CCRN- CRITICAL CARE REGISTERED NURSE PRACTICE QUESTIONS – CARDIOVASCULAR
CCRN- Critical Care Registered Nurse Practice
Questions – Cardiovascular 2024/2025
Completely Solved 100%/ Verified
A Patient Is In Cardiac And Respiratory Arrest. The Selection Of Medications To Re-
establish Cardiac Function Would Stimulate The Sympathetic Nervous System Beta1
Receptors. This Stimulation Would Result In Increased Automaticity And Which Of
The Following?
A. INCREASED MYOCARDIAL CONTRACTILITY
B. Decreased Left Ventricular Stroke Work
C. Decreased Myocardial Oxygen Consumption
D. Increased Left Ventricular Afterload
RATIONALE: The Sympathetic Nervous System Contains Alpha, Beta, And
Dopaminergic Receptors That Produce Various Responses When Stimulated.
Stimulation Of Beta1 Receptors Increases Heart Rate, Conductivity, And Myocardial
Contractility. Stimulation Of Beta2 Receptors Produces Vasodilation And
Bronchodilation. Alpha Receptors, When Stimulated, Produce Vasoconstriction.
Stimulation Of Dopaminergic Receptors Produces A Vasodilating Effect On Renal,
Mesenteric, Coronary, And Cerebral Vessels. Test-Taking Strategy: Note The Helpful
Clue In The Stem: Stimulate The Sympathetic System And Recall That This Results
In A Fight-Or-Flight Response—The Body Is Responding To Survive. Stroke Volume
Would Increase, So Eliminate Option B. Afterload Would Increase, But This Is Due To
Alpha Stimulation, Not Beta1 Stimulation, So Eliminate Option D. Because The Heart
Is Working Faster And Harder, The Myocardial Oxygen Consumption Does Increase,
So Eliminate Option C. Remember That The Primary Effects Of Beta1 Receptors Are
To Increase Heart Rate, Contractility, And Rate Of Conduction. Choose Option A. A
Memory Aid That Also May Help Is This: Beta 1 Beta 2, 1 Heart 2 Lungs: Beta1
Affects The Heart, And Beta2 Affects The Lungs.
A Patient Arrived In The Emergency Department With Complaints Of Chest Pain.
The 12-Lead Electrocardiogram Shows St Segment 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
, CCRN- CRITICAL CARE REGISTERED NURSE PRACTICE QUESTIONS – CARDIOVASCULAR
RATIONALE: St Segment Elevation In Leads V3 And V4 Indicates Injury To The
Anterior Wall, Which Would Occur With Occlusion Of The Left Anterior Descending
(Lad) Artery. In Most Persons, The Sa Node, Bachmann's Bundle, And Av Node Are
Supplied By The Right Coronary Artery. The Bundle Of His Is Supplied By The Left
Anterior Descending Artery. This Is Why An Anterior Myocardial Infarction May
Cause Type Ii Second-Degree Av Block Or Third-Degree Av Heart Block At The Level
Of The Bundle Of His. Test-Taking Strategy: Note That Options A, B, And C Are Part
Of The Supraventricular Conduction System. They Usually Are Supplied By The
Right Coronary Artery. The Lad Artery Supplies Most Of The Interventricular
Conduction System, Including The Bundle Of His And The Bundle Branches.
Oxygen Delivery (Do2) Is The Product Of Which Of The Following?
A. Pao2, Hemoglobin, Mean Arterial Pressure
B. SAO2, HEMOGLOBIN, CARDIAC OUTPUT
C. Svo2, Cardiac Index, Sao2
D. Pao2, Mean Arterial Pressure, Svo2
RATIONALE: Ninety-Seven Percent Of Oxygen Is Attached To The Hemoglobin
Molecule, So The Sao2 (Arterial Oxygen Saturation) Is A More Accurate Reflection Of
The Amount Of Oxygen In Blood. The Pao2 Represents Only The 3% That Is
Dissolved In The Plasma. The Lungs Must Put The Oxygen In The Blood, The
Hemoglobin Must Carry The Oxygen, And The Cardiac Output Is A Reflection Of
How Well The Heart Is Moving The Blood With Its Hemoglobin With Attached
Oxygen. Svo2 (Venous Oxygen Saturation) Is A Reflection Of The Oxygen Reserve.
