CCRN EXAM MIDTERM EXAM QUESTIONS AND ANSWERS ALREADY GRADED A+ LATEST UPDATE 2024-2025 GUARANTEED PASS

CCRN EXAM
MIDTERM EXAM
QUESTIONS AND
ANSWERS
ALREADY GRADED
A+ LATEST
UPDATE 2024-2025
GUARANTEED
PASS
An 18 year old is admitted with a history of
syncopal episode at the mall and has a history of
an eating disorder. The nurse notes a prolonged
QT on the 12-lead EKG and anticipates a
reduction in an electrolyte to be the cause.
Which of the following is LEAST likely to cause
this patient's problems?
(A) sodium
(B) magnesium
(C) potassium
(D) calcium - ANSWER-(A) Abnormal sodium
does NOT cause QT prolongation. In contrast, a
low magnesium, potassium, or calcium, may
cause QT prolongation and may result in
TORSADES DE POINTES ventricular tachycardia
and, if self-limiting, transient syncopal episodes.
An 80 year old female presents with chief
complaint of acute shortness of breath. Clinical
exam reveals B/P 182/102, heart rate
105/minute, respiratory rate 32/minute, lungs
with crackles bilaterally, pulse oximetry of 88%,
S4 on auscultation. EKG revealed sinus
tachycardia, left ventricular hypertrophy
pattern, chest radiograph showed normal heart
size, pulmonary vascular congestion, and
echocardiogram showed EF of 55%. Which of
the following should be avoided in this patient's
treatment plan?
(A) calcium channel blocker
(B) digoxin
(C) low-dose diuretics
(D) oxygen - ANSWER-(B) The patient presents
with signs of heart failure due to diastolic
dysfunction (hypertension, left ventricular
hypertrophy, EF > 40%). These patients have a
problem with FILLING, not ejecting. Digoxin, a
positive inotrope, may increase wall stress and
worsen filling of the left ventricle.
Mrs. Jones has heart failure. Despite optimal
therapy, she gets short of breath when she gets
up to walk to the bathroom. Which of the
following is the patient experiencing regarding
heart failure?
(A) NYHA Class I heart failure, may benefit from
an ICD
(B) NYHA Class II heart failure, may benefit from
an ICD
(C) NYHA Class III heart failure, may benefit from
an ICD
(D) heart failure cannot be classified, further
information is needed - ANSWER-(C) The patient
has symptoms with minimal activity, which
describes NYHA Class III. This would qualify her
for an ICD.
The patient with diagnosis of cardiogenic shock
now requires high dose dopamine (greater than
10 mcg/kg/min) to maintain blood pressure, and
the cardiologist is planning to start IABP
therapy. This therapy will benefit the patient
because it will:
(A) increase afterload with balloon inflation and
decrease diastolic augmentation with balloon
deflation.
(B) decrease afterload with balloon deflation
and increase diastolic augmentation with
balloon inflation.
(C) decrease afterload with balloon inflation and
decrease diastolic augmentation with balloon
deflation
(D) increase afterload with balloon deflation and
decrease diastolic augmentation with balloon
inflation. - ANSWER-(B) Cardiogenic shock
results in a decrease in cardiac output with a
resultant drop in coronary artery perfusion and
compensatory vasoconstriction. The deflation of
the balloon placed into the descending aorta is
beneficial. Deflation decreases afterload and
work of the left ventricle. Inflation of the
balloon is beneficial because it "boluses" blood
into the coronary arteries, increasing perfusion.
Which of the following medication orders
should the nurse question for the patient in
question 1-reperfusion question-patient having
an MI?
(A) metoprolol (Lopressor)
(B) aspirin
(C) propranolol (Inderal)
(D) heparin - ANSWER-(C) The patient in the
scenario is having an acute anterior wall MI. A
beta blocker is beneficial for an acute MI as
these agents decrease the work of the heart
and increase the threshold for ventricular
fibrillation. Propranolol, although a betaandrenergic blocker like metoprolol, is NOT a
cardioselective beta blocker. It affects beta
receptors in heart muscle AND lung tissue.
Therefore, it is more likely to cause
bronchoconstriction than a cardioselective beta
blocker.
The other 3- cardioselective beta blocker,
antiplatelet, and anticoagulation-are indicated
in an acute MI