[Oct 24, 2025] CCRN-Adult Exam Dumps, CCRN-Adult Practice Test Questions
Free CCRN-Adult Study Guides Exam Questions and Answer
NEW QUESTION # 293
All the following are initial strategies that nurses can take to prevent delirium and decrease its effects on a critically ill patient, EXCEPT:
- A. Educate family members to provide frequent reorientation
- B. Promote normal sleep-wake cycles
- C. Ambulate as soon as possible
- D. Medicate when necessary to keep the patient safe
Answer: D
Explanation:
Medications can sometimes be useful in the management of delirium, and may be necessary to keep the patient safe. However, many medications alter neurologic assessment, delay recovery, or even worsen symptoms. Environmental strategies, such as early mobility, promoting normal sleep-wake cycles, and frequent reorientation, may be very effective. These strategies should always be implemented first.
If medications are required, they are combined with environmental strategies and used at the lowest dose possible for the shortest time possible.
NEW QUESTION # 294
Which of the following laboratory values remains elevated for 14 to 21 days following an acute myocardial infarction (AMI)?
- A. Myoglobin
- B. Troponin I
- C. Troponin T
- D. Myocardial muscle creatine kinase (CK-MB)
Answer: C
Explanation:
Troponin T is a protein that is released into the bloodstream when the heart muscle has been damaged, such as with an AMI. The more damage there is to the heart, the greater the amounts of Troponin T and Troponin I there will be in the bloodstream. Troponin T begins to increase 3 to 5 hours after symptoms begin, and remains elevated for 14 to 21 days post-injury.
Troponin I begins to increase 3 hours after onset of MI and remains elevated for 5 to 7 days.
Myoglobin is released from the myocardium within 2 hours of coronary occlusion and peaks in 6 to 7 hours; myoglobin is a better marker for early detection of MI and is a better negative indicator if negative.
CK-MB values return to baseline within 2 to 3 days after symptom onset, and have better sensitivity and specificity for detecting MI within the first 6 hours (values peak at 12 hours after symptom onset).
NEW QUESTION # 295
A patient being treated for acute kidney injury does not have a diuretic phase following the oliguric phase of their pathology. Which of the following MOST likely explains this?
- A. The patient's acute kidney injury is transitioning into chronic renal failure
- B. This is expected if the acute kidney injury was a prerenal acute kidney injury
- C. The patient received dialysis during the oliguric phase
- D. The patient did not actually have an acute kidney injury
Answer: C
Explanation:
Acute kidney injury is characterized by three stages: the oliguric phase, the diuretic phase, and the recovery phase. If dialysis is provided during the oliguric phase, the diuretic phase will be shortened or absent. The absence of the diuretic phase does not necessarily indicate the patient did not actually have an acute kidney injury or that chronic renal failure is developing. An absent diuretic phase is not expected if the acute kidney injury is a prerenal acute kidney injury.
NEW QUESTION # 296
The charge nurse arrives at work for an ICU shift to discover that his coworker has called out sick and has been replaced with a float pool nurse. The float nurse is oriented to the ICU environment. However, she is not competent to care for patients on ventilators.
The float nurse states that she will care for the ventilator patients if shown what to do. The charge nurse should:
- A. Assign her to patients on ventilators and give her clear instructions on suctioning and alarms
- B. Request that the respiratory therapist review the ventilator settings with the float nurse prior to her assuming care
- C. Care for the patients himself, as the float nurse cannot properly care for the ICU patients
- D. Assign her to nonventilated patients only
Answer: D
Explanation:
Planning care for critically ill patients begins with ensuring each nurse caring for a patient has the corresponding competencies and skills to meet the patient's needs.
The American Association of Critical-Care Nurses (AACN) has developed the AACN Synergy Model for Patient Care to delineate core patient characteristics and needs that drive the core competencies of nurses required to care for patients and families. The model notes that when the patient characteristics and nurse competencies are linked, optimal patient outcomes result.
In this case, the float nurse's knowledge of ventilator patients cannot be assured, and the charge nurse should only assign her to patients whose needs do not exceed the extent of her training and competence. Therefore, the patient with the lowest acuity and who requires care that is within the scope of the float pool nurse's skills should be assigned.
