10 exam-style questions with answers and explanations, straight from our 1,030-question bank. Tap an answer to check yourself. When you're ready, take the scored version in the free practice test.
These 10 free CCM questions are organized by exam domain, so you can see how each part of the Certified Construction Manager blueprint is tested. Reveal the answer and explanation under each question.
Domain 1: Project Management Planning 15% of exam
Question 1
Shortly after intubation for severe asthma, a passive, mechanically ventilated adult becomes hypotensive. Volume-control settings include a respiratory rate of 24/min and a tidal volume of 6 mL/kg predicted body weight. Expiratory flow does not return to zero before the next breath. The tube is patent, and bilateral lung sliding is present. Blood pressure improves promptly when the circuit is briefly disconnected to permit exhalation. After reconnection, which ventilator adjustment most directly prevents recurrence?
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Correct answer: C - Reduce the respiratory rate to allow more time for expiration.
Question 2
A patient with a transvenous implantable cardioverter-defibrillator is ventricular-pacing-dependent because of complete heart block. Urgent upper-abdominal surgery will require monopolar electrocautery. Recent interrogation shows normal device function; the documented magnet response suspends tachyarrhythmia therapies without changing pacing mode. External defibrillation and pacing equipment will be immediately available. Which device plan addresses both inappropriate shocks and electrocautery-related pacing inhibition?
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Correct answer: B - Program asynchronous pacing and temporarily disable tachyarrhythmia therapies.
Domain 2: Cost Management 15% of exam
Question 3
Despite initial crystalloid resuscitation, a 56-year-old with septic shock has a mean arterial pressure of 53 mm Hg and delayed capillary refill. Antibiotics have been given, and surgical source control is complete. A technically adequate passive leg raise produces no meaningful increase in measured stroke volume; new bilateral B-lines are present. Left ventricular systolic function is hyperdynamic. A reliable proximal peripheral IV is available, but no central catheter has been placed. How should circulatory support proceed?
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Correct answer: A - Start norepinephrine through the peripheral IV with close site monitoring.
Question 4
Severe ARDS from pneumonia persists 18 hours after intubation. The PaO2/FiO2 ratio is 88 on FiO2 0.80 and PEEP 12 cm H2O. Tidal volume is 6 mL/kg predicted body weight, plateau pressure is 27 cm H2O, PaCO2 is 52 mm Hg, and pH is 7.28. Ventilator synchrony is satisfactory. Hemodynamics are stable, and there is no contraindication to repositioning. What should be added to the respiratory plan at this point?
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Correct answer: B - Prone positioning for approximately 16 hours per session.
Question 5
On postoperative day 2, a patient with type 2 diabetes who recently took empagliflozin develops nausea and deep, rapid breathing after markedly reduced oral intake. Glucose is 178 mg/dL, beta-hydroxybutyrate 5.6 mmol/L, pH 7.22, bicarbonate 11 mmol/L, and potassium 4.4 mmol/L. Initial volume replacement has begun, and empagliflozin has been stopped. Choose the appropriate insulin and fluid strategy.
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Correct answer: C - Begin an IV insulin infusion with concurrent dextrose-containing fluid.
Question 6
Nephrology is following an ICU patient with ischemic acute tubular injury after shock. Creatinine is now 5.2 mg/dL and BUN 96 mg/dL, but urine output is improving to 0.7 mL/kg/h. Potassium is 4.7 mmol/L and arterial pH is 7.35. The patient is alert, has no pericardial rub or other uremic manifestations, and has neither pulmonary edema nor refractory fluid overload. How should kidney support be managed today?
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Correct answer: A - Continue supportive care with serial assessment for dialysis indications.
Question 7
Seventy-five minutes into a red-cell transfusion, a 78-year-old postoperative patient develops acute dyspnea and hypoxemia. Blood pressure rises from 132/76 to 188/104 mm Hg. Jugular venous pressure is elevated, and chest imaging shows new bilateral pulmonary edema with small pleural effusions. Fluid balance was already positive by 3.2 L; echocardiography shows preserved left ventricular ejection fraction. There is no fever or hemoglobinuria. The transfusion is stopped and respiratory support started. Which diagnosis best explains the pulmonary deterioration?
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Correct answer: A - Transfusion-associated circulatory overload.
Question 8
Arterial blood gas results in an adult with septic shock are pH 7.12, PaCO2 38 mm Hg, and bicarbonate 12 mmol/L. Although the PaCO2 falls within the laboratory reference interval of 35-45 mm Hg, which acid-base interpretation accounts for all three values?
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Correct answer: B - Metabolic acidosis with superimposed respiratory acidosis.
Domain 3: Time Management 10% of exam
Question 9
During a morning assessment, an older ICU patient is drowsy but awakens to voice and maintains eye contact for 20 seconds before drifting back to sleep. Compared with the patient's usual cognition, mental status has changed acutely and fluctuated overnight. The patient makes four errors on the CAM-ICU attention task but answers the disorganized-thinking questions and follows the command correctly. Hearing and language barriers have been excluded. Which assessment should be documented?
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Correct answer: D - RASS -1, with a positive CAM-ICU assessment.
Question 10
After sedation is discontinued, an intubated adult repeatedly writes, 'I do not want to remain on the ventilator.' The patient accurately explains the reversible illness, available alternatives, and the possibility of death after withdrawal, and gives a consistent values-based reason for refusing further ventilation. There is no delirium. A spouse named as healthcare agent insists on continued treatment; an older advance directive requested full treatment. Which consideration should govern the decision?
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Correct answer: D - The patient's current informed refusal governs while decision-making capacity is intact.