CCRN EXAM LATEST ACTUAL EXAM QUESTIONS AND CORRECT
CCRN EXAM
DETAILED ANSWERS WITH RATIONALES|ALREADY GRADED
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1. A 59 year old male is admitted complain- (B)Coronary artery reperfusion due to PCI or
ing of chest pain and dyspnea. ST eleva- fibrinolysis results in an ELEVATION of creati-
tion and T wave inversion were seen on nine kinase (CK) or troponin, not decrease. The
the EKG in V2,V3 and V4. IV thrombolytic theory is that the return of blood flow distal to
therapy was started in ED. Indications of the occlusion can result in 'reperfusion injury'
successful reperfusion would include all of the muscle, elevating cardiac biomarkers.
of the following except: The other 3 choices are indicators of reper-
(A) pain cessation fusion: Pain cessation, reversal of ST segment
(B) decrease in CK or troponin elevation with return to baseline, short runs of
(C) reversal of ST segment elevation with ventricular tachycardia.
return to baseline
(D) short runs of ventricular tachycardia
2. Which of the following medication or- (C) The patient in the scenario is having an
ders should the nurse question for the acute anterior wall MI. A beta blocker is bene-
patient in question 1-reperfusion ques- ficial for an acute MI as these agents decrease
tion-patient having an MI? the work of the heart and increase the thresh-
(A) metoprolol (Lopressor) old for ventricular fibrillation. Propranolol, al-
(B) aspirin though a beta-andrenergic blocker like meto-
(C) propranolol (Inderal) prolol, is NOT a cardioselective beta block-
(D) heparin er. It affects beta receptors in heart muscle
AND lung tissue. Therefore, it is more likely to
cause bronchoconstriction than a cardioselec-
tive beta blocker.
The other 3- cardioselective beta blocker, an-
tiplatelet, and anticoagulation-are indicated in
an acute MI.
3. If heart block develops while caring for (C) The patient is having an acute anterior MI,
the patient in question 1 (pt with an MI which is generally due to LAD occlusion. The
who went through reperfusion from PCI LAD supplies the HIS bundle, which could re-
or fibrinolytic therapy), which of the fol- sult in a second-degree, type II heart block. The
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lowing would it most likely be? other 3 types are due to SA node or AV node
(A) sinoatrial block ischemia, which generally occur with an RCA
(B) second degree, Type I occlusion — interior wall MI.
(C) second degree, Type II
(D) third degree, complete
4. Appropriate drug therapy for dilated car- (D) Dilated cardiomyopathy is likely to result in
diomyopathy is aimed toward: systolic dysfunction, which decreases contrac-
(A) decreasing contractility and decreas- tility, causes compensatory arterial constriction
ing preload and afterload , and results in a higher left ventricular preload.
(B) decreasing contractility and increas- To treat this, therapy is aimed at increasing
ing preload and afterload contractility, decreasing afterload (arterial con-
(C) increasing contractility and increasing striction), and decreasing preload that is too
both preload and afterload high.=
(D) increasing contractility and decreas-
ing both preload and afterload
5. An 18 year old is admitted with a history (A) Abnormal sodium does NOT cause QT
of syncopal episode at the mall and has prolongation. In contrast, a low magne-
a history of an eating disorder. The nurse sium, potassium, or calcium, may cause QT
notes a prolonged QT on the 12-lead EKG prolongation and may result in TORSADES
and anticipates a reduction in an elec- DE POINTES ventricular tachycardia and, if
trolyte to be the cause. Which of the fol- self-limiting, transient syncopal episodes.
lowing is LEAST likely to cause this pa-
tient's problems?
(A) sodium
(B) magnesium
(C) potassium
(D) calcium
6. On the third day after admission for (B) The pain described in the scenario is typical
acute MI, a 67 year old male complains of the pain caused by pericarditis. Dressler's
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of chest pain and develops a fever. The syndrome is the pericarditis that may result
pain is worse with deep inspiration and after an acute MI.
is relieved when he leans forward. There
are nonspecific ST changes in the pre-
cordial leads of the EKG. The nurse an-
ticipates that the patient will most likely
need treatment for:
(A) thoracic aneurysm
(B) Dressler's syndrome
(C) reinfarction
(D) pleuritis
7. A patient is admitted to the CCU after (B) Retroperitoneal bleeding may cause signs
a PCI with stent. Femoral sheath is in of hypovolemia and hypovolemic shock as de-
place, site is dry with no hematoma. He scribed in the scenario. It may be a complica-
suddenly complains of severe back pain. tion of a PCI if the femoral artery is the access
Neck veins are flat with head of bed 30 site during the procedure. Only this problem
degrees, heart sounds are normal. Vital results in severe back pain; none of the other 3
signs are BP 78/48, HR 124 and RR 26. choices results in back pain
What should the nurse suspect?
(A) cardiac tamponade
(B) retroperitoneal bleeding
(C) coronary artery dissection
(D) acute closure of the stented coronary
artery
8. Your patient admitted with an NSTEMI (A) The location of the murmur, at the apex of
develops acute shortness of breath, re- the heart (midclavicular, 5th ICS), is one clue to
currence of chest pain, and a loud sys- this answer. In addition, regurgitation occurs
tolic murmur at the apex of the heart. when the valve should be closed and the mitral
Which of the following has most likely valve should be closed during systole. Mitral
occurred? stenosis, choice (C), occurs when the mitral
CCRN EXAM
DETAILED ANSWERS WITH RATIONALES|ALREADY GRADED
Study online at https://quizlet.com/_4f4hvm
A+|BRAND NEW!!