Svo2 Is What Is Left Over After The Tissues Have Extracted What They Need. The
Mean Arterial Pressure Is A Reflection Of Organ Tissue Perfusion Pressure But Does
Not Indicate Anything About The Amount Of Oxygen In That Blood. Test-Taking
Strategy: Oxygen Is Delivered From The Arterial End, So Choose An Option That Has
Sao2 Instead Of Svo2. Also Remember That Most Oxygen Is Carried On Hemoglobin.
Look For Sao2 (Not Pao2) And Hemoglobin. The Only Option With Both Of These Is
Option B.
Which Of The Following Types Of Block Are Most Likely After An Anterior Wall
Myocardial Infarction (Mi)?
A. Sinus Block
B. Second-Degree Atrioventricular (Av) Block, Type I
C. SECOND-DEGREE AV BLOCK, TYPE II
D. Third-Degree Av Block With Junctional Escape Rhythm
, CCRN- CRITICAL CARE REGISTERED NURSE PRACTICE QUESTIONS – CARDIOVASCULAR
RATIONALE: Anterior Mi Is Caused By A Left Anterior Descending (Lad) Artery
Lesion. The Lad Artery Supplies The Bundle Of His And Bundle Branches, So
Anterior Mis May Cause Blocks Of The Bundle Of His Or Bundle Branches. Second-
Degree Av Block Type Ii Is A Block At The Level Of The Bundle Of His. If This Patient
Does Develop A Third-Degree Av Block, It Would Be At The Level Of The Bundle Of
His, And The Only Escape Rhythm Available Below The Bundle Of His Is A
Ventricular Escape Rhythm. Test-Taking Strategy: The Sinus Node Is Supplied By
Right Coronary Artery (In 55% Of People) Or Left Coronary Artery (In 45% Of
People), So Eliminate Option A. Type I Av Block, Also Called Wenckebach, Is A Block
At The Av Node, And The Av Node Is Supplied By Right Coronary Artery (In 90% Of
People) Or Left Coronary Artery (10%), So Eliminate Option B. The Lad Artery
Supplies The Bundle Of His, And Blocks In This Area Would Eliminate The
Possibility Of Junctional Escape Rhythms, So Eliminate Option D. Choose Option C.
A Patient Develops Atrial Fibrillation After Abdominal Surgery. Her Blood Pressure
Falls From 110/70 Mm Hg To 92/68 Mm Hg. The Hypotension Is Related To Which
Of The Following?
A. Decrease In Ventricular Contractility
B. Hypovolemia
C. Mural Thrombi
D. DECREASE IN VENTRICULAR FILLING
RATIONALE: The Contribution That Atrial Contraction Makes To Ventricular Filling
Volume Is Approximately 15% To 30%. Atrial Fibrillation Results In Quivering But
Not Contracting Atria. The Loss Of 15% To 30% Of Diastolic Filling Volume Reduces
Cardiac Output And Can Have Significant Hemodynamic Consequences. Although
Mural Thrombi Also Are A Problem, They Result In An Embolic Phenomenon Rather
Than A Direct Decrease In Cardiac Output. The Relationship Between The
Development Of Atrial Fibrillation And The Decrease In Cardiac Output Make
Hypovolemia And Decrease In Contractility Less Likely. Test-Taking Strategy: Relate
Recent Changes In Patient Status To Recent Occurrences. The Patient Had A Change
In Atrial Function, So Select An Option That Results In Loss Of Atrial Contraction Or
"Kick." Choose Option D.
A Shift In The Point Of Maximal Impulse (Pmi) To The Fifth Left Intercostal Space At
The Anterior Axillary Line Could Be Caused By Any Of These Conditions Except:
A. Left Ventricular Hypertrophy.
B. Right Tension Pneumothorax.
C. PERICARDIAL EFFUSION.
D. Right Pleural Effusion.
