CCRN (Adult) - Direct Care Eligibility Pathway Free Sample Questions

A critically ill patient with cardiogenic shock refractory to inotropic support has an intra-aortic balloon pump (IABP) placed. While assessing the arterial waveform, the critical care nurse observes that balloon inflation occurs immediately prior to the dicrotic notch. Which hemodynamic consequence occurs as a result of this timing abnormality, and what corrective action is required?

A 64-year-old male is admitted to the intensive care unit following an emergent endovascular repair of an infrarenal abdominal aortic aneurysm (EVAR). Postoperative orders include continuous nicardipine infusion to maintain systolic blood pressure between 100 and 120 mmHg.

Four hours after admission, the patient suddenly reports excruciating lumbar back pain and dizziness. On assessment, the nurse notes heart rate 124 beats/min (sinus tachycardia), blood pressure 78/48 mmHg, respiratory rate 24 breaths/min, and urinary output declining to 10 mL over the last hour. Physical examination reveals cool extremities, diaphoresis, and a faint, non-palpable left dorsalis pedis pulse that was previously +2.

Which immediate set of nursing interventions must the critical care nurse prioritize?

A patient with an extensive acute anterior wall ST-elevation myocardial infarction suddenly develops a new second-degree Mobitz Type II AV block with a ventricular rate of 38 beats/min and blood pressure of 78/46 mmHg. Which TWO emergency interventions should the critical care nurse execute immediately? (Select TWO)

A mechanically ventilated patient with severe acute respiratory distress syndrome (ARDS) secondary to viral pneumonia has a PaO2/FiO2 ratio of 88 mmHg despite optimal PEEP titration and neuromuscular blockade. The critical care team decides to implement prone positioning. Which physiological mechanism explains the therapeutic improvement in oxygenation achieved by prone positioning?

A critically ill patient who is volume-controlled mechanically ventilated triggers a high peak inspiratory pressure alarm. The critical care nurse performs an inspiratory hold maneuver and observes that the peak inspiratory pressure (PIP) has increased from 24 cmH2O to 46 cmH2O, while the plateau pressure (Pplat) remains stable at 18 cmH2O. What is the primary clinical etiology of this pressure discrepancy?

True or False: In a mechanically ventilated patient with a chest tube placed for a pneumothorax, continuous, vigorous bubbling across both inspiration and expiration in the water-seal chamber indicates a leak within the drainage system or chest tube connection rather than a simple resolving pleural air leak.