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

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Total 150 questions
Question 1

A patient with unilateral facial droop and slurred speech has a history of hyperlipidemia and hypertension. The nurse should anticipate an order for a



Answer : C

Given the symptoms of unilateral facial droop and slurred speech, a stroke is highly suspected. A head and neck CT scan is the most appropriate initial imaging to quickly evaluate for the presence of an ischemic or hemorrhagic stroke, which is critical for determining the appropriate treatment plan. An MRI may provide more detailed information later but is not the initial test of choice in the acute setting. Reference: = CCRN Exam Handbook, AACN Adult CCRN Certification Review Course


Question 2

A patient presents with the following hemodynamics:

MAP 40 mm Hg

PAD 6 mm Hg

PAOP 5 mm Hg

CI 1.8 L/min/m2

SVR 875 dynes/sec/cm-5

Which of the following is essential in the plan of care?



Answer : B

The patient has signs of hypovolemic shock, which is characterized by low MAP, low PAOP, low CI, and high SVR. The patient needs fluid resuscitation to restore intravascular volume and improve tissue perfusion. Loop diuretic, vasopressors, and whole blood are not indicated in this case.


Reference Guide for CCRN (Adult), page 14.

Adult CCRN/CCRN-E/CCRN-K Certification Review Course Online - Individual Purchase, Module 1: Cardiovascular, Part 1: Shock.

Question 3

A patient is recovering from CABG surgery. On postoperative day 3, the patient's laboratory values indicate thrombocytopenia and elevated liver function tests. The patient is scheduled for hemodialysis today. A nurse notifies the physician of the abnormal laboratory values. The nurse should next anticipate an order to



Answer : B

The patient has thrombocytopenia, which is a low platelet count that increases the risk of bleeding. Heparin is an anticoagulant that prevents clotting, but also increases the risk of bleeding. Therefore, heparin should be avoided in patients with thrombocytopenia. Hemodialysis can be performed without heparin by using alternative methods such as saline flushes, blood predilution, or specialized dialyzers that reduce clotting. Transfusing platelets during hemodialysis is not recommended, as platelets may be damaged by the extracorporeal circuit. Rescheduling hemodialysis may not be feasible, as the patient may have fluid overload, electrolyte imbalance, or uremia that require urgent dialysis.


Use and safety of heparin-free maintenance hemodialysis in the USA

Anticoagulation for the hemodialysis procedure

Dialysis without anticoagulation (Heparin Free Dialysis)

Question 4

A nurse should expect which of the following plans of care for a patient with a complicated RV infarction?



Answer : D

A nurse should expect a plan of care that includes dobutamine (Dobutrex), fluid infusions, and transvenous pacing for a patient with a complicated RV infarction, as these interventions aim to improve RV function, increase cardiac output, and correct bradyarrhythmias. Dobutamine is an inotropic agent that increases myocardial contractility and reduces RV afterload1. Fluid infusions are used to optimize RV preload and maintain adequate systemic perfusion12. Transvenous pacing is indicated for patients with symptomatic bradycardia or high-grade AV block that compromise hemodynamics13. Dobutamine (Dobutrex), fluid restrictions, and furosemide (Lasix) are not appropriate for a patient with a complicated RV infarction, as they may worsen RV preload and cardiac output. Nitroprusside (Nipride), fluid restrictions, and transvenous pacing are not suitable for a patient with a complicated RV infarction, as they may cause excessive vasodilation and hypotension. Nitroglycerin, fluid infusions, and morphine are not optimal for a patient with a complicated RV infarction, as they may reduce RV preload and increase RV ischemia.


Question 5

A patient lying on the left side in Trendelenburg position is in the correct position for postural drainage of which of the following lobes of the lungs?



Answer : C

For postural drainage of the right lower lobe, the patient should be positioned on their left side in the Trendelenburg position. This positioning utilizes gravity to facilitate the drainage of secretions from the right lower lobe of the lungs. In the Trendelenburg position, the body is laid flat on the back with the feet higher than the head, which helps drain the lower lobes effectively. Reference: = CCRN Exam Handbook, page 22


Question 6

The most appropriate therapy for carboxyhemoglobinemia is



Answer : A

The most appropriate therapy for carboxyhemoglobinemia, which is carbon monoxide poisoning, is the administration of 100% oxygen. This treatment helps to displace carbon monoxide from hemoglobin, allowing oxygen to bind to hemoglobin and be transported to tissues more effectively. High-flow oxygen can significantly reduce the half-life of carboxyhemoglobin, facilitating faster recovery. Reference: = CCRN Exam Handbook, page 30


Question 7

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.


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Total 150 questions