CFRN EVALUATION EXAM 2026 QUESTIONS AND
SOLUTIONS RATED A+
✔✔What's a drug with pure alpha agonistic effects? - ✔✔Neosynephrine or
phenylephrine
✔✔In bradycardic patients with a high degree heart block or heart transplant should you
use atropine or go straight to pacing? - ✔✔pacing
✔✔What EKG morphology indicates a high likelihood of Wolff Parkinson White
syndrome? - ✔✔Delta waves
✔✔What are Delta Waves? - ✔✔Broad sloped QRS
✔✔What are Janeway lesions? What are they indicative of? - ✔✔Small, painless,
erythematous lesions on palm or sole
Endocarditis
✔✔What are oslar nodes? What are they indicative of? - ✔✔painful red lesions on
hands and feet. S/S of endocarditis.
✔✔How do you treat acute endocarditis? - ✔✔Support BP, get to facility to start ABX
✔✔Pericarditis will cause what EKG change? - ✔✔Global ST elevation
✔✔What CXR findings indicate Congestive Heart Failure? - ✔✔Butterfly pattern
Kerley A and B lines
Diffuse bilateral infiltrates
Heart >50% of chest
✔✔What is Butterfly pattern on CXR? - ✔✔Bilateral peripheral pulmonary opacities
AKA Bat wing pattern
✔✔What are Kerley A lines? - ✔✔Long lines that course toward the hila, appear
bunched centrally at the hilus
✔✔What are Kerley B lines? - ✔✔small linear densities 2-3cm in length seen in the
periphery of the lung fields on PA view - represent interstitial fluid in the lung tissue
✔✔What BNP levels indicate mild moderate and severe CHF? - ✔✔300
600
900
,✔✔What is the most important transport intervention for CHF? - ✔✔Non invasive
Positive pressure ventilation such as BiPap or CPAP
✔✔When treating Aortic dissection, what is the order of drugs used to decrease
pressure in the Aorta? - ✔✔Beta blockers
then vasodilators
✔✔What is the textbook sign of aortic dissection? - ✔✔Tearing sensation in back &
headache
✔✔What is the most common dissection location of the Aorta? - ✔✔Ascending Aorta or
Type II
✔✔Where is the phlebostatic axis? - ✔✔4th intercostal space, midaxillary line
✔✔What does the dicrotic notch signify on the Art line? - ✔✔Closure of the Aortic valve
✔✔How many oscillations should you observe on the art line square wave test? - ✔✔3?
✔✔How can you tell an Art line is underdamped? - ✔✔Too many oscillations in
waveform
Artificially widened pulse pressure
✔✔How can you tell an Art line is overdamped? - ✔✔Too few oscillations, could be
missing dicrotic notch
Artificially narrows pulse pressure
✔✔How many mL of air is used to inflate distal balloon in swan ganz catheter? -
✔✔1.5mL
✔✔When obtaining a wedge pressure, do not leave the balloon inflated for how long? -
✔✔15 seconds or 3 breaths, whichever comes first
✔✔What is a normal PCWP? - ✔✔4-12 mmHg
✔✔What is a normal PAP? - ✔✔25/10
✔✔Normal CVP? - ✔✔2-6 mmHg
✔✔What is a normal RV pressure? - ✔✔15-25/0-5
✔✔What is a normal PAWP? - ✔✔8-12 mmHg
, ✔✔What is a normal Coronary perfusion pressure? - ✔✔50-60 mmHg
✔✔What is the formula for Coronary perfusion pressure or CPP? - ✔✔Diastolic - PAWP
✔✔Normal CO? - ✔✔4-8L per minute
✔✔What is normal CI or Cardiac index? - ✔✔2.5-5L/min
✔✔What is catheter whip in a PA cath and how do you treat it? - ✔✔Tip of cath is in
Right Ventricle
Lay them on side
Have them cough while insert 1.5mL of air
Otherwise can cause ventricular dysrythmia
✔✔What is textbook neurogenic shock? - ✔✔decrease in BP but no increase in HR,
inversely a Decrease in HR
✔✔When does the balloon inflate in IABP? - ✔✔During diastole at the closure of the
aortic valve
✔✔What setting must you switch your IABP into to determine effective timing? - ✔✔1:2
✔✔What are two indications for initiation of IABP? - ✔✔MI with cardiogenic shock
Post CABG
✔✔What are 3 absolute contraindications for IABP? - ✔✔Aortic insufficiency (need
patent aortic valve)
Aortic regurg
Peripheral vascular disease (relative)
✔✔Where is the IABP placed? - ✔✔Distal tip 2-3 cm below left subclavian artery
✔✔How do you know your IABP balloon has migrated high? - ✔✔no left brachial pulse
or diminished
✔✔How do you know your IABP balloon has migrated low? - ✔✔decreased urine output
✔✔What do you do if you find blood in your IABP ? - ✔✔Stop therapy, head down,
transport to surgeon to remove balloon
✔✔Should you stop Balloon pump during CRP? - ✔✔NO, it helps, a lot
✔✔What two IABP errors are most dangerous? - ✔✔Early inflation
Late Deflation
SOLUTIONS RATED A+
✔✔What's a drug with pure alpha agonistic effects? - ✔✔Neosynephrine or
phenylephrine
✔✔In bradycardic patients with a high degree heart block or heart transplant should you
use atropine or go straight to pacing? - ✔✔pacing
✔✔What EKG morphology indicates a high likelihood of Wolff Parkinson White
syndrome? - ✔✔Delta waves
✔✔What are Delta Waves? - ✔✔Broad sloped QRS
✔✔What are Janeway lesions? What are they indicative of? - ✔✔Small, painless,
erythematous lesions on palm or sole
Endocarditis
✔✔What are oslar nodes? What are they indicative of? - ✔✔painful red lesions on
hands and feet. S/S of endocarditis.
