CCRN-øvespørgsmål
Testens spørgsmål er på engelsk.
Det her er en gratis smagsprøve på 15 spørgsmål til CCRN-eksamen (Adult), skrevet af StudyPDF-teamet. Den går gennem hæmodynamiske beregninger, shockmønstre, blodgasser, ARDS, endokrin fysiologi og nyrefysiologi, intrakranielt tryk, elektrolytter og ét spørgsmål om Synergy Model, og den blander multiple choice, vælg alle der passer og udfyld det tomme felt. Svar på alle 15, se så din score og læs forklaringen til hvert spørgsmål.
Cardiac output is the product of which two values?
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1. Cardiac output is the product of which two values?
- A. Mean arterial pressure and systemic vascular resistance
- B. Stroke volume and ejection fraction
- C. Heart rate and stroke volume
- D. Heart rate and preload
Vis svar og forklaring
Svar: C. Heart rate and stroke volume
Cardiac output is heart rate times stroke volume, usually about 4 to 8 liters per minute in an adult at rest. Stroke volume in turn depends on preload, afterload and contractility, which is why those three come up in almost every hemodynamics question. Cardiac index divides the output by body surface area so that patients of different sizes can be compared.
2. A patient's hemodynamic readings show a low cardiac output, a high systemic vascular resistance and a high pulmonary artery occlusion pressure. Which shock state fits this pattern best?
- A. Cardiogenic shock
- B. Hypovolemic shock
- C. Early septic shock
- D. Neurogenic shock
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Svar: A. Cardiogenic shock
In cardiogenic shock the pump fails, so blood backs up behind the left ventricle and the occlusion or wedge pressure rises, while the vessels clamp down to hold the blood pressure up. Hypovolemic shock also has a low output and a high resistance, but its filling pressures are low because there is not enough volume. Septic and neurogenic shock are distributive, so their resistance is low, and neurogenic shock often comes with a slow heart rate.
3. Complete the sentence.
With a blood pressure of 120/60 mm Hg, the mean arterial pressure is about _____ mm Hg.
Muligheder for felt 1: 70, 80, 90, 100
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Svar: 80
Mean arterial pressure is the diastolic pressure counted twice plus the systolic pressure, divided by three: (60 + 60 + 120) / 3 = 80. Diastole is weighted more because the heart spends about two thirds of each beat in it. The MAP is the pressure that actually pushes blood into the organs, which is why monitors and test questions lean on it more than on the systolic number alone.
4. An arterial blood gas shows a pH of 7.30, a PaCO2 of 55 mm Hg and a bicarbonate of 25 mEq/L. How is this best interpreted?
- A. Metabolic acidosis with respiratory compensation
- B. Uncompensated respiratory acidosis
- C. Respiratory alkalosis
- D. Compensated metabolic alkalosis
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Svar: B. Uncompensated respiratory acidosis
A pH under 7.35 is acidosis. The PaCO2 is above its normal range of about 35 to 45, which matches an acid, so the cause is respiratory. The bicarbonate is still inside its normal range of about 22 to 26, so the kidneys have not started to compensate yet, which usually means the problem is recent.
5. Which change shifts the oxyhemoglobin dissociation curve to the right, so that hemoglobin releases oxygen to the tissues more easily?
- A. Alkalosis
- B. Hypothermia
- C. A low level of 2,3-DPG
- D. Fever
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Svar: D. Fever
Heat, acid, a high carbon dioxide level and more 2,3-DPG all shift the curve to the right, and they are exactly the conditions of hard-working tissue, so oxygen is unloaded where it is needed. Alkalosis, hypothermia and low 2,3-DPG shift it to the left, and hemoglobin then holds on to its oxygen. That is why a normal saturation does not guarantee good tissue oxygen delivery in a cold, alkalotic patient.
6. Which statements describe acute respiratory distress syndrome (ARDS)?
Vælg alle, der passer.
