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| Topic 1 |
- 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.
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- 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.
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| Topic 6 |
- 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.
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| 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 (Q373-Q378):
NEW QUESTION # 373
Diagnostic testing for encephalitis encompasses all the following EXCEPT:
- A. MRI
- B. EEG
- C. CT with contrast
- D. CSF analysis
Answer: C
Explanation:
Encephalitis is inflammation of the brain parenchyma. There are many types of encephalitis, including arboviruses such as West Nile, but the most common type seen in most ICUs in the United States is encephalitis due to the herpes simplex virus (HSV).
HSV encephalitis can result from a new infection, or can represent a reactivation of a preexisting infection.
Signs and symptoms include fever, focal or diffuse neurologic changes, headache, and seizures.
Diagnostic testing includes MRI, EEG, and CSF analysis. The diagnosis is often presumed, pending specialized testing of the CSF. Empiric therapy is started with an antiviral agent.
CT with contrast is not an encephalitis diagnostic.
NEW QUESTION # 374
Which of the following dysrhythmias is the patient is MOST LIKELY being treated for if he has a DVI pacemaker?
- A. Second degree AV block Type I
- B. Atrial fibrillation
- C. Atrial flutter
- D. Atrial tachycardia
Answer: A
Explanation:
DVI pacemakers (paces atria and ventricles, senses only in the ventricle, and inhibits pacing output when sensing occurs) are used to treat a clinically significant AV block.
Pacemaker Codes
1st Letter (Chamber Paced) 2nd Letter (Chamber Sensed) 3rd Letter (Response to Sensing) 4th Letter (Rate Modulation) 5th Letter (Multisite Pacing*)
0=None 0=None 0=None 0=None 0=None
A=Atrium A=Atrium I=Inhibited R=Rate modulation A=Atrial
V=Ventricle V=Ventricle T=Triggered V=Ventricular
D=Dual (A&V) D=Dual (A&V) D=Dual (I&T) D=Dual
Dual-Chamber Pacing Modes
Mode Chamber(s) Paced Chamber(s) Sensed
DVI Atrium and ventricle Ventricle
VDD Ventricle Atrium and ventricle
DDI Atrium and ventricle Atrium and ventricle
DDD Atrium and ventricle Atrium and ventricle
NEW QUESTION # 375
Cushing response is:
- A. Effective in identifying early, significant changes in a patient's neurologic status
- B. A physiological response to increased Intracranial Pressure (ICP)
- C. A diagnostic sign for meningitis
- D. An orthopedic test to confirm damage to cervical nerve roots
Answer: B
Explanation:
Cushing response refers to a triad of vital sign changes seen late (not early) in the course of neurologic deterioration. The classic triad is marked by widened pulse pressure, bradycardia, and an irregular respiratory pattern. Cushing response is a cardiovascular response to increased Intracranial Pressure (ICP).
Cushing response is of minimal value in identifying early, significant changes in the patient's condition, but it is useful to be alert for components of Cushing response. Kernig's sign is a diagnostic sign for meningitis; Brudzinski's sign is an orthopedic test to confirm damage to cervical nerve roots (also associated with meningitis).
NEW QUESTION # 376
Of the following, which is MOST involved in the pathology of Immune Thrombocytopenia Purpura (ITP)?
- A. Splenomegaly
- B. Bone marrow suppression
- C. Hepatomegaly
- D. IgG autoantibodies
Answer: D
Explanation:
Immune Thrombocytopenia Purpura (ITP) is an autoimmune disorder caused by the presence of IgG (Immunoglobulin G) autoantibodies on the surface of the platelets and results in the destruction of platelets in the spleen and a platelet count of less than 20,000. It is defined as isolated thrombocytopenia with normal bone marrow function and the absence of other causes of thrombocytopenia. Clinically, there are two syndromes which manifest; acute in children and chronic in adults. Depending on the patient's status, treatment may or may not be indicated. If indicated, steroids (glucocorticoids) and IV immunoglobulin infusion are the typical mainstays of medical therapy, and surgical options may include splenectomy in adults.
NEW QUESTION # 377
In septic shock, a mixed venous O2 saturation (SO2) of 84% indicates that
- A. the tissue cells are being well oxygenated.
- B. the mixed venous pO2 is low.
- C. venous pO2 and saturation are irrelevant to tissue perfusion.
- D. O2 delivery to tissues is inadequate due to shunting.
Answer: A
Explanation:
A high mixed venous O2 saturation (SO2) indicates that the tissue cells are not extracting enough oxygen from the blood, which can be due to impaired cellular metabolism or increased oxygen delivery. In septic shock, there is often a mismatch between oxygen delivery and consumption, resulting in a high SO2 despite tissue hypoxia. Therefore, SO2 alone is not a reliable indicator of tissue perfusion in septic shock.
References:
* Mixed venous oxygen saturation (SvO2) monitoring * LITFL * CCC
* SvO2 to monitor resuscitation of septic patients: let's just understand the basic physiology | Critical Care
| Full Text
* Reference Guide for CCRN (Adult), page 14.
NEW QUESTION # 378
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