CCRN Plan

CCRN practice question: Cardiovascular

CardiovascularDifficulty 3/5

A patient with an inferior STEMI and suspected right ventricular infarction becomes hypotensive. Which intervention is contraindicated?

  1. ACautious intravenous fluid administration to support preload
  2. BNitroglycerin infusion, because it drops the preload this ventricle depends on
  3. CUrgent reperfusion therapy according to the institutional protocol
  4. DContinuous monitoring for high-degree atrioventricular block
Show answer and rationale

Correct: B. A right ventricular infarct is preload dependent: the failing right ventricle needs filling pressure to deliver blood to the left side. Nitroglycerin drops preload and can cause profound hypotension. Fluids, reperfusion and block monitoring are all appropriate.

  • A — Fluids are the first-line support for a preload-dependent RV infarct.
  • C — Reperfusion remains the definitive treatment.
  • D — Inferior infarcts commonly involve the conduction system, so monitoring is appropriate.

Concept being tested

13% of the exam. Acute coronary syndrome, aortic aneurysm and dissection, cardiac infection and inflammatory disease, cardiac surgery and trauma, tamponade, cardiogenic shock, cardiomyopathy, dysrhythmias, heart failure, hypertensive crisis, conduction defects, structural and valvular disease, and vascular interventions. — 13% of the exam. Study guide for Cardiovascular.

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Primary references

  1. CCRN Exam Handbook — Direct Care (July 2026) — AACN Certification Corporation · primary · retrieved 2026-09-22, verified 2026-09-22
Last reviewed: 2026-10-07Reviewed by: Marcus Vance, MSN, RN, CCRN-CSC, Critical care nursing curriculum & clinical item reviewHow we verify facts