CVN Exam | Comprehensive Cardiac-Vascular Nursing Practice
Questions & Detailed Rationales 2026/2027
Question 1
Which physiological parameter is the primary determinant of
myocardial oxygen demand?
• A. Systemic vascular resistance, central venous pressure, and body
temperature
• B. Heart rate, myocardial contractility, and intramyocardial wall
tension (afterload/preload)
• C. Arterial blood gas pH and carbon dioxide partial pressure
• D. Total blood volume and red blood cell count
Correct Answer: B. Heart rate, myocardial contractility, and
intramyocardial wall tension (afterload/preload)
Detailed Rationale: The major determinants of myocardial oxygen
consumption (𝑀𝑉𝑂2 ) are heart rate, contractility, and wall stress
(tension), which is determined by ventricular preload and afterload.
Question 2
What is the primary mechanism of action of loop diuretics such as
furosemide in the management of acute heart failure?
• A. Aldosterone receptor antagonism in the collecting tubules
• B. Inhibition of sodium and chloride reabsorption in the thick
ascending limb of the loop of Henle
, • C. Osmotic water extraction in the proximal convoluted tubule
• D. Blockade of carbonic anhydrase enzymes
Correct Answer: B. Inhibition of sodium and chloride reabsorption in
the thick ascending limb of the loop of Henle
Detailed Rationale: Loop diuretics inhibit the Na+ K+ 2Cl− cotransporter
in the ascending limb of the loop of Henle, producing potent diuresis
and rapid reduction in intravascular volume and preload.
Question 3
An ECG tracing reveals a prolonged PR interval greater than 0.20
seconds with all P waves followed by a QRS complex. How is this rhythm
classified?
• A. First-degree atrioventricular (AV) block
• B. Second-degree AV block, Mobitz Type I
• C. Third-degree AV block
• D. Junctional escape rhythm
Correct Answer: A. First-degree atrioventricular (AV) block
Detailed Rationale: First-degree AV block is characterized by a constant,
prolonged PR interval exceeding 0.20 seconds, representing delayed
conduction through the AV node, with every P wave successfully
conducted.
Question 4
Which assessment finding is most indicative of cardiac tamponade
following cardiac surgery?
, • A. Widened pulse pressure and bounding peripheral pulses
• B. Hypotension, muffled heart sounds, and jugular venous
distension (Beck's triad)
• C. Bradycardia and bradypnea without hemodynamic compromise
• D. High-pitched systolic murmur at the left sternal border
Correct Answer: B. Hypotension, muffled heart sounds, and jugular
venous distension (Beck's triad)
Detailed Rationale: Cardiac tamponade restricts diastolic filling due to
fluid accumulation in the pericardial sac, classically presenting with
Beck's triad: hypotension, muffled heart sounds, and elevated JVP.
Question 5
Which diagnostic test is considered the gold standard for diagnosing
coronary artery disease?
• A. Resting 12-lead electrocardiogram
• B. Transthoracic echocardiogram
• C. Invasive coronary angiography
• D. Exercise stress test
Correct Answer: C. Invasive coronary angiography
Detailed Rationale: Coronary angiography provides direct visualization
of the coronary arterial lumen, precisely localizing and quantifying
atherosclerotic stenoses and guiding revascularization strategies.
Question 6
, What is the primary hemodynamic goal of intra-aortic balloon pump
(IABP) therapy?
• A. Increase afterload and decrease coronary perfusion
• B. Decrease myocardial oxygen demand while increasing coronary
artery perfusion and cardiac output
• C. Completely replace the pumping function of both ventricles
indefinitely
• D. Induce systemic vasodilation via direct smooth muscle paralysis
Correct Answer: B. Decrease myocardial oxygen demand while
increasing coronary artery perfusion and cardiac output
Detailed Rationale: IABP counterpulsation inflates during diastole to
augment coronary perfusion pressure and deflates just before systole to
reduce afterload, thereby lowering myocardial workload and oxygen
consumption.
Question 7
Which class of antiarrhythmic medications is classified under the
Vaughan-Williams Class III category, primarily prolonging repolarization
and effective refractory period?
• A. Lidocaine and Phenytoin
• B. Amiodarone and Sotalol
• C. Verapamil and Diltiazem
• D. Flecainide and Propafenone
Correct Answer: B. Amiodarone and Sotalol
Questions & Detailed Rationales 2026/2027
Question 1
Which physiological parameter is the primary determinant of
myocardial oxygen demand?
