2024 CCRN Review Exam with Correct Answers: A Comprehensive Guide to Critical Care Nursing, Exams of Advanced Education

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2024 CCRN REVIEW EXAM WITH

CORRECT ANSWERS

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Heart rate (HR) - CORRECT-ANSWERS60-100 beats/min Mean arterial pressure (MAP) - CORRECT-ANSWERS70-105 mmHg Cardiac output (CO) - CORRECT-ANSWERS4-5 L/min Cardiac index (CI) - CORRECT-ANSWERS2.5-4.5 L/min/m Stroke volume (SV) - CORRECT-ANSWERS50-100 ml/beat Stroke index (SI) - CORRECT-ANSWERS35-60 ml/m2/beat Dobutamine - CORRECT-ANSWERSInotropic, chonotropic and vasodilator effects Treats heart failure Improves renal blood flow and u/o 2-20 mcg/kg/min Dopamine - CORRECT-ANSWERSCatacholamine raises bp refractory to fluid therapy treats heart failure corrects hemodynamic imbalances during shock

6mcg/kg/min Epinephrine - CORRECT-ANSWERSCatecholamine Incr CO by incr HR Incr cerebral and coronary blood flow Potent alpha receptor vasoconstrictor 1-10 mcg/min Levophed - CORRECT-ANSWERSCatecholamine Incr contractility to incr bp with mild effect to CO Used to treat hypotension and decr SVR 2-30 mcg/min Milrinone - CORRECT-ANSWERSInotropic vasodilating agent with little chronotropic activity Incr CO without incr myocardial oxygen demand or HR

0.25-0.75 mcg/kg/min Nitroglycerin - CORRECT-ANSWERSVenous vasodilator Decr preload and afterload in L ventricular failure Used for mycardial ischemia and dilator for coronary vasculature 20-40 mcg/min 50-250 mcg/min Nipride - CORRECT-ANSWERSVenous and arterial dilator Incr CO by decr L ventricular afterload Decr bp in hypertensive crises and decr pulmonary hypertension 0.5 - 10 mcg/kg/min Neosynephrine - CORRECT-ANSWERSSympathetic adrenergic agent Constricts blood vessels and raises bp Stimulates baroreceptors to slow HR by incr vagal tone 100-180 mcg/min (can go up to 300 mcg/min) Vasopressin - CORRECT-ANSWERSPotent arterial vasoconstrictor Used for severe hypotension/shock unresponsive to catecholamine therapy, upper GI hemorrhages and ACLS protocol 0.01-0.4 units/min ABG Values - CORRECT-ANSWERSpH 7.35-7. PaCO2 35- PaO2 80- HCO3 22- Normal CBC values - CORRECT-ANSWERSHgb 13-18 M 12-16F Hct 40-52M 35-47F Normal Coag values - CORRECT-ANSWERSPT 12-15 sec aPTT 25-38 sec Platelet 150,000 - 400, Fibrinogen 200- Normal Chemistry values - CORRECT-ANSWERSNa 136 - 145 K 3.5 - 5. Ca 8 - 10. Phos 3 - 4. Mg 1.5 - 2. Chl 96 - 106 Normal Kidney Fxn Values - CORRECT-ANSWERSBUN 5 - 20 Creatinine 0.7 - 1. Anion Gap 5 - 15

