Barron's CCRN Cardiac Exam Questions
and Answers 100% Solved
The nurse is caring for a patient with acute inferior wall MI, post-coronary
artery stent deployment. For optimal care of the patient, the nurse should:
a) administer an analgesic for acute back pain
b) Apply pressure dressing to groin
c) Continuously monitor the patient in lead II
d) Maintain the patient in a supine position - ✔✔Answer: C
It is best practice to continuously monitor the patient status post PCI with
stent, in the lead that was most abnormal during the acute occlusion. Lead
II would most likely meet this criterion for the patient with an inferior wall MI.
The remaining interventions are NOT indicated for the patient post PCI.
The patient with aortic regurgitation will have which of the following on
auscultation?
a) Diastolic murmur, loudest at the 5th intercostal space, midclavicular
b) Systolic murmur, loudest at the apex of the heart
1
©JOSHCLAY 2024/2025. YEAR PUBLISHED 2024.
,c) Diastolic murmur, loudest at the second intercostal space, right sternal
border
d) Systolic murmur, loudest at the base of the heart - ✔✔Answer: C
Aortic insufficiency (regurgitation) is backflow of blood during the time the
aortic valve should be closed. When is the aortic valve closed? During
diastole — therefore it is a diastolic murmur. The aortic area of auscultation
is at the base of the heart, second intercostal space, right sternal border.
Cardiogenic shock secondary to left ventricular failure will generally result
in:
a) Decreased afterload
b) narrow pulse pressure
c) decreased preload
d) Widening pulse pressure - ✔✔Answer: B
The systolic pressure decreases due to a drop in cardiac output; however,
the diastolic pressure either stays the same or increases due to a
compensatory increase of the systemic vascular resistance. The remaining
choices are not found in cardiogenic shock.
The patient was admitted with acute inferior wall STEMI; the physician
advises the nurse to monitor the patient for signs of right ventricular (RV)
infarction. Which of the following are signs of RV infarction?
2
©JOSHCLAY 2024/2025. YEAR PUBLISHED 2024.
,a) S2 heart sounds, lung crackles
b) Hypotension, flat neck veins
c) Hypertension, systolic murmur
d) Distended neck veins, clear lungs - ✔✔Answer: D
If the RV contractility decreases, pressure proximal to the right ventricle
(which is the right atrium) increases, resulting in distended neck veins. As
the right heart fails, left heart preload decreases, lung sounds clear.
The ECG demonstrates ST elevation in leads II, III and aVF. The nurse
needs to monitor the patient closely for which of the following?
a) Tachycardia, lung crackles
b) Sinus bradycardia, acute systolic murmur in the fifth intercostal space,
midclavicular
c) Second-degree heart block Type 2, hypotension
d) Hypoxemia, acute systolic murmur, 5th intercostal space left sternal
border - ✔✔Answer: B
Complications likely to occur after an acute inferior wall MI include
bradycardia secondary to ischemia to the SA and/or AV node, and papillary
muscle rupture or dysfunction due to the anatomical distance between the
right coronary artery and the papillary muscle. The remaining choices are
not common complications of inferior MI.
3
©JOSHCLAY 2024/2025. YEAR PUBLISHED 2024.
, Pulmonary hypertension may result in which of the following?
a) Left heart failure
b) Right heart failure
c) Increased lung compliance
d) Arterial hypertension - ✔✔Answer: B
The right ventricular wall normally is thinner than the left because the RV
generally ejects into a low pressure pulmonary system with a mean
pulmonary pressure of approximately 20 mmHg. An increase in pulmonary
pressure may result in failure of the RV.
The patient with a temporary transvenous pacemaker develops pacemaker
malfunction. The orientee is instructed to reposition the patient to try to
correct the problem. The cardiac monitor most likely demonstrates:
a) Periods of asystole without pacemaker activity
b) Runs of ventricular tachycardia
c) Pacemaker spikes without a QRS
d) Pacemaker spikes on the T-wave of the patient's own beats -
✔✔Answer: C
Failure to capture (spikes present without QRS) may be corrected by
repositioning the patient to the side. The remaining problems would not be
helped by repositioning the patient.
