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Fast and Effective Preparation With CCRN-Adult CCRN (Adult) - Direct Care Eligibility Pathway Exam Questions

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AACN CCRN-Adult Exam Syllabus Topics:

Topic
Details

Topic 2

CLINICAL JUDGMENT: This section measures the skills of Critical Care Nurses and covers a wide range of medical conditions across various systems. It includes cardiovascular issues such as acute coronary syndrome, heart failure, and cardiomyopathies, demonstrating the need for in-depth knowledge in managing these critical conditions. The section also addresses respiratory emergencies like pulmonary embolism and ARDS, emphasizing the importance of understanding respiratory failure and chronic conditions.

Topic 3

In musculoskeletal, neurological, and psychosocial areas, the syllabus includes managing trauma, neurological disorders, and behavioral health issues. This emphasizes the holistic approach required in critical care settings. Lastly, multisystem complications such as sepsis and shock states are included to assess the ability to manage life-threatening conditions that affect multiple organ systems.

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AACN CCRN (Adult) - Direct Care Eligibility Pathway Sample Questions (Q497-Q502):

NEW QUESTION # 497
The nurse is caring for a 32-year-old patient who was struck by a motorcycle. They sustained multiple injuries, including a fractured pelvis. It has been noted that they are in hypovolemic shock.
Which of the following clinical signs and symptoms indicate the patient is in the compensatory stage of hypovolemic shock?

A. No visible signs and symptoms evident from ongoing cellular changes
B. Patient is unresponsive to verbal stimuli, tachycardic, and has absent bowel sounds
C. Patient has a WBC count of 18,000, serum lactate of > 4 mmol/L, and a positive blood culture
D. Patient is confused, tachypneic, and has weak peripheral pulses

Answer: D

Explanation:
Normal hemodynamics are consistent with CO 4-6 L/min, HR 60-100 bpm, SVR 800-1500 dynes/sec/cm-5, and MAP > 65 mmHg.
In hypovolemic states, circulating blood volume is depleted, either by blood loss (internal or external) or by the vascular fluid volume shifting out of the vascular space into other body fluid spaces. Tissue perfusion is inadequate due to the decrease in circulating blood, and as a result, right and left ventricular filling pressures are insufficient, decreasing stroke volume and cardiac output. The compensatory stage is composed of a number of physiologic events that represent an attempt to compensate for these decreases in CO and restore adequate oxygen and nutrient delivery to the tissues.
The patient may be restless, confused or agitated, have an increased respiratory rate and heart rate, have a weak pulse, and have scant urine output with hypoactive bowel sounds.
In the initial stage of shock, there are no obvious signs and symptoms evident as the first cellular changes occur from the decrease in tissue perfusion. Generally, the progressive stage is marked by unconsciousness, increased heart rate, inadequate blood pressure, increased or shallow respirations, and absent bowel sounds. Septic shock is characterized by increased WBC ( > 12,000), serum lactate > 4 mmol/L, and in up to 50% of patients, a positive blood culture.

NEW QUESTION # 498
The critical care nurse observes that a recently implemented hand-off protocol is not consistently followed by the staff, potentially impacting patient safety. What is the MOST appropriate action?

A. Initiate a discussion exploring barriers to the protocol's implementation
B. Take no action, as this is leadership's responsibility
C. Report non-compliant staff to the unit manager
D. Advocate for staff re-education on the importance of the hand-off protocol

Answer: A

Explanation:
Exploring systemic barriers to the successful implementation of the protocol is the first step of process of improvement. Re-educating the staff may be helpful, but only if lack of education is a barrier to following the protocol. It is important to assess for potential barriers first. Reporting non-compliant staff can create a punitive environment that doesn't result in improvement to the system. Taking no action because it's leadership's responsibility is incorrect.

NEW QUESTION # 499
A nurse is caring for a Korean patient who refuses to make eye contact. What of the following responses by the nurse is BEST?

A. "Do you have any cultural preferences regarding making eye contact?"
B. "I notice that you're avoiding me. Do you feel uncomfortable with me as your nurse?"
C. "Would you please look at me while I am speaking so that I know you're paying attention?"
D. "Has anyone at home been physically abusive towards you?"

Answer: A

Explanation:
In some cultures, including many Asian cultures, avoiding direct eye contact is considered respectful, especially with authority figures like healthcare providers. The nurse should directly ask the patient about their cultural practices to avoid any misunderstandings. The nurse should not assume that a lack of eye contact is an indicator of abuse. The nurse should not address the behavior until they understand if there is any cultural significance to the behavior.

NEW QUESTION # 500
The family of a patient with trauma believes that the patient is in pain and requests that a neighbor, a therapeutic touch practitioner, be allowed to see the patient. Unit policy allows visits by immediate family only. Which of the following is the most important consideration in a nurse's decision about facilitating the visit?

A. The family needs an explanation of the rationale for unit visitation policies.
B. Research does not support the value of therapeutic touch in pain management.
C. Alternative modalities have been associated with enhancements in pharmacologic effects.
D. Alternative therapies are not generally acceptable in an ICU setting.

Answer: A

Explanation:
The primary consideration is to ensure that the family understands the unit's visitation policies. While alternative modalities like therapeutic touch can be beneficial, the nurse must adhere to established policies and explain the rationale to the family. This helps maintain the integrity of unit operations and ensures that all patients receive equitable care. Explaining the policies also provides an opportunity to discuss alternative ways to support the patient within the existing framework. References: = CCRN Exam Handbook, AACN Adult CCRN Certification Review Course

NEW QUESTION # 501
Which of the following transport mechanisms are NOT included in Continuous Renal Replacement Therapy (CRRT)?

A. Diffusion
B. Convection
C. Hemostasis
D. Ultrafiltration

Answer: C

Explanation:
CRRT includes any of the following four major types of transport mechanisms:
1. Diffusion
2. Convection
3. Ultrafiltration
4. Adsorption
Because fluid removal with CRRT is much slower than with intermittent hemodialysis, CRRT is an ideal therapy for critically ill patients in unstable conditions.

NEW QUESTION # 502
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