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AACN CCRN-Adult Dumps Questions [2025] Pass for CCRN-Adult Exam
AACN CCRN-Adult Exam Syllabus Topics:
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NEW QUESTION # 234
A 69-year-old female presented to the emergency department with diaphoresis and severe dyspne a. A pulse oximeter revealed 85% oxygen saturation. Oxygen at 4 L/min was started via nasal cannula, and an ECG was performed and showed left ventricular hypertrophy and a Left Bundle Branch Block (LBBB). Her chest x-ray showed an enlarged cardiac silhouette and bilateral infiltrates. The nurse secured IV access, and the patient was started on a dobutamine drip and given IV furosemide.
The PRIMARY purpose of starting the dobutamine infusion and administering the furosemide is to:
- A. increase myocardial contractility and reduce ventricular preload
- B. increase myocardial contractility and reduce ventricular afterload
- C. increase myocardial contractility and increase ventricular afterload
- D. reduce myocardial contractility and increase ventricular preload
Answer: A
Explanation:
This patient is exhibiting signs and symptoms of Heart Failure (HF). Regardless of the underlying cause of the weak pump of the heart, patients with HF present with signs and symptoms of intravascular and interstitial volume overload, as well as manifestations of inadequate tissue perfusion. Diuretic therapy is often initiated (to manage the fluid volume overload) to decrease ventricular preload. In addition, limitation of dietary sodium, and restriction of free water is implemented. Dobutamine is given to improve ventricular function by augmenting ventricular contractility (inotropic agent).
NEW QUESTION # 235
The gold standard for determining left ventricular function is:
- A. Left Ventricular End-Diastolic Pressure (LVEDP)
- B. Cardiac Output (CO)
- C. Cardiac Index (CI)
- D. ejection fraction
Answer: D
Explanation:
Ejection fraction, the percentage of blood volume ejected from the left ventricle with each contraction, is the gold standard for determining left ventricular function and is helpful in selecting treatment strategies. A normal Left Ventricular Ejection Fraction (LVEF) is 55% to 60% and is one of the most important predictors of long-term outcome following acute MI.
NEW QUESTION # 236
A 55-year-old male is admitted with a suspected acute pulmonary embolism (PE). The critical care nurse assessing the patient knows that which of the following is a common clinical manifestation of PE?
- A. Pleuritic chest pain
- B. Hypertension
- C. Hypothermia
- D. Bradycardia
Answer: A
Explanation:
Pulmonary embolism is a complication of DVT, long bone fracture, or air entering the circulatory system.
There are many risk factors for PE, with critically ill patients being especially prone due to the presence of central venous catheters, immobility and the high rates of comorbidities, such as heart failure and cancer. The common clinical manifestations of PE are dyspnea, cough, tachypnea, tachycardia, and pleuritic chest pain.
Other signs and symptoms include rales upon auscultation, apprehension, diaphoresis, evidence of deep vein thrombosis (DVT), hemoptysis, fever, syncope, hypoxia, and hypotension.
NEW QUESTION # 237
A patient with an acute anterior wall MI presents with an S3 gallop and the following values:
Which drug therapy would be most appropriate for this patient?
- A. vasodilators and positive inotropes
- B. vasopressors and calcium-channel blockers
- C. vasopressors and beta-blockers
- D. vasodilators and diuretics
Answer: D
Explanation:
In the setting of an acute anterior wall myocardial infarction (MI) with an S3 gallop, the patient is likely experiencing heart failure and possibly acute pulmonary edema. The appropriate treatment includes vasodilators to reduce afterload and diuretics to decrease preload and pulmonary congestion. This combination helps to improve cardiac output and reduce the workload on the heart. References: CCRN Exam Handbook, AACN, page 20, section on Cardiovascular.
NEW QUESTION # 238
A patient who is being treated for chest trauma from a motor vehicle accident complains of pain that is described as a tearing sensation between his scapulas. Which of the following interventions is MOST important?
- A. Prepare to intubate the patient.
- B. Take the patient's blood pressure and pulse on both arms.
- C. Place the patient in reverse Trendelenburg.
- D. Draw cardiac enzymes and perform a 12 lead EKG.
