Critical Care Register Nurse Practice Test

CCRN Exam Format | Course Contents | Course Outline | Exam Syllabus | Exam Objectives

A criterion-referenced standard setting process, known as the modified Angoff, is used to establish the passing point/cut score for the exam. Each candidates performance on the exam is measured against a predetermined standard.
The passing point/cut score for the exam is established using a panel of subject matter experts, an exam development committee (EDC), who carefully reviews each exam question to determine the basic level of knowledge or skill that is expected. The passing point/cut score is based on the panels established difficulty ratings for each exam question.
Under the guidance of a psychometrician, the panel develops and recommends the passing point/cut score, which is reviewed and approved by AACN Certification Corporation. The passing point/cut score for the exam is established to identify individuals with an acceptable level of knowledge and skill. All individuals who pass the exam, regardless of their score, have demonstrated an acceptable level of knowledge.

I. CLINICAL JUDGMENT (80%)
A. Cardiovascular (17%)
1. Acute coronary syndrome:
a. NSTEMI
b. STEMI
c. Unstable angina
2. Acute peripheral vascular insufficiency:
a. Arterial/venous occlusion
b. Carotid artery stenosis
c. Endarterectomy
d. Fem-Pop bypass
3. Acute pulmonary edema
4. Aortic aneurysm
5. Aortic dissection
6. Aortic rupture
7. Cardiac surgery:
a. CABG
b. Valve replacement or repair
8. Cardiac tamponade
9. Cardiac trauma
10. Cardiac/vascular catheterization
11. Cardiogenic shock
12. Cardiomyopathies:
a. Dilated
b. Hypertrophic
c. Idiopathic
d. Restrictive
13. Dysrhythmias
14. Heart failure
15. Hypertensive crisis
16. Myocardial conduction system abnormalities
(e.g., prolonged QT interval, Wolff-ParkinsonWhite)
17. Papillary muscle rupture
18. Structural heart defects (acquired and congenital, including valvular disease)
19. TAVR

B. Respiratory (15%)
1. Acute pulmonary embolus
2. ARDS
3. Acute respiratory failure
4. Acute respiratory infection (e.g., pneumonia)
5. Aspiration
6. Chronic conditions (e.g., COPD, asthma, bronchitis, emphysema)
7. Failure to wean from mechanical ventilation
8. Pleural space abnormalities (e.g., pneumothorax, hemothorax, empyema, pleural effusions)
9. Pulmonary fibrosis
10. Pulmonary hypertension
11. Status asthmaticus
12. Thoracic surgery
13. Thoracic trauma (e.g., fractured rib, lung contusion, tracheal perforation)
14. Transfusion-related acute lung injury (TRALI)

C. Endocrine/Hematology/Gastrointestinal/Renal/Integumentary (20%)
1. Endocrine
a. Adrenal insufficiency
b. Diabetes insipidus (DI)
c. Diabetes mellitus, types 1 and 2
d. Diabetic ketoacidosis (DKA)
e. Hyperglycemia
f. Hyperosmolar hyperglycemic state (HHS)
g. Hyperthyroidism
h. Hypoglycemia (acute)
i. Hypothyroidism
j. SIADH
2. Hematology and Immunology
a. Anemia
b. Coagulopathies (e.g., ITP, DIC, HIT)
c. Immune deficiencies
d. Leukopenia
e. Oncologic complications (e.g., tumor lysis syndrome, pericardial effusion)
f. Thrombocytopenia
g. Transfusion reactions
3. Gastrointestinal
a. Abdominal compartment syndrome
b. Acute abdominal trauma
c. Acute GI hemorrhage
d. Bowel infarction, obstruction, perforation (e.g., mesenteric ischemia, adhesions)
e. GI surgeries (e.g., Whipple, esophagectomy, resections)
f. Hepatic failure/coma (e.g., portal hypertension, cirrhosis, esophageal varices, fulminant hepatitis, biliary atresia, drug-induced)
g. Malnutrition and malabsorption
h. Pancreatitis
4. Renal and Genitourinary
a. Acute genitourinary trauma
b. Acute kidney injury (AKI)
c. Chronic kidney disease (CKD)
d. Infections (e.g., kidney, urosepsis)
e. Life-threatening electrolyte imbalances
5. Integumentary
a. Cellulitis
b. IV infiltration
c. Necrotizing fasciitis
d. Pressure injury
e. Wounds:
i. infectious
ii. surgical
iii. trauma
D. Musculoskeletal/Neurological/

