CCRN EXAM QUESTIONS AND
ANSWERS GRADED A+ 2025/2026
DI Patho - ANS low ADH > large volume dilute urine. Increased serum solute l/t increased
serum Osm >280. Don't further increase oSmo, ONLY replace with HYPOtonic fluid. Tx with
Pitressin
SIADH - ANS excess salt/fluid retention, dilutional hyponatremia decreased serum oSmo,
elevated urine specific gravity ELEVATED BUN. Don't further dilute ONLY replace w/HYPERtonic.
Tx dilantin.
Poor Self-Esteem - ANS encourage participation in pt care
Grey Turner Sign - ANS flank ecchymosis indicating RPB
ABD Compartment Syndrome - ANS mass fluid sequestration l/t severe life threatening
hypovolemia. Causes acute increase in ICP
Peritonitis Tx - ANS priority is Sx, then Abx, NGT, opiates
Hypoglycemia S/S - ANS secondary to SNS activation > tachycardia, flushed dry skin,
diaphoresis, irritability
MVR - ANS heard at APEX during systole, associated with INFERIOR wall MI. Giant V waves on
wedge pressure. Also d/t DHF d/t pressure backing up from LV inability to pump forward
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
, Lateral Wall AMI - ANS leads v5-v6 (low) also I and aVL (high). Causes LV dysfx. Tx reduce
preload and afterload. LCA occlusion
Prerenal failure - ANS 10:1 BUN/CR ratio, kidneys can still retain sodium > l/t low urine na
high urine Osmo
Acute Pancreatitis - ANS hypokalemia, risk of hemorrhagic shock, risk of ARDS. Elevated
serum Lipase, HYPOcalcemia. CXR LLL consolidation, cullen's sign
Acute SAH - ANS explosive HA, nuchal rigidity, decreased LOC, positive kernig sign. D/t tumor,
trauma or anyerysm rupture along middle cerebral artery
Inferior Wall MI - ANS STE leads ii, iii, aVf reciprocal (I, aVl). Supplies Mitral Valve > may l/t
acute papillary rupture (MVR). BRADYarrythmias common, risk for CHB. High risk RCA occlusion
(v1,v2)
DHF Tx Goals - ANS DECREASE lv WALL STRESS, slow hr TO increase FILLING. O2, CCB, BB,
diuretics
Anterior Wall AMI - ANS aka (widow maker) supplies blood to LAD (bundle of his)> high risk
VSD. STE leads v1, v2, v3, v4 (reciprocal ii, iii, aVf). Associated with 2nd degree AVB type 2, or
new onset RBBB (OMINOUS sign). high risk acute decompensated HF (Cardiogenic Shock)
ventricular septal defect - ANS d/t anterior wall (LAD) occlusion. Loud holo-systolic murmur
heard loudest at left sternal border 5ICS. S/S crackles, tachypnea, high RV venous sat d/t
shunting
Nitroprusside - ANS indicated for hypertensive emergency/crisis WITHOUT s/s of cardiac
ischemia. Preload/Afterload reducer (LVH/preeclampsia)
Normotensive a-fib Tx - ANS CCB and digoxin and or anti coagulation
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
ANSWERS GRADED A+ 2025/2026
DI Patho - ANS low ADH > large volume dilute urine. Increased serum solute l/t increased
serum Osm >280. Don't further increase oSmo, ONLY replace with HYPOtonic fluid. Tx with
Pitressin
SIADH - ANS excess salt/fluid retention, dilutional hyponatremia decreased serum oSmo,
elevated urine specific gravity ELEVATED BUN. Don't further dilute ONLY replace w/HYPERtonic.
Tx dilantin.
Poor Self-Esteem - ANS encourage participation in pt care
Grey Turner Sign - ANS flank ecchymosis indicating RPB
ABD Compartment Syndrome - ANS mass fluid sequestration l/t severe life threatening
hypovolemia. Causes acute increase in ICP
Peritonitis Tx - ANS priority is Sx, then Abx, NGT, opiates
Hypoglycemia S/S - ANS secondary to SNS activation > tachycardia, flushed dry skin,
diaphoresis, irritability
MVR - ANS heard at APEX during systole, associated with INFERIOR wall MI. Giant V waves on
wedge pressure. Also d/t DHF d/t pressure backing up from LV inability to pump forward
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
, Lateral Wall AMI - ANS leads v5-v6 (low) also I and aVL (high). Causes LV dysfx. Tx reduce
preload and afterload. LCA occlusion
Prerenal failure - ANS 10:1 BUN/CR ratio, kidneys can still retain sodium > l/t low urine na
high urine Osmo
Acute Pancreatitis - ANS hypokalemia, risk of hemorrhagic shock, risk of ARDS. Elevated
serum Lipase, HYPOcalcemia. CXR LLL consolidation, cullen's sign
Acute SAH - ANS explosive HA, nuchal rigidity, decreased LOC, positive kernig sign. D/t tumor,
trauma or anyerysm rupture along middle cerebral artery
Inferior Wall MI - ANS STE leads ii, iii, aVf reciprocal (I, aVl). Supplies Mitral Valve > may l/t
acute papillary rupture (MVR). BRADYarrythmias common, risk for CHB. High risk RCA occlusion
(v1,v2)
DHF Tx Goals - ANS DECREASE lv WALL STRESS, slow hr TO increase FILLING. O2, CCB, BB,
diuretics
Anterior Wall AMI - ANS aka (widow maker) supplies blood to LAD (bundle of his)> high risk
VSD. STE leads v1, v2, v3, v4 (reciprocal ii, iii, aVf). Associated with 2nd degree AVB type 2, or
new onset RBBB (OMINOUS sign). high risk acute decompensated HF (Cardiogenic Shock)
ventricular septal defect - ANS d/t anterior wall (LAD) occlusion. Loud holo-systolic murmur
heard loudest at left sternal border 5ICS. S/S crackles, tachypnea, high RV venous sat d/t
shunting
Nitroprusside - ANS indicated for hypertensive emergency/crisis WITHOUT s/s of cardiac
ischemia. Preload/Afterload reducer (LVH/preeclampsia)
Normotensive a-fib Tx - ANS CCB and digoxin and or anti coagulation
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