NEW QUESTION # 297
According to the Center for Disease Control and Prevention (CDC), the FASTEST growing drug problem in the United States is:
- A. Benzodiazeipine abuse
- B. Opioid abuse
- C. Alcohol abuse
- D. Marijuana abuse
Answer: B
Explanation:
Recent data from the CDC indicates that prescription abuse is the fastest growing drug problem in the United States, with drug overdoses from opioid misuse among the highest.
The level of intoxication or overdose varies with the element and amount ingested, the time until the patient is treated, the patient's age, tolerance to medications, and underlying comorbid conditions. The priority of care is maintenance of the patient's airway, breathing, and circulation.
NEW QUESTION # 298
A 78-year-old man with a hearing impairment is admitted to the critical care unit with acute heart failure. What is the BEST communication method to use in this case?
- A. Use written communication to ensure he understands
- B. Assess his preferred method of communication prior to attempting communication
- C. Use sign language to communicate with the patient
- D. Speak loudly and exaggerate your lip movements
Answer: B
Explanation:
The patient's method of communication should be assessed prior to attempting a particular communication method. Speaking loudly or exaggerating lip movements can distort communication and may not be effective if the patient's hearing loss is severe. Sign language can be an effective method, but only if the patient is proficient in sign language. Written communication can be effective if the patient can read; however, this should not be assumed.
NEW QUESTION # 299
The nurse is caring for a 32-year-old patient who was struck by a motorcycle. The patient sustained multiple injuries, including a fractured pelvis, and is in hypovolemic shock.
Which of the following treatments would be contraindicated in the management of this patient's hypovolemic shock?
- A. Administration of normal saline (NS)
- B. Administration of lactated Ringer's (LR) solution
- C. Administration of colloid solutions
- D. Administration of vasopressors
Answer: D
Explanation:
The administration of vasopressors to maintain blood pressure would be contraindicated in the management of this patient's hypovolemic shock. Treatment with vasopressors should only be considered when hypotension is resistant to volume resuscitation.
The goal of therapy in the management of hypovolemic shock is to identify the source and stop bleeding if possible, and replace circulating volume, which can be accomplished with one of the following (in large rapid boluses):
* Administration of lactated Ringer's solution
* Administration of normal saline
* Administration of colloid solutions (plasma or blood)
Control of further bleeding is essential and may require surgical intervention. Direct pressure should be applied for obvious wound sites. Type and cross-match for blood type and administer blood as needed for hypovolemic shock.
NEW QUESTION # 300
A busy ICU has experienced an increased number of medication errors over the past three months.
Which of the following would be the MOST effective action for the unit to take?
- A. Provide staff with education on how to enter incident reports and avoid medication errors
- B. Analyze the medication administration process
- C. Implement disciplinary actions for the staff who made errors
- D. Continue monitoring the situation until a definitive pattern emerges
Answer: B
Explanation:
Analyzing the medication administration process is a critical first step, as it can reveal underlying issues or systemic weaknesses contributing to errors. Continue monitoring the situation until a definitive pattern emerges is incorrect if a pattern has already been identified. Staff education or retraining and disciplinary actions are both reactive solutions that might not address underlying systemic problems causing the errors.
NEW QUESTION # 301
A patient's family disagrees with the treatment plan proposed by the healthcare team. As the patient's nurse, which of the following responses is BEST?
- A. Educating the patient's family on how the treatment plan works and why it is necessary
- B. Encouraging the healthcare team to adjust the treatment plan to meet the patient's family's expectations
- C. Suggesting the family to find another healthcare provider that they can trust
- D. Exploring the reason that the patient's family disagrees with the treatment plan
Answer: D
Explanation:
The nurse should explore the reason that the patient's family disagrees with the treatment plan. This can help the nurse determine if they have a legitimate problem that requires readjustment of the plan of care, a need for more education, or emotional stressors that need to be addressed. Educating the patient's family on how the treatment plan works and why it is necessary is only helpful if their reason for disagreeing is due to a lack of understanding. Suggesting the family find another healthcare provider that they can trust is not correct, unless their sole reason for disagreeing is due to mistrust of the care team. Encouraging the healthcare team to adjust the treatment plan to meet the patient's family's expectations is only appropriate if there is a legitimate reason for changing the care plan.
NEW QUESTION # 302
Postoperatively, symptoms that may indicate hemothorax or internal bleeding in a video-assisted thoracic surgery (VATS) patient include
- A. hypertension.
