Dumps for Free AACN CCRN-Adult Practice Exam Questions [Dec 04, 2025]
CCRN-Adult Dumps PDF And Certification Training
AACN CCRN-Adult Exam Syllabus Topics:
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NEW QUESTION # 50
When a patient with flail chest inspires, which of the following should the nurse expect to see?
- A. The flail chest segment will move outwards
- B. The flail chest segment will move inwards
- C. The trachea will move away from the affected side
- D. The trachea will move towards from the affected side
Answer: B
Explanation:
Flail chest occurs when three or more contiguous ribs are fractured in at least two places, causing a free- floating flail chest segment of the chest wall. This segment will move inward during the negative pressure caused by inspiration and outwards with the positive pressure of expiration. This causes
"paradoxical breathing", creating a less effective ventilatory pattern. Tracheal movement is not a common finding with flail chest.
NEW QUESTION # 51
The nurse is caring for a patient with acute coronary syndrome (ACS), and has an order to obtain an ECG for further evaluation.
Which of the following leads assists in the diagnosis of hemiblock, a common cause of coronary artery disease (CAD)?
- A. Lead II
- B. V1
- C. Lead III
- D. V6
Answer: C
Explanation:
One of the most common causes of hemiblocks is CAD, followed by arterial hypertension. Lead III (or aVF) assists in diagnosing a hemiblock.
V1 and V6 differentiate between right and left bundle branch block, right and left ventricular ectopy, and right and left ventricular pacing.
Lead II is often the best lead for identifying atrial flutter waves.
NEW QUESTION # 52
A 43-year-old male patient is admitted to the ICU following a high-speed motor vehicle collision. He has sustained multiple fractures, a lacerated liver, and blunt chest traum a. His blood pressure is 84/49 mmHg, heart rate 112/min, and his respiratory rate is 25/min. He is becoming increasingly agitated and hypoxemic despite receiving 100% oxygen via non-rebreather mask.
Which of the following actions should the nurse prioritize?
- A. Start aggressive fluid resuscitation
- B. Administer pain medication
- C. Prepare for immediate intubation
- D. Expedite the insertion of an arterial line
Answer: C
Explanation:
The patient's increasing agitation and hypoxemia despite 100% FiO2 and the mechanisms of his injuries all indicate impending respiratory failure, which necessitates immediate intubation. While fluid resuscitation may be beneficial, it does not directly address the patient's compromised breathing and is a secondary concern to facilitating improved oxygenation. Administering pain medication is secondary to addressing the respiratory status. Insertion of an arterial line may be an important intervention but would be secondary to intubation.
NEW QUESTION # 53
For patients with acute respiratory failure, which ventilator mode is MOST likely to be used initially?
- A. High-frequency oscillatory ventilation
- B. Pressure support ventilation
- C. Synchronized intermittent mandatory ventilation
- D. Assist-control ventilation
Answer: D
Explanation:
Assist-Control (AC) ventilation is most commonly initially used for patients with acute respiratory failure because it guarantees a set number of breaths per minute while still allowing the patient to initiate breaths. Pressure support ventilation and synchronized intermittent mandatory ventilation allow more patient control and are often used in weaning. High-frequency oscillatory ventilation is typically used only for patients with severe ARDS (Acute Respiratory Distress Syndrome) who are not responding to other ventilation modes.
NEW QUESTION # 54
The nurse is instructing a student in how to recognize shock. Which of the following statements by the student indicates understanding?
- A. Hypotension will occur in all but one type of shock.
- B. Hypotension is a concern once the MAP is less than 55 mm Hg.
- C. Hypotension in shock should always initially be treated by administering IV boluses.
- D. Lactic acid levels are better indicators of shock than hypotension.
Answer: D
Explanation:
Compensatory mechanisms may make shock a late sign in patients with shock. Elevated lactate levels indicate inadequate tissue perfusion and are better indicators of shock than hypotension. Hypotension will ultimately occur in every type of shock as it progresses. Hypotension is a concern when the MAP reaches 65 mm Hg or less, not 55 mm Hg. Administering IV fluid boluses may not be indicated for every type of shock, especially for cardiogenic shock.
NEW QUESTION # 55
Which of the following factors will NOT increase the risk of developing pneumonia in a critically ill patient?
