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AACN CCRN (Adult) - Direct Care Eligibility Pathway Sample Questions (Q947-Q952):

NEW QUESTION # 947
What results when a patient's needs and characteristics are matched with the nurse's competencies?

A. Caring practices
B. Synergy
C. Collaboration
D. Autonomy

Answer: B

Explanation:
Synergy results when a patient's needs and characteristics are matched with the nurse's competencies.
The Synergy Model encourages nurses to view patients in a holistic manner rather than the "body systems" medical model. Each patient and family is unique, with a varying capacity for health and vulnerability to illness. Each patient, regardless of the clinical setting, brings a set of unique characteristics to the care situation.
Caring practice and collaboration are nurse characteristics, which are derived from patient needs.
Autonomy is an ethical practice.

NEW QUESTION # 948
The critical care nurse is caring for a kidney dialysis patient who has missed his last two appointments at the dialysis center. His ABG values are reported as follows:
* pH: 7.32
* PaCO2: 32 mmHg
* HCO3: 18 mEq/L
Interpret the patient's blood gas results.

A. Partially compensated respiratory acidosis
B. Acute (uncompensated) respiratory acidosis
C. Normal ABG
D. Partially compensated metabolic acidosis

Answer: D

Explanation:
Normal pH is 7.35-7.45. In this scenario, the pH is 7.32; therefore, we have acidosis. PaCO2 is low at 32 mmHg (normal 35-45). Normally, the pH and PaCO2 move in opposite directions, but not in this scenario. Because the pH and PaCO2 are moving in the same direction here, it indicates that the acid- base disorder is primarily metabolic. In this case, the lungs, acting as the primary acid-base buffer, are now attempting to compensate by "blowing off excessive C02", and therefore increasing the pH.
Bicarbonate is low at 18 mEq/L (normal 22-26). Normally, the pH and the HCO3 move in the same direction; since the pH and the HCO3 are both falling, we can confirm that the primary problem is metabolic.
Because there is evidence of compensation (pH and PaCO2 moving in the same direction) and because the pH remains below the normal range, the interpretation of this ABG result is partially compensated metabolic acidosis.

NEW QUESTION # 949
A 78-year-old man with a hearing impairment is admitted to the critical care unit with acute heart failure. What is the BEST communication method to use in this case?

A. Use sign language to communicate with the patient
B. Assess his preferred method of communication prior to attempting communication
C. Use written communication to ensure he understands
D. Speak loudly and exaggerate your lip movements

Answer: B

Explanation:
The patient's method of communication should be assessed prior to attempting a particular communication method. Speaking loudly or exaggerating lip movements can distort communication and may not be effective if the patient's hearing loss is severe. Sign language can be an effective method, but only if the patient is proficient in sign language. Written communication can be effective if the patient can read; however, this should not be assumed.

NEW QUESTION # 950
A patient has a diagnosis of Syndrome of Inappropriate Antidiuretic Hormone (SIADH). As a nurse, you understand that the symptoms of SIADH result from:

A. water intoxication
B. increased serum osmolality
C. hypertension
D. elevated potassium levels

Answer: A

Explanation:
ADH (Antidieuretic Hormone) is produced by the hypothalamus and is stored in the posterior pituitary gland. ADH exerts its primary effects in the distal collecting tubules of the kidneys where it decreases water excretion, conserving body water, thereby increasing urine concentration (osmolality) and hemodilution. SIADH is characterized by excessive release of ADH unrelated to the plasma osmolality.
Normal mechanisms that control ADH secretion fail, causing impaired water excretion and profound hyponatremia.
SIADH is a syndrome of water intoxication. Your responsibility as a nurse of a patient with SIADH includes interventions to prevent or treat symptoms caused by water intoxication. Symptoms include weakness, increased blood pressure, confusion, abdominal cramps, vomiting, and seizures.

NEW QUESTION # 951
A patient reported to have smoked crack cocaine is brought to the hospital by paramedics and admitted in an agitated state. On the way to the hospital, the patient had a generalized seizure. The toxicology screen is positive for cocaine. Which of the following is most appropriate to administer?

A. lorazepam (Ativan)
B. naloxone (Narcan)
C. activated charcoal
D. ipecac

Answer: A

Explanation:
Lorazepam (Ativan) is most appropriate to administer in a patient who has smoked crack cocaine and is agitated, particularly after a generalized seizure. Benzodiazepines like lorazepam help to manage agitation and seizure activity associated with cocaine toxicity by providing sedative and anticonvulsant effects.References: = CCRN Exam Handbook, page 53

NEW QUESTION # 952
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