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