Question 1

A patient admitted with a diagnosis of pneumonia has a temperature of 103.2 F (39.5 C) and copious pulmonary secretions. ABG results drawn on room air are:

The nurse should expect that hemoglobin's affinity for oxygen in this patient to be

Aunchanged.

Bunpredictable.

Cincreased.

Ddecreased.

Answer : D

The patient's ABG results indicate respiratory acidosis (pH 7.33, PaCO2 48 mm Hg) with a slightly elevated temperature (103.2 F). In the context of fever and acidosis, hemoglobin's affinity for oxygen decreases, a phenomenon described by the Bohr effect. This means that hemoglobin will release oxygen more readily to the tissues. Factors like increased temperature and acidosis cause a rightward shift in the oxyhemoglobin dissociation curve, reducing the affinity of hemoglobin for oxygen. Reference: = CCRN Exam Handbook, page 44

Question 2

There is an increase in catheter-associated urinary tract infections (CAUTIs) following a change in urinary catheter insertion trays. After conducting a literature review of evidence-based practices regarding indwelling catheter insertion and care, the nurse should

Alocate a unit in the facility that still has the original trays in stock and restock the supply closet with these.

Bcontact the materials coordinator and request that the previous trays be re-ordered.

Cshare the results of the literature review with the physician team.

Dlead a meeting in which the results of the literature review are presented, and staff input is obtained.

Answer : D

Conducting a literature review is an essential step in evidence-based practice. Sharing these findings with the staff and obtaining their input fosters a collaborative environment and ensures that the best practices are understood and implemented by all. This approach also helps identify any practical concerns or barriers to implementation. Simply switching back to the old trays without addressing the root cause or educating the staff may not prevent future CAUTIs. Reference: = CCRN Exam Handbook, AACN Adult CCRN Certification Review Course

Question 3

A nurse is precepting an experienced critical care nurse who is new to the facility. To develop the orientation plan, which of the following should the preceptor do first?

ADetermine the knowledge and skills the new nurse needs to learn.

BTeach the new nurse about unit routines and practices.

CExplain patient care policies and procedures to the new nurse.

DIntroduce the new nurse to staff and team members on the unit.

Answer : A

The first step in developing an orientation plan is to assess the new nurse's current knowledge and skills. This helps tailor the orientation to address any gaps and build on existing competencies. Understanding the new nurse's background ensures that the training is efficient and effective, focusing on areas that need improvement rather than repeating familiar information. Reference: = CCRN Exam Handbook, AACN Adult CCRN Certification Review Course

Question 4

Which of the following should the nurse expect in a patient with papillary muscle dysfunction?

Amitral insufficiency

Baortic stenosis

Cmitral stenosis

Daortic insufficiency

Answer : A

Papillary muscle dysfunction, often resulting from myocardial infarction, can lead to mitral insufficiency (mitral regurgitation). The papillary muscles support the mitral valve, and if they are damaged, the valve may not close properly, causing blood to flow backward into the left atrium during systole. This condition is not associated with aortic stenosis, mitral stenosis, or aortic insufficiency. Reference: = CCRN Exam Handbook, AACN Adult CCRN Certification Review Course

Question 5

A nurse who is providing care to a patient with a hemorrhagic stroke receives an order to administer 3% Normal Saline IV. The nurse should recognize the goal of therapy is to create an

Aosmotic gradient which pulls fluid from the brain tissue into the vascular system.

Bosmotic gradient which pulls fluid from the vascular system into the brain tissue.

Concotic gradient which pulls fluid from the brain tissue into the vascular system.

Doncotic gradient which pulls fluid from the vascular system into the brain tissue.

Answer : A

The administration of hypertonic saline (3% Normal Saline) creates an osmotic gradient that pulls water out of the swollen brain tissue into the vascular system, helping to reduce cerebral edema. This is a critical intervention in managing increased intracranial pressure in patients with hemorrhagic stroke. Reference: = CCRN Exam Handbook, AACN Adult CCRN Certification Review Course

Free Practice Questions for AACN CCRN-Adult Exam

Question 1

Question 2

Question 3

Question 4

Question 5