CCRN practice questions with Answers
49 year old male with inferior wal MI resulting from 100% occlusion of the RCA.
The 12 lead reveals ST elevation in leads II, III, aVF. Where would you see
reciprocal changes? - ANSWER-I, aVL
RCA perfuses inferior wall and reciprocal changes would be seen in high lateral
wall which is reflected in I and aVL.
46 yo w: pneumonia and sepsis. Treated with 4 days of abs and fluids. Increasingly
SOB and now 100% via non-rebreather. ABG 7.20, paCO2 68, PaO2 102, HCO3
28. Bilateral infiltrates. Pt is likely developing... - ANSWER-ARDS
Bilateral pull infiltrated, P/F ratio <300. To calculate P/F divide pao2/FiO2.
102/1= 102 making it borderline severe ARDS. Other criteria decreased
compliance, high peep requirement and low expired minute volume
Which of the following must be monitored closely when administering Lisinopril
to a pt with systolic heart failure? - ANSWER-Potassium
Ace inhibitors block angiotensin II which may lead to decreased aldosterone.
Aldosterone is responsible for excreting k from the kidneys. Hence Ace inhibitors
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 1
,can cause potassium retention. In addition renal labs such as BUN and creatinine
should also be monitored
A 57yo with acute MI in cardiogenic shock. BO 86/42 (57), HR 110, CI 1.7
L/min/m2, SVR 1929 - ANSWER-Dobutamine. Positive inotropic to improve
myocardial dysfunction on pts with low CI and elevated SVR. Improve
contractility and reduce after load.
DIC work up. Expected labs... - ANSWER-Fibrinogen decreased, fibrin split
products elevated, platelets decreased, d-dimer elevated (in the setting of clot
formation)
Which of the following will cause a shift to the left on the oxyhemoglobin
dissociation curve? - ANSWER-Alkalosis
Causes a stronger affinity between hemoglobin and oxygen. Pts demonstrate
higher SaO2 despite a lower than normal PaO2
46 yo with ruptured cerebral aneurysm will be placed on which of the following
class of medication to prevent cerebral artery vasospasm? - ANSWER-Calcium
channel blocker
Which of the following should be avoided in the setting of basilar skull fractures? -
ANSWER-Nasogastric tubes
You are caring for a patient who was admitted with an occluded VP shunt. Earliest
signs of increased ICP include? - ANSWER-Decreased level of consciousness
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 2
,You are admitting a pt s/p craniotomy for a ruptured aneurysm. Which if the
following nursing actions should you anticipate? - ANSWER-Position with the
head of bed 30 degrees to optimize venous outflow
What is a normal ICP? When do we treat it? - ANSWER-Normal ICP 0-15 mm
Hg
Treatment if sustained >20-25 mm Hg
Cerebral perfusion pressure (CPP) - ANSWER-MAP-ICP
Goal >60 (usually 70-90)
Elevated P2 waves on an ICP waveform are a sign of: - ANSWER-Increased
intracranial pressure and decreased intracranial compliance
Management of a pt post subarachnoid hemorrhage (SAH) with increased ICP
includes: - ANSWER-Optimal positioning, osmotic diuretics and hypertonic saline
What are first tier interventions for increased ICP? - ANSWER-Positioning,
manage fever, pain, mannitol (osmotic diuretic), hypertonic saline, loop diuretics
In addition to figuring out the cause, priorities when caring for a pt experiencing a
seizure include: - ANSWER-Safety and administration of a benzodiazepine
Where on the body do you level a ventriculostomy transducer? - ANSWER-
Foremen of Monro or External auditory meat is
Phenytoin (Dilantin) - ANSWER-10-20 mg/kg
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 3
, Give slowly!!!
Monitor for bradycardia and hypotension
Monitor IV site for infiltration
Guillain-Barré syndrome - ANSWER--Autoimmune disorder
-Present with ascending paralysis often when recovering from an illness or virus
-Damage to the myelin sheath
GB diagnosis and treatment - ANSWER-lumbar puncture
Treatment: plasmapheresis, IV immunoglobulin
Why do we do TTM? - ANSWER-Neuroprotective
Which of the following would be expected in a pt experiencing herniation and
Cushings triad? - ANSWER-Wide pulse pressure, bradycardia, increased systolic
pressure
A pt experienced a devastating rupture basilar aneurysm. When preparing for brain
death examination you should expect which of the following? - ANSWER-Absent
oculocephalic and oculovestibular reflexes
ABG - ANSWER-pH: 7.35-7.45 HC03: 22-26 (acid-alkaline)
CO2: 35-45 (alkaline-acid)
Anion Gap - ANSWER-Normal <11-12
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 4
49 year old male with inferior wal MI resulting from 100% occlusion of the RCA.
