CCRN- Critical Care Registered Nurse | 2024/2025 Test Bank| Completely Answered, Exams of Nursing

Download CCRN- Critical Care Registered Nurse | 2024/2025 Test Bank| Completely Answered and more Exams Nursing in PDF only on Docsity! CCRN- CRITICAL CARE REGISTERED NURSE | 2024/2025 TEST BANK CCRN- Critical Care Registered Nurse | 2024/2025 Test Bank| Completely Answered 100% Correct/Verified/ Guarantee pass A 76-Year-Old Man Is Admitted With Complaints Of Sudden, Sharp, "Tearing" Chest Pain Radiating To The Shoulders, Neck, And Back. He Has Been In Apparent Good Health Except For A History Of Hypertension. Vital Signs Are Blood Pressure, 180/96 Mm Hg; Heart Rate, 90 Beats/Min; And Respiratory Rate, 26 Breaths/Min. He Is Dyspneic, And His Electrocardiogram Shows Nonspecific ST-T Wave Changes. Which Of The Following Would Not Be An Important Aspect Of Care For This Patient? A. Control His Blood Pressure. B. Provide Adequate Analgesia. C. INITIATE FIBRINOLYTIC THERAPY. D. Prepare The Patient For Surgery. Fibrinolytic Therapy Is Contraindicated If Dissecting Thoracic Aortic Aneurysm Is Suspected. All Of The Other Interventions Are Appropriate. Which Of The Following Interventions Would Be Helpful In Prevention Of Aspiration In A Patient Receiving Enteral Feedings? A. Check For Gastric Residuals Every 4 Hours. B. USE A SMALL-BORE DUODENAL FEEDING TUBE. C. Use A High-Fat Feeding. D. Add Blue Food Coloring To The Enteral Feeding. A Tube That Is Placed Below The Pylorus Would Decrease The Risk Of Aspiration Which Of The Following Would Not Cause An Elevated Creatine Kinase-Muscle/Brain (CK-MB)? CCRN- CRITICAL CARE REGISTERED NURSE | 2024/2025 TEST BANK A. Myocarditis B. HEART FAILURE C. Myocardial Infarction D. Post cardiotomy Any Injury To The Myocardium Would Cause Elevation Of Cardiac Isoenzymes. Myocarditis, Myocardial Infarction, And Cardiotomy Cause Injury To The Myocardium. The Ability Of The Brain Contents To Be Shifted To Prevent Intracranial Hypertension When Intracranial Volume Increases Is Referred To As: A. COMPENSATION. B. Autoregulation. C. Normalization. D. Feedback. Remember The Difference Between Compensation And Autoregulation. Compensation Relates To Intracranial Volumes And Resultant Pressure. Autoregulation Relates To The Ability Of The Cerebral Vessels To Change Size To Normalize Blood Flow Which Of The Following Is Not A Therapeutic Effect Of Nifedipine When Used For Angina? A. Decreased Preload. B. Decreased Afterload. C. DECREASED CONTRACTILITY. D. Relieve Vasospasm. Nifedipine Decreases Myocardial Oxygen Consumption By Dilating Veins And Arteries, Thereby Decreasing Preload And Afterload. Nifedipine Also Decreases Vasospasm And Potential For Vasospasm. Unlike Diltiazem And Verapamil, Nifedipine Does Not Significantly Decrease Contractility. Emergency Decompression Of A Tension Pneumothorax Includes Needle Puncture At Which Of The Following Locations? CCRN- CRITICAL CARE REGISTERED NURSE | 2024/2025 TEST BANK Which Of The Following Would Be The Earliest Auscultatory Finding In Left Ventricular Failure (LVF)? A. Crackles B. S3 C. Murmur Of Mitral Regurgitation D. Pericardial Friction Rub LVF Would Be The Most Subtle Because Early Changes Are Usually Subtle Changes. Choose "S3." A Patient With A Triple-Lumen Subclavian Catheter Has Been Receiving Total Parenteral Nutrition, Maintenance Fluids, And Antibiotics By The Catheter. He Has Been Slightly Confused. Suddenly He Grasps The Catheter And Pulls It Out. He Then Complains Of Shortness Of Breath, And His Pulse Oximetry Indicates An Spo2 Of 84%. How Should This Patient Be Positioned? A. HEAD DOWN, LEFT SIDE B. Head Down, Right Side C. Head Of Bed Elevated, Left Side D. Head Of Bed Elevated, Right Side Envision A Big Air Bubble In The Patient's Heart. Think: What Position Would Decrease The Movement Of The Air Embolism Out Of The Right Side Of The Heart. Chose "Head Down, Left Side." Oxygen Delivery (DO2) Is The Product Of Which Of The Following? A. Pao2, Hemoglobin, Mean Arterial Pressure B. Sao2, Hemoglobin, Cardiac Output C. Svo2, Cardiac Index, Sao2 D. Pao2, Mean Arterial Pressure, Svo2 [Correct Ans Is: - B. Sao2, Hemoglobin, Cardiac Output Oxygen Is Delivered From The Arterial End, So Choose An Option That Has Sao2 CCRN- CRITICAL CARE REGISTERED NURSE | 2024/2025 TEST BANK Which Of The Following Is The Most Significant Complication Of Status Asthmaticus? A. Pulmonary Embolism B. Acute Respiratory Failure C. Hypertension D. Anaphylaxis [Correct Ans Is: - B. Acute Respiratory Failure A 22-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 He Is Now Alert And Oriented. Skull Films Show A Linear Fracture Of The Right Temporal Bone. He Is At Significant Risk For: A. Scalp Hematoma. B. Subdural Hematoma. C. Epidural Hematoma. D. Intracerebral Hematoma. [Correct Ans Is: - C. Epidural Hematoma. Linear Fractures Of The Temporal Bone Frequently Disrupt The Middle Meningeal Artery And Cause Epidural Hematoma. Patients With An Epidural Hematoma Classically Present With A Short Period Of Unconsciousness Followed By A Lucid Interval And Then Rapid Deterioration. An Epidural Hematoma Is Usually Caused By Arterial Bleeding. CCRN- CRITICAL CARE REGISTERED NURSE | 2024/2025 TEST BANK A Patient Is Admitted To The ICU After Sustaining A Concussion And Blunt Abdominal Trauma To The Right Upper Quadrant In A Domestic Dispute. The Patient's Vital Signs Are BP 145/86 Mm Hg, Pulse 86 Beats/Min, Respiration 15 Breaths/Min, And Temperature 98.8° F. The Nurse Is Monitoring The Patient's Bowel Sounds, Abdominal Tenderness, And Abdominal Girth Frequently. Which Of The Following Laboratory Parameters Is Especially Important For The Nurse To Closely Monitor