CCRN PRACTICE QUESTIONS AND VERIFIED ANSWERS
WITH COMPLETE SOLUTIONS |LATEST EXAM 2025-2026
|ALREADY GRADED A+
A patient in the ED with complaints of chest pain. The 12-lead EKG shows ST
elevation in leads V3 and V4. Occlusion of the affected coronary artery most likely
would affect perfusion to which portion of the conduction system?
A. Sinoatrial (SA) node
B. Bachmann's bundle
C. Atrioventricular (AV) node
D. Bundle of His - CORRECT ANSWERS - LAD so D. bundle of his
Which of the following is the preferred lead for ST segment monitoring for a
patient with a suspected RCA occlusion?
A.I
B. aver
C. III
D. V1 - CORRECT ANSWERS - c. III
Which of the following is not a manifestation of hypertrophic cardiomyopathy?
A. Syncope
B. Murmur that increases with squatting
,C. Chest pain
D. Sudden cardiac death - CORRECT ANSWERS - *B
Classic manifestations of hypertrophic cardiomyopathy are chest pain, syncope,
and an aortic stenosis type of murmur that decreases when the patient is in a
squatting position. The first manifestation of this condition is occasionally sudden
cardiac death during exercise.
In which quadrant is the mean QRS complex axis located if the QRS complex is
predominantly positive in lead I and negative in lead if?
A. Normal quadrant
B. Left axis deviation quadrant
C. Right axis deviation quadrant
D. In determinant quadrant - CORRECT ANSWERS - *B
Because the positive of lead I is the left arm, if the QRS complex is upright in lead
I, the mean QRS axis is to the left. Because the positive of lead if (a unipolar lead)
is at the foot, if the QRS complex is negative in lead if, the mean QRS axis is
upward away from the foot. This axis would be in the upper left quadrant,
described as left axis deviation.
A patient becomes apneic and pulseless. CPR has been initiated, and the monitor
shows asystole in two leads. Which of the following drugs would be used initially?
A. Calcium gluconate
B. Atropine
C. Epinephrine
D. Amiodarone (Cordarone) - CORRECT ANSWERS - C
,After CPR is initiated and an intravenous access is established, epinephrine should
be given. Calcium was used in the past in asystole but is used today only for
hypocalcemia, calcium channel blocker toxicity, hyperkalemia, and
hypermagnesemia. Atropine is no longer recommended for asystole. Amiodarone
is not indicated in asystole because asystole is the absolute absence of irritability.
What is associated w/ Mitral Stenosis
A. Pinkish discoloration of the cheeks
B. Systolic murmur
C. Widened pulse pressure
D. Narrow pulse pressure - CORRECT ANSWERS - A
Patients with mitral stenosis may exhibit a pinkish discoloration of the cheeks
(i.e., malar blush). Mitral stenosis causes a diastolic murmur. Widened pulse
pressure is associated with aortic regurgitation. Narrowed pulse pressure is
associated with mitral regurgitation.
Four days after a mitral valve replacement, the patient develops atrial fibrillation.
The nurse initially would:
A. order a 12-lead EKG
B. evaluate the patient for clinical indications of hypoperfusion.
C. notify the physician.
D. ask the patient to bear down as if having a bowel movement. - CORRECT
ANSWERS - B
The onset of atrial fibrillation results in the loss of atrial kick. Loss of atrial kick
may reduce the cardiac output by as much as 20-30%. This is especially true in
patients whose cardiac output may be affected by long-standing cardiac disease,
such as mitral valve disease. Assess the patient for clinical indications of
, hypoperfusion (e.g., cool skin, decreased urine output, narrowed pulse pressure,
and hypotension).
A patient has just returned from the cath lab. She had an angioplasty for occlusion
of her RCA. She still has femoral artery and vein sheaths in place. The patient
complains of chest pain that she rates 9/10 about an hour after she returns from
the cath lab. Which of the following is indicated?
A. Administer morphine IV.
B. Administer nitroglycerin sublingual spray.
C. Stop the heparin.
D. Notify the physician - CORRECT ANSWERS - D
New-onset severe chest pain after percutaneous coronary intervention suggests
acute closure of the dilated coronary artery. The patient needs to be returned to
the cardiac catheterization laboratory for repeat dilation and probable insertion
of stent.
A 35-year-old woman underwent a mitral valve replacement. Her chest tube
output has been approximately 125 mL/hr for the last 3 hours, and now the
drainage has ceased suddenly. The immediate assessment reveals a significant
decrease in BP, RAP 12, PAP 30/15 , PAOP 13. What other data would indicate the
development of cardiac tamponade?