Normal Liver/Pancrease Values - CORRECT-ANSWERSAlk Phos 30 - 85 Amylase 56 - 190 Lipase 0 - 15 ALT 5 - 36 AST 15 - 45 GGT 5 - 38 Normal Specific Gravity and Urine Osm values - CORRECT-ANSWERSUrine Specific Gravity 1.005 - 1. Urine Osmololity 50 - 1200 Right arterial pressure (RAP) - CORRECT-ANSWERS4-8 mmHg Pulmonary artery pressure (PAP) - CORRECT-ANSWERSSystolic 15-30 mmHg Diastolic 5-15 mmHg Pulmonary artery occlusive pressure (PAOP) - CORRECT-ANSWERS8- mmHg Systemic vascular resistance (SVR) - CORRECT-ANSWERS800- dynes/sec/cm- Systemic vascular resistance index (SVRI) - CORRECT-ANSWERS1970- dynes/se/com-5/m Pulmonary vascular resistance (PVR) - CORRECT-ANSWERS100- dynes/sec/cm- Pulmonary vascular resistance index (PVRI) - CORRECT-ANSWERS255- dyens/sec/cim-5/m Arterial oxygen saturation (SaO2) - CORRECT-ANSWERS95-100% Venous oxygen saturation (SvO2) - CORRECT-ANSWERS60-80% Delivery of oxygen (DO2) - CORRECT-ANSWERS550-650 ml/min/m Oxygen consumption (VO2) - CORRECT-ANSWERS200-250 ml/min Inferior leads and artery - cardiac - CORRECT-ANSWERSLead II, III, aVF - RCA Anterior septal leads and artery - cardiac - CORRECT-ANSWERSLead V1, V2 - LM

Anterior leads and artery - cardiac - CORRECT-ANSWERSLead V3, V4 - LAD Low lateral lead and artery - cardiac - CORRECT-ANSWERSLead V5, V6 - LCX High lateral lead - cardiac - CORRECT-ANSWERSLead I, aVL Symptoms of Left heart failure - CORRECT-ANSWERSOrthopnea, dyspnea, crackles, Low PaO2, SaO2 & SpO2, S3 & S4, Increased PAOP & PA pressures Symptoms of Right heart failure - CORRECT-ANSWERSJVD, Peripheral edema, Hepatomegaly, Increased CVP/RAP, S3 & S Symptoms of Systolic heart failure - CORRECT-ANSWERSDecreased stroke volume, decreased ejection fraction, S3 and enlarged heart Symptoms of Diastolic heart failure - CORRECT-ANSWERSDecreased stroke volume, normal ejection fraction, S4, normal heart size Laboratory signs of DIC - CORRECT-ANSWERSDecreased platelets Increased PT/INR Increased aPTT Decreased fibrinogen Increased FSP Increased D-Dimer Physical signs of DIC - CORRECT-ANSWERSHypotension, Petechia, Purpura, Bruising, Bleeding in oral, GI/GU, or pulmonary Chvostek's Sign - CORRECT-ANSWERSFacial muscle twitching when cheek is tapped - Hypocalcemia Trousseau's Sign - CORRECT-ANSWERSSpasming of the hand when the bp cuff is inflated beyong systolic pressure for >3 min - Hypocalcemia Grey Turner's Sign - CORRECT-ANSWERSBruising of the flanks, appearing as a blue discoloration - retroperitoneal bleed Cullen's Sign - CORRECT-ANSWERSSuperficial edema and bruising in the subcutaneous fatty tissue around the umbilicus - Intraperitoneal bleed Kehr's Sign - CORRECT-ANSWERSAcute pain in the tip of the shoulder when a person is lying down and the legs are elevated - splenic rupture Calculation of anion gap - CORRECT-ANSWERS(Na + K) - (CL + HCO3) *Cations - Anions Normal is < 15

PaO2/FiO2 Ratio (P/F ratio) - CORRECT-ANSWERSMeasures the difference between oxygen content in PaO2 divided by the FiO2. Used to predict shunting and hypoxemia <300 = ALI <200 = ARDS Acute Respiratory Failure - CORRECT-ANSWERSPaO2 <60 mmHg PaCO2 >50 mmHg pH <7. Acute Lung Injury & ARDS - CORRECT-ANSWERSCxr - bilateral diffuse infiltrates with no cardiac enlargement (white-out or ground-glass appearance) P/F ratio: (<200 ARDS; <300 for ALI) PAOP <18mmHg Acute Pulmonary Embolism - CORRECT-ANSWERSFor Massive PD: Acute right heart failure Shock and crushing chest pain Increased CVP with decreased CO Cyanosis and hemoptysis Status Asthmaticus - CORRECT-ANSWERSABG revealing normalizing or increasing CO2 with no signs of improvement Little to no breath sounds auscultated Disappearance of wheezing Flail Chest - CORRECT-ANSWERSParadoxical wall movement:

