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AACN CCRN (Adult) - Direct Care Eligibility Pathway Sample Questions (Q757-Q762):
NEW QUESTION # 757
In the patient suspected of having sepsis, which of the following interventions takes priority in treatment?
Answer: D
Explanation:
Significant improvement of outcomes has been shown with immediate antibiotic administration with broad coverage in the septic patient. IV fluids and vasopressors are initiated within the first three to six hours of initial symptoms of septic shock for hemodynamic stabilization, but will not treat the infection itself.
NEW QUESTION # 758
Immunosuppressive agents, such as cyclosporine and tacrolimus, are often indicated after organ transplantation to prevent rejection. What is the MOST COMMON adverse effect of these medications?
Answer: B
Explanation:
Nephrotoxicity is the major adverse effect of these medications and occurs in up to 40% of transplant patients receiving tacrolimus. Hyperkalemia can develop secondary to the nephrotoxic effects of the drugs. Other side effects observed include tremors and hypertension.
NEW QUESTION # 759
Which of the following is a complication of the use of high concentrations of oxygen over long periods of time?
Answer: A
Explanation:
The toxic effects of oxygen primarily target the pulmonary system and Central Nervous System (CNS).
Signs and symptoms of oxygen toxicity include nausea, anxiety, visual disturbances, numbness, muscular twitching, and grand mal seizures.
Pulmonary oxygen toxicity is due to prolonged exposure to high FiO2 levels. The critical care nurse must carefully monitor patients requiring high levels of oxygen as these patients are at risk for absorption atelectasis and oxygen toxicity. Signs and symptoms include a nonproductive cough, substernal chest pain, general malaise, nausea, fatigue, and vomiting. Oxygen concentrations > 50% for more than 24 to
48 hours may damage the lungs and worsen respiratory problems. As soon as PaO2 levels return to clinically acceptable levels (≥ 60mmHg), oxygen delivery levels can be decreased.
NEW QUESTION # 760
Which of the following principles in managing MODS is MOST important?
Answer: B
Explanation:
Multiple Organ Dysfunction Syndrome (MODS) refers to progressive damage to two more organs that can result in permanent damage and is caused primarily by hypoperfusion of the organs. Rapidly reversing hypoperfusion is the key principles in optimizing organ function and recovery. While ensuring an adequate O2 saturation is important, this does not indicate that the patient is being adequately perfused. Treating each affected organ separately may be a necessary consideration for some patients, but is not the best way to initially manage MODS. The function of the heart, lungs, kidneys, and brain is important; however, treatment of MODS should focus on the underlying cause, not on maintaining the function of certain organs.
NEW QUESTION # 761
The Glasgow Coma Scale (GCS) includes all the following assessment parameters, EXCEPT:
Answer: C
Explanation:
The GCS is often used to monitor neurologic status in critically ill patients, because it provides a standardized approach to assessing and documenting the level of consciousness (LOC). Response is determined in three categories: eye-opening, motor response, and verbal response.
GCS scores range from 3 to 15, with 15 indicating a patient that is alert, fully oriented, and following commands. As the GCS score decreases, the probability of a poor outcome increases.
Behavior Score
Eye Opening (E)
Spontaneous 4
To verbal stimuli 3
To pain 2
None 1
Motor Response (M)
Obeys commands 6
Localizes pain 5
Withdraws to pain 4
Abnormal flexion 3
Extensor response 2
None 1
Verbal Response (V)
Oriented 5
Confused 4
Inappropriate words 3
Incomprehensible sounds 2
None 1
*Coma score = E + M + V
NEW QUESTION # 762
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