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Are you ready for the CCRN exam?

Updated: Jan 29

Focus on understanding key concepts and critical thinking, not memorizing sample questions.

PDB Nurse Education, LLC CCRN Critical Thinking

  1. Large V-waves may be seen on a pulmonary artery occlusion pressure waveform in what disorder? Mitral insufficiency (regurgitation). (Barron’s 3rd edition, 2022 pg. 24)

  2. Mitral valve regurgitation secondary to papillary muscle rupture is seen more often in which type of MI? Inferior MI. (Barron’s pg. 28)

  3. What are the hemodynamic effects of nitroprusside (Nipride)? Nitroprusside is a potent preload and afterload reducer. (Barron’s pg. 33)

  4. A short PR interval in the presence of a delta wave on ECG is indicative of what conduction abnormality? Wolff-Parkinson-White (WPW) syndrome. (Barron’s pg. 36)

  5. How do you treat ventricular fibrillation (VF) when the implantable cardioverter-defibrillator (ICD) is not functioning properly? Perform CPR and defibrillate as usual. (Barron’s pg. 37)

  6. What hemodynamic parameter abnormalities are seen in cardiogenic shock? Elevated left ventricular preload (PAOP) and afterload (SVR), with a low cardiac out/index (CO/CI). (Barron’s pg. 42)

  7. When does balloon inflation occur during intra-aortic balloon pump (IABP) therapy? At the beginning of diastole to increase coronary artery perfusion. (Barron’s pg. 44)

  8. What is minute ventilation? Tidal volume multiplied by respiratory rate, normal is approximately 4 L/minute. (Barron’s pg. 62)

  9. What is the purpose of positive end-expiratory pressure (PEEP) in acute respiratory distress syndrome (ARDS)? PEEP is utilized for alveolar recruitment. (Barron’s pg. 66)

  10. How does a right shift of the oxyhemoglobin-dissociation curve affect the availability of oxygen to the tissues? Conditions that cause a right shift (acidosis, fever, increased 2,3-DPG) release oxygen to the tissues more readily. (Barron’s pg. 70)

  11. What are indications for high-flow nasal cannula (HFNC) oxygen? Cardiogenic pulmonary edema when NIV is not well tolerated, preoxygenation prior to intubation, post-extubation, and patients who refuse intubation. (Barron’s pg. 79)

  12. What cardiac disorder is a consequence of pulmonary hypertension? Right heart failure (Cor pulmonale). (Barron’s pg. 85)

  13. Is preload decreased or increased in hypovolemic shock? Preload (CVP or RAP) or volume is decreased in hypovolemic shock. (Barron’s pgs. 113 and 152)

  14. Is afterload decreased or increased in hypovolemic shock? Afterload (SVR) or resistance is increased in hypovolemic shock due to catecholamine release. (Barron’s pgs. 113 and 152)

  15. Is afterload decreased or increased in distributive shock? Afterload (SVR) is decreased in distributive shock due to vasodilation. (Barron’s pg. 152)

  16. How do you treat hemorrhagic shock? What is a balanced resuscitation? In what injuries is permissive hypotension allowed? Limit isotonic crystalloids and transfuse plasma, platelets, and packed RBCs so you do not dilute blood. Permissive hypotension allows the blood to clot, useful in abdominal trauma and pelvic fractures. (Barron’s pgs. 114-15)

  17. A trauma patient has received multiple blood transfusions. You notice muscle twitches, carpopedal spasm, and a prolonged QT interval, what do you administer? Calcium gluconate. (Barron’s pg. 115)

  18. Why is glucagon used in beta-blocker toxicity? Glucagon increases heart rate and myocardial contractility and increases blood glucose. (Barron’s pg. 135)

  19. How do you calculate cerebral perfusion pressure (CPP)? CPP=MAP-ICP, average is 80-100 mmHg, but maintain at or above 70 mmHg in elevated intracranial pressure (ICP). (Barron’s pg. 180)

  20. Why are hypotonic fluids contraindicated in patients with increased intracranial pressure? Hypotonic fluids cause swelling of the brain. (Barron’s pg. 182)

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