The 12 lead reveals ST elevation in leads II, III, aVF. Where would you see
reciprocal changes? - ANSWER-I, aVL
RCA perfuses inferior wall and reciprocal changes would be seen in high lateral
wall which is reflected in I and aVL.
46 yo w: pneumonia and sepsis. Treated with 4 days of abs and fluids. Increasingly
SOB and now 100% via non-rebreather. ABG 7.20, paCO2 68, PaO2 102, HCO3
28. Bilateral infiltrates. Pt is likely developing... - ANSWER-ARDS
Bilateral pull infiltrated, P/F ratio <300. To calculate P/F divide pao2/FiO2.
102/1= 102 making it borderline severe ARDS. Other criteria decreased
compliance, high peep requirement and low expired minute volume
Which of the following must be monitored closely when administering Lisinopril
to a pt with systolic heart failure? - ANSWER-Potassium
Ace inhibitors block angiotensin II which may lead to decreased aldosterone.
Aldosterone is responsible for excreting k from the kidneys. Hence Ace inhibitors
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 1
,can cause potassium retention. In addition renal labs such as BUN and creatinine
should also be monitored
A 57yo with acute MI in cardiogenic shock. BO 86/42 (57), HR 110, CI 1.7
L/min/m2, SVR 1929 - ANSWER-Dobutamine. Positive inotropic to improve
myocardial dysfunction on pts with low CI and elevated SVR. Improve
contractility and reduce after load.
DIC work up. Expected labs... - ANSWER-Fibrinogen decreased, fibrin split
products elevated, platelets decreased, d-dimer elevated (in the setting of clot
formation)
Which of the following will cause a shift to the left on the oxyhemoglobin
dissociation curve? - ANSWER-Alkalosis
Causes a stronger affinity between hemoglobin and oxygen. Pts demonstrate
higher SaO2 despite a lower than normal PaO2
46 yo with ruptured cerebral aneurysm will be placed on which of the following
class of medication to prevent cerebral artery vasospasm? - ANSWER-Calcium
channel blocker
Which of the following should be avoided in the setting of basilar skull fractures? -
ANSWER-Nasogastric tubes
You are caring for a patient who was admitted with an occluded VP shunt. Earliest
signs of increased ICP include? - ANSWER-Decreased level of consciousness
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 2
,You are admitting a pt s/p craniotomy for a ruptured aneurysm. Which if the
following nursing actions should you anticipate? - ANSWER-Position with the
head of bed 30 degrees to optimize venous outflow
What is a normal ICP? When do we treat it? - ANSWER-Normal ICP 0-15 mm
Hg
Treatment if sustained >20-25 mm Hg
Cerebral perfusion pressure (CPP) - ANSWER-MAP-ICP
Goal >60 (usually 70-90)
Elevated P2 waves on an ICP waveform are a sign of: - ANSWER-Increased
intracranial pressure and decreased intracranial compliance
Management of a pt post subarachnoid hemorrhage (SAH) with increased ICP
includes: - ANSWER-Optimal positioning, osmotic diuretics and hypertonic saline
What are first tier interventions for increased ICP? - ANSWER-Positioning,
manage fever, pain, mannitol (osmotic diuretic), hypertonic saline, loop diuretics
In addition to figuring out the cause, priorities when caring for a pt experiencing a
seizure include: - ANSWER-Safety and administration of a benzodiazepine
Where on the body do you level a ventriculostomy transducer? - ANSWER-
Foremen of Monro or External auditory meat is
Phenytoin (Dilantin) - ANSWER-10-20 mg/kg
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 3
, Give slowly!!!
Monitor for bradycardia and hypotension
Monitor IV site for infiltration
Guillain-Barré syndrome - ANSWER--Autoimmune disorder
-Present with ascending paralysis often when recovering from an illness or virus
-Damage to the myelin sheath
GB diagnosis and treatment - ANSWER-lumbar puncture
Treatment: plasmapheresis, IV immunoglobulin
Why do we do TTM? - ANSWER-Neuroprotective
Which of the following would be expected in a pt experiencing herniation and
Cushings triad? - ANSWER-Wide pulse pressure, bradycardia, increased systolic
pressure
A pt experienced a devastating rupture basilar aneurysm. When preparing for brain
death examination you should expect which of the following? - ANSWER-Absent
oculocephalic and oculovestibular reflexes
ABG - ANSWER-pH: 7.35-7.45 HC03: 22-26 (acid-alkaline)
CO2: 35-45 (alkaline-acid)
Anion Gap - ANSWER-Normal <11-12
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 4
