Pass CCRN test bank Latest Update 2024-2025 Actual Exam 125 Questions and 100% Verified Correct Answers Guaranteed A+
A 20-mm S wave in lead V1 and a 25-mm R wave in lead V6 are noted on a patient's 12-lead electrocardiogram. This would indicate which of the following?
A.Right bundle branch block (RBBB) B.Left ventricular hypertrophy C.Posterior wall myocardial infarction (MI) D.
Right ventricular hypertrophy - CORRECT ANSWER: B. Left ventricular hypertrophy
When the depth of the S wave in lead V1 or V2 plus the height of the R wave in lead V5 or V6 is 35 mm or greater, this constitutes voltage criteria for left ventricular hypertrophy.
A 22-year-old man is admitted after a bicycle collision with a tree. He has a contusion on the right side of his head. An intraventricular catheter has been inserted via a burr hole to monitor his intracranial pressure (ICP). He develops respiratory depression and is intubated and mechanically ventilated. Which of the following is the most likely cause of an increase in ICP at this time?
A.Positive pressure ventilation B.Hypocapnia caused by hyperventilation C.Sedation D.
Cerebral dehydration caused by osmotic diuretics - CORRECT ANSWER: A. Positive
pressure ventilation
Positive pressure ventilation increases intrathoracic pressure, which leads to increased ICP.
A 22-year-old man is admitted to the critical care unit after a motor vehicle collision. The emergency department nurse reports that he was unconscious at the scene of the accident, but he is now alert and oriented. Skull films show a linear fracture of the right
temporal bone. He is at significant risk for:
- / 4
A.scalp hematoma.B.subdural hematoma.C.epidural hematoma.D.
intracerebral hematoma. - CORRECT ANSWER: C. epidural hematoma.
Linear fractures of the temporal bone frequently disrupt the middle meningeal artery and cause epidural hematoma. Patients with an epidural hematoma classically present with a short period of unconsciousness followed by a lucid interval and then rapid deterioration. An epidural hematoma is usually caused by arterial bleeding.
A 22-year-old man is admitted with spontaneous pneumothorax. He is extremely dyspneic and anxious. He also is complaining of tingling around his mouth and his fingertips and feeling light-headed. Blood pressure is 120/82 mm Hg, heart rate is 110 beats/min, respiratory rate is 36 breaths/min and deep, and temperature is 37° C (98.6° F). Which of the following would not be used to treat this condition?
A.Calcium B.Chest tube C.Analgesia D.
Calming the patient - CORRECT ANSWER: A. Calcium
Remember that respiratory alkalosis, caused by hyperventilation, increases the binding between albumin and calcium and, therefore, reduces the serum ionized calcium level.This is why the patient is having the symptoms of tetany. However, he does not need calcium. He needs a reduction in minute ventilation, which will decrease his pH and correct the binding between calcium and albumin, increasing the ionized calcium level.Chest tube to re-expand the lung, analgesia to treat the chest discomfort, and calming of the patient (including the use of sedatives) would be appropriate components of the treatment plan for this patient.
A 24-year-old man has been diagnosed with acute kidney injury as a result of severe hemorrhaging after a motor vehicle collision. Which of the following would be expected laboratory values for this patient?
A.Low urinary osmolality, high urinary sodium concentration B.High urinary osmolality, high urinary sodium concentration 2 / 4
C.Low urinary osmolality, low urinary sodium concentration D.
High urinary osmolality, low urinary sodium concentration - CORRECT ANSWER: D.
High urinary osmolality, low urinary sodium concentration
Consider that the kidney would want to conserve sodium and water with blood loss. If the kidney is holding onto sodium, little is excreted into the urine, so urinary sodium is low. If the kidney is holding onto water, little is excreted into the urine, so it is concentrated and osmolality is increased.