1. A 59 year old male is admitted complain- (B)Coronary artery reperfusion due to PCI or
ing of chest pain and dyspnea. ST eleva- fibrinolysis results in an ELEVATION of creati-
tion and T wave inversion were seen on nine kinase (CK) or troponin, not decrease. The
the EKG in V2,V3 and V4. IV thrombolytic theory is that the return of blood flow distal to
therapy was started in ED. Indications of the occlusion can result in 'reperfusion injury'
successful reperfusion would include all of the muscle, elevating cardiac biomarkers.
of the following except: The other 3 choices are indicators of reper-
(A) pain cessation fusion: Pain cessation, reversal of ST segment
(B) decrease in CK or troponin elevation with return to baseline, short runs of
(C) reversal of ST segment elevation with ventricular tachycardia.
return to baseline
(D) short runs of ventricular tachycardia
2. Which of the following medication or- (C) The patient in the scenario is having an
ders should the nurse question for the acute anterior wall MI. A beta blocker is bene-
patient in question 1-reperfusion ques- ficial for an acute MI as these agents decrease
tion-patient having an MI? the work of the heart and increase the thresh-
(A) metoprolol (Lopressor) old for ventricular fibrillation. Propranolol, al-
(B) aspirin though a beta-andrenergic blocker like meto-
(C) propranolol (Inderal) prolol, is NOT a cardioselective beta block-
(D) heparin er. It affects beta receptors in heart muscle
AND lung tissue. Therefore, it is more likely to
cause bronchoconstriction than a cardioselec-
tive beta blocker.
The other 3- cardioselective beta blocker, an-
tiplatelet, and anticoagulation-are indicated in
an acute MI.
3. If heart block develops while caring for (C) The patient is having an acute anterior MI,
the patient in question 1 (pt with an MI which is generally due to LAD occlusion. The
who went through reperfusion from PCI LAD supplies the HIS bundle, which could re-
or fibrinolytic therapy), which of the fol- sult in a second-degree, type II heart block. The
, CCRN EXAM
Study online at https://quizlet.com/_4f4hvm
lowing would it most likely be? other 3 types are due to SA node or AV node
(A) sinoatrial block ischemia, which generally occur with an RCA
(B) second degree, Type I occlusion — interior wall MI.
(C) second degree, Type II
(D) third degree, complete
4. Appropriate drug therapy for dilated car- (D) Dilated cardiomyopathy is likely to result in
diomyopathy is aimed toward: systolic dysfunction, which decreases contrac-
(A) decreasing contractility and decreas- tility, causes compensatory arterial constriction
ing preload and afterload , and results in a higher left ventricular preload.
(B) decreasing contractility and increas- To treat this, therapy is aimed at increasing
ing preload and afterload contractility, decreasing afterload (arterial con-
(C) increasing contractility and increasing striction), and decreasing preload that is too
both preload and afterload high.=
(D) increasing contractility and decreas-
ing both preload and afterload
5. An 18 year old is admitted with a history (A) Abnormal sodium does NOT cause QT
of syncopal episode at the mall and has prolongation. In contrast, a low magne-
a history of an eating disorder. The nurse sium, potassium, or calcium, may cause QT
notes a prolonged QT on the 12-lead EKG prolongation and may result in TORSADES
and anticipates a reduction in an elec- DE POINTES ventricular tachycardia and, if
trolyte to be the cause. Which of the fol- self-limiting, transient syncopal episodes.
lowing is LEAST likely to cause this pa-
tient's problems?
(A) sodium
(B) magnesium
(C) potassium
(D) calcium
6. On the third day after admission for (B) The pain described in the scenario is typical
acute MI, a 67 year old male complains of the pain caused by pericarditis. Dressler's
, CCRN EXAM
Study online at https://quizlet.com/_4f4hvm
of chest pain and develops a fever. The syndrome is the pericarditis that may result
pain is worse with deep inspiration and after an acute MI.
is relieved when he leans forward. There
are nonspecific ST changes in the pre-
cordial leads of the EKG. The nurse an-
ticipates that the patient will most likely
need treatment for:
(A) thoracic aneurysm
(B) Dressler's syndrome
(C) reinfarction
(D) pleuritis
7. A patient is admitted to the CCU after (B) Retroperitoneal bleeding may cause signs
a PCI with stent. Femoral sheath is in of hypovolemia and hypovolemic shock as de-
place, site is dry with no hematoma. He scribed in the scenario. It may be a complica-
suddenly complains of severe back pain. tion of a PCI if the femoral artery is the access
Neck veins are flat with head of bed 30 site during the procedure. Only this problem
degrees, heart sounds are normal. Vital results in severe back pain; none of the other 3
signs are BP 78/48, HR 124 and RR 26. choices results in back pain
What should the nurse suspect?
(A) cardiac tamponade
(B) retroperitoneal bleeding
(C) coronary artery dissection
(D) acute closure of the stented coronary
artery
8. Your patient admitted with an NSTEMI (A) The location of the murmur, at the apex of
develops acute shortness of breath, re- the heart (midclavicular, 5th ICS), is one clue to
currence of chest pain, and a loud sys- this answer. In addition, regurgitation occurs
tolic murmur at the apex of the heart. when the valve should be closed and the mitral
Which of the following has most likely valve should be closed during systole. Mitral
occurred? stenosis, choice (C), occurs when the mitral
