CCRN EXAM 2024 NEWEST VERIFIED
QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES ALREADY
GRADED A+.
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 - ANSWER- (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 - ANSWER- (B) The pain described in the scenario is typical of the pain
caused by pericarditis. Dressler's syndrome is the pericarditis that may result after an
acute MI.
A patient is admitted to the CCU after a PCI with stent. Femoral sheath is in place, site
is dry with no hematoma. He suddenly complains of severe back pain. Neck veins are
flat with head of bed 30 degrees, heart sounds are normal. Vital signs are BP 78/48, HR
124 and RR 26. What should the nurse suspect?
(A) cardiac tamponade
(B) retroperitoneal bleeding
(C) coronary artery dissection
(D) acute closure of the stented coronary artery - ANSWER- (B) Retroperitoneal
bleeding may cause signs of hypovolemia and hypovolemic shock as described in the
scenario. It may be a complication of a PCI if the femoral artery is the access site during
the procedure. Only this problem results in severe back pain; none of the other 3
choices results in back pain
Your patient admitted with an NSTEMI develops acute shortness of breath, recurrence
of chest pain, and a loud systolic murmur at the apex of the heart. Which of the
following has most likely occurred?
(A) the patient has developed acute mitral valve regurgitation
(B) the patient has developed acute infarction
(C) the patient has developed acute mitral wave stenosis
,(D) the patient has developed acute ventricular septal defect - ANSWER- (A) The
location of the murmur, at the apex of the heart (midclavicular, 5th ICS), is one clue to
this answer. In addition, regurgitation occurs when the valve should be closed and the
mitral valve should be closed during systole. Mitral stenosis, choice (C), occurs when
the mitral valve is open. Additionally, mitral stenosis cannot be acute, it develops
gradually.
A patient has just returned from the OR after insertion of a VVI pacemaker. In order to
assess function of this pacemaker accurately, the nurse needs to understand that:
(A) both atrium and ventricle are paced and sensed and may either inhibit or pace in
response
to sensing
(B) the ventricle is paced, ventricular activity is sensed and pacing is inhibited in
response to
ventricular sensing.
(C) both the atrium and ventricle are paced, but only ventricular pacing can be inhibited
by a
sensed intrinsic ventricular impulse.
(D) the ventricle is paced in response to a sensed intrinsic atrial impulse or inhibited by
a sensed
intrinsic ventricular impulse. - ANSWER- (B) the first letter indicates chamber paced
(ventricle). The second letter indicates chamber sensed (ventricle). The third letter
indicates the response to sensing (inhibited in response to sensing).
, A patient complains of sudden dyspnea 5 days S/P acute MI (ST elevation in II, III, and
aVF, with ST depression in I and aVL). The patient is anxious, diaphoretic, and
hypotensive. Examination reveals the development of a loud holosystolic murmur at the
apex. What is the most likely cause of this patient's deterioration?
(A) right ventricular failure related to right ventricular MI
(B) ventricular septal defect
(C) left ventricular failure due to extension of MI
(D) acute mitral regurgitation due to papillary muscle rupture or dysfunction - ANSWER-
(D) The scenario describes a patient having an acute inferior wall MI, which is generally
due to occlusion of the RCA. The RCA occlusion may result in papillary muscle
dysfunction or rupture of the mitral valve because it supplies the area of the left ventricle
where this valve is attached. Although RV infarct could result with RCA occlusion, RV
infarct does not result in a systolic murmur at apex of the heart or lung crackles.
When providing care to a bariatric patient, the best weight to use for the tidal volume for
the ventilator settings and propofol dosing is? - ANSWER- Ideal body weight
A woman presents to the ICU with vaginal bleeding at 35 weeks gestation. A d-dimer
and fibrinogen levels are ordered. The nurse draws these blood tests with the
knowledge that:
a. DVT and pulm embolism are common in the third trimester
QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES ALREADY
GRADED A+.
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 - ANSWER- (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 - ANSWER- (B) The pain described in the scenario is typical of the pain
caused by pericarditis. Dressler's syndrome is the pericarditis that may result after an
acute MI.
A patient is admitted to the CCU after a PCI with stent. Femoral sheath is in place, site
is dry with no hematoma. He suddenly complains of severe back pain. Neck veins are
flat with head of bed 30 degrees, heart sounds are normal. Vital signs are BP 78/48, HR
124 and RR 26. What should the nurse suspect?
(A) cardiac tamponade
(B) retroperitoneal bleeding
(C) coronary artery dissection
(D) acute closure of the stented coronary artery - ANSWER- (B) Retroperitoneal
bleeding may cause signs of hypovolemia and hypovolemic shock as described in the
scenario. It may be a complication of a PCI if the femoral artery is the access site during
the procedure. Only this problem results in severe back pain; none of the other 3
choices results in back pain
Your patient admitted with an NSTEMI develops acute shortness of breath, recurrence
of chest pain, and a loud systolic murmur at the apex of the heart. Which of the
following has most likely occurred?
(A) the patient has developed acute mitral valve regurgitation
(B) the patient has developed acute infarction
(C) the patient has developed acute mitral wave stenosis
,(D) the patient has developed acute ventricular septal defect - ANSWER- (A) The
location of the murmur, at the apex of the heart (midclavicular, 5th ICS), is one clue to
this answer. In addition, regurgitation occurs when the valve should be closed and the
mitral valve should be closed during systole. Mitral stenosis, choice (C), occurs when
the mitral valve is open. Additionally, mitral stenosis cannot be acute, it develops
gradually.
A patient has just returned from the OR after insertion of a VVI pacemaker. In order to
assess function of this pacemaker accurately, the nurse needs to understand that:
(A) both atrium and ventricle are paced and sensed and may either inhibit or pace in
response
to sensing
(B) the ventricle is paced, ventricular activity is sensed and pacing is inhibited in
response to
ventricular sensing.
(C) both the atrium and ventricle are paced, but only ventricular pacing can be inhibited
by a
sensed intrinsic ventricular impulse.
(D) the ventricle is paced in response to a sensed intrinsic atrial impulse or inhibited by
a sensed
intrinsic ventricular impulse. - ANSWER- (B) the first letter indicates chamber paced
(ventricle). The second letter indicates chamber sensed (ventricle). The third letter
indicates the response to sensing (inhibited in response to sensing).
, A patient complains of sudden dyspnea 5 days S/P acute MI (ST elevation in II, III, and
aVF, with ST depression in I and aVL). The patient is anxious, diaphoretic, and
hypotensive. Examination reveals the development of a loud holosystolic murmur at the
apex. What is the most likely cause of this patient's deterioration?
(A) right ventricular failure related to right ventricular MI
(B) ventricular septal defect
(C) left ventricular failure due to extension of MI
(D) acute mitral regurgitation due to papillary muscle rupture or dysfunction - ANSWER-
(D) The scenario describes a patient having an acute inferior wall MI, which is generally
due to occlusion of the RCA. The RCA occlusion may result in papillary muscle
dysfunction or rupture of the mitral valve because it supplies the area of the left ventricle
where this valve is attached. Although RV infarct could result with RCA occlusion, RV
infarct does not result in a systolic murmur at apex of the heart or lung crackles.
When providing care to a bariatric patient, the best weight to use for the tidal volume for
the ventilator settings and propofol dosing is? - ANSWER- Ideal body weight
A woman presents to the ICU with vaginal bleeding at 35 weeks gestation. A d-dimer
and fibrinogen levels are ordered. The nurse draws these blood tests with the
knowledge that:
a. DVT and pulm embolism are common in the third trimester
