CCRN EXAM 2025 QUESTIONS AND
ANSWERS
A 59 year old male is admitted complaining of chest pain and dyspnea. ST
elevation and T wave inversion were seen on the EKG in V2,V3 and V4. IV
thrombolytic therapy was started in ED. Indications of successful reperfusion
would include all of the following except:
(A) pain cessation
(B) decrease in CK or troponin
(C) reversal of ST segment elevation with return to baseline
(D) short runs of ventricular tachycardia - ANSWER-(B)Coronary artery
reperfusion due to PCI or fibrinolysis results in an ELEVATION of creatinine
kinase (CK) or troponin, not decrease. The theory is that the return of blood flow
distal to the occlusion can result in 'reperfusion injury' of the muscle, elevating
cardiac biomarkers.
The other 3 choices are indicators of reperfusion: Pain cessation, reversal of ST
segment elevation with return to baseline, short runs of ventricular tachycardia.
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,Which of the following medication orders should the nurse question for the
patient in question 1-reperfusion question-patient having an MI?
(A) metoprolol (Lopressor)
(B) aspirin
(C) propranolol (Inderal)
(D) heparin - ANSWER-(C) The patient in the scenario is having an acute anterior
wall MI. A beta blocker is beneficial for an acute MI as these agents decrease the
work of the heart and increase the threshold for ventricular fibrillation.
Propranolol, although a beta-andrenergic blocker like metoprolol, is NOT a
cardioselective beta blocker. It affects beta receptors in heart muscle AND lung
tissue. Therefore, it is more likely to cause bronchoconstriction than a
cardioselective beta blocker.
The other 3- cardioselective beta blocker, antiplatelet, and anticoagulation-are
indicated in an acute MI.
If heart block develops while caring for the patient in question 1 (pt with an MI
who went through reperfusion from PCI or fibrinolytic therapy), which of the
following would it most likely be?
(A) sinoatrial block
(B) second degree, Type I
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, (C) second degree, Type II
(D) third degree, complete - ANSWER-(C) The patient is having an acute anterior
MI, which is generally due to LAD occlusion. The LAD supplies the HIS bundle,
which could result in a second-degree, type II heart block. The other 3 types are
due to SA node or AV node ischemia, which generally occur with an RCA
occlusion — interior wall MI.
Appropriate drug therapy for dilated cardiomyopathy is aimed toward:
(A) decreasing contractility and decreasing preload and afterload
(B) decreasing contractility and increasing preload and afterload
(C) increasing contractility and increasing both preload and afterload
(D) increasing contractility and decreasing both preload and afterload - ANSWER-
(D) Dilated cardiomyopathy is likely to result in systolic dysfunction, which
decreases contractility, causes compensatory arterial constriction , and results in a
higher left ventricular preload. To treat this, therapy is aimed at increasing
contractility, decreasing afterload (arterial constriction), and decreasing preload that
is too high.
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?
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ANSWERS
A 59 year old male is admitted complaining of chest pain and dyspnea. ST
elevation and T wave inversion were seen on the EKG in V2,V3 and V4. IV
thrombolytic therapy was started in ED. Indications of successful reperfusion
would include all of the following except:
(A) pain cessation
(B) decrease in CK or troponin
(C) reversal of ST segment elevation with return to baseline
(D) short runs of ventricular tachycardia - ANSWER-(B)Coronary artery
reperfusion due to PCI or fibrinolysis results in an ELEVATION of creatinine
kinase (CK) or troponin, not decrease. The theory is that the return of blood flow
distal to the occlusion can result in 'reperfusion injury' of the muscle, elevating
cardiac biomarkers.
The other 3 choices are indicators of reperfusion: Pain cessation, reversal of ST
segment elevation with return to baseline, short runs of ventricular tachycardia.
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 1
,Which of the following medication orders should the nurse question for the
patient in question 1-reperfusion question-patient having an MI?
(A) metoprolol (Lopressor)
(B) aspirin
(C) propranolol (Inderal)
(D) heparin - ANSWER-(C) The patient in the scenario is having an acute anterior
wall MI. A beta blocker is beneficial for an acute MI as these agents decrease the
work of the heart and increase the threshold for ventricular fibrillation.
Propranolol, although a beta-andrenergic blocker like metoprolol, is NOT a
cardioselective beta blocker. It affects beta receptors in heart muscle AND lung
tissue. Therefore, it is more likely to cause bronchoconstriction than a
cardioselective beta blocker.
The other 3- cardioselective beta blocker, antiplatelet, and anticoagulation-are
indicated in an acute MI.
If heart block develops while caring for the patient in question 1 (pt with an MI
who went through reperfusion from PCI or fibrinolytic therapy), which of the
following would it most likely be?
(A) sinoatrial block
(B) second degree, Type I
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 2
, (C) second degree, Type II
(D) third degree, complete - ANSWER-(C) The patient is having an acute anterior
MI, which is generally due to LAD occlusion. The LAD supplies the HIS bundle,
which could result in a second-degree, type II heart block. The other 3 types are
due to SA node or AV node ischemia, which generally occur with an RCA
occlusion — interior wall MI.
Appropriate drug therapy for dilated cardiomyopathy is aimed toward:
(A) decreasing contractility and decreasing preload and afterload
(B) decreasing contractility and increasing preload and afterload
(C) increasing contractility and increasing both preload and afterload
(D) increasing contractility and decreasing both preload and afterload - ANSWER-
(D) Dilated cardiomyopathy is likely to result in systolic dysfunction, which
decreases contractility, causes compensatory arterial constriction , and results in a
higher left ventricular preload. To treat this, therapy is aimed at increasing
contractility, decreasing afterload (arterial constriction), and decreasing preload that
is too high.
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?
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 3
