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AACN CCRN (Adult) - Direct Care Eligibility Pathway Sample Questions (Q420-Q425):

NEW QUESTION # 420
In a healthy adult female, what are the normal values for hemoglobin (Hgb) and hematocrit (Hct)?

A. Hgb 12-16 g/dL, Hct 36%-48%
B. Hgb 14-18 g/dL, Hct 42%-52%
C. Hgb 18-22 g/dL, Hct 39%-49%
D. Hgb 8-12 g/dL, Hct 32%-36%

Answer: A

Explanation:
Hemoglobin is the primary carrier of oxygen to body tissues. Hematocrit measures the RBC mass in relationship to a volume of blood, expressed as the percentage of cells per 100 mL of blood. Normal values in healthy adult women (Hgb 12-16 g/dL, Hct 36%-48%) are slightly less than those of healthy adult men (Hgb 14-18 g/dL, Hct 42%-52%). A lower Hgb and Hct is suggestive of anemia from blood loss, post-surgical values, or chronic disease.

NEW QUESTION # 421
Which of the following critically ill patients is at the LOWEST risk of developing hospital-acquired pneumonia?

A. A 91-year-old female with sepsis who is improving after beginning antibiotic therapy
B. A 21-year-old female with AIDS being treated for cardiac dysrhythmias
C. A 64-year-old male with a COPD exacerbation
D. A 34-year-old male being treated for DKA

Answer: D

Explanation:
There are several factors that can increase the risk of critically ill patients developing hospital-acquired pneumonia. These include advanced age, chronic respiratory or cardiac disease, and immunocompromised condition from diseases such as AIDS. A young patient being treated for DKA has the lowest risk of the available options.

NEW QUESTION # 422
Which of the following BEST describes how pneumonia develops from hematogenous spread?

A. Infection from another part of the body travels to the lungs, causing pneumonia
B. Infectious organisms are inhaled into the lungs, causing infection
C. Inhalation of blood into the lungs causes the development of pneumonia
D. Inadequate circulation to the lungs inhibits adequate immune response, causing infection to develop

Answer: A

Explanation:
Hematogenous spread refers to infection that begins in one part of the body and travels via the bloodstream to another. In the case of pneumonia, infectious organisms from the bloodstream become lodged in the pulmonary vasculature, causing pneumonia to develop.

NEW QUESTION # 423
When a patient with flail chest inspires, which of the following should the nurse expect to see?

A. The trachea will move away from the affected side
B. The trachea will move towards from the affected side
C. The flail chest segment will move inwards
D. The flail chest segment will move outwards

Answer: C

Explanation:
Flail chest occurs when three or more contiguous ribs are fractured in at least two places, causing a free- floating flail chest segment of the chest wall. This segment will move inward during the negative pressure caused by inspiration and outwards with the positive pressure of expiration. This causes
"paradoxical breathing", creating a less effective ventilatory pattern. Tracheal movement is not a common finding with flail chest.

NEW QUESTION # 424
A patient who recently lost their spouse is admitted following an emergent cardiac catheterization. The procedure report states chest pain and ST elevation, no significant coronary artery disease, left ventricular dysfunction with apical ballooning, and an EF of 35%. These findings are consistent for

A. takotsubo cardiomyopathy.
B. arrhythmogenic right ventricular cardiomyopathy.
C. non ischemic cardiomyopathy.
D. hypertrophic cardiomyopathy.

Answer: A

Explanation:
Takotsubo cardiomyopathy, also known as stress-induced cardiomyopathy or "broken heart syndrome," is characterized by transient left ventricular dysfunction often precipitated by significant emotional or physical stress. The key findings of chest pain and ST elevation without significant coronary artery disease, along with left ventricular dysfunction and apical ballooning observed on imaging, are classic for takotsubo cardiomyopathy. This condition is often reversible and is associated with a temporary reduction in the heart's pumping ability, indicated by the reduced ejection fraction (EF) of 35%. References: =
* American Association of Critical-Care Nurses (AACN). (2024). CCRN Exam Handbook. Retrieved from AACN CCRN Exam Handbook
* Adult CCRN/CCRN-E/CCRN-K Certification Review Course Online. AACN

NEW QUESTION # 425
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