Download American Association of Critical-Care Nurses AACN Critical Care Registered Nurse CCRN 2024 and more Exams Nursing in PDF only on Docsity! American Association of Critical-Care Nurses AACN Critical Care Registered Nurse CCRN 2024 Exam Review Questions and Answers 100% Pass 1. Which professional organization's primary focus is to support critical care nursing? A. American Association of Critical-Care Nurses B. American Association of Heart Failure Nurses C. American Nurses Association D. Society of Critical Care Medicine - Answer>> A. Part of the American Association of Critical-Care Nurses' mission is: "Acute and critical care nurses rely on AACN for expert knowledge and the influence to fulfill their promise to patients and their families." 2. A staff nurse states, "I'm a CCRN." What does CCRN mean? A. CCRN certification helps the hospital to maintain accreditation from The Joint Commission. B. CCRN certification means that the nurse has more knowledge than a noncertified nurse. C. CCRN is a registered trademark and stands for "Critical Care Registered Nurse." D. CCRN signifies that the nurse was eligible for certification in critical care and passed the CCRN examination. - Answer>> D. CCRN® is a specialty certification for nurses who provide the majority of their direct care to acutely ill or critically ill adult patients. Certification affirms eligibility to take the examination and successful testing. 3. The strategy developed by the airline industry to improve communication and safety is: A. Ask-Tell-Ask B. Crew resource management C. Situation, background, assessment, and recommendation (SBAR) D. Teachback - Answer>> B. Crew resource management is psychological training used in the airline industry to assist crew members in avoiding or mitigating threats by developing, communicating, and implementing an action plan after identifying potential and existing threats. 4. Communication, collaboration, and respect are exhibited in: A. Burnout B. Compassion fatigue C. Healthy work environments D. Incivility - Answer>> C. The AACN defines a healthy work environment as integrating the following six standards to achieve improved patient, nurse, and family outcomes: skilled communication, true collaboration, appropriate staffing, meaningful recognition, effective decision making, and authentic leadership. 1. Which of the following is associated with an increase in perceptual disturbances such as hallucinations, especially in older adults? A. Music therapy B. Scheduled rest periods C. Communication by family members D. The frequent sound of bedside alarms - Answer>> 1. B. Perceptual disturbances may occur secondary to frequent vital signs and procedures, noise, and an unfamiliar environment. 2. Which of the following statements is true regarding the sedated or unconscious patient? increased heart rate. The patient has orders for IV pain medication, but the nurse is concerned that the medication may affect the patient's breathing and hasten death. What is the appropriate action to take? A. Hold the medication and inform the patient's family that giving pain medication can lead to the patient's death and that this would be considered euthanasia. B. Inform the patient's family that the patient most likely cannot feel pain because the patient is so close to death. C. The patient is suffering; administer the IV pain medication to hasten death. D. Administer the IV pain medication as ordered, with the intent to relieve pain. - Answer>> 4. D. This is an example of the doctrine of double effect. It is ethically acceptable for a nurse to titrate medication to relieve suffering even if the medication causes the patient to stop breathing. 1. What are two significant considerations when a patient's heart rate increases, manifesting with symptoms? A. Venous return diminishes and cardiac filling increases B. Venous return increases and cardiac filling decreases C. Ventricular filling decreases and coronary perfusion is reduced D. Ventricular filling increases and coronary perfusion is increased - Answer>> 1. C. The R-R interval shortens, reducing ventricular filling time (this occurs during ventricular diastole) and also reducing coronary artery perfusion (which also occurs during ventricular diastole). 2. You are asked to look at a patient's rhythm strip and notice that there are no P waves in the rhythm. Your understanding of the rhythm is that the patient may have: A. Sinus rhythm B. Sinus arrhythmia C. Junctional rhythm D. Premature atrial contractions - Answer>> 2. C. Not visualizing any P waves rules out sinus rhythm, sinus arrhythmia, and premature atrial contractions, as all three of these rhythms contain P waves. The term sinus means that there is a P wave. In addition, the term atrial connotates that there is likely to be a P wave. Therefore the most likely correct answer is junctional rhythm. 3. The patient's cardiac monitor is alarming. The heart rate is 200 beats/min, and the QRS complex is very narrow. The patient states that he feels lightheaded and his BP is 80/40 mm Hg. You understand that your priority is to: A. Continue to observe the patient B. Anticipate assisting to administer adenosine C. Get a complete set of vital signs D. Assess if it is time to change the IV access site - Answer>> 3. B. The patient is symptomatic, evidenced by his complaint of feeling lightheaded and low blood pressure. Emergency interventions include administering adenosine, so anticipating the need to assist with this intervention is the first priority. 