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CMC AACN Cardiovascular Medicine Certification
Exam 2026-2027 | Version B | 250 New Complex
Practice Questions with Detailed Rationales | Real
Exam Simulation | Verified Answers | Instant
Download
1. A patient with an acute anterior wall myocardial infarction develops new-
onset hypotension, tachycardia, and clear lung sounds two days after
admission. The nurse should suspect:
A. Left ventricular failure
B. Right ventricular infarction
C. Papillary muscle rupture
D. Ventricular septal defect
Correct Answer: B
Rationale: Right ventricular infarction is associated with inferior wall
myocardial infarction and can present with hypotension, tachycardia, and
clear lung sounds due to decreased right ventricular output. Left ventricular
failure would present with crackles. Papillary muscle rupture would present
with a new murmur and pulmonary edema. Ventricular septal defect would
present with a new murmur and pulmonary edema.
, 2
2. A patient with heart failure is prescribed sacubitril/valsartan. The nurse
should teach the patient that this medication:
A. Should be taken with food
B. Cannot be taken with ACE inhibitors
C. Requires monitoring of potassium levels
D. All of the above
Correct Answer: D
Rationale: Sacubitril/valsartan should be taken with food to improve
absorption. It cannot be taken with ACE inhibitors due to increased risk of
angioedema. It requires monitoring of potassium levels due to the risk of
hyperkalemia.
3. A patient with a mechanical mitral valve is prescribed warfarin. The patient
asks why they cannot take a direct oral anticoagulant instead. The nurse
should explain that:
A. Direct oral anticoagulants are more expensive
B. Direct oral anticoagulants are not approved for mechanical valves
C. Direct oral anticoagulants have more side effects
D. Direct oral anticoagulants are not effective
Correct Answer: B
Rationale: Direct oral anticoagulants are not approved for use with
mechanical heart valves. Warfarin remains the standard of care for
mechanical valve anticoagulation.
, 3
4. A patient with an ejection fraction of 25% is admitted with worsening
dyspnea. The nurse should anticipate which medication to be added to the
regimen?
A. Verapamil
B. Diltiazem
C. Sacubitril/valsartan
D. Flecainide
Correct Answer: C
Rationale: Sacubitril/valsartan is indicated for heart failure with reduced
ejection fraction. Verapamil, diltiazem, and flecainide are contraindicated in
heart failure with reduced ejection fraction due to their negative inotropic
effects.
5. A patient with an ICD experiences an appropriate shock while awake. The
nurse should:
A. Document the event and assess the patient
B. Notify the physician immediately
C. Administer amiodarone
D. Disable the ICD
Correct Answer: A
Rationale: The nurse should document the event and assess the patient.
Notification of the physician is appropriate but assessment is the priority.
Amiodarone may be administered but not immediately. Disabling the ICD is
not appropriate.
, 4
6. A patient with a heart transplant develops a fever and hypotension. The
nurse should suspect:
A. Rejection
B. Infection
C. Both A and B
D. Neither A nor B
Correct Answer: C
Rationale: Both rejection and infection can present with fever and
hypotension in a heart transplant patient. The nurse should assess for both
and notify the physician.
7. A patient with pulmonary arterial hypertension is prescribed sildenafil. The
nurse should teach the patient to avoid:
A. Nitrates
B. Beta-blockers
C. Calcium channel blockers
D. ACE inhibitors
Correct Answer: A
Rationale: Sildenafil combined with nitrates can cause severe hypotension.
Beta-blockers, calcium channel blockers, and ACE inhibitors do not have this
interaction.
CMC AACN Cardiovascular Medicine Certification
Exam 2026-2027 | Version B | 250 New Complex
Practice Questions with Detailed Rationales | Real
Exam Simulation | Verified Answers | Instant
Download
1. A patient with an acute anterior wall myocardial infarction develops new-
onset hypotension, tachycardia, and clear lung sounds two days after
admission. The nurse should suspect:
A. Left ventricular failure
B. Right ventricular infarction
C. Papillary muscle rupture
D. Ventricular septal defect
Correct Answer: B
Rationale: Right ventricular infarction is associated with inferior wall
myocardial infarction and can present with hypotension, tachycardia, and
clear lung sounds due to decreased right ventricular output. Left ventricular
failure would present with crackles. Papillary muscle rupture would present
with a new murmur and pulmonary edema. Ventricular septal defect would
present with a new murmur and pulmonary edema.
, 2
2. A patient with heart failure is prescribed sacubitril/valsartan. The nurse
should teach the patient that this medication:
A. Should be taken with food
B. Cannot be taken with ACE inhibitors
C. Requires monitoring of potassium levels
D. All of the above
Correct Answer: D
Rationale: Sacubitril/valsartan should be taken with food to improve
absorption. It cannot be taken with ACE inhibitors due to increased risk of
angioedema. It requires monitoring of potassium levels due to the risk of
hyperkalemia.
3. A patient with a mechanical mitral valve is prescribed warfarin. The patient
asks why they cannot take a direct oral anticoagulant instead. The nurse
should explain that:
A. Direct oral anticoagulants are more expensive
B. Direct oral anticoagulants are not approved for mechanical valves
C. Direct oral anticoagulants have more side effects
D. Direct oral anticoagulants are not effective
Correct Answer: B
Rationale: Direct oral anticoagulants are not approved for use with
mechanical heart valves. Warfarin remains the standard of care for
mechanical valve anticoagulation.
, 3
4. A patient with an ejection fraction of 25% is admitted with worsening
dyspnea. The nurse should anticipate which medication to be added to the
regimen?
A. Verapamil
B. Diltiazem
C. Sacubitril/valsartan
D. Flecainide
Correct Answer: C
Rationale: Sacubitril/valsartan is indicated for heart failure with reduced
ejection fraction. Verapamil, diltiazem, and flecainide are contraindicated in
heart failure with reduced ejection fraction due to their negative inotropic
effects.
5. A patient with an ICD experiences an appropriate shock while awake. The
nurse should:
A. Document the event and assess the patient
B. Notify the physician immediately
C. Administer amiodarone
D. Disable the ICD
Correct Answer: A
Rationale: The nurse should document the event and assess the patient.
Notification of the physician is appropriate but assessment is the priority.
Amiodarone may be administered but not immediately. Disabling the ICD is
not appropriate.
, 4
6. A patient with a heart transplant develops a fever and hypotension. The
nurse should suspect:
A. Rejection
B. Infection
C. Both A and B
D. Neither A nor B
Correct Answer: C
Rationale: Both rejection and infection can present with fever and
hypotension in a heart transplant patient. The nurse should assess for both
and notify the physician.
7. A patient with pulmonary arterial hypertension is prescribed sildenafil. The
nurse should teach the patient to avoid:
A. Nitrates
B. Beta-blockers
C. Calcium channel blockers
D. ACE inhibitors
Correct Answer: A
Rationale: Sildenafil combined with nitrates can cause severe hypotension.
Beta-blockers, calcium channel blockers, and ACE inhibitors do not have this
interaction.
