AACN CMC Exam Practice
Questions And Correct
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Plus Rationale 2026 Q&A|
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1. A patient with acute chest pain has a blood pressure of 86/54 mm
Hg, heart rate 118/min, cool extremities, and altered mentation.
Which finding most strongly indicates inadequate systemic
perfusion?
A. Heart rate of 118/min
B. Cool extremities
C. Altered mentation
D. Blood pressure of 86/54 mm Hg
Answer: C. Altered mentation
Rationale: Altered mentation is a clinical manifestation of inadequate
cerebral perfusion and is an important indicator of shock.
Hypotension and tachycardia are also concerning, but neurologic
changes indicate compromised end-organ perfusion.
2. Which hemodynamic measurement best reflects left ventricular
preload?
A. Systemic vascular resistance
B. Pulmonary artery occlusion pressure
,C. Cardiac output
D. Mean arterial pressure
Answer: B. Pulmonary artery occlusion pressure
Rationale: Pulmonary artery occlusion pressure (PAOP) estimates left
atrial pressure and is commonly used as an indirect measure of left
ventricular preload.
3. A patient's cardiac output is 3.0 L/min and body surface area is 1.5
m². What is the cardiac index?
A. 1.0 L/min/m²
B. 1.5 L/min/m²
C. 2.0 L/min/m²
D. 4.5 L/min/m²
Answer: C. 2.0 L/min/m²
Rationale: Cardiac index = cardiac output ÷ body surface area.
Therefore, 3.0 ÷ 1.5 = 2.0 L/min/m².
4. Which finding is most consistent with right ventricular failure?
A. Pulmonary crackles
B. Jugular venous distention
C. Pink frothy sputum
D. Orthopnea
Answer: B. Jugular venous distention
Rationale: Right ventricular failure causes systemic venous
congestion, producing jugular venous distention, peripheral edema,
hepatomegaly, and ascites.
,5. Which condition most commonly causes an elevated systemic
vascular resistance?
A. Septic shock
B. Neurogenic shock
C. Cardiogenic shock
D. Anaphylactic shock
Answer: C. Cardiogenic shock
Rationale: In cardiogenic shock, the body compensates for reduced
cardiac output through sympathetic activation and systemic
vasoconstriction, increasing SVR.
6. A patient has a cardiac output of 4 L/min and an oxygen
consumption of 200 mL/min. What approximate arterial-venous
oxygen difference would be expected?
A. 2 mL/dL
B. 5 mL/dL
C. 10 mL/dL
D. 20 mL/dL
Answer: B. 5 mL/dL
Rationale: Fick principle: VO₂ = CO × arterial-venous oxygen content
difference. With 200 mL/min oxygen consumption and 4 L/min
cardiac output, the difference is approximately 5 mL/dL.
7. Which assessment finding suggests decreased cardiac output?
A. Warm, flushed skin
B. Bounding pulses
C. Decreased urine output
D. Hypertension
, Answer: C. Decreased urine output
Rationale: Reduced renal perfusion from decreased cardiac output
commonly causes oliguria. Other manifestations include cool skin,
altered mentation, weak pulses, and fatigue.
8. Which laboratory value is most useful for assessing myocardial
injury?
A. BNP
B. Troponin
C. D-dimer
D. Lactate
Answer: B. Troponin
Rationale: Cardiac troponins are highly sensitive and specific
biomarkers of myocardial injury.
9. Which finding is most characteristic of elevated right-sided filling
pressures?
A. Flat neck veins
B. Jugular venous distention
C. Pulmonary edema
D. Hemoptysis
Answer: B. Jugular venous distention
Rationale: Elevated right atrial pressure causes systemic venous
congestion, commonly manifested by jugular venous distention.
10. A patient with heart failure develops confusion, oliguria, cool
skin, and hypotension. Which complication should the nurse
suspect?
Questions And Correct
Answers (Verified Answers)
Plus Rationale 2026 Q&A|
Instant Download Pdf
1. A patient with acute chest pain has a blood pressure of 86/54 mm
Hg, heart rate 118/min, cool extremities, and altered mentation.
Which finding most strongly indicates inadequate systemic
perfusion?
A. Heart rate of 118/min
B. Cool extremities
C. Altered mentation
D. Blood pressure of 86/54 mm Hg
Answer: C. Altered mentation
Rationale: Altered mentation is a clinical manifestation of inadequate
cerebral perfusion and is an important indicator of shock.
Hypotension and tachycardia are also concerning, but neurologic
changes indicate compromised end-organ perfusion.
2. Which hemodynamic measurement best reflects left ventricular
preload?
A. Systemic vascular resistance
B. Pulmonary artery occlusion pressure
,C. Cardiac output
D. Mean arterial pressure
Answer: B. Pulmonary artery occlusion pressure
Rationale: Pulmonary artery occlusion pressure (PAOP) estimates left
atrial pressure and is commonly used as an indirect measure of left
ventricular preload.
3. A patient's cardiac output is 3.0 L/min and body surface area is 1.5
m². What is the cardiac index?
A. 1.0 L/min/m²
B. 1.5 L/min/m²
C. 2.0 L/min/m²
D. 4.5 L/min/m²
Answer: C. 2.0 L/min/m²
Rationale: Cardiac index = cardiac output ÷ body surface area.
Therefore, 3.0 ÷ 1.5 = 2.0 L/min/m².
4. Which finding is most consistent with right ventricular failure?
A. Pulmonary crackles
B. Jugular venous distention
C. Pink frothy sputum
D. Orthopnea
Answer: B. Jugular venous distention
Rationale: Right ventricular failure causes systemic venous
congestion, producing jugular venous distention, peripheral edema,
hepatomegaly, and ascites.
,5. Which condition most commonly causes an elevated systemic
vascular resistance?
A. Septic shock
B. Neurogenic shock
C. Cardiogenic shock
D. Anaphylactic shock
Answer: C. Cardiogenic shock
Rationale: In cardiogenic shock, the body compensates for reduced
cardiac output through sympathetic activation and systemic
vasoconstriction, increasing SVR.
6. A patient has a cardiac output of 4 L/min and an oxygen
consumption of 200 mL/min. What approximate arterial-venous
oxygen difference would be expected?
A. 2 mL/dL
B. 5 mL/dL
C. 10 mL/dL
D. 20 mL/dL
Answer: B. 5 mL/dL
Rationale: Fick principle: VO₂ = CO × arterial-venous oxygen content
difference. With 200 mL/min oxygen consumption and 4 L/min
cardiac output, the difference is approximately 5 mL/dL.
7. Which assessment finding suggests decreased cardiac output?
A. Warm, flushed skin
B. Bounding pulses
C. Decreased urine output
D. Hypertension
, Answer: C. Decreased urine output
Rationale: Reduced renal perfusion from decreased cardiac output
commonly causes oliguria. Other manifestations include cool skin,
altered mentation, weak pulses, and fatigue.
8. Which laboratory value is most useful for assessing myocardial
injury?
A. BNP
B. Troponin
C. D-dimer
D. Lactate
Answer: B. Troponin
Rationale: Cardiac troponins are highly sensitive and specific
biomarkers of myocardial injury.
9. Which finding is most characteristic of elevated right-sided filling
pressures?
A. Flat neck veins
B. Jugular venous distention
C. Pulmonary edema
D. Hemoptysis
Answer: B. Jugular venous distention
Rationale: Elevated right atrial pressure causes systemic venous
congestion, commonly manifested by jugular venous distention.
10. A patient with heart failure develops confusion, oliguria, cool
skin, and hypotension. Which complication should the nurse
suspect?
