CCRN REVIEW Practice Test

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Which of the following is an isotonic solution that can be given to a hypovolemic patient to replace fluid volume without causing significant fluid shifts across cell membranes or vessels?

Correct! Wrong!

Explanation:
The isotonic solution has risen to concentrations of solutes compared to their environment. In this way, the organization of an isotonic solution will NOT altogether move liquid volumes over the cellular films or vessels. (0.9%) Typical Saline is an isotonic solution that can be utilized for this reason. 3% Typical Saline may be a hypertonic arrangement that will tend to draw liquid from cells and interstitial spaces into vessels. D5W (5% Dextrose in Water) and D5 0.5 NS (5% Dextrose and 0.45% Ordinary Saline) are both hypotonic solutions that will tend to have the inverse impact of hypertonic solutions and will increment add up to body edema

A typical bacterial pathogens associated with community-acquired pneumonia (CAP) include:

Correct! Wrong!

Explanation:
A wide variety of pathogens (typical and atypical) are known to cause community-acquired pneumonia (CAP). Typical bacterial pathogens are Streptococcus pneumonia, Haemophilus influenzae, and Moraxella catarrhalis. Atypical pathogens include Chlamydia pneumoniae, Mycoplasma species, and Legionella species.

The two guideline biochemical operators that are discharged from the endothelium of blood vessels and work to diminish blood flow to destinations of harm and preserve blood volume are:

Correct! Wrong!

Explanation:
The primary arrangement of hemostasis regularly includes diminishing bloodstream to the location of harm in order typically finished through that activity of endothelin and thromboxane A2, biochemical operators that are discharged through the vascular endothelium and cause vasoconstriction of the smooth muscle of the vascular wall. Thrombin, prothrombin, fibrogenin, serotonin, and collagen are variables that help within the arrangement of a platelet plug.

A patient in the intensive care unit has symptoms of delirium. Drug treatment for delirium often includes:
I. Antipsychotics
II. Benzodiazepines
III. Antidepressants

Correct! Wrong!

Explanation:
Delirium is an acute disorder characterized by impaired attention, perception, and memory. It is often the symptom of an underlying medical condition, such as dementia, drug overdose, substance intoxication, and electrolyte imbalances. Drug treatment for delirium often involves the use of antipsychotics or benzodiazepines, depending on the underlying cause of the delirium. Antidepressants are generally not used to treat acute conditions such as delirium.

Regarding the Synergy Model for Patient care, which of the following refers to the nurse's ability to use her knowledge and a set of skills for understanding how one decision can affect the system as a whole?

Correct! Wrong!

Explanation:
One of the four components of the Synergy Model for Patient Care is nurse characteristics. Systems thinking refers to a nurse's capacity to manage environmental and system resources by applying their knowledge and skills in a way that allows them to see how one action affects the entire system.

Damage to the developing brain's motor control areas causes which of the following developmental conditions?

Correct! Wrong!

Explanation:
Cerebral palsy is a term that refers to a range of non-progressive, non-contagious motor problems that arise as a result of injury to the developing brain's motor control areas. Cerebral palsy can cause a wide range of musculoskeletal problems, from slight to severe.

Blood flows back into the ____ in mitral valve regurgitation:

Correct! Wrong!

Explanation:
The defective mitral valve (the valve that separates the left atrium and the left ventricle) permits blood to flow back into the left atrium, causing mitral valve regurgitation.

The number of vertebrae in each section of the vertebral column is appropriately identified by which of the following?

Correct! Wrong!

Explanation:
There are 33 vertebrae in the spinal column: 7 cervical, 12 thoracic, 5 lumbar, 5 sacral, and 4 coccygeal. The five sacral vertebrae, as well as the four coccygeal vertebrae, are fused together as one. Intervertebral discs give flexibility and act as shock absorbers between each of the non-fused vertebrae. The vertebral column's primary role is to protect the spinal cord.

Which of the following organizes the four layers of the gastrointestinal wall from most superficial to most interior correctly?

Correct! Wrong!

