ACCN CCRN GRADE A CERTIFIED EXAM WITH 100% CORRECT AND VERIFIED ANSWERS

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ACCN CCRN GRADE A CERTIFIED
EXAM WITH 100% CORRECT AND
VERIFIED ANSWERS 2025-2026

Ai59iyearioldimaleiisiadmittedicomplainingiofichestipainiandi
dyspnea.iSTielevationiandiTiwaveiinversioniwereiseenionithei
EKGiiniV2,V3iandiV4.iIVithrombolyticitherapyiwasistartediini
ED.iIndicationsiofisuccessfulireperfusioniwouldiincludeiallio
fitheifollowingiexcept:
(A)ipainicessationi
(B)idecreaseiiniCKioritroponin
(C)ireversaliofiSTisegmentielevationiwithireturnitoibaselinei
(D)ishortirunsiofiventricularitachycardiaicorrectianswer(B)C
oronaryiarteryireperfusionidueitoiPCIiorifibrinolysisiresultsii
nianiELEVATIONioficreatinineikinasei(CK)ioritroponin,inotid
ecrease.iTheitheoryiisithatitheireturniofibloodiflowidistalitoit
heiocclusionicaniresultiini'reperfusioniinjury'iofitheimuscle,i
elevatingicardiacibiomarkers.i
Theiotheri3ichoicesiareiindicatorsiofireperfusion:iPainicessat
ion,ireversaliofiSTisegmentielevationiwithireturnitoibaseline,
ishortirunsiofiventricularitachycardia.



Whichiofitheifollowingimedicationiordersishoulditheinurseiq
uestioniforitheipatientiiniquestioni1-reperfusioniquestion-
patientihavingianiMI?
(A)imetoprololi(Lopressor)
(B)iaspirin
(C)ipropranololi(Inderal)
(D)iheparinicorrectianswer(C)iTheipatientiinitheiscenarioiisi
havingianiacuteianterioriwalliMI.iAibetaiblockeriisibeneficiali
forianiacuteiMIiasitheseiagentsidecreaseitheiworkiofitheihear
tiandiincreaseitheithresholdiforiventricularifibrillation.iProp
ranolol,ialthoughiaibeta-
andrenergiciblockerilikeimetoprolol,iisiNOTiaicardioselectiv
eibetaiblocker.iItiaffectsibetaireceptorsiiniheartimuscleiANDi


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lungitissue.iTherefore,iitiisimoreilikelyitoicauseibronchocons
trictionithaniaicardioselectiveibetaiblocker.i
Theiotheri3-
icardioselective ibetaiblocker,iantiplatelet,iandianticoagulati

on-areiindicatediinianiacuteiMI.

Ifiheartiblockidevelopsiwhileicaringiforitheipatientiiniquestio
ni1i(ptiwithianiMIiwhoiwentithroughireperfusionifromiPCIiori
fibrinolyticitherapy),iwhichiofitheifollowingiwouldiitimostilik
elyibe?
(A)isinoatrialiblock
(B)isecondidegree,iTypeiI
(C)isecondidegree,iTypeiII
(D)ithirdidegree,icompleteicorrectianswer(C)iTheipatientiisi
havingianiacuteianterioriMI,iwhichiisigenerallyidueitoiLADioc
clusion.iTheiLADisuppliesitheiHISibundle,iwhichicouldiresult
iiniaisecond-

degree,itypeiIIiheartiblock.iTheiotheri3itypesiareidueitoiSAino
deioriAVinodeiischemia,iwhichigenerallyioccuriwithianiRCAio
cclusioni—iinterioriwalliMI.

Appropriateidrugitherapyiforidilatedicardiomyopathyiisiaime
ditoward:
(A)idecreasingicontractilityiandidecreasingipreloadiandiafte
rloadi
(B)idecreasingicontractilityiandiincreasingipreloadiandiafter
loadi
(C)iincreasingicontractilityiandiincreasingibothipreloadiandi
afterloadi
(D)iincreasingicontractilityiandidecreasingibothipreloadiand
iafterloadicorrectianswer(D)iDilatedicardiomyopathyiisilikel

yitoiresultiinisystolicidysfunction,iwhichidecreasesicontractil
ity,icausesicompensatoryiarterialiconstrictioni,iandiresultsii
niaihigherileftiventricularipreload.iToitreatithis,itherapyiisiai
mediatiincreasingicontractility,idecreasingiafterloadi(arteri
aliconstriction),iandidecreasingipreloadithatiisitooihigh.😃

Ani18iyearioldiisiadmittediwithiaihistoryiofisyncopaliepisodei
atitheimalliandihasiaihistoryiofianieatingidisorder.iTheinursei

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notesiaiprolongediQTionithei12-
leadiEKGiandianticipatesiaireductioniinianielectrolyteitoibeit
heicause.iWhichiofitheifollowingiisiLEASTilikelyitoicauseithisi
patient'siproblems?
(A)isodiumi
(B)imagnesiumi
(C)ipotassiumi
(D)icalciumicorrectianswer(A)iAbnormalisodiumidoesiNOTic
auseiQTiprolongation.iInicontrast,iailowimagnesium,ipotassi
um,ioricalcium,imayicauseiQTiprolongationiandimayiresultiin
iTORSADESiDEiPOINTESiventricularitachycardiaiand,iifiself-

limiting,itransientisyncopaliepisodes.

OnitheithirdidayiafteriadmissioniforiacuteiMI,iai67iyearioldim
aleicomplainsiofichestipainiandidevelopsiaifever.iTheipainiisi
worseiwithideepiinspirationiandiisirelievediwheniheileansifor
ward.iThereiareinonspecificiSTichangesiinitheiprecordialilea
dsiofitheiEKG.iTheinurseianticipatesithatitheipatientiwillimos
tilikelyineeditreatmentifor:
(A)ithoracicianeurysm
(B)iDressler'sisyndromei
(C)ireinfarction
(D)ipleuritisicorrectianswer(B)iTheipainidescribediinitheisce
narioiisitypicaliofitheipainicausedibyipericarditis.iDressler'sis
yndromeiisitheipericarditisithatimayiresultiafterianiacuteiMI.

AipatientiisiadmitteditoitheiCCUiafteriaiPCIiwithistent.iFemor
alisheathiisiiniplace,isiteiisidryiwithinoihematoma.iHeisudden
lyicomplainsiofisevereibackipain.iNeckiveinsiareiflatiwithihea
diofibedi30idegrees,iheartisoundsiareinormal.iVitalisignsiarei
BPi78/48,iHRi124iandiRRi26.iWhatishoulditheinurseisuspect?
(A)icardiacitamponade
(B)iretroperitonealibleeding
(C)icoronaryiarteryidissectioni
(D)iacuteiclosureiofitheistentedicoronaryiarteryicorrectiansw
er(B)iRetroperitonealibleedingimayicauseisignsiofihypovole
miaiandihypovolemicishockiasidescribediinitheiscenario.iItim
ayibeiaicomplicationiofiaiPCIiifitheifemoraliarteryiisitheiacces


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