CCRN Exam Review With 100% Correct Answers 2023, Exams of Advanced Education

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CCRN Exam Review With 100% Correct

Answers 2023

Heart rate (HR) - Correct Answer-60-100 beats/min Mean arterial pressure (MAP) - Correct Answer-70-105 mmHg Cardiac output (CO) - Correct Answer-4-5 L/min Cardiac index (CI) - Correct Answer-2.5-4.5 L/min/m Stroke volume (SV) - Correct Answer-50-100 ml/beat Stroke index (SI) - Correct Answer-35-60 ml/m2/beat Right arterial pressure (RAP) - Correct Answer-4-8 mmHg Pulmonary artery pressure (PAP) - Correct Answer-Systolic 15-30 mmHg Diastolic 5-15 mmHg Pulmonary artery occlusive pressure (PAOP) - Correct Answer-8-12 mmHg Systemic vascular resistance (SVR) - Correct Answer-800-1200 dynes/sec/cm- Systemic vascular resistance index (SVRI) - Correct Answer-1970-2390 dynes/se/com- 5/m Pulmonary vascular resistance (PVR) - Correct Answer-100-250 dynes/sec/cm- Pulmonary vascular resistance index (PVRI) - Correct Answer-255-285 dyens/sec/cim- 5/m Arterial oxygen saturation (SaO2) - Correct Answer-95-100% Venous oxygen saturation (SvO2) - Correct Answer-60-80% Delivery of oxygen (DO2) - Correct Answer-550-650 ml/min/m Oxygen consumption (VO2) - Correct Answer-200-250 ml/min Inferior leads and artery - cardiac - Correct Answer-Lead II, III, aVF - RCA Anterior septal leads and artery - cardiac - Correct Answer-Lead V1, V2 - LM

Anterior leads and artery - cardiac - Correct Answer-Lead V3, V4 - LAD Low lateral lead and artery - cardiac - Correct Answer-Lead V5, V6 - LCX High lateral lead - cardiac - Correct Answer-Lead I, aVL Symptoms of Left heart failure - Correct Answer-Orthopnea, dyspnea, crackles, Low PaO2, SaO2 & SpO2, S3 & S4, Increased PAOP & PA pressures Symptoms of Right heart failure - Correct Answer-JVD, Peripheral edema, Hepatomegaly, Increased CVP/RAP, S3 & S Symptoms of Systolic heart failure - Correct Answer-Decreased stroke volume, decreased ejection fraction, S3 and enlarged heart Symptoms of Diastolic heart failure - Correct Answer-Decreased stroke volume, normal ejection fraction, S4, normal heart size Laboratory signs of DIC - Correct Answer-Decreased platelets Increased PT/INR Increased aPTT Decreased fibrinogen Increased FSP Increased D-Dimer Physical signs of DIC - Correct Answer-Hypotension, Petechia, Purpura, Bruising, Bleeding in oral, GI/GU, or pulmonary Chvostek's Sign - Correct Answer-Facial muscle twitching when cheek is tapped - Hypocalcemia Trousseau's Sign - Correct Answer-Spasming of the hand when the bp cuff is inflated beyong systolic pressure for >3 min - Hypocalcemia Grey Turner's Sign - Correct Answer-Bruising of the flanks, appearing as a blue discoloration - retroperitoneal bleed Cullen's Sign - Correct Answer-Superficial edema and bruising in the subcutaneous fatty tissue around the umbilicus - Intraperitoneal bleed Kehr's Sign - Correct Answer-Acute pain in the tip of the shoulder when a person is lying down and the legs are elevated - splenic rupture Calculation of anion gap - Correct Answer-(Na + K) - (CL + HCO3) *Cations - Anions Normal is < 15

PaO2/FiO2 Ratio (P/F ratio) - Correct Answer-Measures the difference between oxygen content in PaO2 divided by the FiO2. Used to predict shunting and hypoxemia <300 = ALI <200 = ARDS Acute Respiratory Failure - Correct Answer-PaO2 <60 mmHg PaCO2 >50 mmHg pH <7. Acute Lung Injury & ARDS - Correct Answer-Cxr - bilateral diffuse infiltrates with no cardiac enlargement (white-out or ground-glass appearance) P/F ratio: (<200 ARDS; <300 for ALI) PAOP <18mmHg Acute Pulmonary Embolism - Correct Answer-For Massive PD: Acute right heart failure Shock and crushing chest pain Increased CVP with decreased CO Cyanosis and hemoptysis Status Asthmaticus - Correct Answer-ABG revealing normalizing or increasing CO2 with no signs of improvement Little to no breath sounds auscultated Disappearance of wheezing Flail Chest - Correct Answer-Paradoxical wall movement:

• On inspiration when chest wall should move outward, the fractured area will move inward
• On expiration when chest wall should move imward, the fractured area will move outward Tension Pneumothorax - Correct Answer-Tracheal deviation and PMI move away from affected side High peak inspiratory pressure (if vented) Hypotension Cranial Nerve I - Correct Answer-Olfactory - sense of smell Cranial Nerve II - Correct Answer-Optic - Central and peripheral vision Cranial Nerve III - Correct Answer-Oculomotor - Eye and upper eyelid movement, pupil constriction Cranial Nerve IV - Correct Answer-Trochlear - Down and inward eye movement

