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

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Total 150 questions

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

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.

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

A.

administer heparin to prevent clot formation.

B.

complete hemodialysis without heparin.

C.

transfuse platelets during hemodialysis.

D.

reschedule hemodialysis.

Which of the following suggests acute peripheral arterial insufficiency?

A.

positive Homans' sign

B.

capillary refill time less than 2 sec

C.

weak equal bilateral pedal pulses

D.

sudden, severe pain at rest

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

A.

a shortened PR interval.

B.

tall peaked T waves.

C.

ST segment depression.

D.

a prolonged PR interval.

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

A.

chemistry labs every day

B.

ABGs every 4 hours and with any ventilator changes

C.

hourly intake and output

D.

sequential compression devices

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

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."

A common problem in patients with third-degree AV block is

A.

hypoperfusion.

B.

heart failure.

C.

hypoxia.

D.

chest pain.

A patient underwent bariatric surgery for weight loss 3 days ago. The patient appears anxious, restless, and reports increased abdominal pain over the last 24 hours. The nurse palpates mild subcutaneous crepitus over the neck. Vital signs are:

BP 106/64

HR 128

RR 27

T 100.4° F (38°C)

Which action should the nurse anticipate?

A.

Obtain labs.

B.

Administer a 1000 mL bolus of normal saline.

C.

Provide broad spectrum antibiotics.

D.

Prepare the patient for surgery.

After the administration of haloperidol (Haldol), a nurse should monitor closely for

A.

prolonged QT interval and cardiac dysrhythmias.

B.

respiratory failure and cardiac failure.

C.

widened QRS complex.

D.

increased agitation.

Examination of a patient exhibiting Kernig's and Brudzinski's signs indicates which of the following?

A.

autonomic hyperreflexia

B.

adrenal insufficiency

C.

meningeal irritation

D.

increased intracranial pressure