Simulation of Real Life
Testing Conditions

Available on our partner site, BoardVitals, this course contains questions written exclusively by experienced critical care advance practice nurses who are active at the bedside. Structured questions and cases mirror the content and format of the exam. Answer questions in review or timed mode in simulated exam conditions.

Learn While You Earn

Earn up to 35.00 contact hours quickly and easily.

Identify Your Strengths
& Weaknesses

Enables you to recognize knowledge gap through detailed dashboards that track your progress and identify strengths and weaknesses.

Detailed Questions
& Explanations

Test your knowledge by answering 500+ critical care nursing questions mapped to the CCRN exam Then review detailed rationales for every question and correct your answers as you go to receive credit.

Leading Faculty

Developed by top faculty and practicing clinicians, BoardVitals helps thousands of doctors, advanced practice nurses, and other health professionals prepare for board certification exams and complete their CME/CE requirements. BoardVitals is trusted by leading medical and nursing institutions including Harvard, Yale, Mt. Sinai, and Duke.

Convenient Access

Whether testing from your iPad in the hospital between cases, or at home on your couch, you have twenty-four hours a day access for 3 months.

ClinicIan Feedback:

This is a great source of CCRN questions to prepare for the exam. Questions are challenging, but the rationales are great. Everything had references too! Thanks for a good qbank.

Anita Fetzick, UPMC

Critical Care Nursing Sample Questions:

Question 1

A 65-year-old nursing home female patient is transferred to the hospital in respiratory distress. Portable chest x-ray demonstrates a heavy shadowing of the right middle and left lower lobes. Gram stain of sputum shows large numbers of lancet-shaped, gram-positive diplococci. Arterial blood gases reveal a PO2 of 52 mm Hg. Which of the following mechanisms most likely accounts for this patient's hypoxia?

A) Decreased surface area of alveolar capillary membranes
B) Decrease in PO2 of inspired air
C) Hypoventilation of central origin
D) Hypoventilation of peripheral origin
E) Inequalities of ventilation and perfusion

E) Inequalities of ventilation and perfusion

Correct: (E) Inequalities of ventilation and perfusion. Main learning point: Lobar pneumonia causes hypoxia secondary to a V/Q mismatch. Explanation: The patient has lobar pneumococcal pneumonia of the right middle and left lower lobes. Respiratory distress in lobar pneumonia is primarily due to ventilation-perfusion mismatch, since the dilated vessels of the involved lobes transmit a higher volume of blood through the lungs at the same time that the alveolar fluid prevents normal ventilation of the affected areas. Inequalities of ventilation and perfusion is also responsible for hypoxemia in chronic obstructive pulmonary disease, atelectasis, pulmonary infarction, tumors, and granulomatous diseases. (A) Decreased surface area of alveolar capillary membranes is seen following resection and in diseases such as emphysema. (B) Decrease of PO2 in inspired air is seen at higher altitude and during artificial ventilation if the fractional O2 content setting is incorrect. (C) Hypoventilation of central origin is seen with morphine and barbiturate overdose. (D) Hypoventilation of peripheral origin is seen with acute poliomyelitis, chest trauma, suffocation, drowning, phrenic nerve paralysis, and Pickwickian syndrome.

Myint, P. K., Kamath, A. V., Vowler, S. L., Maisey, D. N., & Harrison, B. D. (2006). Severity assessment criteria recommended by the British Thoracic Society (BTS) for community-acquired pneumonia (CAP) and older patients. Should SOAR (systolic blood pressure, oxygenation, age and respiratory rate) criteria be used in older people? A compilation study of two prospective cohorts. Age and ageing, 35(3), 286-291.

Question 2

Burn shock pathophysiology is marked by:

A) Neurogenic shock
B) High pulmonary artery occlusion pressure
C) Decreased cardiac output
D) Decreased systemic vascular resistance
E) Increased intravascular volume

C) Decreased cardiac output

Correct: (C) Decreased cardiac output. Explanation: Burn shock is the result of distributive and hypovolemic shock, manifested by intravascular volume depletion, low pulmonary artery occlusion pressure, elevated systemic vascular resistance and depressed cardiac output. Reduced cardiac output is a combined result of decreased plasma volume, increased afterload and decreased contractility. Impaired cardiac contractility is likely caused by circulating mediators such as tumor necrosis factor and impaired cellular calcium levels.

Pham TN, Cancio LC, Gibran NS (2008) American Burn Association practice guidelines: burn shock resuscitation. Journal of Burn Care and Research 29, 257-66.

Copyright 2012 Surgical Critical Care and Emergency Surgery: Clinical Questions and Answers

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