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CCRN Certification Practice Questions
& Answers 2026-2027 | High-Yield
Exam Review (Rationales)
Document Overview
This document provides 87 CCRN certification practice questions, each with the correct
answer and detailed rationales. It is a high-yield review for critical care nursing, designed
for exam preparation and comprehensive study. This resource directly aligns with the
study needs of nurses seeking CCRN certification.
100% Accurate Questions and Answers 100% Guarantee Pass - Verified by Experts
Expert-Verified
Verified Answers · Detailed Rationales · 87 Questions · September 2026
CCRN Certification Practice Questions & Answers 2026-2027 | High-Yield Exam Review (Rationales) - Practice Questions Page 0
, Topics Covered
Section 1: ECG Interpretation & Arrhythmias Q 1-25
Questions covering eCG Interpretation & Arrhythmias concepts.
Section 2: Myocardial Infarction & Ischemia Q 26-49
Questions covering myocardial Infarction & Ischemia concepts.
Section 3: Heart Failure & Cardiomyopathy Q 50-71
Questions covering heart Failure & Cardiomyopathy concepts.
Section 4: Valvular Heart Disease & Other Cardiac Conditions Q 72-81
Questions covering valvular Heart Disease & Other Cardiac Conditions concepts.
Section 5: Cardiac Pharmacology Q 82-83
Questions covering cardiac Pharmacology concepts.
Section 6: Hemodynamics & Monitoring Q 84-87
Questions covering hemodynamics & Monitoring concepts.
Questions
QUESTION 1 OF 87
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
Rationale: ST elevation in leads V3 and V4 indicates an anterior myocardial infarction, typically caused by occlusion
of the Left Anterior Descending (LAD) artery. The LAD artery supplies the anterior wall of the left ventricle, the
anterior two-thirds of the interventricular septum, and often the proximal portion of the Bundle of His. Therefore,
occlusion of the LAD most likely affects perfusion to the Bundle of His. This aligns with LAD so D. bundle of his.
CCRN Certification Practice Questions & Answers 2026-2027 | High-Yield Exam Review (Rationales) - Practice Questions Page 0
, QUESTION 2 OF 87
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.
QUESTION 3 OF 87
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
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.
QUESTION 4 OF 87
A 52-year-old man is admitted to the critical care unit with a diagnosis of an acute MI.
EKG shows ST elevation and T wave inversion in leads V2, V3, and V4. His history
includes HTN, 80 pack-years of smoking, COPD, and HLD.
An IV and fibrinolytic therapy were initiated in the ED. Which of the following would
not be an indication of successful reperfusion?
A. Pain cessation
B. Absence of creatine kinase (CK) enzyme elevation
C. Reversal of ST segment elevation with return of ST segment to baseline
D. Short runs of ventricular tachycardia
Correct Answer: B. Absence of creatine kinase (CK) enzyme elevation
Rationale: Successful reperfusion following an acute myocardial infarction (MI) is typically associated with a rise
and subsequent fall in cardiac biomarkers like creatine kinase (CK), indicating initial myocardial damage followed by
blood flow restoration. Therefore, the absence of CK enzyme elevation would *not* be an indication of successful
reperfusion, as some enzyme release is expected. While pain cessation, ST segment normalization, and occasional
ventricular arrhythmias can be signs of reperfusion, a lack of any enzyme elevation suggests incomplete or failed
reperfusion. This aligns with B. Absence of creatine kinase (CK) enzyme elevation and Absence of creatine kinase (CK)
enzyme elevation.
CCRN Certification Practice Questions & Answers 2026-2027 | High-Yield Exam Review (Rationales) - Practice Questions Page 0
, QUESTION 5 OF 87
A patient is admitted to the coronary care unit with third-degree AV heart block, and a
transvenous temporary ventricular pacemaker is inserted. Four hours later the patient
complains of dizziness while lying in bed. The monitor shows third-degree AV block
with a ventricular rate of 52 and no pacing spikes. This indicates which of the following?
