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Valid CCRN-Adult Exam Vce - Download CCRN-Adult Demo
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Free PDF Quiz AACN - CCRN-Adult - CCRN (Adult) - Direct Care Eligibility Pathway Newest Valid Exam Vce
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AACN CCRN (Adult) - Direct Care Eligibility Pathway Sample Questions (Q813-Q818):
NEW QUESTION # 813
A 61-year-old male with a history of Congestive Heart Failure (CHF) presents with a worsening of his pulmonary congestion. He has a history of hypertension and has been diagnosed with myocardial hypertrophy. The echocardiogram showed an ejection fraction of 60%.
Which of the following is the MOST probable underlying abnormality?
- A. Diastolic dysfunction
- B. Systolic dysfunction
- C. Mitral regurgitation
- D. Biventricular failure
Answer: A
Explanation:
Diastolic dysfunction is frequently a result of ventricular hypertrophy. The enlarged ventricular wall limits the cavity volume (decreased ventricular compliance), thus limiting filling during diastole. The hallmark is a reduced stroke volume with a normal ejection fraction.
A systolic dysfunction, abnormalities with contractility, demonstrates a reduced stroke volume and ejection fraction. This may also involve a biventricular failure, but there is not enough information provided in the scenario to determine this. Mitral regurgitation results in diminished stroke volume.
NEW QUESTION # 814
Which of the following PRN medications would NOT be recommended in an acutely agitated critically ill patient with a psychiatric diagnosis?
- A. Ziprasidone (Geodon)
- B. Haloperidol (Haldol)
- C. Olanzapine (Zyprexa)
- D. Ketamine (Ketalar)
Answer: D
Explanation:
Ketamine is commonly used as an IV general anesthetic and produces analgesia, anesthesia, and amnesia without the loss of consciousness. It is useful in patients who require repeated painful procedures such as wound debridement.
Atypical antipsychotics such as olanzapine and ziprasidone, as well as neuroleptics such as haloperidol, are effective agents, with or without the concurrent use of a benzodiazepine.
NEW QUESTION # 815
A 26-year-old female was weightlifting and experienced a sudden explosive headache, and was admitted to the ICU. The occurrence of this patient's symptoms MOST LIKELY indicate which of the following conditions?
- A. Basilar skull fracture
- B. Epidural hematoma (EDH)
- C. Brain stem contusion
- D. Ruptured intracranial aneurysm
Answer: D
Explanation:
Subarachnoid hemorrhage (SAH) can result from trauma, aneurysm, or other vascular malformations. In this scenario, the patient is experiencing SAH due to the rupture of an intracranial aneurysm.
Risk factors for intracranial aneurysm formation include smoking, hypertension, family history, and certain genetic disorders. SAH due to the rupture of an intracranial aneurysm is often the result of an extremely strenuous workout or heavy lifting in a patient with existing risk factors. Patients experience sudden, severe headaches described as "explosive" or "the worst headache of my life." Other common signs include nausea and vomiting, stiff neck, blurred vision, mental status changes, and photophobia.
Aneurysmal SAH is more common in men until the age of 50. The incidence is higher in women after age
50 and in the overall population.
Basilar skull fracture, EDH, and brain stem contusion are primary injuries which occur at the time of initial impact, and cause focal or diffuse anatomic changes to the cerebral tissue or cerebral vasculature.
NEW QUESTION # 816
You're the nurse caring for a patient who has recently been placed on a ventilator. The patient's spouse is clearly distressed and asks to speak with you privately. They tell you they're unsure if they can handle seeing their spouse this way and want to know if the ventilator is really necessary. How should you respond?
- A. Reassure them that all possible interventions will be used to help the patient
- B. Explain that the ventilator is necessary for now, and they should try to accept the situation
- C. Arrange a meeting with the healthcare team to discuss the rationale and necessity of the ventilator
- D. Tell them it's best to focus on the positive aspects of the patient's condition
Answer: C
Explanation:
Arranging a meeting with the healthcare team allows the spouse to discuss the rationale and necessity of the ventilator, and is a way of addressing their concerns in a respectful and informative manner.
While the nurse can provide information about the necessity of the ventilator themselves, involving other members of the healthcare team (especially the physician), can provide a more cohesive and unified perspective. Simply reassuring them without addressing their concerns, suggesting acceptance without further discussion, or shifting focus to the positive aspects without acknowledging their distress does not fully address their concerns or promote understanding.
NEW QUESTION # 817
Analyze and interpret the following ABG results:
* pH: 7.28
* PaCO2: 47 mmHg
* HCO3: 21 mEq/L
- A. Normal ABG
- B. Acute (uncompensated) combined acidosis
- C. Partially compensated respiratory acidosis
- D. Acute (uncompensated) metabolic acidosis
Answer: B
Explanation:
Normal pH ranges from 7.35-7.45. Since this patient's pH is below 7.45, the patient is experiencing acidosis. Normal CO2 (carbon dioxide) levels range from 35-45 mmHg, and normal HCO3 (bicarbonate) levels range from 22-26 mEq/L. CO2 is the respiratory component and HCO3 is the metabolic component. The component that matches the pH is the system controlling the ABG (Arterial Blood Gas).
In this scenario, all levels are acidotic, so both the metabolic and respiratory systems are contributing to the acidosis. There is no compensation present here.
NEW QUESTION # 818
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