CCRN adult EXAM A+ GRADE ASSURED COMPLETE SOLUTIONS AND VERIFIED ANSWERS

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Exam Solution vc




CCRN 2026 A+ GRADE ASSURED COMPLETE SOLUTIONS vc vc vc vc vc vc vc




AND VERIFIED ANSWERS (63BF8) vc vc vc




QUESTION 1 vc




A patient in the ED with complaints of chest pain. The 12-
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lead EKG shows ST elevation in leads V3 and V4. Occlusion of the affected coronary arter
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y most likely would affect perfusion to which portion of the conduction system?
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A. Sinoatrial (SA) node
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B. Bachmann's bundle
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C. Atrioventricular (AV) node
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D. Bundle of His
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ANSWER

LAD so vc



D. bundle of his
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QUESTION 2 vc




Which of the following is the preferred lead for ST segment monitoring for a patient with
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a suspected RCA occlusion? A.I
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B. aVR vc



C. III vc



D. V1 vc




ANSWER

c. III
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QUESTION 3 vc




Which of the following is not a manifestation of hypertrophic cardiomyopathy?
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A. Syncopevc



B. Murmur that increases with squatting
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C. Chest pain
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D. Sudden cardiac death
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,ANSWER

*B Classic manifestations of hypertrophic cardiomyopathy are chest pain, syncope, and an aortic stenosi
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s type of murmur that decreases when the patient is in a squatting position. The first manifestation of t
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his condition is occasionally sudden cardiac death during exercise.
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QUESTION 4 vc




In which quadrant is the mean QRS complex axis located if the QRS complex is predomin
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antly positive in lead I and negative in lead aVF?
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A. Normal quadrant
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B. Left axis deviation quadrant
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C. Right axis deviation quadrant
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D. Indeterminant quadrant
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ANSWER

*B Because the positive of lead I is the left arm, if the QRS complex is upright in lead I, the mean QRS ax
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is is to the left. Because the positive of lead aVF (a unipolar lead) is at the foot, if the QRS complex is ne
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gative in lead aVF, the mean QRS axis is upward away from the foot. This axis would be in the upper left
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quadrant, described as left axis deviation.
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QUESTION 5 vc




A patient becomes apneic and pulseless. CPR has been initiated, and the monitor shows a
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systole in two leads. Which of the following drugs would be used initially?
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A. Calcium gluconate
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B. Atropinevc



C. Epinephrine
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D. Amiodarone (Cordarone)
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ANSWER

C After CPR is initiated and an intravenous access is established, epinephrine should be given. Calcium
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was used in the past in asystole but is used today only for hypocalcemia, calcium channel blocker toxicit
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y, hyperkalemia, and hypermagnesemia. Atropine is no longer recommended for asystole. Amiodarone is
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not indicated in asystole because asystole is the absolute absence of irritability.
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QUESTION 6 vc




What is associated w/ Mitral Stenosis
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A. Pinkish discoloration of the cheeks
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B. Systolic murmur
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C. Widened pulse pressure
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D. Narrow pulse pressure
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ANSWER

, A Patients with mitral stenosis may exhibit a pinkish discoloration of the cheeks (i.e., malar blush). Mitr
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al stenosis causes a diastolic murmur. Widened pulse pressure is associated with aortic regurgitation. N
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arrowed pulse pressure is associated with mitral regurgitation.
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QUESTION 7 vc




Four days after a mitral valve replacement, the patient develops atrial fibrillation. The n
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urse initially would:
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A. order a 12-lead EKG
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B. evaluate the patient for clinical indications of hypoperfusion.
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C. notify the physician.
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D. ask the patient to bear down as if having a bowel movement.
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ANSWER

B The onset of atrial fibrillation results in the loss of atrial kick. Loss of atrial kick may reduce the cardi
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ac output by as much as 20-
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30%. This is especially true in patients whose cardiac output may be affected by long-
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standing cardiac disease, such as mitral valve disease. Assess the patient for clinical indications of hypop
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erfusion (e.g., cool skin, decreased urine output, narrowed pulse pressure, and hypotension).
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QUESTION 8 vc




A patient has had an inferior MI. He now has a new holosystolic murmur at apex, acute s
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evere dyspnea, decreased cardiac index, and a normal cardiac silhouette on x-
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ray. Which of the following complications most likely is occurring in this patient?
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A. Acute mitral regurgitation
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B. Rupture of left ventricular free wall
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C. Ventricular septal rupture
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D. Acute aortic stenosis
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ANSWER

A With an inferior MI, the risk of the papillary muscles being affected is greater. The papillary muscles o
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f the LV maintain normal mitral valve fxn. If damaged, acute mitral regurgitation occurs and is manifeste
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d by a new holosystolic murmur at the apex, acute pulmonary edema, and decreased cardiac output/ind
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ex



QUESTION 9 vc




A patient with HF caused by diastolic dysfunction is prescribed carvedilol (Coreg). What
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type of drug is carvedilol?
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A. Calcium channel blocker
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B. Angiotensin-converting enzyme inhibitor
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C. Alpha- and noncardioselective beta-blocker
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D. Cardioselective beta-blocker
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ANSWER