CRRN PRACTICE QUESTIONS AND ANSWERS
A patient in the ED with complaints of chest pain. The 12-
lead EKG shows ST elevation in leads V3 and V4.
Occlusion of the affected coronary artery most likely
would affect perfusion to which portion of the
conduction system?
A. Sinoatrial (SA) node
B. Bachmann's bundle
C. Atrioventricular (AV) node
D. Bundle of His - correct answer LAD so D. bundle of his
Which of the following is the preferred lead for ST
segment monitoring for a patient with a suspected RCA
occlusion?
,CCRN
A.I
B. aVR
C. III
D. V1 - correct answer c. III
Which of the following is not a manifestation of
hypertrophic cardiomyopathy?
A. Syncope
B. Murmur that increases with squatting
C. Chest pain
D. Sudden cardiac death - correct answer *B
Classic manifestations of hypertrophic cardiomyopathy
are chest pain, syncope, and an aortic stenosis type of
murmur that decreases when the patient is in a squatting
position. The first manifestation of this condition is
occasionally sudden cardiac death during exercise.
,CCRN
In which quadrant is the mean QRS complex axis located
if the QRS complex is predominantly positive in lead I and
negative in lead aVF?
A. Normal quadrant
B. Left axis deviation quadrant
C. Right axis deviation quadrant
D. Indeterminant quadrant - correct answer *B
Because the positive of lead I is the left arm, if the QRS
complex is upright in lead I, the mean QRS axis is to the
left. Because the positive of lead aVF (a unipolar lead) is
at the foot, if the QRS complex is negative in lead aVF, the
mean QRS axis is upward away from the foot. This axis
would be in the upper left quadrant, described as left axis
deviation.
A patient becomes apneic and pulseless. CPR has been
initiated, and the monitor shows asystole in two leads.
Which of the following drugs would be used initially?
A. Calcium gluconate
, CCRN
B. Atropine
C. Epinephrine
D. Amiodarone (Cordarone) - correct answer C
After CPR is initiated and an intravenous access is
established, epinephrine should be given. Calcium was
used in the past in asystole but is used today only for
hypocalcemia, calcium channel blocker toxicity,
hyperkalemia, and hypermagnesemia. Atropine is no
longer recommended for asystole. Amiodarone is not
indicated in asystole because asystole is the absolute
absence of irritability.
What is associated w/ Mitral Stenosis
A. Pinkish discoloration of the cheeks
B. Systolic murmur
C. Widened pulse pressure
D. Narrow pulse pressure - correct answer A
Patients with mitral stenosis may exhibit a pinkish
discoloration of the cheeks (i.e., malar blush). Mitral
stenosis causes a diastolic murmur. Widened pulse
pressure is associated with aortic regurgitation.