For Bleeding In This Patient? A. Platelet Count B. Protime C. Hematocrit D. Mean Corpuscular Volume [Correct Ans Is: - C. Hematocrit Common Injuries Resulting From Blunt Abdominal Trauma Can Include Injury To The Liver, Spleen, Mesenteric Vessels, Pancreas, Or Kidneys. In A Nonoperative Approach To Blunt Abdominal Trauma, Observation And Monitoring Include Serial Hematocrits To Evaluate For Intra-Abdominal Bleeding. The Platelet Count Does Not Fluctuate Unless There Is A Disease Process (E.G. Cirrhosis, Leukemia) Or Significant Blood Loss. Protime Is A Monitor Of Coagulation Status And Can Be Prolonged Without Active Bleeding. Mean Corpuscular Volume Measures The Average Volume Or Size Of A Single RBC And Is Used In Classifying Anemias. Which Of The Following Is Associated With Chest Pain, Confusion, And Petechiae? A. Dissecting Aneurysm B. Fat Embolism C. Pneumothorax CCRN- CRITICAL CARE REGISTERED NURSE | 2024/2025 TEST BANK Opposite Of A Normal Physiologic Split Of S2, Which Is Split On Inspiration But Not Split On Expiration Which Of The Following Is Not An Indication For Mechanical Ventilation In Patients With Asthma? A. Respiratory Alkalosis B. Cardiopulmonary Arrest C. Respiratory Muscle Fatigue D. Hypercapnia And Respiratory Acidosis [Correct Ans Is: - A. Respiratory Alkalosis Respiratory Alkalosis Is Seen Early In Asthma Because Of Hyperventilation. A Patient Exhibiting Nystagmus, Ataxia, Unsteady Gait, And Problems With Rapid, Alternating Movements Probably Has A Lesion In The: A. Frontal Lobe. B. Pituitary Gland. C. Cerebellum. D. Brainstem. [Correct Ans Is: - C. Cerebellum The Pituitary Is An Endocrine Gland That Controls Release Of Hormones Within The Body, So Eliminate "Pituitary Gland." The Brainstem Contains The Cardiac And Respiratory Centers, Temperature, And Other Basic Drives, So Eliminate "Brainstem." The Frontal Lobe Controls Voluntary Motor Function And Behavior, So Eliminate "Frontal Lobe." The Cerebellum Controls Balance And Coordination. Associate Bellum With Ballerina, Who Must Balance To Dance. Choose "Cerebellum." CCRN- CRITICAL CARE REGISTERED NURSE | 2024/2025 TEST BANK Which Route Would Be Preferred For The Rapid Administration Of Fluids In Hypovolemic Shock? A. Central Venous Catheter B. Large-Gauge, Short Peripheral Catheter C. Needle Inserted Into Saline Lock D. Large-Gauge, Long Peripheral Catheter [Correct Ans Is: - B. Large-Gauge, Short Peripheral Catheter The Most Rapid Administration Of Fluids Is Achieved Through A Large-Gauge, Short Catheter. Central Venous Catheters Are Long And, If Multiple-Lumen, Each Lumen May Be Smaller Gauge Than Large-Gauge Peripheral Catheters. Large-Gauge, Long Peripheral Catheters, Including Peripherally Inserted Central Catheters, Would Be Slower Than A Short Peripheral Catheter. A Patient Received Humulin NPH Insulin At 7 Am. He Was Nauseated And Vomiting At Lunchtime And Cannot Tolerate PO. If This Patient Develops Manifestations Of Hypoglycemia, Treatment Would Include: A. 25 Ml Of 50% Dextrose In Water (D50W). B. Glucagon Subcutaneously. C. 4 Oz Of Apple Juice. D. 100 Ml Of 5% Dextrose In Water (D5W). [Correct Ans Is: - A. 25 Ml Of 50% Dextrose In Water (D50W). CCRN- CRITICAL CARE REGISTERED NURSE | 2024/2025 TEST BANK A Volume Of 25 Ml Of D50W Would Provide 12.5 G Of Carbohydrate And 50 Calories. A Patient Is Being Treated For Hypertrophic Cardiomyopathy. Which Of The Following Drugs Would Be Contraindicated For This Patient? A. Nitroprusside B. Propranolol C. Verapamil D. Digoxin [Correct Ans Is: - D. Digoxin Remember That With Hypertrophic Cardiomyopathy, It Is Desirable To Decrease Contractility And Afterload; It Is Not Desirable To Increase Contractility Or Decrease Preload. How Would A Pneumothorax Appear On Chest X-Ray Film? A. Less Radiolucent Than Normal Lung B. Less Radiopaque Than Normal Lung C. More Radiopaque Than Normal Lung D. More Radiolucent Than Normal Lung [Correct Ans Is: - D. More Radiolucent Than Normal Lung The Pleura Is Not Visible On A Normal Chest Radiograph, But In A Pneumothorax, The Visceral Pleura Is Displaced From The Parietal Pleura By Air In The Pleural Space. No Lung Markings Can Be Seen In This Area, And It Is Darker Than The Lung. CCRN- CRITICAL CARE REGISTERED NURSE | 2024/2025 TEST BANK C. A Hypertonic Crystalloid D. A Colloid [Correct Ans Is: - A. An Isotonic Crystalloid In This Situation, The Intravascular And The Interstitial Spaces Would Be Depleted. The Priority Is The Intravascular Space, Which Would Be Replaced Best With Isotonic Solution. Because Isotonic Fluids Equilibrate Across All Spaces, The Interstitial Space Also Would Be Replaced. Consider: What Did The Patient Lose? Crystalloid And Electrolyte. Then Ask: Which Crystalloid Would Replace The Intravascular And Interstitial Spaces? An Isotonic Crystalloid. Electrolytes Would Be Added. A 28-Year-Old Man Is Admitted With Bowel Perforation. His Blood Pressure Is 92/64 Mm Hg, Heart Rate Is 116 Beats/Min And Regular, Respiratory Rate Is 22 Breaths/Min And Regular, And Urine Output Has Only Been 20 Ml Since Being Admitted 3 Hours Ago. Mucous Membranes Are Dry, And There Is Poor Skin Turgor. Based On This Information, You Would Expect His Pulmonary Artery Occlusive Pressure To Be: A. 4 Mm Hg. B. 8 Mm Hg. C. 12 Mm Hg. D. 16 Mm Hg. [Correct Ans Is: - A. 4 Mm Hg. This Assessment Reveals Dehydration (Hypotension, Tachycardia, Oliguria, Dry Mucous Membranes, And Poor Skin Turgor). A Pulmonary Artery Occlusive Pressure (PAOP) Of 4 Mm Hg Would Correlate With The Physical Assessment. Normal PAOP Is 12 To 15 Mm Hg. Clinical Indications Of Dehydration Are Present In The Case Study. Choose The Value Below Normal. Choose 4 Mm Hg. CCRN- CRITICAL