Adult CCRN/PCCN Certification Practice Test Exam Questions and Answers, Exams of Medicine

Download Adult CCRN/PCCN Certification Practice Test Exam Questions and Answers and more Exams Medicine in PDF only on Docsity! Adult CCRN/PCCN certification practice test Exam Questions And Answers One day following posterior spinal fusion surgery a 35 year old female suddenly exhibits restlessness, labored breathing and acute chest pain. Her heart rate is 122/min., she is afebrile, and exhibits slightly diminished breath sounds on the right side. The findings described above should lead the nurse to suspect that the patient has developed: A. A spontaneous pneumothorax B. A pulmonary embolus C. Aspiration pneumonia D. A pleural effusion - correct answer B. A pulmonary embolus One day following posterior spinal fusion surgery a 35 year old female suddenly exhibits restlessness, labored breathing and acute chest pain. Her heart rate is 122/min., she is afebrile, and exhibits slightly diminished breath sounds on the right side. Which of the following will most likely confirm the patient's diagnosis? A. Pulmonary radioisotope scan B. Echocardiogram C. Cardiac enzyme studies Adult CCRN/PCCN certification practice test Exam Questions And Answers D. Chest x-ray and arterial blood gases - correct answer A. Pulmonary radioisotope scan The nursing staff does not wish to be assigned a difficult patient who continues to demonstrate disorderly behavior. Which of the following is an acceptable solution? A. Request the family control the patient's behavior. B. Transfer the patient C. The patient assignment should be decided by the Charge Nurse. D. Alternate the patient assignment among the nursing staff. - correct answer D. Alternate the patient assignment among the nursing staff. A patient who is 72 hours postoperative repair of a bowel obstruction suddenly demonstrates shortness of breath and his respiratory rate increases from 22 to 45/min. His SpO2 went from 95% to 88% acutely. An arterial blood gas sample obtained while the patient is receiving oxygen via a nasal cannula at 6L/min reveals the following results: pH 7.40 pCO2 27 pO2 50 A chest x-ray is obtained and a "ground-glass-like appearance" is reported. Auscultation of the lungs reveals diffuse crackles that were not present previously. Adult CCRN/PCCN certification practice test Exam Questions And Answers A. Shifting it to the right B. Causing a plateau in the curve C. Shifting it to the left D. Causing no change in the curve - correct answer C. Shifting it to the left A patient who is 72 hours postoperative repair of a bowel obstruction suddenly demonstrates shortness of breath and his respiratory rate increases from 22 to 45/min. His SpO2 went from 95% to 88% acutely. An arterial blood gas sample obtained while the patient is receiving oxygen via a nasal cannula at 6L/min reveals the following results: pH 7.40 pCO2 27 pO2 50 A chest x-ray is obtained and a "ground-glass-like appearance" is reported. Auscultation of the lungs reveals diffuse crackles that were not present previously. Your patient is currently on a ventilator with the following settings: AC, FiO2 100%, Rate of 12, Tidal Volume 450, PEEP of 5. His arterial blood gas results are the following: pH 7.36, PaCO2 43, PaO2 56, HCO3 28. Which ventilator parameter do you anticipate changing? Adult CCRN/PCCN certification practice test Exam Questions And Answers A. Decrease the FiO2 B. Increase the tidal volume C. Increase the PEEP D. Increase the rate - correct answer C. Increase the PEEP ARDS is characterized by which of the following: A. Refractory hypercarbia B. Increase in surfactant C. Increased lung compliance D. Shunting - correct answer D. Shunting Rationale: ARDS is characterized by refractory hypoxia, shunting, decreased lung compliance, and decreased surfactant. A 42 y/o woman with a 6 month history of worsening anxiety, heat intolerance, and weight loss presents to the emergency department. Which of the following are indicators of hyperthyroidism? A. Constipation, lower body temperature, and edema B. High T3 and T4 and low TSH. C. Depression, dementia, and reflex changes Adult CCRN/PCCN certification practice test Exam Questions And Answers D. Low T3 and T4 and high TSH - correct answer B. High T3 and T4 and low TSH. Rationale: Constipation, lower body temperature, edema, depression, dementia, reflex changes, low T3, low T4, high