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AACN CCRN-Adult Exam Syllabus Topics:

Topic	Details
Topic 1	Facilitation of learning is emphasized, indicating the role of nurses in educating patients and families about health management. Collaboration is another key component, focusing on teamwork within healthcare settings to improve patient outcomes. Systems thinking is included to encourage understanding of how different components of healthcare interact. Finally, clinical inquiry is highlighted as a means to foster evidence-based practice and continuous improvement in patient care.
Topic 4	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 5	In musculoskeletal, neurological, and psychosocial areas, the syllabus includes managing trauma, neurological disorders, and behavioral health issues. This emphasizes the holistic approach required in critical care settings. Lastly, multisystem complications such as sepsis and shock states are included to assess the ability to manage life-threatening conditions that affect multiple organ systems.

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AACN CCRN (Adult) - Direct Care Eligibility Pathway Sample Questions (Q636-Q641):

NEW QUESTION # 636
When advocating for a patient, the nurse should guide the patient through all the following EXCEPT:

A. Values clarification
B. The process of communicating decisions
C. The nurse's view on personal values when asked by the patient
D. Identification of the patient's best interests

Answer: C

Explanation:
Nurses, through their education and experience, are able to interpret healthcare information and understand the impact of disease and medication interventions in a unique way. A nurse acts as a patient advocate by applying this unique understanding to ensure that the patient's beliefs and values guide the plan of care.
When advocating for a patient, the nurse should guide the patient or surrogate decision maker through values clarification, identification of the patient's best interests, and the process of communicating decisions. The nurse does not impose personal values or preferences when acting as an advocate.

NEW QUESTION # 637
Which of the following can be a complication of positive end-expiratory pressure (PEEP)?

A. Barotrauma
B. Hypertension
C. Hyponatremia
D. Hypoxemia

Answer: A

Explanation:
PEEP/CPAP is indicated for hypoxemia, secondary to diffuse lung injury. It is used in conjunction with any of the ventilator modes to help stabilize alveolar lung volume and improve oxygenation.
Use of PEEP may increase the risk of barotrauma due to higher mean and peak airway pressures during ventilation. Barotrauma describes the damage to the pulmonary system due to alveolar rupture from excessive airway pressures or overdistention of alveoli. Alveolar gas enters the interstitial pulmonary structures, causing pneumothorax. The potential for pneumothorax should be considered whenever airway pressure increases acutely, as with the use of PEEP.
Other complications from PEEP include increases in intracranial pressure, decreased renal perfusion, hepatic congestion, and worsening of intracardiac shunts.
Hyponatremia is a common occurrence following the initiation of mechanical ventilation.
Hypertension is not a complication of PEEP.

NEW QUESTION # 638
Which of the following people are LEAST likely to acquire Vancomycin-Resistant Enterococcus (VRE)?

A. A person previously treated with vancomycin or other antibiotics for long periods of time
B. An ICU nurse frequently exposed to the infection
C. A person who recently underwent surgery and has an invasive catheter in place
D. An individual with an impaired immune status

Answer: B

Explanation:
VRE, a multi-drug resistant organism, can cause serious local and systemic infections that can be severely debilitating and even life-threatening. According to the CDC, individuals at-risk for contracting VRE include those who have been previously treated with vancomycin or other antibiotics for long periods of time, hospitalized people who have received antibiotics for a long period of time, persons who are immunocompromised, and those who have had surgery or have invasive catheters.
The generally healthy person, such as the ICU nurse, is not likely to develop VRE, even if they are exposed to the infection. The importance of hand hygiene continues to play a significant role in the prevention of infection and in targeting transmission of multi-drug resistant organisms.

NEW QUESTION # 639
A patient who had a liver resection now has a copious amount of serous drainage from the surgical incision.
Which of the following should a nurse anticipate when caring for this patient?

A. preparing for an incision and debridement of the wound
B. administering antibiotics
C. applying a drainage pouch to the site
D. applying several abdominal dressings

Answer: D

Explanation:
A copious amount of serous drainage from a liver resection incision may indicate a bile leak, which can cause pain, infection, and delayed healing. The nurse should anticipate applying several abdominal dressings to absorb the fluid and protect the wound. The nurse should also monitor the patient for signs of infection, such as fever, increased white blood cell count, and foul-smelling drainage. The nurse should notify the surgeon of the excessive drainage and follow the orders for further interventions, such as imaging studies, drainage catheter placement, or surgical repair. Antibiotics may be prescribed, but they are not the first-line treatment for a bile leak. Incision and debridement of the wound may be necessary if there is necrotic tissue or infection, but it is not the initial action. Applying a drainage pouch to the site may not be sufficient to contain the large amount of fluid and may increase the risk of skin breakdown.
References:
* Problems after cancer surgery to remove part of your liver: This article states that "The bile ducts connect the liver and gallbladder to the small bowel. There is a risk of bile leaking from the ducts on the cut surface of the liver. This may cause pain, sickness and a high temperature. Rarely, you might need another operation to repair the leak."
* Understanding Liver Abscess Treatment - Saint Luke's Health System: This article states that "The provider uses CT scan or ultrasound to help place the wire in the right spot. A thin, flexible tube (catheter) is then placed over the wire and into the abscess. The tube is left in place for 5 to 7 days to drain the fluid. In some cases, surgery may be done to cut into the liver abscess and drain it."
* How Much Time Does it Take to Recover from Liver Surgery?: This article states that "If you have any drainage from your incision or if the area around your incision is puffy or red, visit your surgeon. Take a shower every day with warm water. When you are ready to take solid foods, make sure to eat 4 to 6 small meals every day. Do not lift heavy weights for 8 weeks after your surgery."

NEW QUESTION # 640
Which of the following BEST describes the rationale for performing an echocardiogram in a patient with Pulmonary Arterial Hypertension (PAH)?

A. An echocardiogram will identify restricted blood flow in the pulmonary arteries
B. An echocardiogram will identify hypertensive pulmonary arteries
C. An echocardiogram is not indicated for a patient with PAH
D. An echocardiogram can identify cor pulmonale

Answer: D

Explanation:
Cor pulmonale refers to right ventricular failure and literally means "pulmonary heart". Cor pulmonale is caused by Pulmonary Arterial Hypertension (PAH) due to the increased afterload of the pulmonary arteries. An echocardiogram does not directly assess the pulmonary arteries and is used to evaluate the structure of the heart, not the pulmonary arteries.

NEW QUESTION # 641
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