CVRN Exam Questions with complete verified solutions 2025-2026

Which of the following valves are open during ventricular systole?

a) mitral and tricuspid

b) aortic and pulmonic

c) mitral and aortic

d) aortic and tricuspid

b) aortic and pulmonic

Which lobe of the right lung cannot be assessed from the anterior chest wall?

a) right upper

b) right lower

c) right middle

b) right lower

All of the following are known causes of increased JVD except?

a) RV failure

b) cardiac tamponade

c) mitral stenosis

d) SVC obstruction

e) increased intrathoracic pressure (PEEP, coughing)

f) constrictive pericarditis

c) mitral stenosis

Regarding pulse pressure, we know that the normal resting pulse pressure should be 40 mmHg.

a) true

b) false

a) true

Widened pulse pressure is an indicator of increased cardiovascular risk.

a) true

b) false

a) true

Regarding pitting edema in the extremities, 2+ edema indicates there is:

a) a 6mm deep indentation and it takes > 1 minute to disappear

b) a 4mm moderate indentation and it takes 10-15 seconds to disappear

c) no edema present

d) a 2mm mild or slight indentation and that rapidly disappears

e) an 8mm very deep indentation and it takes 5-8 minutes to disappear

b) a 4mm moderate indentation and it takes 10-15 seconds to disappear

Identify the average rate of an escaping ventricular rhythm.

a) 20-40 bpm

b) 50-100 bpm

c) 100-160 bpm

d) 60-80 bpm

a) 20-40 bpm

The most dangerous complication associated w/ a prolonged QT interval is the development of:

a) atrial fibrillation

b) Torsades de pointes

c) junctional tachycardia

d) bradycardia

b) Torsades de pointes

Identify the ECG criteria for second degree type II AV block.

a) progressive prolongation of the PR interval, before the dropped beats

b) fixed and normal PR intervals, a wide QRS, and random dropping of beats

c) complete AV dissociation from complete heart block

d) abnormally short PR intervals

b) fixed and normal PR intervals, a wide QRS, and random dropping of beats

Identify the ECG criteria for second degree type I AV block.

a) progressive prolongation of the PR interval, before a dropped QRS (P waves not conducted)

b) fixed and normal PR intervals, a wide QRS, and random dropping of beats (P waves not conducted)

c) complete AV dissociation from complete heart block

d) abnormally short PR intervals

a) progressive prolongation of the PR interval, before a dropped QRS (P waves not conducted)

About the management of documented ACS, the recommendations are:

a) therapy should be door-to-balloon inflation (PCI) goal of 90 minutes, or door to fibrinolysis goal of 30 minutes

b) therapy should be door-to-balloon inflation (PCI) goal of 30 minutes, or door to fibrinolysis goal of 60 minutes

c) therapy should be door-to-balloon inflation (PCI) goal of 40 minutes, or door to fibrinolysis goal of 20 minutes

d) therapy should be door-to-balloon inflation (PCI) goal of 20 minutes, or door to fibrinolysis goal of 30 minutes

a) therapy should be door-to-balloon inflation (PCI) goal of 90 minutes, or door to fibrinolysis goal of 30 minutes

Which of the following coronary arteries are involved when myocardial ischemia or injury is present in the anterior wall?

a) left anterior descending (LAD)

b) circumflex (Cx)

c) obtuse marginal (OM)

d) right coronary artery (RCA)

a) left anterior descending (LAD)

Which of the following coronary arteries are involved when myocardial ischemia or injury is present in the anterior and lateral walls?

a) left anterior descending (LAD)

b) circumflex (Cx)

c) obtuse marginal (OM)

d) right coronary artery (RCA)

b) circumflex (Cx)