Psychosocial (14%)
1. Musculoskeletal
a. Compartment syndrome
b. Fractures (e.g., femur, pelvic)
c. Functional issues (e.g., immobility, falls, gait disorders)
d. Osteomyelitis
e. Rhabdomyolysis
2. Neurological
a. Acute spinal cord injury
b. Brain death
c. Delirium (e.g., hyperactive, hypoactive, mixed)
d. Dementia
e. Encephalopathy
f. Hemorrhage:
i. intracranial (ICH)
ii. intraventricular (IVH)
iii. subarachnoid (traumatic or aneurysmal)
g. Increased intracranial pressure (e.g., hydrocephalus)
h. Neurologic infectious disease (e.g., viral, bacterial, fungal)
i. Neuromuscular disorders (e.g., muscular dystrophy, CP, Guillain-Barré, myasthenia)
j. Neurosurgery (e.g., craniotomy, Burr holes)
k. Seizure disorders
l. Space-occupying lesions (e.g., brain tumors)
m. Stroke:
i. hemorrhagic
ii. ischemic (embolic)
iii. TIA
n. Traumatic brain injury (TBI): epidural, subdural, concussion
3. Behavioral and Psychosocial
a. Abuse/neglect
b. Aggression
c. Agitation
d. Anxiety
e. Suicidal ideation and/or behaviors
f. Depression
g. Medical non-adherence
h. PTSD
i. Risk-taking behavior
j. Substance use disorders (e.g., withdrawal, chronic alcohol or drug dependence)
E. Multisystem (14%)
1. Acid-base imbalance
2. Bariatric complications
3. Comorbidity in patients with transplant history
4. End-of-life care
5. Healthcare-associated conditions (e.g., VAE, CAUTI, CLABSI)
6. Hypotension
7. Infectious diseases:
a. Influenza (e.g., pandemic or epidemic)
b. Multi-drug resistant organisms (e.g., MRSA, VRE, CRE)
8. Life-threatening maternal/fetal complications (e.g., eclampsia, HELLP syndrome, postpartum hemorrhage, amniotic embolism)
9. Multiple organ dysfunction syndrome (MODS)
10. Multisystem trauma
11. Pain: acute, chronic
12. Post-intensive care syndrome (PICS)
13. Sepsis
14. Septic shock
15. Shock states:
a. Distributive (e.g., anaphylactic, neurogenic)
b. Hypovolemic
16. Sleep disruption (including sensory overload)
17. Thermoregulation
18. Toxic ingestion/inhalations (e.g., drug/alcohol overdose)
19. Toxin/drug exposure (including allergies)

II. PROFESSIONAL CARING 7 ETHICAL PRACTICE (20%)
A. Advocacy/Moral Agency
B. Caring Practices
C. Response to Diversity
D. Facilitation of Learning
E. Collaboration
F. Systems Thinking
G. Clinical Inquiry

