CCRN EXAM vc
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
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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
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-
vc vc vc vc vc vc vc vc vc vc vc
lead EKG shows ST elevation in leads V3 and V4. Occlusion of the affected coronary arter
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
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
vc
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
vc vc
D. Sudden cardiac death
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,ANSWER
*B Classic manifestations of hypertrophic cardiomyopathy are chest pain, syncope, and an aortic stenosi
vc vc vc vc vc vc vc vc vc vc vc vc vc
s type of murmur that decreases when the patient is in a squatting position. The first manifestation of t
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
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
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
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
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
was used in the past in asystole but is used today only for hypocalcemia, calcium channel blocker toxicit
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
y, hyperkalemia, and hypermagnesemia. Atropine is no longer recommended for asystole. Amiodarone is
vc vc vc vc vc vc vc vc vc vc vc vc
not indicated in asystole because asystole is the absolute absence of irritability.
vc vc vc vc vc vc vc vc vc vc vc vc
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
vc vc vc
ANSWER
, A Patients with mitral stenosis may exhibit a pinkish discoloration of the cheeks (i.e., malar blush). Mitr
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
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
vc vc vc vc vc vc vc vc vc vc vc vc vc
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.
vc vc vc vc vc vc vc vc vc vc vc vc
ANSWER
B The onset of atrial fibrillation results in the loss of atrial kick. Loss of atrial kick may reduce the cardi
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
ac output by as much as 20-
vc vc vc vc vc vc
30%. This is especially true in patients whose cardiac output may be affected by long-
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
standing cardiac disease, such as mitral valve disease. Assess the patient for clinical indications of hypop
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
erfusion (e.g., cool skin, decreased urine output, narrowed pulse pressure, and hypotension).
vc vc vc vc vc vc vc vc vc vc vc
QUESTION 8 vc
A patient has had an inferior MI. He now has a new holosystolic murmur at apex, acute s
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
evere dyspnea, decreased cardiac index, and a normal cardiac silhouette on x-
vc vc vc vc vc vc vc vc vc vc vc
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
vc vc vc vc vc vc
C. Ventricular septal rupture
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D. Acute aortic stenosis
vc vc vc
ANSWER
A With an inferior MI, the risk of the papillary muscles being affected is greater. The papillary muscles o
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
f the LV maintain normal mitral valve fxn. If damaged, acute mitral regurgitation occurs and is manifeste
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
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
vc vc vc vc vc vc vc vc vc vc vc vc vc
type of drug is carvedilol?
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A. Calcium channel blocker
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B. Angiotensin-converting enzyme inhibitor
vc vc vc
C. Alpha- and noncardioselective beta-blocker
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D. Cardioselective beta-blocker
vc vc
ANSWER
