CCRN Questions and Answers 2025 A+
Guide
A patient has had a large anterior myocardial infarction last month and developed a
ventricular aneurysm. He now has episodes of ventricular tachycardia that are not
prevented or converted with antidysrhythmic agents. An implantable cardioverter-
defibrillator (ICD) is implanted. Four days after surgery he develops ventricular tachycardia.
The ICD has delivered three shocks but has not converted the rhythm. He is pulseless and
apneic. Cardiopulmonary resuscitation is in progress. What is the priority action now?
A.
Administer epinephrine IV.
B.
Administer amiodarone.
C.
Defibrillate.
D.
Reset the ICD. - correct answers Defibrillate
A 28-year-old woman is admitted to the critical care unit from the emergency department
with a diagnosis of asthma. Her initial arterial blood gases on a 28% Venturi mask are as
follows:
pH 7.48
PaCO2 30 mm Hg
HCO3 24 mEq/L
PaO2 64 mm Hg
Which of the following repeat arterial blood gases on 40% oxygen indicate that the patient's
condition is worsening?
,CCRN Questions and Answers 2025 A+
Guide
A.
pH 7.48, PaCO2 30 mm Hg, PaO2 68 mm Hg
B.
pH 7.46, PaCO2 32 mm Hg, PaO2 61 mm Hg
C.
pH 7.40, PaCO2 40 mm Hg, PaO2 62 mm Hg
D.
pH 7.39, PaCO2 30 mm Hg, PaO2 60 mm Hg - correct answers C.
pH 7.40, PaCO2 40 mm Hg, PaO2 62 mm Hg
The case study shows stage II asthma. Option c shows stage III asthma. The patient is still
breathing at a fast rate, but carbon dioxide is starting to be retained as evidenced by the
increase of the PaCO2 into normal range. Options a and b are still stage II. Option d shows
a respiratory alkalosis with a metabolic acidosis because you would have expected the pH
to be in an alkalotic range with the PaCO2 of 30.
A patient experiencing alcohol withdrawal syndrome describes the swirls in the wallpaper
as being worms. This is an example of which of the following?
A.
Delusion
,CCRN Questions and Answers 2025 A+
Guide
B.
Hallucination
C.
Illusion
D.
Visual impairment - correct answers C.
Illusion
An illusion is a misperception or misinterpretation of an actual external stimulus. Illusions
and hallucinations (a perception that has no actual external stimulus) are common during
alcohol withdrawal syndrome.
A patient arrives in the emergency department with multiple gunshot wounds. He requires
massive transfusion for blood loss from chest and abdominal wounds. The
electrocardiogram should be observed closely for changes indicative of which of the
following?
A.
Atrioventricular block
B.
Hyperkalemia
C.
, CCRN Questions and Answers 2025 A+
Guide
Hypercalcemia
D.
Hypomagnesemia - correct answers Hyperkalemia
Banked blood is high in potassium because of hemolysis. Look for tall, peaked T waves and
widening of the QRS complex. Other considerations with massive transfusion of banked
blood are hypocalcemia, hypothermia, and decreased tissue oxygen delivery caused by
decreased levels of 2,3-diphosphoglycerate.
A 65-year-old woman reports severe dyspnea 2 days after abdominal surgery. She is
transferred to the critical care unit. On 5 L of oxygen by nasal cannula, her arterial blood
gases are as follows:
pH 7.39
PaCO2 35 mm Hg
HCO3 19 mEq/L
PaO2 40 mm Hg
Arterial oxygen saturation 75%
Why does this patient have hypoxemia without hypercapnia?
A.
Because carbon dioxide is more diffusible than oxygen
B.
Guide
A patient has had a large anterior myocardial infarction last month and developed a
ventricular aneurysm. He now has episodes of ventricular tachycardia that are not
prevented or converted with antidysrhythmic agents. An implantable cardioverter-
defibrillator (ICD) is implanted. Four days after surgery he develops ventricular tachycardia.
The ICD has delivered three shocks but has not converted the rhythm. He is pulseless and
apneic. Cardiopulmonary resuscitation is in progress. What is the priority action now?
A.
Administer epinephrine IV.
B.
Administer amiodarone.
C.
Defibrillate.
D.
Reset the ICD. - correct answers Defibrillate
A 28-year-old woman is admitted to the critical care unit from the emergency department
with a diagnosis of asthma. Her initial arterial blood gases on a 28% Venturi mask are as
follows:
pH 7.48
PaCO2 30 mm Hg
HCO3 24 mEq/L
PaO2 64 mm Hg
Which of the following repeat arterial blood gases on 40% oxygen indicate that the patient's
condition is worsening?
,CCRN Questions and Answers 2025 A+
Guide
A.
pH 7.48, PaCO2 30 mm Hg, PaO2 68 mm Hg
B.
pH 7.46, PaCO2 32 mm Hg, PaO2 61 mm Hg
C.
pH 7.40, PaCO2 40 mm Hg, PaO2 62 mm Hg
D.
pH 7.39, PaCO2 30 mm Hg, PaO2 60 mm Hg - correct answers C.
pH 7.40, PaCO2 40 mm Hg, PaO2 62 mm Hg
The case study shows stage II asthma. Option c shows stage III asthma. The patient is still
breathing at a fast rate, but carbon dioxide is starting to be retained as evidenced by the
increase of the PaCO2 into normal range. Options a and b are still stage II. Option d shows
a respiratory alkalosis with a metabolic acidosis because you would have expected the pH
to be in an alkalotic range with the PaCO2 of 30.
A patient experiencing alcohol withdrawal syndrome describes the swirls in the wallpaper
as being worms. This is an example of which of the following?
A.
Delusion
,CCRN Questions and Answers 2025 A+
Guide
B.
Hallucination
C.
Illusion
D.
Visual impairment - correct answers C.
Illusion
An illusion is a misperception or misinterpretation of an actual external stimulus. Illusions
and hallucinations (a perception that has no actual external stimulus) are common during
alcohol withdrawal syndrome.
A patient arrives in the emergency department with multiple gunshot wounds. He requires
massive transfusion for blood loss from chest and abdominal wounds. The
electrocardiogram should be observed closely for changes indicative of which of the
following?
A.
Atrioventricular block
B.
Hyperkalemia
C.
, CCRN Questions and Answers 2025 A+
Guide
Hypercalcemia
D.
Hypomagnesemia - correct answers Hyperkalemia
Banked blood is high in potassium because of hemolysis. Look for tall, peaked T waves and
widening of the QRS complex. Other considerations with massive transfusion of banked
blood are hypocalcemia, hypothermia, and decreased tissue oxygen delivery caused by
decreased levels of 2,3-diphosphoglycerate.
A 65-year-old woman reports severe dyspnea 2 days after abdominal surgery. She is
transferred to the critical care unit. On 5 L of oxygen by nasal cannula, her arterial blood
gases are as follows:
pH 7.39
PaCO2 35 mm Hg
HCO3 19 mEq/L
PaO2 40 mm Hg
Arterial oxygen saturation 75%
Why does this patient have hypoxemia without hypercapnia?
A.
Because carbon dioxide is more diffusible than oxygen
B.
