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CCRN Cardiovascular Practice Test Exam 2024
What is expected to be true regarding the murmur in this patient?
A It decreases while in an upright posture.
B It becomes less intense with the Valsalva maneuver.
C It decreases with squatting.
D It increases with sustained handgrip.
E It increases with lying down. - answer-C
A 40-year-old man presents with atrial flutter with 2:1 atrioventricular (AV)
conduction, giving him a pulse of 150 per minute, which is perfectly regular. His
blood pressure is 70/40 mmHg. He takes no medications regularly. You plan to
provide him with urgent direct current cardioversion with conscious sedation.
What would be an appropriate level of energy for cardioversion in order to
restore sinus rhythm in this patient?
A 10 Joules
B 15 Joules
C 50 Joules
D 200 Joules
E 300 Joules
F 360 Joules - answer-C
1) A 75-year-old African-American man presents with a 5-month history of
gradually progressive dyspnea that is especially pronounced when climbing stairs.
He also has been noticing that his ankles and lower legs have "gotten larger" over
roughly the same time period, which no longer allows him to fit into his sneakers.
He denies fever, chills, chest pain, palpitations, cough, pleurisy, calf pain,
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abdominal complaints, sick contacts, or travel. His psychosocial history is
noteworthy for chronic alcohol use. His physical exam reveals bibasilar rales, JVD
of 5cm, an S3 gallop, a holosystolic murmur at the apex that radiates to the left
axilla, and 2+ pitting edema to the level of the mid-calves bilaterally. A bedside
echocardiogram was remarkable for biventricular enlargement.
A Tachycardia
B Fever
C Asymmetric upper extremity blood pressures
D Warm, moist skin
E Acanthosis nigricans - answer-A
The patient is a 20-year-old man who presents to a medical clinic for a routine
physical required before he enlists in the army. His family history is significant for
2 relatives who had sudden cardiac arrest in their late 20's or early 30's. He does
not know any more details about these relatives or their medical history. His
review of systems is negative with the exception of rare episodes of heart
palpitations.
What is the most likely finding on the patient's cardiac examination if he has
hypertrophic cardiomyopathy?
A soft heart sounds and an S3 gallop
B brisk heart sounds and an S4 gallop
C early diastolic pericardial knock
D S4 gallop and no murmur
E 3 component friction rub - answer-B
Which of the following complications is commonly associated with subarterial
VSD?
A Infective endocarditis
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B Pulmonary hypertension
C Congestive cardiac failure
D Cor pulmonale
E Aortic insufficiency (AI) - answer-E
A 3-month-old term infant presents for a wellness exam, and his parents report
worsening in his feeding habits and rapid breathing. On exam, there is a grade
III/VI harsh heart murmur heard over the left subclavicular region that starts in
early systole, peaks at S2, and decrescendos until the next S1. The infant is
tachypneic and has bounding pulses of his upper and lower extremities. All other
findings are within normal limits. A chest x-ray shows an enlarged left ventricle
and atrium and increased pulmonary vasculature markings.
Based on the above findings, what is the most likely diagnosis?
Answer Choices:
A Atrial Septal Defect
B Congenital Pulmonic Valve Stenosis
C Ventricular Septal Defect
D Patent Ductus Arteriosus
E Congenital Aortic Valve Stenosis - answer-D
A 12-year-old presents with an injury of his left arm and leg. He states that he felt
dizziness during the 2nd mile of the long distance run organized by the school. He
fell and lost the consciousness for several seconds, but after that he felt "normal".
His father has been diagnosed with Emery-Dreifuss muscular dystrophy type 1. On
examination, you find a few superficial excoriations; there is also symmetric
humero-peroneal weakness involving the biceps, triceps, and peroneal muscles.
There is also atrophy and contractures of Achilles-heel, elbows, and posterior
neck.
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After taking care of his injuries, what test should you order?
A CK
B LDH
C EKG
D EEG
E CT - answer-C
A 63-year-old woman with a 3-day history of hypertension, hyperlipidemia, and
myocardial infarction presents to the emergency room with shortness of breath
at rest. She has found it difficult to walk short distances due to shortness of
breath. Additionally, she complains of orthopnea, nocturnal dyspnea, and
generalized abdominal discomfort. She denies cough, fever, chills, diaphoresis,
anxiety, chest pain, pleurisy, cough, nausea, vomiting, diarrhea, rashes,
lightheadedness, and syncope.
She is well nourished and afebrile, but tachypnic and diaphoretic. There is a
diminished first heart sound, S3 gallop, laterally displaced PMI, bibasilar rales and
dullness to percussion, and expiratory wheezing noted. The abdominal exam
reveals distension, with hepatomegaly in the right upper quadrant. There is 2+
pitting edema of the lower extremities to the level of the mid calf, and the
extremities are cool.
What additional findi - answer-C
A 20-year-old woman presents for counseling after being diagnosed as a carrier of
Emery-Dreifuss muscular dystrophy. She manifests a mild form of the disease,
with only contractures of the Achilles' heels and elbows. Both her brother and her
father have been diagnosed with the disease.
What test will help to change the course of the disease in this young woman?
