CCRN Nursing Adult Critical Care Practice Test

CCRN stands for Critical Care Registered Nurse.

The American Association of Critical-Care Nurses administers the CCRN as an official professional certification for registered nurses.

The CCRN requires re-taking every 3 years.

We offer 25 up-to-date CCRN exam prep questions so you know what to expect on test day.

CCRN Nursing Adult Critical Care Practice Test

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Question 1
What would be the correct medication to give in the following situation: A patient suddenly complains of feeling dizzy, has difficulty breathing and has a swollen tongue.
A
Acetaminophen
B
Ceftriaxone
C
Epinephrine injection
D
Diphenhydramine injection
Question 1 Explanation: 
Since the patient’s symptoms point to an anaphylactic shock, the most appropriate medication to give in the situation would be epinephrine (adrenaline).
Question 2
A patient with diabetes mellitus has received a bolus of 50 mL of dextrose. Nevertheless, blood sugars are less than 60. The patient is admitted to the ICU with blood pressure of 70/40, prolonged feeling of confusion, 50 mL urine output in 6 hours and feeling nauseous or vomiting. What is the best course of action?
A
Glucocorticoid replacement injection
B
Vital signs checkup and telemetry monitoring
C
An IV fluid bolus
D
None of the above
Question 2 Explanation: 
There is no enough indication to administer a glucocorticoid replacement injection. Administering fluid replacement should only begin after the vital signs are assessed, the patient is placed on the telemetry monitor and labs are drawn.
Question 3
Please indicate the symptoms that can be observed in a patient in the early stages of renal disease.
A
The blood-urea-nitrogen lab value is slightly higher than normal
B
Excessive drowsiness or fatigue
C
Glomerular Filtration Rate that is reduced to 50%
D
A and C
Question 3 Explanation: 
During the so-called reduced renal reserve stage, both an elevated BUN value and GFR level reduced by 50% can be observed.
Question 4
In case of thorough lifestyle changes, liver damage is reversible. This statement is...
A
True
B
False
Question 4 Explanation: 
Once the liver sustains damage, it cannot be reversed. Some actions can help control the disease, such as controlled salt intake, adequate rest and regular check-ups.
Question 5
An ICU patient has a Guillain-Barre syndrome diagnosis. What would be important for the nurse to inquire about in the patient’s history, which could have led to the current diagnosis?
A
Recent upper respiratory infection or mild fevers
B
Confusion, headaches and dizziness
C
Excessive fatigue, nausea or vomiting recently
D
Coronary artery disease
Question 5 Explanation: 
While it is still not known what causes Guillian-Barre syndrome, clinical data shows that about half of the patients with Guillian-Barre have had an infection recently.
Question 6
A chemotherapy patient has a very low platelet count (20,000 per microliter). What should the nurse advise the patient?
A
Exercise caution regarding contracting the flu
B
Rest and sleep more
C
Beware of bodily injury
D
None of the above
Question 6 Explanation: 
The nurse must warn the patient to avoid activities that can lead to bodily injury in order to avoid bleeding.
Question 7
A patient in Hypovolemic shock is admitted to the emergency room. The likely course of action the doctor would take is:
A
Fluid supplementation by mouth
B
Urinary Catheter Insertion
C
Rapid infusion of intravenous fluids
D
None of the above is a likely course of action
Question 7 Explanation: 
Hypovolemic shock, a life-threatening condition that can lead to organ failure, results from a rapid loss of about one-fifth of the blood or body fluids. Fluids should not be given by mouth.
Question 8
A CT scan in a patient with contusion would likely show...
A
Hematomas
B
Fractures
C
A CT scan cannot show anything in case of contusion
D
Both A and B
Question 8 Explanation: 
Computerized tomography in a patient with contusion can potentially show tissue density alterations and hematomas, as well as displacement of brain structures and fractures.
Question 9
A CCU patient has a blood pressure of 92/66 and a heart rate of 123. The patient complained of severe chest pain and was already given a 0.04 mg of Nitroglycerin tablet. Please indicate among the following what is the correct course of action in this case.
A
Request an ECG
B
Administer morphine IV injection
C
Give a second Nitroglycerin 0.04 mg tablet
D
None of the above
Question 9 Explanation: 
In order to relieve the patient’s chest pain, a second dose of a 0.04 mg Nitroglycerin tablet should be administered first, since up to three Nitroglycerin tablets can be given in the course of 15 minutes.
Question 10
Three and a half hours after a patient has undergone an emergency surgery for gastrointestinal bleeding, she is experiencing pain in the chest, shortness of breath, coughing and sputum. What is the complication most likely in this case?
A
Hypostatic pneumonia
B
Spontaneous pneumothorax
C
Septic shock
D
Hyperventilation syndrome (HVS)
Question 10 Explanation: 
Chest pain, shortness of breath, and coughing up coloured sputum are all signs of hypostatic pneumonia.
Question 11
A nurse taking care of a Hispanic patient demonstrates awareness and understanding of issues that arise from cultural differences during nursing. The nurse is demonstrating which principle?
A
Clinical judgment
B
Response to diversity
C
Advocacy and moral agency
D
Systems thinking
Question 11 Explanation: 
Response to diversity skills are necessary for nurses operating in a diverse environment.
Question 12
How would likely a nurse advise a patient, who has recently suffered a stroke?
A
Regular use of painkillers
B
Regular exercise
C
Quitting smoking
D
Regular blood pressure tests
E
B, C and D
Question 12 Explanation: 
