Download Adult CCRN/PCCN Certification Practice Test and more Exams Nursing in PDF only on Docsity! adult CCRN/PCCN certification practice test Question & 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 Answers ✅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 Question & Answers D. Chest x-ray and arterial blood gases - Correct Answers ✅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 Answers ✅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 Question & Answers 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 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 Answers ✅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 adult CCRN/PCCN certification practice test Question & Answers 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? A. Decrease the FiO2 B. Increase the tidal volume C. Increase the PEEP D. Increase the rate - Correct Answers ✅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 Answers ✅D. Shunting adult CCRN/PCCN certification practice test Question & Answers 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 D. Low T3 and T4 and high TSH - Correct Answers ✅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? adult CCRN/PCCN certification practice test Question & Answers A 68 y/o male had a AAA repair 3 days ago but is now in renal failure. The nurse understands the likely causes for this may be: A. Post renal kidney stone obstruction B. Malignant hyperthermia C. Rhabdomyolysis D. Acute tubular necrosis due to aortic cross clamping for longer than 30 minutes in surgery. - Correct Answers ✅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 Answers ✅C. Hyperkalemia adult CCRN/PCCN certification practice test Question & Answers 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 Answers ✅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 Answers ✅C. Distributive adult CCRN/PCCN certification practice test Question & Answers 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 Answers ✅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 Answers ✅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 adult CCRN/PCCN certification practice test Question & Answers A. Arrange for the patient to attend a diabetes support group for teenagers B. Encourage the parents to take disciplinary action C. Counsel the patient on the long term consequences of not taking insulin D. Hold a conference with the school nurse regarding the need for monitoring students with diabetes - Correct Answers ✅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 Answers ✅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? adult CCRN/PCCN certification practice test Question & Answers 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 Answers ✅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 Answers ✅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." adult CCRN/PCCN certification practice test Question & Answers 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 Answers ✅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 Answers ✅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 adult CCRN/PCCN certification practice test Question & Answers A. Other vasodilators, such as nitroglycerin, decrease contractility B. Other vasodilators, such as nitroglycerin, decrease heart rate C. Nesiritide has a diuretic effect D. Nesiritide may be used with hypotensive patients - Correct Answers ✅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 Answers ✅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 Question & Answers D. The pressure recording would be falsely low by about 4 mmHg - Correct Answers ✅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 Answers ✅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 D. Atrioventricular (AV) nodes - Correct Answers ✅B. Bundle of His adult CCRN/PCCN certification practice test Question & Answers 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 Answers ✅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 Answers ✅C. Second intercostal space at the midclavicular line on the affected side adult CCRN/PCCN certification practice test Question & Answers 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 Answers ✅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 Answers ✅D. Do not carry out the order, but report it to your charge nurse or nurse manager What ventilatory parameter would provide evidence of fluid volume excess? adult CCRN/PCCN certification practice test Question & Answers A. Increased lung compliance B. Increased vital capacity C. Decreased peak inspiratory pressure D. Increased A:a gradient - Correct Answers ✅D. Increased A:a gradient