CMC CERTIFICATION EXAM MASTERY GUIDE: 100 AACN CARDIAC MEDICINE PRACTICE
QUESTIONS WITH DETAILED RATIONALES (2026 UPDATED EDITION)
Question 1
A patient with acute myocardial infarction develops chest pain unrelieved by nitroglycerin.
What is the nurse’s priority action?
A. Encourage ambulation
B. Notify the provider immediately
C. Reassess in 2 hours
D. Restrict oxygen therapy
Correct Answer: B. Notify the provider immediately
Rationale:
Persistent chest pain despite nitroglycerin may indicate ongoing myocardial ischemia or
infarction requiring urgent intervention.
Potential treatments include:
• Additional anti-ischemic therapy
• Cardiac catheterization
• Reperfusion procedures
Prompt action helps reduce myocardial damage.
Question 2
Which assessment finding is most consistent with left-sided heart failure?
A. Ascites
B. Peripheral edema
,C. Pulmonary crackles
D. Jugular venous distention
Correct Answer: C. Pulmonary crackles
Rationale:
Left-sided heart failure causes fluid backup into the lungs, leading to pulmonary congestion.
Common findings include:
• Crackles
• Dyspnea
• Orthopnea
• Pulmonary edema
Peripheral edema is more commonly associated with right-sided heart failure.
Question 3
A patient develops ventricular fibrillation on the cardiac monitor. What is the nurse’s first
action?
A. Obtain blood pressure
B. Begin chest compressions
C. Immediate defibrillation
D. Administer atropine
Correct Answer: C. Immediate defibrillation
Rationale:
Ventricular fibrillation is a life-threatening pulseless rhythm requiring immediate
defibrillation.
Rapid defibrillation greatly improves survival rates.
CPR should continue until the defibrillator is ready.
Question 4
Which laboratory value is most specific for myocardial injury?
,A. BNP
B. Troponin
C. Potassium
D. Hemoglobin
Correct Answer: B. Troponin
Rationale:
Troponin is the most specific and sensitive biomarker for myocardial injury.
Elevated levels strongly suggest:
• Acute myocardial infarction
• Myocardial damage
Question 5
A patient with atrial fibrillation is at greatest risk for:
A. Pulmonary fibrosis
B. Stroke
C. Pneumothorax
D. Hypercalcemia
Correct Answer: B. Stroke
Rationale:
Atrial fibrillation causes ineffective atrial contractions, increasing the risk of thrombus
formation and embolic stroke.
Anticoagulation therapy is often required.
Question 6
Which medication is commonly administered for symptomatic bradycardia?
A. Adenosine
B. Atropine
C. Digoxin
D. Lidocaine
, Correct Answer: B. Atropine
Rationale:
Atropine increases heart rate by blocking vagal stimulation to the heart.
It is first-line treatment for symptomatic bradycardia.
Question 7
A patient with heart failure has gained 3 pounds in 24 hours. What should the nurse suspect?
A. Fluid retention
B. Dehydration
C. Improved cardiac output
D. Hyperthyroidism
Correct Answer: A. Fluid retention
Rationale:
Rapid weight gain in heart failure commonly indicates fluid accumulation.
Other findings may include:
• Edema
• Crackles
• Dyspnea
Daily weight monitoring is essential.
Question 8
Which ECG finding is commonly associated with hyperkalemia?
A. U waves
B. Peaked T waves
C. Prolonged QT interval
D. ST depression only
Correct Answer: B. Peaked T waves
Rationale:
QUESTIONS WITH DETAILED RATIONALES (2026 UPDATED EDITION)
Question 1
A patient with acute myocardial infarction develops chest pain unrelieved by nitroglycerin.
What is the nurse’s priority action?
A. Encourage ambulation
B. Notify the provider immediately
C. Reassess in 2 hours
D. Restrict oxygen therapy
Correct Answer: B. Notify the provider immediately
Rationale:
Persistent chest pain despite nitroglycerin may indicate ongoing myocardial ischemia or
infarction requiring urgent intervention.
Potential treatments include:
• Additional anti-ischemic therapy
• Cardiac catheterization
• Reperfusion procedures
Prompt action helps reduce myocardial damage.
Question 2
Which assessment finding is most consistent with left-sided heart failure?
A. Ascites
B. Peripheral edema
,C. Pulmonary crackles
D. Jugular venous distention
Correct Answer: C. Pulmonary crackles
Rationale:
Left-sided heart failure causes fluid backup into the lungs, leading to pulmonary congestion.
Common findings include:
• Crackles
• Dyspnea
• Orthopnea
• Pulmonary edema
Peripheral edema is more commonly associated with right-sided heart failure.
Question 3
A patient develops ventricular fibrillation on the cardiac monitor. What is the nurse’s first
action?
A. Obtain blood pressure
B. Begin chest compressions
C. Immediate defibrillation
D. Administer atropine
Correct Answer: C. Immediate defibrillation
Rationale:
Ventricular fibrillation is a life-threatening pulseless rhythm requiring immediate
defibrillation.
Rapid defibrillation greatly improves survival rates.
CPR should continue until the defibrillator is ready.
Question 4
Which laboratory value is most specific for myocardial injury?
,A. BNP
B. Troponin
C. Potassium
D. Hemoglobin
Correct Answer: B. Troponin
Rationale:
Troponin is the most specific and sensitive biomarker for myocardial injury.
Elevated levels strongly suggest:
• Acute myocardial infarction
• Myocardial damage
Question 5
A patient with atrial fibrillation is at greatest risk for:
A. Pulmonary fibrosis
B. Stroke
C. Pneumothorax
D. Hypercalcemia
Correct Answer: B. Stroke
Rationale:
Atrial fibrillation causes ineffective atrial contractions, increasing the risk of thrombus
formation and embolic stroke.
Anticoagulation therapy is often required.
Question 6
Which medication is commonly administered for symptomatic bradycardia?
A. Adenosine
B. Atropine
C. Digoxin
D. Lidocaine
, Correct Answer: B. Atropine
Rationale:
Atropine increases heart rate by blocking vagal stimulation to the heart.
It is first-line treatment for symptomatic bradycardia.
Question 7
A patient with heart failure has gained 3 pounds in 24 hours. What should the nurse suspect?
A. Fluid retention
B. Dehydration
C. Improved cardiac output
D. Hyperthyroidism
Correct Answer: A. Fluid retention
Rationale:
Rapid weight gain in heart failure commonly indicates fluid accumulation.
Other findings may include:
• Edema
• Crackles
• Dyspnea
Daily weight monitoring is essential.
Question 8
Which ECG finding is commonly associated with hyperkalemia?
A. U waves
B. Peaked T waves
C. Prolonged QT interval
D. ST depression only
Correct Answer: B. Peaked T waves
Rationale:
