CCRN PRACTICE QUESTIONS 2025
WITH CORRECT ANSWERS
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 - ANSWER-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
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 1
,D. V1 - ANSWER-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 - ANSWER-*B
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 - ANSWER-*B
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 2
,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
C. Epinephrine
D. Amiodarone (Cordarone) - ANSWER-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
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 3
, B. Systolic murmur
C. Widened pulse pressure
D. Narrow pulse pressure - ANSWER-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.
D. ask the patient to bear down as if having a bowel movement. - ANSWER-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
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 4
WITH CORRECT ANSWERS
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 - ANSWER-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
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 1
,D. V1 - ANSWER-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 - ANSWER-*B
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 - ANSWER-*B
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 2
,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
C. Epinephrine
D. Amiodarone (Cordarone) - ANSWER-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
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 3
, B. Systolic murmur
C. Widened pulse pressure
D. Narrow pulse pressure - ANSWER-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.
D. ask the patient to bear down as if having a bowel movement. - ANSWER-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
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 4