Answer: B
Explanation:
A pain described as tearing is suspicious for aortic aneurism or dissection. The recent chest trauma combined with the location of the pain make it even more likely that a thoracic aortic aneurism is the cause of the pain. In patients who are experiencing a thoracic aortic aneurysm, the blood pressure or pulse may vary between arms and assessing the blood pressure and pulse on both limbs is an appropriate intervention. Placing the patient in reverse Trendelenburg is not likely to improve the patient's situation. Drawing cardiac enzymes and performing a 12 lead EKG may be necessary to rule out other causes of the patient's symptoms; however, the possibility of aortic aneurism should be further assessed first. There are no indicators that intubation is necessary for this patient.
NEW QUESTION # 239
The nurse is caring for a patient who is vulnerable, unable to participate in decision-making and care, and has limited resource availability. In caring for this patient, which of the following competencies, as defined in the Synergy Model, would NOT be of primary focus for the nurse?
- A. Systems thinking
- B. Response to diversity
- C. Advocacy and moral agency
- D. Collaboration
Answer: B
Explanation:
The nurse in this situation would need to focus on advocacy and moral agency, collaboration, and systems thinking to best address the needs of the patient. Response to diversity would not play a major role in caring for this particular patient.
NEW QUESTION # 240
the three main components affecting tissue oxygenation following a chest trauma?
- A. Cardiac output
- B. Stroke volume
- C. Hemoglobin level
- D. Oxygen saturation
Answer: B
Explanation:
Stroke volume is a factor affecting cardiac output, which does affect tissue oxygenation; however, stroke volume itself is not onE of the three main components affecting tissue oxygenation. These main components are cardiac output, hemoglobin level, and oxygen saturation.
NEW QUESTION # 241
A nurse has responded to a rapid response call on a medical-surgical floor in the hospital. The nurse finds the patient with the following data:
BP72/30
HR132
RR24
T102.3° F (39.0° C)
SpO295%
Ph7.13
PaCO234 mm Hg
PaO288 mm Hg
HCO3 14 mEq/L
Na+ 142 mEq/L
The nurse should anticipate an order to administer which of the following?
- A. 0.9% sodium chloride
- B. 8.4% sodium bicarbonate
- C. amiodarone (Cordarone)
- D. phenylephrine (Neo-Synephrine)
Answer: D
Explanation:
The patient's data indicate that the patient is in shock, which is a life-threatening condition characterized by inadequate tissue perfusion and organ dysfunction. The patient has a low blood pressure, a high heart rate, a fever, and a metabolic acidosis, which suggest that the patient may have septic shock, which is caused by a severe infection that triggers a systemic inflammatory response. The nurse should anticipate an order to administer phenylephrine (Neo-Synephrine), which is a vasopressor agent that constricts the blood vessels and increases the blood pressure and tissue perfusion. Phenylephrine is recommended as a first-line agent for septic shock by the Surviving Sepsis Campaign guidelines1. 8.4% sodium bicarbonate is not indicated for the treatment of septic shock, as it may worsen the acid-base balance and increase the risk of complications2.
0.9% sodium chloride is a normal saline solution that may be used for fluid resuscitation, but it may not be sufficient to restore the blood pressure and may cause fluid overload, hyperchloremia, and kidney injury3.
Amiodarone (Cordarone) is an antiarrhythmic drug that is used to treat ventricular tachycardia or fibrillation, but it is not effective for septic shock and may cause hypotension, bradycardia, and other adverse effects4.
References:
* Surviving Sepsis Campaign. (2020). Surviving Sepsis Campaign: Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (COVID-19). Retrieved from 1, p. 16.
* Marik, P. E., & Bellomo, R. (2013). A rational approach to fluid therapy in sepsis. British Journal of Anaesthesia, 110(3), 323-329. Retrieved from 2, p. 327.
* Semler, M. W., & Rice, T. W. (2019). Saline versus balanced crystalloids for intravenous fluid therapy in the emergency department: study protocol for a cluster-randomized, multiple-crossover trial. Trials,
20(1), 1-10. Retrieved from 3, p. 2-3.
* Lexicomp Online. (2021). Amiodarone. Retrieved from 4, p. 1-2.
