Certified Cardiovascular Registered Nurse (CCRN-
Cardiac) Practice Exam Questions, Correct Answers,
and Detailed Explanations for Students||Already
Graded A+
1. A patient presents with acute chest pain radiating to the left
arm. The ECG shows ST-segment elevation in leads II, III, and aVF.
Which coronary artery is most likely occluded?
A. Left anterior descending
B. Circumflex
C. Right coronary artery
D. Left main
Rationale: Inferior STEMI (ST elevation in II, III, aVF) is most
commonly caused by occlusion of the right coronary artery.
2. A patient with heart failure presents with pulmonary edema.
Which medication should be given immediately to reduce preload?
A. Dobutamine
B. Furosemide
C. Norepinephrine
D. Digoxin
Rationale: Furosemide is a loop diuretic that reduces intravascular
volume, decreasing preload and pulmonary congestion.
3. Which electrolyte imbalance increases the risk of torsades de
pointes in a patient with prolonged QT interval?
A. Hypernatremia
B. Hypomagnesemia
,C. Hypercalcemia
D. Hyperkalemia
Rationale: Hypomagnesemia can trigger torsades de pointes,
especially in patients with QT prolongation.
4. A patient with acute decompensated heart failure has an
elevated BNP. What does BNP indicate?
A. Renal failure
B. Myocardial infarction
C. Ventricular stretch and volume overload
D. Pulmonary embolism
Rationale: BNP is released from the ventricles in response to
stretching due to volume or pressure overload.
5. Which hemodynamic parameter is most useful in assessing left
ventricular preload?
A. Cardiac index
B. Pulmonary capillary wedge pressure (PCWP)
C. Central venous pressure
D. Systemic vascular resistance
Rationale: PCWP reflects left atrial pressure and is a surrogate for left
ventricular preload.
6. A patient is receiving dobutamine for cardiogenic shock. What is
the primary effect of this drug?
A. Vasoconstriction
B. Decreased heart rate
C. Increased myocardial contractility
D. Decreased cardiac output
,Rationale: Dobutamine is a positive inotrope that increases
myocardial contractility and cardiac output.
7. Which heart sound is associated with heart failure and
represents early diastolic filling?
A. S1
B. S2
C. S3
D. S4
C. S3
Rationale: S3 (“ventricular gallop”) occurs during rapid ventricular
filling and is indicative of volume overload or heart failure.
8. A patient with chest pain has ST depression in V1-V4. This
suggests ischemia in which area?
A. Inferior wall
B. Lateral wall
C. Posterior wall
D. Right ventricle
Rationale: ST depression in anterior leads can indicate posterior wall
ischemia, as posterior infarctions often present with reciprocal
changes.
9. Which anticoagulant directly inhibits thrombin?
A. Warfarin
B. Dabigatran
C. Heparin (indirect)
D. Clopidogrel
, Rationale: Dabigatran is a direct thrombin inhibitor, preventing
conversion of fibrinogen to fibrin.
10. A patient with an acute MI develops hypotension, elevated
jugular venous pressure, and muffled heart sounds. What is the
likely complication?
A. Cardiogenic shock
B. Ventricular septal rupture
C. Cardiac tamponade
D. Pulmonary embolism
Rationale: Beck’s triad (hypotension, JVD, muffled heart sounds)
indicates cardiac tamponade.
11. Which medication is first-line for rate control in atrial
fibrillation in a patient with reduced ejection fraction?
A. Diltiazem
B. Digoxin
C. Verapamil
D. Metoprolol
Rationale: Digoxin is preferred in heart failure patients because
calcium channel blockers may worsen systolic dysfunction.
12. A patient has a pacemaker. Which rhythm indicates proper
capture?
A. P wave preceding QRS without pacemaker spikes
B. Pacemaker spike without QRS
C. Pacemaker spike followed by QRS complex
D. Irregular QRS complexes without pacemaker spike
Cardiac) Practice Exam Questions, Correct Answers,
and Detailed Explanations for Students||Already
Graded A+
1. A patient presents with acute chest pain radiating to the left
arm. The ECG shows ST-segment elevation in leads II, III, and aVF.
Which coronary artery is most likely occluded?
A. Left anterior descending
B. Circumflex
C. Right coronary artery
D. Left main
Rationale: Inferior STEMI (ST elevation in II, III, aVF) is most
commonly caused by occlusion of the right coronary artery.
2. A patient with heart failure presents with pulmonary edema.
Which medication should be given immediately to reduce preload?
A. Dobutamine
B. Furosemide
C. Norepinephrine
D. Digoxin
Rationale: Furosemide is a loop diuretic that reduces intravascular
volume, decreasing preload and pulmonary congestion.
3. Which electrolyte imbalance increases the risk of torsades de
pointes in a patient with prolonged QT interval?
A. Hypernatremia
B. Hypomagnesemia
,C. Hypercalcemia
D. Hyperkalemia
Rationale: Hypomagnesemia can trigger torsades de pointes,
especially in patients with QT prolongation.
4. A patient with acute decompensated heart failure has an
elevated BNP. What does BNP indicate?
A. Renal failure
B. Myocardial infarction
C. Ventricular stretch and volume overload
D. Pulmonary embolism
Rationale: BNP is released from the ventricles in response to
stretching due to volume or pressure overload.
5. Which hemodynamic parameter is most useful in assessing left
ventricular preload?
A. Cardiac index
B. Pulmonary capillary wedge pressure (PCWP)
C. Central venous pressure
D. Systemic vascular resistance
Rationale: PCWP reflects left atrial pressure and is a surrogate for left
ventricular preload.
6. A patient is receiving dobutamine for cardiogenic shock. What is
the primary effect of this drug?
A. Vasoconstriction
B. Decreased heart rate
C. Increased myocardial contractility
D. Decreased cardiac output
,Rationale: Dobutamine is a positive inotrope that increases
myocardial contractility and cardiac output.
7. Which heart sound is associated with heart failure and
represents early diastolic filling?
A. S1
B. S2
C. S3
D. S4
C. S3
Rationale: S3 (“ventricular gallop”) occurs during rapid ventricular
filling and is indicative of volume overload or heart failure.
8. A patient with chest pain has ST depression in V1-V4. This
suggests ischemia in which area?
A. Inferior wall
B. Lateral wall
C. Posterior wall
D. Right ventricle
Rationale: ST depression in anterior leads can indicate posterior wall
ischemia, as posterior infarctions often present with reciprocal
changes.
9. Which anticoagulant directly inhibits thrombin?
A. Warfarin
B. Dabigatran
C. Heparin (indirect)
D. Clopidogrel
, Rationale: Dabigatran is a direct thrombin inhibitor, preventing
conversion of fibrinogen to fibrin.
10. A patient with an acute MI develops hypotension, elevated
jugular venous pressure, and muffled heart sounds. What is the
likely complication?
A. Cardiogenic shock
B. Ventricular septal rupture
C. Cardiac tamponade
D. Pulmonary embolism
Rationale: Beck’s triad (hypotension, JVD, muffled heart sounds)
indicates cardiac tamponade.
11. Which medication is first-line for rate control in atrial
fibrillation in a patient with reduced ejection fraction?
A. Diltiazem
B. Digoxin
C. Verapamil
D. Metoprolol
Rationale: Digoxin is preferred in heart failure patients because
calcium channel blockers may worsen systolic dysfunction.
12. A patient has a pacemaker. Which rhythm indicates proper
capture?
A. P wave preceding QRS without pacemaker spikes
B. Pacemaker spike without QRS
C. Pacemaker spike followed by QRS complex
D. Irregular QRS complexes without pacemaker spike