A. Failure to capture
B. Failure to pace
C. Competition between pacemaker and intrinsic rhythm
D. Failure to sense
Correct Answer: B. Failure to pace
Rationale: Failure to pace occurs when the pacemaker fails to generate an electrical impulse to stimulate myocardial
contraction. The absence of pacing spikes on the monitor, despite the presence of a slow ventricular rate (52 bpm) and
third-degree AV block, indicates the pacemaker is not firing as programmed. This directly suggests the pacemaker is
not initiating a beat, fitting the definition of failure to pace. This aligns with B. Failure to pace.
QUESTION 6 OF 87
Leads V8 and V9 are used to evaluate which of the following?
A. Left ventricular failure
B. Posterior myocardial infarction (MI)
C. Lateral MI
D. Left bundle branch block
Correct Answer: B. posterior MI
Rationale: Electrocardiogram leads V8 and V9 are posterior chest leads specifically placed to visualize the posterior
wall of the left ventricle. An ST-segment elevation in these leads is indicative of a posterior myocardial infarction,
which is not typically seen in standard anterior and lateral leads. Therefore, leads V8 and V9 are utilized to evaluate
for posterior MI. This aligns with B. posterior MI.
QUESTION 7 OF 87
What type of AV block is characterized by a progressive prolongation of the PR interval
followed by a nonconducted P wave?
A. First-degree AV block
B. Second-degree AV block, type I
C. Second-degree AV block, type II
D. Third-degree AV block
Correct Answer: B.
Second-degree AV block, type I
Rationale: Second-degree AV block, type I (Wenckebach) is defined by a progressive lengthening of the PR interval
with each successive beat until a P wave is blocked, resulting in a dropped QRS complex. This pattern reflects
increasing delay in conduction through the AV node, which eventually fails to conduct an impulse. The described
clinical finding of a progressively prolonged PR interval followed by a nonconducted P wave is the hallmark of this
specific type of AV block. This aligns with B. Second-degree AV block, type I.
CCRN Certification Practice Questions & Answers 2026-2027 | High-Yield Exam Review (Rationales) - Practice Questions Page 0
CCRN Certification Practice Questions
& Answers 2026-2027 | High-Yield
Exam Review (Rationales)
Document Overview
This document provides 87 CCRN certification practice questions, each with the correct
answer and detailed rationales. It is a high-yield review for critical care nursing, designed
for exam preparation and comprehensive study. This resource directly aligns with the
study needs of nurses seeking CCRN certification.
100% Accurate Questions and Answers 100% Guarantee Pass - Verified by Experts
Expert-Verified
Verified Answers · Detailed Rationales · 87 Questions · September 2026
CCRN Certification Practice Questions & Answers 2026-2027 | High-Yield Exam Review (Rationales) - Practice Questions Page 0
, Topics Covered
Section 1: ECG Interpretation & Arrhythmias Q 1-25
Questions covering eCG Interpretation & Arrhythmias concepts.
Section 2: Myocardial Infarction & Ischemia Q 26-49
Questions covering myocardial Infarction & Ischemia concepts.
Section 3: Heart Failure & Cardiomyopathy Q 50-71
Questions covering heart Failure & Cardiomyopathy concepts.
Section 4: Valvular Heart Disease & Other Cardiac Conditions Q 72-81
Questions covering valvular Heart Disease & Other Cardiac Conditions concepts.
Section 5: Cardiac Pharmacology Q 82-83
Questions covering cardiac Pharmacology concepts.
Section 6: Hemodynamics & Monitoring Q 84-87
Questions covering hemodynamics & Monitoring concepts.
Questions
QUESTION 1 OF 87
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
Rationale: ST elevation in leads V3 and V4 indicates an anterior myocardial infarction, typically caused by occlusion
of the Left Anterior Descending (LAD) artery. The LAD artery supplies the anterior wall of the left ventricle, the
anterior two-thirds of the interventricular septum, and often the proximal portion of the Bundle of His. Therefore,
occlusion of the LAD most likely affects perfusion to the Bundle of His. This aligns with LAD so D. bundle of his.
