment for this affected person?
A. Beta-adrenergic stimulant (e.G., dobutamine)
B. Diuretic (e.G., furosemide)
C. Normal saline bolus
D. Antibiotics - ANS-A. Beta-adrenergic stimulant (e.G., dobutamine)
A fifty five-yr-antique guy with a long records of alcoholism maintains to drink alcohol and
now has alcoholic cardiomyopathy, a shape of dilated cardiomyopathy. Which of the
subsequent might this patient now not be expected to obtain?
A. Angiotensin-converting enzyme inhibitors
B. Cardiac transplant referral
C. Diuretics
D. Inotropes - ANS-B. Cardiac transplant referral
A 57-year-old man was admitted to the critical care unit with a diagnosis of anteroseptal MI.
A PA catheter become inserted, and preliminary readings had been inside regular limits. BP
140/92, HR 110 and everyday, RR 24. Breath sounds same and clean. Three hrs after
admission, the pt becomes restless with cool, faded pores and skin. Now BP one hundred
ten/seventy two, HR 120, RR 28 and worked. Crackles are audible on the lung bases BL.
The patient is given furosemide (Lasix) at eight am. At 9 am, the PAOP drops to eight, with a
drop in BP. Which of the following will be the most suitable intervention at the moment?
A. Administer saline bolus.
B. Decrease dobutamine drip price.
C. Increase nitroglycerin drip charge.
D. Replace potassium. - ANS-A. Administer saline bolus.
A 61-yr-vintage man is admitted to the crucial care unit from the cath lab. He has simply had
a PCI and stent insertion to the RCA. His leg is immobilized, and the HOB 30 levels. Six
hours later the patient is stressed and complaining of lower back pain. The femoral sheath is
undamaged inside the right femoral location, and there is no evidence of bleeding or
hematoma. Neck veins are flat with the HOB 30 stages, and coronary heart sounds are
regular. Vital signs are BP 80/50, HR a hundred and twenty, and RR 24. Which of the
subsequent is the concern issue for patient schooling for this affected person?
, A. The need for life-style changes to decelerate the atherosclerotic technique
B. To avoid magnetic resonance imaging
C. The want for taking a platelet aggregation inhibitor day by day
D. How to take nitroglycerin - ANS-C. The want for taking a platelet aggregation inhibitor
day by day
A 65-yr-old black man comes to the ER with court cases of headache. His admission BP
220/one hundred fifty. A nitroprusside (Nipride) drip is initiated. Which of the subsequent
could no longer be an essential component of care for a patient receiving nitroprusside?
A. Closely assessing the patient for scientific indicators of hypoxia
B. Monitoring the patient's blood strain each 1-2 mins till it stabilizes and dosage is
established
C. Checking the patient's serum glucose every 6 hours
D. Monitoring the affected person for symptoms of thiocyanate poisoning - ANS-C.
Checking the patient's serum glucose every 6 hours
A sixty seven-yr-vintage woman with risky angina is admitted to the cardiac unit. She has a
records of DM and reviews having had chest ache intermittently for 4 days. The EKG
suggests nonspecific ST modifications. Which of the following research is most diagnostic in
identifying a MI in this affected person?
A. Elevated creatine kinase-myocardial bound (CK-MB)
B. Elevated creatine kinase-muscle type (CK-MM)
C. Elevated troponin I
D. Lactate dehydrogenase 1 (LDH-1) greater than LDH-2 - ANS-C. Elevated troponin I
A 70-year-vintage woman, weighing 50 kg, involves the ED complaining of chest pain and
shortness of breath. EKG shows ventricular tachycardia HR a hundred and fifty. Which
treatment is suitable in this example?
A. Amiodarone (Cordarone) IV
B. Verapamil HCl (Calan) IV
C. Defibrillation starting at two hundred J
D. Synchronized cardioversion beginning at a hundred J - ANS-D.
Synchronized cardioversion starting at a hundred J
A ninety-12 months-old affected person is admitted with acute respiratory misery. Vital signs
and symptoms are blood stress 92/sixty six mm Hg, coronary heart rate 132 beats/min and
everyday rhythm, and respiratory fee 36 breaths/min and labored. Auscultation of breath
sounds well-knownshows crackles to the scapular degree bilaterally. Which of the
subsequent is the most probably pathophysiologic trouble in this affected person?
A. Acute myocardial infarction
B. Mild heart failure
C. Massive pulmonary embolus
D. Acute pulmonary edema - ANS-D.
Acute pulmonary edema
A patient arrives to the ED with a knife sticking out of his chest. He is solid at this time
however complaining of ache at the knife insertion website online. The medical doctor is
busy resuscitating another affected person. What need to be completed?
