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CMC Practice Questions - AACN Exam with Questions & Answers 2025/2026
A. incorrect. decreasing urine output with increasing BUN and CR levels with an
IABP in place indicates obstruction of the renal arteries. The nurse should plan for
removal.
While caring for a patient with an IABP at B. incorrect. absent pulses distal to the insertion site indicates complete occlusion of
3:1, the nurse notes: the femoral artery. application of pressure to the insertion site will worsen the
A. decreasing urine output as well as obstruction.
increasing BUN and CR levels; the nurse C. correct. blood in the IABP tubing indicates a rupture of the balloon. Continuing to
should increase timing to 2:1 allow the IABP to inflate and deflate will increase the size of the rupture, causing
B. absent pulses in the proximal extremity; more bleeding. the nurse should plan for removal or exchange of the IABP catheter.
the nurse should apply pressure at the D. incorrect. a fasciotomy would be indicated if the patient had an increase in fluid
insertion site. accumulation in the extremities causing significant injury to the limb.
C. blood in the IABP tubing; the nurse
should disconnect the balloon catheter
from the IABP.
D. blood oozing from the insertion site; the
nurse should anticipate the need for an
emergency fasciotomy.
A. correct. the IABP will not be able to time correctly when a patient is in V-Fib. by
placing the system to trigger on internal or pressure support, it will generate off the
pressure created during compressions.
An IABP is currently at 3:1 when the B. incorrect. attempting to time the IABP back to 1:1 will be counterproductive, as it
patient suddenly goes into ventricular will not be able to trigger correctly.
fibrillation. In addition to resuscitative C. incorrect. there is significant risk of clot forming on the IABP when placed in stand
measures, the nurse should: for an indeterminate amount of time.
A. change the trigger to internal or D. incorrect. the primary goal during resuscitative measures is to attempt to circulate
pressure support resuscitative measures. blood volume as effectively as possible. assessing the timing of the IABP is
B. increase timing back to 1:1 to increase unnecessary.
coronary artery perfusion pressure.
C. put the pump on standby until the return
of spontaneous circulation.
D. assess the IABP timing to chest
compressions at 1:2.
A. correct. digitalis can cause false-positive EKG changes during a stress test. there
is an association between the development of ST segment depression during stress
testing. the mechanism of this EKG change is not clear. further, digitalis should be
The nurse is reviewing the home
withheld on the day of the test because of its negative chronotropic effects.
medications list for a patient admitted c/o
B. incorrect.
severe chest pain. serial EKGs and blood
C & D. incorrect. beta-blockers and calcium channel blockers blunt the heart rate
testing are negative, so an exercise stress
response to exercise and may prevent achievement of maximum predicted heart
test is scheduled. which of the following
rate. they should be withheld on the day of the test.
medications may result in a false-positive
finding on the stress test?
A. digitalis (Digoxin)
B. potassium chloride (K-Dur)
C. sotalol (Betapace)
D. diltiazem (Cardiazem)
A. incorrect. enoxaparin is an alternative to heparin in patients with unstable angina,
NSTEMI or DVT.
A patient is admitted with elevated troponin B. incorrect. streptokinase is indicated for acute arterial thrombosis or embolism, or
levels and ST segment elevation in leads occluded AV cannulas.
II, III, and aVF. Administration of which of C. incorrect. alteplase in indicated for acute ischemic stroke or acute massive
the following should the nurse anticipate pulmonary embolism.
initially? D. correct. reteplase is indicated for AMI when fibrinolytics are indicated.
A. enoxaparin (Lovenox)
B. streptokinase (Strepase)
C. alteplase (Activase)
D. reteplase (Retavase)
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CMC Practice Questions - AACN Exam with Questions & Answers 2025/2026
A. correct. with diastolic heart failure the left ventricle is unable to relax, leading to
signs and symptoms of heart failure, but the patient maintains a preserved EF as
the muscle retains its ability to contract.
B. incorrect. dilation of the ventricular chambers is a characteristic of systolic heart
failure.
Which of the following is a characteristic of C. incorrect. diastolic heart failure is an abnormality with heart filling. the heart
diastolic heart failure? muscle does not relax normally, and the heart may fill too slowly or asynchronously.
A. inability of the heart muscle to relax. if the left ventricle does not relax properly or is thick and stiff, it does not fill in the
B. dilation of the ventricular chambers. usual manner and blood is drawn back into the left atrium and eventually into the
C. increased filling of the left ventricle. lungs.
D. decreased ability of the ventricle to D. incorrect. decreased ability of the ventricle to contract is a symptom of
contract. overextension of the heart muscle in patients with cardiomyopathy.