A. Increased venous oxygen saturation (SvO2)
B. Decreased UO
C. Muffled heart sounds
D. New holosystolic murmur at the sternum - CORRECT ANSWERS - C
Muffled heart sounds are a classic finding in cardiac tamponade. Remember the
classic indications of cardiac tamponade referred to as Beck's triad: muffled heart
WITH COMPLETE SOLUTIONS |LATEST EXAM 2025-2026
|ALREADY GRADED A+
A patient in the ED with complaints of chest pain. The 12-lead EKG shows ST
elevation in leads V3 and V4. Occlusion of the affected coronary artery most likely
would affect perfusion to which portion of the conduction system?
A. Sinoatrial (SA) node
B. Bachmann's bundle
C. Atrioventricular (AV) node
D. Bundle of His - CORRECT ANSWERS - LAD so D. bundle of his
Which of the following is the preferred lead for ST segment monitoring for a
patient with a suspected RCA occlusion?
A.I
B. aver
C. III
D. V1 - CORRECT ANSWERS - c. III
Which of the following is not a manifestation of hypertrophic cardiomyopathy?
A. Syncope
B. Murmur that increases with squatting
,C. Chest pain
D. Sudden cardiac death - CORRECT ANSWERS - *B
Classic manifestations of hypertrophic cardiomyopathy are chest pain, syncope,
and an aortic stenosis type of murmur that decreases when the patient is in a
squatting position. The first manifestation of this condition is occasionally sudden
cardiac death during exercise.
In which quadrant is the mean QRS complex axis located if the QRS complex is
predominantly positive in lead I and negative in lead if?
A. Normal quadrant
B. Left axis deviation quadrant
C. Right axis deviation quadrant
D. In determinant quadrant - CORRECT ANSWERS - *B
Because the positive of lead I is the left arm, if the QRS complex is upright in lead
I, the mean QRS axis is to the left. Because the positive of lead if (a unipolar lead)
is at the foot, if the QRS complex is negative in lead if, the mean QRS axis is
upward away from the foot. This axis would be in the upper left quadrant,
described as left axis deviation.
A patient becomes apneic and pulseless. CPR has been initiated, and the monitor
shows asystole in two leads. Which of the following drugs would be used initially?
A. Calcium gluconate
B. Atropine
C. Epinephrine
D. Amiodarone (Cordarone) - CORRECT ANSWERS - C
,After CPR is initiated and an intravenous access is established, epinephrine should
be given. Calcium was used in the past in asystole but is used today only for
hypocalcemia, calcium channel blocker toxicity, hyperkalemia, and
hypermagnesemia. Atropine is no longer recommended for asystole. Amiodarone
is not indicated in asystole because asystole is the absolute absence of irritability.
What is associated w/ Mitral Stenosis
A. Pinkish discoloration of the cheeks
B. Systolic murmur
C. Widened pulse pressure
D. Narrow pulse pressure - CORRECT ANSWERS - A
Patients with mitral stenosis may exhibit a pinkish discoloration of the cheeks
(i.e., malar blush). Mitral stenosis causes a diastolic murmur. Widened pulse
pressure is associated with aortic regurgitation. Narrowed pulse pressure is
associated with mitral regurgitation.
Four days after a mitral valve replacement, the patient develops atrial fibrillation.
The nurse initially would:
A. order a 12-lead EKG
B. evaluate the patient for clinical indications of hypoperfusion.
C. notify the physician.
D. ask the patient to bear down as if having a bowel movement. - CORRECT
ANSWERS - B
The onset of atrial fibrillation results in the loss of atrial kick. Loss of atrial kick
may reduce the cardiac output by as much as 20-30%. This is especially true in
patients whose cardiac output may be affected by long-standing cardiac disease,
such as mitral valve disease. Assess the patient for clinical indications of
, hypoperfusion (e.g., cool skin, decreased urine output, narrowed pulse pressure,
and hypotension).
A patient has just returned from the cath lab. She had an angioplasty for occlusion
of her RCA. She still has femoral artery and vein sheaths in place. The patient
complains of chest pain that she rates 9/10 about an hour after she returns from
the cath lab. Which of the following is indicated?
A. Administer morphine IV.
B. Administer nitroglycerin sublingual spray.
C. Stop the heparin.
D. Notify the physician - CORRECT ANSWERS - D
New-onset severe chest pain after percutaneous coronary intervention suggests
acute closure of the dilated coronary artery. The patient needs to be returned to
the cardiac catheterization laboratory for repeat dilation and probable insertion
of stent.
A 35-year-old woman underwent a mitral valve replacement. Her chest tube
output has been approximately 125 mL/hr for the last 3 hours, and now the
drainage has ceased suddenly. The immediate assessment reveals a significant
decrease in BP, RAP 12, PAP 30/15 , PAOP 13. What other data would indicate the
development of cardiac tamponade?
A. Increased venous oxygen saturation (SvO2)
B. Decreased UO
C. Muffled heart sounds
D. New holosystolic murmur at the sternum - CORRECT ANSWERS - C
Muffled heart sounds are a classic finding in cardiac tamponade. Remember the
classic indications of cardiac tamponade referred to as Beck's triad: muffled heart
