Page 1 of 234
AACN PCCN - Progressive Care Certified Nurse
(CARDIAC EXAM) 500 QUESTIONS AND CORRECT
ANSWERS LATEST UPDATE THIS YEAR
AACN PCCN CARDIAC
Q; Mr K is a 54 YO dockworker who was admitted with a NSTEMI to the inferior wall. He is c/o
dyspnea, weakness, bilateral crackles, and demonstrates orthopnea. He has developed an S3
heart sound. You suspect he has also developed?
• Pulmonary Embolus
• Pulmonary HTN
• A fat embolism
• Cardiogenic shock
CARDIOGENIC SHOCK
The MI has impaired the heart's ability to pump effectively. The CO falls and the body reacts by
vasoconstricting peripheral circulation and increasing the HR.
Tachycardia is also the result of catecholamine release, and the myocardial O2 consumption
increases.
The left ventricle works harder, but has been compromised by the MI.
ALL THE BEST CHAMP!!
1
,Page 2 of 234
Preload increases because fluid cannot be pumped out of the chambers effectively.
S3 is a signal of increased PREload.
Pulmonary congestion occurs because of increased LEFT heart pressures.
Your pt suddenly complains of chest pain. You auscultate a new holosystolic murmur at the
lower left sternal border. Your pt has probable experienced a
• Dissecting thoracic aneurysm
• Pulmonary embolus
• Ventricular septal rupture
• Lateral wall MI
VENTRICULAR SEPTAL RUPTURE
A new holosystolic murmur at the lower left sternal border means that turbulent blood flow is
occurring there. The turbulence is caused by a hole that is allowing blood to flow through a
previously closed area. The SvO2 will increase due to the mixing of blood. This condition must
be corrected surgically.
Mrs F was admitted for DVT management 3 days ago. During your initial assessment, you
found her sitting on the side of the bed leaning forward. Mrs. F states that this position
relieved her newly developed chest pain. She also states her pain is worse on inspiration. You
call the doc who orders a CXR and labs. The lab results show that the pt's sed rate and WBCs
are elevated. Mrs. F most likely has?
• Pericarditis
ALL THE BEST CHAMP!!
2
,Page 3 of 234
• Thoracic aneurysm
• Pulmonary embolus
• Pulmonary edema
PERICARDITIS
The CXR will probably show a pericardial effusion.
The elevated sed rate and WBCs indicate infection.
Learning forward will relieve the chest pain whereas lying supine makes it worse.
If the pain worsens with inspiration, it's because the lungs expand and come in contact with the
pericardium.
The pt will also probably have a fever.
It's also important to assess for s/s of tamponade and to make certain that any anticoagulants
are d/c'd.
A probable candidate for a CABG (coronary artery bypass graft) might have?
• An EF of 55% and diabetes
• Right main artery disease
• An EF of 35% and CAD (coronary artery disease)
• A previous history of cardiac surgery
An EF of 35% and CAD
ALL THE BEST CHAMP!!
3
, Page 4 of 234
You are performing CPR on a pt with an endotracheal tube (ET) in place. The placement of the
tube has been confirmed. THe pt should be ventilated every:
6 to 8 seconds
5 Compressions
15 Compressions
3 to 5 seconds
6 to 8 seconds
The new AHA guidelines specify t hat ventilation should occur every 6 to 8 seconds. The
compressions should continue at a rate of 100 per minute. The recommended ventilation rate
approximates a normal adult rate and allows for cardiac refill. Ventilating too fast raises
intrathoracic pressure and interferes with cardiac fill.
If you are using a biphasic defibrillator on an adult, t he energy setting should be:
360 joules
50 to 100 joules
300 joules
200 joules
200 joules
ALL THE BEST CHAMP!!
4
AACN PCCN - Progressive Care Certified Nurse
(CARDIAC EXAM) 500 QUESTIONS AND CORRECT
ANSWERS LATEST UPDATE THIS YEAR
AACN PCCN CARDIAC
Q; Mr K is a 54 YO dockworker who was admitted with a NSTEMI to the inferior wall. He is c/o
dyspnea, weakness, bilateral crackles, and demonstrates orthopnea. He has developed an S3
heart sound. You suspect he has also developed?
• Pulmonary Embolus
• Pulmonary HTN
• A fat embolism
• Cardiogenic shock
CARDIOGENIC SHOCK
The MI has impaired the heart's ability to pump effectively. The CO falls and the body reacts by
vasoconstricting peripheral circulation and increasing the HR.
Tachycardia is also the result of catecholamine release, and the myocardial O2 consumption
increases.
The left ventricle works harder, but has been compromised by the MI.
ALL THE BEST CHAMP!!
1
,Page 2 of 234
Preload increases because fluid cannot be pumped out of the chambers effectively.
S3 is a signal of increased PREload.
Pulmonary congestion occurs because of increased LEFT heart pressures.
Your pt suddenly complains of chest pain. You auscultate a new holosystolic murmur at the
lower left sternal border. Your pt has probable experienced a
• Dissecting thoracic aneurysm
• Pulmonary embolus
• Ventricular septal rupture
• Lateral wall MI
VENTRICULAR SEPTAL RUPTURE
A new holosystolic murmur at the lower left sternal border means that turbulent blood flow is
occurring there. The turbulence is caused by a hole that is allowing blood to flow through a
previously closed area. The SvO2 will increase due to the mixing of blood. This condition must
be corrected surgically.
Mrs F was admitted for DVT management 3 days ago. During your initial assessment, you
found her sitting on the side of the bed leaning forward. Mrs. F states that this position
relieved her newly developed chest pain. She also states her pain is worse on inspiration. You
call the doc who orders a CXR and labs. The lab results show that the pt's sed rate and WBCs
are elevated. Mrs. F most likely has?
• Pericarditis
ALL THE BEST CHAMP!!
2
,Page 3 of 234
• Thoracic aneurysm
• Pulmonary embolus
• Pulmonary edema
PERICARDITIS
The CXR will probably show a pericardial effusion.
The elevated sed rate and WBCs indicate infection.
Learning forward will relieve the chest pain whereas lying supine makes it worse.
If the pain worsens with inspiration, it's because the lungs expand and come in contact with the
pericardium.
The pt will also probably have a fever.
It's also important to assess for s/s of tamponade and to make certain that any anticoagulants
are d/c'd.
A probable candidate for a CABG (coronary artery bypass graft) might have?
• An EF of 55% and diabetes
• Right main artery disease
• An EF of 35% and CAD (coronary artery disease)
• A previous history of cardiac surgery
An EF of 35% and CAD
ALL THE BEST CHAMP!!
3
, Page 4 of 234
You are performing CPR on a pt with an endotracheal tube (ET) in place. The placement of the
tube has been confirmed. THe pt should be ventilated every:
6 to 8 seconds
5 Compressions
15 Compressions
3 to 5 seconds
6 to 8 seconds
The new AHA guidelines specify t hat ventilation should occur every 6 to 8 seconds. The
compressions should continue at a rate of 100 per minute. The recommended ventilation rate
approximates a normal adult rate and allows for cardiac refill. Ventilating too fast raises
intrathoracic pressure and interferes with cardiac fill.
If you are using a biphasic defibrillator on an adult, t he energy setting should be:
360 joules
50 to 100 joules
300 joules
200 joules
200 joules
ALL THE BEST CHAMP!!
4