✔✔How do you treat acute endocarditis? - ✔✔Support BP, get to facility to start ABX
✔✔Pericarditis will cause what EKG change? - ✔✔Global ST elevation
✔✔What CXR findings indicate Congestive Heart Failure? - ✔✔Butterfly pattern
Kerley A and B lines
Diffuse bilateral infiltrates
Heart >50% of chest
✔✔What is Butterfly pattern on CXR? - ✔✔Bilateral peripheral pulmonary opacities
AKA Bat wing pattern
✔✔What are Kerley A lines? - ✔✔Long lines that course toward the hila, appear
bunched centrally at the hilus
✔✔What are Kerley B lines? - ✔✔small linear densities 2-3cm in length seen in the
periphery of the lung fields on PA view - represent interstitial fluid in the lung tissue
✔✔What BNP levels indicate mild moderate and severe CHF? - ✔✔300
600
900
,✔✔What is the most important transport intervention for CHF? - ✔✔Non invasive
Positive pressure ventilation such as BiPap or CPAP
✔✔When treating Aortic dissection, what is the order of drugs used to decrease
pressure in the Aorta? - ✔✔Beta blockers
then vasodilators
✔✔What is the textbook sign of aortic dissection? - ✔✔Tearing sensation in back &
headache
✔✔What is the most common dissection location of the Aorta? - ✔✔Ascending Aorta or
Type II
✔✔Where is the phlebostatic axis? - ✔✔4th intercostal space, midaxillary line
✔✔What does the dicrotic notch signify on the Art line? - ✔✔Closure of the Aortic valve
✔✔How many oscillations should you observe on the art line square wave test? - ✔✔3?
✔✔How can you tell an Art line is underdamped? - ✔✔Too many oscillations in
waveform
Artificially widened pulse pressure
✔✔How can you tell an Art line is overdamped? - ✔✔Too few oscillations, could be
missing dicrotic notch
Artificially narrows pulse pressure
✔✔How many mL of air is used to inflate distal balloon in swan ganz catheter? -
✔✔1.5mL
✔✔When obtaining a wedge pressure, do not leave the balloon inflated for how long? -
✔✔15 seconds or 3 breaths, whichever comes first
✔✔What is a normal PCWP? - ✔✔4-12 mmHg
✔✔What is a normal PAP? - ✔✔25/10
✔✔Normal CVP? - ✔✔2-6 mmHg
✔✔What is a normal RV pressure? - ✔✔15-25/0-5
✔✔What is a normal PAWP? - ✔✔8-12 mmHg
, ✔✔What is a normal Coronary perfusion pressure? - ✔✔50-60 mmHg
✔✔What is the formula for Coronary perfusion pressure or CPP? - ✔✔Diastolic - PAWP
✔✔Normal CO? - ✔✔4-8L per minute
✔✔What is normal CI or Cardiac index? - ✔✔2.5-5L/min
✔✔What is catheter whip in a PA cath and how do you treat it? - ✔✔Tip of cath is in
Right Ventricle
Lay them on side
Have them cough while insert 1.5mL of air
Otherwise can cause ventricular dysrythmia
✔✔What is textbook neurogenic shock? - ✔✔decrease in BP but no increase in HR,
inversely a Decrease in HR
✔✔When does the balloon inflate in IABP? - ✔✔During diastole at the closure of the
aortic valve
✔✔What setting must you switch your IABP into to determine effective timing? - ✔✔1:2
✔✔What are two indications for initiation of IABP? - ✔✔MI with cardiogenic shock
Post CABG
✔✔What are 3 absolute contraindications for IABP? - ✔✔Aortic insufficiency (need
patent aortic valve)
Aortic regurg
Peripheral vascular disease (relative)
✔✔Where is the IABP placed? - ✔✔Distal tip 2-3 cm below left subclavian artery
✔✔How do you know your IABP balloon has migrated high? - ✔✔no left brachial pulse
or diminished
✔✔How do you know your IABP balloon has migrated low? - ✔✔decreased urine output
✔✔What do you do if you find blood in your IABP ? - ✔✔Stop therapy, head down,
transport to surgeon to remove balloon
✔✔Should you stop Balloon pump during CRP? - ✔✔NO, it helps, a lot
✔✔What two IABP errors are most dangerous? - ✔✔Early inflation
Late Deflation