When there is an inferior infarction, evidence-based practice standards tell us that there is upwards of a 40% association of a right ventricular infarction necessitating that we record:

a) a standard 12-lead ECG

b) a 15-lead ECG involving the recording of the right side of the chest (V4R-V6R)

c) a 15-lead ECG involving the recording of the posterior chest wall (leads V7-V9)

d) a complete 18-lead ECG involving (V4R-V6R and V7-V9)

b) a 15-lead ECG involving the recording of the right side of the chest (V4R-V6R)

What is the most important predictor of a positive patient outcome following a myocardial infarction?

a) the height of ST elevation

b) CK-MB levels

c) troponin I levels

d) successful reperfusion

d) successful reperfusion

Regarding troponin I, which of the following statements is NOT true?

a) troponin I will be detectable within 4 hours after onset of acute MI

b) troponin I will reach peak levels within 24 hours after onset of acute MI

c) troponin I may remain elevated for only 48 hours after onset of acute MI

d) troponin I may remain elevated for 5-10 days after onset of acute MI

c) troponin I may remain elevated for only 48 hours after onset of acute MI

End organ damage from hypertensive emergencies includes

a) pulmonary edema with respiratory failure

b) severe pre-eclampsia in the pregnant patient

c) unstable angina or acute MI

d) mitral stenosis

e) b, c, and d only

f) a, b, and c only

f) a, b, and c only

What effect dose high blood pressure have on the Renin-Angiotensin System?

a) high pressures decrease renin production in the juxtaglomerular cells in the kidneys resulting in vasodilation and decrease in blood pressure

b) high pressures increase renin production in the juxtaglomerular cells in the kidneys resulting in vasoconstriction and an increase in blood pressure

a) high pressures decrease renin production in the juxtaglomerular cells in the kidneys resulting in vasodilation and increase in blood pressure

a) high pressures decrease renin production in the juxtaglomerular cells in the kidneys resulting in vasodilation and decrease in blood pressure

In the management of stage 2 hypertension you may expect to see the patient prescribed:

a) thiazide type diuretics

b) ACEI or ARB

c) beta blockers or calcium channel blockers

d) any of the above in combination therapy

d) any of the above in combination therapy

Which of the following agents is less effective as monotherapy in the management of African American patients with hypertension?

a) ACE-I

b) calcium channel blockers

c) beta blockers

d) diuretics

c) beta blockers

Which of the following statements regarding the pharmacologic management of renal patients with hypertension is NOT true?

a) only requires monotherapy or a single drug to control

b) requires 3 or more drugs to control

c) ACE-I and ARBs are effective in decreasing diabetic and non-diabetic renal disease

d) often give loop diuretics

a) only requires monotherapy or a single drug to control

Which of the following agents is more likely to cause side effects when used in the management of elderly patients with hypertension?

a) beta blockers

b) diuretics

c) calcium channel blockers

d) ACE inhibitors

a) beta blockers

Identify the new AHA/ACC guidelines for a normal blood pressure range:

a) <120 systolic, <80 diastolic

b) 120-139 systolic, 80-89 diastolic

c) 140-159 systolic, 90-99 diastolic

d) >160 systolic, >100 diastolic

e) >180 systolic, >110 diastolic

a) <120 systolic, <80 diastolic

Which of the following statements is true regarding the pharmacologic management of hypertrophic cardiomyopathy?

a) beta blockers are strictly prohibited as they may decreased left ventricular filling pressures

b) calcium channel blockers can be used only when there is no obstruction present

c) antihistamines are prohibited in these patients

d) diuretics may be considered for patients with fluid overload, but use with caution if there is evidence of obstruction

e) a and d

f) b and d

f) b and d

Which of the following statements are true regarding hypertrophic cardiomyopathy?

