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AACN CCRN (Adult) - Direct Care Eligibility Pathway Sample Questions (Q48-Q53):

NEW QUESTION # 48
A nurse is performing medication reconciliation during a patient's admission. To determine the patient's current understanding of the medication furosemide (Lasix), which of the following is the best statement by the nurse?

* A. "Can you explain to me what furosemide (Lasix) does for you?"
* B. "When is the best time of day to take furosemide (Lasix)?"
* C. "Do you take the furosemide (Lasix) for your hypertension?"
* D. "Which of your medications help to remove extra fluid?"
Answer: A

Explanation:
Asking the patient to explain what furosemide (Lasix) does for them assesses their understanding and allows the nurse to gauge their knowledge and correct any misconceptions. This method is more effective than asking yes/no questions, as it provides a comprehensive insight into the patient's medication literacy. References: = AACN Handbook for CCRN Certification, pp. 102-105.

NEW QUESTION # 49
The family of a patient with trauma believes that the patient is in pain and requests that a neighbor, a therapeutic touch practitioner, be allowed to see the patient. Unit policy allows visits by immediate family only. Which of the following is the most important consideration in a nurse's decision about facilitating the visit?

* A. Alternative modalities have been associated with enhancements in pharmacologic effects.
* B. The family needs an explanation of the rationale for unit visitation policies.
* C. Research does not support the value of therapeutic touch in pain management.
* D. Alternative therapies are not generally acceptable in an ICU setting.
Answer: B

Explanation:
The primary consideration is to ensure that the family understands the unit's visitation policies. While alternative modalities like therapeutic touch can be beneficial, the nurse must adhere to established policies and explain the rationale to the family. This helps maintain the integrity of unit operations and ensures that all patients receive equitable care. Explaining the policies also provides an opportunity to discuss alternative ways to support the patient within the existing framework. References: = CCRN Exam Handbook, AACN Adult CCRN Certification Review Course

NEW QUESTION # 50
An older adult patient is admitted with acute exacerbation of congestive heart failure. An echocardiogram indicates that EF is unchanged at 50%. The patient is most likely experiencing

* A. heart failure with reduced EF.
* B. advanced heart failure.
* C. left ventricular failure.
* D. heart failure with preserved EF.
Answer: D

Explanation:
Heart failure with preserved ejection fraction (HFpEF) is a type of heart failure that occurs when the heart muscle is stiff and does not relax well, causing high pressure in the heart and lungs. HFpEF is diagnosed when the patient has symptoms and signs of heart failure and a normal or high ejection fraction (EF), which is the percentage of blood pumped out of the left ventricle with each heartbeat. HFpEF is usually caused by conditions that affect the heart or blood vessels, such as aging, high blood pressure, diabetes, obesity, or kidney disease12 References:
* What Is Heart Failure with Preserved Ejection Fraction? - Healthline
* Heart failure with preserved ejection fraction - BMJ Best Practice

NEW QUESTION # 51
Treatment of cerebral vasospasm includes administration of

* A. lorazepam (Ativan).
* B. propranolol (Inderal).
* C. nimodipine (Nimotop).
* D. pentobarbital (Nembutal).
Answer: C

Explanation:
Nimodipine is a calcium channel blocker that is used to prevent or treat cerebral vasospasm after subarachnoid hemorrhage. It works by relaxing the smooth muscle of the cerebral arteries and improving blood flow to the brain. Nimodipine is the only FDA-approved agent for vasospasm and has been shown to reduce the risk of ischemic complications and improve neurological outcomes12. Lorazepam, propranolol, and pentobarbital are not effective for treating cerebral vasospasm and may have adverse effects on the patient's blood pressure, heart rate, and level of consciousness.

NEW QUESTION # 52
Which of the following are physiologic effects of pulmonary contusion?

* A. increased dead space and decreased airway resistance
* B. increased lung compliance and decreased dead space
* C. increased gas diffusion and decreased lung compliance
* D. increased airway resistance and decreased gas diffusion
Answer: D

Explanation:
Pulmonary contusion leads to damage to lung parenchyma, resulting in alveolar hemorrhage and edema. This causes increased airway resistance and decreased gas diffusion due to the inflammatory response and accumulation of fluid within the alveoli, impairing effective gas exchange and reducing lung compliance.References: = CCRN Exam Handbook, page 40

NEW QUESTION # 53
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