CCRN-Critical Care Registered Nurse Practice, Exams of Nursing

Download CCRN-Critical Care Registered Nurse Practice and more Exams Nursing in PDF only on Docsity! CCRN-CRITICAL CARE REGISTERED NURSE PRACTICE CCRN-Critical Care Registered Nurse Practice Questions Latest 2024/2025 Fully Solved 100% Correct A Patient Returns To The Critical Care Unit After Insertion Of A Transvenous Pacemaker. There Are Pacing Spikes Not Followed By A Qrs. Which Of The Following Is A Method To Facilitate Capture During Pacing? A. Increase The Pacing Rate. B. INCREASE THE MILLIAMPERAGE. C. Suppress The Competitive Rhythm. D. Increase The Sensitivity Education In Peripheral Circulation And Shifting Of The Oxyhemoglobin Dissociation Curve Can Affect The Accuracy Of Which Of The Following? A. Arterial Blood Gases B. Capnography C. Hemoglobin And Hematocrit D. PULSE OXIMETRY Which Of The Following Would Not Be Recommended For Diastolic Dysfunction? A. Angiotensin Receptor Blockers B. Beta-Blockers C. INOTROPES D. Angiotensin-Converting Enzyme Inhibitors Why Does Nitroprusside (Nipride) Cause Tachycardia? CCRN-CRITICAL CARE REGISTERED NURSE PRACTICE A. Stimulation Of Cardioacceleratory Center B. Stimulation Of Alpha Receptors C. STIMULATION OF BARORECEPTORS D. Stimulation Of Renin-Angiotensin-Aldosterone System Aortic Stenosis Would Elevate Which Of The Following? A. LEFT VENTRICULAR SYSTOLIC PRESSURE B. Pulmonary Artery Systolic Pressure C. Arterial Systolic Pressure D. Arterial Diastolic Pressure Which Of The Following Does Not Predispose The Patient To Digitalis Toxicity? A. Hypokalemia B. Hypercalcemia C. Hypomagnesemia D. HYPONATREMIA Which Of The Following Types Of Drugs Can Cause Hypotension, Hyperkalemia, Angioedema, Proteinuria, And Cough? A. Beta-Blockers B. Loop Diuretics C. Calcium Channel Blockers D. ANGIOTENSIN-CONVERTING ENZYME (ACE) INHIBITORS Ashman's Phenomenon Is Most Likely To Be Evident In Which Of The Following Electrocardiogram Changes? A. Second-Degree Atrioventricular Block, Type I (Wenckebach) B. ATRIAL FIBRILLATION CCRN-CRITICAL CARE REGISTERED NURSE PRACTICE A. Ii, Iii, Avf B. V1, V2 C. V5, V6 D. I, Avl A 52-Year-Old Woman Arrives In The Ed. Started Having Fluttering In Her Chest About 1 Hour Ago And Now Is Having Chest Pain. She Has A History Of Htn. The EKG Monitor Shows Paroxysmal Atrial Tachycardia With Hr 150, Bp 130/88. Verapamil 5 Mg Is Given Via Slow Iv Push. What Would Be A Desirable Therapeutic Outcome? A. Decrease In Blood Pressure B. Decrease In Heart Rate C. Change In Rhythm To Atrial Fibrillation D. A Decrease In The Fluttering Feeling In Her Chest [Correct Ans Is: - B. Decrease In Heart Rate Which Of The Following Is The Most Common Cause Of Death Associated With An Acute Mi? A. Heart Failure B. Ventricular Dysrhythmias C. Pulmonary Edema D. Thromboembolism [Correct Ans Is: - B. Ventricular Dysrhythmias A Patient In The Ed With Complaints Of Chest Pain. The 12-Lead EKG Shows St Elevation In Leads V3 And V4. Occlusion Of The Affected Coronary Artery Most Likely Would Affect Perfusion To Which Portion Of The Conduction System? A. Sinoatrial (Sa) Node B. Bachmann's Bundle C. Atrioventricular (Av) Node D. Bundle Of His [Correct Ans Is: - Lad So D. Bundle Of His CCRN-CRITICAL CARE REGISTERED NURSE PRACTICE Which Of The Following Is The Preferred Lead For St Segment Monitoring For A Patient