CCRN (Adult) - Direct Care Eligibility Pathway CCRN-Adult Exam Questions

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Question #1 (Topic: Demo Questions)

For a patient who sustained blunt renal trauma and a crush injury to the leg, monitoring should include observing for

a shortened PR interval.

tall peaked T waves.

ST segment depression.

a prolonged PR interval.

Correct Answer: B

Explanation:

Crush injuries can lead to significant muscle damage and rhabdomyolysis, resulting in the release of intracellular potassium into the bloodstream, causing hyperkalemia. Tall peaked T waves are a classic sign of hyperkalemia, which needs to be closely monitored in these patients. References : = CCRN Exam Handbook and AACN ' s Certification Review Course materials.

Question #2 (Topic: Demo Questions)

The water retention associated with SIADH is characterized by

fluid intake greater than UO, weight gain, and increased urine osmolality and sodium.

UO greater than fluid intake, extreme weight gain, and mild (2+) pitting edema.

UO greater than fluid intake and severe (4+) pitting edema.

fluid intake greater than UO, increased serum osmolality and sodium, and severe (4+) pitting edema.

Correct Answer: A

Explanation:

The syndrome of inappropriate antidiuretic hormone (SIADH) is characterized by excessive release of antidiuretic hormone (ADH), leading to water retention. This results in fluid intake being greater than urine output (UO), weight gain due to fluid retention, and concentrated urine with increased osmolality and sodium levels. SIADH does not typically present with severe pitting edema or increased serum osmolality and sodium. References : =

CCRN (Adult) Certification Review Course Online: Endocrine Emergencies.

American Association of Critical-Care Nurses (AACN). (2024). CCRN Exam Handbook. Retrieved from AACN CCRN Exam Handbook

Adult CCRN/CCRN-E/CCRN-K Certification Review Course Online. AACN

Question #3 (Topic: Demo Questions)

A unit council is requesting to change a documentation screen of the electronic health record (EHR) at a large health system. The change was not discussed with the department prior to the request and was denied by the EHR committee. Which of the following strategies will most likely lead to accomplishing the team ' s goals?

Have nursing leadership evaluate the proposal before resubmitting the request.

Discuss the proposed solution with stakeholders to determine buy in.

Work with key staff members to rewrite the request to present at the next meeting.

Attempt to change the process through another format.

Correct Answer: B

Explanation:

When seeking to make changes to a documentation screen in the electronic health record (EHR), it is crucial to involve all relevant stakeholders to ensure their buy-in and support. This includes discussing the proposed changes with those who will be directly impacted by it and obtaining their feedback. This collaborative approach can help in identifying potential issues and garnering the necessary support for the proposal, increasing the likelihood of it being accepted by the EHR committee in the future. References : = CCRN Exam Handbook, page 58

Question #4 (Topic: Demo Questions)

Which of the following assessment findings would be found in a patient with pulmonary hypertension?

crackles in the bases bilaterally

rhonchi in the apices bilaterally

pink frothy sputum

distended neck veins

Correct Answer: D

Explanation:

Pulmonary hypertension leads to increased pressure in the pulmonary circulation, which can cause right ventricular hypertrophy and failure. This results in systemic venous congestion, presenting as distended neck veins. Crackles, rhonchi, and pink frothy sputum are more indicative of pulmonary edema or other respiratory conditions rather than pulmonary hypertension. References : AACN Adult CCRN Certification Review Course, AACN CCRN Exam Handbook.

Question #5 (Topic: Demo Questions)

A patient is admitted for hypertensive crisis. As a nurse is starting a peripheral IV, the patient appears increasingly anxious as the catheter is about to be inserted. The patient threatens to harm the nurse if the catheter insertion causes pain. Which of the following is the nurse ' s best action?

Engage the patient in a conversation and encourage him to verbalize his feelings.

Physically restrain the patient during the performance of the procedure.

Ask another staff member to distract the patient during insertion.

Tell the patient to remain still in a stern, authoritative voice.

Correct Answer: A

Explanation:

When a patient exhibits anxiety and threats of harm, it is crucial to de-escalate the situation through verbal communication and engagement. By encouraging the patient to verbalize their feelings, the nurse can address the patient ' s fears and anxieties, reducing the likelihood of aggression. This approach promotes a therapeutic nurse-patient relationship and ensures the safety of both the patient and healthcare staff. References : = CCRN Exam Handbook, AACN Adult CCRN Certification Review Course

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