• On inspiration when chest wall should move outward, the fractured area will move inward
• On expiration when chest wall should move imward, the fractured area will move outward Tension Pneumothorax - CORRECT-ANSWERSTracheal deviation and PMI move away from affected side High peak inspiratory pressure (if vented) Hypotension Cranial Nerve I - CORRECT-ANSWERSOlfactory - sense of smell Cranial Nerve II - CORRECT-ANSWERSOptic - Central and peripheral vision Cranial Nerve III - CORRECT-ANSWERSOculomotor - Eye and upper eyelid movement, pupil constriction

Cranial Nerve IV - CORRECT-ANSWERSTrochlear - Down and inward eye movement Cranial Nerve V - CORRECT-ANSWERSTrigeminal - Touch, pain, temperature, jaw and eye muscle proprioception (sense of position), chewing Cranial Nerve VI - CORRECT-ANSWERSAbduncens - Lateral eye movement Cranial Nerve VII - CORRECT-ANSWERSFacial - Close eyelid, taste (anterior 2/3 of tongue), saliva and tears Cranial Nerve VIII - CORRECT-ANSWERSAcoustic - equalibrium and hearing Cranial Nerve IX - CORRECT-ANSWERSGlossopharyngeal - Gag reflex, swallowing, taste in posterior 1/3 of tongue Cranial Nerve X - CORRECT-ANSWERSVagus - Salivary gland secretion, vagal control of heart, lungs and GI tract, gag reflex Cranial Nerve XI - CORRECT-ANSWERSSpinal accessory - Shoulder movement Cranial Nerve XII - CORRECT-ANSWERSHypoglossal - Tongue movement CPP - CORRECT-ANSWERSMap - ICU = CPP Normal is 60-100 mmHg ICP - CORRECT-ANSWERSNormal ICP is 5-15 mmHg Wernicke's area - CORRECT-ANSWERSTemporal lobe Broca's area - CORRECT-ANSWERSFrontal lobe Occipital lobe - CORRECT-ANSWERSVision and color recognition Parietal lobe - CORRECT-ANSWERSSensation and body awareness Temporal lobe - CORRECT-ANSWERSReceptive speech Frontal lobe - CORRECT-ANSWERSUnderstands what is said but is unable to express themselves appropriately Brudzinski's Sign - CORRECT-ANSWERSLay flat on back, flex the head down towards the chest and the knees pop up = meningeal irritation Kernig's sign - CORRECT-ANSWERSLay flat on back, bend knee towards chest creates severe pain = meningial irritation

Prerenal - CORRECT-ANSWERSSodium <20 mEq/L BUN >25mg/dl FENa <1% *hypotension/hypo-perfusion Postrenal - CORRECT-ANSWERSSodium >40 mEq/L BUN <25 mg/dl * only in postrenal *obstruction (tumors/stones) Antidote for acetaminophen - CORRECT-ANSWERSN-Acetrylcysteine (Mucomyst) Antidote for Opiates - CORRECT-ANSWERSNaloxone (Narcan) Antidote for benzodiapine - CORRECT-ANSWERSFlumazenil (Romazicon) Antidote for Digoxin - CORRECT-ANSWERSDigibind Antidote for Beta Blockers - CORRECT-ANSWERSGlucagon, Calcium Chloride Antidote for Carbon monoxide - CORRECT-ANSWERS100% FiO2 or hyperbaric chamber Antidote for Ethylene glycol and methanol - CORRECT-ANSWERS10% ethanol infusion, dialysis Antidote for Tricyclic antidepressants - CORRECT-ANSWERSsodium bicarb Antidote for coumadin - CORRECT-ANSWERSVitamin K Antidote for heparin - CORRECT-ANSWERSProtamine sulfate Antidote for amphetamines - CORRECT-ANSWERSbenzodiazepines Antidote for calcium-channel blockers - CORRECT-ANSWERSCalcium chloride, glucagon Antidote for lithium - CORRECT-ANSWERShemodialysis Antidote for nitrates - CORRECT-ANSWERSmethylene blue Antidote for salicylates - CORRECT-ANSWERSsodium bicarb, hemodialysis