- A. Inability to eat by mouth (NPO)
- B. Poor oral hygiene
- C. Limited mobility
- D. Increased salivary flow rate
Answer: D
Explanation:
Pneumonia is the most common respiratory infection, and is the most common cause of acute respiratory failure (ARF) in a critically ill patient. High-risk individuals include infants and children, older adults, those with chronic cardiopulmonary disease, and immunocompromised individuals. Routes of entry include aspiration of oropharyngeal or gastric contents into the lungs, inhalation of bacteria- containing particles, and spread of the causative agent into the lungs from another site in the body.
Several factors present in critically ill patients increase the risk for the development of pneumonia.
Systemic antibiotics, limited mobility, poor oral hygiene, inability to eat by mouth, and a decreased (not increased) salivary flow rate all contribute to an increased risk of colonization.
Symptoms include fever, productive cough, purulent sputum, dyspnea, chest pain, tachypnea, and abnormal breathing sounds.
NEW QUESTION # 56
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. Patient is confused, tachypneic, and has weak peripheral pulses
- B. No visible signs and symptoms evident from ongoing cellular changes
- C. Patient is unresponsive to verbal stimuli, tachycardic, and has absent bowel sounds
- D. Patient has a WBC count of 18,000, serum lactate of > 4 mmol/L, and a positive blood culture
Answer: A
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 # 57
Which of the following BEST describes advocacy in nursing?
- A. Empowering the patient to make their own care decisions
- B. Using one's skills and knowledge to promote someone else's interests
- C. Standing up for someone else's perspective
- D. Making decisions on behalf of another person
Answer: B
Explanation:
Advocacy means intervening on someone else's behalf to promote their interests, using one's skill and knowledge to do so. Standing up for someone else's perspective does not describe advocacy well, as their perspective is not necessarily aligned with their interests. While nurses should empower patients to make their own care decisions, this is not advocacy, but autonomy. Making decisions on behalf of another person requires advocacy to be done in an ethical manner, but describes surrogacy, not advocacy, as advocacy is not always implied during surrogacy,
NEW QUESTION # 58
A patient with Hyperosmolar Hyperglycemic Syndrome (HHS) asks the nurse, "What caused this condition?" Which of the following responses is BEST?
- A. You should have been on more insulin than you were.
- B. This condition happens randomly to some patients with diabetes.
- C. What makes you concerned about the cause of this condition?
- D. Your blood sugar levels were too high for too long.
Answer: D
Explanation:
Hyperosmolar Hyperglycemic Syndrome (HHS) is caused by elevated blood glucose levels that are sustained for too long at too high a level. While it is possible the patient should have been taking more insulin than they were, most patients who develop HHS have type 2 diabetes and may not even be on insulin. Telling the patient that the condition is random is not correct. The patient's question should be answered.
NEW QUESTION # 59
Which of the following components of the AACN's Synergy Model describes working with others to achieve the BEST possible goal for a patient?
- A. Caring practices
- B. Collaboration
- C. Complexity
- D. Systems thinking
Answer: B
Explanation:
The AACN Synergy Model for Patient Care delineates core patient characteristics and needs that drive the core nurse competencies required to care for patients and families. Collaboration is essential for a critical care nurse's practice, and describes working with others in a way that promotes each person's contributions toward achieving optimal patient/family goals.
Systems thinking refers to the body of knowledge that helps the nurse to manage the system through which patient care is provided. Caring practices are activities that promote a therapeutic environment.
Complexity is a patient characteristic referring to the intricate entanglement of two or more systems.
NEW QUESTION # 60
Which of the following patients is exhibiting a compensated response to shock?
- A. Patient with decreased intravascular volume and polyuria
- B. Patient with increased production of catecholamines and ACTH
- C. Patient who is flushed, warm, and clammy
- D. Patient with decreased heart rate and blood pressure (parasympathetic response)
Answer: B
Explanation:
The compensatory stage of shock begins almost immediately as the body's homeostatic mechanisms attempt to maintain cardiac output, blood pressure, and tissue perfusion. The sympathetic nervous system initiates neural, hormonal, and chemical compensatory mechanisms causing peripheral vasoconstriction and elevation of the blood pressure. Hormonal responses include increased production of catecholamines and ACTH (Adrenocorticotropic Hormone) and activation of the renin-angiotensin- aldosterone system. Sodium and potassium retention, in combination with increased ADH (Antidiuretic Hormone), ACTH , and circulating catecholamines, effectively increases intravascular volume, heart rate, and BP, and decreases urine output. The patient becomes tachycardic, cyanotic, and the skin is cool and clammy to the touch.
