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CCRN EXAM Questions with Detailed Verified
Answers
A 59 year old male is admitted complaining of chest pain and dyspnea. ST elevation and
T wave inversion were seen on the EKG in V2,V3 and V4. IV thrombolytic therapy was
started in ED. Indications of successful reperfusion would include all of the following
except:
(A) pain cessation
(B) decrease in CK or troponin
(C) reversal of ST segment elevation with return to baseline
(D) short runs of ventricular tachycardia
Ans: (B)Coronary artery reperfusion due to PCI or fibrinolysis results in an ELEVATION
of creatinine kinase (CK) or troponin, not decrease. The theory is that the return of
blood flow distal to the occlusion can result in 'reperfusion injury' of the muscle,
elevating cardiac biomarkers.
The other 3 choices are indicators of reperfusion: Pain cessation, reversal of ST
segment elevation with return to baseline, short runs of ventricular tachycardia.
Which of the following medication orders should the nurse question for the patient in
question 1-reperfusion question-patient having an MI?
(A) metoprolol (Lopressor)
(B) aspirin
(C) propranolol (Inderal)
(D) heparin
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Ans: (C) The patient in the scenario is having an acute anterior wall MI. A beta blocker
is beneficial for an acute MI as these agents decrease the work of the heart and
increase the threshold for ventricular fibrillation. Propranolol, although a beta-
andrenergic blocker like metoprolol, is NOT a cardioselective beta blocker. It affects
beta receptors in heart muscle AND lung tissue. Therefore, it is more likely to cause
bronchoconstriction than a cardioselective beta blocker.
The other 3- cardioselective beta blocker, antiplatelet, and anticoagulation-are
indicated in an acute MI.
If heart block develops while caring for the patient in question 1 (pt with an MI who
went through reperfusion from PCI or fibrinolytic therapy), which of the following
would it most likely be?
(A) sinoatrial block
(B) second degree, Type I
(C) second degree, Type II
(D) third degree, complete
Ans: (C) The patient is having an acute anterior MI, which is generally due to LAD
occlusion. The LAD supplies the HIS bundle, which could result in a second-degree,
type II heart block. The other 3 types are due to SA node or AV node ischemia, which
generally occur with an RCA occlusion — interior wall MI.
Appropriate drug therapy for dilated cardiomyopathy is aimed toward:
(A) decreasing contractility and decreasing preload and afterload
(B) decreasing contractility and increasing preload and afterload
(C) increasing contractility and increasing both preload and afterload
(D) increasing contractility and decreasing both preload and afterload
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Ans: (D) Dilated cardiomyopathy is likely to result in systolic dysfunction, which
decreases contractility, causes compensatory arterial constriction , and results in a
higher left ventricular preload. To treat this, therapy is aimed at increasing contractility,
decreasing afterload (arterial constriction), and decreasing preload that is too high.😃
An 18 year old is admitted with a history of syncopal episode at the mall and has a
history of an eating disorder. The nurse notes a prolonged QT on the 12-lead EKG
and anticipates a reduction in an electrolyte to be the cause. Which of the following is
LEAST likely to cause this patient's problems?
(A) sodium
(B) magnesium
(C) potassium
(D) calcium
Ans: (A) Abnormal sodium does NOT cause QT prolongation. In contrast, a low
magnesium, potassium, or calcium, may cause QT prolongation and may result in
TORSADES DE POINTES ventricular tachycardia and, if self-limiting, transient syncopal
episodes.
On the third day after admission for acute MI, a 67 year old male complains of chest
pain and develops a fever. The pain is worse with deep inspiration and is relieved when
he leans forward. There are nonspecific ST changes in the precordial leads of the EKG.