Explanation:
There are four layers to the gastrointestinal tract's wall. The serosa, muscularis, submucosa, and mucosa are the layers in order, starting with the most superficial.

HIPPA laws require which of the following ethical principles?

Correct! Wrong!

Explanation:
HIPPA statutes need patient confidentiality as an ethical precept. The Privacy Rule, in particular, prohibits healthcare practitioners from sharing or revealing any healthcare-related conversations they have with their patients. Without the patient's express consent, the Privacy Rule also bans the distribution of any medically connected documents.

Which of the following granulocytes contributes to the inflammatory response by releasing histamine?

Correct! Wrong!

Explanation:
Basophils are nonphagocytic cells that live on the periphery of capillaries. They release histamine, heparin, and other chemicals.IgE is attracted to their cell surface by bradykinin and serotonin, which stimulates the inflammatory response/allergic reaction. within the human body

Which of the following statements accurately describes encephalitis?

Correct! Wrong!

Explanation:
Encephalitis is a CNS infection characterized by brain tissue inflammation. Viral infection is the most prevalent cause, but other pathogens such as bacteria, fungi, and parasites can also cause the illness. Encephalitis is most common in children under the age of ten, with symptoms such as headache, nausea, fever, and photophobia being typical. The administration of appropriate anti-infectious drugs is usually the first line of treatment.

Damage to or illness of the adrenal cortex's zona glomerulosa is likely to cause electrolyte imbalance due to dysfunction of:

Correct! Wrong!

Explanation:
The adrenal cortex's zona glomerulosa secretes aldosterone. This hormone aids in the regulation of electrolyte imbalance by promoting sodium reabsorption and potassium loss. As a result, injury to this part of the adrenal cortex is likely to result in aldosterone malfunction, which can lead to electrolyte imbalance.

When assessing renal function, a normal BUN-to-creatinine ratio is as:

Correct! Wrong!

Explanation:
Normal renal function is defined as a BUN-to-creatinine ratio of less than 20:1. A BUN-to-creatinine ratio of 20:1 or above indicates acute renal insufficiency (dehydration or fluid loss).

Osmotic diuretics include which of the following medications?
I. Mannitol
II. Furosemide
III. Ethacrynic acid

Correct! Wrong!

Explanation:
Diuretics are categorized based on which part of the kidney they affect. Furosemide and ethacrynic acid are examples of loop diuretics that work on the Henle loop. Mannitol is a type of osmotic diuretic.

You're using a pulmonary artery catheter to monitor a patient. You are unable to determine the pulmonary artery wedge pressure of the patient. You check the ___________ to get a value that matches to the pulmonary artery wedge pressure.

Correct! Wrong!

Explanation:
Use the pulmonary artery diastolic pressure to discover patterns in the pulmonary artery wedge pressure if you can't get a pulmonary artery wedge pressure. The diastolic pressure of the pulmonary artery is normally 1 to 4 mm/Hg higher than the pulmonary artery wedge pressure. The pulmonary artery diastolic pressure of a patient with pulmonary disease, on the other hand, is influenced by increased right heart pressures, which do not correspond with the pulmonary artery wedge pressure. (Recall that pulmonary artery wedge pressure is a measure of heart pressure on the left side.) The right atrial and right ventricular pressures indicate heart pressures on the right side of the heart, not the left. Calculate pulmonary vascular resistance using the pulmonary artery mean pressure.

A normal wedge pressure, elevated pulmonary artery pressures, and indications of right ventricular failure are all assessed by the nurse. Which condition is this most likely to indicate?

Correct! Wrong!

Explanation:
A pulmonary embolus can be identified by a normal wedge pressure, elevated pulmonary artery pressures, and symptoms of right ventricular failure. Respiratory disease would elevate right ventricular pressures since the pulmonary vasculature is located between the right and left sides of the heart. There would be no increase in wedge pressure, which is a reflection of left ventricular pressures.

An alcohol abuser's spontaneous and painless GI tract bleeding could indicate which of the following patient conditions?

Correct! Wrong!

