Critical Care Register Nurse Exam Dumps

CCRN Exam Format | Course Contents | Course Outline | Exam Syllabus | Exam Objectives

A criterion-referenced standard setting process, known as the modified Angoff, is used to establish the passing point/cut score for the exam. Each candidates performance on the exam is measured against a predetermined standard.

The passing point/cut score for the exam is established using a panel of subject matter experts, an exam development committee (EDC), who carefully reviews each exam question to determine the basic level of knowledge or skill that is expected. The passing point/cut score is based on the panels established difficulty ratings for each exam question.

Under the guidance of a psychometrician, the panel develops and recommends the passing point/cut score, which is reviewed and approved by AACN Certification Corporation. The passing point/cut score for the exam is established to identify individuals with an acceptable level of knowledge and skill. All individuals who pass the exam, regardless of their score, have demonstrated an acceptable level of knowledge.



I. CLINICAL JUDGMENT (80%)

A. Cardiovascular (17%)

1. Acute coronary syndrome:

a. NSTEMI

b. STEMI

c. Unstable angina

2. Acute peripheral vascular insufficiency:

a. Arterial/venous occlusion

b. Carotid artery stenosis

c. Endarterectomy

d. Fem-Pop bypass

3. Acute pulmonary edema

4. Aortic aneurysm

5. Aortic dissection

6. Aortic rupture

7. Cardiac surgery:

a. CABG

b. Valve replacement or repair

8. Cardiac tamponade

9. Cardiac trauma

10. Cardiac/vascular catheterization

11. Cardiogenic shock

12. Cardiomyopathies:

a. Dilated

b. Hypertrophic

c. Idiopathic

d. Restrictive

13. Dysrhythmias

14. Heart failure

15. Hypertensive crisis

16. Myocardial conduction system abnormalities

(e.g., prolonged QT interval, Wolff-ParkinsonWhite)

17. Papillary muscle rupture

18. Structural heart defects (acquired and congenital, including valvular disease)

19. TAVR



B. Respiratory (15%)

1. Acute pulmonary embolus

2. ARDS

3. Acute respiratory failure

4. Acute respiratory infection (e.g., pneumonia)

5. Aspiration

6. Chronic conditions (e.g., COPD, asthma, bronchitis, emphysema)

7. Failure to wean from mechanical ventilation

8. Pleural space abnormalities (e.g., pneumothorax, hemothorax, empyema, pleural effusions)

9. Pulmonary fibrosis

10. Pulmonary hypertension

11. Status asthmaticus

12. Thoracic surgery

13. Thoracic trauma (e.g., fractured rib, lung contusion, tracheal perforation)

14. Transfusion-related acute lung injury (TRALI)



C. Endocrine/Hematology/Gastrointestinal/Renal/Integumentary (20%)

1. Endocrine

a. Adrenal insufficiency

b. Diabetes insipidus (DI)

c. Diabetes mellitus, types 1 and 2

d. Diabetic ketoacidosis (DKA)

e. Hyperglycemia

f. Hyperosmolar hyperglycemic state (HHS)

g. Hyperthyroidism

h. Hypoglycemia (acute)

i. Hypothyroidism

j. SIADH

2. Hematology and Immunology

a. Anemia

b. Coagulopathies (e.g., ITP, DIC, HIT)

c. Immune deficiencies

d. Leukopenia

e. Oncologic complications (e.g., tumor lysis syndrome, pericardial effusion)

f. Thrombocytopenia

g. Transfusion reactions

3. Gastrointestinal

a. Abdominal compartment syndrome

b. Acute abdominal trauma

c. Acute GI hemorrhage

d. Bowel infarction, obstruction, perforation (e.g., mesenteric ischemia, adhesions)

e. GI surgeries (e.g., Whipple, esophagectomy, resections)

f. Hepatic failure/coma (e.g., portal hypertension, cirrhosis, esophageal varices, fulminant hepatitis, biliary atresia, drug-induced)

g. Malnutrition and malabsorption

h. Pancreatitis

4. Renal and Genitourinary

a. Acute genitourinary trauma

b. Acute kidney injury (AKI)

c. Chronic kidney disease (CKD)

d. Infections (e.g., kidney, urosepsis)

e. Life-threatening electrolyte imbalances

5. Integumentary

a. Cellulitis

b. IV infiltration

c. Necrotizing fasciitis

d. Pressure injury

e. Wounds:

i. infectious

ii. surgical

iii. trauma

D. Musculoskeletal/Neurological/



Psychosocial (14%)

1. Musculoskeletal

a. Compartment syndrome

b. Fractures (e.g., femur, pelvic)

c. Functional issues (e.g., immobility, falls, gait disorders)

d. Osteomyelitis

e. Rhabdomyolysis

2. Neurological

a. Acute spinal cord injury

b. Brain death

c. Delirium (e.g., hyperactive, hypoactive, mixed)

d. Dementia

e. Encephalopathy

f. Hemorrhage:

i. intracranial (ICH)

ii. intraventricular (IVH)

iii. subarachnoid (traumatic or aneurysmal)

g. Increased intracranial pressure (e.g., hydrocephalus)

h. Neurologic infectious disease (e.g., viral, bacterial, fungal)

i. Neuromuscular disorders (e.g., muscular dystrophy, CP, Guillain-Barré, myasthenia)

j. Neurosurgery (e.g., craniotomy, Burr holes)

k. Seizure disorders

l. Space-occupying lesions (e.g., brain tumors)

m. Stroke:

i. hemorrhagic

ii. ischemic (embolic)

iii. TIA

n. Traumatic brain injury (TBI): epidural, subdural, concussion

3. Behavioral and Psychosocial

a. Abuse/neglect

b. Aggression

c. Agitation

d. Anxiety

e. Suicidal ideation and/or behaviors

f. Depression

g. Medical non-adherence

h. PTSD

i. Risk-taking behavior

j. Substance use disorders (e.g., withdrawal, chronic alcohol or drug dependence)

E. Multisystem (14%)

1. Acid-base imbalance

2. Bariatric complications

3. Comorbidity in patients with transplant history

4. End-of-life care

5. Healthcare-associated conditions (e.g., VAE, CAUTI, CLABSI)

6. Hypotension

7. Infectious diseases:

a. Influenza (e.g., pandemic or epidemic)

b. Multi-drug resistant organisms (e.g., MRSA, VRE, CRE)

