AACN Updated CCRN-Adult Exam Questions and Answers by aysha

Takotsubo cardiomyopathy, also known as stress-induced cardiomyopathy or "broken heart syndrome," is characterized by transient left ventricular dysfunction often precipitated by significant emotional or physical stress. The key findings of chest pain and ST elevation without significant coronary artery disease, along with left ventricular dysfunction and apical ballooning observed on imaging, are classic for takotsubo cardiomyopathy. This condition is often reversible and is associated with a temporary reduction in the heart's pumping ability, indicated by the reduced ejection fraction (EF) of 35%. References: =

• American Association of Critical-Care Nurses (AACN). (2024). CCRN Exam Handbook. Retrieved from AACN CCRN Exam Handbook
• Adult CCRN/CCRN-E/CCRN-K Certification Review Course Online. AACN

Pulsus paradoxus is defined as a decrease in systolic blood pressure (BP) of more than 10 mm Hg during normal inspiration. This phenomenon occurs due to the increased negative intrathoracic pressure during inspiration, which exaggerates the normal drop in systolic BP. It is often seen in conditions such as cardiac tamponade, constrictive pericarditis, and severe asthma or COPD exacerbations. References: = CCRN Exam Handbook, AACN Adult CCRN Certification Review Course

Nutritional supplements are beneficial for patients with neutropenia secondary to chemotherapy, as they can help provide adequate calories, protein, vitamins, and minerals that are essential for immune function and tissue repair. Chemotherapy can cause side effects such as nausea, vomiting, loss of appetite, taste changes, and mouth sores, which can make it difficult for patients to eat enough food and meet their nutritional needs. Nutritional supplements can be in the form of oral drinks, shakes, bars, or powders, or they can be administered through a feeding tube or intravenously. The nurse should request nutritional supplements that are appropriate for the patient’s condition, preferences, and tolerance, and that are compatible with the neutropenic diet and food safety guidelines. The nurse should also monitor the patient’s weight, hydration, and laboratory values, and report any signs of malnutrition, infection, or intolerance to the provider.

References:

• Nutrition for the Person With Cancer During Treatment: A Guide for Patients and Families: This article states that “Nutritional supplements are products that can be used to add nutrients to your diet or to lower your risk of health problems. They can be in pill, capsule, tablet, or liquid form. They might have vitamins, minerals, amino acids, herbs, or other substances. Some examples of common supplements are calcium, iron, omega-3 fatty acids, vitamin C, and vitamin D. You might need supplements if you cannot get enough nutrients from foods or if you have certain health conditions that might cause a deficiency, such as cancer, diabetes, or chronic diarrhea.”
• Nutrition in Cancer Care (PDQ®)–Patient Version: This article states that “Nutritional support is therapy for people who do not get enough nourishment by eating or drinking. You may need nutritional support if you have trouble swallowing, have lost your appetite, or are losing weight. Nutritional support can be given in different ways: Enteral nutrition is liquid food given through a tube (called a feeding tube) into the stomach or small intestine. Parenteral nutrition is a liquid mixture of nutrients given through a vein (intravenous or IV). Oral nutrition is food or liquid taken by mouth. This includes nutritional supplements, such as drinks, shakes, bars, or powders that have protein, carbohydrates, fat, vitamins, and minerals.”
• Nutrition and Cancer: What You Need to Know: This article states that “Nutritional supplements can help you meet your calorie and protein needs when you are not able to eat enough food. They can also provide extra vitamins and minerals. There are many types of nutritional supplements, such as drinks, shakes, puddings, bars, and powders. Some are designed for people with cancer and have extra calories and protein. Your doctor, nurse, or dietitian can help you choose the best supplement for you. You can buy some supplements at the grocery store or pharmacy, but others may need a prescription.”

The first step in developing a teaching plan is to assess the learner’s needs, knowledge, and readiness to learn. This will help the nurse tailor the teaching plan to the individual’s learning style, preferences, and goals. Obtaining written information, determining a schedule, and encouraging observation are all strategies that can be used later in the teaching plan, but they are not the first step.

References:

• AACN Essentials of Critical Care Nursing, Fourth Edition, page 18.
• Patient Education and Counseling, page 3.