CCRN EXAM |ACTUAL QUESTIONS AND VERIFIED
ANSWERS 2026-2027 UPDATED EDITION|GRADED
A+
Question 1
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
CORRECT 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.
Question 2
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
CORRECT ANSWER
1
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, (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.
Question 3
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
(C) second degree, Type II
(D) third degree, complete
CORRECT 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.
Question 4
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
2
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, CORRECT 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.😃
Question 5
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?
(A) sodium
(B) magnesium
(C) potassium
(D) calcium
CORRECT ANSWER
(A) Abnormal sodium does NOT cause QT prolongation. In contrast, a low magnesium,
potassium, or calcium, may cause QT prolongation and may result in TORSADES DE
POINTES ventricular tachycardia and, if self-limiting, transient syncopal episodes.
Question 6
On the third day after admission for acute MI, a 67 year old male complains of chest pain
and develops a fever. The pain is worse with deep inspiration and is relieved when he
leans forward. There are nonspecific ST changes in the precordial leads of the EKG. The
nurse anticipates that the patient will most likely need treatment for:
(A) thoracic aneurysm
(B) Dressler's syndrome
(C) reinfarction
(D) pleuritis
3
@https://www.stuvia.com/user/thestudyvault
ANSWERS 2026-2027 UPDATED EDITION|GRADED
A+
Question 1
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
CORRECT 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.
Question 2
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
CORRECT ANSWER
1
@https://www.stuvia.com/user/thestudyvault
, (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.
Question 3
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
(C) second degree, Type II
(D) third degree, complete
CORRECT 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.
Question 4
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
2
@https://www.stuvia.com/user/thestudyvault
, CORRECT 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.😃
Question 5
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?
(A) sodium
(B) magnesium
(C) potassium
(D) calcium
CORRECT ANSWER
(A) Abnormal sodium does NOT cause QT prolongation. In contrast, a low magnesium,
potassium, or calcium, may cause QT prolongation and may result in TORSADES DE
POINTES ventricular tachycardia and, if self-limiting, transient syncopal episodes.
Question 6
On the third day after admission for acute MI, a 67 year old male complains of chest pain
and develops a fever. The pain is worse with deep inspiration and is relieved when he
leans forward. There are nonspecific ST changes in the precordial leads of the EKG. The
nurse anticipates that the patient will most likely need treatment for:
(A) thoracic aneurysm
(B) Dressler's syndrome
(C) reinfarction
(D) pleuritis
3
@https://www.stuvia.com/user/thestudyvault
