CCRN Actual Exam Questions With Reviewed
100% Correct Detailed Answers
Guaranteed Pass!!Current Update
(Verified Pass)
1. Which drug would most likely be given to a patient with hypertrophic
cardiomyopathy?
(A) metoprolol
(B) digoxin
(C) dopamine
(D) dobutamine - ANSWER (A) A decrease in heart rate, provided by a beta
blocker such as metoprolol, would increase filling time. In hypertrophic
cardiomyopathy, there is a problem with filling. A decrease in heart rate would
increase filling time. Diastolic dysfunction does NOT cause a problem with
ejection, and the EF is normal. The other 3 choices may be indicated for systolic
dysfunction.
2. A patient is admitted with ST elevation in V2, V3, and V4. Four days after
admission, the patient suddenly developed a holosystolic murmur at the lower left
sternal border, chest pain, and hypotension. What complication should the nurse
expect?
(A) papillary muscle rupture
(B) ventricular septal defect
(C) acute mitral stenosis
,(D) acute reinfarction - ANSWER The scenario describes an acute anterior
STEMI, generally caused by an occlusion of the LAD. This type of MI is most likely
to result in a VSD. Additionally, the location of the murmur is important. Mitral
valve disease-related problems do NOT cause murmurs to be loudest at the left
sternal border, whereas a VSD would result in a murmur at this location.
3. A postoperative patient on the surgical unit suddenly develops chest pain,
extreme weakness, and dyspnea and is found to have ST elevation in II, III, and aVF
on the stat EKG. B/P is 92/62, heart rate 58, respiratory rate 28, lungs are clear,
and heart sound assessment reveals an S4, no murmurs. In addition to preparing
the patient for PCI, which of the following interventions would you anticipate?
(A) nitroglycerin drip, aspirin
(B) furosemide, atropine
(C) transcutaneous pacing, morphine
(D) aggressive fluid administration, right-sided EKG. - ANSWER (D) The
scenario describes a patient having an acute inferior STEMI, generally due to RCA
occlusion. An RCA occlusion may result in RV infarct, which this patient has signs
of (hypotension with clear lungs). The definitive treatment is emergent PCI. Fluid
administration will help increase coronary artery perfusion by correcting
hypotension and ensure adequate RV preload. The right-sided EKG may help
confirm the RV infarct. Nitroglycerin, diuretics, and morphine may decrease
preload, which would worsen hypotension.
4. A 52 yearold male presents with complaints of blurred vision and shortness of
breath. B/P is 232/136, heart rate 102, respiratory rate 28 with crackles in lower
lung fields bilaterally, with S3 and S4 heart sounds on auscultation. Which of the
following would be indicated for this patient?
(A) nitroprusside drip, admit to critical care unit
, (B) digoxin, furosemide
(C) labetalol drip, admit to a medical unit
(D) lisinopril, calcium channel blocker - ANSWER (A) The patient has signs of
organ dysfunction (heart failure) secondary to extreme hypertension. Therefore,
he has hypertension crisis or emergency. The B/P needs to be emergently
decreased. Most often this treatment is best done in an ICU.
5. An 80 yearold female presents with chief complaint of acute shortness of
breath. Clinical exam reveals B/P 182/102, heart rate 105/minute, respiratory rate
32/minute, lungs with crackles bilaterally, pulse oximetry of 88%, S4 on
auscultation. EKG revealed sinus tachycardia, left ventricular hypertrophy pattern,
chest radiograph showed normal heart size, pulmonary vascular congestion, and
echocardiogram showed EF of 55%. Which of the following should be avoided in
this patient's treatment plan?
(A) calcium channel blocker
(B) digoxin
(C) low-dose diuretics
(D) oxygen - ANSWER (B) The patient presents with signs of heart failure due
to diastolic dysfunction (hypertension, left ventricular hypertrophy, EF > 40%).
These patients have a problem with FILLING, not ejecting. Digoxin, a positive
inotrope, may increase wall stress and worsen filling of the left ventricle.
6. Mrs. Jones has heart failure. Despite optimal therapy, she gets short of
breath when she gets up to walk to the bathroom. Which of the following is the
patient experiencing regarding heart failure?
