AACN CCRN (Adult) - Direct Care Eligibility Pathway CCRN-Adult Exam Dumps: Updated Questions & Answers (October 2025)

The first priority in the management of an acute gastrointestinal (GI) hemorrhage is fluid resuscitation. This is critical to maintaining hemodynamic stability and ensuring adequate perfusion of vital organs. Monitoring of serial hemoglobin and hematocrit (Hgb and Hct) levels, while important for ongoing assessment, is secondary to the immediate need to stabilize the patient's circulatory status. Pain relief and insertion of a Sengstaken-Blakemore tube may be part of the overall management plan but are not the first priority. References: CCRN Exam Handbook, AACN, page 27, section on GI emergencies.

Noncardiogenic pulmonary edema is most often associated with damage to the alveolar capillary membrane secondary to aspiration. This condition occurs when there is increased permeability of the alveolar-capillary barrier, leading to fluid leakage into the alveoli. It is a hallmark of Acute Respiratory Distress Syndrome (ARDS), which can be triggered by aspiration, resulting in inflammatory damage to the lungs.References: = CCRN Exam Handbook, page 29

The absence of regulators from O2 tanks is a serious issue that can affect patient care1. The nurse manager is in a position to address this problem effectively by ensuring the availability of necessary equipment2. Therefore, the best action would be to inform the nurse manager of the need for more regulators123. While documenting the issue and reporting to the shift supervisor are important, they do not directly address the problem. Forming a task force could be helpful, but it might take more time to implement solutions23.

In patients with head injuries, increased muscle tone and contractured positioning (such as decorticate or decerebrate posturing) are signs of significant neurological impairment. It is essential to manage these symptoms to prevent further complications. Consulting a physical therapist is the best course of action to ensure appropriate positioning, prevent contractures, and manage spasticity effectively. References: = CCRN Exam Handbook and AACN's Certification Review Course materials.

The first step in developing a teaching plan is to assess the learner’s needs, knowledge, and readiness to learn. This will help the nurse tailor the teaching plan to the individual’s learning style, preferences, and goals. Obtaining written information, determining a schedule, and encouraging observation are all strategies that can be used later in the teaching plan, but they are not the first step.

References:

AACN Essentials of Critical Care Nursing, Fourth Edition, page 18.

Patient Education and Counseling, page 3.

The patient’s data indicate that the patient is in shock, which is a life-threatening condition characterized by inadequate tissue perfusion and organ dysfunction. The patient has a low blood pressure, a high heart rate, a fever, and a metabolic acidosis, which suggest that the patient may have septic shock, which is caused by a severe infection that triggers a systemic inflammatory response. The nurse should anticipate an order to administer phenylephrine (Neo-Synephrine), which is a vasopressor agent that constricts the blood vessels and increases the blood pressure and tissue perfusion. Phenylephrine is recommended as a first-line agent for septic shock by the Surviving Sepsis Campaign guidelines1. 8.4% sodium bicarbonate is not indicated for the treatment of septic shock, as it may worsen the acid-base balance and increase the risk of complications2. 0.9% sodium chloride is a normal saline solution that may be used for fluid resuscitation, but it may not be sufficient to restore the blood pressure and may cause fluid overload, hyperchloremia, and kidney injury3. Amiodarone (Cordarone) is an antiarrhythmic drug that is used to treat ventricular tachycardia or fibrillation, but it is not effective for septic shock and may cause hypotension, bradycardia, and other adverse effects4.

References:

Surviving Sepsis Campaign. (2020). Surviving Sepsis Campaign: Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (COVID-19). Retrieved from 1, p. 16.

Marik, P. E., & Bellomo, R. (2013). A rational approach to fluid therapy in sepsis. British Journal of Anaesthesia, 110(3), 323-329. Retrieved from 2, p. 327.

Semler, M. W., & Rice, T. W. (2019). Saline versus balanced crystalloids for intravenous fluid therapy in the emergency department: study protocol for a cluster-randomized, multiple-crossover trial. Trials, 20(1), 1-10. Retrieved from 3, p. 2-3.

Lexicomp Online. (2021). Amiodarone. Retrieved from 4, p. 1-2.

This is the nurse’s best initial response, as it expresses empathy, validates the patient’s feelings, and assesses the patient’s risk of suicide. Depression is a common and serious mental health condition that affects older adults, especially those living in nursing homes. Depression can cause persistent sadness, hopelessness, loss of interest, and suicidal thoughts or behaviors. The nurse should screen the patient for depression using a validated tool, such as the Patient Health Questionnaire (PHQ-9) 1, and ask about any suicidal ideation or plans. The nurse should also provide emotional support, education, and referral to appropriate resources for the patient.

B. “Those feelings should resolve when the medication you’ve started has a chance to take effect.”

This is not the nurse’s best initial response, as it dismisses the patient’s feelings, implies that the patient just needs to wait for the medication to work, and does not address the patient’s psychosocial needs. Antidepressants are one of the treatment options for depression, but they may take several weeks to show their full effect, and they may not work for everyone. The nurse should also explore other factors that may contribute to the patient’s depression, such as social isolation, loss of autonomy, chronic illness, or grief, and offer interventions that may help the patient cope, such as counseling, psychotherapy, cognitive-behavioral therapy, or social activities.

C. “I understand how you feel. We all get that way when we’re depressed.”

This is not the nurse’s best initial response, as it assumes that the nurse knows how the patient feels, minimizes the patient’s experience, and generalizes the patient’s condition. Depression is not a normal or inevitable part of aging, and it affects each person differently. The nurse should not compare the patient’s feelings to their own or to others, but rather acknowledge and respect the patient’s unique perspective and situation. The nurse should also avoid using words like “we” or “you” that may create a sense of distance or judgment, and instead use words like “I” or “me” that may convey a sense of empathy or rapport.

D. “Have you talked to anyone about what is bothering you?”

This is not the nurse’s best initial response, as it may sound like the nurse is trying to avoid listening to the patient, or that the patient is bothering the nurse with their problems. The nurse should not imply that the patient should talk to someone else, but rather show interest and willingness to listen to the patient. The nurse should also use open-ended questions that invite the patient to share more, such as “How are you feeling today?” or “What has been on your mind lately?” The nurse should also use active listening skills, such as nodding, paraphrasing, reflecting, or summarizing, to demonstrate understanding and engagement.

Acute pancreatitis is most commonly indicated by severe mid-epigastric pain, which often radiates to the back, leukocytosis (an elevated white blood cell count indicating inflammation), and hypocalcemia (low calcium levels in the blood). The inflammation of the pancreas leads to the release of digestive enzymes and inflammatory mediators that can cause widespread effects, including alterations in calcium metabolism.References: = CCRN Exam Handbook, page 47

A patient with COPD may have a chronically elevated PaCO2 and rely on hypoxia as the main stimulus for breathing. If the patient receives too much oxygen, this may reduce the hypoxic drive and cause respiratory depression, leading to lethargy and hypercapnia. O2 toxicity, absorption atelectasis, and decreased end-tidal CO2 are unlikely to occur with 4 L/min of O2 via nasal cannula in a short period of time.

References:

Reference Guide for CCRN (Adult), page 14.

Oxygen Saturation Target of 88-92% in COPD: Evidence-based Medicine?

Pulmonary hypertension leads to increased pressure in the pulmonary circulation, which can cause right ventricular hypertrophy and failure. This results in systemic venous congestion, presenting as distended neck veins. Crackles, rhonchi, and pink frothy sputum are more indicative of pulmonary edema or other respiratory conditions rather than pulmonary hypertension. References: AACN Adult CCRN Certification Review Course, AACN CCRN Exam Handbook.