CCRN Practice Questions

Nimodipine is a calcium channel blocker that is used to prevent or treat cerebral vasospasm after

subarachnoid hemorrhage. It works by relaxing the smooth muscle of the cerebral arteries and

improving blood flow to the brain. Nimodipine is the only FDA-approved agent for vasospasm and

has been shown to reduce the risk of ischemic complications and improve neurological outcomes12.

Lorazepam, propranolol, and pentobarbital are not effective for treating cerebral vasospasm and may

have adverse effects on the patient’s blood pressure, heart rate, and level of consciousness.

A serum potassium level of 7.2 mEq/L is critically high and can lead to life-threatening cardiac

arrhythmias. The most immediate intervention is the administration of 50% dextrose followed by

insulin, which helps drive potassium back into the cells, thereby rapidly lowering the serum

potassium level. Hemodialysis and Kayexalate are also effective but may not act as quickly as the

dextrose-insulin combination. Reference: = CCRN Exam Handbook, AACN Adult CCRN Certification

Review Course

In the context of cardiogenic shock managed with vasopressor and inotrope therapies, organ

dysfunction from hypoperfusion can manifest as elevated creatinine and abdominal pain. Elevated

creatinine indicates renal impairment, a common result of poor perfusion to the kidneys. Abdominal

pain can indicate hypoperfusion to the gastrointestinal tract, leading to ischemic bowel or other GI

complications. These symptoms are direct indicators of hypoperfusion and organ dysfunction.

Reference: = CCRN Exam Handbook, AACN Adult CCRN Certification Review Course

The administration of hypertonic saline (3% Normal Saline) creates an osmotic gradient that pulls

water out of the swollen brain tissue into the vascular system, helping to reduce cerebral edema.

This is a critical intervention in managing increased intracranial pressure in patients with

hemorrhagic stroke. Reference: = CCRN Exam Handbook, AACN Adult CCRN Certification Review

Course

The primary consideration is to ensure that the family understands the unit's visitation policies.

While alternative modalities like therapeutic touch can be beneficial, the nurse must adhere to

established policies and explain the rationale to the family. This helps maintain the integrity of unit

operations and ensures that all patients receive equitable care. Explaining the policies also provides

an opportunity to discuss alternative ways to support the patient within the existing framework.

Reference: = CCRN Exam Handbook, AACN Adult CCRN Certification Review Course

Morphine is often used to relieve symptoms such as shortness of breath and anxiety in patients with

pulmonary fibrosis. It works by reducing the sensation of dyspnea and the sense of impending doom

by decreasing the respiratory drive and alleviating anxiety through its sedative effects. Additionally,

morphine can help reduce tachypnea by slowing down the respiratory rate. Reference: = CCRN Exam

Handbook, AACN Adult CCRN Certification Review Course

The most appropriate therapy for carboxyhemoglobinemia, which is carbon monoxide poisoning, is

the administration of 100% oxygen. This treatment helps to displace carbon monoxide from

hemoglobin, allowing oxygen to bind to hemoglobin and be transported to tissues more effectively.

High-flow oxygen can significantly reduce the half-life of carboxyhemoglobin, facilitating faster

recovery.

Reference: = CCRN Exam Handbook, page 30

An increase in peak inspiratory pressure (PIP) over time in a mechanically ventilated patient

indicates a decrease in lung compliance. This means the lungs are becoming stiffer and less able to

expand, which can be caused by conditions such as pulmonary edema, ARDS, or pneumothorax. It is

important to address the underlying cause of decreased lung compliance to prevent further

respiratory complications. Reference: = CCRN Exam Handbook, AACN Adult CCRN Certification

Review Course

In the setting of an acute anterior wall myocardial infarction (MI) with an S3 gallop, the patient is

likely experiencing heart failure and possibly acute pulmonary edema. The appropriate treatment

includes vasodilators to reduce afterload and diuretics to decrease preload and pulmonary

congestion. This combination helps to improve cardiac output and reduce the workload on the heart.

Reference: CCRN Exam Handbook, AACN, page 20, section on Cardiovascular.

The spleen plays a crucial role in filtering bacteria and old or damaged blood cells, as well as

mounting an immune response. After a splenectomy, the patient is at increased risk for infections,

particularly from encapsulated organisms like Streptococcus pneumoniae, Haemophilus influenzae,

and Neisseria meningitidis. This heightened susceptibility to infection can lead to sepsis, a life-

threatening condition. Reference: AACN Adult CCRN Certification Review Course, AACN CCRN Exam

Handbook.