TSH are all indicators of hypothyroidism. An elderly man with Type 2 DM comes into the emergency department after spending all day in the mall shopping with his wife. He tells you that his heart is racing and he is sweaty and shaky. What is the best course of action for the nurse? A. Give the patient a candy bar and drink regular soda then check his BG. B. Check his blood glucose level and obtain an ECG. C. Check his blood glucose and inject NPH insulin if he's hyperglycemic. D. Give the patient 4 glucose tablets and then check his blood glucose. - correct answer B. Check his blood glucose level and obtain an ECG. Successful treatment of DKA revolves around: A. Correction of orthostatic hypotension with electrolytes B. Administration of fluids, electrolytes and insulin Adult CCRN/PCCN certification practice test Exam Questions And Answers A 72 y/o man is in the ICU for chronic renal failure. What electrolyte abnormalities would the nurse watch for? A. Decreased BUN and Creatinine from diseased kidneys B. High pH and alkalosis C. Hyperkalemia D. Thrombocytopenia - correct answer C. Hyperkalemia The nurse is providing care for a patient with pyelonephritis. What treatment is appropriate for this patient? A. Restrict oral and IV fluids to prevent renal failure B. 2 L hypertonic solution with magnesium rider C. 2 Grams Ceftriaxone D. Prepare patient for emergent dialysis - correct answer C. 2 Grams Ceftriaxone Rationale: Appropriate therapy for pyelonephritis includes: Give 2 L of IV fluid, Give 2 Tylenol #3 or similar pain control. Give 2 gm ceftriaxone. If the patient can tolerate two glasses of water and fever decreases by 2 degrees: Trimethoprim/Sulfamethoxazole (TMP/SMX) double-strength BID for two weeks; follow-up in two days for progress check. Adult CCRN/PCCN certification practice test Exam Questions And Answers Toxic Shock, Myxedema coma, and Addisonian Crisis are all types of what type of shock? A. Neurogenic B. Anaphylactic C. Distributive D. Hypovolemic - correct answer C. Distributive Positive cultures distinguish what two stages of the sepsis spectrum? A. SIRS and sepsis B. Sepsis and severe sepsis C. Sepsis and septic shock D. SIRS and severe shock - correct answer A. SIRS and sepsis Which scenario would be the best example of secondary MODS? A. Respiratory failure due to pneumonia B. Acute respiratory distress syndrome secondary to pancreatitis C. Neurologic anoxia due to hypoxemia Adult CCRN/PCCN certification practice test Exam Questions And Answers D. Renal Failure due to prolonged hypovolemic shock - correct answer B. Acute respiratory distress syndrome secondary to pancreatitis Example of catecholamines are: A. Mast cells, basophils, and eosinophils B. Histamine, tryptase, and heparin C. Histamine, epinephrine, and steroids D. Epinephrine, norepinephrine, and dopamine - correct answer D. Epinephrine, norepinephrine, and dopamine Which of following is a nursing priority when providing care to a patient during a seizure? A. Ensure the patient has an open airway B. Stay away from the patient C. Administer Haldol D. Padded tongue blade in mouth - correct answer A. Ensure the patient has an open airway The nurse assesses damage to the right cerebral hemisphere in a patient. Assessment finding would include Adult CCRN/PCCN certification practice test Exam Questions And Answers B. Decrease the rate C. Decrease the PEEP D. Increase the rate - correct answer D. Increase the rate Your patient was recently told he has portal hypertension. You know that which of the following statements about portal hypertension is true? A. Portal hypertension may lead to an enlargement of the kidneys B. Patients should adhere to a cardiac diet. C. The most common cause of portal hypertension is hepatitis D. Patients with portal hypertension are at risk for developing esophageal varices - correct answer D. Patients with portal hypertension are at risk for developing esophageal varices Which of the following might cause a shift to the RIGHT on the oxyhemoglobin dissociation curve? A. Low 2, 3-DPG levels B. Acidosis C. Low pCO2 D. Hypothermia - correct answer B. Acidosis Adult CCRN/PCCN certification practice test Exam Questions And Answers After telling your patient that he will be transferred out of the ICU, he begs you to allow him to stay longer because he doesn't feel healthy enough to leave. How would you best respond to this patient? A. "Your