CCRN Practice Questions –
Cardiovascular Exam Questions and
Answers (Latest Update 2024)
A patient is in cardiac and respiratory arrest. The selection of
medications to reestablish cardiac function would stimulate
the sympathetic nervous system beta1 receptors. This
stimulation would result in increased automaticity and which
of the
following?
a. Increased myocardial contractility
b. Decreased left ventricular stroke work
c. Decreased myocardial oxygen consumption
d. Increased left ventricular afterload - Correct Answer ✅
Correct Answer : a
Rationale: The sympathetic nervous system contains alpha,
beta, and dopaminergic receptors that produce various
responses when stimulated. Stimulation of beta1 receptors
increases heart rate, conductivity, and myocardial
contractility. Stimulation of beta2 receptors produces
vasodilation and bronchodilation. Alpha receptors, when
stimulated,
produce vasoconstriction. Stimulation of dopaminergic
receptors produces a vasodilating
effect on renal, mesenteric, coronary, and cerebral vessels.
,CCRN Practice Questions –
Cardiovascular Exam Questions and
Answers (Latest Update 2024)
Test-Taking Strategy: Note the helpful clue in the stem:
stimulate the sympathetic system and recall that this results
in a fight-or-flight response—the body is responding to
survive. Stroke volume would increase, so eliminate option b.
Afterload would increase, but this is due to alpha stimulation,
not beta1 stimulation, so eliminate option d. Because the
heart is working faster and harder, the myocardial oxygen
consumption does increase, so eliminate option c. Remember
that the primary effects of beta1 receptors are to increase
heart rate, contractility, and rate of conduction. Choose
option a. A memory aid that also may help is this: beta 1 beta
2, 1 heart 2 lungs: beta1 affects the heart, and beta2 affects
the lungs.
A patient arrived in the emergency department with
complaints of chest pain. The 12-lead electrocardiogram
shows ST segment 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
,CCRN Practice Questions –
Cardiovascular Exam Questions and
Answers (Latest Update 2024)
c. Atrioventricular (AV) node
d. Bundle of His - Correct Answer ✅ Correct Answer : d
Rationale: ST segment elevation in leads V3 and V4 indicates
injury to the anterior wall, which would occur with occlusion
of the left anterior descending (LAD) artery. In most persons,
the SA node, Bachmann's bundle, and AV node are supplied
by the right coronary artery. The bundle of His is supplied by
the left anterior descending artery. This is why an
anterior myocardial infarction may cause type II second-
degree AV block or third-degree AV heart block at the level of
the bundle of His.
Test-Taking Strategy: Note that options a, b, and c are part of
the supraventricular conduction system. They usually are
supplied by the right coronary artery. The LAD artery supplies
most of the interventricular conduction system, including the
bundle of His and
the bundle branches.
Oxygen delivery (DO2) is the product of which of the
following?
a. PaO2, hemoglobin, mean arterial pressure
, CCRN Practice Questions –
Cardiovascular Exam Questions and
Answers (Latest Update 2024)
b. SaO2, hemoglobin, cardiac output
c. SvO2, cardiac index, SaO2
d. PaO2, mean arterial pressure, SvO2 - Correct Answer ✅
Correct Answer : b
Rationale: Ninety-seven percent of oxygen is attached to the
hemoglobin molecule, so the SaO2 (arterial oxygen
saturation) is a more accurate reflection of the amount of
oxygen in blood. The PaO2 represents only the 3% that is
dissolved in the plasma. The lungs must put the oxygen in
the blood, the hemoglobin must carry the oxygen, and the
cardiac output is a reflection of how well the heart is moving
the blood with its hemoglobin with attached
oxygen. SvO2 (venous oxygen saturation) is a reflection of
the oxygen reserve. SvO2 is what is left over after the tissues
have extracted what they need. The mean arterial pressure is
a reflection of organ tissue perfusion pressure but does not
indicate anything about the amount of oxygen in that blood.
Test-Taking Strategy: Oxygen is delivered from the arterial
end, so choose an option that has SaO2 instead of SvO2. Also
remember that most oxygen is carried on hemoglobin. Look
for SaO2 (not PaO2) and hemoglobin. The only option with
both of these is option b.
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