AACN CMC EXAM |ACTUAL QUESTIONS AND
VERIFIED ANSWERS|BRAND NEW 2026-2027
UPDATE|GRADED A+
Question 1
While caring for a patient with an IABP at 3:1, the nurse notes:
A. decreasing urine output as well as increasing BUN and CR levels; the nurse should
increase timing to 2:1
B. absent pulses in the proximal extremity; the nurse should apply pressure at the insertion
site.
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.
CORRECT ANSWER
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.
B. incorrect. absent pulses distal to the insertion site indicates complete occlusion of the
femoral artery. application of pressure to the insertion site will worsen the obstruction.
C. correct. blood in the IABP tubing indicates a rupture of the balloon. Continuing to allow
the IABP to inflate and deflate will increase the size of the rupture, causing more bleeding.
the nurse should plan for removal or exchange of the IABP catheter.
D. incorrect. a fasciotomy would be indicated if the patient had an increase in fluid
accumulation in the extremities causing significant injury to the limb.
Question 2
An IABP is currently at 3:1 when the patient suddenly goes into ventricular fibrillation. In
addition to resuscitative measures, the nurse should:
A. change the trigger to internal or pressure support resuscitative measures.
B. increase timing back to 1:1 to increase coronary artery perfusion pressure.
1
,C. put the pump on standby until the return of spontaneous circulation.
D. assess the IABP timing to chest compressions at 1:2.
CORRECT ANSWER
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.
B. incorrect. attempting to time the IABP back to 1:1 will be counterproductive, as it will not
be able to trigger correctly.
C. incorrect. there is significant risk of clot forming on the IABP when placed in stand for an
indeterminate amount of time.
D. incorrect. the primary goal during resuscitative measures is to attempt to circulate blood
volume as effectively as possible. assessing the timing of the IABP is unnecessary.
Question 3
The nurse is reviewing the home medications list for a patient admitted c/o severe chest
pain. serial EKGs and blood testing are negative, so an exercise stress test is scheduled.
which of the following 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)
CORRECT ANSWER
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 withheld on the day of
the test because of its negative chronotropic effects.
B. incorrect.
C & D. incorrect. beta-blockers and calcium channel blockers blunt the heart rate response to
exercise and may prevent achievement of maximum predicted heart rate. they should be
withheld on the day of the test.
2
,Question 4
A patient is admitted with elevated troponin levels and ST segment elevation in leads II, III,
and aVF. Administration of which of the following should the nurse anticipate initially?
A. enoxaparin (Lovenox)
B. streptokinase (Strepase)
C. alteplase (Activase)
D. reteplase (Retavase)
CORRECT ANSWER
A. incorrect. enoxaparin is an alternative to heparin in patients with unstable angina,
NSTEMI or DVT.
B. incorrect. streptokinase is indicated for acute arterial thrombosis or embolism, or
occluded AV cannulas.
C. incorrect. alteplase in indicated for acute ischemic stroke or acute massive pulmonary
embolism.
D. correct. reteplase is indicated for AMI when fibrinolytics are indicated.
Question 5
Which of the following is a characteristic of diastolic heart failure?
A. inability of the heart muscle to relax.
B. dilation of the ventricular chambers.
C. increased filling of the left ventricle.
D. decreased ability of the ventricle to contract.
CORRECT ANSWER
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.
3
, B. incorrect. dilation of the ventricular chambers is a characteristic of systolic heart failure.
C. incorrect. diastolic heart failure is an abnormality with heart filling. the heart muscle does
not relax normally, and the heart may fill too slowly or asynchronously. if the left ventricle
does not relax properly or is thick and stiff, it does not fill in the usual manner and blood is
drawn back into the left atrium and eventually into the lungs.
D. incorrect. decreased ability of the ventricle to contract is a symptom of overextension of
the heart muscle in patients with cardiomyopathy.
Question 6
Following a STEMI, the nurse auscultates a late systolic murmur at the apex. The nurse
should suspect the finding is r/t the new onset of a:
A. right bundle branch block
B. left bundle branch block
C. papillary muscle rupture
D. calcific plaque rupture
CORRECT ANSWER
A. incorrect. a RBBB would cause an electrical delay in conduction for a wide split S2.
B. incorrect. a LBBB would cause and electrical delay in ventricular conduction for a paroxical
split S2.
C. correct. a papillary muscle chord rupture results from ischemia to the tissue supplying the
mitral valve. a systolic murmur is heard due to mitral regurgitation.
D. incorrect. plaque rupture would cause an occlusion of the coronary artery that would not
directly cause a new systolic murmur.
Question 7
The nurse is reviewing the plan of care for a patient with systolic heart failure who has
enalapril (Vasotec), furosemide (Lasix), metoprolol (Lopressor), and carvedilol (Coreg)
ordered. Which of the following will provide the most accurate assessment of the
regimen?