A. incorrect. a RBBB would cause an electrical delay in conduction for a wide split
S2.
Following a STEMI, the nurse auscultates B. incorrect. a LBBB would cause and electrical delay in ventricular conduction for a
a late systolic murmur at the apex. The paroxical split S2.
nurse should suspect the finding is r/t the C. correct. a papillary muscle chord rupture results from ischemia to the tissue
new onset of a: supplying the mitral valve. a systolic murmur is heard due to mitral regurgitation.
A. right bundle branch block D. incorrect. plaque rupture would cause an occlusion of the coronary artery that
B. left bundle branch block would not directly cause a new systolic murmur.
C. papillary muscle rupture
D. calcific plaque rupture
A. correct. assessing daily weights is a noninvasive and easy method to assess
compliance with the effectiveness of a medical regimen in patients with heart failure,
observing the patient's ability to maintain a consistent weight indicates compliance
The nurse is reviewing the plan of care for
as well as the effectiveness of the medical regimen.
a patient with systolic heart failure who has
B. incorrect. strict I&O is only one component of a plan of care but does not assess
enalapril (Vasotec), furosemide (Lasix),
if a patient adheres to the medical regimen or if the regimen is effective.
metoprolol (Lopressor), and carvedilol
C. incorrect. a daily BMP would not help assess the effectiveness of the medical
(Coreg) ordered. Which of the following will
regimen as the majority of the panel components are not affected by the drugs
provide the most accurate assessment of
listed.
the regimen?
D. incorrect. serial CXRYs could reveal worsening heart failure, but assessing daily
A. daily weights
weights is far easier, noninvasive and cost-effective.
B. strict I&O
C. BMP every morning
D. serial CXRYs
A. incorrect. recurrent ventricular tachycardia refractory to cardioversion would be
best treated with the insertion of an automatic implantable cardioverter defibrillator.
B. correct. in a maze procedure, numerous incisions are made on the left and right
Which of the following patient situations atrium so that scar tissue forms. this scar tissue does not conduct electricity, which
might be best treated with the maze disrupts the path of abnormal electrical impulses.
procedure? C. incorrect. cardiomyopathy with an EF <20% would be best treated with either
A. recurrent ventricular tachycardia inotropic or mechanical circulatory support.
refractory to cardioversion D. incorrect. coronary artery restenosis following PCI would be best treated with
B. recurrent atrial fibrillation refractory to antiplatelet therapy.
drug therapy
C. cardiomyopathy with an EF <20%
D. coronary artery restenosis following PCI
A. incorrect. an anterior wall MI would have EKG changes in leads V1-V4
B. correct. in the standard lead setup, the EKG typically does not look at the
A patient develops chest pain, nausea, posterior wall; because of the location of the occlusion, ECG changes would not be
vomiting and diaphoresis. the 12-lead EKG apparent.
is normal. a further cardiac assessment is C. incorrect. a lateral wall MI would present changes in leads I, aVL, V5, and V6.
warranted, as it is common for ST segment D. incorrect. an inferior wall MI would present changes in leads II, III, aVF.
elevation to be absent in:
A. an anterior wall MI
B. a posterior wall MI
C. a lateral wall MI
D. an inferior wall MI
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CMC Practice Questions - AACN Exam with Questions & Answers 2025/2026
A. correct. the ST segment elevation and reciprocal changes are indicative of
occlusion of the left anterior descending and left circumflex arteries. these will affect
While reviewing the 12-lead EKG, the the anterior and lateral walls.
nurse notes new changes with ST-segment B. incorrect. an infarct in the posterior and inferior walls would present via EKG with
elevation in leads 1, aVL, and V2-V6, plus changes in the II, III, and aVF leads.
reciprocal changes in III, aVF, and aVR. C. incorrect. an infarct in the lateral and septal walls would present via EKG
The nurse should realize that the area of changes in leads I, aVL, V5, and V6.
infarct involve the: D. incorrect. an infarct in the septal and posterior walls would present via EKG
A. anterior and lateral walls changes in V1-V4.
B. posterior and inferior walls
C. lateral and septal walls
D. septal and posterior walls
A. incorrect.
B. incorrect.
A patient is being discharged on aspirin C. correct. there is an increased risks of bleeding in kidney failure. this tendency is
therapy following recovery from an AMI. attributed to impaired platelet aggregation and adhesion and an altered response to
Which of the following comorbidities puts clotting factor VII.
the patient at greatest risk for developing a D. incorrect.
bleeding complication?
