AACN CCRN-Adult Exam Practice Test Instant Access

Question 1

A patient is intubated, is unable to follow simple commands, and has no history of alcohol abuse. The patient has become increasingly disoriented and confused over the past 24 hours. After assessment and treatment of pain, the best medication intervention for management is

Alorazepam (Ativan).

Bcisatracurium (Nimbex).

Cmidazolam (Versed).

Ddexmedetomidine (Precedex).

Answer : D

Dexmedetomidine (Precedex) is the most appropriate medication for managing agitation and delirium in a critically ill intubated patient. It provides sedation without significant respiratory depression and has analgesic properties, which makes it suitable for patients who are disoriented and confused. Unlike benzodiazepines (lorazepam and midazolam) or neuromuscular blockers (cisatracurium), dexmedetomidine can improve delirium outcomes and facilitates easier weaning from mechanical ventilation. Reference: = AACN Certification and Core Review for High Acuity and Critical Care, 7th Edition, AACN Handbook for CCRN Certification, pp. 57-60.

Question 2

Pulsus paradoxus is defined as

Aa decrease in systolic BP of greater than 10 mm Hg during normal expiration.

Ba decrease in systolic BP of greater than 10 mm Hg during normal inspiration.

Ca decrease in diastolic BP of greater than 10 mm Hg during normal expiration.

Dan increase in systolic BP of greater than 10 mm Hg during normal inspiration.

Answer : B

Pulsus paradoxus is defined as a decrease in systolic blood pressure (BP) of more than 10 mm Hg during normal inspiration. This phenomenon occurs due to the increased negative intrathoracic pressure during inspiration, which exaggerates the normal drop in systolic BP. It is often seen in conditions such as cardiac tamponade, constrictive pericarditis, and severe asthma or COPD exacerbations. Reference: = CCRN Exam Handbook, AACN Adult CCRN Certification Review Course

Question 3

Which of the following is a cause of cardiogenic pulmonary edema?

Aelevated PAOP reading

BRV chamber enlargement

Cpulmonary hypertension

DLV noncompliance

Answer : D

Cardiogenic pulmonary edema is primarily caused by left ventricular (LV) noncompliance. When the left ventricle is unable to properly fill or eject blood, pressure increases in the left atrium and pulmonary veins, leading to fluid leakage into the pulmonary interstitium and alveoli, causing pulmonary edema. Elevated PAOP readings, RV chamber enlargement, and pulmonary hypertension are not primary causes of cardiogenic pulmonary edema but can be related to other cardiac conditions. Reference: = CCRN Exam Handbook, AACN Adult CCRN Certification Review Course

Question 4

While recording hourly ventilator checks on a patient who is being mechanically ventilated, the nurse notes that the PIP has gradually increased by 5 cm H2O over the past 4 hours. This increase indicates

Aan improvement in pulmonary function.

Ba leak in the ET tube cuff.

Ca decrease in airway resistance.

Da decrease in lung compliance.

Answer : D

An increase in peak inspiratory pressure (PIP) over time in a mechanically ventilated patient indicates a decrease in lung compliance. This means the lungs are becoming stiffer and less able to expand, which can be caused by conditions such as pulmonary edema, ARDS, or pneumothorax. It is important to address the underlying cause of decreased lung compliance to prevent further respiratory complications. Reference: = CCRN Exam Handbook, AACN Adult CCRN Certification Review Course

Question 5

A nurse is caring for a patient with pulmonary fibrosis who is exhibiting shortness of breath, tachypnea, and feels a sense of impending doom. In order to relieve these symptoms, the nurse should anticipate an order for

Amorphine.

Bhydromorphone.

Clorazepam.

Ddiazepam.

Answer : A

Morphine is often used to relieve symptoms such as shortness of breath and anxiety in patients with pulmonary fibrosis. It works by reducing the sensation of dyspnea and the sense of impending doom by decreasing the respiratory drive and alleviating anxiety through its sedative effects. Additionally, morphine can help reduce tachypnea by slowing down the respiratory rate. Reference: = CCRN Exam Handbook, AACN Adult CCRN Certification Review Course

Question 6

A patient with cardiogenic shock for several days has been managed aggressively with vasopressor and inotrope therapies. Which of the following indicates organ dysfunction from hypoperfusion?

Adecreased insulin requirements and abdominal pain

Belevated creatinine and fever

Cabdominal pain and elevated creatinine

Dfever and decreased insulin requirements

Answer : C

In the context of cardiogenic shock managed with vasopressor and inotrope therapies, organ dysfunction from hypoperfusion can manifest as elevated creatinine and abdominal pain. Elevated creatinine indicates renal impairment, a common result of poor perfusion to the kidneys. Abdominal pain can indicate hypoperfusion to the gastrointestinal tract, leading to ischemic bowel or other GI complications. These symptoms are direct indicators of hypoperfusion and organ dysfunction. Reference: = CCRN Exam Handbook, AACN Adult CCRN Certification Review Course

Question 7

In order to meet the spiritual needs of critically ill patients and their families, which of the following should the nurse understand regarding chaplain services?

AThe chaplain may be of a specific denomination, but the chaplain provides resources to patients of many faiths and beliefs.

BThe service should be provided only when specifically requested by the patient or family.

CA chaplain's visit will not benefit a patient who is comatose or non-communicative.

DIt would be inappropriate for the hospital chaplain to document in the medical record.

Answer : A

Chaplain services in hospitals are designed to address the spiritual needs of patients and their families, regardless of their specific faith or belief system. While a chaplain may belong to a particular denomination, they are trained to provide support and resources to people of various faiths and spiritual beliefs. This approach helps ensure that all patients receive appropriate spiritual care, which can be a crucial part of holistic care in critical situations. Reference: = CCRN Exam Handbook, AACN Adult CCRN Certification Review Course

AACN CCRN-Adult CCRN (Adult) – Direct Care Eligibility Pathway Exam Practice Test