CCRN : Clinical Competencies

Study concepts, example questions & explanations for CCRN

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Example Questions

Example Question #1 : Clinical Competencies

Atrial septal defects allow blood to be shunted between the left and right atria. The most common atrial septal defect is:

Possible Answers:

none of the given answers are correct

ostium primum

ostium secundum

sinus venosus

Correct answer:

ostium secundum

Explanation:

There are typically three types of atrial septal defects: ostium secundum, sinus venosus, and ostium primum. Of the three, ostium secundum, which occurs around the region of the foramen ovale, is the most common.

Example Question #2 : Clinical Competencies

Direct-acting vasodilators that are smooth muscle relaxants include which of the following medications?
I. Nitroglycerin
II. Furosemide
III. Nitroprusside

Possible Answers:

I and III only

II only

I and II only

III only

Correct answer:

I and III only

Explanation:

Smooth muscle relaxants that are direct-acting vasodilators include nitroprusside and nitroglycerin. These medications, which are used in the treatment of heart failure, work to reduce cardiac filling pressures and dilate coronary arteries. Furosemide is a loop diuretic.

Example Question #3 : Clinical Competencies

The two specialized cell types contained within the sinoatrial (SA) node:

Possible Answers:

chondrocytes and border zone cells

border zone cells and specialized pacemaker cells

specialized pacemaker cells and cardiomyocytes

cardiomyocytes and border zone cells

Correct answer:

border zone cells and specialized pacemaker cells

Explanation:

The sinoatrial (SA) node contains two specialized cell types: border zone cells and specialized pacemaker cells. Cardiomyocytes are heart muscle cells, and chondrocytes are cartilage producing cells.

Example Question #4 : Clinical Competencies

Which of the following is NOT a measurement on an arterial blood gas (ABG) analysis?

Possible Answers:

bicarbonate ion (HCO3-)

fraction of inspired oxygen (FiO2)

pH

arterial partial pressure of carbon dioxide (PaCO2)

Correct answer:

fraction of inspired oxygen (FiO2)

Explanation:

Arterial blood gas (ABG) analysis includes five measurements: pH, arterial partial pressure of carbon dioxide (PaCO2), bicarbonate ion (HCO3-), arterial partial pressure of oxygen (PaO2), and base excess (BE). Fraction of inspired oxygen (FiO2) is not apart of an ABG analysis.

Example Question #5 : Clinical Competencies

The process of ventilation has four phases. Which of the following correctly describes the events of Phase III?

Possible Answers:

delivery of oxygen to the erythrocytes, and the removal of carbon dioxide from the erythrocytes and the bloodstream

diffusion of oxygen and carbon dioxide in the alveoli

movement of ambient air in and out of the respiratory tract

regulation of ventilation

Correct answer:

delivery of oxygen to the erythrocytes, and the removal of carbon dioxide from the erythrocytes and the bloodstream

Explanation:

The four phases of ventilation are as follows: Phase I is the movement of ambient air in and out of the respiratory tract; Phase II is the diffusion of oxygen and carbon dioxide in the alveoli; Phase III entails the delivery of oxygen to erythrocytes, and the removal of carbon dioxide from the erythrocytes and the bloodstream; Phase IV is the regulation of ventilation.

Example Question #6 : Clinical Competencies

Sepsis is defined as a systemic response to an infection that includes the presence of two or more of a number of clinical conditions. Which of the following is NOT a clinical condition for sepsis?

Possible Answers:

heart rate over 90 beats per minute

temperature less than 36°C

respiratory rate over 20 breaths per minute

white blood cell (WBC) count greater than 6,000 cells/mm3

Correct answer:

white blood cell (WBC) count greater than 6,000 cells/mm3

Explanation:

Sepsis is defined as a systemic response to an infection that includes the presence of two or more of the following conditions: a temperature greater that 38°C or a temperature less than 36°C; a heart rate greater than 90 beats per minute; a respiratory rate greater than 20 breaths per minute; a WBC greater than 12,000 cells/mm3; or a PaCO2 less than 32 mmHG. If sepsis occurs along with hypoperfusion and organ dysfunction, it becomes classified as severe sepsis. If sepsis occurs with hypotension and insufficient tissue perfusion that does not respond to fluid resuscitation, it becomes classified as septic shock.

Example Question #7 : Clinical Competencies

A patient with renal dysfunction presents with hypernatremia. This is most likely the result of:

Possible Answers:

an inability of the adrenal cortex to secrete aldosterone

an inability of the renal tubules to respond to ADH secretion

an inability of the kidneys to secrete renin

an inability of the posterior pituitary to secrete ADH

Correct answer:

an inability of the renal tubules to respond to ADH secretion

Explanation:

Hypernatremia is an electrolyte imbalance characterized via elevated sodium levels in the blood. This condition results in water retention and the development of excess extracellular fluid volume. In patient's with normal renal function, the condition is typically caused by a lack of ADH secretion via the posterior pituitary. In patients with renal dysfunction, the condition is typically the result of an inability of the renal tubules to respond to ADH secretion. The renin-angiotensin-aldosterone system functions to increase sodium reabsorption via the renal tubules, and thus insufficient secretion of either renin or aldosterone would work to produce the opposite effect of hypernatremia.

Example Question #8 : Clinical Competencies

A patient who has been exposed to tularemia is likely to be treated with:

Possible Answers:

antivirals

anthelmintics

antibiotics

antitoxin

Correct answer:

antibiotics

Explanation:

Tularemia is an infectious disease caused by the bacterium Francisella tularensis. The bacteria is generally found in rodents and rabbits, and the most common vectors are ticks and deer flies. A patient who has been exposed to tularemia is likely to be treated with antibiotics (streptomycin, gentamycin, tetracyclines, or fluoroquinolones).

Example Question #9 : Clinical Competencies

Which of the following is NOT an accessory organ of the GI tract that assists with digestion?

Possible Answers:

gallbladder

spleen

liver

pancreas

Correct answer:

spleen

Explanation:

The major organs that make up the GI tract are: the mouth, the esophagus, the stomach, the small intestine, the large intestine, the rectum, and the anus. The accessory organs of digestion include the liver, the gallbladder, and the pancreas. The spleen plays a major role in filtering blood, working to remove old red blood cells.

Example Question #10 : Clinical Competencies

A patient in the ICU presents with acute pancreatitis. An examination reveals that the patient almost never consumes alcohol. The most common cause of acute pancreatitis in the nonalcoholic patient is:

Possible Answers:

codeine reaction

steroids

cystic fibrosis

biliary disease

Correct answer:

biliary disease

Explanation:

Pancreatitis is an inflammatory disease in which pancreatic enzymes, which normally function to digest food in the small intestines, become activated in the pancreas and initiate autodigestion. The most common causes of acute pancreatitis are alcoholism and biliary disease (gallstones). Other less common causes of acute pancreatitis include: codeine reaction, cystic fibrosis, and use of steroid medications.

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