- A. Hypoxemia that improves poorly with supplemental oxygen alone
- B. Pulmonary edema caused mainly by a high pulmonary artery occlusion pressure
- C. Bilateral opacities on chest imaging
- D. Consolidation limited to a single lobe on one side
- E. Fluid leaking into the alveoli because the capillaries have become more permeable
Vis svar og forklaring
Svar: A. Hypoxemia that improves poorly with supplemental oxygen alone, C. Bilateral opacities on chest imaging, E. Fluid leaking into the alveoli because the capillaries have become more permeable
In ARDS an injury such as sepsis, pneumonia or trauma makes the lung capillaries leaky, so protein-rich fluid floods the alveoli on both sides. Blood then passes through lung units that cannot take up oxygen, a shunt, which is why extra oxygen helps so little. The edema is noncardiogenic: if a high wedge pressure from a failing heart explains it, the picture is heart failure, not ARDS, and severity is usually graded by the ratio of arterial oxygen to inspired oxygen.
7. Complete the sentence.
In the syndrome of inappropriate antidiuretic hormone (SIADH), the kidneys keep holding on to water, so the urine is inappropriately _____ and the serum sodium _____.
Muligheder for felt 1: concentrated, dilute, alkaline
Muligheder for felt 2: rises, falls, does not change
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Svar: concentrated, falls
Too much antidiuretic hormone makes the kidneys reabsorb free water even when the body does not need it, so the urine stays concentrated and the extra water dilutes the blood sodium. Diabetes insipidus is the mirror image: too little hormone, or kidneys that ignore it, produce large amounts of dilute urine and the serum sodium climbs. Both turn up after head injury and neurosurgery, which is why they are tested side by side.
8. In diabetic ketoacidosis, which breathing pattern reflects the body's attempt to compensate for the acidosis?
- A. Kussmaul respirations
- B. Cheyne-Stokes respirations
- C. Biot respirations
- D. Apneustic breathing
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Svar: A. Kussmaul respirations
Kussmaul breathing is deep and rapid, and it blows off carbon dioxide to push the pH back up, a respiratory compensation for a metabolic acidosis. The ketones that cause the acidosis also give the breath its fruity smell. Hyperosmolar hyperglycemic state is the contrast case: a very high glucose and serum osmolality with little or no ketoacidosis, so Kussmaul breathing is not expected.
9. Which signs make up Cushing's triad, a late sign of rising intracranial pressure?
Vælg alle, der passer.
- A. Tachycardia
- B. A rising systolic pressure with a widening pulse pressure
- C. Bradycardia
- D. Irregular or abnormal respirations
- E. A narrowing pulse pressure
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Svar: B. A rising systolic pressure with a widening pulse pressure, C. Bradycardia, D. Irregular or abnormal respirations
As the pressure inside the skull rises, the body pushes the systolic pressure up to keep blood reaching the brain, which widens the pulse pressure. The heart slows in response, and pressure on the brainstem disturbs the breathing pattern. Because the triad appears late, a falling level of consciousness is usually the earlier warning, and the triad means the brainstem is already under threat.
10. Complete the sentence.
With a mean arterial pressure of 80 mm Hg and an intracranial pressure of 20 mm Hg, the cerebral perfusion pressure is _____ mm Hg.
Muligheder for felt 1: 40, 50, 60, 100
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Svar: 60
Cerebral perfusion pressure is the mean arterial pressure minus the intracranial pressure, so 80 - 20 = 60. Normal intracranial pressure in adults is usually given as about 5 to 15 mm Hg. The formula shows why a rising ICP or a falling MAP threatens the brain the same way: either one shrinks the pressure difference that drives blood into it.
11. Which finding is typical of prerenal acute kidney injury, as opposed to acute tubular necrosis?
- A. Muddy brown granular casts and a high urine sodium
- B. Red blood cell casts in the urine
- C. A BUN to creatinine ratio above 20 to 1 and a low urine sodium
- D. A urine specific gravity fixed at about 1.010
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Svar: C. A BUN to creatinine ratio above 20 to 1 and a low urine sodium
In prerenal injury the kidney itself still works but is underperfused, so it holds on to sodium and water as hard as it can, the urine sodium drops and urea is reabsorbed out of proportion to creatinine. Once the tubules are damaged, as in acute tubular necrosis, they can no longer conserve sodium or concentrate urine, which gives a high urine sodium, a fixed specific gravity near 1.010 and muddy brown casts. Red cell casts point to the glomeruli instead.
12. Why does a patient with disseminated intravascular coagulation (DIC) bleed?
- A. Antibodies against heparin destroy the platelets
- B. Widespread clotting uses up platelets and clotting factors
- C. The liver stops producing albumin
- D. Vitamin C deficiency weakens the vessel walls
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Svar: B. Widespread clotting uses up platelets and clotting factors
DIC starts with clotting, not bleeding: a trigger such as sepsis, trauma or an obstetric emergency switches on coagulation throughout the small vessels. That consumes platelets and clotting factors faster than the body can replace them, and the breakdown of all those clots adds to the problem. The typical labs are a low platelet count, a low fibrinogen, a prolonged PT and aPTT and a high D-dimer, while heparin-induced thrombocytopenia, the first option, causes clots rather than bleeding.
13. Which findings are signs of hypocalcemia?
Vælg alle, der passer.
- A. A positive Chvostek sign
- B. A positive Trousseau sign
- C. A shortened QT interval
- D. Numbness and tingling around the mouth
- E. Decreased deep tendon reflexes
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Svar: A. A positive Chvostek sign, B. A positive Trousseau sign, D. Numbness and tingling around the mouth
Low calcium makes nerves and muscles too excitable: tapping the facial nerve twitches the face (Chvostek), a blood pressure cuff on the arm brings on a hand spasm (Trousseau), and the lips and fingertips tingle. It also lengthens the QT interval. A short QT and weak reflexes belong to high calcium, and low calcium is watched for after thyroid or parathyroid surgery and after large transfusions, because the citrate in stored blood binds calcium.
14. In the AACN Synergy Model, which nurse characteristic means speaking up for the patient and family and helping to resolve the ethical problems that come up in their care?
- A. Systems thinking
- B. Clinical inquiry
- C. Facilitation of learning
- D. Advocacy and moral agency
Vis svar og forklaring
Svar: D. Advocacy and moral agency
The Synergy Model, the framework behind every AACN certification exam, matches patient characteristics such as stability, complexity and resiliency with eight nurse characteristics. Clinical judgment is one of them and drives the clinical 80 percent of the exam. The other seven, advocacy and moral agency, caring practices, clinical inquiry, collaboration, facilitation of learning, response to diversity and systems thinking, make up the Professional Caring and Ethical Practice domain.
15. A patient after cardiac surgery becomes hypotensive with distended neck veins, muffled heart sounds and a systolic pressure that drops more than 10 mm Hg on inspiration. Which complication do these findings point to?
- A. Cardiac tamponade
- B. Tension pneumothorax
- C. Acute aortic dissection
- D. Hypovolemia from chest tube losses
Vis svar og forklaring
Svar: A. Cardiac tamponade
Hypotension, distended neck veins and muffled heart sounds are Beck's triad, and the inspiratory drop in systolic pressure is pulsus paradoxus: fluid around the heart keeps the chambers from filling. On a pulmonary artery catheter the right atrial, pulmonary artery diastolic and occlusion pressures tend to equalize. A tension pneumothorax also raises the neck veins and drops the pressure, but it comes with absent breath sounds on one side, and hypovolemia flattens the neck veins.
Hvad CCRN-eksamen (Adult) dækker
CCRN er den amerikanske specialcertificering for sygeplejersker, der passer akut og kritisk syge patienter, og den udstedes af AACN Certification Corporation. Der er separate eksamener for voksne, børn og nyfødte, og håndbogen understreger, at CCRN ikke er en forkortelse for critical care registered nurse. Før du kan gå op, skal du have en aktiv RN- eller APRN-autorisation uden begrænsninger og et bestemt antal dokumenterede kliniske timer med kritisk syge patienter. Håndbogen oplister de præcise muligheder for timerne, så læs dem der i stedet for på en side med eksamensforberedelse.
Ifølge AACN CCRN Exam Handbook er eksamen en prøve på 3 timer med 150 multiple choice-spørgsmål. Kun 125 af dem tæller med i din score. De andre 25 er uscorede spørgsmål, som AACN afprøver til fremtidige eksamener, og du kan ikke se, hvilke det er. Beståelsesgrænsen fastsættes af et ekspertpanel ud fra en fast standard, så du konkurrerer ikke med de andre, der går op samme dag.
