CMC AACN Cardiovascular Medicine Certification
Exam 2026-2027 | 300 Complex Practice Questions
with Detailed Rationales | Real Exam Simulation |
Verified Answers | Instant Download
1. A patient with type 2 diabetes is scheduled for PCI in the morning. The
nurse should ensure that metformin is held to minimize which risk?
A. Hypoglycemia
B. Injury to the kidneys
C. Injury to the liver
D. Heart block
Correct Answer: B
Rationale: The combination of contrast medium during PCI and metformin
should be avoided in patients with renal dysfunction, hepatic dysfunction,
alcohol abuse, or severe CHF because all these conditions limit metformin
excretion, possibly leading to fatal lactic acidosis. Metformin does not directly
affect the liver but should be avoided in hepatic dysfunction. It has no effect
on heart block risk.
2. A patient questions the reason for a scheduled TEE rather than a standard
ECHO. A TEE allows better visualization for patients with which condition?
A. Osteoporosis and valve problems
B. Smoking and pulmonary HTN
C. Obesity and emphysema
D. CAD and a BMI of 18
,Correct Answer: C
Rationale: Visualization of cardiac structures is challenging in obese patients
due to a greater amount of tissue through which to transmit ultrasound waves
and receive signals. TEE omits the need to penetrate a thick chest wall to
clearly visualize cardiac structures. A TEE may worsen ventilation-perfusion
mismatch and hypoxia in patients with pulmonary hypertension.
3. A nurse is reviewing orders for a patient experiencing unstable angina who
is scheduled for a stress test. The nurse should question the use of which
medication?
A. Dopamine
B. Dipyridamole
C. Adenosine
D. Lexiscan
Correct Answer: A
Rationale: Dopamine is not one of the recommended drugs for a
pharmacologic stress test. Dobutamine is one of the recommended drugs for a
pharmacologic stress test. Dipyridamole, adenosine, and lexiscan are
recommended drugs for pharmacologic stress testing.
4. A patient presents with peripheral edema, DOE, JVD, and lightheadedness.
Which condition should the nurse suspect?
A. Pulmonic valve stenosis
B. Aortic valve regurgitation
C. Mitral valve regurgitation
,D. Aortic valve stenosis
Correct Answer: A
Rationale: Patients with pulmonic valve stenosis may have symptoms of right
heart failure due to right ventricular dysfunction. Mitral regurgitation does
not cause JVD or peripheral edema.
5. A patient with cardiomyopathy is receiving dobutamine at 10 mcg/kg/min.
VS: BP 108/66, PAOP 18 mmHg, CO 4.2 L/min, CI 2.5 L/min/m, SvO2 65%. The
pump infusing the dobutamine fails and the nurse quickly works to switch it
out. Which clinical effect should the nurse anticipate to occur first?
A. BP would increase
B. PAOP would increase
C. GFR would decrease
D. SvO2 would decrease
Correct Answer: D
Rationale: When contractility falls due to the dobutamine stopping, the SvO2
will decrease as cardiac output is a component of SvO2. The BP would
decrease, not increase. The PAOP might increase depending on the type of
cardiomyopathy, but it would not be first. GFR decrease is a later happening.
6. A nurse is establishing alarm limits on a patient admitted to rule out MI.
Which patient position and ST segment alarm settings should the nurse use?
A. Supine position and 1 mm above and below baseline
B. Supine position and 2 mm above and below baseline
C. Upright position and 1 mm above and below baseline
D. Upright position and 2 mm above and below baseline
, Correct Answer: A
Rationale: Supine position allows for more accurate electrode placement. ST
segment limits are placed 1 mm above or below for monitoring patients at
high risk for ischemia. ST segment may be set 2 mm above or below for stable
patients without high risk for ischemia.
7. Following a patient's emergency PCI with the sheath left in, the nurse pulls
back the covers and discovers the bandage over the procedure site and the
linens soaked with blood. The nurse should first:
A. Assess the site and call the cath lab staff
B. Place the patient in Trendelenburg and infuse fluids
C. Apply direct pressure and notify the MD
D. Reinforce the dressing and obtain a CBC
Correct Answer: C
Rationale: Applying direct pressure and notifying the MD is the priority.
Assessing the site and calling the cath lab staff is not the first thing to do.
Reinforcing the dressing does not stop the bleeding. A CBC could be obtained
but is not the first priority.
