AACN CCRN Exam PRACTICE
QUESTIONS |ORIGINAL QUESTIONS &
ANSWERS |DETAILED RATIONALES
|HINTED COMPLETE EXAM PREP
GRADED A+*INSTANT DOWNLOAD PDF
1. A patient with acute left ventricular failure develops severe
dyspnea, crackles, and pink frothy sputum. Which intervention
should the nurse prioritize?
A. Place the patient supine
B. Administer a rapid IV fluid bolus
C. Apply supplemental oxygen and position upright
D. Encourage oral fluids
Answer: C. Apply supplemental oxygen and position upright
Rationale: Upright positioning decreases venous return and improves
lung expansion, while oxygen supports gas exchange during acute
pulmonary edema.
2. Which hemodynamic finding is most consistent with cardiogenic
shock?
A. Low SVR with high cardiac output
B. High cardiac output with low filling pressures
C. Low cardiac output with elevated filling pressures
D. Normal cardiac output with low pulmonary pressures
Answer: C. Low cardiac output with elevated filling pressures
Rationale: Cardiogenic shock results from pump failure, producing
decreased cardiac output and increased ventricular filling pressures.
,3. A patient with an acute myocardial infarction develops
hypotension, clear lung sounds, and jugular venous distention.
Which complication is most likely?
A. Left ventricular failure
B. Right ventricular infarction
C. Pulmonary edema
D. Septic shock
Answer: B. Right ventricular infarction
Rationale: Right ventricular infarction commonly causes hypotension
and elevated right-sided filling pressures, manifested by JVD, often
with relatively clear lungs.
4. Which ECG finding is most characteristic of hyperkalemia?
A. Prominent U waves
B. Prolonged QT interval
C. Peaked T waves
D. ST elevation in contiguous leads
Answer: C. Peaked T waves
Rationale: Tall, peaked T waves are an early ECG manifestation of
hyperkalemia; progressive toxicity can cause PR prolongation, QRS
widening, and dysrhythmias.
5. A patient receiving amiodarone develops marked QT prolongation.
Which dysrhythmia is the patient at increased risk for?
A. Torsades de pointes
B. Sinus bradycardia only
,C. Atrial flutter
D. First-degree AV block only
Answer: A. Torsades de pointes
Rationale: Significant QT prolongation increases the risk of
polymorphic ventricular tachycardia known as torsades de pointes.
6. Which assessment finding is most concerning in a patient with an
intra-aortic balloon pump?
A. Augmented diastolic pressure
B. Slight increase in urine output
C. Absent pedal pulse in the affected limb
D. Improved cardiac output
Answer: C. Absent pedal pulse in the affected limb
Rationale: An absent distal pulse may indicate limb ischemia from
vascular compromise and requires immediate evaluation.
7. The primary purpose of intra-aortic balloon pump inflation during
diastole is to:
A. Decrease coronary perfusion
B. Increase coronary perfusion
C. Increase afterload
D. Reduce venous return
Answer: B. Increase coronary perfusion
Rationale: Diastolic balloon inflation increases aortic diastolic
pressure, improving coronary artery perfusion.
, 8. Which patient is at greatest risk for developing cardiac
tamponade?
A. Patient with chronic hypertension
B. Patient with penetrating chest trauma
C. Patient with uncomplicated pneumonia
D. Patient with chronic anemia
Answer: B. Patient with penetrating chest trauma
Rationale: Penetrating cardiac or chest trauma can cause rapid
accumulation of blood in the pericardial space, producing
tamponade.
9. Beck's triad includes:
A. Hypertension, bradycardia, crackles
B. Hypotension, muffled heart sounds, JVD
C. Tachycardia, hypertension, fever
D. Bradycardia, widened pulse pressure, edema
Answer: B. Hypotension, muffled heart sounds, JVD
Rationale: Beck's triad describes classic findings associated with
cardiac tamponade.
10. A patient with cardiac tamponade becomes increasingly
hypotensive. Which intervention should the nurse anticipate?
