pdf
ACCN/CCRN QUESTIONS WITH 100%
CORRECT AND VERIFIED ANSWERS
GRADE A+ CERTIFIED 2025-2026
AipatientiinitheiEDiwithicomplaintsiofichestipain.iThei12-
leadiEKGishowsiSTielevationiinileadsiV3iandiV4.iOcclusioniof
itheiaffectedicoronaryiarteryimostilikelyiwouldiaffectiperfusi
onitoiwhichiportioniofitheiconductionisystem?
A.iSinoatriali(SA)inode
iB.iBachmann'sibundle
iC.iAtrioventriculari(AV)inode
iD.iBundleiofiHisi
-icorrectianswerLADisoiD.ibundleiofihis
WhichiofitheifollowingiisitheipreferredileadiforiSTisegmenti
monitoringiforiaipatientiwithiaisuspectediRCAiocclusion?
iA.I
iB.iaVR
iC.iIII
iD.iV1i-icorrectianswerc.iIII
Whichiofitheifollowingiisinotiaimanifestationiofihypertrophic
icardiomyopathy?
A.iSyncope
B.iMurmurithatiincreasesiwithisquatting
C.iChestipain
D.iSuddenicardiacideathi
-icorrectianswer*B
Classicimanifestationsiofihypertrophicicardiomyopathyiareic
hestipain,isyncope,iandianiaorticistenosisitypeiofimurmurith
atidecreasesiwhenitheipatientiisiiniaisquattingiposition.iThei
firstimanifestationiofithisiconditioniisioccasionallyisuddenic
ardiacideathiduringiexercise.
,pdf
IniwhichiquadrantiisitheimeaniQRSicomplexiaxisilocatediifith
eiQRSicomplexiisipredominantlyipositiveiinileadiIiandinegati
veiinileadiaVF?
iA.iNormaliquadrant
iB.iLeftiaxisideviationiquadrant
iC.iRightiaxisideviationiquadrant
iD.iIndeterminantiquadrant
i-icorrectianswer*Bi
BecauseitheipositiveiofileadiIiisitheileftiarm,iifitheiQRSicompl
exiisiuprightiinileadiI,itheimeaniQRSiaxisiisitoitheileft.iBecaus
eitheipositiveiofileadiaVFi(aiunipolarilead)iisiatitheifoot,iifithe
iQRSicomplexiisinegativeiinileadiaVF,itheimeaniQRSiaxisiisiu
pwardiawayifromitheifoot.iThisiaxisiwouldibeiinitheiupperileft
iquadrant,idescribediasileftiaxisideviation.
Aipatientibecomesiapneiciandipulseless.iCPRihasibeeniinitiat
ed,ianditheimonitorishowsiasystoleiinitwoileads.iWhichiofithei
followingidrugsiwouldibeiusediinitially?
iA.iCalciumigluconate
iB.iAtropine
iC.iEpinephrine
iD.iAmiodaronei(Cordarone)
i-icorrectianswerC
AfteriCPRiisiinitiatediandianiintravenousiaccessiisiestablishe
d,iepinephrineishouldibeigiven.iCalciumiwasiusediinitheipasti
iniasystoleibutiisiuseditodayionlyiforihypocalcemia,icalciumic
hanneliblockeritoxicity,ihyperkalemia,iandihypermagnesemi
a.iAtropineiisinoilongerirecommendediforiasystole.iAmiodar
oneiisinotiindicatediiniasystoleibecauseiasystoleiisitheiabsolu
teiabsenceiofiirritability.
Whatiisiassociatediw/iMitraliStenosis
A.iPinkishidiscolorationiofitheicheeks
iB.iSystolicimurmur
iC.iWidenedipulseipressure
iD.iNarrowipulseipressure
, pdf
- correctianswerA
i i
Patientsiwithimitralistenosisimayiexhibitiaipinkishidiscolorat
ioniofitheicheeksi(i.e.,imalariblush).iMitralistenosisicausesiai
diastolicimurmur.iWidenedipulseipressureiisiassociatediwith
iaorticiregurgitation.iNarrowedipulseipressureiisiassociatedi
withimitraliregurgitation.
