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Free PDF 2025 Valid AACN CCRN-Adult: Prep CCRN (Adult) - Direct Care Eligibility Pathway Guide

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AACN CCRN-Adult Exam Syllabus Topics:

Topic
Details

Topic 1

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.

Topic 2

CLINICAL JUDGMENT: This section measures the skills of Critical Care Nurses and covers a wide range of medical conditions across various systems. It includes cardiovascular issues such as acute coronary syndrome, heart failure, and cardiomyopathies, demonstrating the need for in-depth knowledge in managing these critical conditions. The section also addresses respiratory emergencies like pulmonary embolism and ARDS, emphasizing the importance of understanding respiratory failure and chronic conditions.

Topic 3

Facilitation of learning is emphasized, indicating the role of nurses in educating patients and families about health management. Collaboration is another key component, focusing on teamwork within healthcare settings to improve patient outcomes. Systems thinking is included to encourage understanding of how different components of healthcare interact. Finally, clinical inquiry is highlighted as a means to foster evidence-based practice and continuous improvement in patient care.

Topic 7

PROFESSIONAL CARING & ETHICAL PRACTICE: This section assesses the skills of Clinical Nurse Leaders in professional caring and ethical practice. It covers advocacy and moral agency, highlighting the importance of representing patients' interests in healthcare decisions. The section also addresses caring practices that promote patient-centered care and response to diversity, ensuring that care is tailored to individual needs.

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AACN CCRN (Adult) - Direct Care Eligibility Pathway Sample Questions (Q332-Q337):

NEW QUESTION # 332
The RIFLE classification system provides a definition and classification system for Acute Renal Failure (ARF). To what does the "R" in the RIFLE acronym refer?

A. Recurrence of intrinsic injury
B. Response to renal injury
C. Risk of renal dysfunction
D. Role of renal perfusion

Answer: C

Explanation:
A classification system for the ARF spectrum is RIFLE; this system allows patients to be classified by changes in serum creatinine, urine output, or both. The "R" in RIFLE stands for risk of renal dysfunction.
The remainder of the acronym represents the following: "I" for injury to the kidney, "F" for failure or loss of kidney function, and "E" for End-Stage Kidney Disease (ESKD).

NEW QUESTION # 333
The nurse is caring for a patient who requires oral placement of an endotracheal (ET) tube. Which nursing action is a priority when preliminarily confirming proper ET tube placement?

A. Anchor the tubing with tape or a special ET fixation device
B. Obtain a chest x-ray
C. Auscultate for breath sounds over the stomach
D. Provide frequent oral hygiene

Answer: C

Explanation:
Though all the answer choices are important nursing interventions to ensure adequate oxygenation to the patient with an ET tube, the nurse's priority when confirming proper ET tube placement is to auscultate for the presence of bilateral breath sounds, along with equal chest excursion during inspiration and the absence of breath sounds over the stomach, to preliminarily confirm proper tube placement. If breath sounds are heard over the stomach, the tube should be pulled out until the nurse can no longer hear breath sounds over the stomach, and can hear them bilaterally in the lung fields.
An end-tidal CO2 with waveform verification monitor is used as an immediate assessment for determining tracheal placement. A portable bedside chest x-ray verifies proper tube placement.
Once proper placement is confirmed, the tube is anchored with either tape or a special ET fixation device to prevent movement. The centimeter marking of the ET tube at the lip is documented and checked during each shift to monitor proper tube placement.

NEW QUESTION # 334
Which of the following patients is exhibiting a compensated response to shock?

A. Patient with decreased intravascular volume and polyuria
B. Patient with decreased heart rate and blood pressure (parasympathetic response)
C. Patient who is flushed, warm, and clammy
D. Patient with increased production of catecholamines and ACTH

Answer: D

Explanation:
The compensatory stage of shock begins almost immediately as the body's homeostatic mechanisms attempt to maintain cardiac output, blood pressure, and tissue perfusion. The sympathetic nervous system initiates neural, hormonal, and chemical compensatory mechanisms causing peripheral vasoconstriction and elevation of the blood pressure. Hormonal responses include increased production of catecholamines and ACTH (Adrenocorticotropic Hormone) and activation of the renin-angiotensin- aldosterone system. Sodium and potassium retention, in combination with increased ADH (Antidiuretic Hormone), ACTH , and circulating catecholamines, effectively increases intravascular volume, heart rate, and BP, and decreases urine output. The patient becomes tachycardic, cyanotic, and the skin is cool and clammy to the touch.

NEW QUESTION # 335
The nurse is caring for a patient that goes into ventricular asystole, with no rate or rhythm present on the patient's ECG strip. Occasional P waves show on ECG.
All of the following interventions are recommended for the treatment of asystole EXCEPT:

A. Atropine
B. Cardiopulmonary Resuscitation (CPR)
C. Vasopressin therapy
D. IV epinephrine

Answer: C

Explanation:
Ventricular asystole is the absence of any ventricular rhythm. The nurse would expect to see an absent QRS complex, no pulse, and no cardiac output. P waves may be present if the sinus node is functioning.
If ventricular asystole is not treated immediately, the results are fatal.
Current recommended treatment for ventricular asystole includes:
* Immediate CPR
* IV epinephrine
* Vasopressin therapy
Asystole has a very poor prognosis despite the best resuscitation efforts because it usually represents severe and extensive myocardial ischemia or underlying metabolic problems. Pacing and atropine are no longer recommendations for treatment.

NEW QUESTION # 336
The nurse is caring for a newly admitted patient with worsening chronic heart failure. The nurse notes on the patient's EKG strip that the P wave in lead II is > 0.13 seconds and > 3.2 mm.
The nurse knows that these findings MOST LIKELY indicate:

A. Ventricular hypertrophy
B. Atrial hypertrophy
C. Ventricular hypotrophy
D. Atrial hypotrophy

Answer: B

Explanation:
The P wave represents atrial muscle depolarization. It is normally 2.5 mm or less in height and 0.11 seconds or less in duration. The P wave morphology, which is smooth and rounded, can reveal right or left atrial hypertrophy or atrial arrhythmias and is best determined in leads II and V1 during sinus rhythm.
Patient's EKG Findings Normal EKG Findings
> 3.2 mm ≤ 2.5 mm
> 0.13 seconds ≤ 0.11 seconds

NEW QUESTION # 337
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