The nurse should respect the mother’s request and facilitate the family’s emotional needs during the

end-of-life care. The nurse should also ensure the patient’s safety and dignity by preparing and

organizing the necessary equipment and monitoring before moving the mother next to the patient.

The other options are not appropriate because they either deny the mother’s request, imply that the

patient is no longer alive, or delay the organ donation process.

Reference:

Donor Family Care Service - NHS Blood and Transplant

Family-Centered Care to Improve Family Consent for Organ Donation

For a patient with type 1 diabetes admitted for diabetic ketoacidosis (DKA) who reports not following

the prescribed medication plan, assessing the patient's ability to afford medications and supplies is

crucial. Financial barriers are a common reason for non-adherence to treatment plans. Addressing

these barriers can help the healthcare team provide the necessary resources or support to ensure

the patient can follow the prescribed regimen, potentially preventing future hospitalizations.

Reference: =

CCRN (Adult) Certification Review Course Online: Behavioral/Psychosocial.

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

For a post-surgical patient with a history of heroin addiction, a PCA (patient-controlled analgesia)

with both continuous and on-demand opioid delivery ensures consistent pain control and addresses

both baseline pain and breakthrough pain. This approach helps manage pain more effectively and

can prevent withdrawal symptoms in patients with opioid tolerance. Reference: = AACN Certification

and Core Review for High Acuity and Critical Care, 7th Edition, AACN Handbook for CCRN

Certification, pp. 88-90.

Ventilator-associated events (VAEs) can be prevented by reducing the risk of aspiration and

maintaining airway hygiene. Subglottic suctioning is an effective measure to remove secretions that

accumulate above the endotracheal tube cuff, which can harbor bacteria and lead to infection. This

intervention helps prevent the development of pneumonia and other VAEs. Reference: AACN Adult

CCRN Certification Review Course, AACN CCRN Exam Handbook.

Hypoxia-induced cerebral edema after a near-drowning incident can be managed by administering

osmotic diuretics like mannitol. These medications help reduce intracranial pressure by drawing fluid

out of the brain tissue and into the bloodstream, thereby alleviating cerebral edema. Maintaining a

MAP of 60-70 mm Hg may not be sufficient to address the elevated intracranial pressure, keeping the

patient flat could worsen cerebral edema, and hyperventilation with a PaCO2 of 40-45 mm Hg is not

typically recommended for managing increased intracranial pressure as it can lead to

vasoconstriction and decreased cerebral perfusion. Reference: = CCRN Exam Handbook, AACN Adult

CCRN Certification Review Course

:

The patient has signs of hypovolemic shock, which is characterized by low MAP, low PAOP, low CI,

and high SVR. The patient needs fluid resuscitation to restore intravascular volume and improve

tissue perfusion. Loop diuretic, vasopressors, and whole blood are not indicated in this case.

Reference:

Reference Guide for CCRN (Adult), page 14.

Adult CCRN/CCRN-E/CCRN-K Certification Review Course Online - Individual Purchase, Module 1:

Cardiovascular, Part 1: Shock.

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https://kxbjsyuhceggsyvxdkof.supabase.co/storage/v1/object/public/file-images/AACN_CCRN-ADULT/page_21_img_2.jpg

Cellular dehydration is one of the potentially life-threatening

consequences of diabetic ketoacidosis (DKA), which is a condition that

occurs when the body does not have enough insulin to use glucose for

energy and starts to break down fat instead. This produces ketones, which

are acidic substances that accumulate in the blood and urine. DKA causes

hyperglycemia, which is a high level of glucose in the blood, and osmotic

diuresis, which is the loss of water and electrolytes through the urine. This

leads to cellular dehydration, which is the shrinkage of the cells due to the

loss of water from the intracellular fluid. Cellular dehydration can affect the

brain and cause neurological symptoms, such as confusion, lethargy, coma, and death12.

Other potentially life-threatening consequences of DKA include metabolic acidosis, which is a low pH

of the blood due to the excess of ketones, and respiratory compensation, which is the increase of the

breathing rate and depth to expel carbon dioxide and lower the acidity of the blood12. These are not

the same as metabolic alkalosis or respiratory alkalosis, which are conditions that cause a high pH of

the blood due to the loss of acids or the retention of bases2. Intracellular hyperglycemia is not a

consequence of DKA, as the glucose cannot enter the cells without insulin and remains in the

extracellular fluid12.

A high mixed venous O2 saturation (SO2) indicates that the tissue cells are not extracting enough

oxygen from the blood, which can be due to impaired cellular metabolism or increased oxygen

delivery. In septic shock, there is often a mismatch between oxygen delivery and consumption,

resulting in a high SO2 despite tissue hypoxia. Therefore, SO2 alone is not a reliable indicator of

tissue perfusion in septic shock.

Reference:

Mixed venous oxygen saturation (SvO2) monitoring • LITFL • CCC

SvO2 to monitor resuscitation of septic patients: let’s just understand the basic physiology | Critical

Care | Full Text

Reference Guide for CCRN (Adult), page 14.

Papillary muscle dysfunction, often resulting from myocardial infarction, can lead to mitral

insufficiency (mitral regurgitation). The papillary muscles support the mitral valve, and if they are

damaged, the valve may not close properly, causing blood to flow backward into the left atrium

during systole. This condition is not associated with aortic stenosis, mitral stenosis, or aortic

insufficiency. Reference: = CCRN Exam Handbook, AACN Adult CCRN Certification Review Course