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CCRN-Adult CCRN (Adult) - Direct Care Eligibility Pathway Questions and Answers

Questions 4

A patient in septic shock is treated with a dopamine (Intropin) infusion of 10 mcg/kg/min. Which of the following indicates that this intervention has been effective?

Options:

A.

decreased systemic vascular resistance and decreased MAP

B.

increased systemic vascular resistance and decreased MAP

C.

decreased systemic vascular resistance and increased MAP

D.

increased systemic vascular resistance and increased MAP

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Questions 5

A patient is admitted with Gl bleeding. During the assessment, the nurse notes the patient to be tremulous, anxious, and startles every time he is touched by the nurse. Which of the following is the most pertinent part of the patient's history to obtain?

Options:

A.

last alcohol intake

B.

medication history

C.

time of last meal

D.

psychiatric history

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Questions 6

During the monthly code team review, it is noted that regulators have been consistently missing from the O2 tanks. Which of the following is a nurse's best action?

Options:

A.

Document on the daily flow sheets when the regulators are missing.

B.

Inform the nurse manager of the need for more regulators.

C.

Form a task force to try to find a solution.

D.

Report the missing regulators to the shift supervisor.

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Questions 7

A consistent prolongation of the P-R interval beyond 0.20 sec indicates which of the following types of AV block?

Options:

A.

second-degree, Mobitz Type II

B.

first-degree

C.

second-degree, Mobitz Type I (Wenckebach)

D.

third-degree (complete)

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Questions 8

For a patient with unstable angina, the major goal of treatment is to

Options:

A.

increase afterload.

B.

decrease myocardial contractility.

C.

increase preload.

D.

decrease myocardial O2 consumption.

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Questions 9

A patient with acute renal failure has a serum potassium level of 7.2 mEq/L. The most appropriate immediate intervention for this patient is

Options:

A.

3% NS infusion.

B.

Kayexalate in sorbitol.

C.

hemodialysis.

D.

50% dextrose and insulin.

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Questions 10

In order to meet the spiritual needs of critically ill patients and their families, which of the following should the nurse understand regarding chaplain services?

Options:

A.

The chaplain may be of a specific denomination, but the chaplain provides resources to patients of many faiths and beliefs.

B.

The service should be provided only when specifically requested by the patient or family.

C.

A chaplain's visit will not benefit a patient who is comatose or non-communicative.

D.

It would be inappropriate for the hospital chaplain to document in the medical record.

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Questions 11

A terminally ill patient is deteriorating. The patient's family states, "We don't want him to suffer any more." The most appropriate response is

Options:

A.

"I have given him the medication that was ordered."

B.

"Do you feel he is suffering now?"

C.

"He probably isn't feeling anything right now."

D.

"I will make a referral to the chaplain."

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Questions 12

A patient with end-stage COPD who has failed multiple mechanical ventilation weaning trials communicates a desire to discontinue mechanical ventilation and be extubated. Which of the following is a nurse's best response?

Options:

A.

Advocate with the care team for a withdrawal of treatment plan.

B.

Encourage the patient to continue with current medications and attempts to wean.

C.

Explore the patient's reasons for the request and understanding of potential consequences.

D.

Refer the patient's request to the healthcare facility's ethics committee for review.

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Questions 13

A patient develops the dysrhythmia shown below:

CCRN-Adult Question 13

Blood pressure is 83/40. The patient is pale, diaphoretic, lethargic, and disoriented. The most appropriate treatment is

Options:

A.

defibrillation at 200 J.

B.

adenosine (Adenocard), 6 mg rapid IV bolus.

C.

lidocaine (Xylocaine), 1.5 mg/kg IV.

D.

cardioversion at 100 J.

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Questions 14

Which of the following assessment findings would be found in a patient with pulmonary hypertension?

Options:

A.

crackles in the bases bilaterally

B.

rhonchi in the apices bilaterally

C.

pink frothy sputum

D.

distended neck veins

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Questions 15

A patient with type 1 diabetes admitted for DKA for the third time in 6 months reports not following the medication plan prescribed by the endocrinologist.

Which of the following strategies should a nurse use first?

Options:

A.

Discuss ability to pay for medications and supplies.

B.

Provide low-literacy materials for diabetic education.

C.

Assure scheduled follow-up medical visits prior to discharge.

D.

Consult the diabetes nurse educator.

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Questions 16

To maintain adequate pain control in a post-surgical patient addicted to heroin, a nurse should plan to

Options:

A.

administer oral opioids only as needed.

B.

administer PCA opioids with on-demand dosing only.

C.

administer PCA with continuous and on-demand opioid delivery.

D.

avoid administering any intravenous pain medication.

