CCRN Sample Exam Questions
The CCRN exam incorporates Professional Caring and Ethical Practice, based on the AACN Synergy Model for Patient Care. This section makes up 20% of the exam. The remaining 80% of the exam covers Clinical Judgment.
Adult CCRN Sample Questions
- If a patient with a documented myocardial infarction suddenly develops a loud systolic murmur, the most likely cause is which of the following?
- A patient with unstable angina has an IABP inserted. Hemodynamics are: HR = 148 (sinus tachycardia); MAP = 40 mm Hg; PAOP = 25 mm Hg; CI = 1.4 L/min/m2. Which of the following should be included in this patient's plan of care?
- The family of a critically ill patient wishes to spend the night, which is contrary to visiting policy. The nurse's best action would be to:
For questions 4 & 5
One day following gastroplasty surgery an obese male has a sudden onset of restlessness, dyspnea and chest pain. His heart rate is 122/min., and auscultation of heart sound reveals an increased intensity of a pulmonary S2.
- These findings should lead the nurse to suspect that the patient has developed:
- The nurse should expect which of the following to confirm the patient's diagnosis?
- The nursing staff is resisting being assigned to a disruptive patient. An appropriate resolution would be to:
For question 7
A patient who is 72 hours postoperative repair of a ruptured abdominal aortic aneurysm suddenly becomes dyspneic and his respiratory rate increases from 24 to 40/min. An arterial blood gas sample obtained while the patient is receiving oxygen via a nasal cannula at 6L/min reveals the following results:
A chest x-ray is obtained and a "ground-glass-like appearance" is reported. Auscultation of the lungs reveals basilar crackles that were not previously present.
- On the basis of this information, the nurse should suspect that the patient has developed:
- Members of the nursing staff are developing written patient education materials for a group of patients with diverse reading abilities. It would be most effective for the staff to:
Neonatal Sample Questions
- After application of a warm saline-soaked gauze dressing to an infant's abdominal wall defect, the most effective method for preventing evaporative heat loss is to:
- A baby has just been intubated for respiratory failure due to respiratory distress syndrome (RDS). The infant's breath sounds are heard on the right side but not on the left. Which of the following interventions would be most appropriate?
- A preterm infant with necrotizing enterocolitis and resultant bowel perforation has returned from the operating room with an ileostomy. The first step in management of the ostomy should include:
For question 4
An infant at 38-weeks-gestation is born via cesarean section. At four hours of age, heart rate is 155 and respiratory rate is at 60. Physical assessment reveals grunting, mild retractions and nasal flaring. A chest x-ray reveals perihilar streaking bilaterally. The following arterial blood gas (ABG) results are obtained:
- Appropriate management of this patient would consist of:
- A meeting is planned to discuss the parent's ethical concerns regarding life support interventions for their neonate with Trisomy 18. The nurse's role would be to:
- An infant with documented hypoglycemia is being started on a continuous dextrose infusion following a bolus injection of glucose. An appropriate rate of dextrose infusion would be:
- An infant with hydrops fetalis is delivered at 28 weeks of gestation by cesarean section. Which of the following interventions should be anticipated in the initial management of this infant?
For question 8
The following results were obtained from a cerebrospinal fluid (CSF) sample obtained by lumbar puncture:
65% polymorphonuclear cells
Glucose 50 mg/dl
Protein 165 mg/dl
Bacteria shown by Gram-staining
- On the basis of these results, the most appropriate additional study would include:
- The mother of an infant with severe persistent pulmonary hypertension of the newborn (PPHN) would like to hold her infant. The infant's oxygen saturation is 88-92% at rest and the mean blood pressure is 28. The nurse's best response would be to:
Pediatric Sample Questions
- In caring for a patient with salicylate intoxication, the critical care nurse would anticipate which of the following as a primary treatment measure?
- An adolescent with the developmental age of a 4-year-old requires placement of a chest tube. The best way to prepare the patient for this procedure is to:
- An 8-year-old is admitted with a gunshot wound to the head, accidentally inflicted by an older sibling. The parents are overcome with grief, and appear to be ignoring the following statements made by the older sibling: "It was an accident; I didn't mean to do it; I'm sorry!" Which of the following actions by the nurse would be most appropriate?
- Which of the following laboratory findings is indicative of the syndrome of inappropriate ADH secretion (SIADH)?
For question 5
A 3-year-old is admitted to the ICU with a 10-hour history of an acute-onset asthma attack. Initial assessment reveals the following:
HR 160 pH 7.25
RR 48 pCO2 35
BP 112/76 pO2 40
T 32C (oral) HCO3- 22
- In this situation, the nurse would expect initial treatment to include:
- A 2-year-old with heart failure is experiencing manifestations of digoxin (Lanoxin) toxicity. BP is 94/60 and the electrocardiogram reveals supraventricular tachycardia with a heart rate of 200. The critical care nurse would anticipate which of the following interventions?
- A 13-year-old with asthma is readmitted just a week after discharge from the hospital. On questioning, the nurse learns that the patient refuses to use the inhalers at school. The nurse should: