CCRN Domain 5: Multisystem Welcome to your CCRN Domain 5: Multisystem 1. CCRN: Multisystem In the context of multisystem organ failure, which laboratory finding is most indicative of early disseminated intravascular coagulation 'DIC'? Elevated D-dimer Decreased platelet count Increased PT/INR Decreased fibrinogen levels None 2. CCRN: Multisystem In a patient with multisystem organ failure, which hemodynamic parameter is most directly indicative of deteriorating cardiac output due to septic shock? Decreased systemic vascular resistance (SVR) Increased central venous pressure (CVP) Decreased pulmonary artery wedge pressure (PAWP) Increased mixed venous oxygen saturation (SvO2) None 3. CCRN: Multisystem A critical care nurse is monitoring a patient for signs of abdominal compartment syndrome (ACS). Which clinical finding is most suggestive of this condition? Hypoactive bowel sounds Decreased urinary output Elevated peak inspiratory pressures Bradycardia None 4. CCRN: Multisystem In a patient with acute respiratory distress syndrome (ARDS) and sepsis, which ventilator strategy is preferred to minimize ventilator-induced lung injury? High tidal volume ventilation Low tidal volume ventilation High-frequency oscillatory ventilation Inverse ratio ventilation None 5. CCRN: Multisystem When managing a patient with severe pancreatitis, which of the following is the most critical intervention to prevent multisystem organ failure? Aggressive fluid resuscitation Prophylactic antibiotics Early enteral nutrition Immediate ERCP None 6. CCRN: Multisystem In the setting of anaphylactic shock, which medication is the first-line treatment to prevent progression to multisystem organ failure? Epinephrine Antihistamines Corticosteroids Beta-agonists None 7. CCRN: Multisystem In a patient with toxic shock syndrome, which organ system should be monitored most closely for signs of failure? Renal Hepatic Cardiovascular Pulmonary None 8. CCRN: Multisystem For a patient experiencing myxedema coma, which therapeutic intervention is most critical to prevent progression to multisystem organ failure? Intravenous levothyroxine Corticosteroids Thermal warming blankets Intravenous insulin None 9. CCRN: Multisystem In a patient with acute liver failure, what is the most immediate risk leading to multisystem organ failure? Hypoglycemia Coagulopathy Ascites Encephalopathy None 10. CCRN: Multisystem When treating a patient with rhabdomyolysis, which strategy is essential to prevent kidney injury and subsequent multisystem organ failure? High-dose corticosteroids Aggressive hydration Immediate dialysis Intravenous calcium None 11. CCRN: Multisystem In the context of a patient with carbon monoxide poisoning, which treatment is most effective in preventing multisystem organ failure? High-flow oxygen therapy Hyperbaric oxygen therapy Intravenous fluids Mechanical ventilation None 12. CCRN: Multisystem Which clinical indicator is most predictive of poor outcome in a patient with septic shock potentially leading to multisystem organ failure? Elevated white blood cell count Hyperlactatemia Tachycardia Hypothermia None 13. CCRN: Multisystem For a patient with a severe burn injury, which factor is most critical in preventing the development of multisystem organ failure? Pain management Fluid resuscitation Infection control Nutritional support None 14. CCRN: Multisystem In the management of a patient with crush syndrome, what is the primary therapeutic goal to prevent multisystem organ failure? Alkalinization of urine Hemodialysis Fasciotomy Aggressive pain management None 15. CCRN: Multisystem In the setting of acute adrenal crisis, which intervention is most critical to prevent progression to multisystem organ failure? Immediate administration of hydrocortisone Aggressive fluid resuscitation Administration of vasopressors High-dose insulin therapy None 16. CCRN: Multisystem For a patient undergoing a massive transfusion, which complication should be most closely monitored to prevent multisystem organ failure? Transfusion-related acute lung injury (TRALI) Hypocalcemia Hyperkalemia Citrate toxicity None 17. CCRN: Multisystem In a patient with acute mesenteric ischemia, which intervention is most urgent to prevent multisystem organ failure? Immediate anticoagulation Surgical revascularization Broad-spectrum antibiotics Enteral nutrition None 18. CCRN: Multisystem When managing a patient with acute kidney injury (AKI) due to rhabdomyolysis, which of the following is a key indicator for initiating renal replacement therapy to prevent multisystem organ failure? Myoglobinuria Hyperphosphatemia Elevated creatine kinase Oliguria None 19. CCRN: Multisystem In the treatment of a patient with necrotizing fasciitis, what is the most critical intervention to prevent spread and subsequent multisystem organ failure? High-dose antibiotic therapy Surgical debridement Hyperbaric oxygen therapy Immunoglobulin therapy None 20. CCRN: Multisystem For a patient with acute respiratory failure and suspected pulmonary embolism, which diagnostic test is most critical to confirm the diagnosis and prevent progression to multisystem organ failure? Chest X-ray D-dimer assay Computed tomography pulmonary angiography 'CTPA' Ventilation-perfusion (V/Q) scan None 1 out of 20 Time is Up! Time's up