A. Pericardiocentesis
B. Diuretic administration
C. Fluid restriction
D. Beta-blocker administration
Answer: A. Pericardiocentesis
QUESTIONS |ORIGINAL QUESTIONS &
ANSWERS |DETAILED RATIONALES
|HINTED COMPLETE EXAM PREP
GRADED A+*INSTANT DOWNLOAD PDF
1. A patient with acute left ventricular failure develops severe
dyspnea, crackles, and pink frothy sputum. Which intervention
should the nurse prioritize?
A. Place the patient supine
B. Administer a rapid IV fluid bolus
C. Apply supplemental oxygen and position upright
D. Encourage oral fluids
Answer: C. Apply supplemental oxygen and position upright
Rationale: Upright positioning decreases venous return and improves
lung expansion, while oxygen supports gas exchange during acute
pulmonary edema.
2. Which hemodynamic finding is most consistent with cardiogenic
shock?
A. Low SVR with high cardiac output
B. High cardiac output with low filling pressures
C. Low cardiac output with elevated filling pressures
D. Normal cardiac output with low pulmonary pressures
Answer: C. Low cardiac output with elevated filling pressures
Rationale: Cardiogenic shock results from pump failure, producing
decreased cardiac output and increased ventricular filling pressures.
,3. A patient with an acute myocardial infarction develops
hypotension, clear lung sounds, and jugular venous distention.
Which complication is most likely?
A. Left ventricular failure
B. Right ventricular infarction
C. Pulmonary edema
D. Septic shock
Answer: B. Right ventricular infarction
Rationale: Right ventricular infarction commonly causes hypotension
and elevated right-sided filling pressures, manifested by JVD, often
with relatively clear lungs.
4. Which ECG finding is most characteristic of hyperkalemia?
A. Prominent U waves
B. Prolonged QT interval
C. Peaked T waves
D. ST elevation in contiguous leads
Answer: C. Peaked T waves
Rationale: Tall, peaked T waves are an early ECG manifestation of
hyperkalemia; progressive toxicity can cause PR prolongation, QRS
widening, and dysrhythmias.
5. A patient receiving amiodarone develops marked QT prolongation.
Which dysrhythmia is the patient at increased risk for?
A. Torsades de pointes
B. Sinus bradycardia only
,C. Atrial flutter
D. First-degree AV block only
Answer: A. Torsades de pointes
Rationale: Significant QT prolongation increases the risk of
polymorphic ventricular tachycardia known as torsades de pointes.
6. Which assessment finding is most concerning in a patient with an
intra-aortic balloon pump?
A. Augmented diastolic pressure
B. Slight increase in urine output
C. Absent pedal pulse in the affected limb
D. Improved cardiac output
Answer: C. Absent pedal pulse in the affected limb
Rationale: An absent distal pulse may indicate limb ischemia from
vascular compromise and requires immediate evaluation.
7. The primary purpose of intra-aortic balloon pump inflation during
diastole is to:
A. Decrease coronary perfusion
B. Increase coronary perfusion
C. Increase afterload
D. Reduce venous return
Answer: B. Increase coronary perfusion
Rationale: Diastolic balloon inflation increases aortic diastolic
pressure, improving coronary artery perfusion.
, 8. Which patient is at greatest risk for developing cardiac
tamponade?
A. Patient with chronic hypertension
B. Patient with penetrating chest trauma
C. Patient with uncomplicated pneumonia
D. Patient with chronic anemia
Answer: B. Patient with penetrating chest trauma
Rationale: Penetrating cardiac or chest trauma can cause rapid
accumulation of blood in the pericardial space, producing
tamponade.
9. Beck's triad includes:
A. Hypertension, bradycardia, crackles
B. Hypotension, muffled heart sounds, JVD
C. Tachycardia, hypertension, fever
D. Bradycardia, widened pulse pressure, edema
Answer: B. Hypotension, muffled heart sounds, JVD
Rationale: Beck's triad describes classic findings associated with
cardiac tamponade.
10. A patient with cardiac tamponade becomes increasingly
hypotensive. Which intervention should the nurse anticipate?
A. Pericardiocentesis
B. Diuretic administration
C. Fluid restriction
D. Beta-blocker administration
Answer: A. Pericardiocentesis
