These CCRN practice questions target management — including LCOS, Op Day, Low Cardiac Output Syndrome. The complete CCRN deck holds 1000 flashcards, 230 of them dedicated to this topic. Study the free samples below, then unlock the whole collection for a one-time $7.
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A patient with STEMI presents to a non-PCI capable facility. Transfer to a PCI center will take 120 minutes. According to current guidelines, what is the preferred reperfusion strategy and the target time frame for administration?
Show answer →If the expected Door-to-Balloon (D2B) time at a PCI-capable center exceeds 120 minutes from first medical contact, fibrinolytic therapy is indicated unless contraindicated. The goal Door-to-Needle (D2N) time for fibrinolytics is within 30 minutes of arrival. Exam Tip: AACN emphasizes the 120-minute window for transfer. If transfer can be done such that D2B is <120 mins, PCI is superior. If not, give fibrinolytics. Always monitor for reperfusion signs: ST-segment resolution >50% within 60-90 mins, relief of chest pain, and reperfusion arrhythmias like Accelerated Idioventricular Rhythm (AIVR).
On Post-Op Day 1, a patient has CI 1.8, PAOP 20, and SVR 1600. Why might Milrinone be preferred over Dobutamine for Low Cardiac Output Syndrome (LCOS) in a patient with concomitant pulmonary hypertension?
Show answer →Milrinone (a PDE3 inhibitor) provides inotropy PLUS systemic and pulmonary vasodilation (inotrope/lusitrope). Unlike Dobutamine, Milrinone does not rely on beta-receptors, which may be downregulated or blocked by pre-op medications. It is specifically effective at reducing RV afterload, making it superior for pulmonary hypertension. Clinical Pearl: Milrinone has a longer half-life (2-3 hours) than Dobutamine; if the patient becomes hypotensive, the effect lasts longer after stopping the infusion. A vasopressor may be needed to maintain MAP.
You observe continuous bubbling in the water-seal chamber of a chest tube for a patient post-lobectomy. What is the priority assessment to differentiate a patient-side leak from a system-side leak?
Show answer →Briefly clamp the chest tube close to the insertion site. Rationale: If bubbling stops, the leak is from the patient (e.g., bronchopleural fistula or incision). If bubbling continues, the leak is in the drainage system (tubing or unit). Exam Tip: Never clamp a chest tube for long periods or during transport. AACN emphasizes identifying the source of the leak before notifying the provider.
A patient's vasospasm is refractory to induced hypertension. The neurosurgeon plans an endovascular intervention. What are the two primary interventional options for focal vs. diffuse spasm?
Show answer →1. Transluminal Balloon Angioplasty: Preferred for focal spasm in proximal large vessels (e.g., MCA, ICA). 2. Intra-arterial (IA) Vasodilators (e.g., Nicardipine, Verapamil, or Milrinone): Preferred for distal or diffuse spasm where a balloon cannot reach. Exam Strategy: Angioplasty provides more durable results than IA vasodilators, which often have a short half-life and may require repeat treatments. Recognize these as rescue therapies when medical management fails.
A 45-year-old patient with severe trauma and a BMI of 24 is receiving EN. What is the recommended daily protein intake to promote a positive nitrogen balance in this catabolic state?
Show answer →1.2 to 2.0 g/kg of pre-pregnancy or actual body weight per day. Patients with severe burns or multi-organ failure may require up to 2.5 g/kg. Strategy: Critical care nutrition focuses heavily on protein delivery rather than just total calories. Distinguish between protein (1.2-2.0 g/kg) and total energy requirements (25-30 kcal/kg).
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Try 30 free CCRN cards firstThe full CCRN deck contains 1000 flashcards, and 230 of them focus on management. This page shows 5 free samples.
Our CCRN deck dedicates 230 of 1000 cards (23%) to management — always cross-check the official AACN exam outline for the current blueprint weighting.
Yes — the samples on this page are free, and the CCRN preview page has 30 more free cards. Full access to all 1000 cards is a one-time $7.
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