Cranial Nerve V - Correct Answer-Trigeminal - Touch, pain, temperature, jaw and eye muscle proprioception (sense of position), chewing Cranial Nerve VI - Correct Answer-Abduncens - Lateral eye movement Cranial Nerve VII - Correct Answer-Facial - Close eyelid, taste (anterior 2/3 of tongue), saliva and tears Cranial Nerve VIII - Correct Answer-Acoustic - equalibrium and hearing Cranial Nerve IX - Correct Answer-Glossopharyngeal - Gag reflex, swallowing, taste in posterior 1/3 of tongue Cranial Nerve X - Correct Answer-Vagus - Salivary gland secretion, vagal control of heart, lungs and GI tract, gag reflex Cranial Nerve XI - Correct Answer-Spinal accessory - Shoulder movement Cranial Nerve XII - Correct Answer-Hypoglossal - Tongue movement CPP - Correct Answer-Map - ICU = CPP Normal is 60-100 mmHg ICP - Correct Answer-Normal ICP is 5-15 mmHg Wernicke's area - Correct Answer-Temporal lobe Broca's area - Correct Answer-Frontal lobe Occipital lobe - Correct Answer-Vision and color recognition Parietal lobe - Correct Answer-Sensation and body awareness Temporal lobe - Correct Answer-Receptive speech Frontal lobe - Correct Answer-Understands what is said but is unable to express themselves appropriately Brudzinski's Sign - Correct Answer-Lay flat on back, flex the head down towards the chest and the knees pop up = meningeal irritation Kernig's sign - Correct Answer-Lay flat on back, bend knee towards chest creates severe pain = meningial irritation Prerenal - Correct Answer-Sodium <20 mEq/L BUN >25mg/dl

FENa <1% *hypotension/hypo-perfusion Postrenal - Correct Answer-Sodium >40 mEq/L BUN <25 mg/dl * only in postrenal *obstruction (tumors/stones) Antidote for acetaminophen - Correct Answer-N-Acetrylcysteine (Mucomyst) Antidote for Opiates - Correct Answer-Naloxone (Narcan) Antidote for benzodiapine - Correct Answer-Flumazenil (Romazicon) Antidote for Digoxin - Correct Answer-Digibind Antidote for Beta Blockers - Correct Answer-Glucagon, Calcium Chloride Antidote for Carbon monoxide - Correct Answer-100% FiO2 or hyperbaric chamber Antidote for Ethylene glycol and methanol - Correct Answer-10% ethanol infusion, dialysis Antidote for Tricyclic antidepressants - Correct Answer-sodium bicarb Antidote for coumadin - Correct Answer-Vitamin K Antidote for heparin - Correct Answer-Protamine sulfate Antidote for amphetamines - Correct Answer-benzodiazepines Antidote for calcium-channel blockers - Correct Answer-Calcium chloride, glucagon Antidote for lithium - Correct Answer-hemodialysis Antidote for nitrates - Correct Answer-methylene blue Antidote for salicylates - Correct Answer-sodium bicarb, hemodialysis Dobutamine - Correct Answer-Inotropic, chonotropic and vasodilator effects Treats heart failure Improves renal blood flow and u/o 2-20 mcg/kg/min Dopamine - Correct Answer-Catacholamine raises bp refractory to fluid therapy treats heart failure

corrects hemodynamic imbalances during shock

6mcg/kg/min Epinephrine - Correct Answer-Catecholamine Incr CO by incr HR Incr cerebral and coronary blood flow Potent alpha receptor vasoconstrictor 1-10 mcg/min Levophed - Correct Answer-Catecholamine Incr contractility to incr bp with mild effect to CO Used to treat hypotension and decr SVR 2-30 mcg/min Milrinone - Correct Answer-Inotropic vasodilating agent with little chronotropic activity Incr CO without incr myocardial oxygen demand or HR 0.25-0.75 mcg/kg/min Nitroglycerin - Correct Answer-Venous vasodilator Decr preload and afterload in L ventricular failure Used for mycardial ischemia and dilator for coronary vasculature 20-40 mcg/min 50-250 mcg/min Nipride - Correct Answer-Venous and arterial dilator Incr CO by decr L ventricular afterload Decr bp in hypertensive crises and decr pulmonary hypertension 0.5 - 10 mcg/kg/min Neosynephrine - Correct Answer-Sympathetic adrenergic agent Constricts blood vessels and raises bp Stimulates baroreceptors to slow HR by incr vagal tone 100-180 mcg/min (can go up to 300 mcg/min) Vasopressin - Correct Answer-Potent arterial vasoconstrictor Used for severe hypotension/shock unresponsive to catecholamine therapy, upper GI hemorrhages and ACLS protocol 0.01-0.4 units/min ABG Values - Correct Answer-pH 7.35-7. PaCO2 35- PaO2 80- HCO3 22- Normal CBC values - Correct Answer-Hgb 13-18 M 12-16F Hct 40-52M 35-47F

Normal Coag values - Correct Answer-PT 12-15 sec

• Platelet 150,000 - 400, aPTT 25-38 sec
• Fibrinogen 200-
• Normal Chemistry values - Correct Answer-Na 136 -
• K 3.5 - 5.
• Ca 8 - 10.
• Phos 3 - 4.
• Mg 1.5 - 2.
• Chl 96 -
• Normal Kidney Fxn Values - Correct Answer-BUN 5 -
• Creatinine 0.7 - 1.
• Anion Gap 5 -
• Normal Liver/Pancrease Values - Correct Answer-Alk Phos 30 -
• Amylase 56 -
• Lipase 0 -
• ALT 5 -
• AST 15 -
• GGT 5 -
• 1.005 - 1. Normal Specific Gravity and Urine Osm values - Correct Answer-Urine Specific Gravity
• Urine Osmololity 50 -