With A Suspected Rca Occlusion? A.I B. Avr C. Iii D. V1 [Correct Ans Is: - C. Iii Which Of The Following Is Not A Manifestation Of Hypertrophic Cardiomyopathy? A. Syncope B. Murmur That Increases With Squatting C. Chest Pain D. Sudden Cardiac Death [Correct Ans Is: - *B Classic Manifestations Of Hypertrophic Cardiomyopathy Are Chest Pain, Syncope, And An Aortic Stenosis Type Of Murmur That Decreases When The Patient Is In A Squatting Position. The First Manifestation Of This Condition Is Occasionally Sudden Cardiac Death During Exercise. In Which Quadrant Is The Mean Qrs Complex Axis Located If The Qrs Complex Is Predominantly Positive In Lead I And Negative In Lead Avf? A. Normal Quadrant B. Left Axis Deviation Quadrant C. Right Axis Deviation Quadrant D. Indeterminant Quadrant [Correct Ans Is: - *B Because The Positive Of Lead I Is The Left Arm, If The Qrs Complex Is Upright In Lead I, The Mean Qrs Axis Is To The Left. Because The Positive Of Lead Avf (A Unipolar Lead) Is At The Foot, If The Qrs Complex Is Negative In Lead Avf, The Mean Qrs Axis Is Upward Away From The Foot. This Axis Would Be In The Upper Left Quadrant, Described As Left Axis Deviation. A Patient Becomes Apneic And Pulseless. Cpr Has Been Initiated, And The Monitor Shows Asystole In Two Leads. Which Of The Following Drugs Would Be Used Initially? CCRN-CRITICAL CARE REGISTERED NURSE PRACTICE A. Calcium Gluconate B. Atropine C. Epinephrine D. Amiodarone (Cordarone) [Correct Ans Is: - C After Cpr Is Initiated And An Intravenous Access Is Established, Epinephrine Should Be Given. Calcium Was Used In The Past In Asystole But Is Used Today Only For Hypocalcemia, Calcium Channel Blocker Toxicity, Hyperkalemia, And Hypermagnesemia. Atropine Is No Longer Recommended For Asystole. Amiodarone Is Not Indicated In Asystole Because Asystole Is The Absolute Absence Of Irritability. What Is Associated W/ Mitral Stenosis A. Pinkish Discoloration Of The Cheeks B. Systolic Murmur C. Widened Pulse Pressure D. Narrow Pulse Pressure [Correct Ans Is: - A Patients With Mitral Stenosis May Exhibit A Pinkish Discoloration Of The Cheeks (I.E., Malar Blush). Mitral Stenosis Causes A Diastolic Murmur. Widened Pulse Pressure Is Associated With Aortic Regurgitation. Narrowed Pulse Pressure Is Associated With Mitral Regurgitation. Four Days After A Mitral Valve Replacement, The Patient Develops Atrial Fibrillation. The Nurse Initially Would: A. Order A 12-Lead EKG B. Evaluate The Patient For Clinical Indications Of Hypoperfusion. C. Notify The Physician. D. Ask The Patient To Bear Down As If Having A Bowel Movement. [Correct Ans Is: - B The Onset Of Atrial Fibrillation Results In The Loss Of Atrial Kick. Loss Of Atrial Kick May Reduce The Cardiac Output By As Much As 20-30%. This Is Especially True In Patients Whose Cardiac Output May Be Affected By Long-Standing Cardiac Disease, Such As Mitral Valve Disease. Assess The Patient For Clinical Indications Of Hypoperfusion (E.G., Cool Skin, Decreased Urine Output, Narrowed Pulse Pressure, And Hypotension). CCRN-CRITICAL CARE REGISTERED NURSE PRACTICE D. Pleurisy [Correct Ans Is: - A. Pericarditis A Patient Sustains A Myocardial Contusion As A Result Of A Mvc. Which Of The Following Signs And Symptoms Would Be Most Likely? A. Jugular Venous Distention B. Crackles C. Bradycardia D. S3 At The Apex [Correct Ans Is: - A. Jugular Venous Distention A Patient Is Admitted To The Coronary Care Unit With Third-Degree Av Heart Block, And A Transvenous Temporary Ventricular Pacemaker Is Inserted. Four Hours Later The Patient Complains Of Dizziness While Lying In Bed. The Monitor Shows Third- Degree Av Block With A Ventricular Rate Of 52 And No Pacing Spikes. This Indicates Which Of The Following? A. Failure To Capture B. Failure To Pace C. Competition Between Pacemaker And Intrinsic Rhythm D. Failure To Sense [Correct Ans Is: - B. Failure To Pace Which One Of The Following Structures Is At Greatest Risk For Trauma In Myocardial Contusion? A. Right Atrium B. Right Ventricle C. Aorta D. Left Ventricle [Correct Ans Is: - B. Rv Leads V8 And V9 Are Used To Evaluate Which Of The Following? A. Left Ventricular Failure B. Posterior Myocardial Infarction (Mi) C. Lateral Mi CCRN-CRITICAL CARE REGISTERED NURSE PRACTICE D. Left Bundle Branch Block [Correct Ans Is: - B. Posterior Mi Which Of The Following Is The Major Advantage Of Minimally Invasive Direct Coronary Artery Bypass Grafting (Midcabg)? A. Decreased Cost B. Decreased Length Of Stay C. Avoidance Of Cardiopulmonary Bypass D. Less Patient Pain [Correct Ans Is: - C. Avoidance Of Cardiopulmonary Bypass A Patient Arrives To The Ed With A Knife Sticking Out Of His Chest. He Is Stable At This Time But Complaining Of Pain At The Knife Insertion Site. The Physician Is Busy Resuscitating Another Patient. What Should Be Done? A. Remove The Knife So That The Wound Can Be Cleansed. B. Remove The Knife And Apply A Sterile, Occlusive Dressing. C. Leave The Knife In But Stabilize It With Adhesive Tape. D. Leave The Knife In But Apply A Pressure Dressing Over It. [Correct Ans Is: - C. Leave The Knife In But Stabilize It With Adhesive Tape. A 57-Year-Old Man Was Admitted To The Critical Care Unit With A Diagnosis Of Anteroseptal Mi. A Pa Catheter Was Inserted, And Initial Readings Were Within Normal Limits. Bp 140/92, Hr 110 And Regular, Rr 24. Breath Sounds Equal And Clear. 3 Hrs After Admission, The Pt Becomes Restless With Cool, Pale Skin. Now Bp 110/72, Hr 120, Rr 28 And Labored. Crackles Are Audible At The Lung Bases Bl. The Patient Is Given Furosemide (Lasix) At 8 Am. At 9 Am, The Paop Drops To 8, With A Drop In Bp. Which Of The Following Would Be The Most Appropriate Intervention At This Time? A. Administer Saline Bolus. B. Decrease Dobutamine Drip Rate. C. Increase Nitroglycerin Drip Rate. D. Replace Potassium. [Correct Ans Is: - A. Administer Saline Bolus. CCRN-CRITICAL CARE REGISTERED NURSE PRACTICE What Type Of Av Block Is Characterized By A Progressive Prolongation Of The Pr Interval Followed By A Nonconducted P Wave? A. First-Degree Av Block B. Second-Degree Av Block, Type I C. Second-Degree Av Block, Type Ii D. Third-Degree Av Block [Correct Ans Is: - B. Second-Degree Av Block, Type I A Premature P Wave Buried In The T Wave Before A Run Of Wide Qrs Complex Tachycardia Indicates That The Wide Qrs Complex Tachycardia Is Most Likely Which Of The Following? A. Supraventricular Tachycardia With Aberrancy B. Ventricular Tachycardia C. Bundle Branch Block D. Wolff-Parkinson-White Syndrome [Correct Ans Is: - A. Supraventricular Tachycardia With Aberrancy Which Of The Following Drugs Are Used For First-Line Therapy For Chronic Management Of Hypertension? A. Ace Inhibitors And Vasodilators