insurance only covers a limited time in the ICU." B. "There is a crashing patient in the Emergency Department that needs this bed." C. "You sound like you have some concerns about leaving the unit." D. "Please don't worry - You will do just fine after transferring out of the ICU." - correct answer C. "You sound like you have some concerns about leaving the unit." An EKG was performed on Mrs. Smith and revealed peaked T waves and a widened QRS complex. Which of the following electrolyte abnormalities would you expect? A. Hyperkalemia B. Hypocalcemia C. Hypercalcemia D. Hypomagnesemia - correct answer A. Hyperkalemia Adult CCRN/PCCN certification practice test Exam Questions And Answers The intra-aortic balloon pump (IABP) device is indicated for which of the following? A. Aortic regurgitation B. Abdominal aortic aneurysm C. Treatment of Right-sided heart failure D. As a bridge to LVAD or transplant - correct answer D. As a bridge to LVAD or transplant Cardiac Tamponade symptoms that are most common are: A. Retrosternal pain, vomiting, no change in heart sounds B. Substernal pain, dizziness, palpitations C. Weakness on right side, fatigue, and diarrhea D. Muffled heart sounds, dyspnea, agitation - correct answer D. Muffled heart sounds, dyspnea, agitation Which finding is most consistent with myocardial contusion diagnosis? A. S3 at apex B. Crackles in the lung fields C. Tachycardia Adult CCRN/PCCN certification practice test Exam Questions And Answers A. The pressure recording would be falsely high by about 4 mmHg B. The pressure recording would be falsely low by about 2 mmHg C. The pressure recording would be falsely high by about 2 mmHg D. The pressure recording would be falsely low by about 4 mmHg - correct answer A. The pressure recording would be falsely high by about 4 mmHg Which indicator would be important in differentiating unstable angina from stable angina? A. Chest pain relived by nitroglycerin B. Development of Q waves on the electrocardiogram C. Chest pain at rest D. Development of ST segment elevation or depression in affect leads - correct answer C. Chest pain at rest A 62-year-old man arrives in the emergency department with the complaints of chest pain. The 12-lead electrocardiogram shows ST segment 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. Bachmann's Bundle Adult CCRN/PCCN certification practice test Exam Questions And Answers B. Bundle of His C. Sinoatrial (SA) node D. Atrioventricular (AV) nodes - correct answer B. Bundle of His A 44-year-old female patient is being suctioned through her endotracheal tube, and her heart rate drops dramatically. What should you do? A. Continue suctioning and then administer 100% oxygen B. Turn the head to the left side C. Instill saline down the endotracheal tube to loosen up the mucus plus D. Stop suctioning and administer 100% oxygen - correct answer D. Stop suctioning and administer 100% oxygen What location is used for an emergency decompression of a tension pneumothorax with a 14-guage needle? A. Fifth intercostal space at the midclavicular line on the affected side B. Second intercostal space at the midaxillary line on the affected side C. Second intercostal space at the midclavicular line on the affected side D. Fifth intercostal space at the midaxillary line on the affected side - correct answer C. Second intercostal space at the midclavicular line on the affected side Adult CCRN/PCCN certification practice test Exam Questions And Answers A 46-year-old male developed an epidural hematoma after being in a motor vehicle collison. He has had a craniotomy to evacuate the clot, and an intraventricular catheter was placed during surgery. Which of the following is important in caring for the patient with intracranial pressure (ICP) monitoring? A. Use a flush system B. Use a preservative-free isotonic saline C. Use a pressure bag D. Use heparin to maintain integrity of the line - correct answer B. Use a preservative-free isotonic saline A 30-year-old man is admitted to the critical care unit after a motor vehicle collision. The emergency department nurse reports that he was unconscious at the scene of the accident but is now alert and oriented. Skull films show a linear fracture of the right temporal bone. He is a significant risk for _______. A. Subdural hematoma B. Intracerebral hematoma C. Epidural hematoma D. Scalp hematoma - correct answer C. Epidural hematoma