NEW QUESTION # 61
A patient who has acute gastrointestinal bleeding was given two units of blood and was started on an octreotide drip four hours ago. The patient begins experiencing noncardiogenic pulmonary edema.
Which of the following is MOST LIKELY true?
- A. The pulmonary edema is unlikely to be related to the patient's bleeding or recent treatments.
- B. The pulmonary edema is likely related to the octreotide drip the patient is on.
- C. The pulmonary edema is likely a complication associated with the acute gastrointestinal bleeding.
- D. The pulmonary edema is likely related to the transfusions the patient received.
Answer: D
Explanation:
Transfusion-Related Acute Lung Injury (TRALI) is characterized by an acute onset of hypoxia and noncardiogenic pulmonary edema within 6 hours of a transfusion. The patient is likely experiencing a TRALI. An octreotide drip or gastrointestinal bleeding are both unlikely to cause pulmonary edema.
NEW QUESTION # 62
A critical care nurse is taking over the care of a patient who was admitted during the previous shift. The previous nurse provides a handover, but the information appears to be lacking crucial details about the patient's care. What response by the receiving nurse is BEST?
- A. Request additional information from the previous nurse
- B. Report the previous nurse to the charge nurse for incomplete handoff
- C. Supplement details missed in the handoff from the patient's chart
- D. Dismiss the previous nurse's report as inaccurate
Answer: A
Explanation:
The best approach is to ask the previous nurse for additional information. Collaboration and clear communication are key components of patient safety and effective nursing practice. Accepting the incomplete report and looking for missing details in the patient's chart could result in critical information being overlooked. Dismissing the previous nurse's report as inaccurate may result in the dismissal of important information that they provided. Reporting the previous nurse to the charge nurse for incomplete handoff does not help the nurse to ensure that they have complete information on the patient.
NEW QUESTION # 63
There are three primary causes of distributive shock. Which of the following is NOT one of these causes?
- A. Sepsis
- B. Neurologic damage
- C. Hypovolemia
- D. Anaphylaxis
Answer: C
Explanation:
Distributive shock is characterized by an abnormal placement or distribution of vascular volume. Primary causes include sepsis, neurologic damage, and anaphylaxis. In each of these situations, the pumping function of the heart and the total blood volume are normal, but the blood is not appropriately distributed throughout the vascular bed.
Massive vasodilation occurs in each of these situations for various reasons, causing the vascular bed to be much larger than normal. Due to this enlarged vascular bed, the normal circulating blood volume (approximately 5 L) is no longer sufficient to fill the vascular space, causing a decrease in BP and inadequate tissue perfusion. For this reason, distributive shock is also referred to as relative hypovolemic shock. But hypovolemia is NOT a primary cause of distributive shock.
NEW QUESTION # 64
A patient's family is providing the patient with alternative therapies that may interfere with the patient's current medical treatment. What should the nurse do?
- A. Have a meeting with the family and the healthcare team to discuss the potential risks and benefits of alternative therapies
- B. Allow the family to continue with the alternative therapies if it is what the patient wants
- C. Report the family to the hospital administration
- D. Advise the family to stop all alternative therapies
Answer: A
Explanation:
The nurse should facilitate an open discussion about the potential risks and benefits of alternative therapies with the family and the healthcare team. The patient should be permitted to receive alternative therapies that can be accommodated, but it's essential to ensure that any alternative therapies do not interfere with the patient's current treatment plan. Simply allowing the family to continue or advising them to stop all alternative therapies may not be in the patient's best interest or consistent with their wishes. Reporting the family to the hospital administration could create unnecessary conflict and the situation should be initially addressed through a collaborative conversation.
NEW QUESTION # 65
The family of a patient requests permission to administer traditional herbs to the patient. Which of the following should be the nurse's first action?
- A. Obtain an order for the herbs.
- B. Consult with the pharmacist on the effects of the specific herbs.
- C. Allow the patient to take the herbs because they are natural.
- D. Inform the family that herbal therapy is not appropriate in the hospital.