Fouridaysiafteriaimitralivalveireplacement,itheipatientidevel
opsiatrialifibrillation.iTheinurseiinitiallyiwould:
A.iorderiai12-leadiEKG
B.ievaluateitheipatientiforiclinicaliindicationsiofihypoperfusi
on.
C.inotifyitheiphysician.
D.iaskitheipatientitoibearidowniasiifihavingiaibowelimovemen
t
.i-icorrectianswerB
Theionsetiofiatrialifibrillationiresultsiinitheilossiofiatrialikick
.iLossiofiatrialikickimayireduceitheicardiacioutputibyiasimuch
iasi20-
30%.iThisiisiespeciallyitrueiinipatientsiwhoseicardiacioutputi
mayibeiaffectedibyilong-
standingicardiacidisease,isuchiasimitralivalveidisease.iAsses
sitheipatientiforiclinicaliindicationsiofihypoperfusioni(e.g.,ic
ooliskin,idecreasediurineioutput,inarrowedipulseipressure,ia
ndihypotension).
Aipatientihasijustireturnedifromitheicathilab.iSheihadianiangi
oplastyiforiocclusioniofiheriRCA.iSheistillihasifemoraliarteryi
andiveinisheathsiiniplace.iTheipatienticomplainsiofichestipai
nithatisheiratesi9/10iaboutianihouriafterisheireturnsifromithe
icathilab.iWhichiofitheifollowingiisiindicated?
iA.iAdministerimorphineiIV.
iB.iAdministerinitroglycerinisublingualispray.
iC.iStopitheiheparin.
iD.iNotifyitheiphysician
i-icorrectianswerD
New-
onsetisevereichestipainiafteripercutaneousicoronaryiinterve
ACCN/CCRN QUESTIONS WITH 100%
CORRECT AND VERIFIED ANSWERS
GRADE A+ CERTIFIED 2025-2026
AipatientiinitheiEDiwithicomplaintsiofichestipain.iThei12-
leadiEKGishowsiSTielevationiinileadsiV3iandiV4.iOcclusioniof
itheiaffectedicoronaryiarteryimostilikelyiwouldiaffectiperfusi
onitoiwhichiportioniofitheiconductionisystem?
A.iSinoatriali(SA)inode
iB.iBachmann'sibundle
iC.iAtrioventriculari(AV)inode
iD.iBundleiofiHisi
-icorrectianswerLADisoiD.ibundleiofihis
WhichiofitheifollowingiisitheipreferredileadiforiSTisegmenti
monitoringiforiaipatientiwithiaisuspectediRCAiocclusion?
iA.I
iB.iaVR
iC.iIII
iD.iV1i-icorrectianswerc.iIII
Whichiofitheifollowingiisinotiaimanifestationiofihypertrophic
icardiomyopathy?
A.iSyncope
B.iMurmurithatiincreasesiwithisquatting
C.iChestipain
D.iSuddenicardiacideathi
-icorrectianswer*B
Classicimanifestationsiofihypertrophicicardiomyopathyiareic
hestipain,isyncope,iandianiaorticistenosisitypeiofimurmurith
atidecreasesiwhenitheipatientiisiiniaisquattingiposition.iThei
firstimanifestationiofithisiconditioniisioccasionallyisuddenic
ardiacideathiduringiexercise.
