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AACN CCRN-Adult Exam Syllabus Topics:

Topic
Details

Topic 1

PROFESSIONAL CARING & ETHICAL PRACTICE: This section assesses the skills of Clinical Nurse Leaders in professional caring and ethical practice. It covers advocacy and moral agency, highlighting the importance of representing patients' interests in healthcare decisions. The section also addresses caring practices that promote patient-centered care and response to diversity, ensuring that care is tailored to individual needs.

Topic 2

The endocrine, hematology, gastrointestinal, renal, and integumentary domains are also covered, focusing on conditions like diabetes mellitus, acute kidney injury, and infections. This section highlights the need for nurses to manage complex patient scenarios involving multiple systems effectively.

Topic 4

CLINICAL JUDGMENT: This section measures the skills of Critical Care Nurses and covers a wide range of medical conditions across various systems. It includes cardiovascular issues such as acute coronary syndrome, heart failure, and cardiomyopathies, demonstrating the need for in-depth knowledge in managing these critical conditions. The section also addresses respiratory emergencies like pulmonary embolism and ARDS, emphasizing the importance of understanding respiratory failure and chronic conditions.

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AACN CCRN (Adult) - Direct Care Eligibility Pathway Sample Questions (Q393-Q398):

NEW QUESTION # 393
An ICU nurse suspects a healthcare provider is exhibiting unprofessional behavior that could harm a patient. What response by the nurse is BEST?

A. Ignore the behavior if the patient is not currently in danger
B. Confront the healthcare provider directly
C. Discuss the situation with a trusted colleague
D. Report the behavior to a supervisor or appropriate authority

Answer: D

Explanation:
The nurse has a moral and professional duty to report unsafe practices that could potentially harm a patient. Confronting the healthcare provider directly may not effectively resolve the issue and could create conflict and does not fulfill the nurse's duty to report the behavior. Discussing the situation with a colleague also does not fulfill the nurse's duty to report the behavior. Ignoring the provider's behavior is inappropriate, as it does not ensure patient safety.

NEW QUESTION # 394
INITIAL management of the patient with upper Gastrointestinal (GI) bleeding would include:

A. transfusion
B. initiation of treatment to control bleeding within 24 hours of admit
C. identification of the site of bleeding
D. volume resuscitation

Answer: D

Explanation:
The primary goal for initial management of the patient in this scenario is volume resuscitation. However, hemodynamic stabilization, identification of the bleeding site, and control of bleeding are all key points for managing the patient with upper GI bleeding. Assessment of vital signs is the most reliable reflection of blood loss. If the patient is hemodynamically stable, resuscitation begins with the initiation of 2-3 L of crystalloid. Blood products are considered if the response to fluid resuscitation is poor.

NEW QUESTION # 395
All of the following are evidence-based treatment approaches in the acute management of Myocardial Infarction (MI) EXCEPT:

A. Fibrinolytics for STEMI
B. Fibrinolytics for NSTEMI
C. Percutaneous coronary intervention for NSTEMI
D. ECG obtained within ten minutes of arrival to emergency department

Answer: B

Explanation:
For acute management of MI, the optimal time for initiation of therapy is within one hour of symptom onset (rarely feasible due to delay in seeking treatment). Fibrinolytics are not recommended for reperfusion of a NSTEMI (Non-ST-Elevation Myocardial Infarction).
Fibrinolytics should be initiated within 30 minutes of the arrival of a STEMI. PCI (Percutaneous Coronary Intervention) should be performed within 24 hours of arrival for NSTEMI reperfusion. An initial ECG (Electrocardiogram) should be obtained within ten minutes of emergency department arrival for all acute coronary symptomatology.

NEW QUESTION # 396
Which of the following is the BEST method to assess pain in a critically ill patient who is intubated and nonresponsive?

A. Behavioral pain scale
B. Visual analog scale (VAS)
C. Vital signs
D. FLACC pain scale

Answer: A

Explanation:
When a critically ill patient is unable to indicate their pain intensity either verbally or nonverbally, nurses must often use other criteria to assess the patient's pain. Using a behavioral pain scale provides a guide for identifying and assessing pain in nonverbal patients. Two examples include the Detroit Medical Center Behavioral Pain Scale and the Behavioral Pain Assessment Tool (BPAT). These scales measure facial signs and expressions, restlessness, muscle tone, vocalization, and consolability.
Vital signs alone should not be used for pain assessment in a critically ill patient. The FLACC (Face, Legs, Activity, Cry, Consolability) pain scale is used in children, not adults. The VAS is used with patients who are not verbal but can still communicate nonverbally.

NEW QUESTION # 397
An ICU nurse is educating a patient about their newly-diagnosed type 2 diabetes. The patient is struggling with understanding the importance of regular glucose monitoring. Which of the following methods is MOST effective for promoting patient learning in this situation?

A. Telling the patient that not monitoring glucose could lead to amputation
B. Presenting the patient with statistics and charts about the negative effects of uncontrolled diabetes
C. Explaining how the body regulates glucose levels and the mechanism through which high blood glucose negatively impacts health
D. Demonstrating how to use a glucometer, then having the patient demonstrate it back

Answer: C

Explanation:
If the patient is struggling to understand the importance of regular glucose monitoring, the nurse should explain the rationale for this intervention by explaining how the body regulates glucose levels and the mechanism through which high blood glucose negatively impacts health. Presenting the patient with statistics and charts about the negative effects of uncontrolled diabetes is not likely to be effective unless it is tied in with how regular glucose monitoring mitigates these risks. Demonstrating how to use a glucometer, then having the patient demonstrate it back does not address the underlying lack of understanding about the importance of regular glucose monitoring. Telling the patient that not monitoring glucose could lead to amputation may cause compliance based on fear, not based on an understanding of the rationale for glucose monitoring.

NEW QUESTION # 398
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