NEW QUESTION # 242
A critical care nurse's colleague asks them why they administer intramuscular (IM) injections the way they do, pointing out that the technique is outdated. Which of the following considerations should primarily guide the critical care nurse's response?
- A. The nurse's colleague is being unprofessional
- B. The nurse's colleague is exhibiting clinical inquiry
- C. The nurse is independently licensed, making their practice their own responsibility
- D. The nurse's colleague is exhibiting clinical judgment
Answer: B
Explanation:
Clinical inquiry refers to the ongoing process of questioning and evaluating practice and providing informed practice. A nurse questioning the potentially outdated clinical practice of another nurse exhibits clinical inquiry, and promotes the improvement of the other nurse's practice.
Clinical judgment refers to the competency of having a sound rationale for clinical decisions and making good clinical decisions. The nurse getting feedback should understand that the other nurse is trying to help them improve their care. This does not mean that the other nurse is being unprofessional or nosey.
While nurses are independently licensed, making their practice their own responsibility, they should be open to feedback. They should also put the consideration that another nurse is exhibiting clinical inquiry ahead of the fact that they are ultimately responsible for their own clinical practice.
NEW QUESTION # 243
A 35-year-old male patient with a history of drug abuse is admitted to the ICU for severe pneumoni a. He expresses a desire to leave the hospital Against Medical Advice (AMA). As the patient's nurse, what should you do FIRST?
- A. Ensure the patient signs the AMA form prior to leaving
- B. Call security to prevent the patient from leaving
- C. Place the patient in restraints
- D. Explain the risks associated with leaving AMA to the patient
Answer: D
Explanation:
The nurse's first responsibility is to the patient, ensuring their safety and recognizing their right to autonomy. The nurse should explain the potential risks and consequences associated with leaving AMA to ensure the patient's decision is informed. For legal purposes, the nurse should ensure the patient signs an AMA form prior to leaving; however, it is more important that patient safety is prioritized than to ensure legal paperwork is completed. Calling security or placing the patient in restraints are not appropriate responses as they do not respect the patient's autonomy.
NEW QUESTION # 244
Which of the following methods of preventing aspiration in a patient who is receiving tube feedings is CORRECT?
- A. Provide bolus feedings to prevent constant exposure to the feeding solution
- B. Check feeding tube placement with a chest radiograph every 4 hours
- C. Use sedatives sparingly
- D. Check for gastric residuals at least once in a 12-hour shift
Answer: C
Explanation:
Prevention of aspiration includes using sedatives as sparingly as possible. In addition, maintaining the head of the bed at an elevation of 30-45 degrees, unless contraindicated, will greatly help to reduce the likelihood of aspiration occurring.
Bolus feedings should be avoided, as they increase the risk of aspiration. Gastric residuals should be checked at least once every 8 hours, preferably every 4 hours. While the placement of a feeding tube should be verified every 4 hours, this should not be done with a chest radiograph, as it is not feasible or economical.
NEW QUESTION # 245
Initial treatment for a pulmonary contusion includes all of the following EXCEPT:
- A. pulmonary hygiene
- B. pain control
- C. humidified oxygenation
- D. immediate thoracotomy and pneumonectomy
Answer: D
Explanation:
A pulmonary contusion is defined as an injury to the lung parenchyma, which commonly occurs after a blunt injury to the chest. It generally involves pulmonary infiltrates with hemorrhage in the lung tissue.
Initial treatment typically includes humidified oxygenation, pulmonary hygiene to keep the airway clear of mucous and secretions, fluid resuscitation, and pain control.
Depending on the severity of the lung contusion, a thoracotomy to obtain surgical control of bleeding vessels and/or a pneumonectomy may be necessary but is not generally part of initial management.
NEW QUESTION # 246
Which of the following is LEAST LIKELY to be a complication of immobility?
- A. Urinary tract infection (UTI)
- B. Venous thromboembolism (VTE)
- C. Compartment syndrome
- D. Pressure injury
Answer: C
Explanation:
Compartment syndrome is normally caused by an injury, especially by a crush-related injury, and is not likely to be caused by immobility.
Immobility can lead to VTEs, pressure ulcers, and muscle atrophy. UTIs can result from immobility, but compartment syndrome is less likely than a UTI.