(A) NYHA Class I heart failure, may benefit from an ICD
(B) NYHA Class II heart failure, may benefit from an ICD
100% Correct Detailed Answers
Guaranteed Pass!!Current Update
(Verified Pass)
1. Which drug would most likely be given to a patient with hypertrophic
cardiomyopathy?
(A) metoprolol
(B) digoxin
(C) dopamine
(D) dobutamine - ANSWER (A) A decrease in heart rate, provided by a beta
blocker such as metoprolol, would increase filling time. In hypertrophic
cardiomyopathy, there is a problem with filling. A decrease in heart rate would
increase filling time. Diastolic dysfunction does NOT cause a problem with
ejection, and the EF is normal. The other 3 choices may be indicated for systolic
dysfunction.
2. A patient is admitted with ST elevation in V2, V3, and V4. Four days after
admission, the patient suddenly developed a holosystolic murmur at the lower left
sternal border, chest pain, and hypotension. What complication should the nurse
expect?
(A) papillary muscle rupture
(B) ventricular septal defect
(C) acute mitral stenosis
,(D) acute reinfarction - ANSWER The scenario describes an acute anterior
STEMI, generally caused by an occlusion of the LAD. This type of MI is most likely
to result in a VSD. Additionally, the location of the murmur is important. Mitral
valve disease-related problems do NOT cause murmurs to be loudest at the left
sternal border, whereas a VSD would result in a murmur at this location.
3. A postoperative patient on the surgical unit suddenly develops chest pain,
extreme weakness, and dyspnea and is found to have ST elevation in II, III, and aVF
on the stat EKG. B/P is 92/62, heart rate 58, respiratory rate 28, lungs are clear,
and heart sound assessment reveals an S4, no murmurs. In addition to preparing
the patient for PCI, which of the following interventions would you anticipate?
(A) nitroglycerin drip, aspirin
(B) furosemide, atropine
(C) transcutaneous pacing, morphine
(D) aggressive fluid administration, right-sided EKG. - ANSWER (D) The
scenario describes a patient having an acute inferior STEMI, generally due to RCA
occlusion. An RCA occlusion may result in RV infarct, which this patient has signs
of (hypotension with clear lungs). The definitive treatment is emergent PCI. Fluid
administration will help increase coronary artery perfusion by correcting
hypotension and ensure adequate RV preload. The right-sided EKG may help
confirm the RV infarct. Nitroglycerin, diuretics, and morphine may decrease
preload, which would worsen hypotension.
4. A 52 yearold male presents with complaints of blurred vision and shortness of
breath. B/P is 232/136, heart rate 102, respiratory rate 28 with crackles in lower
lung fields bilaterally, with S3 and S4 heart sounds on auscultation. Which of the
following would be indicated for this patient?
(A) nitroprusside drip, admit to critical care unit
, (B) digoxin, furosemide
(C) labetalol drip, admit to a medical unit
(D) lisinopril, calcium channel blocker - ANSWER (A) The patient has signs of
organ dysfunction (heart failure) secondary to extreme hypertension. Therefore,
he has hypertension crisis or emergency. The B/P needs to be emergently
decreased. Most often this treatment is best done in an ICU.
5. An 80 yearold female presents with chief complaint of acute shortness of
breath. Clinical exam reveals B/P 182/102, heart rate 105/minute, respiratory rate
32/minute, lungs with crackles bilaterally, pulse oximetry of 88%, S4 on
auscultation. EKG revealed sinus tachycardia, left ventricular hypertrophy pattern,
chest radiograph showed normal heart size, pulmonary vascular congestion, and
echocardiogram showed EF of 55%. Which of the following should be avoided in
this patient's treatment plan?
(A) calcium channel blocker
(B) digoxin
(C) low-dose diuretics
(D) oxygen - ANSWER (B) The patient presents with signs of heart failure due
to diastolic dysfunction (hypertension, left ventricular hypertrophy, EF > 40%).
These patients have a problem with FILLING, not ejecting. Digoxin, a positive
inotrope, may increase wall stress and worsen filling of the left ventricle.
6. Mrs. Jones has heart failure. Despite optimal therapy, she gets short of
breath when she gets up to walk to the bathroom. Which of the following is the
patient experiencing regarding heart failure?
(A) NYHA Class I heart failure, may benefit from an ICD
(B) NYHA Class II heart failure, may benefit from an ICD
