Certification Practice Exam Questions

Certified Critical Care Nurse (CCRN) Certification Practice Exam Questions And Correct Answers (Verified Answers) Plus Rationales 2026 Q&A | Instant Download Pdf

• A patient with acute respiratory distress syndrome (ARDS) is being

mechanically ventilated. The nurse notes increasing peak inspiratory pressures. What is the most likely cause?

• Decreased airway resistance
• Decreased lung compliance
• Leak in the ventilator tubing
• Increased alveolar surface tension

Rationale: In ARDS, lung stiffness increases due to fluid accumulation and

loss of surfactant, resulting in decreased compliance and increased peak inspiratory pressures.

• / 4

• A patient with septic shock is started on norepinephrine. The nurse

understands that the main goal of this medication is to:

• Increase heart rate
• Increase systemic vascular resistance
• Decrease myocardial workload
• Reduce preload

Rationale: Norepinephrine acts primarily on alpha receptors, causing

vasoconstriction and increasing systemic vascular resistance to raise blood pressure.

• Which arterial blood gas result indicates metabolic acidosis?
• pH 7.48, PaCO₂ 32 mmHg, HCO₃⁻ 26 mEq/L
• pH 7.30, PaCO₂ 38 mmHg, HCO₃⁻ 18 mEq/L
• pH 7.45, PaCO₂ 40 mmHg, HCO₃⁻ 26 mEq/L
• pH 7.35, PaCO₂ 50 mmHg, HCO₃⁻ 30 mEq/L

Rationale: Low pH with low bicarbonate indicates metabolic acidosis.

4. The nurse recognizes that ST elevation in leads II, III, and aVF suggests:

• Anterior wall myocardial infarction
• Lateral wall myocardial infarction
• Inferior wall myocardial infarction
• Posterior wall myocardial infarction 2 / 4

Rationale: Leads II, III, and aVF view the inferior portion of the heart

supplied by the right coronary artery.

• In a patient with increased intracranial pressure (ICP), which nursing

action is most appropriate?

• Place the patient in Trendelenburg position
• Hyperextend the neck
• Maintain the head midline and elevate HOB 30 degrees
• Encourage coughing

Rationale: Keeping the head midline and elevated promotes venous

drainage and reduces ICP.

• Which finding is expected in a patient experiencing hypovolemic shock?
• Increased central venous pressure (CVP)
• Decreased urine output
• Bounding pulses
• Warm, flushed skin

Rationale: Hypovolemia leads to decreased preload and cardiac output,

resulting in reduced renal perfusion and oliguria.

• A patient with COPD is receiving oxygen therapy. The nurse should

monitor for: 3 / 4

• Hypoventilation and CO₂ retention
• Increased respiratory drive
• Metabolic alkalosis
• Pulmonary embolism

Rationale: Excess oxygen can suppress hypoxic drive in COPD, leading to

hypoventilation and CO₂ retention.

• Which electrolyte imbalance is most commonly associated with cardiac

arrest?

• Hypocalcemia
• Hyperkalemia
• Hypomagnesemia
• Hyponatremia

Rationale: Elevated serum potassium affects cardiac conduction and can

cause life-threatening arrhythmias.

• A patient with diabetic ketoacidosis (DKA) presents with Kussmaul

respirations. The nurse recognizes this as:

• Hypoventilation due to acidosis
• Compensatory mechanism to eliminate CO₂
• Sign of worsening hypoxia
• Metabolic compensation for alkalosis
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