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使用完美的AACN CCRN-Adult證照信息輕松地通過您的AACN CCRN-Adult考試
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看到CCRN-Adult證照信息,通過了CCRN (Adult) - Direct Care Eligibility Pathway考試的一半
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最新的 AACN CCRN CCRN-Adult 免費考試真題 (Q936-Q941):
問題 #936
A patient who has acute gastrointestinal bleeding was given two units of blood and was started on an octreotide drip four hours ago. The patient begins experiencing noncardiogenic pulmonary edema.
Which of the following is MOST LIKELY true?
- A. The pulmonary edema is likely a complication associated with the acute gastrointestinal bleeding.
- B. The pulmonary edema is unlikely to be related to the patient's bleeding or recent treatments.
- C. The pulmonary edema is likely related to the transfusions the patient received.
- D. The pulmonary edema is likely related to the octreotide drip the patient is on.
答案:C
解題說明:
Transfusion-Related Acute Lung Injury (TRALI) is characterized by an acute onset of hypoxia and noncardiogenic pulmonary edema within 6 hours of a transfusion. The patient is likely experiencing a TRALI. An octreotide drip or gastrointestinal bleeding are both unlikely to cause pulmonary edema.
問題 #937
The nurse is caring for a 32-year-old patient who was struck by a motorcycle. The patient sustained multiple injuries, including a fractured pelvis, and is in hypovolemic shock.
Which of the following treatments would be contraindicated in the management of this patient's hypovolemic shock?
- A. Administration of vasopressors
- B. Administration of lactated Ringer's (LR) solution
- C. Administration of colloid solutions
- D. Administration of normal saline (NS)
答案:A
解題說明:
The administration of vasopressors to maintain blood pressure would be contraindicated in the management of this patient's hypovolemic shock. Treatment with vasopressors should only be considered when hypotension is resistant to volume resuscitation.
The goal of therapy in the management of hypovolemic shock is to identify the source and stop bleeding if possible, and replace circulating volume, which can be accomplished with one of the following (in large rapid boluses):
* Administration of lactated Ringer's solution
* Administration of normal saline
* Administration of colloid solutions (plasma or blood)
Control of further bleeding is essential and may require surgical intervention. Direct pressure should be applied for obvious wound sites. Type and cross-match for blood type and administer blood as needed for hypovolemic shock.
問題 #938
During the care of a patient with a diagnosis of Diabetic Ketoacidosis (DKA), the nurse knows that all of the following are commonly manifested in this condition EXCEPT:
- A. hyperglycemia
- B. oliguria
- C. low bicarbonate level
- D. acidosis
答案:B
解題說明:
Diabetic Ketoacidosis (DKA) consists of the biochemical triad of hyperglycemia, ketonemia, and metabolic acidosis. It is characterized by blood glucose levels > 300 mg/dL (hyperglycemia), low bicarbonate levels (< 15 mEq/L), and pH < 7.30 (acidosis). The hyperglycemia causes an osmotic diuresis, or polyuria (not oliguria), and the patient often has diminished bicarbonate levels because of this osmotic diuresis. The respiratory system attempts to compensate by blowing off carbon dioxide to restore normal blood pH. This explains the deep rapid breathing, called "Kussmaul respirations."
問題 #939
A patient in the ICU has an advance directive indicating "Do Not Resuscitate" (DNR), but when the patient has a sudden cardiac arrest, the patient's spouse, who is their legal decision maker, insists that the nurse perform CPR. What should the nurse do in this situation?
- A. Follow the patient's advanced directive and do not perform CPR
- B. Discuss the situation with their supervisor
- C. Follow the spouse's demand and perform CPR
- D. Consult the ethics committee immediately
答案:C
解題說明:
If the patient's spouse is legally entitled to make decisions for the patient while the patient is incapacitated and the patient experiences a cardiac arrest, then the patient's spouse is legally entitled to make all medical decisions for the patient, including rescinding their DNR. The nurse must consider the DNR rescinded and perform CRP. During a cardiac arrest, there is likely not enough time to discuss the situation with the nurse's supervisor or with the ethics committee.
問題 #940
Which of the following statements is MOST ACCURATE about compartment syndrome?
- A. The "five Ps" are good early indicators of compartment syndrome
- B. The limb in which compartment syndrome is developing should be elevated above the heart
- C. If compartment pressures are high, surgical intervention is necessary
- D. Compartment syndrome becomes problematic when distal pulses are affected
答案:C
解題說明:
A fasciotomy is the best and most effective treatment for compartment syndrome. In most situations, it is the only effective way to treat this condition.
If the compartment pressures are high (measured via a specialized needle that is inserted directly into the tissue compartment), a fasciotomy is performed to relieve pressure. This procedure entails surgically opening the skin and fascia to relieve the pressure in a muscle compartment, and is the treatment of choice for compartment syndrome. The primary goal of this surgical intervention is to improve perfusion and minimize ischemia and injury to distal tissues.
The nurse performs repeated neurovascular checks to assess for signs of compartment syndrome, but the five Ps (pain, pallor, pulselessness, paresthesia, paralysis) may not provide an accurate early assessment of rising compartment pressures.
Normal compartment pressures are 0-8 mm Hg, and distal pulses are only affected when the compartment pressures are equal to the systolic blood pressure (SBP), meaning that significant pressure has already developed in the compartment.
Compartment syndrome occurs when fluid leaks from out of the vascular space. Therefore, elevating the affected limb will not enhance venous return, but will decrease circulation, exacerbating the condition.
問題 #941
......
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CCRN-Adult真實考試題庫
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