CLINICAL JUDGMENT
General
• Recognize normal and abnormal:
o developmental assessment findings and provide developmentally appropriate care
o physical assessment findings
o psychosocial assessment findings
• Recognize signs and symptoms of emergencies, initiate interventions, and seek assistance as needed
• Recognize indications for, and manage patients requiring:
o capnography (EtCO2)
o central venous access
o medication reversal agents
o palliative care
o SvO2 monitoring
• Manage patients receiving:
o complementary/alternative medicine and/or nonpharmacologic interventions
o medications (e.g., safe administration, monitoring, polypharmacy)
• Monitor patients and follow protocols for pre- and postoperative care
• Assess pain
• Evaluate patients response to interventions
• Identify and monitor normal and abnormal diagnostic test results
• Manage fluid and electrolyte balance
• Manage monitor alarms based on protocols and changes in patient condition Cardiovascular
• Apply leads for cardiac monitoring
• Identify, interpret and monitor cardiac rhythms
• Recognize indications for, and manage patients requiring:
o 12-lead ECG
o arterial catheter
o cardiac catheterization
o cardioversion central venous pressure monitoring
o defibrillation
o IABP
o invasive hemodynamic monitoring
o pacing: epicardial, transcutaneous, transvenous
o pericardiocentesis
o QT interval monitoring
o ST segment monitoring
• Manage patients requiring:
o endovascular stenting
o PCI Respiratory
• Interpret blood gas results
• Recognize indications for, and manage patients requiring:
o modes of mechanical ventilation
o noninvasive positive pressure ventilation (e.g., BiPAP, CPAP, high-flow nasal cannula)
o oxygen therapy delivery devices
o prevention of complications related to mechanical ventilation (ventilator bundle)
o prone positioning
o pulmonary therapeutic interventions related to mechanical ventilation: airway clearance, extubation, intubation, weaning
o therapeutic gases (e.g., oxygen, nitric oxide, heliox, CO2 )
o thoracentesis
o tracheostomy Hematology and Immunology
• Manage patients receiving transfusion of blood products
• Monitor patients and follow protocols:
o pre-, intra-, post-intervention (e.g., plasmapheresis, exchange transfusion, leukocyte depletion)
o related to blood conservation Neurological
• Recognize indications for, and manage patients requiring neurologic monitoring devices and drains (e.g., ICP, ventricular or lumbar drain)
• Use a swallow evaluation tool to assess dysphagia
• Manage patients requiring:
o neuroendovascular interventions (e.g., coiling, thrombectomy)
o neurosurgical procedures (e.g., pre-, intra-, post-procedure)
o spinal immobilization Integumentary
• Recognize indications for, and manage patients requiring, therapeutic interventions (e.g. wound VACs, pressure reduction surfaces, fecal management devices, IV infiltrate treatment) Gastrointestinal
• Monitor patients and follow protocols for procedures pre-, intra-, post-procedure (e.g., EGD, PEG placement)
• Intervene to address barriers to nutritional/fluid adequacy (e.g., chewing/swallowing difficulties, alterations in hunger and thirst, inability to self-feed)
• Recognize indications for, and manage patients requiring:
o abdominal pressure monitoring
o GI drains
o enteral and parenteral nutrition Renal and Genitourinary
• Identify nephrotoxic agents
• Monitor patients and follow protocols pre-, intra-, and post-procedure (e.g., renal biopsy, ultrasound)
• Recognize indications for, and manage patients requiring, renal therapeutic intervention (e.g., hemodialysis, CRRT, peritoneal dialysis)
Musculoskeletal
• Manage patients requiring progressive mobility
• Recognize indications for, and manage patients requiring, compartment syndrome monitoring
Multisystem
• Manage continuous temperature monitoring
• Provide end-of-life and palliative care
• Recognize risk factors and manage malignant hyperthermia
• Recognize indications for, and manage patients undergoing:
o continuous sedation
o intermittent sedation
o neuromuscular blockade agents
o procedural sedation - minimal
o procedural sedation - moderate
o targeted temperature management (previously known as therapeutic hypothermia)
Behavioral and Psychosocial
• Respond to behavioral emergencies (e.g., nonviolent crisis intervention, de-escalation techniques)
• Use behavioral assessment tools (e.g., delirium, alcohol withdrawal, cognitive impairment)
• Recognize indications for, and manage patients requiring:
o behavioral therapeutic interventions
o medication management for agitation
o physical restraints

I. CLINICAL JUDGMENT (80%)
A. Cardiovascular (14%)
1. Cardiac infection and inflammatory diseases
2. Cardiac malformations
3. Cardiac surgery
4. Cardiogenic shock
5. Cardiomyopathies
6. Cardiovascular catheterization
7. Dysrhythmias
8. Heart failure
9. Hypertensive crisis
10. Myocardial conduction system defects
11. Obstructive shock
12. Vascular occlusion
B. Respiratory (18%)
1. Acute pulmonary edema
2. Acute pulmonary embolus
3. Acute respiratory distress syndrome (ARDS)
4. Acute respiratory failure
5. Acute respiratory infection
6. Air-leak syndromes
7. Apnea of prematurity
8. Aspiration
9. Chronic pulmonary conditions
10. Congenital airway malformations
11. Failure to wean from mechanical ventilation
12. Pulmonary hypertension
13. Status asthmaticus
14. Thoracic and airway trauma
15. Thoracic surgery