IniwhichiquadrantiisitheimeaniQRSicomplexiaxisilocatediifith
eiQRSicomplexiisipredominantlyipositiveiinileadiIiandinegati
veiinileadiaVF?
iA.iNormaliquadrant
iB.iLeftiaxisideviationiquadrant
iC.iRightiaxisideviationiquadrant
iD.iIndeterminantiquadrant
i-icorrectianswer*Bi
BecauseitheipositiveiofileadiIiisitheileftiarm,iifitheiQRSicompl
exiisiuprightiinileadiI,itheimeaniQRSiaxisiisitoitheileft.iBecaus
eitheipositiveiofileadiaVFi(aiunipolarilead)iisiatitheifoot,iifithe
iQRSicomplexiisinegativeiinileadiaVF,itheimeaniQRSiaxisiisiu
pwardiawayifromitheifoot.iThisiaxisiwouldibeiinitheiupperileft
iquadrant,idescribediasileftiaxisideviation.
Aipatientibecomesiapneiciandipulseless.iCPRihasibeeniinitiat
ed,ianditheimonitorishowsiasystoleiinitwoileads.iWhichiofithei
followingidrugsiwouldibeiusediinitially?
iA.iCalciumigluconate
iB.iAtropine
iC.iEpinephrine
iD.iAmiodaronei(Cordarone)
i-icorrectianswerC
AfteriCPRiisiinitiatediandianiintravenousiaccessiisiestablishe
d,iepinephrineishouldibeigiven.iCalciumiwasiusediinitheipasti
iniasystoleibutiisiuseditodayionlyiforihypocalcemia,icalciumic
hanneliblockeritoxicity,ihyperkalemia,iandihypermagnesemi
a.iAtropineiisinoilongerirecommendediforiasystole.iAmiodar
oneiisinotiindicatediiniasystoleibecauseiasystoleiisitheiabsolu
teiabsenceiofiirritability.
Whatiisiassociatediw/iMitraliStenosis
A.iPinkishidiscolorationiofitheicheeks
iB.iSystolicimurmur
iC.iWidenedipulseipressure
iD.iNarrowipulseipressure
- correctianswerA
i i
Patientsiwithimitralistenosisimayiexhibitiaipinkishidiscolorat
ioniofitheicheeksi(i.e.,imalariblush).iMitralistenosisicausesiai
diastolicimurmur.iWidenedipulseipressureiisiassociatediwith
iaorticiregurgitation.iNarrowedipulseipressureiisiassociatedi
withimitraliregurgitation.
Fouridaysiafteriaimitralivalveireplacement,itheipatientidevel
opsiatrialifibrillation.iTheinurseiinitiallyiwould:
A.iorderiai12-leadiEKG
B.ievaluateitheipatientiforiclinicaliindicationsiofihypoperfusi
on.
C.inotifyitheiphysician.
D.iaskitheipatientitoibearidowniasiifihavingiaibowelimovemen
t
.i-icorrectianswerB
Theionsetiofiatrialifibrillationiresultsiinitheilossiofiatrialikick
.iLossiofiatrialikickimayireduceitheicardiacioutputibyiasimuch
iasi20-
30%.iThisiisiespeciallyitrueiinipatientsiwhoseicardiacioutputi
mayibeiaffectedibyilong-
standingicardiacidisease,isuchiasimitralivalveidisease.iAsses
sitheipatientiforiclinicaliindicationsiofihypoperfusioni(e.g.,ic
ooliskin,idecreasediurineioutput,inarrowedipulseipressure,ia
ndihypotension).
Aipatientihasijustireturnedifromitheicathilab.iSheihadianiangi
oplastyiforiocclusioniofiheriRCA.iSheistillihasifemoraliarteryi
andiveinisheathsiiniplace.iTheipatienticomplainsiofichestipai
nithatisheiratesi9/10iaboutianihouriafterisheireturnsifromithe
icathilab.iWhichiofitheifollowingiisiindicated?
iA.iAdministerimorphineiIV.
iB.iAdministerinitroglycerinisublingualispray.
iC.iStopitheiheparin.
iD.iNotifyitheiphysician
i-icorrectianswerD
New-
onsetisevereichestipainiafteripercutaneousicoronaryiinterve