CARE REGISTERED NURSE | 2024/2025 TEST BANK A Patient With Acute Kidney Injury Has The Following Arterial Blood Gas Results: Ph7.32Paco235 Mm Hghco318 Meq/L This Acid-Base Imbalance Is The Result Of The Inability Of The Kidney To: A. Excrete Acid By-Products Of Metabolism. B. Excrete Carbon Dioxide. C. Excrete Bicarbonate Ions. D. Excrete Calcium Ions. [Correct Ans Is: - A. Excrete Acid By-Products Of Metabolism. The Patient Has A Metabolic Acidosis Because The Kidneys Are Unable To Excrete The Acid By-Products Of Cellular Metabolism. A 42-Year-Old Woman Is Admitted With Myasthenic Crisis After A Viral Illness. Which Of The Following Are Characteristics Of Myasthenia Gravis? A. It Causes Muscle Weakness And Fatigability. B. It Is Associated With Demyelination Of Peripheral Nerve Fibers. C. It Affects The Nerve Roots. D. It May Result In Adrenergic Crisis. [Correct Ans Is: - A. It Causes Muscle Weakness And Fatigability. CCRN- CRITICAL CARE REGISTERED NURSE | 2024/2025 TEST BANK Myasthenia Gravis Is A Disorder Of Voluntary Muscles Caused By A Defect In Nerve Impulse Transmission At The Neuromuscular Junction. It Causes Muscle Weakness And Fatigability. A 42-Year-Old Man Is Admitted To The Critical Care Unit With Smoke Inhalation And Acute Respiratory Distress Syndrome (ARDS). He Is Intubated, And The Following Mechanical Ventilation Is Initiated: Fraction Of Inspired Oxygen, 0.6; Intermittent Mandatory Ventilation, 10 Breaths/Min; Tidal Volume, 450 Ml; Positive End-Expiratory Pressure (PEEP), 15 Cm H2O. Arterial Blood Gases Are Ph, 7.39; Paco2, 42 Mm Hg; HCO3, 24 Meq/L; And Pao2, 70 Mm Hg. The Purpose Of Using PEEP In The Treatment Of This Patient Is Which Of The Following? A. Increase Pulmonary Compliance. B. Decrease The Chance Of Barotrauma. C. Increase Alveolar Surface Tension. D. Decrease Intrapulmonary Shunt. [Correct Ans Is: - D. Decrease Intrapulmonary Shunt. PEEP Has Three Primary Purposes: To Increase The Driving Pressure Of Oxygen, To Decrease Surface Tension And The Work Of Breathing, And To Decrease Shunt By Reopening Collapsed Alveoli. In ARDS, The Purpose Of PEEP Is To Open Alveoli That Have Collapsed (Called Alveolar Recruitment) And To Keep Alveoli Open That Are Still Open. The Effect Of This Action Is To Decrease Intrapulmonary Shunt. Which Ventilator Mode Requires Close Monitoring For Auto-PEEP (Positive End- Expiratory Pressure)? A. Intermittent Mandatory Ventilation B. Pressure Support Ventilation C. Pressure-Controlled Inverse Ratio Ventilation CCRN- CRITICAL CARE REGISTERED NURSE | 2024/2025 TEST BANK A. 50 Mm Hg. B. 60 Mm Hg. C. 70 Mm Hg. D. 80 Mm Hg. [Correct Ans Is: - D. 80 Mm Hg. If The Radial Artery Can Be Palpated, The Systolic BP Is At Least 80 Mm Hg. If The Brachial Artery Can Be Palpated, The Systolic BP Is At Least 70 Mm Hg. If Only The Carotid Artery Can Be Palpated, The Systolic BP Is Approximately 60 Mm Hg. Your Patient Has An Increase In Venous Oxygen Saturation (Svo2) Along With A Decrease In Oxygen Consumption (VO2) And Ph. What Do You Suspect? A. Early Septic Shock B. Cardiogenic Shock C. Hemorrhagic Shock D. Anaphylactic Shock [Correct Ans Is: - A. Early Septic Shock In The Early Or Hyperdynamic Phase Of Septic Shock, Oxygen Delivery (DO2) Is Increased But The Tissues Cannot Extract And Use The Oxygen, So VO2 Is Decreased And Svo2 Is Increased. Lactic Acidosis Occurs Because The Cells Are Hypoxic. In Multiple Organ Dysfunction Syndrome (MODS), Clinical Indications Of Respiratory Failure Include: CCRN- CRITICAL CARE REGISTERED NURSE | 2024/2025 TEST BANK A. Increased Ph. B. Increased Paco2. C. Pao2/Fio2 (Fraction Of Inspired Oxygen) Ratio Of Greater Than 300 Mm Hg. D. Narrow A:A Gradient. [Correct Ans Is: - B. Increased Paco2. Hypoventilation Would Cause The Paco2 To Increase. A 52-Year-Old Patient With A History Of Alcoholism Is Admitted With Massive Esophageal Bleeding. Which Of The Following Would Be An Indication For The Administration Of Blood In This Patient? A. Hemoglobin Less Than 10 G/Dl B. Hematocrit Less Than 30% C. Inability To Control Bleeding Via Endoscopic Sclerosing Therapy D. Symptoms Of Hypoperfusion Such As Chest Pain Or Dyspnea [Correct Ans Is: - D. Symptoms Of Hypoperfusion Such As Chest Pain Or Dyspnea Clinical Indications Of Hypoperfusion Such As Chest Pain, Dyspnea, Or Hypotension Are Indications That Blood Should Be Administered. Absolute Hemoglobin Or Hematocrit Levels Are No Longer Indications Because Of The Risk Of Blood- Transmitted Diseases. Inability To Control Bleeding Is An Indication For Surgery. Which Of The Following Are The Major Sources Of Intracranial Hypertension After Craniocerebral Trauma? A. CCRN- CRITICAL CARE REGISTERED NURSE | 2024/2025 TEST BANK Cerebral Edema And Expanding Lesions B. Hypervolemia And Hyperthermia C. Hypovolemia And Hypothermia D. Hydrocephalous And Infection [Correct Ans Is: - A. Cerebral Edema And Expanding Lesions Cerebral Edema And Expanding Lesions (E.G., Hematoma) Are The Two Major Sources Of Increased Intracranial Pressure. A Patient Received One Unit Of Packed Cells. Which Of The Following Would Be The Expected Effects Of The Transfusion? A. Increase In Hemoglobin By 0.5 G/Dl And Increase In Hematocrit By 2% B. Increase In Hemoglobin By 0.5 G/Dl And Increase In Platelets By 50,000/Mm3 C. Increase In Hemoglobin By 1 G/Dl And Increase In Hematocrit By 3% D. Increase In Hemoglobin By 1 G/Dl And Increase In Platelets By 50,000/Mm3 [Correct Ans Is: - C. Increase In Hemoglobin By 1 G/Dl And Increase In Hematocrit By 3% One Unit Of Packed Red Blood Cells Should Increase The Hemoglobin By 1 G/Dl And Hematocrit By 3% Within Approximately 4 To 6 Hours. Red Blood Cells Do Not Provide Platelets. A 20-Mm