CCRN PRACTICE Exam Latest Update 2024 |
CCRN Practice Actual Exam 2024 Questions
and Correct Answers Rated A+
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
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
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
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 hypoperfusion (e.g., cool skin, decreased urine
output, narrowed pulse pressure, and hypotension).
A patient has just returned from the cath lab. She had an angioplasty for
occlusion of her RCA. She still has femoral artery and vein sheaths in
place. The patient complains of chest pain that she rates 9/10 about an
hour after she returns from the cath lab. Which of the following is indicated?
A. Administer morphine IV.
B. Administer nitroglycerin sublingual spray.
C. Stop the heparin.
D. Notify the physician -ANSWER-D
New-onset severe chest pain after percutaneous coronary intervention
suggests acute closure of the dilated coronary artery. The patient needs to
be returned to the cardiac catheterization laboratory for repeat dilation and
probable insertion of stent.
A 35-year-old woman underwent a mitral valve replacement. Her chest
tube output has been approximately 125 mL/hr for the last 3 hours, and
now the drainage has ceased suddenly. The immediate assessment
, reveals a significant decrease in BP, RAP 12, PAP 30/15 , PAOP 13. What
other data would indicate the development of cardiac tamponade?
A. Increased venous oxygen saturation (SvO2)
B. Decreased UO
C. Muffled heart sounds
D. New holosystolic murmur at the sternum -ANSWER-C
Muffled heart sounds are a classic finding in cardiac tamponade.
Remember the classic indications of cardiac tamponade referred to as
Beck's triad: muffled heart sounds, jugular venous distention, and
hypotension. Even though urine output is a sensitive indicator of cardiac
output and in cardiac tamponade a decreased stroke volume results in a
decreased cardiac output, by the time a nurse would notice the decreased
urine output, the patient may have already had a cardiopulmonary arrest.
The SvO2 actually would decrease because of the decrease in cardiac
output. New holosystolic murmur at the lower left sternal border is a sign of
ventricular septal rupture.
A patient has had an inferior MI. He now has a new holosystolic murmur at
apex, acute severe dyspnea, decreased cardiac index, and a normal
cardiac silhouette on x-ray. Which of the following complications most likely
is occurring in this patient?
A. Acute mitral regurgitation
B. Rupture of left ventricular free wall
C. Ventricular septal rupture
D. Acute aortic stenosis -ANSWER-A
With an inferior MI, the risk of the papillary muscles being affected is
greater. The papillary muscles of the LV maintain normal mitral valve fxn. If
damaged, acute mitral regurgitation occurs and is manifested by a new
holosystolic murmur at the apex, acute pulmonary edema, and decreased
cardiac output/index
A patient with HF caused by diastolic dysfunction is prescribed carvedilol
(Coreg). What type of drug is carvedilol?
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