C. Endocrine/Hematology/Gastrointestinal/Renal/Integumentary (20%)
1. Endocrine
a. Adrenal insufficiency
b. Diabetes insipidus (DI)
c. Diabetic ketoacidosis (DKA)
d. Diabetes mellitus, types 1 and 2
e. Hyperglycemia
f. Hypoglycemia
g. Inborn errors of metabolism
h. Syndrome of inappropriate secretion of antidiuretic hormone (SIADH)
2. Hematology and Immunology
a. Anemia
b. Coagulopathies (e.g., ITP, DIC)
c. Immune deficiencies
d. Myelosuppression (e.g., thrombocytopenia, neutropenia)
e. Oncologic complications
f. Sickle cell crisis
g. Transfusion reactions
3. Gastrointestinal
a. Abdominal compartment syndrome
b. Abdominal trauma
c. Bowel infarction, obstruction and perforation
d. Gastroesophageal reflux
e. GI hemorrhage
f. GI surgery
g. Liver disease and failure
h. Malnutrition and malabsorption
i. Necrotizing enterocolitis (NEC)
j. Peritonitis
4. Renal and Genitourinary
a. AKI
b. Chronic kidney disease (CKD)
c. Hemolytic uremic syndrome (HUS)
d. Kidney transplant
e. Life-threatening electrolyte imbalances
f. Renal and genitourinary infections
g. Renal and genitourinary surgery
5. Integumentary
a. IV infiltration
b. Pressure injury
c. Skin failure (e.g., hypoperfusion)
d. Wounds

D. Musculoskeletal/Neurological/Psychosocial (15%)
1. Musculoskeletal
a. Compartment syndrome
b. Musculoskeletal surgery
c. Musculoskeletal trauma
d. Rhabdomyolysis
2. Neurological
a. Acute spinal cord injury
b. Agitation
c. Brain death
d. Congenital neurological abnormalities
e. Delirium
f. Encephalopathy
g. Head trauma
h. Hydrocephalus
i. Intracranial hemorrhage
j. Neurogenic shock
k. Neurologic infectious disease
l. Neuromuscular disorders
m. Neurosurgery
n. Pain: acute, chronic
o. Seizure disorders
p. Space-occupying lesions
q. Spinal fusion
r. Stroke
s. Traumatic brain injury (TBI)
3. Behavioral and Psychosocial
a. Abuse and neglect
b. Post-traumatic stress disorder (PTSD)
c. Post-intensive care syndrome (PICS)
d. Self-harm
e. Suicidal ideation and behavior

E. Multisystem (13%)
1. Acid-base imbalance
2. Anaphylactic shock
3. Death and dying
4. Healthcare-associated conditions (e.g., VAE, CAUTI, CLABSI)
5. Hypovolemic shock
6. Post-transplant complications
7. Sepsis
8. Submersion injuries (i.e. near drowning)
9. Hyperthermia and hypothermia
10. Toxin and drug exposure

II. Professional Caring & Ethical Practice (20%)
A. Advocacy/Moral Agency
B. Caring Practices
C. Response to Diversity
D. Facilitation of Learning
E. Collaboration
F. Systems Thinking
G. Clinical Inquiry

CLINICAL JUDGMENT
General
• Manage patients receiving:
o continuous sedation
o extracorporeal membrane oxygenation (ECMO)
o nonpharmacologic interventions
o pharmacologic interventions
o intra-procedural and post-procedural care
o post-operative care
o vascular access
• Conduct physical assessment of critically ill or injured patients
• Conduct psychosocial assessment of critically ill or injured patients
• Evaluate diagnostic test results and laboratory values
• Manage patients during intrahospital transport
• Manage patients undergoing procedural sedation
• Manage patients with temperature monitoring and regulation devices
• Provide family-centered care Cardiovascular
• Manage patients requiring:
o arterial catheterization (e.g., arterial line)
o cardiac catheterization
o cardioversion
o CVP monitoring
o defibrillation
o epicardial pacing
o near-infrared spectroscopy (NIRS)
o umbilical catheterization (e.g., UVC, UAC)
• Manage patients with:
• cardiac dysrhythmias
• hemodynamic instability Respiratory
• Manage patients requiring:
o artificial airways (e.g., endotracheal tubes, tracheotomy)
o assistance with airway clearance chest tubes
o high-frequency oscillatory ventilation (HFOV)
o mechanical ventilation
o noninvasive positive-pressure ventilation (e.g., CPAP, nasal IMV, high-flow nasal cannula)
o prone positioning
o respiratory monitoring devices (e.g., SpO2, SVO2, EtCO2)
o therapeutic gases (e.g., oxygen, nitric oxide, heliox, CO2)
o thoracentesis
Hematology and Immunology
• Manage patients receiving:
o plasmapheresis, exchange transfusion or leukocyte depletion
o transfusion
Neurological
• Conduct pain assessment of critically ill or injured patients
• Manage patients with seizure activity
• Provide end-of-life and palliative care
• Manage patients requiring:
o neurologic monitoring devices and drains (e.g., ICP, ventricular drains, grids)
o spinal immobilization Integumentary
• Manage patients requiring wound prevention and/or treatment (e.g., wound VACs, pressure reduction surfaces, fecal management devices, IV infiltrate treatment)
Gastrointestinal
• Manage patients with inadequate nutrition and fluid intake (e.g., chewing and swallowing difficulties, alterations in hunger and thirst, inability to self-feed)
• Manage patients receiving:
o enteral and parenteral nutrition
o GI drains
o intra-abdominal pressure monitoring Renal and Genitourinary
• Manage patients requiring:
o electrolyte replacement
o renal replacement therapies (e.g., hemodialysis, CRRT, peritoneal dialysis)
Multisystem
• Manage patients requiring progressive mobility
Behavioral and Psychosocial
• Conduct behavioral assessment of critically ill or injured patients (e.g., delirium, withdrawal)
• Manage patients requiring behavioral and mental health interventions
• Respond to behavioral emergencies (e.g., nonviolent crisis intervention, de-escalation techniques)