• A. Systemic vascular resistance, central venous pressure, and body
temperature
• B. Heart rate, myocardial contractility, and intramyocardial wall
tension (afterload/preload)
• C. Arterial blood gas pH and carbon dioxide partial pressure
• D. Total blood volume and red blood cell count
Correct Answer: B. Heart rate, myocardial contractility, and
intramyocardial wall tension (afterload/preload)
Detailed Rationale: The major determinants of myocardial oxygen
consumption (𝑀𝑉𝑂2 ) are heart rate, contractility, and wall stress
(tension), which is determined by ventricular preload and afterload.
Question 2
What is the primary mechanism of action of loop diuretics such as
furosemide in the management of acute heart failure?
• A. Aldosterone receptor antagonism in the collecting tubules
• B. Inhibition of sodium and chloride reabsorption in the thick
ascending limb of the loop of Henle
, • C. Osmotic water extraction in the proximal convoluted tubule
• D. Blockade of carbonic anhydrase enzymes
Correct Answer: B. Inhibition of sodium and chloride reabsorption in
the thick ascending limb of the loop of Henle
Detailed Rationale: Loop diuretics inhibit the Na+ K+ 2Cl− cotransporter
in the ascending limb of the loop of Henle, producing potent diuresis
and rapid reduction in intravascular volume and preload.
Question 3
An ECG tracing reveals a prolonged PR interval greater than 0.20
seconds with all P waves followed by a QRS complex. How is this rhythm
classified?
• A. First-degree atrioventricular (AV) block
• B. Second-degree AV block, Mobitz Type I
• C. Third-degree AV block
• D. Junctional escape rhythm
Correct Answer: A. First-degree atrioventricular (AV) block
Detailed Rationale: First-degree AV block is characterized by a constant,
prolonged PR interval exceeding 0.20 seconds, representing delayed
conduction through the AV node, with every P wave successfully
conducted.
Question 4
Which assessment finding is most indicative of cardiac tamponade
following cardiac surgery?
, • A. Widened pulse pressure and bounding peripheral pulses
• B. Hypotension, muffled heart sounds, and jugular venous
distension (Beck's triad)
• C. Bradycardia and bradypnea without hemodynamic compromise
• D. High-pitched systolic murmur at the left sternal border
Correct Answer: B. Hypotension, muffled heart sounds, and jugular
venous distension (Beck's triad)
Detailed Rationale: Cardiac tamponade restricts diastolic filling due to
fluid accumulation in the pericardial sac, classically presenting with
Beck's triad: hypotension, muffled heart sounds, and elevated JVP.
Question 5
Which diagnostic test is considered the gold standard for diagnosing
coronary artery disease?
• A. Resting 12-lead electrocardiogram
• B. Transthoracic echocardiogram
• C. Invasive coronary angiography
• D. Exercise stress test
Correct Answer: C. Invasive coronary angiography
Detailed Rationale: Coronary angiography provides direct visualization
of the coronary arterial lumen, precisely localizing and quantifying
atherosclerotic stenoses and guiding revascularization strategies.
Question 6
, What is the primary hemodynamic goal of intra-aortic balloon pump
(IABP) therapy?
• A. Increase afterload and decrease coronary perfusion
• B. Decrease myocardial oxygen demand while increasing coronary
artery perfusion and cardiac output
• C. Completely replace the pumping function of both ventricles
indefinitely
• D. Induce systemic vasodilation via direct smooth muscle paralysis
Correct Answer: B. Decrease myocardial oxygen demand while
increasing coronary artery perfusion and cardiac output
Detailed Rationale: IABP counterpulsation inflates during diastole to
augment coronary perfusion pressure and deflates just before systole to
reduce afterload, thereby lowering myocardial workload and oxygen
consumption.
Question 7
Which class of antiarrhythmic medications is classified under the
Vaughan-Williams Class III category, primarily prolonging repolarization
and effective refractory period?
• A. Lidocaine and Phenytoin
• B. Amiodarone and Sotalol
• C. Verapamil and Diltiazem
• D. Flecainide and Propafenone
Correct Answer: B. Amiodarone and Sotalol