Explanation:
In an alcoholic, a spontaneous, painless GI tract hemorrhage could indicate esophageal varices or a Mallory-Weiss rip. Reflux esophagitis is caused by alcoholism, and it erodes and weakens the esophagus; retching or coughing causes an esophageal (or Mallory-Weiss) rupture. Pain is generally linked with hemorrhage caused by peptic ulcers, gastric rupture, or a duodenal tear.

The nurse examines Mr. David., a 45-year-old sportsman. His heart rate speeds up and slows down. In Lead II, he has upright P and R waves at 70 beats per minute. Most likely, his rhythm is an example of:

Correct! Wrong!

Explanation:
Mr. David is most likely suffering from a sinus arrhythmia, which is prevalent among athletes, children, and the elderly. Acceleration corresponds to inhalation, whereas deceleration corresponds to exhalation. Increased intracranial pressure, inferior wall MI, advanced age, and use of digoxin or morphine are all circumstances that can cause sinus arrhythmia; nonetheless, his sports past is the most likely explanation for his rhythm fluctuation.

What does the "spine sign" shown on Daniel's chest x-ray mean?

Correct! Wrong!

Explanation:
On a chest x-ray, the presence of the "spine sign" indicates bilateral lower lobe pneumonia. At the level of bilateral lower lobe pulmonary infiltrates, which obstruct visibility of the vertebrae, the spinal marks vanish.

Which of the following is NOT the most appropriate first intervention if a patient is suspected of having an episode of acute hypoglycemia?

Correct! Wrong!

Explanation:
Although drawing a STAT blood glucose level may be part of a number of initial interventions, it should not be the first, since results will take too long to obtain. Patients who are suffering from acute hypoglycemia are at high risk of incurring permanent neurological damage, since the primary energy source for the brain is sugar. Patients who are conscious should consume a simple sugar which will absorb rapidly, like orange juice or glucose tablets. Patients who are unconscious outside the hospital setting or without IV access in the hospital setting should receive IM glucagon. Patients who are conscious in the hospital setting with IV access may be given IV dextrose.

The nurse expects that the foremost life-threatening occasion of adrenal crisis is:

Correct! Wrong!

Explanation:
The most serious risk in an adrenal crisis is fringe vascular collapse, with as much as 20% of extracellular liquid lost. In this way, the primary objective of crisis treatment is liquid substitution.

Of the following, which is included within the etiology of idiopathic thrombocytopenic purpura (ITP)?

Correct! Wrong!

Explanation:
Idiopathic thrombocytopenic purpura (ITP) is caused by the presence of Immunoglobulin G (IgG) autoantibodies on the surface of the platelets. It is defined as isolated thrombocytopenia with normal bone marrow function and the absence of other causes of thrombocytopenia. Clinically, there are two syndromes which manifest; acute in children and chronic in adults. Depending on the patient's status, treatment may or may not be indicated. If indicated, glucocorticoids and IVIg are the typical mainstays of medical therapy, and surgical options may include splenectomy in adults.

What is the most common location for a brain aneurysm to burst and cause a subarachnoid hemorrhage (SAH)?

Correct! Wrong!

Explanation:
The most common site of cerebral aneurysm rupture and subarachnoid hemorrhage is the anterior communicating artery (SAH). Prior to rupture, there are usually no precipitating indications, but thereafter, several aberrant signs, such as nuchal rigidity, decreased level of consciousness, and abnormal pupillary findings, may be present (usually dilation).

Janice is a Type I diabetic who was admitted to the unit after losing consciousness due to a severe hypoglycemia episode. She claims to have experienced numerous episodes of hypoglycemia, but she no longer seems to be able to predict when they will occur.
What do you call this phenomenon?

Correct! Wrong!

Explanation:
When hypoglycemia occurs frequently, a condition known as hypoglycemia unawareness can develop. This occurs more frequently in Type I diabetics and is caused by the body's inability to release adrenaline and other stress hormones during hypoglycemic episodes. Without the symptoms associated with the production of adrenaline and stress hormones, a person is unaware that their blood sugar levels are plummeting, preventing them from acting quickly to cure hypoglycemia. Hypoglycemia-associated autonomic failure is another name for this syndrome (HAAF).

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