I. CLINICAL JUDGMENT (80%)
A. Cardiovascular (5%)
1. Acute pulmonary edema
2. Cardiac surgery (e.g., congenital defects, patent ductus arteriosus)
3. Dysrhythmias
4. Heart failure
5. Hypovolemic shock
6. Structural heart defects (acquired and congenital, including valvular disease)

B. Respiratory (21%)
1. Acute respiratory distress syndrome (ARDS)
2. Acute respiratory failure
3. Acute respiratory infection (e.g., pneumonia)
4. Air-leak syndromes
5. Apnea of prematurity
6. Aspiration
7. Chronic conditions (e.g., chronic lung disease/bronchopulmonary dysplasia)
8. Congenital anomalies (e.g., diaphragmatic hernia, tracheoesophageal fistula, choanal atresia, tracheomalacia, tracheal stenosis)
9. Failure to wean from mechanical ventilation
10. Meconium aspiration syndrome
11. Persistent pulmonary hypertension of the newborn (PPHN)
12. Pulmonary hemorrhage
13. Pulmonary hypertension
14. Respiratory distress (RDS)
15. Thoracic surgery
16. Transient tachypnea of the newborn

C. Endocrine/Hematology/Gastrointestinal/Renal/Integumentary (27%)
1. Endocrine
a. Adrenal insufficiency
b. Hyperbilirubinemia
c. Hyperglycemia
d. Hypoglycemia
e. Inborn errors of metabolism
2. Hematology and Immunology
a. Anemia
b. Coagulopathies (e.g., ITP, DIC)
c. Immune deficiencies
d. Leukopenia
e. Polycythemia
f. Rh incompatibilities, ABO incompatibilities, hydrops fetalis
g. Thrombocytopenia
3. Gastrointestinal
a. Bowel infarction/obstruction/perforation (e.g., mesenteric ischemia, adhesions)
b. Feeding intolerance
c. Gastroesophageal reflux
d. GI abnormalities (e.g., omphalocele, gastroschisis, volvulus, imperforate anus, Hirshsprung disease, malrotation, intussusception, hernias)
e. GI surgeries
f. Hepatic failure (e.g., biliary atresia, portal hypertension, esophageal varices)
g. Malnutrition and malabsorption
h. Necrotizing enterocolitis (NEC)
i. Pyloric stenosis
4. Renal and Genitourinary
a. Acute kidney injury (AKI)
b. Chronic kidney disease
c. Congenital genitourinary conditions (e.g., hypospadias, polycystic kidney disease, hydronephrosis, bladder exstrophy)
d. Genitourinary surgery
e. Infections
f. Life-threatening electrolyte imbalances
5. Integumentary
a. Congenital abnormalities (e.g., epidermolysis bullosa, skin tags)
b. IV infiltration
c. Pressure injury/ulcer (e.g., device, incontinence, immobility)
d. Wounds:
i. non-surgical
ii. surgical