S Wave In Lead V1 And A 25-Mm R Wave In Lead V6 Are Noted On A Patient's 12-Lead Electrocardiogram. This Would Indicate Which Of The Following? A. Right Bundle Branch Block (RBBB) CCRN- CRITICAL CARE REGISTERED NURSE | 2024/2025 TEST BANK One Hundred Percent (Or As Close As Can Be Achieved) Oxygen Should Be Used In Cardiopulmonary Arrest. There Is No Contraindication To 100% Oxygen In Cardiopulmonary Arrest. A 65-Year-Old Man Is Admitted To The Critical Care Unit With A Diagnosis Of Septic Shock. He Has Been Receiving Chemotherapy For Lung Cancer. His Skin Is Warm And Dry, And He Is Restless. His White Blood Cell Count Is Elevated Above Normal. Hemoglobin, Hematocrit, And Red Blood Cell Count Are Normal. Vital Signs Are Blood Pressure 80/50 Mm Hg, Heart Rate 120 Beats/Min And Regular, Respiratory Rate 32 Breaths/Min And Regular, And Temperature 39° C. Arterial Blood Gases Reveal The Following: Ph7.25pao260 Mm Hgpaco225 Mm Hghco313 Meq/Loxygen Saturation86% Dobutamine Is Started At 10 Mcg/Kg/Min. Normal Saline Is Infusing At 150 Ml/Hr. Which Of The Following Would Be Most Indicative Of Improvement In This Patient? A. Increase In Venous Oxygen Saturation (Svo2) B. Decrease In Arterial Lactate C. Increase In Cardiac Output D. Increase In Urine Output [Correct Ans Is: - B. Decrease In Arterial Lactate Associate Lactate With Lactic Acid. You Know That A Decrease In Lactic Acid Would Indicate Less Anaerobic Metabolism. Adequate Oxygen Extraction And Aerobic Metabolism Would Decrease The Lactic Acid Level. The Physician Has Prescribed Mannitol For A Patient With Intracranial Hypertension. Which Of The Following Is An Important Consideration When Administering Mannitol? CCRN- CRITICAL CARE REGISTERED NURSE | 2024/2025 TEST BANK A. The Drug Must Be Protected From Light. B. The Drug Must Be Administered Through An In-Line Filter. C. The Drug Must Be Administered Into A Central Venous Catheter. D. The Drug Must Be Refrigerated. [Correct Ans Is: - B. The Drug Must Be Administered Through An In-Line Filter. If A Patient With A Normal Ph And Temperature Has A Pao2 Of 60 Mm Hg, His Arterial Oxygen Saturation (Sao2) Is Closest To Which Of The Following Values? A. 75% B. 90% C. 95% D. 99% [Correct Ans Is: - B. 90% One Way To Remember This Is To Consider What Level Concerns You. At An Sao2 Of Less Than 90%, We Get Concerned Because We Are No Longer On The Horizontal End Of The Oxyhemoglobin Dissociation Curve. This Means That There Will Be Significant Desaturation For Every Drop In The Pao2 Of Even 1 Mm Hg Because We Are On The Vertical Limb Of The Curve. Note How Significantly The Saturation Dropped Between The Pao2 Of 60 Mm Hg And 40 Mm Hg. A Patient Had A Craniotomy 2 Days Ago For Removal Of A Tumor. He Is Awake And Talking To The Nurse And Demonstrates No Neurologic Deficit. Blood Pressure Is 110/80 Mm Hg, Pulse Is 92 Beats/Min, And Respiratory Rate Is 22 Breaths/Min. Urine Outputs Have Been Approximately 60 Ml/Hr Over The Last 2 Days, But He Has Had A Recent Change. He Has Had 300 To 400 Ml/Hr Of Urine Output Over The Last Several Hours. The Urine Has A Specific Gravity Of 1.002. The Nurse Checks His Serum Glucose And Finds That It Is 100 Mg/Dl. The Intravenous Solution Most Appropriate For Fluid Replacement Would Be: CCRN- CRITICAL CARE REGISTERED NURSE | 2024/2025 TEST BANK A. 5% Dextrose In Water (D5W). B. Normal Saline. C. Lactated Ringer Solution. D. 10% Dextrose In Water (D10W). [Correct Ans Is: - A. 5% Dextrose In Water (D5W). D5W Is An Isotonic Solution While In The Bottle, But When It Is Administered, The Dextrose Is Quickly Metabolized, Leaving Free Water. The Patient In This Case Has Indications Of Diabetes Insipidus. Patients With Diabetes Insipidus Lose More Water Than Sodium, And They Need To Be Treated With More Water Than Sodium. Saline And Lactated Ringer Solution Would Contribute To The Hypernatremia. D10W Could Cause A Hypertonic Diuresis. The Primary Result Of Carbon Monoxide Poisoning Is: A. Hypoxia. B. Hypercapnia. C. Hypertension. D. Metabolic Acidosis. [Correct Ans Is: - A. Hypoxia A Patient With Myasthenia Gravis Develops Hypoxemia With Hypercapnia. What Is The Cause Of Hypoxemia In This Patient? A. Alveolar Hypoventilation CCRN- CRITICAL CARE REGISTERED NURSE | 2024/2025 TEST BANK Electrocardiogram B. Echocardiogram C. Thoracic Aortogram D. Transesophageal Echocardiogram [Correct Ans Is: - C. Thoracic Aortogram A 40-Year-Old Patient Has Been Admitted To The Critical Care Unit After Sustaining Multiple Injuries From A Cave-In Accident This Morning. X-Ray Films Confirm Multiple Fractures, Including The Left Femur. During The Afternoon, He Was Taken To Surgery For Internal Fixation Of The Left Femur. It Is Now 10 Pm, And The Patient Is Complaining Of Severe Throbbing Pain In His Thigh. The Patient Received 5 Mg Of Morphine Sulfate IV 30 Min Ago. The Anterior Left Thigh Is Firm To Touch, And The Pain Increases When The Patient Flexes His Left Leg. Further Assessment Reveals That Swelling Extends To The Knee, And Popliteal, Posterior Tibial, And Dorsalis Pedis Pulses Are Not Palpable. What Should Be Done Next? A. Call The Physician And Prepare For Fasciotomy. B. Check Pulses With A Doppler Stethoscope. C. Call The Physician And Prepare For Embolectomy. D. Check For Homans Sign. [Correct Ans Is: - B. Check Pulses With A Doppler Stethoscope. There Appears To Be An Arterial Occlusion, But Before Deciding To Prepare For Surgical Procedures, The Nurse Should Complete The Assessment By Using A Doppler Stethoscope To See Whether Pulses Are Audible. Swelling Makes It Difficult To Palpate Pulses, But The Pulses Will Be Audible With A Doppler Stethoscope If Present. Homans Sign Is A Sign Of Venous