8. In reviewing the lab findings of a patient who has not been able to afford
medication, the nurse observes elevated T3 and T4 results. The nurse
recognizes the patient is at risk for developing:
A. V-Tach
Exam 2026-2027 | 300 Complex Practice Questions
with Detailed Rationales | Real Exam Simulation |
Verified Answers | Instant Download
1. A patient with type 2 diabetes is scheduled for PCI in the morning. The
nurse should ensure that metformin is held to minimize which risk?
A. Hypoglycemia
B. Injury to the kidneys
C. Injury to the liver
D. Heart block
Correct Answer: B
Rationale: The combination of contrast medium during PCI and metformin
should be avoided in patients with renal dysfunction, hepatic dysfunction,
alcohol abuse, or severe CHF because all these conditions limit metformin
excretion, possibly leading to fatal lactic acidosis. Metformin does not directly
affect the liver but should be avoided in hepatic dysfunction. It has no effect
on heart block risk.
2. A patient questions the reason for a scheduled TEE rather than a standard
ECHO. A TEE allows better visualization for patients with which condition?
A. Osteoporosis and valve problems
B. Smoking and pulmonary HTN
C. Obesity and emphysema
D. CAD and a BMI of 18
,Correct Answer: C
Rationale: Visualization of cardiac structures is challenging in obese patients
due to a greater amount of tissue through which to transmit ultrasound waves
and receive signals. TEE omits the need to penetrate a thick chest wall to
clearly visualize cardiac structures. A TEE may worsen ventilation-perfusion
mismatch and hypoxia in patients with pulmonary hypertension.
3. A nurse is reviewing orders for a patient experiencing unstable angina who
is scheduled for a stress test. The nurse should question the use of which
medication?
A. Dopamine
B. Dipyridamole
C. Adenosine
D. Lexiscan
Correct Answer: A
Rationale: Dopamine is not one of the recommended drugs for a
pharmacologic stress test. Dobutamine is one of the recommended drugs for a
pharmacologic stress test. Dipyridamole, adenosine, and lexiscan are
recommended drugs for pharmacologic stress testing.
4. A patient presents with peripheral edema, DOE, JVD, and lightheadedness.
Which condition should the nurse suspect?
A. Pulmonic valve stenosis
B. Aortic valve regurgitation
C. Mitral valve regurgitation
,D. Aortic valve stenosis
Correct Answer: A
Rationale: Patients with pulmonic valve stenosis may have symptoms of right
heart failure due to right ventricular dysfunction. Mitral regurgitation does
not cause JVD or peripheral edema.
5. A patient with cardiomyopathy is receiving dobutamine at 10 mcg/kg/min.
VS: BP 108/66, PAOP 18 mmHg, CO 4.2 L/min, CI 2.5 L/min/m, SvO2 65%. The
pump infusing the dobutamine fails and the nurse quickly works to switch it
out. Which clinical effect should the nurse anticipate to occur first?
A. BP would increase
B. PAOP would increase
C. GFR would decrease
D. SvO2 would decrease
Correct Answer: D
Rationale: When contractility falls due to the dobutamine stopping, the SvO2
will decrease as cardiac output is a component of SvO2. The BP would
decrease, not increase. The PAOP might increase depending on the type of
cardiomyopathy, but it would not be first. GFR decrease is a later happening.
6. A nurse is establishing alarm limits on a patient admitted to rule out MI.
Which patient position and ST segment alarm settings should the nurse use?
A. Supine position and 1 mm above and below baseline
B. Supine position and 2 mm above and below baseline
C. Upright position and 1 mm above and below baseline
D. Upright position and 2 mm above and below baseline
, Correct Answer: A
Rationale: Supine position allows for more accurate electrode placement. ST
segment limits are placed 1 mm above or below for monitoring patients at
high risk for ischemia. ST segment may be set 2 mm above or below for stable
patients without high risk for ischemia.
7. Following a patient's emergency PCI with the sheath left in, the nurse pulls
back the covers and discovers the bandage over the procedure site and the
linens soaked with blood. The nurse should first:
A. Assess the site and call the cath lab staff
B. Place the patient in Trendelenburg and infuse fluids
C. Apply direct pressure and notify the MD
D. Reinforce the dressing and obtain a CBC
Correct Answer: C
Rationale: Applying direct pressure and notifying the MD is the priority.
Assessing the site and calling the cath lab staff is not the first thing to do.
Reinforcing the dressing does not stop the bleeding. A CBC could be obtained
but is not the first priority.
8. In reviewing the lab findings of a patient who has not been able to afford
medication, the nurse observes elevated T3 and T4 results. The nurse
recognizes the patient is at risk for developing:
A. V-Tach