D. Musculoskeletal/Neurological/Psychosocial (13%)
1. Musculoskeletal
a. Congenital or acquired musculoskeletal conditions
b. Osteopenia
2. Neurological
a. Agitation
b. Congenital neurological abnormalities (e.g., AV malformation, myelomeningocele, encephalocele)
c. Encephalopathy
d. Head trauma (e.g., forceps and/or vacuum injury)
e. Hemorrhage:
i. intracranial (ICH)
ii. intraventricular (IVH)
f. Hydrocephalus
g. Ischemic insult (e.g., stroke, periventricular leukomalacia)
h. Neurologic infectious disease (e.g., viral, bacterial, fungal)
i. Neuromuscular disorders (e.g., spinal muscular atrophy)
j. Neurosurgery
k. Pain (acute, chronic)
l. Seizure disorders
m. Sensory impairment (e.g., retinopathy of prematurity, hearing impairment, visual impairment)
n. Stress (e.g., noise, overstimulation, sleep disturbances)
o. Traumatic brain injury (e.g., epidural, subdural, concussion, physical abuse)
3. Behavioral and Psychosocial
a. Abuse and neglect
b. Families in crisis (e.g., stress, grief, lack of coping)

E. Multisystem (14%)
1. Birth injuries (e.g., hypoxic-ischemic encephalopathy, brachial plexus injury, lacerations)
2. Developmental delays
3. Failure to thrive
4. Healthcare-associated conditions (e.g., VAE, CAUTI, CLABSI)
5. Hypotension
6. Infectious diseases (e.g., influenza, respiratory syncytial virus, multidrugresistant organisms)
7. Life-threatening maternal/fetal complications (e.g., eclampsia, HELLP syndrome, maternal-fetal transfusion, placental abruption, placenta previa)
8. Low birth weight/prematurity
9. Sepsis
10. Terminal conditions (e.g., end-of-life, palliative care)
11. Thermoregulation
12. Toxin/drug exposure (e.g., neonatal abstinence syndrome, fetal alcohol syndrome, maternal or iatrogenic).

II. Professional Caring & Ethical Practice (20%)
A. Advocacy/Moral Agency
B. Caring Practices
C. Response to Diversity
D. Facilitation of Learning
E. Collaboration
F. Systems Thinking
G. Clinical Inquiry

CLINICAL JUDGMENT
General
• Assess pain considering patients gestational age
• Follow protocol for newborn car seat testing, hearing and congenital heart disease screening
• Follow protocol for feeding and supplementation
• Identify and monitor normal and abnormal diagnostic test results
• Implement interventions to keep neonates safe (e.g., transponder use, safe sleep)
• Manage monitor alarms based on protocol and change in patient condition
• Manage patients receiving complementary alternative medicine and/or nonpharmacologic interventions
• Manage patients receiving medications (e.g., safe administration, monitoring, polypharmacy)
• Monitor patients and follow protocols for pre- and postoperative care
• Recognize indications for, and manage patients requiring, central venous access
• Recognize normal and abnormal:
o developmental assessment findings and provide developmentally appropriate care
o family psychosocial assessment findings
o physical assessment findings
• Recognize signs and symptoms of emergencies, initiate interventions, and seek assistance as needed
Cardiovascular
• Apply leads for cardiac monitoring
• Identify, interpret and monitor cardiac rhythms
• Monitor hemodynamic status and recognize signs and symptoms of hemodynamic instability
• Recognize early signs of decreased cardiac output
• Recognize normal fetal circulation and transition to extra-uterine life
Recognize indications for, and manage patients requiring:
o 12-lead ECG
o arterial catheter
o cardioversion
o invasive hemodynamic monitoring Respiratory
• Interpret blood gas results
• Manage medications and monitor patients requiring rapid sequence intubation (RSI)
• Recognize indications for, and manage patients with, tracheostomy
• Recognize indications for, and manage patients requiring:
o assisted ventilation
o bronchoscopy
o chest tubes
o endotracheal tubes
o non-invasive positive pressure ventilation (e.g., bilevel positive airway pressure, CPAP, high-flow nasal cannula)
o oxygen therapy delivery device
o prone positioning (lateral rotation therapy)
o rescue airways (e.g., laryngeal mask airway [LMA])
o respiratory monitoring devices (e.g., SpO2, EtCO2) and report values
o therapeutic gases (e.g., oxygen, nitric oxide, heliox, CO2)
o thoracentesis
Hematology and Immunology
• Manage patients receiving transfusion of blood products
• Monitor and manage patients with bleeding disorders
• Monitor patients and follow protocols:
o pre-, intra-, post-intervention (e.g., exchange transfusion)
o related to blood conservation
Neurological
• Manage patients with congenital neurological abnormalities