8. Life-threatening maternal/fetal complications (e.g., eclampsia, HELLP syndrome, postpartum hemorrhage, amniotic embolism)

9. Multiple organ dysfunction syndrome (MODS)

10. Multisystem trauma

11. Pain: acute, chronic

12. Post-intensive care syndrome (PICS)

13. Sepsis

14. Septic shock

15. Shock states:

a. Distributive (e.g., anaphylactic, neurogenic)

b. Hypovolemic

16. Sleep disruption (including sensory overload)

17. Thermoregulation

18. Toxic ingestion/inhalations (e.g., drug/alcohol overdose)

19. Toxin/drug exposure (including allergies)



II. PROFESSIONAL CARING 7 ETHICAL PRACTICE (20%)

A. Advocacy/Moral Agency

B. Caring Practices

C. Response to Diversity

D. Facilitation of Learning

E. Collaboration

F. Systems Thinking

G. Clinical Inquiry



CLINICAL JUDGMENT

General

• Recognize normal and abnormal:

o developmental assessment findings and provide developmentally appropriate care

o physical assessment findings

o psychosocial assessment findings

• Recognize signs and symptoms of emergencies, initiate interventions, and seek assistance as needed

• Recognize indications for, and manage patients requiring:

o capnography (EtCO2)

o central venous access

o medication reversal agents

o palliative care

o SvO2 monitoring

• Manage patients receiving:

o complementary/alternative medicine and/or nonpharmacologic interventions

o medications (e.g., safe administration, monitoring, polypharmacy)

• Monitor patients and follow protocols for pre- and postoperative care

• Assess pain

• Evaluate patients response to interventions

• Identify and monitor normal and abnormal diagnostic test results

• Manage fluid and electrolyte balance

• Manage monitor alarms based on protocols and changes in patient condition Cardiovascular

• Apply leads for cardiac monitoring

• Identify, interpret and monitor cardiac rhythms

• Recognize indications for, and manage patients requiring:

o 12-lead ECG

o arterial catheter

o cardiac catheterization

o cardioversion central venous pressure monitoring

o defibrillation

o IABP

o invasive hemodynamic monitoring

o pacing: epicardial, transcutaneous, transvenous

o pericardiocentesis

o QT interval monitoring

o ST segment monitoring

• Manage patients requiring:

o endovascular stenting

o PCI Respiratory

• Interpret blood gas results

• Recognize indications for, and manage patients requiring:

o modes of mechanical ventilation

o noninvasive positive pressure ventilation (e.g., BiPAP, CPAP, high-flow nasal cannula)

o oxygen therapy delivery devices

o prevention of complications related to mechanical ventilation (ventilator bundle)

o prone positioning

o pulmonary therapeutic interventions related to mechanical ventilation: airway clearance, extubation, intubation, weaning

o therapeutic gases (e.g., oxygen, nitric oxide, heliox, CO2 )

o thoracentesis

o tracheostomy Hematology and Immunology

• Manage patients receiving transfusion of blood products

• Monitor patients and follow protocols:

o pre-, intra-, post-intervention (e.g., plasmapheresis, exchange transfusion, leukocyte depletion)

o related to blood conservation Neurological

• Recognize indications for, and manage patients requiring neurologic monitoring devices and drains (e.g., ICP, ventricular or lumbar drain)

• Use a swallow evaluation tool to assess dysphagia

• Manage patients requiring:

o neuroendovascular interventions (e.g., coiling, thrombectomy)

o neurosurgical procedures (e.g., pre-, intra-, post-procedure)

o spinal immobilization Integumentary

• Recognize indications for, and manage patients requiring, therapeutic interventions (e.g. wound VACs, pressure reduction surfaces, fecal management devices, IV infiltrate treatment) Gastrointestinal

• Monitor patients and follow protocols for procedures pre-, intra-, post-procedure (e.g., EGD, PEG placement)

• Intervene to address barriers to nutritional/fluid adequacy (e.g., chewing/swallowing difficulties, alterations in hunger and thirst, inability to self-feed)

• Recognize indications for, and manage patients requiring:

o abdominal pressure monitoring

o GI drains

o enteral and parenteral nutrition Renal and Genitourinary

• Identify nephrotoxic agents

• Monitor patients and follow protocols pre-, intra-, and post-procedure (e.g., renal biopsy, ultrasound)

• Recognize indications for, and manage patients requiring, renal therapeutic intervention (e.g., hemodialysis, CRRT, peritoneal dialysis)

Musculoskeletal

• Manage patients requiring progressive mobility

• Recognize indications for, and manage patients requiring, compartment syndrome monitoring

Multisystem

• Manage continuous temperature monitoring

• Provide end-of-life and palliative care

• Recognize risk factors and manage malignant hyperthermia

• Recognize indications for, and manage patients undergoing:

o continuous sedation

o intermittent sedation

o neuromuscular blockade agents

o procedural sedation - minimal

o procedural sedation - moderate

o targeted temperature management (previously known as therapeutic hypothermia)

Behavioral and Psychosocial

• Respond to behavioral emergencies (e.g., nonviolent crisis intervention, de-escalation techniques)

• Use behavioral assessment tools (e.g., delirium, alcohol withdrawal, cognitive impairment)

• Recognize indications for, and manage patients requiring:

o behavioral therapeutic interventions

o medication management for agitation

o physical restraints



I. CLINICAL JUDGMENT (80%)

A. Cardiovascular (14%)

1. Cardiac infection and inflammatory diseases

2. Cardiac malformations

3. Cardiac surgery

4. Cardiogenic shock

5. Cardiomyopathies

6. Cardiovascular catheterization

7. Dysrhythmias

8. Heart failure

9. Hypertensive crisis

10. Myocardial conduction system defects

11. Obstructive shock

12. Vascular occlusion

B. Respiratory (18%)

1. Acute pulmonary edema

2. Acute pulmonary embolus

3. Acute respiratory distress syndrome (ARDS)

4. Acute respiratory failure

5. Acute respiratory infection

6. Air-leak syndromes

7. Apnea of prematurity

8. Aspiration

9. Chronic pulmonary conditions

10. Congenital airway malformations

11. Failure to wean from mechanical ventilation

12. Pulmonary hypertension

13. Status asthmaticus

14. Thoracic and airway trauma

15. Thoracic surgery



C. Endocrine/Hematology/Gastrointestinal/Renal/Integumentary (20%)

1. Endocrine

a. Adrenal insufficiency

b. Diabetes insipidus (DI)

c. Diabetic ketoacidosis (DKA)

d. Diabetes mellitus, types 1 and 2

e. Hyperglycemia

f. Hypoglycemia

g. Inborn errors of metabolism

h. Syndrome of inappropriate secretion of antidiuretic hormone (SIADH)

