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AACN CCRN-Adult Exam Syllabus Topics:

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Topic 1

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 (Q680-Q685):

NEW QUESTION # 680
A patient has recently undergone surgery for a fracture of the left tibi a. The patient complains of severe pain that is not relieved by analgesics. On examination, you note that the patient's left lower leg is pale. What is the MOST likely explanation of the patient's symptoms?

A. Deep vein thrombosis
B. Peripheral artery disease
C. Compartment syndrome
D. Cellulitis

Answer: C

Explanation:
Compartment syndrome is characterized by increased pressure within a muscle compartment that can compromise circulation, leading to nerve and muscle damage. Symptoms include severe pain unrelieved by analgesics and pallor. While DVT (Deep vein Thrombosis) could also present with severe pain, it is not typically associated with pallor as it does not inhibit arterial circulation. Cellulitis would present with local warmth and redness. Peripheral artery disease could present with claudication, decreased pulses, and pallor. The patient's recent history, however, suggests that compartment syndrome is more likely.

NEW QUESTION # 681
A 62-year-old man with diabetes is not adhering to his medication regimen. What would be the BEST approach for the nurse to take in this case?

A. Assess for a religious or cultural belief that could be inhibiting the patient's adherence to following instructions
B. Tell the patient that failing to follow medical instructions could result in permanent harm or death
C. Reinforce the importance of taking medication properly
D. Evaluate what potential barriers are keeping the patient from adhering to his medication regimen

Answer: D

Explanation:
Before the nurse implements any interventions, they should first assess for barriers that could be keeping the patient from adhering to his medication regimen. Understanding the patient's barriers allows the nurse to tailor education and interventions to the patient's unique situation, facilitating learning and adherence. Reinforcing the importance of taking medication is important, but it may not address the underlying reasons for non-adherence. Telling the patient that failure to follow medical instructions could result in permanent harm or death could fail to address the underlying barrier to adherence. The nurse should consider assessing for religious or cultural beliefs that may be barriers to the patient's adherence but should also consider assessing for other potential barriers.

NEW QUESTION # 682
Which of the following BEST describes the function of the papillary muscles?

A. The papillary muscles control the opening and closure of heart valves.
B. The papillary muscles assist the ventricles to fully contract during systole.
C. The papillary muscles maintain vascular tone in the smallest blood vessels throughout the body.
D. The papillary muscles plan an important role in the letdown reflex during lactation.

Answer: A

Explanation:
The papillary muscles sit within the ventricles and control the opening and closure of heart valves. These muscles account for about 10% of heart mass. They do not assist the ventricles in fully contracting during systole and are not connected with any non-cardiac functions.

NEW QUESTION # 683
Acute Renal Failure (ARF) differs from Chronic Renal Failure (CRF) in that it:

A. is associated with diabetes
B. has a higher mortality rate
C. results in higher BUN levels
D. requires Peritoneal Dialysis (PD)

Answer: B

Explanation:
CRF is characterized by slow, progressive, irreversible damage to the nephron, resulting in deterioration over months to years. ARF is characterized by a rapid deterioration in function that results in the accumulation of nitrogenous wastes, and the inability to regulate electrolyte and fluid balance. ARF happens quickly, producing high levels of toxicity in a short amount of time, thus having a higher mortality rate than CRF.

NEW QUESTION # 684
A patient with a history of COPD is admitted with increasing dyspnea and fatigue. O2 is initiated via nasal cannula at 4 L/min with an O2 saturation of 99%. One hour later, the patient becomes lethargic. Which of the following is the most likely cause for the change in the patient's mental status?

A. O2 toxicity
B. depressed hypoxic drive
C. absorption atelectasis
D. decreased end-tidal CO2

Answer: B

Explanation:
A patient with COPD may have a chronically elevated PaCO2 and rely on hypoxia as the main stimulus for breathing. If the patient receives too much oxygen, this may reduce the hypoxic drive and cause respiratory depression, leading to lethargy and hypercapnia. O2 toxicity, absorption atelectasis, and decreased end-tidal CO2 are unlikely to occur with 4 L/min of O2 via nasal cannula in a short period of time.
References:
* Reference Guide for CCRN (Adult), page 14.
* Oxygen Saturation Target of 88-92% in COPD: Evidence-based Medicine?

NEW QUESTION # 685
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