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 Adult CCRN/PCCN Certification Practice Test Exam Questions and Answers C. Cardiac enzyme studies 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 Adult CCRN/PCCN Certification Practice Test Exam Questions and Answers Your patient just received 10 units of banked blood for a GI bleed. You know this will affect the oxyhemoglobin dissociation curve by: 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 Adult CCRN/PCCN Certification Practice Test Exam Questions and Answers gas results are the following: pH 7.36, PaCO2 43, PaO2 56, HCO3 28. Which ventilator parameter do you anticipate changing? 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? Adult CCRN/PCCN Certification Practice Test Exam Questions and Answers A. Constipation, lower body temperature, and edema B. High T3 and T4 and low TSH. C. Depression, dementia, and reflex changes 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. Adult CCRN/PCCN Certification Practice Test Exam Questions and Answers D. Acute tubular necrosis due to aortic cross clamping for longer than 30 minutes in surgery. - correct answer ✅D. Acute tubular necrosis due to aortic cross clamping for longer than 30 minutes in surgery. Rationale: Kidney stones, malignant hyperthermia, and rhabdomyolysis are not results of a AAA surgical procedure specifically. 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 Adult CCRN/PCCN Certification Practice Test Exam Questions and Answers 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. 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 Adult CCRN/PCCN Certification Practice Test Exam Questions and Answers 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 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? Adult CCRN/PCCN Certification Practice Test Exam Questions and Answers D. Hold a conference with the school nurse regarding the need for monitoring students with diabetes - correct answer ✅A. Arrange for the patient to attend a diabetes support group for teenagers Mrs. Wethersby was admitted to the ICU with severe hypoxia due to bilateral pneumonia. She was emergently intubated and placed on the following ventilator settings: Mode: Assist Control, FiO2 100%, Rate 12, Tidal Volume 400, Peep 10. Thirty minutes later you draw an arterial blood gas and the results are the following: pH 7.25, PaO2 180, PaCO2 50, HCO3 28.You anticipate which of the following ventilator changes? A. Decrease the tidal volume 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. Adult CCRN/PCCN Certification Practice Test Exam Questions and Answers 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 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." Adult CCRN/PCCN Certification Practice Test Exam Questions and Answers 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 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 Adult CCRN/PCCN Certification Practice Test Exam Questions and Answers B. Other vasodilators, such as nitroglycerin, decrease heart rate C. Nesiritide has a diuretic effect D. Nesiritide may be used with hypotensive patients - correct answer ✅C. Nesiritide has a diuretic effect P-waves that are abnormally notched and wide may be seen in patients with A. Myocardial infarction B. Mitral stenosis C. Heart failure D. Chronic obstructive pulmonary disease - correct answer ✅B. Mitral stenosis What effect would the air fluid meniscus of the zero reference port of the transducer of a pressure monitoring system have on the pressure measurement if it was 2 inches below the phlebostatic axis? 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 Adult CCRN/PCCN Certification Practice Test Exam Questions and Answers 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 B. Bundle of His C. Sinoatrial (SA) node Adult CCRN/PCCN Certification Practice Test Exam Questions and Answers 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 What is the best approach to use when a patient become agitated and refused to take his/her meditation? A. "Take your medications now. Your doctor knows what is the best for you." B. "If you take your medications, I'll get you an extra pudding." C. "You always feel better after your medications." D. Take your pills now, or I will have to put a tube into your stomach to give them to you." - correct answer ✅C. "You always feel better after your medications." The physician wrote an order for your patient that you think is unethical. Even after discussing the issue with the physician, he insists that you carry out the order. What should you do? A. Carry out the order, but report it to the supervisor B. Do not carry out the order, but report it to the medical officer for service C. Carry out the order and then discuss it with the physician D. Do not carry out the order, but report it to your charge nurse or nurse manager - correct answer ✅D. Do not carry out the order, but report it to your charge nurse or nurse manager Adult CCRN/PCCN Certification Practice Test Exam Questions and Answers What ventilatory parameter would provide evidence of fluid volume excess? A. Increased lung compliance B. Increased vital capacity C. Decreased peak inspiratory pressure D. Increased A:a gradient - correct answer ✅D. Increased A:a gradient