CCRN Barron's EXAM with complete
solutions 2024/2025
"high dose" dopamine causes vasoconstriction and
(C) Increase afterload - ANSWER-What is the primary hemodynamic effect of:
Dopamine >10 mcg/kg/min
(A) Increase preload
(B) Decrease preload
(C) Increase afterload
(D) Decreased afterload
(E) Increase contractility
(D) Decrease contractility
Pulmonary HTN and cor pulmonale;
Mitral, aortic, or tricuspid insufficiency - ANSWER-What causes the S3 sound?
during diastole - ANSWER-When are coronary arteries perfused?
S3 heart sound - ANSWER-What may you hear before crackles when a patient is
going into heart failure?
,Variant or Prinzmetal's Angina - ANSWER-What is this called?
Unstable angina with transient ST segment elevation
Can occur at rest or may be cyclic (occurring at the same time daily)
troponin negative
Can be precipitated by nicotine, coke, or ETOH
RCA, inferior LV - ANSWER-There are changes in leads II, III, aVF....what type of
MI?
LAD, anterior LV - ANSWER-There are changes in leads V1, V3 V3, V4
circumflex, lateral LV - ANSWER-There are changes in leads V5, V6, I, aVL
Low lateral LB - ANSWER-There are changes in leads V5, V6
high lateral LB - ANSWER-There are changes in leads I aVL
RCA, posterior LV - ANSWER-There are changes in leads V1 and V2
RCA, right ventricular infarct - ANSWER-There are changes in leads V3R, V4R
Marked ELEVATION of troponin/CK-MB: due to miocardial stunning when vessel
opens
reperfusion arrhythmias: VT, Vfib, accelerated idioventricular rhythm (due to
stunning)
resolution of ST segment deviations
Chest pain relief - ANSWER-What are some signs of reperfusion following
fibrinolytic treatment of a STEMI?
contact the physician. Could be coronary artery re-occlusion/stent thrombosis. -
ANSWER-Your patient just had a percutaneous coronary intervention (PCI)
(stenting) less than 24 hours ago:
, He is experiencing unrelenting chest pain, his EKG shows ST elevation. What
should you do? What could be happening?
retroperitoneal bleeding is most likely. Give fluids/blood - ANSWER-Your patient
just had a percutaneous coronary intervention (PCI) (stenting) less than 24 hours
ago:
He is experiencing sudden low severe back pain and becomes hypotensive. What
is happening?
>1 (get by dividing ankle pressure by brachial pressure on the same side) -
ANSWER-what is a normal ankle-brachial index (ABI)?
do not elevate the affected extremity, it will decrease perfusion
Put bed in reverse trendelenburg - ANSWER-Your patient has PAD and just had a
bypass graft. How should you care for the extremity? How should the HOB be?
torsades - ANSWER-prolonged QT can lead to what deadly rhythm?
Amiodarone
Haldol
Quinidine
Procainamide
Low mag, calcium, or potassium - ANSWER-Causes of prolonged QT
Amiodarone 150 mg IV over 10 min; Prepare for elective synchronized
cardioversion. - ANSWER-Your patient has a pacemaker and has gone into Vtach.
The pacemaker does not correct the rhythm and your patient goes unresponsive.
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