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AACN CCRN-Adult Exam Syllabus Topics:
Topic
Details
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.
Topic 2
- 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.
Topic 7
- 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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AACN CCRN (Adult) - Direct Care Eligibility Pathway Sample Questions (Q949-Q954):
NEW QUESTION # 949
The nurse is caring for a patient with a tracheostomy tube that requires suctioning. The nurse knows to hyper-oxygenate the patient with 100% oxygen before and between suctioning for a minimum of:
- A. 20 seconds
- B. 30 seconds
- C. 10 seconds
- D. 60 seconds
Answer: B
Explanation:
Suctioning through an artificial airway should only be performed when clinically indicated and for as short a time as possible. It is recommended to hyperoxygenate the patient with 100% oxygen for a minimum of 30 seconds both before suctioning and between passes.
NEW QUESTION # 950
A patient is admitted with Gl bleeding. During the assessment, the nurse notes the patient to be tremulous, anxious, and startles every time he is touched by the nurse. Which of the following is the most pertinent part of the patient's history to obtain?
- A. medication history
- B. psychiatric history
- C. last alcohol intake
- D. time of last meal
Answer: C
Explanation:
Alcohol withdrawal syndrome
Explore
answer: A
The patient's symptoms of tremulousness, anxiety, and startle response suggest that he may be experiencing alcohol withdrawal, which can occur within hours to days after the last drink. Alcohol withdrawal can cause severe complications, such as seizures, delirium tremens, and death, if not treated promptly and appropriately.
Alcohol withdrawal can also worsen GI bleeding by increasing gastric acid secretion, impairing clotting factors, and causing hypertension and tachycardia. Therefore, the most pertinent part of the patient's history to obtain is the last alcohol intake, which can help determine the risk and severity of withdrawal and guide the management of the patient.
References:
* Management of moderate and severe alcohol withdrawal syndromes: This article states that "Symptoms of alcohol withdrawal occur because alcohol is a central nervous system depressant. When a person drinks frequently, the brain compensates for alcohol's depressant effects by increasing the activity of excitatory neurotransmitters, such as norepinephrine, serotonin, dopamine, and glutamate, and reducing the activity of inhibitory neurotransmitters, such as gamma-aminobutyric acid (GABA). When alcohol intake is abruptly discontinued or reduced, this neuroadaptation is unmasked, resulting in a hyperexcitable state that is responsible for the characteristic withdrawal symptoms."
* Alcoholic Gastritis: Causes, Symptoms and Treatment: This article states that "Alcohol Gastritis is a type of acute gastritis and is caused by excessive alcohol consumption. The sudden inflammation of the stomach lining can be very painful and cause severe stomach cramping, irritability and vomiting. While consuming too much alcohol is the main cause of Alcohol Gastritis, it often develops in connection with some sort of infection, direct irritation or localized tissue damage. It can be caused by: Taking non-steroidal, anti-inflammatory medications like aspirin or ibuprofen (i.e., NSAIDs). Certain bacterial infections. Bile reflux from proximal small intestine. Autoimmune disorders."
* Can You Get Internal Bleeding from Alcohol Abuse: This article states that "Over time, alcohol abuse
* starts to eat away at the stomach lining. Continued drinking sets the stage for alcoholic gastritis to develop. Under these conditions, internal bleeding from alcohol abuse takes the form of blood oozing from stomach lines on an ongoing basis."
NEW QUESTION # 951
Of the following drug classes, which is NOT indicated for the management of heart failure (HF)?
- A. Nitrates
- B. Angiotensin-converting enzyme (ACE) inhibitors
- C. Calcium channel-blocking (CCBs) agents
- D. Selective beta-blocking agents
Answer: C
Explanation:
CCBs should generally be avoided in patients with HF plus reduced ejection fraction since they provide no functional or mortality benefit, and some first generation agents may worsen outcomes. They have negative inotropic activity, and therefore, weaken the force of myocardial contractility.
First line drugs in the management of acute heart failure include:
* Nitrates: reduce oxygen consumption, dilate venous system, and relax arterial smooth muscle
* ACE inhibitors: decrease afterload, inhibit the renin-angiotensin-aldosterone system (RAAS), reducing fluid volume overload and remodeling of the left ventricle
* Beta-blockers: reduce the frequency of ventricular tachycardia and ventricular fibrillation, which are the most prevalent cause of death in heart failure patients
NEW QUESTION # 952
A patient with a history of six cardiac catheterizations relates that he has received differing instructions about the duration of required bedrest after the procedure. To further investigate this issue, which of the following is a nurse's most appropriate action?
- A. Conduct an informal chart review and outcome evaluation of patients treated with different bedrest protocols.
- B. Ask the nursing supervisor to request standardized physician orders for patients who have undergone catheterization.
- C. Ask about obtaining an independent evaluation of unit outcomes.
- D. Review recent published research about bedrest protocols.
Answer: D
Explanation:
The nurse's most appropriate action is to review recent published research about bedrest protocols, as this would provide the nurse with the most current and reliable evidence to guide clinical practice and improve patient outcomes. Bedrest protocols after cardiac catheterization may vary depending on the type of access site, the use of closure devices, the patient's risk factors, and the clinician's preference. However, there is a growing body of research that supports early ambulation and shorter bedrest duration to reduce the risk of complications, such as bleeding, hematoma, back pain, and venous thromboembolism, and to enhance patient comfort and satisfaction123. Asking about obtaining an independent evaluation of unit outcomes, conducting an informal chart review and outcome evaluation of patients treated with different bedrest protocols, or asking the nursing supervisor to request standardized physician orders for patients who have undergone catheterization are not the most appropriate actions, as they may not reflect the best available evidence, may be biased or incomplete, or may not address the patient's concern.
References:
* 1: Bedrest After Cardiac Catheterization: A Systematic Review and Meta-analysis4, p. 1-2.
* 2: Early Ambulation After Cardiac Catheterization: A Literature Review, p. 1-2.
* 3: Bed Rest After Cardiac Catheterization: A Review of the Evidence, p. 1-2.
NEW QUESTION # 953
When considering abdominal trauma, which of the following is LEAST LIKELY to be affected by blunt trauma?
- A. Kineys
- B. Intestines
- C. Spleen
- D. Liver
Answer: B
Explanation:
Blunt trauma is most likely to affect solid organs and have less effect on hollow organs, such as the intestines. The spleen, liver, and kidneys are all solid organs, making them more likely to be injured due to blunt trauma.
NEW QUESTION # 954
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