Preparing for the CCRN (Critical Care Registered Nurse) exam? Pathology is one of the areas our deck drills hardest: 370 of its 1000 flashcards focus on pathology. Try the sample questions below — every card is a real question-and-answer pair from the full deck.
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A patient's ECG shows ST-segment elevation in leads II, III, and aVF. Reciprocal changes are noted in I and aVL. Which coronary artery is most likely occluded, and what specific clinical assessment is prioritized?
Show answer →Right Coronary Artery (RCA). Reciprocal changes in I and aVL (lateral leads) confirm inferior wall STEMI. Priority assessment: Right ventricular (RV) involvement via a right-sided ECG (V4R). Clinical clues: Bradycardia, high-degree AV blocks (RCA supplies SA/AV nodes), and hypotension with clear lungs. AACN Tip: Avoid nitrates/diuretics if RV MI is suspected due to preload dependence; treatment is IV fluids.
A patient with chest pain has an initial hs-cTnT of 14 ng/L (normal <14). A 1-hour repeat is 18 ng/L. Based on 2026 rapid protocols, what is the next diagnostic step and the physiological rationale for the delta?
Show answer →The patient requires further observation or a 3-hour troponin (Gray Zone). A delta (change) of ≥3-5 ng/L within 1-2 hours suggests acute myocardial injury rather than chronic elevation (e.g., CKD). In ACS, plaque rupture leads to progressive cardiomyocyte necrosis and continuous protein release. If the delta was >10-12, rule-in for NSTEMI would occur. AACN emphasizes interpreting troponin in context of clinical symptoms.
ECG shows ST-segment depression in V1-V3 with tall R-waves and upright T-waves. The patient reports crushing retrosternal pain. What is the most likely diagnosis, and how should it be confirmed?
Show answer →Posterior Wall MI (often involving the LCX or distal RCA). ST depression in V1-V3 represents mirror images of posterior ST elevation. Confirmation: Place posterior leads V7-V9 (at the level of the 5th intercostal space; V7 posterior axillary line, V8 scapular tip, V9 paraspinal). Elevation ≥0.5mm in V7-V9 is diagnostic for STEMI. This is a commonly missed STEMI equivalent on the CCRN exam.
A patient with resolved chest pain presents with deeply inverted T-waves in V2-V4. Cardiac enzymes are currently negative. What is the pathophysiological significance of this finding, and what is the definitive management?
Show answer →Wellens' Syndrome (Type B). Pathophysiology: Critical stenosis of the proximal Left Anterior Descending (LAD) artery. Though pain has subsided (reperfusion), the patient is at extremely high risk for a massive anterior wall MI (widow maker). Management: Urgent cardiac catheterization. Exam Strategy: Do NOT choose stress testing for these patients; it may provoke a fatal MI due to the critical nature of the lesion.
3 days post-inferior MI, a patient suddenly develops acute pulmonary edema and a new, loud holosystolic murmur at the apex. What is the most likely mechanical complication and the physiological consequence?
Show answer →Acute Papillary Muscle Rupture (PMR) causing severe Mitral Regurgitation (MR). Usually occurs 2-7 days post-MI (often RCA/inferior). The sudden volume overload in the left atrium leads to rapid increases in pulmonary capillary wedge pressure (PCWP) and cardiogenic shock. Key exam point: Differentiate from VSD (murmur at LSB with oxygen step-up in the RV). PMR is a surgical emergency.
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1,000 CCRN question-and-answer cards across 12 topics, written for this exam. Refund policy.
The full CCRN deck contains 1000 flashcards, and 370 of them focus on pathology. This page shows 5 free samples.
Our CCRN deck dedicates 370 of 1000 cards (37%) to pathology — always cross-check the official AACN exam outline for the current blueprint weighting.
Yes — the samples on this page are free, and the CCRN preview page has 30 more free cards. Full access to all 1000 cards is a one-time $7.
Assessment
40 cards
Diagnostics
40 cards
Ethics
30 cards
Management
230 cards
Pharmacology
50 cards
Procedures
170 cards
Professional
10 cards
Toxicology
30 cards
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