a) primarily a right ventricular disease

b) primarily a left ventricular disease

c) may affect the entire septum or only a portion of it in 2/3rds of patients

d) may be a non-obstructive or an obstructive type

e) all of the above

f) b, c, and d only

f) b, c, and d only

Management for dilated cardiomyopathy include:

a) agents to increase preload

b) agents to decrease preload

c) ACE-Is to lower blood pressure, improve blood flow, and decrease the workload of the heart

d) aldosterone antagonists

e) all of the above

f) b, c, and d only

f) b, c, and d only

Which type of cardiomyopathy leads to the gradual dilation of the ventricle changing its shape from the normal elliptical egg shape to a spherical shape, and leads to a decline in the ejection fraction?

a) hypertrophic

b) dilated

c) restrictive

d) arrhythmogenic right ventricular dysplasia

e) all of the above

f) a and d only

b) dilated

Dilated cardiomyopathy is often associated with:

a) alcohol abuse

b) myocarditis

c) valvular heart disease

d) hypertension

e) all the above

f) b and d only

e) all the above

Systolic dysfunction, or heart failure with reduced ejection fraction is characterized by:

a) a failure of pump function of ventricles, dilated thin wall; eccentrically hypertrophied

b) decreased EF, SV, and CO

c) backward flow of blood from the LV into the lungs

d) increased pulmonary pressures

e) dyspnea, orthopnea, and wheezing

f) all the above

f) all the above

In left ventricular heart failure, we may find:

a) distended neck veins (increased JVD)

b) systolic murmur such as mitral regurgitation

c) S3 and S4

d) decreased PA pressure

e) all the above

f) b and c only

f) b and c only

In right ventricular heart failure, we may find:

a) distended neck veins (increased JVD)

b) hepatic engorgement

c) weight gain

d) increased CVP

e) all the above

f) a and d only

e) all the above

Nursing management for patients on ACE inhibitors includes monitoring:

a) for hypotension and dizziness

b) for worsening renal function - checking serum creatinine levels

c) for the development of an irritating cough

d) for hyperkalemia

e) all the above

f) b and c only

e) all the above

Manifestations of diastolic dysfunction or heart failure with preserved ejection fraction include:

a) impaired relaxation during diastole

b) increased filling pressured in LA and LV due to stiff noncompliant ventricles

c) fluid accumulation in feet, ankles, and legs

d) may have a normal ejection fraction

e) all the above

f) b and c only

e) all the above

With regard to a left heart catheterization, we know that:

a) a catheter is fed through a vein to the right side of the heart

b) it provides direct pressure measurements of the aorta, left atria, and left ventricle

c) it provides direct pressure measurements of the superior vena cava, right atria and right ventricle

d) it provides assessment of blood flow through the pulmonary and tricuspid valves

b) it provides direct pressure measurements of the aorta, left atria, and left ventricle

With regard to a right heart catheterization, we know that:

a) a catheter is fed through a vein to the right side of the heart

b) it provides direct pressure measurements of the aorta, left atria, and left ventricle

c) it provides direct pressure measurements of the superior vena cava, right atria and right ventricle

d) it provides assessment of blood flow through the pulmonary and tricuspid valves

c) it provides direct pressure measurements of the superior vena cava, right atria and right ventricle

Identify risks associated with cardiac catheterization:

a) arrhythmias

b) cardiac tamponade

c) infection

d) stroke

e) all the above

e) all the above

Possible complications associated with atherectomy include all the following EXCEPT:

a) damage to the artery

b) hyperkalemia

c) bleeding

d) infection

b) hyperkalemia

While assessing a patient post-cardiac catheterization, you discover blanching, cramping, and coolness of the extremity distal to the insertion site. What else might you find when assessing the patient?

a) "Water hammer" pulse

b) atrial premature beats secondary to loss of oxygen to the myocardium

c) a dressing that is too tight due to increased swelling at the insertion site

d) sinus bradycardia

e) signs of vasospasm

c) a dressing that is too tight due to increased swelling at the insertion site

Why do we give aspirin before a PCTA procedure?

a) for its antiplatelet effect

b) for its thrombin inhibition

c) for its endothelin inhibition

d) to produce prolongation of the prothrombin time

a) for its antiplatelet effect