A Electrocardiography
B Creatine kinase
CCRN Cardiovascular Practice Test Exam 2024
What is expected to be true regarding the murmur in this patient?
A It decreases while in an upright posture.
B It becomes less intense with the Valsalva maneuver.
C It decreases with squatting.
D It increases with sustained handgrip.
E It increases with lying down. - answer-C
A 40-year-old man presents with atrial flutter with 2:1 atrioventricular (AV)
conduction, giving him a pulse of 150 per minute, which is perfectly regular. His
blood pressure is 70/40 mmHg. He takes no medications regularly. You plan to
provide him with urgent direct current cardioversion with conscious sedation.
What would be an appropriate level of energy for cardioversion in order to
restore sinus rhythm in this patient?
A 10 Joules
B 15 Joules
C 50 Joules
D 200 Joules
E 300 Joules
F 360 Joules - answer-C
1) A 75-year-old African-American man presents with a 5-month history of
gradually progressive dyspnea that is especially pronounced when climbing stairs.
He also has been noticing that his ankles and lower legs have "gotten larger" over
roughly the same time period, which no longer allows him to fit into his sneakers.
He denies fever, chills, chest pain, palpitations, cough, pleurisy, calf pain,
, Page 2 of 114
abdominal complaints, sick contacts, or travel. His psychosocial history is
noteworthy for chronic alcohol use. His physical exam reveals bibasilar rales, JVD
of 5cm, an S3 gallop, a holosystolic murmur at the apex that radiates to the left
axilla, and 2+ pitting edema to the level of the mid-calves bilaterally. A bedside
echocardiogram was remarkable for biventricular enlargement.
A Tachycardia
B Fever
C Asymmetric upper extremity blood pressures
D Warm, moist skin
E Acanthosis nigricans - answer-A
The patient is a 20-year-old man who presents to a medical clinic for a routine
physical required before he enlists in the army. His family history is significant for
2 relatives who had sudden cardiac arrest in their late 20's or early 30's. He does
not know any more details about these relatives or their medical history. His
review of systems is negative with the exception of rare episodes of heart
palpitations.
What is the most likely finding on the patient's cardiac examination if he has
hypertrophic cardiomyopathy?
A soft heart sounds and an S3 gallop
B brisk heart sounds and an S4 gallop
C early diastolic pericardial knock
D S4 gallop and no murmur
E 3 component friction rub - answer-B
Which of the following complications is commonly associated with subarterial
VSD?
A Infective endocarditis
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B Pulmonary hypertension
C Congestive cardiac failure
D Cor pulmonale
E Aortic insufficiency (AI) - answer-E
A 3-month-old term infant presents for a wellness exam, and his parents report
worsening in his feeding habits and rapid breathing. On exam, there is a grade
III/VI harsh heart murmur heard over the left subclavicular region that starts in
early systole, peaks at S2, and decrescendos until the next S1. The infant is
tachypneic and has bounding pulses of his upper and lower extremities. All other
findings are within normal limits. A chest x-ray shows an enlarged left ventricle
and atrium and increased pulmonary vasculature markings.
Based on the above findings, what is the most likely diagnosis?
Answer Choices:
A Atrial Septal Defect
B Congenital Pulmonic Valve Stenosis
C Ventricular Septal Defect
D Patent Ductus Arteriosus
E Congenital Aortic Valve Stenosis - answer-D
A 12-year-old presents with an injury of his left arm and leg. He states that he felt
dizziness during the 2nd mile of the long distance run organized by the school. He
fell and lost the consciousness for several seconds, but after that he felt "normal".
His father has been diagnosed with Emery-Dreifuss muscular dystrophy type 1. On
examination, you find a few superficial excoriations; there is also symmetric
humero-peroneal weakness involving the biceps, triceps, and peroneal muscles.
There is also atrophy and contractures of Achilles-heel, elbows, and posterior
neck.
, Page 4 of 114
After taking care of his injuries, what test should you order?
A CK
B LDH
C EKG
D EEG
E CT - answer-C
A 63-year-old woman with a 3-day history of hypertension, hyperlipidemia, and
myocardial infarction presents to the emergency room with shortness of breath
at rest. She has found it difficult to walk short distances due to shortness of
breath. Additionally, she complains of orthopnea, nocturnal dyspnea, and
generalized abdominal discomfort. She denies cough, fever, chills, diaphoresis,
anxiety, chest pain, pleurisy, cough, nausea, vomiting, diarrhea, rashes,
lightheadedness, and syncope.
She is well nourished and afebrile, but tachypnic and diaphoretic. There is a
diminished first heart sound, S3 gallop, laterally displaced PMI, bibasilar rales and
dullness to percussion, and expiratory wheezing noted. The abdominal exam
reveals distension, with hepatomegaly in the right upper quadrant. There is 2+
pitting edema of the lower extremities to the level of the mid calf, and the
extremities are cool.
What additional findi - answer-C
A 20-year-old woman presents for counseling after being diagnosed as a carrier of
Emery-Dreifuss muscular dystrophy. She manifests a mild form of the disease,
with only contractures of the Achilles' heels and elbows. Both her brother and her
father have been diagnosed with the disease.
What test will help to change the course of the disease in this young woman?
A Electrocardiography
B Creatine kinase
