CCRN PRACTICE QUESTIONS
A 62-year-old man is admitted with chest pain. His electrocardiogram reveals ST
segment elevation and T wave inversion in leads V1 to V4. Aspirin has been given, and
morphine titration and nitroglycerin infusion are used to relieve his chest pain. The
patient suddenly develops a loud holosystolic murmur at the lower left sternal border,
chest pain, and hypotension 5 days after his myocardial infarction. A pulmonary artery
catheter is inserted. Which of the following parameters would be noted in this patient?
A.
Increase in venous oxygen saturation (SvO2)
B.
Decrease in pulmonary artery occlusive pressure (PAOP)
C.
Decrease in cardiac output
D.
Increase in systolic blood pressure (BP) - Answer .
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 - Answer
Which of the following would not be expected in a postoperative cardiac surgery patient
with a cardiac tamponade?
A.
Muffled heart sounds
B.
Increase in drainage from the mediastinal tube
, C.
Jugular venous distention (JVD)
D.
Pulsus paradoxus - Answer
A patient with acute anterior myocardial infarction develops a third-degree
atrioventricular block with a ventricular escape rhythm with a rate of 38 beats/min. What
would be the best immediate intervention?
A.
Atropine 1 mg
B.
Transcutaneous pacemaker
C.
Transvenous pacemaker
D.
Epinephrine 1 mg - Answer
An aortic tear commonly is associated with which of the following?
A.
Acceleration-deceleration injury
B.
Barotrauma
C.
Penetrating injury of the chest wall
D.
Blunt force injury to the chest wall - Answer
Which of the following is the preferred lead for ST segment monitoring for a patient with
a suspected right coronary artery occlusion?
A.I
B. aVR
C. III
D. V1 - Answer
,A 55-year-old man with a long history of alcoholism continues to drink alcohol and now
has alcoholic cardiomyopathy, a form of dilated cardiomyopathy. Which of the following
statements about dilated cardiomyopathy is incorrect?
A.It was previously called idiopathic hypertrophic subaortic stenosis.
B. It causes gross enlargement of the heart.
C. It interferes with systolic ejection function.
D. It causes signs and symptoms of heart failure. - Answer
A 72-year-old man arrived in the emergency department after 4 hours of substernal pain
radiating to the left arm. He has a 100 pack-year history of cigarette smoking, chronic
obstructive pulmonary disease, and intermittent claudication. His electrocardiogram on
admission shows sinus tachycardia with a rate of 120 beats/min and ST segment
elevation in leads I, AVL, and V3 to V6. Vital signs include blood pressure, 150/84 mm
Hg; respiratory rate, 15 breaths/min; functional oxygen saturation (SpO2), 95%; and
temperature, 38.3° C (100.9° F). Which of the following treatments would not be
indicated for this patient at this time?
A.
Morphine and nitroglycerin
B.
Aspirin and fibrinolytic drugs
C.
Beta-blockers
D.
Lidocaine - Answer
Which of the following describes the pulse pressure of a patient with aortic
regurgitation?
A.
30-40 mm Hg
B.
Less than 30 mm Hg
C.
More than 40 mm Hg
D.
, Varies with phase of respiratory cycle - Answer
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. Cardiopulmonary resuscitation (CPR) has
been initiated, and the monitor shows asystole in two leads. Which of the following
drugs would be used initially?
A.
Calcium gluconate
A 62-year-old man is admitted with chest pain. His electrocardiogram reveals ST
segment elevation and T wave inversion in leads V1 to V4. Aspirin has been given, and
morphine titration and nitroglycerin infusion are used to relieve his chest pain. The
patient suddenly develops a loud holosystolic murmur at the lower left sternal border,
chest pain, and hypotension 5 days after his myocardial infarction. A pulmonary artery
catheter is inserted. Which of the following parameters would be noted in this patient?
A.
Increase in venous oxygen saturation (SvO2)
B.
Decrease in pulmonary artery occlusive pressure (PAOP)
C.
Decrease in cardiac output
D.
Increase in systolic blood pressure (BP) - Answer .
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 - Answer
Which of the following would not be expected in a postoperative cardiac surgery patient
with a cardiac tamponade?
A.
Muffled heart sounds
B.
Increase in drainage from the mediastinal tube
, C.
Jugular venous distention (JVD)
D.
Pulsus paradoxus - Answer
A patient with acute anterior myocardial infarction develops a third-degree
atrioventricular block with a ventricular escape rhythm with a rate of 38 beats/min. What
would be the best immediate intervention?
A.
Atropine 1 mg
B.
Transcutaneous pacemaker
C.
Transvenous pacemaker
D.
Epinephrine 1 mg - Answer
An aortic tear commonly is associated with which of the following?
A.
Acceleration-deceleration injury
B.
Barotrauma
C.
Penetrating injury of the chest wall
D.
Blunt force injury to the chest wall - Answer
Which of the following is the preferred lead for ST segment monitoring for a patient with
a suspected right coronary artery occlusion?
A.I
B. aVR
C. III
D. V1 - Answer
,A 55-year-old man with a long history of alcoholism continues to drink alcohol and now
has alcoholic cardiomyopathy, a form of dilated cardiomyopathy. Which of the following
statements about dilated cardiomyopathy is incorrect?
A.It was previously called idiopathic hypertrophic subaortic stenosis.
B. It causes gross enlargement of the heart.
C. It interferes with systolic ejection function.
D. It causes signs and symptoms of heart failure. - Answer
A 72-year-old man arrived in the emergency department after 4 hours of substernal pain
radiating to the left arm. He has a 100 pack-year history of cigarette smoking, chronic
obstructive pulmonary disease, and intermittent claudication. His electrocardiogram on
admission shows sinus tachycardia with a rate of 120 beats/min and ST segment
elevation in leads I, AVL, and V3 to V6. Vital signs include blood pressure, 150/84 mm
Hg; respiratory rate, 15 breaths/min; functional oxygen saturation (SpO2), 95%; and
temperature, 38.3° C (100.9° F). Which of the following treatments would not be
indicated for this patient at this time?
A.
Morphine and nitroglycerin
B.
Aspirin and fibrinolytic drugs
C.
Beta-blockers
D.
Lidocaine - Answer
Which of the following describes the pulse pressure of a patient with aortic
regurgitation?
A.
30-40 mm Hg
B.
Less than 30 mm Hg
C.
More than 40 mm Hg
D.
, Varies with phase of respiratory cycle - Answer
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. Cardiopulmonary resuscitation (CPR) has
been initiated, and the monitor shows asystole in two leads. Which of the following
drugs would be used initially?
A.
Calcium gluconate
