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

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Total 150 questions
Question 1

The rationale for initiating early enteral feeding in a patient with sepsis is to



Answer : A

Early enteral feeding in patients with sepsis is crucial as it helps maintain gut integrity, thereby minimizing the translocation of gastrointestinal (GI) bacteria. The presence of nutrients in the gut lumen supports the mucosal barrier function and reduces bacterial translocation, which can lead to secondary infections and further complications in septic patients. Reference: = CCRN Exam Handbook and AACN's Certification Review Course materials.


Question 2

A patient underwent bariatric surgery for weight loss 3 days ago. The patient appears anxious, restless, and reports increased abdominal pain over the last 24 hours. The nurse palpates mild subcutaneous crepitus over the neck. Vital signs are:

BP 106/64

HR 128

RR 27

T 100.4 F (38C)

Which action should the nurse anticipate?



Answer : D

The signs and symptoms described in the patient post-bariatric surgery, including anxiety, restlessness, increased abdominal pain, and subcutaneous crepitus over the neck, suggest a potential anastomotic leak, which is a surgical emergency. Given the vital signs indicating possible sepsis or shock (elevated heart rate, increased respiratory rate, and fever), immediate surgical intervention is likely required to repair the leak and prevent further complications. Reference: CCRN Exam Handbook, AACN, page 30, section on GI surgical emergencies.


Question 3

The primary pathophysiology underlying acute respiratory failure in a patient with head trauma involves



Answer : A

In a patient with head trauma, the primary pathophysiology underlying acute respiratory failure often involves hypercapnia due to decreased minute ventilation. Head trauma can impair the central nervous system's ability to regulate breathing, leading to inadequate ventilation and a build-up of carbon dioxide (CO2) in the blood. Other factors like shifting of the oxyhemoglobin dissociation curve, increased intrapulmonary shunt, and dehydration due to diabetes insipidus may be present but are not the primary causes. Reference: CCRN Exam Handbook, AACN, page 25, section on Respiratory.


Question 4

Which of the following is the most common prerenal cause of acute tubular necrosis?



Answer : A

Shock is the most common prerenal cause of acute tubular necrosis (ATN). In the context of prerenal conditions, shock leads to decreased renal perfusion and subsequent ischemia, which can cause damage to the renal tubules. Other options such as blood transfusion reaction, crush injury, and beta-hemolytic streptococcal infection can lead to renal damage but are not the most common prerenal causes of ATN. Reference: CCRN Exam Handbook, AACN, page 28, section on Renal/GU.


Question 5

Family members have been complaining about limited visiting hours. To facilitate a potential change in practice, a nurse should first



Answer : B

The initial step in facilitating a change in practice regarding visiting hours should involve a literature search on family visitation practices. This allows the nurse to gather evidence-based information that can support any proposed changes. After gathering sufficient evidence, the nurse can then schedule an interdisciplinary team meeting to discuss the findings, consult with medical staff, and draft a new policy if necessary. Reference: CCRN Exam Handbook, AACN, page 35, section on Professional Caring and Ethical Practice.


Question 6

Laboratory values diagnostic for disseminated intravascular coagulation (DIC) include



Answer : B

Laboratory values diagnostic for disseminated intravascular coagulation (DIC) include increased prothrombin time (PT), partial thromboplastin time (PTT), and fibrin split products (FSP), also known as fibrin degradation products (FDP). These increases indicate widespread clotting and subsequent fibrinolysis, which are characteristic of DIC. The consumption of clotting factors and platelets in DIC leads to prolonged clotting times and elevated levels of fibrin degradation products. Reference: = CCRN Exam Handbook, page 42


Question 7

A consistent prolongation of the P-R interval beyond 0.20 sec indicates which of the following types of AV block?



Answer : B

A consistent prolongation of the P-R interval beyond 0.20 seconds indicates a first-degree atrioventricular (AV) block. This type of block is characterized by a delay in the conduction of electrical impulses through the AV node, resulting in a prolonged P-R interval. However, every P wave is still followed by a QRS complex, distinguishing it from higher-degree AV blocks where some P waves are not followed by QRS complexes. Reference: = CCRN Exam Handbook, page 35


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Total 150 questions