A. asthma
B. transient ischemic attack
C. chronic kidney failure
D. cor pulmonale
A. incorrect. dalteparin is low molecular weight heparin. the patient likely manifested
HIT in the past. heparin is contraindicated.
B. correct. bivalirudin is a direct thrombin inhibitor and may be administered as an
A patient is to undergo PCI. in a previous
alternative to heparin in patients with HIT.
admission the patient received heparin. the
C. incorrect. contraindicated.
patient initially had a platelet count of
D. incorrect. alteplase is indicated for acute ischemic stroke.
250,000; the platelet count was 115,000 a
few days later. which of the following
should the nurse anticipate administering
for the current procedure?
A. dalteparin (Fragmin)
B. bivalirudin (Angiomax)
C. enoxaparin (Lovenox)
D. alteplase (Activase)
A. incorrect. increased perfusion of the coronary arteries occurs during the inflation
phase of the balloon pump timing.
B. incorrect. closing the aortic valve is affected by the preload into the left ventricle.
While timing the balloon pump, the nurse C. incorrect. decreased preload indicates the low volume of blood entering the left
should understand that during the deflation ventricle during relaxation of the left ventricle.
phase the patient will benefit from: D. correct. the relaxation phase of the balloon pump timing reduces systemic
A. increased perfusion of the coronary vascular resistance which in turn improves cardiac output.
arteries
B. decreased resistance to closing the
aortic valve
C. decreased ventricular preload
D. improved cardiac output.
A. incorrect. PAOP reflects the volume in the left ventricle at the end of filling.
B. correct. SvO2 is a reflection of the end result of the balance between oxygen
Which of the following monitoring delivery and oxygen consumption. SvO2 can be used to guide treatment based on
parameters would be the best choice for adequate oxygenation to the tissues.
evaluating tissue oxygenation? C. incorrect. SVR is a measure of the resistance the left ventricle must overcome to
A. PAOP perfuse the body.
B. SvO2 D. incorrect. EF is a measure of what percentage of blood is ejected from the left
C. SVR ventricle during each contraction.
D. EF
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CMC Practice Questions - AACN Exam with Questions & Answers 2025/2026
A. incorrect. decreasing urine output with increasing BUN and CR levels with an
IABP in place indicates obstruction of the renal arteries. The nurse should plan for
removal.
While caring for a patient with an IABP at B. incorrect. absent pulses distal to the insertion site indicates complete occlusion of
3:1, the nurse notes: the femoral artery. application of pressure to the insertion site will worsen the
A. decreasing urine output as well as obstruction.
increasing BUN and CR levels; the nurse C. correct. blood in the IABP tubing indicates a rupture of the balloon. Continuing to
should increase timing to 2:1 allow the IABP to inflate and deflate will increase the size of the rupture, causing
B. absent pulses in the proximal extremity; more bleeding. the nurse should plan for removal or exchange of the IABP catheter.
the nurse should apply pressure at the D. incorrect. a fasciotomy would be indicated if the patient had an increase in fluid
insertion site. accumulation in the extremities causing significant injury to the limb.
C. blood in the IABP tubing; the nurse
should disconnect the balloon catheter
from the IABP.
D. blood oozing from the insertion site; the
nurse should anticipate the need for an
emergency fasciotomy.
A. correct. the IABP will not be able to time correctly when a patient is in V-Fib. by
placing the system to trigger on internal or pressure support, it will generate off the
pressure created during compressions.
An IABP is currently at 3:1 when the B. incorrect. attempting to time the IABP back to 1:1 will be counterproductive, as it
patient suddenly goes into ventricular will not be able to trigger correctly.
fibrillation. In addition to resuscitative C. incorrect. there is significant risk of clot forming on the IABP when placed in stand
measures, the nurse should: for an indeterminate amount of time.
A. change the trigger to internal or D. incorrect. the primary goal during resuscitative measures is to attempt to circulate
pressure support resuscitative measures. blood volume as effectively as possible. assessing the timing of the IABP is
B. increase timing back to 1:1 to increase unnecessary.
coronary artery perfusion pressure.
C. put the pump on standby until the return
of spontaneous circulation.
D. assess the IABP timing to chest
compressions at 1:2.
