AACN CCRN EXAM COMPLETE ACTUAL EXAMS
QUESTIONS AND ANSWERS ADVANCED
PHARMACOLOGY FUNDAMENTALS 100% PASS
GUARANTED GRADED A+
,Cardiovascular
1. A patient in the ICU develops a narrow-complex tachycardia with a rate of 180 bpm and a blood pressure of
70/40 mmHg. The patient is symptomatic with altered mental status. What is the priority intervention?
A) Administer amiodarone 150 mg IV push
B) Perform synchronized cardioversion
C) Administer adenosine 6 mg rapid IV push
D) Initiate a diltiazem drip
Answer: B
Rationale: The patient is unstable (hypotensive, altered mental status) with a tachyarrhythmia. The priority is
immediate synchronized cardioversion. Pharmacologic interventions are appropriate for stable patients.
2. A patient with an acute inferior wall MI develops bradycardia with a heart rate of 42 bpm and BP of 85/50
mmHg. The ECG shows a third-degree AV block. What is the most appropriate initial treatment?
A) Transcutaneous pacing
B) Atropine 0.5 mg IV push
C) Dopamine infusion
D) Epinephrine infusion
,Answer: B
Rationale: Atropine is the first-line treatment for symptomatic bradycardia, including third-degree AV block,
especially in the setting of an inferior MI where increased vagal tone is often the cause. If atropine is ineffective,
pacing is indicated.
3. A patient post-CABG surgery has a cardiac output of 3.5 L/min, CVP of 12 mmHg, PAOP of 18 mmHg, and
SVR of 1600 dynes/sec/cm-5. Which hemodynamic profile is consistent with these findings?
A) Hypovolemic shock
B) Cardiogenic shock
C) Septic shock
D) Neurogenic shock
Answer: B
Rationale: The high PAOP (18 mmHg) indicates elevated left ventricular filling pressures. The high SVR (1600)
is a compensatory mechanism in cardiogenic shock. The low cardiac output (3.5 L/min) with high filling
pressures is classic for cardiogenic shock.
4. A patient with a pulmonary artery catheter has a PAOP of 14 mmHg and a CVP of 15 mmHg. What is the
most likely cause of this discrepancy?
, A) Left ventricular failure
B) Right ventricular failure
C) Cardiac tamponade
D) Aortic stenosis
Answer: B
Rationale: In right ventricular failure, the right ventricle cannot effectively pump blood to the left side. This causes
blood to back up in the right side of the heart, increasing CVP (15 mmHg), while the left ventricular filling
pressure (PAOP) remains normal or low (14 mmHg).
5. A patient with an acute anterior MI suddenly develops a loud holosystolic murmur at the apex radiating to the
axilla. The patient becomes hypotensive and develops pulmonary edema. What complication is most likely?
A) Ventricular septal rupture
B) Papillary muscle rupture
C) Aortic dissection
D) Pericarditis
Answer: B
QUESTIONS AND ANSWERS ADVANCED
PHARMACOLOGY FUNDAMENTALS 100% PASS
GUARANTED GRADED A+
,Cardiovascular
1. A patient in the ICU develops a narrow-complex tachycardia with a rate of 180 bpm and a blood pressure of
70/40 mmHg. The patient is symptomatic with altered mental status. What is the priority intervention?
A) Administer amiodarone 150 mg IV push
B) Perform synchronized cardioversion
C) Administer adenosine 6 mg rapid IV push
D) Initiate a diltiazem drip
Answer: B
Rationale: The patient is unstable (hypotensive, altered mental status) with a tachyarrhythmia. The priority is
immediate synchronized cardioversion. Pharmacologic interventions are appropriate for stable patients.
2. A patient with an acute inferior wall MI develops bradycardia with a heart rate of 42 bpm and BP of 85/50
mmHg. The ECG shows a third-degree AV block. What is the most appropriate initial treatment?
A) Transcutaneous pacing
B) Atropine 0.5 mg IV push
C) Dopamine infusion
D) Epinephrine infusion
,Answer: B
Rationale: Atropine is the first-line treatment for symptomatic bradycardia, including third-degree AV block,
especially in the setting of an inferior MI where increased vagal tone is often the cause. If atropine is ineffective,
pacing is indicated.
3. A patient post-CABG surgery has a cardiac output of 3.5 L/min, CVP of 12 mmHg, PAOP of 18 mmHg, and
SVR of 1600 dynes/sec/cm-5. Which hemodynamic profile is consistent with these findings?
A) Hypovolemic shock
B) Cardiogenic shock
C) Septic shock
D) Neurogenic shock
Answer: B
Rationale: The high PAOP (18 mmHg) indicates elevated left ventricular filling pressures. The high SVR (1600)
is a compensatory mechanism in cardiogenic shock. The low cardiac output (3.5 L/min) with high filling
pressures is classic for cardiogenic shock.
4. A patient with a pulmonary artery catheter has a PAOP of 14 mmHg and a CVP of 15 mmHg. What is the
most likely cause of this discrepancy?
, A) Left ventricular failure
B) Right ventricular failure
C) Cardiac tamponade
D) Aortic stenosis
Answer: B
Rationale: In right ventricular failure, the right ventricle cannot effectively pump blood to the left side. This causes
blood to back up in the right side of the heart, increasing CVP (15 mmHg), while the left ventricular filling
pressure (PAOP) remains normal or low (14 mmHg).
5. A patient with an acute anterior MI suddenly develops a loud holosystolic murmur at the apex radiating to the
axilla. The patient becomes hypotensive and develops pulmonary edema. What complication is most likely?
A) Ventricular septal rupture
B) Papillary muscle rupture
C) Aortic dissection
D) Pericarditis
Answer: B