1. What treatment might you anticipate for an increased right atrial pressure (RAP)? A. Blood transfusion B. Diuretics C. Vasopressors D. Coughing and deep breathing - Answer>> 1. B. An increased RAP is synonymous with too much fluid; thus the best treatment is to decrease fluid by administering diuretics ordered by a provider. 2. Pulmonary artery catheters are used primarily to assess: A. Left ventricular function B. Pulmonary function C. Right atrial function D. Right ventricular function - Answer>> 2. A. The distal tip of the pulmonary artery catheter is positioned to obtain pulmonary artery pressures. These pressures reflect left ventricular function. 3. An increase in pulse pressure variation (PPV) of ____ indicates that the patient will likely respond to fluid resuscitation. A. 2% B. 5% C. 8% D. 10% - Answer>> 3. D. A positive response to fluids has been observed when the PPV is 10% or higher in most patients who are in normal sinus rhythm, are intubated on mechanical ventilation without spontaneous respirations, and have no alterations in chest wall compliance. 1. Endotracheal tube (ETT) placement can be confirmed by all of the following except: A. ETCO2 detector color change B. Auscultating breath sounds over the epigastrium and lung fields C. Fiberoptic bronchoscopy through the ETT to visualize the carina D. Chest x-ray - Answer>> 1. A. Objective verification of correct placement of the endotracheal tube (ETT) in the trachea (versus incorrect placement in the esophagus) is imperative and is performed through clinical assessment and confirmation devices. Clinical assessment includes auscultating the epigastrium and lung fields and observing for bilateral chest expansion. Devices to thermoregulation. These reactions result in hypotension, bradycardia, and warm, dry skin. 1. The left atrium receives oxygenated blood from which vessel? A. Pulmonary artery B. Pulmonary vein C. Right ventricle D. Superior vena cava - Answer>> 1. B. After blood has been oxygenated in the lungs, newly oxygenated blood flows from the pulmonary vein to the left atrium. 2. When assessing chest pain using the PQRST mnemonic, the P refers to which of the following? A. Place B. Pressure C. Prevention D. Provocation - Answer>> 2. D. P stands for Provocation. Q stands for Quality, R for Region and Radiation, S for Severity, and T for Timing and Treatment. 3. Which of the following is considered a normal left ventricular ejection fraction (LVEF)? A. 30% B. 40% C. 50% D. 60% - Answer>> 3. D. The LVEF is the percentage of blood ejected from the left ventricle during systole, normally 55% to 60%. 4. Which of following types of angina is associated with ST- segment elevation? A. Exercise-induced B. Prinzmetal's C. Smoking-induced D. Stable - Answer>> 4. B. Variant, or Prinzmetal's, angina is caused by coronary artery spasms. It often occurs at rest and without other precipitating factors. The electrocardiogram (ECG) shows a marked ST elevation (usually seen only in acute myocardial infarction [AMI]) during the episode. 5. Which of the following treatments is done in conjunction with an angioplasty procedure to facilitate long-term patency of the vessel? A. Coronary artery bypass B. Insertion of a stent C. Thrombectomy D. Thrombolysis - Answer>> 5. B. Placement of bare metal stents or drug-eluting stents is common during angioplasty to maintain patency of the vessel. 6. What does HFrEF refer to? A. Heart failure that is compensated B. Heart failure with preserved ejection fraction C. Heart failure with reduced ejection fraction D. Heart failure with refractory ejection fraction - Answer>> 6. C. HFrEF refers to heart failure with reduced ejection fraction. 1. The Berlin criteria for acute respiratory distress syndrome (ARDS) include: A. Acute onset within 1 week after clinical insult B. Bilateral pulmonary opacities not explained by other conditions C. Altered partial pressure of arterial oxygen/fraction of inspired oxygen (PaO2/FiO2) ratio D. All the above - Answer>> 1. D. All of the above are components of the Berlin definition of ARDS. In particular, the PaO2/FiO2 ratio determines the severity of ARDS. 2. Lung-protective ventilation strategies include: A. Tidal volume (VT) calculated according to current patient weight B. VT at 4 to 8 mL/kg predicted ideal body weight C. Consistent use of 100% fraction of inspired oxygen (FiO2) D. Positive end-expiratory pressure (PEEP) levels of 30 cm H20 for 8 hours each day - Answer>> 2. B. Lower tidal volumes are an evidence-based method for preventing ventilator-induced lung injury. 3. Possible treatments for acute respiratory failure (ARF) in the patient with chronic obstructive pulmonary disease (COPD) include: A. Noninvasive ventilation B. Bronchodilators C. Corticosteroids D. All the above - Answer>> 3. D. All of the above are methods for treating ARF in COPD. Early treatment with noninvasive ventilation has been found to decrease mortality. Bronchodilators can decrease airway resistance, and corticosteroids can decrease inflammation and edema, improving lung function. 4. Evidence-based interventions for the prevention of ventilator- associated pneumonia (VAP) include: A. Head of bed (HOB) flat with patient supine B. Readiness-to-wean trials every other day C. Regular antiseptic oral care