Answer: B
Explanation:
Verified answer: B. Consult with the pharmacist on the effects of the specific herbs. Herbal therapy is a type of complementary and alternative medicine (CAM) that uses plants or plant extracts to treat various health conditions. Many patients use herbal therapy for various reasons, such as cultural beliefs, personal preferences, or dissatisfaction with conventional medicine. However, herbal therapy is not without risks and challenges, especially in the hospital setting. Some of the potential problems include lack of standardization, quality control, and regulation of herbal products; adverse effects and interactions with other medications; and ethical and legal issues regarding informed consent, documentation, and liability12. Therefore, the nurse's first action should be to consult with the pharmacist on the effects of the specific herbs that the family wants to administer to the patient. The pharmacist can provide information on the safety, efficacy, dosage, and compatibility of the herbs with the patient's condition and current medications. The nurse should also inform the patient's primary provider and obtain an order for the herbs before allowing the patient to take them. The nurse should document the use of herbal therapy in the patient's medical record and monitor the patient for any adverse effects or changes in response to other treatments. Informing the family that herbal therapy is not appropriate in the hospital is not respectful of the patient's autonomy and cultural values. Allowing the patient to take the herbs without consulting the pharmacist and obtaining an order is not safe and may violate the hospital's policies and standards of care.
NEW QUESTION # 66
A patient being treated for Diabetic Ketoacidosis (DKA) is at HIGHEST risk for which of the following complications?
- A. Lactic acidosis
- B. Hypercalcemia
- C. Cardiogenic shock
- D. Hypokalemia
Answer: D
Explanation:
In general, Diabetic Ketoacidosis (DKA) consists of the biochemical triad of hyperglycemia, ketonemia, and metabolic acidosis. Serum potassium is elevated initially in DKA probably due to potassium shifts from the intracellular to the extracellular space because of the acidosis. Later, after therapy for DKA has been initiated, hypokalemia is common because of insulin-induced transfer of plasma potassium into cells and increased urinary excretion of potassium with the osmotic diuresis.
The hyperglycemia causes an osmotic diuresis and hypotonic losses, leading to fluid volume deficits and electrolyte losses. Thus, hypocalcemia may be present (not hypercalcemia), as well as hypovolemic shock (not cardiogenic shock), which can result from the severe fluid losses in DKA. There may be relative lactic acidosis that ensues due to dehydration, but hypokalemia is a higher risk and complication (and more severe) than relative lactic acidosis.
NEW QUESTION # 67
Diagnosis of acute myocardial infarction (AMI) is based on two of three findings.
Of the following, which is NOT one of these findings diagnostic for acute myocardial infarction (AMI)?
- A. Changes on serial ECGs
- B. History of ischemic-like symptoms
- C. ST-segment elevation on ECGs
- D. Elevation and fall of serum cardiac enzymes
Answer: C
Explanation:
Diagnosis of AMI is based on two of three findings:
1. History of ischemic-like symptoms
2. Changes on serial ECGs (T-wave inversion or ST-segment depression)
3. Elevation and fall in level of serum cardiac biomarkers (Troponin I or T, myoglobin, and creatine kinase) Of AMI patients, 50% do not present with ST-segment elevation.
Other indicators include: ST-segment depression (may indicate NSTEMI), new left bundle branch block (LBBB) and ST-segment depression that resolves with relief of chest pain. T-wave inversion in all chest leads may indicate NSTEMI with a critical stenosis in the proximal left anterior descending coronary artery (LAD).
NEW QUESTION # 68
In hyperglycemic crisis, what is the blood glucose reduction target in the first hour of using an insulin infusion?
- A. Decrease blood glucose by 50 to 70 mg/dL
- B. Normalize blood glucose as quickly as possible
- C. Decrease blood glucose by 150 to 200 mg/dL
- D. Maintain blood glucose until 2 liters of crystalloid has infused
Answer: A
Explanation:
An insulin infusion is preferable in all hyperglycemic, critically and acutely ill patients, not just those experiencing diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic states (HHSs).
Management strategies include regular insulin at 0.15 U/kg as an IV bolus. Then, low-dose IV insulin should be initiated at a rate of 0.1 U/kg/h. If serum glucose does not fall by 50 to 70 mg/dL in the first hour, the insulin infusion should be doubled on an hourly basis until the glucose falls by 50 to 70 mg/dL.
NEW QUESTION # 69
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