Firs procent af eksamen er Clinical Judgment, og tyve procent er Professional Caring and Ethical Practice. For eksamener taget 12. november 2025 eller senere deler Adult-testplanen Clinical Judgment op sådan: hjerte-kar 13 procent, respiration 12 procent, endokrinologi, hæmatologi og immunologi, mave-tarm, nyrer og urinveje samt hud tilsammen 21 procent, bevægeapparat, neurologi og adfærd eller psykosociale forhold 18 procent, og multisystemproblemer som sepsis, shock og syre-base-forstyrrelser 16 procent. Domænet om omsorg og etik dækker advocacy og moral agency, omsorgspraksis, klinisk undersøgelse, samarbejde, at fremme læring, respons på mangfoldighed og systemtænkning.
Den testplan er nyere end mange eksamensbøger og spørgsmålsbanker. Viser en kilde andre procenter, er den sandsynligvis skrevet til den tidligere plan, så tjek datoen på den håndbog, du downloader fra aacn.org, før du beslutter, hvor du vil bruge din læsetid.
Sådan bruger du smagsprøven
Den rigtige eksamen stiller mange spørgsmål om, hvad sygeplejersken skal gøre som det næste. Det gør denne smagsprøve med vilje ikke. Interventioner, valg af lægemidler og doser afhænger af dit afsnits retningslinjer, lægens ordinationer og aktuelle opslagsværker, så de hører ikke hjemme på en gratis øveside. Hvert spørgsmål her tester i stedet tankegangen bag de beslutninger: hvad en hæmodynamisk profil betyder, hvordan man læser en blodgas, og hvorfor et mønster i blodprøverne peger på én årsag og ikke en anden. Det her er eksamenstræning, ikke medicinsk vejledning.
Den tankegang er værd at træne for sig selv, for det er den, der lader dig udelukke forkerte svar på den rigtige eksamen. Ved du, hvorfor kardiogent shock hæver kiletrykket (wedge-trykket), og hypovolæmisk shock sænker det, bliver et spørgsmål om et af dem et spørgsmål om at læse tallene. Det samme gælder syre-base: find først ud af pH, så hvilken værdi der forklarer den, og så om den anden værdi er begyndt at kompensere.
Tag de 15 spørgsmål i ét stræk uden noter, og læs så hver forklaring, også dem til spørgsmål, du svarede rigtigt på. Behandl hvert forkert svar som et emne. To fejl på de hæmodynamiske spørgsmål peger på ét hul, ikke to, så gå tilbage til minutvolumen, preload, afterload og shockprofilerne samlet. Fordi den rigtige eksamen spænder over hele kroppen, betyder en svag score i multisystem eller neurologi lige så meget som en svag score i hjerte-kar.
Hvert spørgsmål på denne side er skrevet af StudyPDF-teamet ud fra den offentliggjorte testplan. Ingen af dem kommer fra AACN, fra AACN's øveprøver eller fra nogen kommerciel spørgsmålsbank.
Sådan bygger du flere øveprøver ud fra dit eget materiale
Femten spørgsmål kan vise dig, hvilket organsystem der kræver arbejde. De kan ikke gøre dig klar til en certificeringseksamen alene, og en generisk spørgsmålsbank ved ikke, hvad dit repetitionskursus lagde vægt på, eller hvilke områder du bliver ved med at ramme forkert.
StudyPDF tager i stedet udgangspunkt i dit materiale. Upload din repetitionsbog i intensiv sygepleje, slides fra dit CCRN-kursus, dit afsnits undervisningsmateriale eller dine egne noter. Tryk derefter på Nyt materiale, vælg en øveeksamen eller en quiz, vælg de filer som kilder, og bestem længden og sværhedsgraden. Hvert spørgsmål er skrevet ud fra præcis de sider, og hver forklaring henviser til, hvor svaret kommer fra, så du kan åbne kilden, så snart noget ser forkert ud. Du kan snævre en prøve ind til ét område som hæmodynamik eller neurologi, og dine svar bygger et billede, begreb for begreb, af hvad der bliver ved med at koste dig point.
Bo er tutoren til resten. Spørg ham, hvorfor et svar er rigtigt, så forklarer han det ud fra dine egne sider, med et hint først, hvis du vil have et.
Du behøver ikke uploade noget for at komme i gang. Nævn i stedet et emne, for eksempel shocktilstande, tolkning af syre-base eller intrakranielt tryk, så sætter Bo det op med de vigtigste begreber, og du kan bygge en øveprøve om det. Det er gratis at starte.
Skrevet af StudyPDF-teamet. Sidst opdateret 2026-08-19.