Free Practice Questions for AACN CCRN-Adult Exam

In hypertensive crisis, neurologic changes are often caused by increased intracranial pressure (ICP) as a result of loss of cerebral autoregulation. Autoregulation normally maintains consistent cerebral blood flow despite changes in systemic blood pressure. In hypertensive crisis, the extremely high blood pressure overwhelms these mechanisms, leading to increased cerebral blood flow, disruption of the blood-brain barrier, and cerebral edema, which subsequently increases ICP and causes neurologic changes.References: = CCRN Exam Handbook, page 48

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

Pulmonary contusion leads to damage to lung parenchyma, resulting in alveolar hemorrhage and edema. This causes increased airway resistance and decreased gas diffusion due to the inflammatory response and accumulation of fluid within the alveoli, impairing effective gas exchange and reducing lung compliance.References: = CCRN Exam Handbook, page 40

After gastric bypass surgery, the altered anatomy of the gastrointestinal tract makes it challenging to place a gastric tube. Performing the procedure under fluoroscopy provides real-time imaging guidance, ensuring correct placement and reducing the risk of complications, such as perforation or misplacement.References: = CCRN Exam Handbook, page 45

Flumazenil is a benzodiazepine antagonist that can reverse the effects of benzodiazepine overdose. It acts by competitively inhibiting the activity at the benzodiazepine receptor, thus reversing sedation and other effects caused by benzodiazepines. Sodium bicarbonate, naloxone, and osmotic diuretics are not appropriate treatments for benzodiazepine overdose. References: AACN Adult CCRN Certification Review Course, AACN CCRN Exam Handbook.

Acute pancreatitis is most commonly indicated by severe mid-epigastric pain, which often radiates to the back, leukocytosis (an elevated white blood cell count indicating inflammation), and hypocalcemia (low calcium levels in the blood). The inflammation of the pancreas leads to the release of digestive enzymes and inflammatory mediators that can cause widespread effects, including alterations in calcium metabolism.References: = CCRN Exam Handbook, page 47

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.

Pulsus paradoxus is defined as a decrease in systolic blood pressure (BP) of more than 10 mm Hg during normal inspiration. This phenomenon occurs due to the increased negative intrathoracic pressure during inspiration, which exaggerates the normal drop in systolic BP. It is often seen in conditions such as cardiac tamponade, constrictive pericarditis, and severe asthma or COPD exacerbations. References: = CCRN Exam Handbook, AACN Adult CCRN Certification Review Course

The nurse’s most appropriate action is to review recent published research about bedrest protocols, as this would provide the nurse with the most current and reliable evidence to guide clinical practice and improve patient outcomes. Bedrest protocols after cardiac catheterization may vary depending on the type of access site, the use of closure devices, the patient’s risk factors, and the clinician’s preference. However, there is a growing body of research that supports early ambulation and shorter bedrest duration to reduce the risk of complications, such as bleeding, hematoma, back pain, and venous thromboembolism, and to enhance patient comfort and satisfaction123. Asking about obtaining an independent evaluation of unit outcomes, conducting an informal chart review and outcome evaluation of patients treated with different bedrest protocols, or asking the nursing supervisor to request standardized physician orders for patients who have undergone catheterization are not the most appropriate actions, as they may not reflect the best available evidence, may be biased or incomplete, or may not address the patient’s concern.

References:

1: Bedrest After Cardiac Catheterization: A Systematic Review and Meta-analysis4, p. 1-2.

2: Early Ambulation After Cardiac Catheterization: A Literature Review, p. 1-2.

3: Bed Rest After Cardiac Catheterization: A Review of the Evidence, p. 1-2.