2. Hematology and Immunology

a. Anemia

b. Coagulopathies (e.g., ITP, DIC)

c. Immune deficiencies

d. Myelosuppression (e.g., thrombocytopenia, neutropenia)

e. Oncologic complications

f. Sickle cell crisis

g. Transfusion reactions

3. Gastrointestinal

a. Abdominal compartment syndrome

b. Abdominal trauma

c. Bowel infarction, obstruction and perforation

d. Gastroesophageal reflux

e. GI hemorrhage

f. GI surgery

g. Liver disease and failure

h. Malnutrition and malabsorption

i. Necrotizing enterocolitis (NEC)

j. Peritonitis

4. Renal and Genitourinary

a. AKI

b. Chronic kidney disease (CKD)

c. Hemolytic uremic syndrome (HUS)

d. Kidney transplant

e. Life-threatening electrolyte imbalances

f. Renal and genitourinary infections

g. Renal and genitourinary surgery

5. Integumentary

a. IV infiltration

b. Pressure injury

c. Skin failure (e.g., hypoperfusion)

d. Wounds



D. Musculoskeletal/Neurological/Psychosocial (15%)

1. Musculoskeletal

a. Compartment syndrome

b. Musculoskeletal surgery

c. Musculoskeletal trauma

d. Rhabdomyolysis

2. Neurological

a. Acute spinal cord injury

b. Agitation

c. Brain death

d. Congenital neurological abnormalities

e. Delirium

f. Encephalopathy

g. Head trauma

h. Hydrocephalus

i. Intracranial hemorrhage

j. Neurogenic shock

k. Neurologic infectious disease

l. Neuromuscular disorders

m. Neurosurgery

n. Pain: acute, chronic

o. Seizure disorders

p. Space-occupying lesions

q. Spinal fusion

r. Stroke

s. Traumatic brain injury (TBI)

3. Behavioral and Psychosocial

a. Abuse and neglect

b. Post-traumatic stress disorder (PTSD)

c. Post-intensive care syndrome (PICS)

d. Self-harm

e. Suicidal ideation and behavior



E. Multisystem (13%)

1. Acid-base imbalance

2. Anaphylactic shock

3. Death and dying

4. Healthcare-associated conditions (e.g., VAE, CAUTI, CLABSI)

5. Hypovolemic shock

6. Post-transplant complications

7. Sepsis

8. Submersion injuries (i.e. near drowning)

9. Hyperthermia and hypothermia

10. Toxin and drug exposure



II. Professional Caring & Ethical Practice (20%)

A. Advocacy/Moral Agency

B. Caring Practices

C. Response to Diversity

D. Facilitation of Learning

E. Collaboration

F. Systems Thinking

G. Clinical Inquiry



CLINICAL JUDGMENT

General

• Manage patients receiving:

o continuous sedation

o extracorporeal membrane oxygenation (ECMO)

o nonpharmacologic interventions

o pharmacologic interventions

o intra-procedural and post-procedural care

o post-operative care

o vascular access

• Conduct physical assessment of critically ill or injured patients

• Conduct psychosocial assessment of critically ill or injured patients

• Evaluate diagnostic test results and laboratory values

• Manage patients during intrahospital transport

• Manage patients undergoing procedural sedation

• Manage patients with temperature monitoring and regulation devices

• Provide family-centered care Cardiovascular

• Manage patients requiring:

o arterial catheterization (e.g., arterial line)

o cardiac catheterization

o cardioversion

o CVP monitoring

o defibrillation

o epicardial pacing

o near-infrared spectroscopy (NIRS)

o umbilical catheterization (e.g., UVC, UAC)

• Manage patients with:

• cardiac dysrhythmias

• hemodynamic instability Respiratory

• Manage patients requiring:

o artificial airways (e.g., endotracheal tubes, tracheotomy)

o assistance with airway clearance chest tubes

o high-frequency oscillatory ventilation (HFOV)

o mechanical ventilation

o noninvasive positive-pressure ventilation (e.g., CPAP, nasal IMV, high-flow nasal cannula)

o prone positioning

o respiratory monitoring devices (e.g., SpO2, SVO2, EtCO2)

o therapeutic gases (e.g., oxygen, nitric oxide, heliox, CO2)

o thoracentesis

Hematology and Immunology

• Manage patients receiving:

o plasmapheresis, exchange transfusion or leukocyte depletion

o transfusion

Neurological

• Conduct pain assessment of critically ill or injured patients

• Manage patients with seizure activity

• Provide end-of-life and palliative care

• Manage patients requiring:

o neurologic monitoring devices and drains (e.g., ICP, ventricular drains, grids)

o spinal immobilization Integumentary

• Manage patients requiring wound prevention and/or treatment (e.g., wound VACs, pressure reduction surfaces, fecal management devices, IV infiltrate treatment)

Gastrointestinal

• Manage patients with inadequate nutrition and fluid intake (e.g., chewing and swallowing difficulties, alterations in hunger and thirst, inability to self-feed)

• Manage patients receiving:

o enteral and parenteral nutrition

o GI drains

o intra-abdominal pressure monitoring Renal and Genitourinary

• Manage patients requiring:

o electrolyte replacement

o renal replacement therapies (e.g., hemodialysis, CRRT, peritoneal dialysis)

Multisystem

• Manage patients requiring progressive mobility

Behavioral and Psychosocial

• Conduct behavioral assessment of critically ill or injured patients (e.g., delirium, withdrawal)

• Manage patients requiring behavioral and mental health interventions

• Respond to behavioral emergencies (e.g., nonviolent crisis intervention, de-escalation techniques)



