NEWEST CCRN EXAM CRAM ACTUAL EXAM LATEST 2025 WITH COMPLETE REAL QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (100% CORRECT VERIFIED SOLUTIONS) A NEW UPDATED VERSION

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CCRN Exam Notesb b




Whichb ofb theb followingb doesb notb predisposeb theb patientb tob digitalisb toxicity?b Hyponatremia
.
Rememberbthatbpotassium,bcalcium,bandbmagnesiumbaffectbcardiacbcontractility,
Whichbsinglebleadbisbthebmostbvaluablebforbthebdiagnosisbofbventricularbtachycardia?bV1


Cardio

Sites of MIs
b b


b Inferior MI - b b


Right Coronary (RC), associated with papillarymuscle ruputu
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re
Indicative Changes: II, III, b b b b


aVFReciprocal Changes: I, b b b


AVL b




Anterior MI - b b

Left Anterior Descending (LAD), associated with
b b b b b b

ventricular septal ruputure (holosystic murmur)
b b b b


Indicative Changes: V2, V3, V4Reci b b b b b


procal Changes: II, III, AVF b b b b




Septal Wall - b b


Left Anterior Descending (LAD)Ind
b b b b b


icative Changes: V1 , sometimes V2 b b b b b


Reciprocal Changes: V5, V6
b b b b




Lateral MI - b b


Circumflex Artery Indicative
b b b b


Changes: I, AVL, V5, V6Recipr b b b b b


ocal Changes: II, III, AVF b b b b




Posterior Wall MI - b b b


Right coronary, if dominantIndicative
b b b b b b


Changes: V7, V8, V9 b b b


Reciprocal Changes: V1, V2, V3 b b b b


**Remember posterior Wall MI has leads that are high numbers, post mean
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s after soassociate these two
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• murmur is loudest at the apex, and the clinical presentation is related to acute
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, 2


pulmonary edema.
b




Cardiac Values
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, 3



Swanz gaz – measures pressure , cardiac output , and oxygen
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PAOP 6-12mmHg (left atrial pressures = left ventricular end-
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diastolic pressure)(aka left ventricular preload) PAWP (pulmonary artery wedge pre
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ssure) 4-12mmHG (in the pulmonaryartery), inflate for 3-
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5 seconds and will have direct measurement of from back pressure.
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PAOP or PAWP <4 = hypovolemic p
b b b b b b




atientPAOP or PAWP >4 = hypervole
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mic patient b




The PAd is normally 2 to 5 mm Hg higher than the PAOP. PAd may be more than 5
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mm Hg higher than the PAOP in patients with pulmonary hypertension. If the PAO
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P is higher than the PAd, suspect that there is an occlusion in the catheter or that
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the catheter is not in the correctarea of the pulmonary vasculature. The RAP is no
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rmally lower than the PAOP. b b b b




RAP/CVP 2-6mmHg or 1-8( right atrium pressure) b b b b b b




Optimal in Critical Care Can be up to 10mmHgb b b b b b b b




PAP (pulmonary artery pressure) –
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could be systolic and diastolicPAP systolic – 15-26 mmhG
b b b b b b b b b b




PAD diastolic 5-15 mmHG
b b b




CardiacbtamponadebwouldbcausebanbincreasebinbRAP,bPAP,bandbPAOP.

SV02 –mixed venous saturation of oxygen.normal 60-
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80%bItbisbbasicallybthebpercentagebofboxygenbremainingbinbthebvenousbbloodbreturningbtobthebrigh
tbsidebofbthebheart.bThisbisbtheboxygenbleftboverbinbthebbloodbafterbsupplyingballbthebpartsbofbthebbo
dybexceptbthebhead.

Systolic – squeeze b b




Diastolic – relaxation and filing b b b b




CO 4-8 L/minb b




CI 2.5-4.3 L/min/m²
b b




Stroke Volume 60- b b

, 4



100 mL/beat Stroke Volume I
b b b b




ndex 35- b




60mL/m²Stroke Volume Vari
b b b




ation 10-15%
b




SVmax-SVmin/SVmean x 100 b b




LV Stroke Work Index 50-62gm-m/m²/beat
b b b b