Obstruction Or Phlebitis, Which Would Not Cause A Loss Of Arterial Pulses. A 50-Year-Old Patient Is Transferred To The Critical Care Unit From The Emergency Department. A Rattlesnake Bit Him Approximately 6 Hours Ago. He Is Having A CCRN- CRITICAL CARE REGISTERED NURSE | 2024/2025 TEST BANK Severe Reaction To The Venom, And Antivenom Is Being Flown To The Hospital. The Patient Is Bleeding From His IV Insertion Sites And Continues To Seep Blood From The Wound. Treatment For Disseminated Intravascular Coagulation In This Particular Case Would Include Which Of The Following? A. Clotting Factors And Antivenom B. Clotting Factors And Heparin C. IV Fluids And Antivenom D. IV Fluids And Heparin [Correct Ans Is: - A. Clotting Factors And Antivenom A 22-Year-Old Man Is Admitted After A Bicycle Collision With A Tree. He Has A Contusion On The Right Side Of His Head. An Intraventricular Catheter Has Been Inserted Via A Burr Hole To Monitor His Intracranial Pressure (ICP). He Develops Respiratory Depression And Is Intubated And Mechanically Ventilated. Which Of The Following Is The Most Likely Cause Of An Increase In ICP At This Time? A. Positive Pressure Ventilation B. Hypocapnia Caused By Hyperventilation C. Sedation D. Cerebral Dehydration Caused By Osmotic Diuretics [Correct Ans Is: - A. Positive Pressure Ventilation Positive Pressure Ventilation Increases Intrathoracic Pressure, Which Leads To Increased ICP. A 24-Year-Old Man Is Admitted To The Critical Care Unit After Sustaining A Pulmonary Contusion In A Motor Vehicle Collision. He Has No History Of Cardiac Or Pulmonary Disease. During The First 24 Hours After Admission, He Has Been CCRN- CRITICAL CARE REGISTERED NURSE | 2024/2025 TEST BANK Complaining Of Increasing Dyspnea, His Respiratory Rate Has Been Increasing, And His Oxygen Saturation Via Pulse Oximetry Has Been Decreasing Despite Supplemental Oxygen. Breath Sound Assessment Reveals Fine Crackles Bilaterally. Arterial Blood Gases Reveal Respiratory Alkalosis And Hypoxemia. Chest X-Ray Film Reveals Patchy Infiltrates. Acute Respiratory Distress Syndrome Is Diagnosed. Oxygen Therapy Is Initiated, And Arterial Blood Gases Are Monitored Closely, But Sao2 Continues To Fall. Which Of These Oxygen Delivery Systems Will Provide The Highest Concentration Of Oxygen And Indicated In This Case? A. Face Tent B. Nonrebreathing Mask C. Nasal Cannula D. Venturi Mask [Correct Ans Is: - B. Nonrebreathing Mask The Nonrebreathing Mask Stores Oxygen In Nose, Pharynx, Mask, And Reservoir Bag Between Breaths. This Allows A Concentration Of Close To 100%. A 22-Year-Old Man Is Admitted With Spontaneous Pneumothorax. He Is Extremely Dyspneic And Anxious. He Also Is Complaining Of Tingling Around His Mouth And His Fingertips And Feeling Light-Headed. Blood Pressure Is 120/82 Mm Hg, Heart Rate Is 110 Beats/Min, Respiratory Rate Is 36 Breaths/Min And Deep, And Temperature Is 37° C (98.6° F). Which Of The Following Would Not Be Used To Treat This Condition? A. Calcium B. Chest Tube C. Analgesia D. Calming The Patient [Correct Ans Is: - A. Calcium CCRN- CRITICAL CARE REGISTERED NURSE | 2024/2025 TEST BANK Chest Tube B. Oxygen Therapy C. Mechanical Ventilation D. Pain Management [Correct Ans Is: - A. Chest Tube Flail Chest Occurs When Two Or More Ribs Are Fractured In Two Or More Locations, There Is A Fractured Sternum, Or There Is A Poorly Healed Sternotomy. Treatment Of Flail Chest Includes Pain Management, Internal Stabilization Using Mechanical Ventilation, And Oxygen To Maintain The Arterial Oxygen Saturation At A Minimum Of 95%. Chest Tubes Are Used For Pneumothorax, Hemothorax, Or Pleural Effusion. Patients With Flail Chest Or Rib Fractures Sometimes May Have A Concurrent Pneumothorax But Flail Chest Alone Is Not An Indication For A Chest Tube. A 54-Year-Old Man Has Just Returned To The Critical Care Unit From The Postanesthesia Care Unit. He Has A 60-Pack-Year History Of Cigarette Smoking And Had A Right Lower Lobectomy Performed Earlier Today For Treatment Of Lung Cancer. He Is Still Intubated And On A Positive Pressure Mechanical Ventilator. The Next Morning A Short-Term Breathing Trial Is Conducted. Spontaneous Ventilatory Parameters And Arterial Blood Gases Are Measured In Preparation For Weaning And Extubation. Which Of The Following Ventilatory Parameters Are Most Indicative Of The Patient's Ability To Cough And Clear His Airways? A. Tidal Volume And Vital Capacity B. Vital Capacity And Negative Inspiratory Pressure C. Tidal Volume And Minute Ventilation D. Minute Ventilation And Maximal Inspiratory Pressure [Correct Ans Is: - B. Vital Capacity And Negative Inspiratory Pressure CCRN- CRITICAL CARE REGISTERED NURSE | 2024/2025 TEST BANK The Patient Must Be Able To Pull Air Into His Lungs To Be Able To Perform A Forcible Cough. Being Able To Pull A Significant Negative (Inspiratory) Pressure And Take A Deep Breath (Vital Capacity) Are Critical In Performing An Effective Cough. A Patient Is Started On Nitroprusside, And His Oxygen Saturation By Pulse Oximetry Decreases To 90%. Arterial Blood Gases Are Drawn, Which Show A Pao2 Of 60 Mm Hg And An Arterial Oxygen Saturation (Sao2) Of 90%. What Is The Mechanism For This Change? A. Methemoglobinemia B. Intrapulmonary Shunt C. Thiocyanate Toxicity D. Coronary Artery Steal [Correct Ans Is: - B. Intrapulmonary Shunt Intrapulmonary Shunt Occurs When Perfusion Exceeds Ventilation. This Can Be Due To Decreased Ventilation Relative To Normal Perfusion (E.G., Acute Respiratory Distress Syndrome) Or Normal Ventilation Relative To Increased Perfusion (E.G., Nitroprusside-Induced Intrapulmonary Shunt). Which Of The Following Are Classic Signs Of Systemic Inflammatory Response Syndrome (SIRS)? A. Hypothermia, Hypotension, And Bradypnea B. Fever, Tachycardia, And Hypotension C. Fever, Tachycardia, And Tachypnea D. Hypothermia, Bradycardia, And Leucopenia [Correct Ans Is: - C. Fever, Tachycardia, And Tachypnea CCRN- CRITICAL CARE REGISTERED NURSE | 2024/2025 TEST BANK A 72-Year-Old Man Arrived In The Emergency Department After 4 Hours Of Substernal Pain Radiating To The Left Arm. He Has A 100 Pack-Year History Of Cigarette Smoking, Chronic Obstructive Pulmonary Disease, And Intermittent Claudication. His Electrocardiogram On Admission Shows Sinus Tachycardia With A Rate Of 120 Beats/Min And ST Segment Elevation In Leads I, AVL, And V3 To V6. Vital Signs Include Blood Pressure, 150/84 Mm Hg; Respiratory Rate, 15 Breaths/Min; Functional Oxygen Saturation (Spo2), 95%; And Temperature, 38.3° C (100.9° F). This Patient Is At Particular Risk For Which Of The Following? A. Sinoatrial (SA) Blocks B. Type I Second-Degree AV Block C. Type II Second-Degree AV Block D. Third-Degree AV Heart Block With Junctional Escape Rhythm [Correct Ans Is: - C. Type II Second-Degree AV Block SA Blocks, Second-Degree AV Block Type I, And Third-Degree AV Heart Block At The Level Of The AV Node Would Occur In Right Coronary Artery Occlusion And Inferior Myocardial Infarction Rather Than In This Example Of Left Coronary Artery Occlusion And Anterolateral Myocardial Infarction. A 70-Year-Old Woman, Weighing 50 Kg, Comes To The Emergency Department Complaining Of Chest Pain And Shortness Of Breath. The Electrocardiogram Monitor Shows Ventricular Tachycardia At A Rate Of 150 Beats/Min. Which Treatment Is Appropriate In This Situation? A. Amiodarone IV B. Verapamil Hcl IV C. Defibrillation Beginning At 200 J D. CCRN- CRITICAL CARE REGISTERED NURSE | 2024/2025 TEST BANK Osteomyelitis B. Rheumatoid Arthritis C. Broken Hip D. Cellulitis [Correct Ans Is: - A. Osteomyelitis This Patient Has A Fever Associated With Redness And Exudate At The Left Hip Area. According To The Volume-Pressure Curve, Initial Small Increases In Intracranial Volume In A Patient With No Brain Pathology Would Have Which Of The Following Effects On Intracranial Pressure (ICP)? A. No Effect B. Small Increase In ICP C. Moderate Increase In ICP D. Profound Increase In ICP [Correct Ans Is: - A. No Effect The Brain Is Normally Compliant And Small Increases In Intracranial Volume Have No Effect On ICP. However, When The Brain Is Injured And Noncompliant, Increases In Volume Result In Increases In Pressure. As The End Of The Volume Pressure- Curve Is Approached, Even Small Increases In Volume Result In Profound Increase In ICP And Resultant Herniation. An Elderly Man Is Admitted After Several Days Of Nausea, Vomiting, And Diarrhea. Which Of The Following Would Be Most Indicative Of Dehydration In This Patient? A. Thirst, Hypotension, Bradycardia CCRN- CRITICAL CARE REGISTERED NURSE | 2024/2025 TEST BANK B. Hypotension, Tachycardia, Oliguria C. Thirst, Tachycardia, Dry Mucous Membranes D. Bradycardia, Dry Mucous Membranes, Oliguria [Correct Ans Is: - B. Hypotension, Tachycardia, Oliguria Tachycardia, Hypotension, Oliguria, Dry Mucous Membranes, And Poor Skin Turgor Would All Be Indications Of Dehydration. Even Though Thirst May Be An Indication Of Dehydration, It Is Frequently Not Seen In Elderly Patients, Which Makes Hypotension, Tachycardia, Oliguria Preferred Over Thirst, Tachycardia, Dry Mucous Membranes. A Patient Has Just Returned From Surgery After A Carotid Endarterectomy. Why Is Asking Him To Smile And Checking For Symmetry Of Facial Movement Important? A. To Assess The Patient's Level Of Consciousness. B. To Detect Injury To The Facial Nerve. C. To Detect Injury To The Trigeminal Nerve. D. To Assess The Patient's Degree Of Cooperativeness. [Correct Ans Is: - B. To Detect Injury To The Facial Nerve. Cranial Nerve VII Is Located In The Operative Area And May Be Injured During Surgery. A Patient Develops Diabetes Insipidus After A Craniotomy. Which Group Of Findings Would Be Most Characteristic Of Diabetes Insipidus? A. Oliguria, Low Serum Osmolality, Hyponatremia, And High Urine Specific Gravity CCRN- CRITICAL CARE REGISTERED NURSE | 2024/2025 TEST BANK B. Polyuria, High Serum Osmolality, Hypernatremia, And Low Urine Specific Gravity C. Oliguria, High Serum Osmolality, Hypernatremia, And Low Urine Specific Gravity D. Polyuria, Low Serum Osmolality, Hyponatremia, And High Urine Specific Gravity [Correct Ans Is: - B. Polyuria, High Serum Osmolality, Hypernatremia, And Low Urine Specific Gravity A Patient 5 Days After An Acute Inferior Myocardial Infarction Suddenly Complains Of Severe Dyspnea And Palpitations. The Patient Appears Anxious And Diaphoretic. While Completing The Assessment Of The Patient, A Loud Holosystolic Murmur At The Apex That Radiates To The Axilla Is Noted. The Patient Also Has Crackles Throughout The Lung Field But An S3 At The Apex Is Not Audible. Which Of The Following Is Most Likely To Be Descriptive Of The Pulmonary Artery Occlusive Pressure (PAOP) In This Patient? A. An Elevated V Wave And An Overestimate Of The Left Ventricular End-Diastolic Pressure (LVEDP) B. A Dampened V Wave And An Underestimate Of The LVEDP C. A Normal V Wave And An Accurate Reflection Of The LVEDP D. An Elevated V Wave And A Direct Correlation To The Pulmonary Artery Diastolic Pressure [Correct Ans Is: - A. An Elevated V Wave And An Overestimate Of The Left Ventricular End-Diastolic Pressure (LVEDP) What Is The Priority Of Management In Respiratory Acidosis? A. Improve Alveolar Ventilation By Treating The Cause Of Hypoventilation. B. Buffer The Acid With Sodium Bicarbonate. C. CCRN- CRITICAL CARE REGISTERED NURSE | 2024/2025 TEST BANK Ventricle, There