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Questions 17

A patient with a left ventricular assist device has been hospitalized for 5 days. A nurse notes anasarca and skin breakdown over multiple pressure points. When addressing the patient's nutritional needs, which of the following should the nurse consider?

Options:

A.

Edema may mask physical signs of protein calorie malnutrition.

B.

Initial signs may include low hemoglobin and hematocrit.

C.

Parenteral administration of amino acids is the first-line treatment.

D.

Lipids are needed for the utilization of protein calorie replacements.

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Questions 18

An oncology patient presents with hematuria and bleeding from previous injection sites. Which diagnostic test result should the nurse review first?

Options:

A.

complete blood count

B.

arterial blood gas

C.

complete metabolic panel

D.

coagulation panel

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Questions 19

A patient is admitted for hypertensive crisis. As a nurse is starting a peripheral IV, the patient appears increasingly anxious as the catheter is about to be inserted. The patient threatens to harm the nurse if the catheter insertion causes pain. Which of the following is the nurse's best action?

Options:

A.

Engage the patient in a conversation and encourage him to verbalize his feelings.

B.

Physically restrain the patient during the performance of the procedure.

C.

Ask another staff member to distract the patient during insertion.

D.

Tell the patient to remain still in a stern, authoritative voice.

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Questions 20

A patient is admitted with anaphylactic shock secondary to a blood transfusion. The patient's spouse asks the nurse to explain how blood can cause a low blood pressure. The nurse responds that with anaphylactic shock the

Options:

A.

heart muscle weakens and is unable to pump effectively.

B.

peripheral blood vessels dilate, and this creates a maldistribution of volume.

C.

kidneys excrete large amounts of urine dropping the blood pressure.

D.

autonomic nervous system is disrupted dropping blood pressure.

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Questions 21

A nurse admits a patient awaiting surgery for an unstable pelvic fracture following a fall in which no other injuries were sustained. The nurse should prioritize

Options:

A.

transportation to radiology for an MRI.

B.

type and crossmatch PRBC prior to surgery.

C.

placement of a binder across the patient's hips.

D.

administration of a sedative to reduce movement.

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Questions 22

Laboratory values diagnostic for disseminated intravascular coagulation (DIC) include

Options:

A.

decreases in PT and thrombin time.

B.

increases in PT, PTT, and FSP (FDP).

C.

increases in platelet count and fibrinogen.

D.

decreases in platelet count, thrombin time, and FSP (FDP).

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Questions 23

Which of the following is a cause of cardiogenic pulmonary edema?

Options:

A.

elevated PAOP reading

B.

RV chamber enlargement

C.

pulmonary hypertension

D.

LV noncompliance

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Questions 24

Which of the following is a late finding in hypovolemic shock?

Options:

A.

tachycardia

B.

UO greater than 30 mL/hr

C.

cool, dry skin

D.

hypotension

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Questions 25

The intended effects of medications for a patient in acute CHF are to

Options:

A.

reduce CVP and increase SVR.

B.

reduce CVP and reduce SVR.

C.

increase CVP and reduce SVR.

D.

increase CVP and increase SVR.

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Questions 26

An older adult patient reports an inability to sleep due to staff waking the patient for frequent neurological assessments. In order to minimize sleep disruptions, the nurse should

Options:

A.

encourage the patient to sleep between assessments.

B.

discontinue neurologic assessments.

C.

establish a schedule with the provider.

D.

move the patient to the quieter part of the unit.

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Questions 27

Which of the following serum laboratory results is most concerning to a nurse who is caring for a patient with a Stage Ill pressure ulcer on the coccyx?

Options:

A.

albumin 2.1 mg/dL

B.

hemoglobin 10.2 mg/dL

C.

WBC 6,000/mm3

D.

glucose 125 mg/dL

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Questions 28

A patient presents with the following hemodynamics:

MAP 40 mm Hg

PAD6 mm Hg

PAOP5 mm Hg

CI1.8 L/min/m2

SVR875 dynes/sec/cm-5

Which of the following is essential in the plan of care?

Options:

A.

loop diuretic

B.

fluid resuscitation

C.

vasopressors

D.

whole blood

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Questions 29

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

Options:

A.

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

B.

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

C.

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

D.

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

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Questions 30

A patient who underwent bowel resection surgery due to small bowel rupture is tachycardic and hypotensive. A nurse calls the on-call surgical resident and reports the findings. No new orders are received. The nurse should continue to monitor the patient and

Options:

A.

notify the charge nurse during nightly rounds.

B.

inform the clinical manager in the morning.

C.

initiate the rapid response team.

D.

consult the nearest nursing colleague.