I. CLINICAL JUDGMENT (80%)

A. Cardiovascular (5%)

1. Acute pulmonary edema

2. Cardiac surgery (e.g., congenital defects, patent ductus arteriosus)

3. Dysrhythmias

4. Heart failure

5. Hypovolemic shock

6. Structural heart defects (acquired and congenital, including valvular disease)



B. Respiratory (21%)

1. Acute respiratory distress syndrome (ARDS)

2. Acute respiratory failure

3. Acute respiratory infection (e.g., pneumonia)

4. Air-leak syndromes

5. Apnea of prematurity

6. Aspiration

7. Chronic conditions (e.g., chronic lung disease/bronchopulmonary dysplasia)

8. Congenital anomalies (e.g., diaphragmatic hernia, tracheoesophageal fistula, choanal atresia, tracheomalacia, tracheal stenosis)

9. Failure to wean from mechanical ventilation

10. Meconium aspiration syndrome

11. Persistent pulmonary hypertension of the newborn (PPHN)

12. Pulmonary hemorrhage

13. Pulmonary hypertension

14. Respiratory distress (RDS)

15. Thoracic surgery

16. Transient tachypnea of the newborn



C. Endocrine/Hematology/Gastrointestinal/Renal/Integumentary (27%)

1. Endocrine

a. Adrenal insufficiency

b. Hyperbilirubinemia

c. Hyperglycemia

d. Hypoglycemia

e. Inborn errors of metabolism

2. Hematology and Immunology

a. Anemia

b. Coagulopathies (e.g., ITP, DIC)

c. Immune deficiencies

d. Leukopenia

e. Polycythemia

f. Rh incompatibilities, ABO incompatibilities, hydrops fetalis

g. Thrombocytopenia

3. Gastrointestinal

a. Bowel infarction/obstruction/perforation (e.g., mesenteric ischemia, adhesions)

b. Feeding intolerance

c. Gastroesophageal reflux

d. GI abnormalities (e.g., omphalocele, gastroschisis, volvulus, imperforate anus, Hirshsprung disease, malrotation, intussusception, hernias)

e. GI surgeries

f. Hepatic failure (e.g., biliary atresia, portal hypertension, esophageal varices)

g. Malnutrition and malabsorption

h. Necrotizing enterocolitis (NEC)

i. Pyloric stenosis

4. Renal and Genitourinary

a. Acute kidney injury (AKI)

b. Chronic kidney disease

c. Congenital genitourinary conditions (e.g., hypospadias, polycystic kidney disease, hydronephrosis, bladder exstrophy)

d. Genitourinary surgery

e. Infections

f. Life-threatening electrolyte imbalances

5. Integumentary

a. Congenital abnormalities (e.g., epidermolysis bullosa, skin tags)

b. IV infiltration

c. Pressure injury/ulcer (e.g., device, incontinence, immobility)

d. Wounds:

i. non-surgical

ii. surgical



D. Musculoskeletal/Neurological/Psychosocial (13%)

1. Musculoskeletal

a. Congenital or acquired musculoskeletal conditions

b. Osteopenia

2. Neurological

a. Agitation

b. Congenital neurological abnormalities (e.g., AV malformation, myelomeningocele, encephalocele)

c. Encephalopathy

d. Head trauma (e.g., forceps and/or vacuum injury)

e. Hemorrhage:

i. intracranial (ICH)

ii. intraventricular (IVH)

f. Hydrocephalus

g. Ischemic insult (e.g., stroke, periventricular leukomalacia)

h. Neurologic infectious disease (e.g., viral, bacterial, fungal)

i. Neuromuscular disorders (e.g., spinal muscular atrophy)

j. Neurosurgery

k. Pain (acute, chronic)

l. Seizure disorders

m. Sensory impairment (e.g., retinopathy of prematurity, hearing impairment, visual impairment)

n. Stress (e.g., noise, overstimulation, sleep disturbances)

o. Traumatic brain injury (e.g., epidural, subdural, concussion, physical abuse)

3. Behavioral and Psychosocial

a. Abuse and neglect

b. Families in crisis (e.g., stress, grief, lack of coping)



E. Multisystem (14%)

1. Birth injuries (e.g., hypoxic-ischemic encephalopathy, brachial plexus injury, lacerations)

2. Developmental delays

3. Failure to thrive

4. Healthcare-associated conditions (e.g., VAE, CAUTI, CLABSI)

5. Hypotension

6. Infectious diseases (e.g., influenza, respiratory syncytial virus, multidrugresistant organisms)

7. Life-threatening maternal/fetal complications (e.g., eclampsia, HELLP syndrome, maternal-fetal transfusion, placental
abruption, placenta previa)
8. Low birth weight/prematurity

9. Sepsis

10. Terminal conditions (e.g., end-of-life, palliative care)

11. Thermoregulation

12. Toxin/drug exposure (e.g., neonatal abstinence syndrome, fetal alcohol syndrome, maternal or iatrogenic).



II. Professional Caring & Ethical Practice (20%)

A. Advocacy/Moral Agency

B. Caring Practices

C. Response to Diversity

D. Facilitation of Learning

E. Collaboration

F. Systems Thinking

G. Clinical Inquiry



CLINICAL JUDGMENT

General

• Assess pain considering patients gestational age

• Follow protocol for newborn car seat testing, hearing and congenital heart disease screening

• Follow protocol for feeding and supplementation

• Identify and monitor normal and abnormal diagnostic test results

• Implement interventions to keep neonates safe (e.g., transponder use, safe sleep)

• Manage monitor alarms based on protocol and change in patient condition

• Manage patients receiving complementary alternative medicine and/or nonpharmacologic interventions

• Manage patients receiving medications (e.g., safe administration, monitoring, polypharmacy)

• Monitor patients and follow protocols for pre- and postoperative care

• Recognize indications for, and manage patients requiring, central venous access

• Recognize normal and abnormal:

o developmental assessment findings and provide developmentally appropriate care

o family psychosocial assessment findings

o physical assessment findings

• Recognize signs and symptoms of emergencies, initiate interventions, and seek assistance as needed

Cardiovascular

• Apply leads for cardiac monitoring

• Identify, interpret and monitor cardiac rhythms

• Monitor hemodynamic status and recognize signs and symptoms of hemodynamic instability