B. Vasodilators And Beta-Blockers C. Diuretics And Beta-Blockers D. Diuretics And Ace Inhibitors [Correct Ans Is: - C. Diuretics And Beta-Blockers A 61-Year-Old Man Is Admitted To The Critical Care Unit From The Cath Lab. He Has Just Had A Pci And Stent Insertion To The Rca. His Leg Is Immobilized, And The Hob 30 Degrees. Six Hours Later The Patient Is Restless And Complaining Of Back Pain. The Femoral Sheath Is Intact In The Right Femoral Area, And There Is No Evidence Of Bleeding Or Hematoma. Neck Veins Are Flat With The Hob 30 Degrees, And Heart Sounds Are Normal. Vital Signs Are Bp 80/50, Hr 120, And Rr 24. Which Of The Following Is The Priority Issue For Patient Education For This Patient? CCRN-CRITICAL CARE REGISTERED NURSE PRACTICE C. The Pressures Recorded Would Be Falsely High By About 4 Mm Hg. D. The Pressures Recorded Would Be Falsely Low By About 4 Mm Hg. [Correct Ans Is: - C. The Pressures Recorded Would Be Falsely High By About 4 Mm Hg. A Patient Is Admitted To The Coronary Care Unit In Third-Degree Av Heart Block With Syncopal Episodes. Which Of The Following Defines Syncope? A. Dizziness B. Ataxia C. Vertigo D. Transient Loss Of Consciousness [Correct Ans Is: - D. Transient Loss Of Consciousness Clinical Indications Of A Right Tension Pneumothorax Include Which Of The Following? A. Tracheal Shift Toward The Right With Diminished Or Absent Breath Sounds On The Left B. Tracheal Shift Toward The Left With Diminished Or Absent Breath Sounds On The Right C. Tracheal Shift Toward The Left With Diminished Or Absent Breath Sounds On The Left D. Tracheal Shift Toward The Right With Diminished Or Absent Breath Sounds On The Right [Correct Ans Is: - B. Tracheal Shift Toward The Left With Diminished Or Absent Breath Sounds On The Right A 70-Year-Old Woman, Weighing 50 Kg, Comes To The Ed Complaining Of Chest Pain And Shortness Of Breath. EKG Shows Ventricular Tachycardia Hr 150. Which Treatment Is Appropriate In This Situation? A. Amiodarone (Cordarone) Iv B. Verapamil Hcl (Calan) Iv C. Defibrillation Beginning At 200 J D. Synchronized Cardioversion Beginning At 100 J [Correct Ans Is: - D. Synchronized Cardioversion Beginning At 100 J CCRN-CRITICAL CARE REGISTERED NURSE PRACTICE A Patient Is Admitted To The Coronary Care Unit With Third-Degree Av Heart Block, And A Transvenous Temporary Ventricular Pacemaker Is Inserted. Four Hours Later The Patient Complains Of Dizziness While Lying In Bed. The Monitor Shows Third- Degree Av Heart Block With A Ventricular Rate Of 52 Beats/Min And No Pacing Spikes. This Indicates Failure To Pace, And The Patient Is Taken To Surgery For Insertion Of A Dvi Permanent Pacemaker. Which Of The Following Describes The Function Of A Dvi Pacemaker? A. Senses Atrium And Ventricle; Paces Ventricle; Inhibited By Qrs Complex B. Senses Atrium And Ventricle; Paces Ventricle; Triggered By Qrs Complex C. Paces Atrium And Ventricle; Senses Ventricle; Inhibited By The Qrs Complex D. Paces And Senses Atrium And Ventricle; Inhibited By The P Wave [Correct Ans Is: - C. Paces Atrium And Ventricle; Senses Ventricle; Inhibited By The Qrs Complex Shortly After Returning From Pci, A Patient Begins To Complain Of Chest Pain Similar In Intensity And Character To The Pre-Pci Pain. The Pain Is Unresponsive To Nitroglycerin Infusion Titration. The Patient Should Be Prepared For: A. Return To Cardiac