- B. bradycardia.
- C. pain with deep inspiration.
- D. diminished breath sounds.
Answer: D
Explanation:
Hemothorax
Diminished breath sounds are one of the symptoms that may indicate hemothorax or internal bleeding in a video-assisted thoracic surgery (VATS) patient. VATS is a minimally invasive surgical technique that uses a small video camera (thoracoscope) and special instruments to access the chest cavity through small incisions1.
Hemothorax is a condition where blood accumulates in the pleural space, the area between the lungs and the chest wall2. Hemothorax can occur as a complication of VATS due to injury to the lung, blood vessels, or chest wall during the procedure3. Hemothorax can cause compression of the lung and reduce its expansion, leading to diminished breath sounds on the affected side2. Other symptoms of hemothorax may include chest pain, shortness of breath, low blood pressure, rapid heart rate, and pale or clammy skin2.
Internal bleeding is another possible complication of VATS that can cause similar symptoms as hemothorax.
Internal bleeding can occur due to damage to the major vessels, such as the aorta, pulmonary artery, or vena cava, during VATS. Internal bleeding can cause hypovolemia, which is a decrease in the volume of blood in the body, and hypoxemia, which is a low level of oxygen in the blood. These conditions can impair the delivery of oxygen to the tissues and organs, including the lungs, and cause diminished breath sounds, as well as other signs of shock, such as confusion, weakness, dizziness, and loss of consciousness.
Pain with deep inspiration, bradycardia, and hypertension are not typical symptoms of hemothorax or internal bleeding in a VATS patient. Pain with deep inspiration may be a normal postoperative finding after VATS, as the incisions and the chest tube may cause discomfort. Bradycardia and hypertension may be caused by other factors, such as medications, cardiac disorders, or neurological conditions, but they are not directly related to hemothorax or internal bleeding .
References:
* 1: Video-Assisted Thoracoscopic Surgery (VATS) | Johns Hopkins Medicine
* 2: Hemothorax: Causes, Symptoms, Diagnosis & Treatment - Cleveland Clinic2
* 3: Complications of video-assisted thoracoscopic surgery: a retrospective analysis of 3000 cases - PubMed
* : Major vascular complications after video-assisted thoracoscopic surgery: a case report and literature review - PubMed
* : Video-Assisted Thoracoscopic Surgery (VATS) | Michigan Medicine
* : Bradycardia - Symptoms and causes - Mayo Clinic
* : High blood pressure (hypertension) - Symptoms and causes - Mayo Clinic
NEW QUESTION # 303
A patient underwent bariatric surgery for weight loss 3 days ago. The patient appears anxious, restless, and reports increased abdominal pain over the last 24 hours. The nurse palpates mild subcutaneous crepitus over the neck. Vital signs are:
BP 106/64
HR 128
RR 27
T 100.4° F (38°C)
Which action should the nurse anticipate?
- A. Prepare the patient for surgery.
- B. Obtain labs.
- C. Provide broad spectrum antibiotics.
- D. Administer a 1000 mL bolus of normal saline.
Answer: A
Explanation:
The signs and symptoms described in the patient post-bariatric surgery, including anxiety, restlessness, increased abdominal pain, and subcutaneous crepitus over the neck, suggest a potential anastomotic leak, which is a surgical emergency. Given the vital signs indicating possible sepsis or shock (elevated heart rate, increased respiratory rate, and fever), immediate surgical intervention is likely required to repair the leak and prevent further complications. References: CCRN Exam Handbook, AACN, page 30, section on GI surgical emergencies.
NEW QUESTION # 304
In the critically ill patient with dementia, all of the following would be helpful interventions to include in the plan of care EXCEPT:
- A. encouraging patient input and participation in care
- B. providing limited choices
- C. decreasing noise and distractions
- D. providing a structured environment
Answer: B
Explanation:
The patient should always be an active participant in the plan of care and limiting choices would not be helpful. Providing options gives the patient a sense of independence and allows trust to be built between patients and healthcare professionals.
Providing a structured environment and implementing strategies such as dimming lights and decreasing noise are also helpful interventions for critically ill patients with dementia.