A. correct. digitalis can cause false-positive EKG changes during a stress test. there
is an association between the development of ST segment depression during stress
testing. the mechanism of this EKG change is not clear. further, digitalis should be
The nurse is reviewing the home
withheld on the day of the test because of its negative chronotropic effects.
medications list for a patient admitted c/o
B. incorrect.
severe chest pain. serial EKGs and blood
C & D. incorrect. beta-blockers and calcium channel blockers blunt the heart rate
testing are negative, so an exercise stress
response to exercise and may prevent achievement of maximum predicted heart
test is scheduled. which of the following
rate. they should be withheld on the day of the test.
medications may result in a false-positive
finding on the stress test?
A. digitalis (Digoxin)
B. potassium chloride (K-Dur)
C. sotalol (Betapace)
D. diltiazem (Cardiazem)
A. incorrect. enoxaparin is an alternative to heparin in patients with unstable angina,
NSTEMI or DVT.
A patient is admitted with elevated troponin B. incorrect. streptokinase is indicated for acute arterial thrombosis or embolism, or
levels and ST segment elevation in leads occluded AV cannulas.
II, III, and aVF. Administration of which of C. incorrect. alteplase in indicated for acute ischemic stroke or acute massive
the following should the nurse anticipate pulmonary embolism.
initially? D. correct. reteplase is indicated for AMI when fibrinolytics are indicated.
A. enoxaparin (Lovenox)
B. streptokinase (Strepase)
C. alteplase (Activase)
D. reteplase (Retavase)
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CMC Practice Questions - AACN Exam with Questions & Answers 2025/2026
A. correct. with diastolic heart failure the left ventricle is unable to relax, leading to
signs and symptoms of heart failure, but the patient maintains a preserved EF as
the muscle retains its ability to contract.
B. incorrect. dilation of the ventricular chambers is a characteristic of systolic heart
failure.
Which of the following is a characteristic of C. incorrect. diastolic heart failure is an abnormality with heart filling. the heart
diastolic heart failure? muscle does not relax normally, and the heart may fill too slowly or asynchronously.
A. inability of the heart muscle to relax. if the left ventricle does not relax properly or is thick and stiff, it does not fill in the
B. dilation of the ventricular chambers. usual manner and blood is drawn back into the left atrium and eventually into the
C. increased filling of the left ventricle. lungs.
D. decreased ability of the ventricle to D. incorrect. decreased ability of the ventricle to contract is a symptom of
contract. overextension of the heart muscle in patients with cardiomyopathy.
A. incorrect. a RBBB would cause an electrical delay in conduction for a wide split
S2.
Following a STEMI, the nurse auscultates B. incorrect. a LBBB would cause and electrical delay in ventricular conduction for a
a late systolic murmur at the apex. The paroxical split S2.
nurse should suspect the finding is r/t the C. correct. a papillary muscle chord rupture results from ischemia to the tissue
new onset of a: supplying the mitral valve. a systolic murmur is heard due to mitral regurgitation.
A. right bundle branch block D. incorrect. plaque rupture would cause an occlusion of the coronary artery that
B. left bundle branch block would not directly cause a new systolic murmur.
C. papillary muscle rupture
D. calcific plaque rupture
A. correct. assessing daily weights is a noninvasive and easy method to assess
compliance with the effectiveness of a medical regimen in patients with heart failure,
observing the patient's ability to maintain a consistent weight indicates compliance
The nurse is reviewing the plan of care for
as well as the effectiveness of the medical regimen.
a patient with systolic heart failure who has
B. incorrect. strict I&O is only one component of a plan of care but does not assess
enalapril (Vasotec), furosemide (Lasix),
if a patient adheres to the medical regimen or if the regimen is effective.
metoprolol (Lopressor), and carvedilol
C. incorrect. a daily BMP would not help assess the effectiveness of the medical
(Coreg) ordered. Which of the following will
regimen as the majority of the panel components are not affected by the drugs
provide the most accurate assessment of
listed.
the regimen?
D. incorrect. serial CXRYs could reveal worsening heart failure, but assessing daily
A. daily weights
weights is far easier, noninvasive and cost-effective.
B. strict I&O
C. BMP every morning
D. serial CXRYs
A. incorrect. recurrent ventricular tachycardia refractory to cardioversion would be
best treated with the insertion of an automatic implantable cardioverter defibrillator.
