Free CCRN Adult certification exam Practice Questions

Sample Practice Questions

Try these 10 sample questions from the CCRN Adult certification exam practice bank. Each includes the answer and explanation. Continue with the interactive practice above to review the full question set.

1. 1An adult with atrial fibrillation has rapid ventricular response and ongoing cardiac ischemia attributed to the rhythm. Which intervention addresses the immediate rhythm-related threat?

   1. A. Prompt synchronized cardioversion
   2. B. Routine observation of the ventricular rate
   3. C. Elective rate control after the ischemia resolves
   4. D. A delayed cardioversion after a trial of oral therapy

   Answer: A

   Explanation: The AHA states, "unstable patients or patients with ongoing cardiac ischemia caused or exacerbated by atrial fibrillation/flutter require prompt cardioversion." The ongoing ischemia makes prompt rhythm restoration appropriate.

   Reference: Part 9: Adult Advanced Life Support — Section 18, Electrical Therapies, Recommendation-Specific Supportive Text

2. 2An adult patient is temporarily unable to speak, and the care team has overlooked a previously documented preference. Which nursing response best represents advocacy in this situation?

   1. A. Wait for the patient to regain speech before raising the preference.
   2. B. Present the documented preference to the team on the patient's behalf.
   3. C. Replace the preference with the nurse's own view of the best outcome.
   4. D. Ask the team to disregard preferences until all treatment is complete.

   Answer: B

   Explanation: The model describes advocacy as "representing the concerns of the patient/family and nursing staff." Bringing a known preference into the discussion represents this patient without substituting the nurse’s wishes.

   Reference: The AACN Synergy Model for Patient Care — p. 4, Advocacy and Moral Agency definition

3. 3An adult has atrial fibrillation with ventricular preexcitation. Which proposed rate-control medication should be avoided because it may accelerate ventricular response and precipitate ventricular fibrillation?

   1. A. Intravenous digoxin
   2. B. Intravenous procainamide
   3. C. Intravenous ibutilide
   4. D. Intravenous magnesium sulfate

   Answer: A

   Explanation: The AHA warns, "In adult patients with preexcitation atrial fibrillation or atrial flutter, digoxin, nondihydropyridine calcium channel antagonists, β-adrenergic blockers, and IV amiodarone should not be administered because they may increase the ventricular response and result in VF." Digoxin is one of the explicitly excluded drugs.

   Reference: Part 9: Adult Advanced Life Support — Recommendations for Medical Therapies for Atrial Fibrillation/Flutter, recommendation 3

4. 4A patient's expressed treatment values differ from the bedside nurse's personal values. Which approach best protects the patient's voice in care planning?

   1. A. Ask the patient to adopt the nurse's values before planning care.
   2. B. Leave the patient's values out of the plan to avoid conflict.
   3. C. Consider the patient's values and incorporate them into care.
   4. D. Defer every care decision until a different nurse takes over.

   Answer: C

   Explanation: AACN says the nurse "considers patient values and incorporates in care, even when differing from personal values." Personal disagreement alone does not justify erasing the patient’s perspective.

   Reference: The AACN Synergy Model for Patient Care — p. 5, Advocacy and Moral Agency, Level 3

5. 5An adult with acute bradycardia has hypotension and signs of poor perfusion. Which medication is reasonable to raise the heart rate?

   1. A. Atropine
   2. B. Adenosine
   3. C. Diltiazem
   4. D. Metoprolol

   Answer: A

   Explanation: The AHA says, "In adult patients with acute bradycardia associated with hemodynamic compromise, administration of atropine is reasonable to increase heart rate." Hypotension and poor perfusion establish the stated compromise.

   Reference: Part 9: Adult Advanced Life Support — Recommendations for Initial Management of Bradycardia, recommendation 2

6. 6An alert patient wants to explain a care preference directly at a family meeting. What should the nurse do to support the patient's agency?

   1. A. Invite the patient to speak and help the team hear the preference.
   2. B. Speak for the patient throughout the meeting to save time.
   3. C. Ask the family to decide the patient's preference without discussion.
   4. D. Present the nurse's preference as if it were the patient's choice.

   Answer: A

   Explanation: The model calls for nurses to "empowers the patient and family to speak for/represent themselves." The alert patient should have the opportunity to speak directly.

   Reference: The AACN Synergy Model for Patient Care — p. 5, Advocacy and Moral Agency, Level 5

7. 7An adult remains hemodynamically unstable from bradycardia despite medical therapy. Which pacing approach is reasonable to improve the heart rate and symptoms?

   1. A. Temporary transvenous pacing
   2. B. Elective permanent pacing after discharge
   3. C. Observation without pacing until spontaneous recovery
   4. D. Synchronized cardioversion for the slow rhythm

   Answer: A

   Explanation: The AHA states, "In adult patients with persistent hemodynamically unstable bradycardia refractory to medical therapy, temporary transvenous pacing is reasonable to increase heart rate and improve symptoms." The stem supplies each limiting condition.

   Reference: Part 9: Adult Advanced Life Support — Recommendations for Initial Management of Bradycardia, recommendation 3

8. 8A nurse notices an ethical concern arising in the unit's treatment plan. Which action most directly reflects moral agency?

   1. A. Treat the concern as outside nursing practice.
   2. B. Avoid the concern because the plan is already written.
   3. C. Record only the technical aspects of the plan.
   4. D. Identify the concern and help the team address it.

   Answer: D

   Explanation: AACN defines moral agency as "identifying and helping to resolve ethical and clinical concerns within and outside the clinical setting." Naming and addressing the concern fits this role.

   Reference: The AACN Synergy Model for Patient Care — p. 4, Advocacy and Moral Agency definition

9. 9During assessment of an adult with acute symptomatic bradycardia, which concurrent action addresses a factor that may be causing the slow rhythm?

   1. A. Evaluate and treat reversible causes
   2. B. Assume the rhythm is always a primary conduction defect
   3. C. Delay assessment of causes until after discharge
   4. D. Treat every slow rate as an indication for permanent pacing

   Answer: A

   Explanation: The AHA recommends, "In adult patients presenting with acute symptomatic bradycardia, evaluation and treatment of reversible causes are recommended." Potential causes must be addressed while stabilizing the patient.

   Reference: Part 9: Adult Advanced Life Support — Recommendations for Initial Management of Bradycardia, recommendation 1

10. 10A colleague asks for support while working through a patient care decision with an ethical conflict. Which response aligns with the nurse's advocacy role?

    1. A. Support the colleague in discussing the ethical and clinical issue.
    2. B. Tell the colleague that advocacy applies only to patients.
    3. C. Keep the conflict out of team discussions in all circumstances.
    4. D. Choose the outcome using the nurse's personal values alone.

    Answer: A

    Explanation: AACN includes "supports colleagues in ethical and clinical issues" in advocacy and moral agency. Supporting a colleague is within this competency.

    Reference: The AACN Synergy Model for Patient Care — p. 5, Advocacy and Moral Agency, Level 3