All of the above should be included when a nurse is advising a this type of patient on lifestyle changes except for pain killer use. Some pain medications are blood thinners and should be used with doctor's knowledge only.
Question 13
A patient with severe gastrointestinal bleeding has been vomiting for the past 24 hours. Nasogastric intubation was just initiated on the patient. What would be the appropriate course of action to prevent aspiration?
A
Raise the head of the patient by at least 30 degrees
B
Administer IV PPI
C
A and B
D
None of the above
Question 14
A patient has just undergone permanent pacemaker insertion. What would the nurse likely advise the patient?
A
To avoid dressing in tight-fitting clothing
B
To start regular physical activity
C
To have an MRI scan done
D
A and C
Question 14 Explanation: 
A nurse should advise the patient not to wear tight clothing and not to have MRI scans done.
Question 15
A patient has undergone total thyroidectomy. On day one of the post-operative care, the patient is experiencing tingling sensation in the toes and fingers. What is an appropriate course of action?
A
Increase pain medication dosage
B
Order a total calcium blood test
C
Assess wound exudate
D
Administer an antidepressant
Question 15 Explanation: 
Tingling can be a symptom of calcium deficiency. During a total Thyroidectomy, there is a high risk of damage to the calcium-producing parathyroid glands.
Question 16
A patient, who had suffered a heart attack is undergoing Thrombolytic Therapy for three and a half hours. What would be an indication of success of the therapy?
A
The patient's heart rate is 103 and the blood pressure is 137/83
B
The ECG shows that the elevated ST interval has returned to normal
C
Chest pain relief
D
B and C
Question 16 Explanation: 
Signs of success of Thrombolytic Therapy on a patient who had an acute myocardial infarction (MI) are chest pain relief and the return of the ST interval from elevated to normal.
Question 17
In evaluating the gag reflex, which nerve is usually tested?
A
The glossopharyngeal nerve
B
The trigeminal nerve
C
The trochlear nerve
D
None of the above
Question 17 Explanation: 
The glossopharyngeal nerve carries information for the gag reflex, also called the pharyngeal reflex. On the other hand, the trigeminal nerve is tested in evaluating the ability to swallow, while the trochlear nerve, in evaluating the ability for eye movement.
Question 18
What is the primary role of dopamine in the treatment of cardiogenic shock?
A
Lowers the systolic blood pressure
B
Causes an increase in renal perfusion
C
Leads to arterial vasodilation
D
Lowers venous resistance
Question 18 Explanation: 
As a catecholamine, Dopamine has an inotropic effect on the heart muscle. Its primary effect is to cause increased renal perfusion, which in turn can eventually raise blood pressure.
Question 19
Bacterial meningitis is the most serious type of meningitis. What drug is best used for it?
A
Amobarbital
B
Acetaminophen
C
Penicillin
D
Rifampin
Question 19 Explanation: 
Rifampin is the most adequate medication for patients who have been exposed to Bacterial Meningitis.
Question 20
Please indicate which of the following could not be a part of the interventions for preventing bleeding in a patient with Arteriovenous Malformation?
A
Checking for potential seizures
B
Administering high blood pressure medications
C
Providing emotional care and support
D
Admitting the patient's family for emotional support
Question 20 Explanation: 
In a patient with Arteriovenous Malformation, it is of utmost importance to ensure a quiet environment. Thus, admitting family members would not be an appropriate course of action in this case.
Question 21
A patient is admitted to the emergency room with Type I diabetes. The 19-year-old woman has had a Diabetic Ketoacidosis episode and insulin needs to be administered subcutaneously. Please indicate which of the following statements is true.
A
It will peak in one hour
B
It will peak in 2-4 hours
C
It will peak in 6 hours
D
None of the above
Question 21 Explanation: 
When administered subcutaneously, regular insulin peaks in 2-4 hours. Initially, however, insulin with rapid action must be used instead of regular insulin.
Question 22
Which of the following may be symptoms and indications that a patient diagnosed with sepsis is having a gastrointestinal bleed?
A
Excessive fatigue and headaches
B
Dark, tarry feces
C
Chest pain
D
A and B
Question 22 Explanation: 
Blood in the stool is an indication of gastrointestinal bleeding.
Question 23
Please indicate which of the following is a serious side effect of Thrombolytic Therapy?
A
Thrombosis
B
Fever and chills
C
Hemorrhage
D
Thyroid gland dysfunction
Question 23 Explanation: 
Thrombolytic therapy involves the use of medication to dissolve blood clots blocking major blood vessels that can be life-threatening. Hemorrhage is a serious and possible adverse effect. The signs and symptoms must be continuously assessed.
Question 24
Please indicate the ventilator type that should be used on a patient, who needs only a little ventilator support.Assist-control ventilation (ACV) Synchronized intermittent mandatory ventilation(SIMV)Pressure- regulated volume control (PRVC)
A
The PCV type (Pressure controlled ventilation)
B
The SIMV type (Synchronized intermittent mandatory ventilation)
C
A HCV type (Home care ventilator)
D
None of the above
Question 24 Explanation: 
In this case, the SIMV should be used. Synchronized intermittent mandatory ventilation does not come in competition with the patient's effort, but instead adjusts to it.
Question 25
A patient with congestive cardiac failure (CCF) is receiving diuretics. Please indicate which of the following indicators would be necessary to be monitored:
A
Blood Urea Nitrogen (BUN)
B
Serum potassium and serum creatinine
C
Serum albumin and serum sodium
D
A and C
Question 25 Explanation: 
It is essential in this case to observe Serum potassium and Serum creatinine, because diuretics can harm the kidneys.
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