CCRN CERTIFICATION PRACTICE EXAM
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A patient in the ED with complaints LAD so D. bundle of his
of chest pain. The 12-lead EKG shows
ST 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
,Which of the following is the c. III
preferred lead for ST segment
monitoring for a patient with a
suspected RCA occlusion?
A.I
B. aVR
C. III
D. V1
Which of the following is not a *B
manifestation of hypertrophic Classic manifestations of hypertrophic
cardiomyopathy? cardiomyopathy are chest pain, syncope, and an
aortic stenosis type of murmur that decreases
A. Syncope when the patient is in a squatting position. The first
B. Murmur that increases with manifestation of this condition is occasionally
squatting sudden cardiac death during exercise.
C. Chest pain
D. Sudden cardiac death
In which quadrant is the mean QRS *B
complex axis located if the QRS Because the positive of lead I is the left arm, if the
complex is predominantly positive in QRS complex is upright in lead I, the mean QRS
lead I and negative in lead aVF? axis is to the left. Because the positive of lead aVF
(a unipolar lead) is at the foot, if the QRS complex
A. Normal quadrant is negative in lead aVF, the mean QRS axis is
B. Left axis deviation quadrant upward away from the foot. This axis would be in
C. Right axis deviation quadrant the upper left quadrant, described as left axis
D. Indeterminant quadrant deviation.
,A patient becomes apneic and C
pulseless. CPR has been initiated, After CPR is initiated and an intravenous access is
and the monitor shows asystole in established, epinephrine should be given. Calcium
two leads. Which of the following was used in the past in asystole but is used today
drugs would be used initially? only for hypocalcemia, calcium channel blocker
toxicity, hyperkalemia, and hypermagnesemia.
A. Calcium gluconate Atropine is no longer recommended for asystole.
B. Atropine Amiodarone is not indicated in asystole because
C. Epinephrine asystole is the absolute absence of irritability.
D. Amiodarone (Cordarone)
What is associated w/ Mitral Stenosis A
A. Pinkish discoloration of the cheeks Patients with mitral stenosis may exhibit a pinkish
B. Systolic murmur discoloration of the cheeks (i.e., malar blush). Mitral
C. Widened pulse pressure stenosis causes a diastolic murmur. Widened pulse
D. Narrow pulse pressure pressure is associated with aortic regurgitation.
Narrowed pulse pressure is associated with mitral
regurgitation.
Four days after a mitral valve B
replacement, the patient develops The onset of atrial fibrillation results in the loss of
atrial fibrillation. The nurse initially atrial kick. Loss of atrial kick may reduce the cardiac
would: output by as much as 20-30%. This is especially true
in patients whose cardiac output may be affected
A. order a 12-lead EKG by long-standing cardiac disease, such as mitral
B. evaluate the patient for clinical valve disease. Assess the patient for clinical
indications of hypoperfusion. indications of hypoperfusion (e.g., cool skin,
C. notify the physician. decreased urine output, narrowed pulse pressure,
D. ask the patient to bear down as if and hypotension).
having a bowel movement.
, A patient has just returned from the D
cath lab. She had an angioplasty for New-onset severe chest pain after percutaneous
occlusion of her RCA. She still has coronary intervention suggests acute closure of
femoral artery and vein sheaths in the dilated coronary artery. The patient needs to
place. The patient complains of chest be returned to the cardiac catheterization
pain that she rates 9/10 about an laboratory for repeat dilation and probable
hour after she returns from the cath insertion of stent.
lab. Which of the following is
indicated?
A. Administer morphine IV.
B. Administer nitroglycerin sublingual
spray.
C. Stop the heparin.
D. Notify the physician
A 35-year-old woman underwent a C
mitral valve replacement. Her chest Muffled heart sounds are a classic finding in
tube output has been approximately cardiac tamponade. Remember the classic
125 mL/hr for the last 3 hours, and indications of cardiac tamponade referred to as
now the drainage has ceased Beck's triad: muffled heart sounds, jugular venous
suddenly. The immediate assessment distention, and hypotension. Even though urine
reveals a significant decrease in BP, output is a sensitive indicator of cardiac output and
RAP 12, PAP 30/15 , PAOP 13. What in cardiac tamponade a decreased stroke volume
other data would indicate the results in a decreased cardiac output, by the time a
development of cardiac tamponade? nurse would notice the decreased urine output, the
patient may have already had a cardiopulmonary
A. Increased venous oxygen arrest. The SvO2 actually would decrease because
saturation (SvO2) of the decrease in cardiac output. New holosystolic
B. Decreased UO murmur at the lower left sternal border is a sign of
C. Muffled heart sounds ventricular septal rupture.
D. New holosystolic murmur at the
sternum
QUESTIONS WITH 100% VERIFIED CORRECT
ANSWERS (LATEST 2026/27 UPDATE) ALREADY
GRADED A+
Save
Terms in this set (87) Hide definitions
A patient in the ED with complaints LAD so D. bundle of his
of chest pain. The 12-lead EKG shows
ST 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
,Which of the following is the c. III
preferred lead for ST segment
monitoring for a patient with a
suspected RCA occlusion?