4
©JOSHCLAY 2024/2025. YEAR PUBLISHED 2024.
and Answers 100% Solved
The nurse is caring for a patient with acute inferior wall MI, post-coronary
artery stent deployment. For optimal care of the patient, the nurse should:
a) administer an analgesic for acute back pain
b) Apply pressure dressing to groin
c) Continuously monitor the patient in lead II
d) Maintain the patient in a supine position - ✔✔Answer: C
It is best practice to continuously monitor the patient status post PCI with
stent, in the lead that was most abnormal during the acute occlusion. Lead
II would most likely meet this criterion for the patient with an inferior wall MI.
The remaining interventions are NOT indicated for the patient post PCI.
The patient with aortic regurgitation will have which of the following on
auscultation?
a) Diastolic murmur, loudest at the 5th intercostal space, midclavicular
b) Systolic murmur, loudest at the apex of the heart
1
©JOSHCLAY 2024/2025. YEAR PUBLISHED 2024.
,c) Diastolic murmur, loudest at the second intercostal space, right sternal
border
d) Systolic murmur, loudest at the base of the heart - ✔✔Answer: C
Aortic insufficiency (regurgitation) is backflow of blood during the time the
aortic valve should be closed. When is the aortic valve closed? During
diastole — therefore it is a diastolic murmur. The aortic area of auscultation
is at the base of the heart, second intercostal space, right sternal border.
Cardiogenic shock secondary to left ventricular failure will generally result
in:
a) Decreased afterload
b) narrow pulse pressure
c) decreased preload
d) Widening pulse pressure - ✔✔Answer: B
The systolic pressure decreases due to a drop in cardiac output; however,
the diastolic pressure either stays the same or increases due to a
compensatory increase of the systemic vascular resistance. The remaining
choices are not found in cardiogenic shock.
The patient was admitted with acute inferior wall STEMI; the physician
advises the nurse to monitor the patient for signs of right ventricular (RV)
infarction. Which of the following are signs of RV infarction?
2
©JOSHCLAY 2024/2025. YEAR PUBLISHED 2024.
,a) S2 heart sounds, lung crackles
b) Hypotension, flat neck veins
c) Hypertension, systolic murmur
d) Distended neck veins, clear lungs - ✔✔Answer: D
If the RV contractility decreases, pressure proximal to the right ventricle
(which is the right atrium) increases, resulting in distended neck veins. As
the right heart fails, left heart preload decreases, lung sounds clear.
The ECG demonstrates ST elevation in leads II, III and aVF. The nurse
needs to monitor the patient closely for which of the following?
a) Tachycardia, lung crackles
b) Sinus bradycardia, acute systolic murmur in the fifth intercostal space,
midclavicular
c) Second-degree heart block Type 2, hypotension
d) Hypoxemia, acute systolic murmur, 5th intercostal space left sternal
border - ✔✔Answer: B
Complications likely to occur after an acute inferior wall MI include
bradycardia secondary to ischemia to the SA and/or AV node, and papillary
muscle rupture or dysfunction due to the anatomical distance between the
right coronary artery and the papillary muscle. The remaining choices are
not common complications of inferior MI.
3
©JOSHCLAY 2024/2025. YEAR PUBLISHED 2024.
, Pulmonary hypertension may result in which of the following?
a) Left heart failure
b) Right heart failure
c) Increased lung compliance
d) Arterial hypertension - ✔✔Answer: B
The right ventricular wall normally is thinner than the left because the RV
generally ejects into a low pressure pulmonary system with a mean
pulmonary pressure of approximately 20 mmHg. An increase in pulmonary
pressure may result in failure of the RV.
The patient with a temporary transvenous pacemaker develops pacemaker
malfunction. The orientee is instructed to reposition the patient to try to
correct the problem. The cardiac monitor most likely demonstrates:
a) Periods of asystole without pacemaker activity
b) Runs of ventricular tachycardia
c) Pacemaker spikes without a QRS
d) Pacemaker spikes on the T-wave of the patient's own beats -
✔✔Answer: C
Failure to capture (spikes present without QRS) may be corrected by
repositioning the patient to the side. The remaining problems would not be
helped by repositioning the patient.
4
©JOSHCLAY 2024/2025. YEAR PUBLISHED 2024.
