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AACN CCRN-Adult Exam Syllabus Topics:

Topic
Details

Topic 1

The endocrine, hematology, gastrointestinal, renal, and integumentary domains are also covered, focusing on conditions like diabetes mellitus, acute kidney injury, and infections. This section highlights the need for nurses to manage complex patient scenarios involving multiple systems effectively.

Topic 4

In musculoskeletal, neurological, and psychosocial areas, the syllabus includes managing trauma, neurological disorders, and behavioral health issues. This emphasizes the holistic approach required in critical care settings. Lastly, multisystem complications such as sepsis and shock states are included to assess the ability to manage life-threatening conditions that affect multiple organ systems.

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AACN CCRN (Adult) - Direct Care Eligibility Pathway Sample Questions (Q423-Q428):

NEW QUESTION # 423
A patient admitted with an acute spinal cord injury at the T6 level has developed a sudden increase in blood pressure and heart rate. Which of the following actions would be most appropriate for the nurse to take FIRST?

A. Check for noxious stimuli affecting the patient
B. Administer IV morphine
C. Initiate therapeutic hypothermia
D. Increase the rate of the patient's IV fluids

Answer: A

Explanation:
The correct response is to assess for autonomic dysreflexia, a potentially life-threatening condition common in patients with spinal cord injuries above T6. Autonomic dysreflexia can cause sudden high blood pressure and heart rate due to overstimulation of the autonomic nervous system, often triggered by a distended bladder or bowel. This makes checking for noxious stimuli affecting the patient and removing the underlying causative factor a top priority. Morphine, hypothermia, and increased IV fluids are not initial interventions for these symptoms and could exacerbate the patient's condition.

NEW QUESTION # 424
The patient with which of the following conditions is NOT a good candidate for initiation of thrombolytic therapy?

A. Head trauma two months ago
B. Recent myocardial infarction
C. History of GI bleed six months ago
D. Left Bundle Branch Block (LBBB)

Answer: A

Explanation:
Absolute contraindication to thrombolytic therapy include:
* Stroke or head trauma within three months
* Active internal bleeding
* History of intracranial bleeding, cerebral neoplasm, or other intracranial pathology
* Known allergy to chosen drug
Alternatives to thrombolytic therapy include interventional therapies done via catheters, such as balloon angioplasty (Percutaneous transluminal coronary angioplasty (PTCA)) with or without stenting, and thrombectomy (removing the clot).
Left Bundle Branch Block (LBBB) and recent Myocardial Infarction (MI) are both considered indications for thrombolytic therapy. A GI bleed within two months (not six) is a relative contraindication, not an absolute contraindication.

NEW QUESTION # 425
On which of the following patients would a bilateral pneumonectomy potentially be performed?

A. A patient who is brain-dead
B. A patient with lung cancer in lobes of both lungs
C. A patient with pulmonary fibrosis
D. A patient who is receiving Extracorporeal Membrane Oxygenation (ECMO)

Answer: A

Explanation:
A bilateral pneumonectomy is surgical removal of both lungs and would only be performed in patients who are legally dead and are organ donor candidates. The only patient described that meets this criteria is the patient who is brain-dead. This procedure would only be performed if the patient was an organ donor.

NEW QUESTION # 426
Which of the following laboratory values remains elevated for 14 to 21 days following an acute myocardial infarction (AMI)?

A. Troponin T
B. Myoglobin
C. Troponin I
D. Myocardial muscle creatine kinase (CK-MB)

Answer: A

Explanation:
Troponin T is a protein that is released into the bloodstream when the heart muscle has been damaged, such as with an AMI. The more damage there is to the heart, the greater the amounts of Troponin T and Troponin I there will be in the bloodstream. Troponin T begins to increase 3 to 5 hours after symptoms begin, and remains elevated for 14 to 21 days post-injury.
Troponin I begins to increase 3 hours after onset of MI and remains elevated for 5 to 7 days.
Myoglobin is released from the myocardium within 2 hours of coronary occlusion and peaks in 6 to 7 hours; myoglobin is a better marker for early detection of MI and is a better negative indicator if negative.
CK-MB values return to baseline within 2 to 3 days after symptom onset, and have better sensitivity and specificity for detecting MI within the first 6 hours (values peak at 12 hours after symptom onset).

NEW QUESTION # 427
An array of factors cause plaque to become susceptible to tearing and rupture. Which of the following is NOT a characteristic of plaque at an increased risk for rupture?

A. The plaque is infiltrated with macrophages
B. There is a large amount of lipid inside the plaque's core
C. The plaque is covered by a smooth fibrous cap
D. The plaque is located in an area of greater turbulence of blood flow

Answer: C

Explanation:
Although most people have some degree of atherosclerotic plaque formation by age 30, the vast majorty of these plaques are considered "stable," covered by smooth fibrous caps that allow sufficient blood flow through the coronary arteries. Thus, these "stable" plaques are not prone to development of unstable angina or myocardial ischemia (MI).
However, in young, growing plaques, the fibrous cap may become thin and rupture, resulting in unstable angina, ischemia, or MI.
Characteristics of plaque at an increased risk of rupture include:
* Location of the lesion in the vascular tree: Areas of greater turbulence of flow and dynamic activity during the cardiac cycle are at higher risk of rupture.
* Size of the lipid pool within the plaque: A large amount of lipid inside the plaque core is more likely to be associated with plaque disruption.
* Invasion of the plaque with macrophages: Macrophages tend to weaken the lining of the fibrous cap of the plaque, making rupture more likely.

NEW QUESTION # 428
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