A 24-year-old man is admitted to the critical care unit after sustaining a pulmonary contusion in a motor vehicle collision. He has no history of cardiac or pulmonary disease. During the first 24 hours after admission, he has been complaining of increasing dyspnea, his respiratory rate has been increasing, and his oxygen saturation via pulse oximetry has been decreasing despite supplemental oxygen. Breath sound assessment reveals fine crackles bilaterally. Arterial blood gases reveal respiratory alkalosis and hypoxemia. Chest x-ray film reveals patchy infiltrates. Acute respiratory distress syndrome is diagnosed. Oxygen therapy is initiated, and arterial blood gases are monitored closely, but SaO2 continues to fall. Which of these oxygen delivery systems will provide the highest concentration of oxygen and indicated in this case?
A.Face tent B.Nonrebreathing mask C.Nasal cannula D.
Venturi mask - CORRECT ANSWER: B. Nonrebreathing mask
The nonrebreathing mask stores oxygen in nose, pharynx, mask, and reservoir bag between breaths. This allows a concentration of close to 100%.
A 24-year-old man is admitted to the critical care unit after sustaining a pulmonary contusion in a motor vehicle collision. He has no history of cardiac or pulmonary disease. Over the last few hours, he has been complaining of increasing dyspnea, his respiratory rate has been increasing, and his oxygen saturation via pulse oximetry has been decreasing. Breath sound assessment reveals fine crackles bilaterally. Arterial blood gases reveal respiratory alkalosis and hypoxemia. Chest x-ray film reveals patchy infiltrates. Acute respiratory distress syndrome (ARDS) is diagnosed. Oxygen therapy is initiated, and arterial blood gases are monitored closely. The massive atelectasis that occurs in acute respiratory distress syndrome is a classic example of intrapulmonary shunt. Intrapulmonary shunting is best described as which of the following?
A. 3 / 4
Ventilated alveoli having blocked perfusion.B.Perfused alveoli having bloc - CORRECT ANSWER: B. Perfused alveoli having blocked ventilation.
A 27-year-old woman arrives in the emergency department 3 weeks after the vaginal delivery of her first child. She is transferred to the critical care unit after an acute onset of dyspnea and chest pain. Vital signs are blood pressure, 120/88 mm Hg; heart rate, 122 beats/min; and respiratory rate, 32 breaths/min. Arterial blood gases reveal a pH of 7.48, a PaCO2 of 30 mm Hg, an HCO3 of 24 mEq/L, a PaO2 of 55 mm Hg, and an arterial oxygen saturation of 89% on 100% oxygen by nonrebreathing mask. Jugular venous distention is evident, and cardiac auscultation reveals an accentuated P2 and a right-sided S3 and S4. A ventilation/perfusion scan indicates high probability of a pulmonary embolism. Which of the following is not evident by the heart sound changes?
A.Pulmonary hypertension B.Right ventricular strain and noncompliance C.Right ventricular failure D.
Pulmonary edema - CORRECT ANSWER: D. Pulmonary edema
A 27-year-old woman arrives in the emergency department 3 weeks after the vaginal delivery of her first child. She is transferred to the critical care unit after an acute onset of dyspnea and chest pain. Vital signs are blood pressure, 120/88 mm Hg; heart rate, 122 beats/min; and respiratory rate, 32 breaths/min. Arterial blood gases reveal a pH of 7.48, a PaCO2 of 30 mm Hg, an HCO3 of 24 mEq/L, a PaO2 of 55 mm Hg, and an arterial oxygen saturation of 89% on 100% oxygen by nonrebreathing mask. Jugular venous distention is evident, and cardiac auscultation reveals an accentuated P2 and an S3 and S4 of the right side. A ventilation/perfusion scan indicates high probability of a pulmonary embolism. What treatment is indicated at this time?
A.Intubation and mechanical ventilation B.Heparin C.Fibrinolytic agents D.
Pulmonary embolectomy - CORRECT ANSWER: C. Fibrinolytic agents
Remember that fibrinolytic agents are not contraindicated by surgery or trauma after about 2 weeks because the normal fibrinolytic process already would have broken down
- / 4