Catheterization For An Additional Procedure. B. Emergency Coronary Artery Bypass Grafting. C. Intraaortic Balloon Pump Therapy. D. A Catheterization Of The Right Side Of The Heart. [Correct Ans Is: - A. Return To Cardiac Catheterization For An Additional Procedure. Which Of The Following Would Not Be Associated With A False-Positive Result For An Acute Mi Using The Total Creatine Kinase (Ck)? A. Hypothyroidism B. Hemorrhagic Stroke C. Cardioversion D. Ulcerative Colitis [Correct Ans Is: - D. Ulcerative Colitis While Auscultating The Patient's Heart, An S3 Is Noted. What Does This Heart Sound Indicate? A. Atrial Contraction And Propulsion Of Blood Into A Noncompliant Ventricle B. Inflammation Of The Pericardium CCRN-CRITICAL CARE REGISTERED NURSE PRACTICE C. Opening Of A Defective Semilunar Valve D. Rapid Ventricular Filling Into An Already Distended Ventricle [Correct Ans Is: - D. Rapid Ventricular Filling Into An Already Distended Ventricle Which Of The Following Is The Best Hemodynamic Parameter For Assessing Lv Function? A. Pulmonary Artery Occlusive Pressure (Paop) B. Pulmonary Artery Diastolic Pressure (Pad) C. Cardiac Index (Ci) D. Pulmonary Artery Systolic Pressure (Pas) [Correct Ans Is: - A. Paop Which Of The Following Are Therapeutic Goals For Drug Therapy For Dilated Cardiomyopathy? A. Decreasing Contractility, Decreasing Afterload And Preload B. Decreasing Contractility, Increasing Afterload And Preload C. Increasing Contractility, Decreasing Afterload And Preload D. Increasing Contractility, Increasing Afterload And Preload [Correct Ans Is: - C. Increasing Contractility, Decreasing Afterload And Preload A 65-Year-Old Black Man Comes To The Er With Complaints Of Headache. His Admission Bp 220/150. A Nitroprusside (Nipride) Drip Is Initiated. Which Of The Following Would Not Be An Important Aspect Of Care For A Patient Receiving Nitroprusside? A. Closely Assessing The Patient For Clinical Indications Of Hypoxia B. Monitoring The Patient's Blood Pressure Every 1-2 Minutes Until It Stabilizes And Dosage Is Established C. Checking The Patient's Serum Glucose Every 6 Hours D. Monitoring The Patient For Signs Of Thiocyanate Poisoning [Correct Ans Is: - C. Checking The Patient's Serum Glucose Every 6 Hours CCRN-CRITICAL CARE REGISTERED NURSE PRACTICE A Patient Is In Cardiogenic Shock And Requires Careful Volume Titration To Enhance Contractility. Which Of The Following Ranges Describes The Most Likely Optimal Paop In This Patient? A. 0-5 Mm Hg B. 10-15 Mm Hg C. 15-20 Mm Hg D. 20-25 Mm Hg [Correct Ans Is: - C. 15-20 Mm Hg Which Of The Following Drugs Prescribed For A Patient With Stable Angina Does Not Decrease Myocardial Oxygen Consumption? A. Beta-Blocker B. Calcium Channel Blocker C. Nitrate D. Aspirin [Correct Ans Is: - D. Aspirin Which Of The Following Is The Most Common Complication Of Infective Endocarditis? A. Heart Failure B. Emboli C. Myocarditis D. Pericarditis [Correct Ans Is: - B. Emboli Which Of The Following Is Likely To Correlate Most Directly With The Need For Electrical Cardioversion For A Tachydysrhythmia? A. Degree Of Instability B. Presence Of Heart Failure C. Heart Rate D. Origin Of The Rhythm [Correct Ans Is: - A. Degree Of Instability CCRN-CRITICAL CARE REGISTERED NURSE PRACTICE What Is The Most Frequently Identified Primary Mechanism Of Cardiac Arrest? A. Asystole B. Ventricular