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AACN CCRN-Adult - CCRN (Adult) - Direct Care Eligibility Pathway

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Total 150 questions

The family of a patient with trauma believes that the patient is in pain and requests that a neighbor, a therapeutic touch practitioner, be allowed to see the patient. Unit policy allows visits by immediate family only. Which of the following is the most important consideration in a nurse's decision about facilitating the visit?

A.

Alternative modalities have been associated with enhancements in pharmacologic effects.

B.

Research does not support the value of therapeutic touch in pain management.

C.

Alternative therapies are not generally acceptable in an ICU setting.

D.

The family needs an explanation of the rationale for unit visitation policies.

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

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.

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

A.

second-degree, Mobitz Type II

B.

first-degree

C.

second-degree, Mobitz Type I (Wenckebach)

D.

third-degree (complete)

A patient presents with fever and chills, is diaphoretic, and reports experiencing abdominal and intermittent left shoulder pain for the past week. An

ultrasound shows an enlarged spleen. Vital signs are:

BP 106/59

HR 118

RR 23

T101.2° F (38.4° C)

When reviewing the lab report, which of the following findings is most significant to this presentation?

A.

positive blood cultures

B.

PLT 150,000/mm3

C.

WBC less than 500/mm3

D.

Hct 39%

An unconscious patient in hepatic failure secondary to alcoholism becomes acutely hypoglycemic. Glucagon administration is contraindicated for this patient because glucagon

A.

interferes with lactulose (Cephulac) therapy.

B.

produces additional sedative effects.

C.

is ineffective when hepatocytes are damaged.

D.

causes rebound hyperglycemia.

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

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.

The family of a patient requests permission to administer traditional herbs to the patient. Which of the following should be the nurse's first action?

A.

Inform the family that herbal therapy is not appropriate in the hospital.

B.

Consult with the pharmacist on the effects of the specific herbs.

C.

Allow the patient to take the herbs because they are natural.

D.

Obtain an order for the herbs.

Appropriate outcomes for a patient with status asthmaticus include

A.

increased PaCO2 and decreased FEV1.

B.

decreased peak flow rates and decreased wheezing.

C.

paradoxical breathing and increased FEV1.

D.

normal PaCO2 and increased FEV1.

A patient is admitted with hypotension, tachycardia, and intermittent confusion. Upon arrival, the patient asks to walk to the bathroom. Which of the

following is a nurse's best action?

A.

Assess the patient's vital signs and ask the physician for an order for activity.

B.

Conduct a fall risk assessment and institute appropriate interventions.

C.

Encourage the patient to walk independently to the bathroom to enhance early mobility.

D.

Situate the patient in bed and provide a bed pan.

A unit council is requesting to change a documentation screen of the electronic health record (EHR) at a large health system. The change was not discussed with the department prior to the request and was denied by the EHR committee. Which of the following strategies will most likely lead to accomplishing the team's goals?

A.

Have nursing leadership evaluate the proposal before resubmitting the request.

B.

Discuss the proposed solution with stakeholders to determine buy in.

C.

Work with key staff members to rewrite the request to present at the next meeting.

D.

Attempt to change the process through another format.