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CCRN Practice Questions – Cardiovascular Questions and Correct Answers | Latest Update

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A patient is in cardiac and respiratory arrest. The selection of medications to reestablish cardiac function would stimulate the sympathetic nervous system beta1 receptors. This stimulation would result in increased automaticity and which of the following? a. Increased myocardial contractility b. Decreased left ventricular stroke work c. Decreased myocardial oxygen consumption d. Increased left ventricular afterload -:- Correct answer: a Rationale: The sympathetic nervous system contains alpha, beta, and dopaminergic receptors that produce various responses when stimulated. Stimulation of beta1 receptors increases heart rate, conductivity, and myocardial contractility. Stimulation of beta2 receptors produces vasodilation and bronchodilation. Alpha receptors, when stimulated, produce vasoconstriction. Stimulation of dopaminergic receptors produces a vasodilating effect on renal, mesenteric, coronary, and cerebral vessels. Test-Taking Strategy: Note the helpful clue in the stem: stimulate the sympathetic system and recall that this results in a fight-or-flight response—the body is responding to survive. 2 | P a g e | G r a d e A + | 2 0 2 4 / 2 0 2 5 Excel! 2 0 2 4 /2025 | © copyright | This work may not be copied for profit gain Stroke volume would increase, so eliminate option b. Afterload would increase, but this is due to alpha stimulation, not beta1 stimulation, so eliminate option d. Because the heart is working faster and harder, the myocardial oxygen consumption does increase, so eliminate option c. Remember that the primary effects of beta1 receptors are to increase heart rate, contractility, and rate of conduction. Choose option a. A memory aid that also may help is this: beta 1 beta 2, 1 heart 2 lungs: beta1 affects the heart, and beta2 affects the lungs. A patient arrived in the emergency department with complaints of chest pain. The 12-lead electrocardiogram shows ST segment 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 answer: d Rationale: ST segment elevation in leads V3 and V4 indicates injury to the anterior wall, which would occur with occlusion of the left anterior descending (LAD) artery. In most persons, the SA node, Bachmann's bundle, and AV node are supplied by the right coronary artery. The bundle of His is supplied by the left anterior descending artery. This is why an 3 | P a g e | G r a d e A + | 2 0 2 4 / 2 0 2 5 Excel! 2 0 2 4 /2025 | © copyright | This work may not be copied for profit gain anterior myocardial infarction may cause type II second-degree AV block or third-degree AV heart block at the level of the bundle of Hi

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2024 /2025 | © copyright | This work may not be copied for profit gain Excel!




CCRN Practice Questions – Cardiovascular
Questions and Correct Answers | Latest
Update
A patient is in cardiac and respiratory arrest. The selection of medications to reestablish

cardiac function would stimulate the sympathetic nervous system beta1 receptors. This

stimulation would result in increased automaticity and which of the


following?


a. Increased myocardial contractility


b. Decreased left ventricular stroke work


c. Decreased myocardial oxygen consumption


d. Increased left ventricular afterload


✓ -:- Correct answer: a

Rationale: The sympathetic nervous system contains alpha, beta, and dopaminergic

receptors that produce various responses when stimulated. Stimulation of beta1 receptors

increases heart rate, conductivity, and myocardial contractility. Stimulation of beta2

receptors produces vasodilation and bronchodilation. Alpha receptors, when stimulated,


produce vasoconstriction. Stimulation of dopaminergic receptors produces a vasodilating


effect on renal, mesenteric, coronary, and cerebral vessels.


Test-Taking Strategy: Note the helpful clue in the stem: stimulate the sympathetic system

and recall that this results in a fight-or-flight response—the body is responding to survive.
1|P a g e | G r a d e A + | 2 0 2 0 2 5

,2024 /2025 | © copyright | This work may not be copied for profit gain Excel!



Stroke volume would increase, so eliminate option b. Afterload would increase, but this is

due to alpha stimulation, not beta1 stimulation, so eliminate option d. Because the heart is

working faster and harder, the myocardial oxygen consumption does increase, so eliminate

option c. Remember that the primary effects of beta1 receptors are to increase heart rate,

contractility, and rate of conduction. Choose option a. A memory aid that also may help is

this: beta 1 beta 2, 1 heart 2 lungs: beta1 affects the heart, and beta2 affects the lungs.




A patient arrived in the emergency department with complaints of chest pain. The 12-lead

electrocardiogram shows ST segment 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 answer: d

Rationale: ST segment elevation in leads V3 and V4 indicates injury to the anterior wall,

which would occur with occlusion of the left anterior descending (LAD) artery. In most

persons, the SA node, Bachmann's bundle, and AV node are supplied by the right coronary

artery. The bundle of His is supplied by the left anterior descending artery. This is why an


2|P a g e | G r a d e A + | 2 0 2 0 2 5

,2024 /2025 | © copyright | This work may not be copied for profit gain Excel!



anterior myocardial infarction may cause type II second-degree AV block or third-degree

AV heart block at the level of the bundle of His.


Test-Taking Strategy: Note that options a, b, and c are part of the supraventricular

conduction system. They usually are supplied by the right coronary artery. The LAD artery

supplies most of the interventricular conduction system, including the bundle of His and


the bundle branches.




Oxygen delivery (DO2) is the product of which of the following?


a. PaO2, hemoglobin, mean arterial pressure


b. SaO2, hemoglobin, cardiac output


c. SvO2, cardiac index, SaO2


d. PaO2, mean arterial pressure, SvO2


✓ -:- Correct answer: b

Rationale: Ninety-seven percent of oxygen is attached to the hemoglobin molecule, so the

SaO2 (arterial oxygen saturation) is a more accurate reflection of the amount of oxygen in

blood. The PaO2 represents only the 3% that is dissolved in the plasma. The lungs must put

the oxygen in the blood, the hemoglobin must carry the oxygen, and the cardiac output is a

reflection of how well the heart is moving the blood with its hemoglobin with attached


oxygen. SvO2 (venous oxygen saturation) is a reflection of the oxygen reserve. SvO2 is

what is left over after the tissues have extracted what they need. The mean arterial
3|P a g e | G r a d e A + | 2 0 2 0 2 5

, 2024 /2025 | © copyright | This work may not be copied for profit gain Excel!



pressure is a reflection of organ tissue perfusion pressure but does not indicate anything

about the amount of oxygen in that blood.


Test-Taking Strategy: Oxygen is delivered from the arterial end, so choose an option that

has SaO2 instead of SvO2. Also remember that most oxygen is carried on hemoglobin.

Look for SaO2 (not PaO2) and hemoglobin. The only option with both of these is option b.




Which of the following types of block are most likely after an anterior wall myocardial

infarction (MI)?


a. Sinus block


b. Second-degree atrioventricular (AV) block, type I


c. Second-degree AV block, type II


d. Third-degree AV block with junctional escape rhythm


✓ -:- Correct answer: c

Rationale: Anterior MI is caused by a left anterior descending (LAD) artery lesion. The LAD

artery supplies the bundle of His and bundle branches, so anterior MIs may cause blocks of

the bundle of His or bundle branches. Second-degree AV block type II is a block at the level

of the bundle of His. If this patient does develop a third-degree AV block, it would be at the

level of the bundle of His, and the only escape rhythm available below the bundle of His is a

ventricular escape rhythm.




4|P a g e | G r a d e A + | 2 0 2 0 2 5

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