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AACN CCRN (Adult) - Direct Care Eligibility Pathway Sample Questions (Q987-Q992):
NEW QUESTION # 987
Which of the following are the major signs and symptoms of pulmonary embolism (PE)?
- A. Dyspnea, hypertension, tachycardia
- B. Tachycardia, tachypnea, dyspnea
- C. Crackles in all lung fields, tachypnea, hypertension
- D. Pleuritic chest pain, bradycardia, dyspnea
Answer: B
Explanation:
PE is a complication of deep venous thrombosis (DVT), long bone fracture, or air entering the circulatory system. There are many risk factors for PE, with critically ill patients especially susceptible due to the presence of central venous catheters, immobility and the high rate of comorbidities, such as heart failure and cancer.
Many of the signs and symptoms of PE are nonspecific, making this a difficult diagnosis. The major signs and symptoms of PE are dyspnea, tachycardia, tachypnea, and pleuritic chest pain.
Other signs and symptoms include:
* Cough
* Rales
* Apprehension
* Diaphoresis
* Evidence of DVT
* Hemoptysis
* Fever
* Syncope
* Hypoxia
* Hypotension
The key to reducing morbidity and mortality from PE is primarily prevention, and secondarily, early diagnosis and treatment to prevent reembolization.
NEW QUESTION # 988
A patient lying on the left side in Trendelenburg position is in the correct position for postural drainage of which of the following lobes of the lungs?
- A. left upper
- B. right upper
- C. right lower
- D. left lower
Answer: C
Explanation:
For postural drainage of the right lower lobe, the patient should be positioned on their left side in the Trendelenburg position. This positioning utilizes gravity to facilitate the drainage of secretions from the right lower lobe of the lungs. In the Trendelenburg position, the body is laid flat on the back with the feet higher than the head, which helps drain the lower lobes effectively.References: = CCRN Exam Handbook, page 22
NEW QUESTION # 989
All of the following signs and symptoms of drug overdose are commonly seen with an opioid overdose EXCEPT:
- A. decreased Level of Consciousness (LOC)
- B. behavioral changes
- C. seizures
- D. respiratory depression
Answer: C
Explanation:
The specific signs and symptoms of drug overdose depend on the substance ingested, with opioids overdoses resulting in neurological depression. The changes that occur with this include changes in mental status (generally decreased LOC), behavioral changes, and respiratory depression.
Seizures are specific to PCP intoxication and tricyclic antidepressant overdoses, but may also occur with certain types of withdrawals.
NEW QUESTION # 990
There are three clinical phases of Acute Renal Failure (ARF). Which of the following is NOT one of these three phases?
- A. Diuretic phase
- B. Uremic phase
- C. Recovery phase
- D. Oliguric phase
Answer: B
Explanation:
The three clinical phases of ARF, seen primarily in intrarenal failure, include:
1. The oliguric phase - this begins within the first 48 hours of the insult to the kidney; common manifestations include fluid overload and acute hyperkalemia; may last from a few days to several weeks
2. The diuretic phase - gradual return of renal function with an increase in urine output; this phase generally lasts from seven to 10 days
3. The recovery phase - stabilization of laboratory values and can last from three to 12 months Uremia is a clinical manifestation of renal failure, not a phase of ARF; it describes the clinical syndrome that accompanies the detrimental effects of renal dysfunction on the other organ systems.
NEW QUESTION # 991
Which of the following signs and symptoms is specific to right-sided heart failure?
- A. Dyspnea on exertion (DOE)
- B. Decreased RA and RV pressure
- C. Paroxysmal nocturnal dyspnea (PND)
- D. Pansystolic murmur at lower left sternal border (LLSB)
Answer: D
Explanation:
An S3 heart sound is an early sign of right heart failure. A wide split S2 is heard, and S4 may also be present. A pansystolic murmur at the LLSB secondary to stretching of the tricuspid ring is heard.
In addition, jugular vein distention (JVD) is present, which is the visible "bulging" of the external jugular veins on either side of the neck. These are large veins that drain blood from the head and return it directly to the heart. Since they're located near the surface, they provide a reasonably good measure of systemic venous pressure. JVD is elevated any time venous return is greater than the heart's ability to pump the blood back out. Liver enlargement and tenderness, dependent edema, ascites, decreased appetite, nausea, and vomiting may all accompany right heart failure.
There is an increase in RA (right atrial) and RV (right ventricle) cardiac pressures (not a decrease). Left heart failure is the result of pulmonary congestion (where right heart failure is from hepatic congestion); therefore, dyspnea is common with left heart failure, not right.
In left heart failure, a pansystolic murmur may be auscultated at the apex secondary to mitral regurgitation.
NEW QUESTION # 992
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