• Recognize early signs of decreased cardiac output

• Recognize normal fetal circulation and transition to extra-uterine life

Recognize indications for, and manage patients requiring:

o 12-lead ECG

o arterial catheter

o cardioversion

o invasive hemodynamic monitoring Respiratory

• Interpret blood gas results

• Manage medications and monitor patients requiring rapid sequence intubation (RSI)

• Recognize indications for, and manage patients with, tracheostomy

• Recognize indications for, and manage patients requiring:

o assisted ventilation

o bronchoscopy

o chest tubes

o endotracheal tubes

o non-invasive positive pressure ventilation (e.g., bilevel positive airway pressure, CPAP, high-flow nasal cannula)

o oxygen therapy delivery device

o prone positioning (lateral rotation therapy)

o rescue airways (e.g., laryngeal mask airway [LMA])

o respiratory monitoring devices (e.g., SpO2, EtCO2) and report values

o therapeutic gases (e.g., oxygen, nitric oxide, heliox, CO2)

o thoracentesis

Hematology and Immunology

• Manage patients receiving transfusion of blood products

• Monitor and manage patients with bleeding disorders

• Monitor patients and follow protocols:

o pre-, intra-, post-intervention (e.g., exchange transfusion)

o related to blood conservation

Neurological

• Manage patients with congenital neurological abnormalities

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CCRN PDF Sample Questions

CCRN Sample Questions

Medical
CCRN
Critical Care Register Nurse
https://killexams.com/pass4sure/exam-detail/CCRN
Answer: D
Section 20: Sec Twenty (351 to 355)
Details:Critical Care Nursing Neonatal Exam
QUESTION: 351
If a newborn's stroke volume is about 5 mL, what is the average pulse required to ensure
adequate cardiac output?
A. 100 bpm.
B. 145 bpm.
C. 180 bpm.
D. 195 bpm.
Answer: B
QUESTION: 352
A neonate has a differential diagnosis of congenital muscular dystrophy (CMD) (laminin
alpha-2 deficiency) and exhibits hypotonia at birth with poor feeding and mild respiratory
distress. Which tests are necessary to establish the diagnosis?
A. Creatinine kinase.
B. Electromyogram, nerve conduction studies, and muscle biopsy.
C. Muscle biopsy only.
D. MRI only.
Answer: B
QUESTION: 353
The nurse is inserting a PICC for an infant who requires extended IV therapy because of very
low birth weight. During the procedure, the infant must be monitored for which of the
following?
A. Tachycardia and tachypnea.
B. Bradycardia and hypoxia.
C. Atrial fibrillation.
D. Blood pressure.
Answer: B
QUESTION: 354
A mixed venous oxygen saturation (SvO2) level of less than 60% can indicate which of the
following?
A. Increased hemoglobin, PaO2, and/or cardiac output.
B. Decreased hemoglobin, PaO2, and/or cardiac output.
C. Decreased oxygen consumption.
D. Sepsis.
Answer: B
QUESTION: 355
A 21-day-old neonate develops green-bronze jaundice, dark urine, claycolored stools,
abdominal distention with distended abdominal veins, and hepatosplenomegaly with firm
liver. Liver biopsy and test shows extrahepatic biliary atresia, and a hepatoportoenterostomy
(Kasai procedure) is done to create a conduit between the liver and small intestine. Which
added vitamin(s) or minerals should the baby receive postoperatively?
A. Water-soluble vitamins (B-complex, C).
B. Fat-soluble vitamins (A, D, E, K).
C. Calcium.
D. Potassium.
Answer: B
Section 21: Sec Twenty One (356 to 360)
Details:Progressive Care Certified Nurse (PCCN) Practice
QUESTION: 356
Thoracic electrical bioimpedence monitoring with 4 sets of bioimpedence electrodes and 3
ECG electrodes is used to evaluate hemodynamic status of a postsurgical cardiac patient.
Where are the bioimpedence electrodes placed?
A. One set on the arms, one set on the legs, and one set on the sides of the chest.
B. Two sets bilaterally at the base of the neck and two sets on each side of the chest.
C. One set on the legs and three sets on each side of the chest.
D. One set on the arms, one set bilaterally at the base of the neck, and two sets on each side
of the chest.
Answer: B
QUESTION: 357
A 52-year-old female with a history of bipolar disease is one-day post-operative following a
hip replacement. The patient slept only one or two hours during the night and is speaking
rapidly, throwing her belongings at the nurses, and insisting she is going to leave the hospital
against medical advice. The nurse should notify:
A. The mental health crisis team
B. Social services
C. A home health agency
D. The patient's husband
Answer: A
QUESTION: 358
If all patients who develop urinary infections are evaluated per urine culture and sensitivities
for microbial resistance, but only those with clinically-evident infections are included, then
those with subclinical infections may be missed, skewing results. This is an example of:
A. Information bias
B. Selection bias
C. Hypothesis testing
D. Generalizability
Answer: B
QUESTION: 359
A 28-year-old male with extensive second and third-degree burns develops abdominal
discomfort and vomits coffee ground emesis and frank blood. The most likely cause is:
A. A peptic ulcer
B. The erosion of the esophagus from burns
C. Paralytic ileus
D. Stress-related erosive syndrome
Answer: D
QUESTION: 360
Beck's triad (increased central venous pressure with distended neck veins, muffled heart
sounds, and hypotension) is indicative of which condition?
A. Myocardial infarction
B. Aortic valve prolapse
C. Cardiac tamponade
D. Pulmonary embolism
Answer: C
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Formatting book

This e book describes the way to prepare contributions for submission. We recommend you examine this in full if you haven't up to now submitted a contribution to Nature. We also recommend that, before submission, you get to grips with Nature’s vogue and content material by reading the journal, both in print or online, notably in case you haven't submitted to the journal these days.

Articles are the leading layout for usual research contributions to Nature. additionally, Nature publishes different submitted cloth as specified below.

Articles are usual studies whose conclusions signify a considerable increase in knowing of a crucial difficulty and have immediate, far-achieving implications. In print, physical sciences papers do not perpetually exceed 6 pages on general and biological sciences papers don't constantly exceed eight pages on typical. despite the fact, the ultimate print size is on the editor’s discretion.