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Nursing
CCRN
Critical Care Register Nurse
https://killexams.com/pass4sure/exam-detail/CCRN
Answer: D
Section 20: Sec Twenty (351 to 355)
Details:Critical Care Nursing Neonatal Exam
QUESTION: 351
If a newborn's stroke volume is about 5 mL, what is the average pulse required to ensure
adequate cardiac output?
A. 100 bpm.
B. 145 bpm.
C. 180 bpm.
D. 195 bpm.
Answer: B
QUESTION: 352
A neonate has a differential diagnosis of congenital muscular dystrophy (CMD) (laminin
alpha-2 deficiency) and exhibits hypotonia at birth with poor feeding and mild respiratory
distress. Which tests are necessary to establish the diagnosis?
A. Creatinine kinase.
B. Electromyogram, nerve conduction studies, and muscle biopsy.
C. Muscle biopsy only.
D. MRI only.
Answer: B
QUESTION: 353
The nurse is inserting a PICC for an infant who requires extended IV therapy because of very
low birth weight. During the procedure, the infant must be monitored for which of the
following?
A. Tachycardia and tachypnea.
B. Bradycardia and hypoxia.
C. Atrial fibrillation.
D. Blood pressure.
Answer: B
QUESTION: 354
A mixed venous oxygen saturation (SvO2) level of less than 60% can indicate which of the
following?
A. Increased hemoglobin, PaO2, and/or cardiac output.
B. Decreased hemoglobin, PaO2, and/or cardiac output.
C. Decreased oxygen consumption.
D. Sepsis.
Answer: B
QUESTION: 355
A 21-day-old neonate develops green-bronze jaundice, dark urine, claycolored stools,
abdominal distention with distended abdominal veins, and hepatosplenomegaly with firm
liver. Liver biopsy and test shows extrahepatic biliary atresia, and a hepatoportoenterostomy
(Kasai procedure) is done to create a conduit between the liver and small intestine. Which
added vitamin(s) or minerals should the baby receive postoperatively?
A. Water-soluble vitamins (B-complex, C).
B. Fat-soluble vitamins (A, D, E, K).
C. Calcium.
D. Potassium.
Answer: B
Section 21: Sec Twenty One (356 to 360)
Details:Progressive Care Certified Nurse (PCCN) Practice
QUESTION: 356
Thoracic electrical bioimpedence monitoring with 4 sets of bioimpedence electrodes and 3
ECG electrodes is used to evaluate hemodynamic status of a postsurgical cardiac patient.
Where are the bioimpedence electrodes placed?
A. One set on the arms, one set on the legs, and one set on the sides of the chest.
B. Two sets bilaterally at the base of the neck and two sets on each side of the chest.
C. One set on the legs and three sets on each side of the chest.
D. One set on the arms, one set bilaterally at the base of the neck, and two sets on each side
of the chest.
Answer: B
QUESTION: 357
A 52-year-old female with a history of bipolar disease is one-day post-operative following a
hip replacement. The patient slept only one or two hours during the night and is speaking
rapidly, throwing her belongings at the nurses, and insisting she is going to leave the hospital
against medical advice. The nurse should notify:
A. The mental health crisis team
B. Social services
C. A home health agency
D. The patient's husband
Answer: A
QUESTION: 358
If all patients who develop urinary infections are evaluated per urine culture and sensitivities
for microbial resistance, but only those with clinically-evident infections are included, then
those with subclinical infections may be missed, skewing results. This is an example of:
A. Information bias
B. Selection bias
C. Hypothesis testing
D. Generalizability
Answer: B
QUESTION: 359
A 28-year-old male with extensive second and third-degree burns develops abdominal
discomfort and vomits coffee ground emesis and frank blood. The most likely cause is:
A. A peptic ulcer
B. The erosion of the esophagus from burns
C. Paralytic ileus
D. Stress-related erosive syndrome
Answer: D
QUESTION: 360
Beck's triad (increased central venous pressure with distended neck veins, muffled heart
sounds, and hypotension) is indicative of which condition?
A. Myocardial infarction
B. Aortic valve prolapse
C. Cardiac tamponade
D. Pulmonary embolism
Answer: C
/( 48(67,216

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