CCRN PRACTICE QUESTIONS And
Answers 2025
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 answers ✅✅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?
A.I
B. aVR
C. III
D. V1 - correct answers ✅✅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 answers ✅✅*B
,CCRN PRACTICE QUESTIONS And
Answers 2025
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.
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 answers ✅✅*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
B. Atropine
,CCRN PRACTICE QUESTIONS And
Answers 2025
C. Epinephrine
D. Amiodarone (Cordarone) - correct answers ✅✅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 answers ✅✅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. Narrowed pulse pressure is associated with mitral
regurgitation.
Four days after a mitral valve replacement, the patient develops
atrial fibrillation. The nurse initially would:
A. order a 12-lead EKG
B. evaluate the patient for clinical indications of hypoperfusion.
C. notify the physician.
, CCRN PRACTICE QUESTIONS And
Answers 2025
D. ask the patient to bear down as if having a bowel movement. -
correct answers ✅✅B
The onset of atrial fibrillation results in the loss of atrial kick. Loss
of atrial kick may reduce the cardiac output by as much as 20-
30%. This is especially true in patients whose cardiac output may
be affected by long-standing cardiac disease, such as mitral valve
disease. Assess the patient for clinical indications of
hypoperfusion (e.g., cool skin, decreased urine output, narrowed
pulse pressure, and hypotension).
A patient has just returned from the cath lab. She had an
angioplasty for occlusion of her RCA. She still has femoral artery
and vein sheaths in place. The patient complains of chest pain
that she rates 9/10 about an hour after she returns from the cath
lab. Which of the following is indicated?
A. Administer morphine IV.
B. Administer nitroglycerin sublingual spray.
C. Stop the heparin.
D. Notify the physician - correct answers ✅✅D
New-onset severe chest pain after percutaneous coronary
intervention suggests acute closure of the dilated coronary artery.
The patient needs to be returned to the cardiac catheterization
laboratory for repeat dilation and probable insertion of stent.
A 35-year-old woman underwent a mitral valve replacement. Her
chest tube output has been approximately 125 mL/hr for the last
3 hours, and now the drainage has ceased suddenly. The
immediate assessment reveals a significant decrease in BP, RAP
Answers 2025
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 answers ✅✅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?
A.I
B. aVR
C. III
D. V1 - correct answers ✅✅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 answers ✅✅*B
,CCRN PRACTICE QUESTIONS And
Answers 2025
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.
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 answers ✅✅*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
B. Atropine
,CCRN PRACTICE QUESTIONS And
Answers 2025
C. Epinephrine
D. Amiodarone (Cordarone) - correct answers ✅✅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 answers ✅✅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. Narrowed pulse pressure is associated with mitral
regurgitation.
Four days after a mitral valve replacement, the patient develops
atrial fibrillation. The nurse initially would:
A. order a 12-lead EKG
B. evaluate the patient for clinical indications of hypoperfusion.
C. notify the physician.
, CCRN PRACTICE QUESTIONS And
Answers 2025
D. ask the patient to bear down as if having a bowel movement. -
correct answers ✅✅B
The onset of atrial fibrillation results in the loss of atrial kick. Loss
of atrial kick may reduce the cardiac output by as much as 20-
30%. This is especially true in patients whose cardiac output may
be affected by long-standing cardiac disease, such as mitral valve
disease. Assess the patient for clinical indications of
hypoperfusion (e.g., cool skin, decreased urine output, narrowed
pulse pressure, and hypotension).
A patient has just returned from the cath lab. She had an
angioplasty for occlusion of her RCA. She still has femoral artery
and vein sheaths in place. The patient complains of chest pain
that she rates 9/10 about an hour after she returns from the cath
lab. Which of the following is indicated?
A. Administer morphine IV.
B. Administer nitroglycerin sublingual spray.
C. Stop the heparin.
D. Notify the physician - correct answers ✅✅D
New-onset severe chest pain after percutaneous coronary
intervention suggests acute closure of the dilated coronary artery.
The patient needs to be returned to the cardiac catheterization
laboratory for repeat dilation and probable insertion of stent.
A 35-year-old woman underwent a mitral valve replacement. Her
chest tube output has been approximately 125 mL/hr for the last
3 hours, and now the drainage has ceased suddenly. The
immediate assessment reveals a significant decrease in BP, RAP