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Questions 31

The first priority in management of an acute GI hemorrhage is

Options:

A.

monitoring of serial Hgb and Hct.

B.

fluid resuscitation.

C.

pain relief.

D.

Sengstaken-Blakemore tube insertion.

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Questions 32

A patient with history of hypothyroidism is admitted with severe confusion and nonpitting edema. The nurse should anticipate which order?

Options:

A.

insulin drip

B.

3% saline 150 mL/hour

C.

diuretics

D.

forced air warming blanket

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Questions 33

A patient with an acute anterior wall MI presents with an S3 gallop and the following values:

CCRN-Adult Question 33

Which drug therapy would be most appropriate for this patient?

Options:

A.

vasodilators and positive inotropes

B.

vasopressors and beta-blockers

C.

vasodilators and diuretics

D.

vasopressors and calcium-channel blockers

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Questions 34

When caring for a patient with septic shock secondary to osteomyelitis, which of the following laboratory tests will best monitor response to therapy?

Options:

A.

basic metabolic panel

B.

complete blood count

C.

erythrocyte sedimentation rate

D.

blood cultures

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Questions 35

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

Options:

A.

mitral insufficiency

B.

aortic stenosis

C.

mitral stenosis

D.

aortic insufficiency

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Questions 36

A patient is receiving therapeutic hypothermia post-cardiac arrest. Which of the following orders should a nurse clarify?

Options:

A.

chemistry labs every day

B.

ABGs every 4 hours and with any ventilator changes

C.

hourly intake and output

D.

sequential compression devices

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Questions 37

The dysrhythmia most commonly associated with mitral stenosis is

Options:

A.

second-degree AV heart block, Mobitz Type II.

B.

idioventricular rhythm.

C.

sinus bradycardia.

D.

atrial fibrillation.

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Questions 38

A patient is experiencing lower left quadrant pain with guarding, as well as abdominal distention and rigidity. KUB reveals free air in the abdominal

cavity. Vital signs are:

BP76/40

HR130

RR32

T101.7° F (38.7°C)

A nurse would suspect

Options:

A.

perforated bowel.

B.

paralytic ileus.

C.

appendicitis.

D.

acute pancreatitis.

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Questions 39

A patient is intubated, is unable to follow simple commands, and has no history of alcohol abuse. The patient has become increasingly disoriented and confused over the past 24 hours. After assessment and treatment of pain, the best medication intervention for management is

Options:

A.

lorazepam (Ativan).

B.

cisatracurium (Nimbex).

C.

midazolam (Versed).

D.

dexmedetomidine (Precedex).

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Questions 40

A patient with cardiogenic shock for several days has been managed aggressively with vasopressor and inotrope therapies. Which of the following indicates organ dysfunction from hypoperfusion?

Options:

A.

decreased insulin requirements and abdominal pain

B.

elevated creatinine and fever

C.

abdominal pain and elevated creatinine

D.

fever and decreased insulin requirements

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Questions 41

For a patient who sustained blunt renal trauma and a crush injury to the leg, monitoring should include observing for

Options:

A.

a shortened PR interval.

B.

tall peaked T waves.

C.

ST segment depression.

D.

a prolonged PR interval.

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Questions 42

In a patient with status asthmaticus, which of the following indicate a deteriorating condition?

Options:

A.

increased compliance and respiratory acidosis

B.

increased PaCO2 and decreased expiratory flow

C.

respiratory alkalosis and increased expiratory flow

D.

decreased PaCO2 and increased minute ventilation

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Questions 43

Which of the following is a sign of splenic injury and diaphragmatic irritation?

Options:

A.

tachypnea

B.

flank pain

C.

left shoulder pain

D.

hiccoughs

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Questions 44

The family member of a patient who is receiving mechanical ventilation is to be taught suctioning. When developing a teaching plan, the nurse should first

Options:

A.

obtain written information about the procedure.

B.

determine a schedule for demonstrating the technique.

C.

identify the areas in which the family member needs information and skills.

D.

encourage the family member to observe the procedure on other patients.

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Questions 45

A patient is recovering from CABG surgery. On postoperative day 3, the patient's laboratory values indicate thrombocytopenia and elevated liver function tests. The patient is scheduled for hemodialysis today. A nurse notifies the physician of the abnormal laboratory values. The nurse should next anticipate an order to

Options:

A.

administer heparin to prevent clot formation.

B.

complete hemodialysis without heparin.

C.

transfuse platelets during hemodialysis.

D.

reschedule hemodialysis.

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Exam Code: CCRN-Adult
Exam Name: CCRN (Adult) - Direct Care Eligibility Pathway
Last Update: Oct 16, 2025
Questions: 150

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