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CCRN-Adult Valid Test Sims, CCRN-Adult Valid Study Guide

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AACN CCRN-Adult Exam Syllabus Topics:

Topic
Details

Topic 1

In musculoskeletal, neurological, and psychosocial areas, the syllabus includes managing trauma, neurological disorders, and behavioral health issues. This emphasizes the holistic approach required in critical care settings. Lastly, multisystem complications such as sepsis and shock states are included to assess the ability to manage life-threatening conditions that affect multiple organ systems.

Topic 2

Facilitation of learning is emphasized, indicating the role of nurses in educating patients and families about health management. Collaboration is another key component, focusing on teamwork within healthcare settings to improve patient outcomes. Systems thinking is included to encourage understanding of how different components of healthcare interact. Finally, clinical inquiry is highlighted as a means to foster evidence-based practice and continuous improvement in patient care.

Topic 5

PROFESSIONAL CARING & ETHICAL PRACTICE: This section assesses the skills of Clinical Nurse Leaders in professional caring and ethical practice. It covers advocacy and moral agency, highlighting the importance of representing patients' interests in healthcare decisions. The section also addresses caring practices that promote patient-centered care and response to diversity, ensuring that care is tailored to individual needs.

Topic 6

The endocrine, hematology, gastrointestinal, renal, and integumentary domains are also covered, focusing on conditions like diabetes mellitus, acute kidney injury, and infections. This section highlights the need for nurses to manage complex patient scenarios involving multiple systems effectively.

Topic 7

CLINICAL JUDGMENT: This section measures the skills of Critical Care Nurses and covers a wide range of medical conditions across various systems. It includes cardiovascular issues such as acute coronary syndrome, heart failure, and cardiomyopathies, demonstrating the need for in-depth knowledge in managing these critical conditions. The section also addresses respiratory emergencies like pulmonary embolism and ARDS, emphasizing the importance of understanding respiratory failure and chronic conditions.

AACN CCRN (Adult) - Direct Care Eligibility Pathway Sample Questions (Q676-Q681):

NEW QUESTION # 676
In which of the following clinical scenarios is intra-aortic balloon pump (IABP) therapy contraindicated?

A. Aortic aneurysm
B. Cardiogenic shock
C. Angina refractory to medical therapy
D. Failure to wean from cardiopulmonary bypass after cardiac surgery

Answer: A

Explanation:
The IABP provides cardiac assistance by improving myocardial oxygen supply and reducing cardiac workload. The IABP works on the principle of counterpulsation. Gas (helium or CO2) moves back and forth from the IABP console to the IABP catheter, causing inflation and deflation of the balloon. Inflation occurs during ventricular diastole, increasing intra-aortic pressure and blood flow to coronary arteries.
Deflation occurs immediately before ventricular systole, decreasing intra-aortic pressure. This pressure reduces the resistance to left ventricular ejection, or afterload.
IABP therapy may be used to treat:
* Angina refractory to medical therapy
* Left ventricular failure
* Cardiogenic shock
* Failure to wean from cardiopulmonary bypass after cardiac surgery
Symptoms necessitating the need for IABP therapy include symptoms of cardiogenic shock (tachycardia, systolic BP > 90 mmHg, MAP < 70 mmHg, CI < 2.2-2.5 L/min/square meter, PAOP pressure < 18 mmHg), decreased oxygenation, unstable angina, inadequate peripheral perfusion, and decreased urine output.
Contraindications to IABP therapy include moderate to severe aortic insufficiency and aortic aneurysms.

NEW QUESTION # 677
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. V6
B. Lead III
C. V1
D. Lead II

Answer: B

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 # 678
Which of the following is a sign of brain death?

A. positive vestibulo-ocular reflex
B. positive cough reflex
C. negative cold caloric test
D. negative apnea test

Answer: D

Explanation:
A negative apnea test means that the patient does not breathe spontaneously when disconnected from the ventilator and exposed to a high level of carbon dioxide, which normally stimulates breathing. A negative apnea test is one of the criteria for brain death, as it indicates the loss of brainstem function. A positive vestibulo-ocular reflex, also known as the oculocephalic or doll's eye reflex, means that the eyes move in the opposite direction of the head when the head is turned. A positive cough reflex means that the patient coughs when the trachea is stimulated. A negative cold caloric test means that the eyes do not move when cold water is injected into the ear canal. All these tests assess the integrity of the brainstem, and a positive result would exclude brain death. Therefore, the correct answer is B.
References:
* Diagnosis of brain death - UpToDate, under "Apnea testing".
* Brain Death | Critical Care Medicine | JAMA | JAMA Network, under "How Is Brain Death Diagnosed?".
* The 2023 AAN/AAP/CNS/SCCM Pediatric and Adult Brain Death/Death by ..., under "Apnea Testing".

NEW QUESTION # 679
Which of the following is the MOST common adverse effect of Positive End-Expiratory Pressure (PEEP)?

A. Decreased renal perfusion
B. Increased Cardiac Output (CO)
C. Pulmonary hypertension
D. Decreased venous return

Answer: D

Explanation:
Use of PEEP may increase the risk of barotrauma due to higher mean and peak airway pressures during ventilation. Venous return and CO may be affected by these high pressures. If CO decreases with PEEP initiation and oxygenation is improved, a fluid bolus may be administered to correct hypovolemia. Other less common complications from PEEP include increased ICP, decreased renal perfusion, hepatic congestion, and worsening of intracardiac shunts.

NEW QUESTION # 680
Following a craniotomy, a patient develops a fever, headache, and lethargy. A CT scan reveals a subdural empyem a. What is the MOST likely causative organism for this condition?

A. Staphylococcus aureus
B. Neisseria meningitidis
C. Candida albicans
D. Herpes simplex virus

Answer: A

Explanation:
Staphylococcus aureus is the most common causative organism for subdural empyema, especially following neurological surgery. Neisseria meningitidis and Herpes simplex virus are more commonly associated with meningitis, not empyema. Herpes simplex virus especially will not cause a subdural empyema, as these are almost always bacterial in origin. Candida albicans could cause an empyema, but it is less likely than Staphylococcus aureus in postoperative patients.

NEW QUESTION # 681
......

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