Will Be A Disproportionate Increase In Pressure With An Increase In Volume In A Noncompliant Ventricle. Remember That Compliance Is The Change In Pressure For A Given Change In Volume. Use Of Volumetric Parameters Measured With A Right Ejection Fraction Catheter Would Allow Measurement Of Volumes As A Reflection Of Preload. Which Of The Following Would Not Be Associated With A False-Positive Result For An Acute Myocardial Infarction Using The Total Creatine Kinase (CK)? A. Hypothyroidism B. Hemorrhagic Stroke C. Cardioversion D. Ulcerative Colitis [Correct Ans Is: - D. Ulcerative Colitis CK May Be Elevated By Chronic Alcoholism, Cardioversion, Strokes, Hypothyroidism, Intramuscular Injections, Skeletal Muscle Injury, And Trauma. Which Of The Following Is A Manifestation Of Left Atrial Enlargement On The Electrocardiogram? A. Increased Amplitude Of The P Wave On A Rhythm Strip B. Wide, Notched P Waves In Lead II On 12-Lead Electrocardiogram C. Diphasic P Wave In Lead V1 On 12-Lead Electrocardiogram D. Tall, Peaked P Waves In Lead II On 12-Lead Electrocardiogram [Correct Ans Is: - B. Wide, Notched P Waves In Lead II On 12-Lead Electrocardiogram CCRN- CRITICAL CARE REGISTERED NURSE | 2024/2025 TEST BANK Nutrition Is An Important Component Of The Therapeutic Regimen For A Patient With Hepatic Failure. Which Of The Following Is Characteristic Of The Therapeutic Diet For The Patient With Hepatic Failure? A. High In Protein And Calories B. Restricted In Protein And Potassium C. High In Sodium And Vitamins D. Restricted In Carbohydrates And Fats [Correct Ans Is: - A. High In Protein And Calories The Blood Ph Is A Measure Of Which Of The Following? A. Ability Of The Lungs To Eliminate Carbon Dioxide B. Ability Of The Kidneys To Eliminate Nonvolatile Acids C. The Hydrogen Ion Concentration In The Blood D. The Balance Between Carbonic Acid And Hydrogen Ions [Correct Ans Is: - C. The Hydrogen Ion Concentration In The Blood The Blood Ph Is An Indirect And Inverse Measurement Of The Hydrogen Ion Concentration. If The Ph Goes Up (I.E., Alkalosis), The Hydrogen Concentration Is Down. If The Ph Goes Down (I.E., Acidosis), The Hydrogen Concentration Is Up. Blood Ph Is A Reflection Of The Balance Between Carbonic Acid (Acid Regulated By The Lungs) And Bicarbonate (Base Regulated By The Kidneys) A 45-Year-Old Woman Is Admitted With Deep Venous Thrombosis And Pulmonary Embolism. She Has Received A Heparin Bolus And Has Been On A Continuous Heparin Drip For 3 Days. If The Patient Develops Heparin-Induced Thrombocytopenia (HIT), What Clinical Sign Would The Nurse Expect To See First? CCRN- CRITICAL CARE REGISTERED NURSE | 2024/2025 TEST BANK A. Surface Bleeding From Wounds And IV Sites B. Hematuria C. Petechiae D. Bleeding From Gums [Correct Ans Is: - C. Petechia HIT Is An Immune-Mediated Adverse Effect Of Heparin. It Causes Thrombosis And Thrombocytopenia. The First Clinical Sign Of A Decrease In Platelet Quantity Or Quality Is Petechiae. Which Of The Following Assessment Findings Is Specific To Hemothorax Rather Than Pneumothorax? A. Chest Or Shoulder Pain B. Diminished Or Absent Breath Sounds C. Tachypnea D. Dullness To Percussion [Correct Ans Is: - D. Dullness To Prercussion Percussion Helps To Differentiate Various Densities Such As Fluid Versus Air. A Patient Is Admitted With Subarachnoid Hemorrhage. He Develops A Fever Of 38.5° C. Which Of The Following Is Of Greatest Concern For This Patient? A. The Effect Of The Febrile State On The Immune System CCRN- CRITICAL CARE REGISTERED NURSE | 2024/2025 TEST BANK Imagine Putting An Object Straight Through The Heart From The Posterior Wall. It Would End Up In The Anterior Wall. Indicative Changes Of A Posterior MI Are Seen In V8 And V9, And Reciprocal Changes Are Seen In "V1 And V2." A Patient Has Gained 1 Kg Since Yesterday. How Much Fluid Does This Weight Gain Represent? A. 250 Ml B. 500 Ml C. 1000 Ml D. 2000 Ml [Correct Ans Is: - C. 1000ml One Pound Is Equal To Approximately 500 Ml. One Kilogram (2.2 Lb) Is Equal To Approximately 1 L. Which Of The Following Drugs Are Used For First-Line Therapy For Chronic Management Of Hypertension? A. Angiotensin-Converting Enzyme (ACE) Inhibitors And Vasodilators B. Vasodilators And Β-Blockers C. Diuretics And Β-Blockers D. Diuretics And ACE Inhibitors Or Angiotensin-Receptor Blockers (Arbs) [Correct Ans Is: - D. Diuretics And ACE Inhibitors Or Angiotensin-Receptor Blockers (Arbs) A 32-Year-Old Woman Has Systemic Lupus Erythematosus And Chronic Kidney Disease. Over The Past 2 Weeks, She Has Complained Of Feeling Fatigued And Short CCRN- CRITICAL CARE REGISTERED NURSE | 2024/2025 TEST BANK Of Breath After Minimal Exertion. She Is Receiving Hemodialysis. Her Hemoglobin Level Is 4.5 G/Dl.Which Of The Following Is Indicated? A. Recombinant Human Erythropoietin (Epogen) B. Two Units Of Packed Red Blood Cells C. Nitroglycerin Sublingual As Needed D. Azathioprine [Correct Ans Is: - A. Recombinant Human Erythropoietin (Epogen) This Patient Is Having Symptoms Of Decreased Tissue Oxygenation. In Acute Situations, This Would Be An Indication For Blood. In This Patient, Recombinant Human Erythropoietin Is A More Appropriate Treatment. Recombinant Human Erythropoietin Is Used To Treat Anemia Resulting From Reduced Renal Production Of Erythropoietin (The Hormone That Promotes The Production Of Red Blood Cells) In Multiple Organ Dysfunction Syndrome, Which Of The Following Is The Earliest Indication Of Hepatic Failure? A. Ascites B. Increased Serum Bilirubin C. Hypoglycemia D. Increased Blood Ammonia Levels [Correct Ans Is: - C. Hypoglycemia The Liver Performs The Functions Of Glycogenolysis And Gluconeogenesis, So When Hepatic Function Is