AACN CCRN-Adult Exam With Confidence Using Practice Dumps

The signs and symptoms described in the patient post-bariatric surgery, including anxiety, restlessness, increased abdominal pain, and subcutaneous crepitus over the neck, suggest a potential anastomotic leak, which is a surgical emergency. Given the vital signs indicating possible sepsis or shock (elevated heart rate, increased respiratory rate, and fever), immediate surgical intervention is likely required to repair the leak and prevent further complications. References: CCRN Exam Handbook, AACN, page 30, section on GI surgical emergencies.

The patient who has been in the unit for 60 hours and reports agitation, noise disturbances, and an inability to get peace and quiet may be experiencing sleep disturbances. Factors such as the ICU environment, frequent interventions, and the medications being administered (e.g., benzodiazepines, opioids, and bronchodilators) can significantly disrupt sleep patterns, leading to further agitation and delirium. Addressing the patient's sleep hygiene and implementing measures to promote rest can be beneficial.References: = CCRN Exam Handbook, page 52

The patient’s findings are consistent with a ruptured diaphragm, which is a tear in the muscle that separates the chest and abdominal cavities. A blunt chest trauma can cause a sudden increase in intra-abdominal pressure, which can rupture the diaphragm and allow abdominal organs to herniate into the thorax. This can cause dyspnea, hypotension, shoulder pain, and bowel sounds over the lower thorax. A ruptured abdominal viscus would cause peritonitis, which would present with abdominal pain, distension, fever, and signs of sepsis. A flail chest would cause paradoxical chest movement, respiratory distress, and cyanosis. A mediastinal shift would cause tracheal deviation, decreased breath sounds, and jugular venous distension.

References:

• AACN. (2023). CCRN (Adult) Exam Handbook. Retrieved from [CCRN Exam Handbook], p. 18.
• AACN. (2023). CCRN (Adult) Exam Blueprint. Retrieved from [CCRN Exam Blueprint], p. 2.
• BCEN. (2020). Trauma Certified Registered Nurse (TCRN) Examination Content Outline. Retrieved from [TCRN Exam Content Outline], p. 8.
• Lewis, S. L., Bucher, L., Heitkemper, M. M., Harding, M. M., Kwong, J., & Roberts, D. (2017). Medical-surgical nursing: Assessment and management of clinical problems (11th ed.). St. Louis, MO: Elsevier. Retrieved from [Textbook], p. 1789-1790.