B. correct. in a maze procedure, numerous incisions are made on the left and right
Which of the following patient situations atrium so that scar tissue forms. this scar tissue does not conduct electricity, which
might be best treated with the maze disrupts the path of abnormal electrical impulses.
procedure? C. incorrect. cardiomyopathy with an EF <20% would be best treated with either
A. recurrent ventricular tachycardia inotropic or mechanical circulatory support.
refractory to cardioversion D. incorrect. coronary artery restenosis following PCI would be best treated with
B. recurrent atrial fibrillation refractory to antiplatelet therapy.
drug therapy
C. cardiomyopathy with an EF <20%
D. coronary artery restenosis following PCI
A. incorrect. an anterior wall MI would have EKG changes in leads V1-V4
B. correct. in the standard lead setup, the EKG typically does not look at the
A patient develops chest pain, nausea, posterior wall; because of the location of the occlusion, ECG changes would not be
vomiting and diaphoresis. the 12-lead EKG apparent.
is normal. a further cardiac assessment is C. incorrect. a lateral wall MI would present changes in leads I, aVL, V5, and V6.
warranted, as it is common for ST segment D. incorrect. an inferior wall MI would present changes in leads II, III, aVF.
elevation to be absent in:
A. an anterior wall MI
B. a posterior wall MI
C. a lateral wall MI
D. an inferior wall MI
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CMC Practice Questions - AACN Exam with Questions & Answers 2025/2026
A. correct. the ST segment elevation and reciprocal changes are indicative of
occlusion of the left anterior descending and left circumflex arteries. these will affect
While reviewing the 12-lead EKG, the the anterior and lateral walls.
nurse notes new changes with ST-segment B. incorrect. an infarct in the posterior and inferior walls would present via EKG with
elevation in leads 1, aVL, and V2-V6, plus changes in the II, III, and aVF leads.
reciprocal changes in III, aVF, and aVR. C. incorrect. an infarct in the lateral and septal walls would present via EKG
The nurse should realize that the area of changes in leads I, aVL, V5, and V6.
infarct involve the: D. incorrect. an infarct in the septal and posterior walls would present via EKG
A. anterior and lateral walls changes in V1-V4.
B. posterior and inferior walls
C. lateral and septal walls
D. septal and posterior walls
A. incorrect.
B. incorrect.
A patient is being discharged on aspirin C. correct. there is an increased risks of bleeding in kidney failure. this tendency is
therapy following recovery from an AMI. attributed to impaired platelet aggregation and adhesion and an altered response to
Which of the following comorbidities puts clotting factor VII.
the patient at greatest risk for developing a D. incorrect.
bleeding complication?
A. asthma
B. transient ischemic attack
C. chronic kidney failure
D. cor pulmonale
A. incorrect. dalteparin is low molecular weight heparin. the patient likely manifested
HIT in the past. heparin is contraindicated.
B. correct. bivalirudin is a direct thrombin inhibitor and may be administered as an
A patient is to undergo PCI. in a previous
alternative to heparin in patients with HIT.
admission the patient received heparin. the
C. incorrect. contraindicated.
patient initially had a platelet count of
D. incorrect. alteplase is indicated for acute ischemic stroke.
250,000; the platelet count was 115,000 a
few days later. which of the following
should the nurse anticipate administering
for the current procedure?
A. dalteparin (Fragmin)
B. bivalirudin (Angiomax)
C. enoxaparin (Lovenox)
D. alteplase (Activase)
A. incorrect. increased perfusion of the coronary arteries occurs during the inflation
phase of the balloon pump timing.
B. incorrect. closing the aortic valve is affected by the preload into the left ventricle.
While timing the balloon pump, the nurse C. incorrect. decreased preload indicates the low volume of blood entering the left
should understand that during the deflation ventricle during relaxation of the left ventricle.
phase the patient will benefit from: D. correct. the relaxation phase of the balloon pump timing reduces systemic
A. increased perfusion of the coronary vascular resistance which in turn improves cardiac output.
arteries
B. decreased resistance to closing the
aortic valve
C. decreased ventricular preload
D. improved cardiac output.
A. incorrect. PAOP reflects the volume in the left ventricle at the end of filling.
B. correct. SvO2 is a reflection of the end result of the balance between oxygen
Which of the following monitoring delivery and oxygen consumption. SvO2 can be used to guide treatment based on
parameters would be the best choice for adequate oxygenation to the tissues.
evaluating tissue oxygenation? C. incorrect. SVR is a measure of the resistance the left ventricle must overcome to
A. PAOP perfuse the body.
B. SvO2 D. incorrect. EF is a measure of what percentage of blood is ejected from the left
C. SVR ventricle during each contraction.
D. EF
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