NEW QUESTION # 247
The critical care nurse is caring for a patient on a mechanical ventilator for ongoing pulmonary problems. His Arterial Blood Gas (ABG) results are: pH 7.50; PaCO2 25 mm/Hg; PaO2 88 mm/Hg; and HCO3- 24 mEq/L. The ventilator is set in assist-control mode with a rate of 18 breaths/minute, tidal volume of 500 ml, and oxygen at 50%.
Based on the patient's ABG results, which intervention is CORRECT?
- A. Increase the oxygen
- B. Decrease the rate
- C. Increase the tidal volume
- D. Add Positive End-Expiratory Pressure (PEEP)
Answer: B
Explanation:
The patient's ABG results indicate respiratory alkalosis, which is corrected by retaining more carbon dioxide (CO2). Changing the mode to intermittent mandatory ventilation, decreasing the rate, or decreasing the tidal volume may accomplish this.
The oxygen level is within normal limits, so do not adjust it. Adding PEEP would increase gas diffusion, not decrease CO2 levels.
NEW QUESTION # 248
Delirium Tremens (DTs), the most severe form of alcohol withdrawal, is BEST managed by which of the following treatments?
- A. Dexmedetomidine (Precedex)
- B. Benzodiazepines
- C. Haloperidol (Haldol)
- D. Tapered ethanol wean
Answer: B
Explanation:
Alcohol withdrawal DTs (Delirium Tremens) is characterized by hallucinations, disorientation, hypertension, tachycardia, low-grade fever, agitation, and diaphoresis, and usually occurs 48-72 hours after initial cessation of alcohol use. In severe alcohol withdrawal such as DTs, benzodiazepines are preferred over other drugs. Adjunctive medications such as haloperidol, beta-blockers, clonidine, and dexmedetomidine are used as needed to decrease agitation and autonomic symptoms. In addition, fluid, electrolyte, nutrition, and vitamin/mineral repletion are also often included in treatment management.
NEW QUESTION # 249
Which of the following electrolyte imbalances is common in the patient with acute kidney injury (AKI), indicating the need for initiation of dialysis?
- A. Hypercalcemia
- B. Hypocalcemia
- C. Hypokalemia
- D. Hyperkalemia
Answer: D
Explanation:
Hyperkalemia is one of the common electrolyte abnormalities in the patient with AKI, and is the most common reason for initiation of dialysis.
Hyperkalemia is considered the most life-threatening of all the electrolyte disorders because of potassium's profound impact on the electrophysiology of the heart. These conduction abnormalities can lead to serious cardiac arrhythmias and death.
NEW QUESTION # 250
During a unit staff meeting, a suggestion is made to use a new technique for improving ventilation in patients with septic shock. What response by the critical care nurse is BEST?
- A. Begin implementing the new technique into her practice
- B. Research the technique and its impact on septic shock outcomes
- C. Use established techniques that the nurse is familiar with
- D. Ask the respiratory therapists their impressions of the efficacy of the new technique
Answer: B
Explanation:
As part of the nurse's ongoing process of questioning and evaluating their practice, they should research the technique and its impact on septic shock outcomes to evaluate whether they should implement the new technique into their clinical practice. Asking the respiratory therapists their impressions of the efficacy of the new technique is not as ideal as researching the technique using evidence-based studies.
Beginning to implement the new technique into practice or avoiding using the technique in favor of previously used techniques is not correct until the nurse has researched it.
NEW QUESTION # 251
Another name for the Billroth II procedure is:
- A. gastrojejunostomy
- B. cholangiogram
- C. cholecystogram
- D. gastroduodenostomy
Answer: A
Explanation:
Surgical therapies for Peptic Ulcer Disease (PUD) or stress ulcers include gastric resections such as antrectomy, gastrectomy, vagotomy, or combination procedures. A Billroth II, also called a gastrojejunostomy, is a combination procedure consisting of a vagotomy (decreases acid secretion in the stomach by dividing the vagus nerve along the esophagus), resection of the antrum, and anastomosis of the stomach to the jejunum. The Billroth II is preferred over the Billroth I (gastroduodenostomy) because it does not present the risk for dumping syndrome.
NEW QUESTION # 252
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