The nurse anticipates that the patient will most likely need treatment for:
(A) thoracic aneurysm
(B) Dressler's syndrome
(C) reinfarction
(D) pleuritis
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CCRN EXAM Questions with Detailed Verified
Answers
A 59 year old male is admitted complaining of chest pain and dyspnea. ST elevation and
T wave inversion were seen on the EKG in V2,V3 and V4. IV thrombolytic therapy was
started in ED. Indications of successful reperfusion would include all of the following
except:
(A) pain cessation
(B) decrease in CK or troponin
(C) reversal of ST segment elevation with return to baseline
(D) short runs of ventricular tachycardia
Ans: (B)Coronary artery reperfusion due to PCI or fibrinolysis results in an ELEVATION
of creatinine kinase (CK) or troponin, not decrease. The theory is that the return of
blood flow distal to the occlusion can result in 'reperfusion injury' of the muscle,
elevating cardiac biomarkers.
The other 3 choices are indicators of reperfusion: Pain cessation, reversal of ST
segment elevation with return to baseline, short runs of ventricular tachycardia.
Which of the following medication orders should the nurse question for the patient in
question 1-reperfusion question-patient having an MI?
(A) metoprolol (Lopressor)
(B) aspirin
(C) propranolol (Inderal)
(D) heparin
© Get it right 2025 Getaway - Stuvia US All rights reserved
,Click here for more: Scholars nexus
Ans: (C) The patient in the scenario is having an acute anterior wall MI. A beta blocker
is beneficial for an acute MI as these agents decrease the work of the heart and
increase the threshold for ventricular fibrillation. Propranolol, although a beta-
andrenergic blocker like metoprolol, is NOT a cardioselective beta blocker. It affects
beta receptors in heart muscle AND lung tissue. Therefore, it is more likely to cause
bronchoconstriction than a cardioselective beta blocker.
The other 3- cardioselective beta blocker, antiplatelet, and anticoagulation-are
indicated in an acute MI.
If heart block develops while caring for the patient in question 1 (pt with an MI who
went through reperfusion from PCI or fibrinolytic therapy), which of the following
would it most likely be?
(A) sinoatrial block
(B) second degree, Type I
(C) second degree, Type II
(D) third degree, complete
Ans: (C) The patient is having an acute anterior MI, which is generally due to LAD
occlusion. The LAD supplies the HIS bundle, which could result in a second-degree,
type II heart block. The other 3 types are due to SA node or AV node ischemia, which
generally occur with an RCA occlusion — interior wall MI.
Appropriate drug therapy for dilated cardiomyopathy is aimed toward:
(A) decreasing contractility and decreasing preload and afterload
(B) decreasing contractility and increasing preload and afterload
(C) increasing contractility and increasing both preload and afterload
(D) increasing contractility and decreasing both preload and afterload
© Get it right 2025 Getaway - Stuvia US All rights reserved
, Click here for more: Scholars nexus
Ans: (D) Dilated cardiomyopathy is likely to result in systolic dysfunction, which
decreases contractility, causes compensatory arterial constriction , and results in a
higher left ventricular preload. To treat this, therapy is aimed at increasing contractility,
decreasing afterload (arterial constriction), and decreasing preload that is too high.😃
An 18 year old is admitted with a history of syncopal episode at the mall and has a
history of an eating disorder. The nurse notes a prolonged QT on the 12-lead EKG
and anticipates a reduction in an electrolyte to be the cause. Which of the following is
LEAST likely to cause this patient's problems?
(A) sodium
(B) magnesium
(C) potassium
(D) calcium
Ans: (A) Abnormal sodium does NOT cause QT prolongation. In contrast, a low
magnesium, potassium, or calcium, may cause QT prolongation and may result in
TORSADES DE POINTES ventricular tachycardia and, if self-limiting, transient syncopal
episodes.
On the third day after admission for acute MI, a 67 year old male complains of chest
pain and develops a fever. The pain is worse with deep inspiration and is relieved when
he leans forward. There are nonspecific ST changes in the precordial leads of the EKG.
The nurse anticipates that the patient will most likely need treatment for:
(A) thoracic aneurysm
(B) Dressler's syndrome
(C) reinfarction
(D) pleuritis
© Get it right 2025 Getaway - Stuvia US All rights reserved
