AACN Updated CCRN-Adult Exam Questions and Answers by sasha

The clinical presentation of lower left quadrant pain with guarding, abdominal distention, rigidity, and free air in the abdominal cavity on a KUB (kidney, ureter, and bladder) radiograph strongly suggests a perforated bowel. The presence of free air indicates that there is a breach in the gastrointestinal tract, allowing air to escape into the peritoneal cavity. The patient's vital signs, including hypotension (BP 76/40), tachycardia (HR 130), tachypnea (RR 32), and fever (T 101.7°F), are consistent with sepsis and shock, which are common complications of bowel perforation. References: CCRN Exam Handbook, AACN, page 30, section on Gastrointestinal.

Abdominal compartment syndrome (ACS) involves increased intra-abdominal pressure, which can significantly impact various body systems. One of the major concerns is its effect on respiratory function, leading to increased peak inspiratory pressure. This happens because the elevated pressure in the abdomen can push up against the diaphragm, making it harder for the lungs to expand during inhalation. Increased urine output is unlikely as ACS usually leads to decreased renal perfusion and output. Increased preload and decreased intracranial pressure are not typically associated with ACS. References: = CCRN Exam Handbook, AACN Adult CCRN Certification Review Course

When a patient exhibits anxiety and threats of harm, it is crucial to de-escalate the situation through verbal communication and engagement. By encouraging the patient to verbalize their feelings, the nurse can address the patient's fears and anxieties, reducing the likelihood of aggression. This approach promotes a therapeutic nurse-patient relationship and ensures the safety of both the patient and healthcare staff. References: = CCRN Exam Handbook, AACN Adult CCRN Certification Review Course

While it is important to support family involvement, previous disruptive behavior necessitates setting clear behavioral limits to ensure a safe and therapeutic environment for the patient. Allowing the visit with established guidelines helps balance the need for patient support with maintaining unit order. This approach also respects the patient's rest and recovery needs. References: = CCRN Exam Handbook, AACN Adult CCRN Certification Review Course