CCRN Plan

Cardiovascular: practice questions

3 original questions · 3 editor-approved · every choice explained.

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Blueprint-mapped questions with full rationales for every choice.

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CardiovascularDifficulty 3/5

A patient has a cardiac index of 1.6 L/min/m2, pulmonary artery occlusion pressure of 26 mmHg and systemic vascular resistance of 1,900 dynes/sec/cm-5. Which shock state do these numbers describe?

  1. ACardiogenic shock, because the pump fails and filling pressures rise behind it
  2. BDistributive shock, because vascular resistance is abnormal and output is inadequate
  3. CObstructive shock caused by a tension pneumothorax reducing venous return
  4. DHypovolaemic shock, because cardiac index is low and filling pressure has fallen
Show answer and rationale

Correct: A. Low cardiac index with a high PAOP and high SVR is the classic cardiogenic pattern: the pump fails, filling pressures rise behind it, and the body compensates by vasoconstricting. Hypovolaemia would show a low PAOP and distributive shock a low SVR.

  • D — Hypovolaemia lowers filling pressures; this PAOP is high.
  • B — Distributive shock is characterised by a low SVR, not 1,900.
  • C — Obstructive shock is possible with high filling pressure but would present with acute deterioration and other signs rather than these steady-state numbers.
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.
CardiovascularDifficulty 3/5

Four hours after coronary artery bypass grafting, chest-tube drainage abruptly stops, central venous pressure rises, blood pressure falls and the pulse pressure narrows. What is the priority interpretation?

  1. AVasoplegic syndrome after cardiopulmonary bypass requiring vasopressor titration
  2. BHypovolaemia from ongoing surgical bleeding requiring rapid volume replacement
  3. CCardiac tamponade from obstructed drainage, needing immediate surgical review
  4. DAcute graft occlusion causing ischaemic left ventricular failure
Show answer and rationale

Correct: C. Abrupt cessation of drainage with rising filling pressure, falling blood pressure and a narrowing pulse pressure is tamponade until proven otherwise. Volume may temporise, but the clot must be relieved surgically.

  • B — Hypovolaemia lowers CVP rather than raising it.
  • D — Graft occlusion typically presents with ischaemic ECG changes and does not stop chest-tube output.
  • A — Vasoplegia presents with low systemic vascular resistance and warm extremities, not rising CVP.

Primary references

  1. CCRN Exam Handbook — Direct Care (July 2026) — AACN Certification Corporation · primary · retrieved 2026-09-22, verified 2026-09-22