Articles birth with a fully referenced summary paragraph, ideally of no more than 200 words, which is break free the leading textual content and avoids numbers, abbreviations, acronyms or measurements unless standard. it's aimed toward readers backyard the self-discipline. This summary paragraph may still be structured as follows: 2-three sentences of primary-level introduction to the container; a brief account of the heritage and purpose of the work; an announcement of the leading conclusions (introduced by the phrase 'here we exhibit' or its equivalent); and at last, 2-three sentences placing the leading findings into normal context so it is obvious how the effects described in the paper have moved the field forwards. Please discuss with our annotated illustration  to see how the abstract paragraph should still be constructed.

The usual length of a 6-page article with 4 modest reveal items (figures and tables) is 2500 phrases (abstract paragraph plus body text). The regular length of an 8-page article with 5-6 modest display gadgets is 4300 words. A ‘modest’ monitor item is one that, with its legend, occupies about 1 / 4 of a web page (similar to ~270 words). If a composite determine (with several panels) needs to occupy as a minimum half a web page to ensure that the entire facets to be visible, the textual content size may need to be reduced consequently to accommodate such figures. take into account that fundamental but technical particulars will also be moved into the methods or Supplementary information.

As a suggestion, articles typically haven't any more than 50 references. (There isn't any such constraint on any further references linked to methods or Supplementary assistance.)

Sections are separated with subheadings to help navigation. Subheadings may well be up to forty characters (including areas).

notice counts seek advice from the text of the paper. Title, writer record, acknowledgements and references don't seem to be blanketed in total notice counts.

concerns coming up are chiefly pleasing or important feedback and clarifications on normal research papers or other peer-reviewed material posted in Nature. they're published online however not in print.

For extra particulars of and directions for a way to publish such feedback on peer-reviewed fabric posted in Nature — or to notify editors of the competencies need for a correction — please consult our concerns bobbing up page.

Please entry the different submitted material pages for additional particulars on any of the contribution forms beneath:

See this section for a proof of Nature's editorial criteria for e-book, refereeing policy and how editors tackle papers after submission. Submission to a Nature journal is taken via the journal to mean that all of the listed authors have agreed to the entire contents. See authorship coverage for greater particulars.

if you want to enquire no matter if your Article may be relevant for consideration through Nature, please use our on-line presubmission enquiry provider. All presubmission enquiries need to consist of a canopy paragraph to the editor pointing out the interest to a vast scientific readership, a fully referenced summary paragraph, and a reference list.

Nature is an international journal protecting all the sciences. Contributions should still therefore be written naturally and easily so that they're available to readers in different disciplines and to readers for whom English is not their first language. as a result, technical jargon may still be prevented as far as feasible and obviously explained where its use is unavoidable. Abbreviations, chiefly those that don't seem to be standard, should also be stored to a minimum. The historical past, intent and main conclusions of the examine should still be obviously defined. Titles and abstracts in certain should still be written in language that should be readily intelligible to any scientist. basic but really good phrases should still be explained concisely however not didactically.

For gene, protein and other really good names authors can use their favourite terminology so lengthy because it is in present use with the aid of the community, however they must supply all typical names for the entity firstly use within the paper. Nature prefers authors to use internationally agreed nomenclature. Papers containing new or revised formal taxonomic nomenclature for animals, no matter if dwelling or extinct, are approved conditional on the provision of LSIDs (life Science Identifiers) by means of means of registration of such nomenclature with ZooBank, the proposed online registration gadget for the overseas Code of Zoological Nomenclature (ICZN).

even if no paper can be rejected because of bad language, non–native English audio system every now and then receive feedback from editors and reviewers regarding language and grammar usage in their manuscripts. You might also are looking to agree with asking colleagues to examine your manuscript and/or to use knowledgeable editing provider comparable to those provided by using our associates Nature research modifying provider or American Journal specialists. you can also get a fast, free grammar determine of your manuscript that takes into consideration all features of readability in English. Please observe that the use of a language editing carrier isn't a requirement for booklet in Nature.

Nature's editors provide particular information about the anticipated print length when asking for the closing edition of the manuscript. Nature's editors regularly suggest revised titles and rewrite the summary paragraphs of Articles so the conclusions are clear to a broad readership.

After acceptance, Nature's subeditors (copyeditors) make sure that the textual content and figures are readable and clear to those outdoor the field, and edit papers into Nature's condominium trend. They pay selected consideration to abstract paragraphs, universal clarity, figures, determine legends and titles.

Proofs are sent earlier than e-book; authors are welcome to focus on proposed changes with Nature's subeditors, however Nature reserves the right to make the remaining resolution about concerns of vogue and the measurement of figures.

A advantageous set of articles presenting conventional information about writing and submitting scientific papers can also be found on the SciDev.internet website.

Contributions should be double-spaced and written in English (spellings as in the Oxford English Dictionary).

Contributions may still be prepared within the sequence: title, authors, affiliations (plus latest addresses), daring first paragraph, leading text, main references, tables, determine legends, methods (together with separate statistics and code availability statements), methods references, acknowledgements, author contributions, competing activity statement, additional info (containing supplementary suggestions line (if any) and corresponding creator line), prolonged statistics figure/desk legends. as a way to facilitate the overview system, for initial submissions we inspire authors to existing the manuscript textual content and figures together in a single file (Microsoft note or PDF, as much as 30 MB in size). The figures can be inserted inside the text at the applicable positions or grouped on the conclusion, and every figure legend should be offered at the side of its figure. also, please consist of line numbers inside the textual content.

Titles do not exceed two strains in print. This equates to seventy five characters (including areas). Titles don't always consist of numbers, acronyms, abbreviations or punctuation. They may still consist of adequate detail for indexing applications but be commonplace adequate for readers outdoor the box to admire what the paper is about.

An uninterrupted web page of text carries about 1250 phrases.

Authors of contributions that significantly exceed the limits mentioned here (or as detailed by way of the editor) will ought to shorten their papers earlier than acceptance, inevitably delaying e-book.

Nature requires authors to specify the contribution made through their co-authors within the end notes of the paper (see part 5.5). If authors regard it as primary to point out that two or extra co-authors are equal in reputation, they may well be recognized by means of an asterisk symbol with the caption ‘These authors contributed equally to this work’ immediately under the tackle checklist. If greater than three co-authors are equal in repute, this may still be indicated within the writer contributions commentary. existing addresses appear automatically under the author checklist (beneath the footnote rule at the bottom of the first page) and may be recognized through a dagger image; all other standard writer-related rationalization is positioned in the acknowledgements.