CCRN Certification Practice Questions & Answers 2026-2027 | High-Yield Exam Review (Rationales) - Practice Questions Page 0
, QUESTION 2 OF 87
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.
QUESTION 3 OF 87
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
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.
QUESTION 4 OF 87
A 52-year-old man is admitted to the critical care unit with a diagnosis of an acute MI.
EKG shows ST elevation and T wave inversion in leads V2, V3, and V4. His history
includes HTN, 80 pack-years of smoking, COPD, and HLD.
An IV and fibrinolytic therapy were initiated in the ED. Which of the following would
not be an indication of successful reperfusion?
A. Pain cessation
B. Absence of creatine kinase (CK) enzyme elevation
C. Reversal of ST segment elevation with return of ST segment to baseline
D. Short runs of ventricular tachycardia
Correct Answer: B. Absence of creatine kinase (CK) enzyme elevation
Rationale: Successful reperfusion following an acute myocardial infarction (MI) is typically associated with a rise
and subsequent fall in cardiac biomarkers like creatine kinase (CK), indicating initial myocardial damage followed by
blood flow restoration. Therefore, the absence of CK enzyme elevation would *not* be an indication of successful
reperfusion, as some enzyme release is expected. While pain cessation, ST segment normalization, and occasional
ventricular arrhythmias can be signs of reperfusion, a lack of any enzyme elevation suggests incomplete or failed
reperfusion. This aligns with B. Absence of creatine kinase (CK) enzyme elevation and Absence of creatine kinase (CK)
enzyme elevation.
CCRN Certification Practice Questions & Answers 2026-2027 | High-Yield Exam Review (Rationales) - Practice Questions Page 0
, QUESTION 5 OF 87
A patient is admitted to the coronary care unit with third-degree AV heart block, and a
transvenous temporary ventricular pacemaker is inserted. Four hours later the patient
complains of dizziness while lying in bed. The monitor shows third-degree AV block
with a ventricular rate of 52 and no pacing spikes. This indicates which of the following?
A. Failure to capture
B. Failure to pace
C. Competition between pacemaker and intrinsic rhythm
D. Failure to sense
Correct Answer: B. Failure to pace
Rationale: Failure to pace occurs when the pacemaker fails to generate an electrical impulse to stimulate myocardial
contraction. The absence of pacing spikes on the monitor, despite the presence of a slow ventricular rate (52 bpm) and
third-degree AV block, indicates the pacemaker is not firing as programmed. This directly suggests the pacemaker is
not initiating a beat, fitting the definition of failure to pace. This aligns with B. Failure to pace.
QUESTION 6 OF 87
Leads V8 and V9 are used to evaluate which of the following?
A. Left ventricular failure
B. Posterior myocardial infarction (MI)
C. Lateral MI
D. Left bundle branch block
Correct Answer: B. posterior MI
Rationale: Electrocardiogram leads V8 and V9 are posterior chest leads specifically placed to visualize the posterior
wall of the left ventricle. An ST-segment elevation in these leads is indicative of a posterior myocardial infarction,
which is not typically seen in standard anterior and lateral leads. Therefore, leads V8 and V9 are utilized to evaluate
for posterior MI. This aligns with B. posterior MI.
QUESTION 7 OF 87
What type of AV block is characterized by a progressive prolongation of the PR interval
followed by a nonconducted P wave?
A. First-degree AV block
B. Second-degree AV block, type I
C. Second-degree AV block, type II
D. Third-degree AV block
Correct Answer: B.
Second-degree AV block, type I
Rationale: Second-degree AV block, type I (Wenckebach) is defined by a progressive lengthening of the PR interval
with each successive beat until a P wave is blocked, resulting in a dropped QRS complex. This pattern reflects
increasing delay in conduction through the AV node, which eventually fails to conduct an impulse. The described
clinical finding of a progressively prolonged PR interval followed by a nonconducted P wave is the hallmark of this
specific type of AV block. This aligns with B. Second-degree AV block, type I.
CCRN Certification Practice Questions & Answers 2026-2027 | High-Yield Exam Review (Rationales) - Practice Questions Page 0