Impaired, Hypoglycemia Occurs Because Glucose Cannot Be Mobilized Through These Processes. CCRN- CRITICAL CARE REGISTERED NURSE | 2024/2025 TEST BANK A Patient Is In Cardiogenic Shock And Requires Careful Volume Titration To Enhance Contractility. Which Of The Following Ranges Describes The Most Likely Optimal Pulmonary Artery Occlusive Pressure (PAOP) In This Patient? A. 0 To Mm Hg B. 10 To 15 Mm Hg C. 15 To 20 Mm Hg D. 20 To 25 Mm Hg [Correct Ans Is: - C. 15 To 20mm Hg Consider A PAOP Of Under 8 Mm Hg As Understretched (Needs Fluid), A PAOP Of 8 To 12 Mm Hg As Normal But Suboptimally Stretched (Many Patients Need More Fluid So That An Optimal Stretch Can Be Achieved), And A PAOP Of 12 To 20 As Optimally Stretched Depending On The Degree Of Ventricular Dilation. Consider A PAOP Of More Than 20 Mm Hg Excessive For Anyone (Needs Diuretics And/Or Venous Vasodilators). A 48-Year-Old Male Patient With A History Of Inferior Myocardial Infarction (MI) Is Admitted With An Acute Anterolateral MI. He Is Tachycardic And Hypotensive. Cardiac Index Is 1.9 L/Min/M2. Pulmonary Artery Occlusive Pressure (PAOP) Is 20 Mm Hg, And Systemic Vascular Resistance (SVR) Is 2000 Dynes/Sec/Cm-5. Which Of The Following Is The Priority In This Patient? A. Prevent Dysrhythmias. B. Increase Myocardial Perfusion. C. Decrease Preload. D. Decrease Afterload. [Correct Ans Is: - B. Increase Myocardial Perfusion CCRN- CRITICAL CARE REGISTERED NURSE | 2024/2025 TEST BANK Electrocardiogram Monitor Shows Sinus Bradycardia. Which Of The Following Treatments Is Indicated? A. Epinephrine 1 Mg IV B. Atropine 0.5 Mg IV C. Isoproterenol IV Infusion At 2 Mcg/Min D. Transcutaneous Pacemaker [Correct Ans Is: - D. Transcutaneous Pacemaker Which Of The Following Assessment Findings Most Often Is Associated With A Traumatic Diaphragmatic Rupture? A. Bowel Sounds In The Chest B. Breath Sounds Over The Abdomen C. Right Shoulder Pain D. Bruising At The Lower Sternal Margin [Correct Ans Is: - A. Bowel Sounds In The Chest The Pain Of A Diaphragmatic Rupture Usually Is Abdominal Or Epigastric And May Radiate To The Left Shoulder. The Abdominal Contents Move Up Into The Thorax Rather Than The Lungs Moving Down Into The Abdomen, So Bowel Sounds May Be Heard Over The Thorax On The Affected Side ("Bowel Sounds In The Chest"). To Maintain Autoregulation, The Cerebral Perfusion Pressure (CPP) Must Be Maintained Above Which Level? A. CCRN- CRITICAL CARE REGISTERED NURSE | 2024/2025 TEST BANK 150 Mm Hg B. 100 Mm Hg C. 50 Mm Hg D. 30 Mm Hg [Correct Ans Is: - C. 50mm Hg Think Numbers. You Know That A MAP Of 60 Mm Hg Is Required To Perfuse Vital Organs. You Probably Remember That A Normal Intracranial Pressure (ICP) Is Around 10 Mm Hg. So A MAP Of Less Than 60 Mm Hg Would Result In A CPP Of Less Than 50 Mm Hg Which Would Significantly Adversely Affect CPP. Weakness, Fatigue, Muscle Pain, And Abdominal Discomfort In A Patient Receiving Metformin Would Likely Be Associated With Which Of The Following? A. Hypoglycemia B. Hyperglycemia C. Heart Failure D. Lactic Acidosis [Correct Ans Is: - D. Lactic Acidosis These Are Symptoms That May Indicate The Serious Adverse Effect Of Metformin Of Lactic Acidosis And Rhabdomyolysis. A. Decreased Urine Specific Gravity B. Increased Hematocrit C. CCRN- CRITICAL CARE REGISTERED NURSE | 2024/2025 TEST BANK Central Venous Pressure Greater Than 8 Mm Hg D. Decreased Systemic Vascular Resistance (SVR) [Correct Ans Is: - B. Increased Hematocrit The Patient Lost Fluid, So The Hematocrit Would Be Increased Because The Blood Is Hemoconcentrated. If The Patient Had Lost Blood, The Hematocrit Would Be Decreased. Platelet-Activating Factor, Development Of Microclots, And Activation Of The Fibrinolytic System In Septic Shock Set The Stage For Which Of The Following? A. Disseminated Intravascular Coagulation (DIC) B. Pulmonary Embolism C. Acute Arterial Occlusion D. Myocardial Infarction [Correct Ans Is: - A. Disseminated Intravascular Coagulation (DIC) A Sound Occurring In Early Diastole Caused By A Rapid Opening Of A Stenotic Mitral Valve Is Which Of The Following? A. An S4 B. A Pansystolic Murmur C. An Ejection Click D. An Opening Snap [Correct Ans Is: - D. An Opening Snap CCRN- CRITICAL CARE REGISTERED NURSE | 2024/2025 TEST BANK C. Right Ventricular Failure D. Pulmonary Edema [Correct Ans Is: - D. Pulmonary Edema Which Of The Following Produces Intrapulmonary Shunt? A. Pulmonary Embolism B. Shock C. Pneumonia D. Hypoxemia [Correct Ans Is: - C. Pneumonia In Giving His Health History, A 65-Year-Old Man States That He Has Pain In His Legs When He Walks Fast Or Uphill. He Says The Pain Goes Away When He Slows Down Or Stops To Rest. This Is An Indication Of Which Of The Following? A. Acute Arterial Occlusion B. Chronic Arterial Insufficiency C. Deep Vein Thrombophlebitis D. Varicose Veins [Correct Ans Is: - B. Chronic Arterial Insufficiency Which Of The Following Drugs May Increase The QT Interval By 50% Or More? A. CCRN- CRITICAL CARE REGISTERED NURSE | 2024/2025 TEST BANK Verapamil B. Metoprolol C. Lidocaine D. Procainamide [Correct Ans Is: - D. Procainamide Which Of The Following Is Not A Cause Of Metabolic Acidosis? A. Diuretics B. Hypoperfusion C. Insulin Deficiency D. Starvation [Correct Ans Is: - A. Diuretics A 52-Year-Old Man Is Admitted With Hepatic Failure Caused By Chronic Alcoholism. He Is Nonresponsive To Verbal Stimuli At This Time. Which Intervention Would Not Specifically Decrease Serum Ammonia Levels In Patients With Hepatic Encephalopathy? A. Administration Of Rifaximin B. Administration Of Lactulose C. Provision Of Adequate Caloric Intake D. Avoidance Of All Hepatotoxic Agents [Correct Ans Is: - D. Avoidance Of All Hepatotoxic Agents