Our favored layout for textual content is Microsoft word, with the style tags removed.

TeX/LaTeX: if in case you have prepared your paper the use of TeX/LaTeX, we can should convert this to be aware after acceptance, earlier than your paper will also be typeset. All textual material of the paper (together with references, tables, determine captions, online strategies, and so on.) should be covered as a single .tex file.

We decide on the use of a ‘commonplace’ font, preferably 12-point times New Roman. For mathematical symbols, Greek letters and different particular characters, use typical text or image font. word Equation Editor/MathType may still be used simplest for formulae that can't be produced the use of regular textual content or image font.

The ‘strategies’ section is in general textual content file, following the determine legends. This methods part will seem in the PDF and in the full-text (HTML) edition of the paper on-line, but will now not appear within the printed subject. The methods area should still be written as concisely as viable however should still include all elements critical to permit interpretation and replication of the consequences. As a tenet, the strategies part does not typically exceed three,000 phrases. To increase reproducibility, authors are inspired to deposit a detailed description of protocols used in their study in a protocol sharing platform of their alternative. Nature Portfolio’s Protocol trade is a free and open carrier designed to help researchers share experimental knowledge. Protocols deposited via the authors in Protocol exchange can be linked to the on-line strategies part upon ebook.

exact descriptions of methods already posted should be avoided; a reference quantity may also be provided to keep house, with any new addition or edition pointed out.

The methods section should be subdivided by means of short bold headings referring to strategies used and we encourage the inclusion of selected subsections for statistics, reagents and animal models. If further references are included during this area their numbering may still proceed from the conclusion of the remaining reference number in the leisure of the paper and they're listed after the methods section.

Please supply separate data Availability and Code Availability statements after the leading text statements and earlier than the prolonged information legends; distinct assistance can also be present in our information availability and records citations coverage. certain information kinds must be deposited in a suitable public structured information depository (particulars can be found right here), and the accession number(s) provided in the manuscript. Full access is required on the time of booklet. should still full access to information be required for peer overview, authors must provide it.

The methods part cannot contain figures or tables (elementary display objects should be blanketed within the prolonged information or primarily within the Supplementary assistance).

References are every numbered, ordered sequentially as they appear in the textual content, tables, containers, determine legends, strategies, extended records tables and prolonged facts determine legends.

When noted within the textual content, reference numbers are superscript, no longer in brackets until they are prone to be confused with a superscript number.

don't use linked fields (produced through EndNote and equivalent classes). Please use the one-click on button supplied by means of EndNote to remove EndNote codes earlier than saving your file.

As a suggestion, Articles enable as much as 50 references in most cases textual content if needed and within the regular page price range. only 1 booklet will also be listed for each and every number. additional references for methods or Supplementary information aren't covered in this count number.

simplest articles that have been posted or approved through a named e-book, or which have been uploaded to a identified preprint server (as an example, arXiv, bioRxiv), should be in the reference listing; papers in instruction may still be outlined within the textual content with an inventory of authors (or initials if any of the authors are co-authors of the latest contribution).

published convention abstracts, numbered patents, preprints on recognized servers, papers in press, and analysis datasets which have been assigned a digital object identifier could be included in reference lists, however textual content, provide particulars and acknowledgements can also not. (An exception is the highlighted references which we ask authors of stories, perspectives and Insights articles to give.)

All authors should still be protected in reference lists except there are more than five, during which case simplest the first writer may still be given, adopted by ‘et al.’.

Please observe the fashion under in the published edition of Nature in making ready reference lists.

conclusion notes are quick and observe the strategies (or strategies References, if any).

Acknowledgements should still be short, and may no longer consist of because of anonymous referees and editors, inessential words, or effusive feedback. an individual will also be thanked for assistance, not “dazzling” counsel, or for comments, no longer “insightful” comments, for example. Acknowledgements can contain supply and contribution numbers.

writer Contributions: Authors are required to consist of a press release to specify the contributions of each and every co-creator. The statement may also be up to a few sentences lengthy, describing the projects of individual authors noted through their initials. See the authorship policy web page for extra explanation and examples.

Competing hobbies observation.

more information: Authors should consist of a collection of statements on the end of the paper, in right here order:

To enhance the transparency of reporting and the reproducibility of published effects, authors of life sciences and behavioural & social sciences Articles ought to deliver a accomplished Reporting abstract that might be made available to editors and reviewers all over manuscript evaluation. The Reporting abstract might be posted with all authorised manuscripts.

Please note: as a result of the advanced features used in these varieties, you must use Adobe Reader to open the files and fill them out.

guidance and resources regarding the use and reporting of facts are available here.

Tables should still each and every be presented on a separate page, portrait (now not panorama) orientation, and upright on the page, no longer sideways.

Tables have a short, one-line title in daring textual content. Tables may still be as small as possible. bear in mind the dimension of a Nature page as a limiting aspect when compiling a desk.

Symbols and abbreviations are described automatically under the table, adopted by using standard descriptive cloth as in brief as possible, all in double-spaced text.

average table formats are available for submissions of cryo-EM, NMR and X-ray crystallography facts. Authors offering these facts ought to use these general tables and include them as extended information.

For preliminary submissions, we encourage authors to existing the manuscript text and figures collectively in a single be aware doc or PDF file, and for each and every figure legend to be presented along with its determine. youngsters, when preparing the closing paper to be permitted, we require determine legends to be listed one after the different, as part of the textual content doc, cut loose the figure data, and after the main reference listing.

each and every determine legend may still begin with a short title for the total determine and proceed with a brief description of each panel and the symbols used. If the paper includes a methods area, legends may still no longer contain any details of methods. Legends should still be fewer than 300 words each.

All error bars and facts need to be defined in the figure legend, as mentioned above.

Nature requires figures in digital format. Please make sure that all digital photographs comply with the nature journals’ coverage on photo integrity.

Figures should be as small and easy as is suitable with readability. The goal is for figures to be comprehensible to readers in other or linked disciplines, and to support their understanding of the paper. unnecessary figures and components (panels) of figures may still be prevented: information offered in small tables or histograms, for example, can frequently be mentioned in brief within the text instead. stay away from pointless complexity, colouring and excessive detail.