Tachycardia C. Third-Degree Atrioventricular Block D. Ventricular Fibrillation [Correct Ans Is: - D. Ventricular Fibrillation Which Are The Two Most Common Dysrhythmias Associated With Wolff-Parkinson- White Syndrome? A. Atrial Fibrillation And Supraventricular Tachycardia B. Atrial Fibrillation And Ventricular Tachycardia C. Supraventricular And Ventricular Tachycardia D. Atrioventricular Nodal Blocks And Ventricular Fibrillation [Correct Ans Is: - A. Atrial Fibrillation And Supraventricular Tachycardia Patient In Ed With Complaints Of Severe Headache. She States That She Has Been Out Of Her Bp Pills For 3 Weeks And Cannot Afford To Buy More. Bp Ranges From 250/128 To 200/110. Nitroprusside (Nipride) Is Being Titrated, And The Patient Is On O2 By Nc. In Considering The Risk For Cardiac Failure And Pulmonary Edema, Consideration Should Be Made To The Physiologic Principle That The Majority Of Myocardial Oxygen Consumption Occurs During Which Phase Of The Cardiac Cycle? A. Ventricular Ejection B. Isovolumetric Contraction C. Ventricular Filling D. Isovolumetric Relaxation [Correct Ans Is: - B. Isovolumetric Contraction A Postoperative Cardiac Surgery Patient's Blood Pressure Suddenly Drops To 70 Mm Hg Palpable, With A Loss Of The A Wave In The Paop Waveform. What Change In His Cardiac Rhythm Would Cause This Change In His Paop Waveform? A. Sinus Tachycardia B. Sinus Dysrhythmia C. Atrial Tachycardia D. Atrial Fibrillation [Correct Ans Is: - D. Afib CCRN-CRITICAL CARE REGISTERED NURSE PRACTICE A 40-Year-Old Patient Has Been Admitted To The Critical Care Unit After Sustaining Multiple Injuries From A Cave-In Accident This Morning. X-Ray Confirm Multiple Fractures, Including The Left Femur. During The Afternoon He Was Taken To Surgery For Internal Fixation Of The Left Femur. It Is Now 10 Pm, And The Patient Is Complaining Of Severe Throbbing Pain In His Thigh. The Patient Received 5 Mg Of Morphine Sulfate Iv 30 Minutes Ago. The Anterior Left Thigh Is Firm To Touch, And The Pain Increases When The Patient Flexes His Left Leg. The Nurse Should Suspect Which Of The Following? A. Normal Pain Related To Fractured Femur B. Abnormal Pain Related To Compartment Syndrome C. Abnormal Pain Related To Infection D. Abnormal Pain Related To Lumbosacral Plexus Injury [Correct Ans Is: - B. Abnormal Pain Related To Compartment Syndrome Which Of The Following Medications Is Associated With Thiocyanate Toxicity? A. Nicardipine (Cardene) B. Captopril (Capoten) C. Metoprolol (Lopressor) D. Nitroprusside (Nipride) [Correct Ans Is: - D. Nitroprusside (Nipride) Patient Is In Cardiac And Respiratory Arrest. The Selection Of Medications To Reestablish Cardiac Function Would Stimulate The Sympathetic Nervous System Beta1 Receptors. This Stimulation Would Result In Increased Automaticity And Which Of The Following? A. Increased Myocardial Contractility B. Decreased Left Ventricular Stroke Work C. Decreased Myocardial Oxygen Consumption D. Increased Left Ventricular Afterload [Correct Ans Is: - A. Increased Myocardial Contractility A 55-Year-Old Man Had A Heart Transplant 10 Hours Ago. Present Assessment Includes Cold, Clammy Skin, Jugular Venous Distention, Bilateral Crackles, And Tachycardia. Vital Signs Are Temperature 98.6° F, Bp 80/60, Hr 120 And Rr 24 . Mediastinal Tube Drainage Is Approximately 50 Ml/Hr. He Is Diagnosed With