4
VERIFIED ANSWERS|BRAND NEW 2026-2027
UPDATE|GRADED A+
Question 1
While caring for a patient with an IABP at 3:1, the nurse notes:
A. decreasing urine output as well as increasing BUN and CR levels; the nurse should
increase timing to 2:1
B. absent pulses in the proximal extremity; the nurse should apply pressure at the insertion
site.
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.
CORRECT ANSWER
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.
B. incorrect. absent pulses distal to the insertion site indicates complete occlusion of the
femoral artery. application of pressure to the insertion site will worsen the obstruction.
C. correct. blood in the IABP tubing indicates a rupture of the balloon. Continuing to allow
the IABP to inflate and deflate will increase the size of the rupture, causing more bleeding.
the nurse should plan for removal or exchange of the IABP catheter.
D. incorrect. a fasciotomy would be indicated if the patient had an increase in fluid
accumulation in the extremities causing significant injury to the limb.
Question 2
An IABP is currently at 3:1 when the patient suddenly goes into ventricular fibrillation. In
addition to resuscitative measures, the nurse should:
A. change the trigger to internal or pressure support resuscitative measures.
B. increase timing back to 1:1 to increase coronary artery perfusion pressure.
1
,C. put the pump on standby until the return of spontaneous circulation.
D. assess the IABP timing to chest compressions at 1:2.
CORRECT ANSWER
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.
B. incorrect. attempting to time the IABP back to 1:1 will be counterproductive, as it will not
be able to trigger correctly.
C. incorrect. there is significant risk of clot forming on the IABP when placed in stand for an
indeterminate amount of time.
D. incorrect. the primary goal during resuscitative measures is to attempt to circulate blood
volume as effectively as possible. assessing the timing of the IABP is unnecessary.
Question 3
The nurse is reviewing the home medications list for a patient admitted c/o severe chest
pain. serial EKGs and blood testing are negative, so an exercise stress test is scheduled.
which of the following 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)
CORRECT ANSWER
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 withheld on the day of
the test because of its negative chronotropic effects.
B. incorrect.
C & D. incorrect. beta-blockers and calcium channel blockers blunt the heart rate response to
exercise and may prevent achievement of maximum predicted heart rate. they should be
withheld on the day of the test.
2
,Question 4
A patient is admitted with elevated troponin levels and ST segment elevation in leads II, III,
and aVF. Administration of which of the following should the nurse anticipate initially?
A. enoxaparin (Lovenox)
B. streptokinase (Strepase)
C. alteplase (Activase)
D. reteplase (Retavase)
CORRECT ANSWER
A. incorrect. enoxaparin is an alternative to heparin in patients with unstable angina,
NSTEMI or DVT.
B. incorrect. streptokinase is indicated for acute arterial thrombosis or embolism, or
occluded AV cannulas.
C. incorrect. alteplase in indicated for acute ischemic stroke or acute massive pulmonary
embolism.
D. correct. reteplase is indicated for AMI when fibrinolytics are indicated.
Question 5
Which of the following is a characteristic of diastolic heart failure?
A. inability of the heart muscle to relax.
B. dilation of the ventricular chambers.
C. increased filling of the left ventricle.
D. decreased ability of the ventricle to contract.
CORRECT ANSWER
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.
3
, B. incorrect. dilation of the ventricular chambers is a characteristic of systolic heart failure.
C. incorrect. diastolic heart failure is an abnormality with heart filling. the heart muscle does
not relax normally, and the heart may fill too slowly or asynchronously. if the left ventricle
does not relax properly or is thick and stiff, it does not fill in the usual manner and blood is
drawn back into the left atrium and eventually into the lungs.
D. incorrect. decreased ability of the ventricle to contract is a symptom of overextension of
the heart muscle in patients with cardiomyopathy.
Question 6
Following a STEMI, the nurse auscultates a late systolic murmur at the apex. The nurse
should suspect the finding is r/t the new onset of a:
A. right bundle branch block
B. left bundle branch block
C. papillary muscle rupture
D. calcific plaque rupture
CORRECT ANSWER
A. incorrect. a RBBB would cause an electrical delay in conduction for a wide split S2.
B. incorrect. a LBBB would cause and electrical delay in ventricular conduction for a paroxical
split S2.
C. correct. a papillary muscle chord rupture results from ischemia to the tissue supplying the
mitral valve. a systolic murmur is heard due to mitral regurgitation.
D. incorrect. plaque rupture would cause an occlusion of the coronary artery that would not
directly cause a new systolic murmur.
Question 7
The nurse is reviewing the plan of care for a patient with systolic heart failure who has
enalapril (Vasotec), furosemide (Lasix), metoprolol (Lopressor), and carvedilol (Coreg)
ordered. Which of the following will provide the most accurate assessment of the
regimen?
4