Figures should still now not comprise more than one panel until the elements are logically connected; each panel of a multipart determine should still be sized so that the whole determine may also be reduced by using the same volume and reproduced on the published page at the smallest size at which simple details are visible. For counsel, Nature’s commonplace determine sizes are ninety mm (single column) and one hundred eighty mm (double column) and the entire depth of the web page is one hundred seventy mm.

Amino-acid sequences may still be printed in Courier (or other monospaced) font the usage of the one-letter code in traces of fifty or one hundred characters.

Authors describing chemical buildings should still use the nature research Chemical constructions trend guide.

Some quick tips for figure training:

figure first-class

At preliminary submission, figures may still be at respectable enough great to be assessed by referees, ideally incorporated into the manuscript textual content in a single notice doc or PDF, youngsters figures may also be supplied separately as JPEGs if authors are unable to consist of them with the text. Authors are suggested to comply with the preliminary and revised submissions instructions with respect to sizing, decision and labelling.

Please notice that print-e-book first-rate figures are huge and it is not effective to upload them at the submission stage. Authors will be requested for awesome figures when they are requested to publish the closing version of their article for e-book.At that stage, please prepare figures according to these instructions.

Third celebration rights

Nature discourages the use or adaptation of up to now published monitor objects (for instance, figures, tables, images, movies or text containers). despite the fact, we respect that to illustrate some ideas using published information is required and the reuse of in the past posted reveal gadgets can be quintessential. Please word that in these circumstances we may no longer be able to acquire the essential rights for some photos to be reused (as is, or tailored models) in our articles. In such situations, we can contact you to focus on the sourcing of choice fabric.

determine expenses

in an effort to help cover some of the additional charge of four-colour copy, Nature Portfolio expenses our authors a price for the printing of their colour figures. Please contact our workplaces for exact pricing and particulars. lack of ability to pay this can charge will now not evade publication of color figures judged basic by means of the editors, but this ought to be agreed with the editor earlier than acceptance.

When a manuscript is accredited in precept for booklet, the editor will ask for prime-resolution figures. do not post book-nice figures except asked to do so by way of an editor. At that stage, please put together figures in accordance with these instructions.

prolonged records figures and tables are online-only (acting within the on-line PDF and entire-textual content HTML version of the paper), peer-reviewed reveal objects that give basic heritage to the Article however aren't covered in the printed edition of the paper because of area constraints or being of interest best to just a few specialists. A highest of ten extended facts display objects (figures and tables) is customarily accepted. See Composition of a Nature analysis paper.

prolonged data tables may still be formatted alongside similar traces to tables acting in print (see area 5.7) but the leading physique (except for title and legend, which should be covered on the conclusion of the observe file) should still be submitted one by one as a picture in preference to as an editable layout in word, as prolonged records tables aren't edited by way of Nature’s subediting department. Small tables may also also be included as sub-panels inside extended statistics figures. See prolonged statistics Formatting e book.

extended records figures may still be prepared alongside just a little distinct instructions in comparison to figures performing in print, and can be multi-panelled provided that they fit to size rules (see prolonged facts Formatting e-book). extended records figures don't seem to be edited or styled through Nature’s art branch; for that reason, authors are requested to follow Nature style as intently as viable when getting ready these figures. The legends for extended information figures may still be organized as for print figures and may be listed one after the different on the end of the note file.

If house allows, Nature encourages authors to include an easy schematic, as a panel in an extended statistics determine, that summarizes the main discovering of the paper, the place acceptable (as an example, to aid understanding of complex detail in telephone, structural and molecular biology disciplines).

If a manuscript has extended facts figures or tables, authors are requested to discuss with discrete objects at an acceptable area mostly text (for example, extended information Fig. 1 and prolonged statistics table 1).

If further references are protected within the prolonged records tables and extended information figure legends, the numbering should continue from the conclusion of the remaining reference quantity in the main paper (or from the remaining reference quantity in the further methods area if existing) and the listing should be added to the end of the list accompanying the additional strategies section, if current, or introduced beneath the prolonged facts legends if no additional methods area is latest.

Supplementary counsel (SI) is on-line-handiest, peer-reviewed fabric it really is primary historical past to the Article (as an example, massive data sets, methods, calculations), but which is simply too colossal or impractical, or of interest best to a number of consultants, to justify inclusion in the printed version of the paper. See the Supplementary information page for further particulars.

Supplementary information may still not comprise figures (any figures additional to these performing in print should be formatted as prolonged records figures). Tables may be blanketed in Supplementary counsel, however only if they are unsuitable for formatting as prolonged facts tables (for example, tables containing gigantic information sets or raw records which are most useful ideal to Excel information).

If a manuscript has accompanying SI, both at submission or in keeping with an editor’s letter that requests it, authors are asked to discuss with discrete objects of the SI (as an instance, movies, tables) at an appropriate point in the main manuscript.

For instructions describing Nature’s requirements for experimental methods and the characterization of new compounds, please see the guidance sheet on the characterization of chemical substances.

We purpose to provide chemical structures in a consistent format during our articles. Please use the nature Portfolio Chemical constructions book and ChemDraw template to make sure that you prepare your figures in a layout in order to require minimal changes with the aid of our artwork and construction groups. put up last info at a hundred% as .cdx data.

Registered reports are empirical articles checking out confirmatory hypotheses through which the methods and proposed analyses are pre-registered and peer reviewed prior to analysis being performed. For additional particulars about Registered stories and instructions for the way to post such articles to Nature please check with our Registered stories page.

All contributions may still be submitted on-line, until otherwise steered by way of the editors. Please make certain to study the guidance on what to consist of to your cover letter in addition to a few essential content material-related considerations when putting a submission collectively.

earlier than submitting, all contributors ought to agree to all of Nature's e-book guidelines.

Nature authors must make facts and substances publicly accessible upon e-book. This contains deposition of records into the principal databases and arranging for them to be publicly launched by means of the on-line ebook date (no longer after). an outline of our initiative to increase the transparency and the reproducibility of posted effects is accessible here. A full description of Nature’s publication policies is on the Nature Portfolio Authors and Referees web site.

An account of the connection between the entire Nature journals is supplied on the Nature family unit web page. 

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