A.I
B. aVR
C. III
D. V1
Which of the following is not a *B
manifestation of hypertrophic Classic manifestations of hypertrophic
cardiomyopathy? cardiomyopathy are chest pain, syncope, and an
aortic stenosis type of murmur that decreases
A. Syncope when the patient is in a squatting position. The first
B. Murmur that increases with manifestation of this condition is occasionally
squatting sudden cardiac death during exercise.
C. Chest pain
D. Sudden cardiac death
In which quadrant is the mean QRS *B
complex axis located if the QRS Because the positive of lead I is the left arm, if the
complex is predominantly positive in QRS complex is upright in lead I, the mean QRS
lead I and negative in lead aVF? axis is to the left. Because the positive of lead aVF
(a unipolar lead) is at the foot, if the QRS complex
A. Normal quadrant is negative in lead aVF, the mean QRS axis is
B. Left axis deviation quadrant upward away from the foot. This axis would be in
C. Right axis deviation quadrant the upper left quadrant, described as left axis
D. Indeterminant quadrant deviation.
,A patient becomes apneic and C
pulseless. CPR has been initiated, After CPR is initiated and an intravenous access is
and the monitor shows asystole in established, epinephrine should be given. Calcium
two leads. Which of the following was used in the past in asystole but is used today
drugs would be used initially? only for hypocalcemia, calcium channel blocker
toxicity, hyperkalemia, and hypermagnesemia.
A. Calcium gluconate Atropine is no longer recommended for asystole.
B. Atropine Amiodarone is not indicated in asystole because
C. Epinephrine asystole is the absolute absence of irritability.
D. Amiodarone (Cordarone)
What is associated w/ Mitral Stenosis A
A. Pinkish discoloration of the cheeks Patients with mitral stenosis may exhibit a pinkish
B. Systolic murmur discoloration of the cheeks (i.e., malar blush). Mitral
C. Widened pulse pressure stenosis causes a diastolic murmur. Widened pulse
D. Narrow pulse pressure pressure is associated with aortic regurgitation.
Narrowed pulse pressure is associated with mitral
regurgitation.
Four days after a mitral valve B
replacement, the patient develops The onset of atrial fibrillation results in the loss of
atrial fibrillation. The nurse initially atrial kick. Loss of atrial kick may reduce the cardiac
would: output by as much as 20-30%. This is especially true
in patients whose cardiac output may be affected
A. order a 12-lead EKG by long-standing cardiac disease, such as mitral
B. evaluate the patient for clinical valve disease. Assess the patient for clinical
indications of hypoperfusion. indications of hypoperfusion (e.g., cool skin,
C. notify the physician. decreased urine output, narrowed pulse pressure,
D. ask the patient to bear down as if and hypotension).
having a bowel movement.
, A patient has just returned from the D
cath lab. She had an angioplasty for New-onset severe chest pain after percutaneous
occlusion of her RCA. She still has coronary intervention suggests acute closure of
femoral artery and vein sheaths in the dilated coronary artery. The patient needs to
place. The patient complains of chest be returned to the cardiac catheterization
pain that she rates 9/10 about an laboratory for repeat dilation and probable
hour after she returns from the cath insertion of stent.
lab. Which of the following is
indicated?
A. Administer morphine IV.
B. Administer nitroglycerin sublingual
spray.
C. Stop the heparin.
D. Notify the physician
A 35-year-old woman underwent a C
mitral valve replacement. Her chest Muffled heart sounds are a classic finding in
tube output has been approximately cardiac tamponade. Remember the classic
125 mL/hr for the last 3 hours, and indications of cardiac tamponade referred to as
now the drainage has ceased Beck's triad: muffled heart sounds, jugular venous
suddenly. The immediate assessment distention, and hypotension. Even though urine
reveals a significant decrease in BP, output is a sensitive indicator of cardiac output and
RAP 12, PAP 30/15 , PAOP 13. What in cardiac tamponade a decreased stroke volume
other data would indicate the results in a decreased cardiac output, by the time a
development of cardiac tamponade? nurse would notice the decreased urine output, the
patient may have already had a cardiopulmonary
A. Increased venous oxygen arrest. The SvO2 actually would decrease because
saturation (SvO2) of the decrease in cardiac output. New holosystolic
B. Decreased UO murmur at the lower left sternal border is a sign of
C. Muffled heart sounds ventricular septal rupture.
D. New holosystolic murmur at the
sternum