NEW QUESTION # 305
The critical care nurse understands that the primary etiology of hyperphosphatemia in all patients, including the critically ill, is:
- A. renal failure
- B. excessive intake of vitamin D
- C. bone tumors
- D. Addison disease
Answer: A
Explanation:
Renal failure is the most common cause of excessive phosphate levels in all patients, including the critically ill. The regulation of phosphate in the body is performed by the kidneys. Other causes of hyperphosphatemia include hypoparathyroidism, excessive intake of alkali or vitamin D, Addison disease, and with bone tumors or fractures. It is often associated with hypocalcemia and presents most commonly with muscle cramps, joint pain, and seizures.
NEW QUESTION # 306
The term "hypotension" does not have a specific definition, however, it is generally understood that that hypotension is assumed to refer to which of the following?
- A. SBP <90 mm Hg
- B. PAWP < 25 mm Hg
- C. MAP <65 mm Hg
- D. DBP < 40 mm Hg
Answer: C
Explanation:
While the danger with hypertension occurs due to the high amount of pressure exerted on the vasculature, making Systolic Blood Pressure (SBP) the most important parameter, the danger of hypotension occurs due to inadequate perfusion. Perfusion is best measured by assessing Mean Arterial Pressure (MAP), and a MAP of less than 65 mm Hg is typically used to define hypotension.
NEW QUESTION # 307
A critical care nurse has noticed a pattern of delayed wound healing among patients on the unit. What should be the nurse's FIRST step to address this issue?
- A. Promote changes to the wound care protocol that will ensure faster healing times
- B. Report the observation to the nursing team and initiate a root cause analysis
- C. Contact the hospital administration to ensure that the matter is addressed promptly
- D. Continue to monitor the pattern, as transient superfluous correlations that are similar to true patterns are common
Answer: B
Explanation:
When a pattern is recognized, initiating a root cause analysis is the most appropriate response. It also demonstrates systems thinking. This response involves understanding how the different parts of the system interact and contribute to patient outcomes. Ignoring the issue or continuing to monitor it is inappropriate as it doesn't address the problem. Changing the protocol without first conducting a root cause analysis does not take the broader system into consideration. While notifying hospital administration could be a part of the process, it's best to first discuss with the immediate healthcare team to gather more information to develop a comprehensive understanding of the issue.
NEW QUESTION # 308
Which of the following BEST describes the function of the papillary muscles?
- A. The papillary muscles assist the ventricles to fully contract during systole.
- B. The papillary muscles plan an important role in the letdown reflex during lactation.
- C. The papillary muscles control the opening and closure of heart valves.
- D. The papillary muscles maintain vascular tone in the smallest blood vessels throughout the body.
Answer: C
Explanation:
The papillary muscles sit within the ventricles and control the opening and closure of heart valves. These muscles account for about 10% of heart mass. They do not assist the ventricles in fully contracting during systole and are not connected with any non-cardiac functions.
NEW QUESTION # 309
A patient with an arterial line does not have a dicrotic notch in their arterial waveform. This is an expected finding if the patient has which of the following?
- A. Mitral valve prolapse
- B. Cardiogenic shock
- C. Atrial fibrillation
- D. Aortic valvular insufficiency
Answer: D
Explanation:
The dicrotic notch occurs due to closure of the aortic valve temporarily increasing aortic pressure at the end of systole. A patient with aortic valvular insufficiency will not have effective closure of the aortic valve, obscuring the dicrotic notch. Patients who are in cardiogenic shock, have mitral valve prolapse, or have atrial fibrillation will all still have closure of the aortic valve, maintaining a dicrotic notch.
NEW QUESTION # 310
A nurse is providing care to a patient diagnosed with abdominal compartment syndrome. The nurse should recognize the patient is most at risk for developing
- A. increased peak inspiratory pressure.
- B. increased preload.
- C. decreased intracranial pressure.
- D. increased urine output.
Answer: A
Explanation:
Abdominal compartment syndrome (ACS) involves increased intra-abdominal pressure, which can significantly impact various body systems. One of the major concerns is its effect on respiratory function, leading to increased peak inspiratory pressure. This happens because the elevated pressure in the abdomen can push up against the diaphragm, making it harder for the lungs to expand during inhalation. Increased urine output is unlikely as ACS usually leads to decreased renal perfusion and output. Increased preload and decreased intracranial pressure are not typically associated with ACS. References: = CCRN Exam Handbook, AACN Adult CCRN Certification Review Course
NEW QUESTION # 311
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AACN CCRN-Adult Exam Syllabus Topics:
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