AACN CCRN-Adult Exam - Topic 2 Question 2 Discussion

Actual exam question for AACN's CCRN-Adult exam

Question #: 2
Topic #: 2

A patient was admitted 3 days ago for an overdose of acetaminophen (Tylenol). The patient is developing a decreasing level of consciousness. Which the following is the most likely finding?

ACheyne-Stokes respirations

Bsplenomegaly

Cdecreased GFR

Dincreased INR

Show Suggested Answer

Suggested Answer: D

A patient with acetaminophen overdose is at risk for acute liver failure, which can lead to coagulopathy. This condition is often marked by an increased International Normalized Ratio (INR) due to impaired synthesis of clotting factors in the liver. Decreasing level of consciousness can also result from hepatic encephalopathy, a complication of liver failure. Reference: = CCRN Exam Handbook and AACN's Certification Review Course materials.

by Lorrine at Mar 09, 2025, 10:47 PM

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Alethea

4 months ago

Wait, are we sure about the increased INR? Sounds a bit off.

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Sol

5 months ago

I thought splenomegaly was more related to other conditions?

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Leoma

5 months ago

Cheyne-Stokes respirations? Not really typical for this scenario.

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Kimberely

5 months ago

Totally agree, INR levels can rise due to liver damage.

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Lindsey

5 months ago

Increased INR is common in acetaminophen overdose.

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Vinnie

5 months ago

I feel like splenomegaly wouldn’t be a direct result of an overdose, so I’m not considering that option at all. Increased INR seems more plausible.

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Lai

6 months ago

I practiced a question similar to this, and I think decreased GFR could be a sign of liver damage, but I’m leaning towards increased INR as the most likely finding.

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Krystal

6 months ago

I’m not entirely sure, but I think Cheyne-Stokes respirations are more common in conditions like heart failure, not specifically with acetaminophen.

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Benedict

6 months ago

I remember reading that acetaminophen overdose can lead to liver failure, so maybe increased INR is related to that?

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Yvonne

6 months ago

I've seen questions like this before. The key is to remember the typical presentation of acetaminophen toxicity. I'm pretty confident the Cheyne-Stokes respirations are the most likely finding in this case.

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Cornell

6 months ago

Okay, let's see. Acetaminophen overdose can lead to liver damage, which can cause coagulation issues and decreased GFR. I think the increased INR is the most likely finding here.

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Lashonda

6 months ago

Hmm, I'm a bit unsure about this one. The decreasing level of consciousness could be related to the overdose, but I'm not sure which specific finding would be most likely. I'll have to think this through carefully.

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Rhea

6 months ago

This seems like a classic acetaminophen overdose question. I'll focus on the key signs of liver toxicity like Cheyne-Stokes respirations and increased INR.

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Isreal

1 year ago

Decreased GFR? Nah, that's more of a kidney thing. This is all about the liver, baby!

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Graciela

1 year ago

Liver issues can definitely affect the clotting factors.

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Fallon

1 year ago

D) increased INR

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Dean

1 year ago

Exactly, it's all about the liver in this case.

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Cruz

1 year ago

D) increased INR

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Dannette

1 year ago

C) decreased GFR

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Paris

1 year ago

B) splenomegaly

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Son

1 year ago

A) Cheyne-Stokes respirations

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Vernell

1 year ago

I don't think Cheyne-Stokes respirations would be the most likely finding in this case. I still believe D) increased INR is the correct answer.

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Jeannetta

1 year ago

I'm just going to go with the 'Cheyne-Stokes' option. It sounds like something a doctor would say to make patients feel more intelligent.

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Moon

1 year ago

Increased INR is definitely the correct answer. Acetaminophen overdose leads to liver damage, which causes coagulation factors to decrease, resulting in a higher INR.

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Jenise

1 year ago

But what about option A) Cheyne-Stokes respirations? Could that be a possible finding as well?

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Hershel

1 year ago

I agree with Leila. The patient's decreasing level of consciousness could be due to increased INR.

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Linn

1 year ago

Hmm, I don't think splenomegaly is related to acetaminophen overdose. That's more of a sign of liver cirrhosis or portal hypertension.

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Yuette

1 year ago

D: True, but I think INR is a more specific finding in this case.

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Tamekia

1 year ago

C: Cheyne-Stokes respirations could also be a sign of decreasing consciousness.

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Abraham

1 year ago

B: I agree, that could indicate liver damage from the acetaminophen overdose.

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Xuan

1 year ago

A: I think the most likely finding would be increased INR.

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Gilma

1 year ago

Cheyne-Stokes respirations is the most likely finding for a patient with acetaminophen overdose and decreasing level of consciousness. It's a classic sign of liver failure.

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