AACN CMC EXAM LATEST 2026/2027 – COMPLETE 500
REAL QUESTIONS WITH CORRECT DETAILED ANSWERS
(VERIFIED) GRADED A+ | TEST BANK & EXAM PREP
(BRAND NEW!)
1 A patient with acute decompensated heart failure presents with dyspnea,
crackles, and an S3 gallop. Which hemodynamic profile is most consistent with
these findings?
a. Low cardiac output, high systemic vascular resistance
b. High cardiac output, low systemic vascular resistance
c. Low cardiac output, low systemic vascular resistance
d. Normal cardiac output, normal systemic vascular resistance
- Correct Answer- A
Rationale: Acute decompensated heart failure typically presents with low cardiac
output (fatigue, poor perfusion) and high systemic vascular resistance
(compensatory vasoconstriction). The S3 gallop indicates elevated filling
pressures.
2 A patient with an acute myocardial infarction develops a new harsh holosystolic
murmur at the apex radiating to the axilla. This is most consistent with:
a. Ventricular septal rupture
b. Papillary muscle rupture causing mitral regurgitation
c. Pericardial friction rub
d. Aortic stenosis
- Correct Answer- B
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,Rationale: Papillary muscle rupture causes acute mitral regurgitation, producing a
holosystolic murmur at the apex radiating to the axilla. VSD murmur is typically at
the left sternal border.
3 Which class of antiarrhythmic drug is amiodarone primarily classified as?
a. Class Ia
b. Class II
c. Class III
d. Class IV
- Correct Answer- C
Rationale: Amiodarone is a Class III antiarrhythmic (potassium channel blocker),
though it has properties of all four classes.
4 A patient on continuous telemetry shows a rhythm with absent P waves, narrow
QRS complexes, and an irregularly irregular ventricular rate of 140 beats per
minute. What is the most likely rhythm?
a. Atrial flutter with variable block
b. Multifocal atrial tachycardia
c. Atrial fibrillation
d. Sinus tachycardia with PACs
- Correct Answer- C
Rationale: Atrial fibrillation is characterized by absent P waves, irregularly
irregular rhythm, and narrow QRS when not conducted aberrantly.
5 A patient with hypertrophic cardiomyopathy (HOCM) should avoid which
medication due to risk of worsening outflow obstruction?
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,a. Beta-blockers
b. Calcium channel blockers
c. Nitroglycerin
d. Verapamil
- Correct Answer- C
Rationale: Nitrates and other vasodilators reduce preload and afterload,
worsening outflow obstruction in HOCM. Beta-blockers and calcium channel
blockers are mainstays of therapy.
6 Which ECG finding is most specific for acute pericarditis?
a. Widespread ST-segment elevation with PR-segment depression
b. Q waves in leads II, III, and AVF
c. ST-segment elevation in leads V1-V4 only
d. T-wave inversion in precordial leads
- Correct Answer- A
Rationale: Diffuse ST elevation with PR depression is characteristic of acute
pericarditis. Q waves suggest prior infarction; regional ST elevation suggests
ischemia.
7 A patient with severe aortic stenosis presents with exertional syncope. The
mechanism is most likely:
a. Arrhythmia triggered by exercise
b. Fixed cardiac output with peripheral vasodilation during exercise
c. Increased vagal tone during valsalva
d. Embolic stroke from calcific emboli
- Correct Answer- B
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, Rationale: In severe aortic stenosis, cardiac output is fixed. During exercise,
peripheral vasodilation occurs without a compensatory increase in output,
causing hypotension and syncope.
8 A patient with chronic heart failure is being managed with carvedilol. The
primary benefit of carvedilol in heart failure is:
a. Positive inotropy
b. Reduction of preload
c. Reduction of sympathetic nervous system activation and remodeling
d. Diuresis
- Correct Answer- C
Rationale: Carvedilol is a beta-blocker that reduces sympathetic activation, heart
rate, and myocardial remodeling, improving survival in heart failure with reduced
ejection fraction.
9 A patient presents with chest pain, fever, and a pericardial friction rub. An
echocardiogram shows a moderate pericardial effusion without tamponade. The
most appropriate initial treatment is:
a. Pericardiocentesis
b. High-dose aspirin or ibuprofen
c. Colchicine alone
d. Intravenous heparin
- Correct Answer- B
Rationale: NSAIDs are first-line for acute pericarditis without high-risk features.
Colchicine may be added. Pericardiocentesis is for tamponade or purulent
pericarditis.
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REAL QUESTIONS WITH CORRECT DETAILED ANSWERS
(VERIFIED) GRADED A+ | TEST BANK & EXAM PREP
(BRAND NEW!)
1 A patient with acute decompensated heart failure presents with dyspnea,
crackles, and an S3 gallop. Which hemodynamic profile is most consistent with
these findings?
a. Low cardiac output, high systemic vascular resistance
b. High cardiac output, low systemic vascular resistance
c. Low cardiac output, low systemic vascular resistance
d. Normal cardiac output, normal systemic vascular resistance
- Correct Answer- A
Rationale: Acute decompensated heart failure typically presents with low cardiac
output (fatigue, poor perfusion) and high systemic vascular resistance
(compensatory vasoconstriction). The S3 gallop indicates elevated filling
pressures.
2 A patient with an acute myocardial infarction develops a new harsh holosystolic
murmur at the apex radiating to the axilla. This is most consistent with:
a. Ventricular septal rupture
b. Papillary muscle rupture causing mitral regurgitation
c. Pericardial friction rub
d. Aortic stenosis
- Correct Answer- B
1|Page
,Rationale: Papillary muscle rupture causes acute mitral regurgitation, producing a
holosystolic murmur at the apex radiating to the axilla. VSD murmur is typically at
the left sternal border.
3 Which class of antiarrhythmic drug is amiodarone primarily classified as?
a. Class Ia
b. Class II
c. Class III
d. Class IV
- Correct Answer- C
Rationale: Amiodarone is a Class III antiarrhythmic (potassium channel blocker),
though it has properties of all four classes.
4 A patient on continuous telemetry shows a rhythm with absent P waves, narrow
QRS complexes, and an irregularly irregular ventricular rate of 140 beats per
minute. What is the most likely rhythm?
a. Atrial flutter with variable block
b. Multifocal atrial tachycardia
c. Atrial fibrillation
d. Sinus tachycardia with PACs
- Correct Answer- C
Rationale: Atrial fibrillation is characterized by absent P waves, irregularly
irregular rhythm, and narrow QRS when not conducted aberrantly.
5 A patient with hypertrophic cardiomyopathy (HOCM) should avoid which
medication due to risk of worsening outflow obstruction?
2|Page
,a. Beta-blockers
b. Calcium channel blockers
c. Nitroglycerin
d. Verapamil
- Correct Answer- C
Rationale: Nitrates and other vasodilators reduce preload and afterload,
worsening outflow obstruction in HOCM. Beta-blockers and calcium channel
blockers are mainstays of therapy.
6 Which ECG finding is most specific for acute pericarditis?
a. Widespread ST-segment elevation with PR-segment depression
b. Q waves in leads II, III, and AVF
c. ST-segment elevation in leads V1-V4 only
d. T-wave inversion in precordial leads
- Correct Answer- A
Rationale: Diffuse ST elevation with PR depression is characteristic of acute
pericarditis. Q waves suggest prior infarction; regional ST elevation suggests
ischemia.
7 A patient with severe aortic stenosis presents with exertional syncope. The
mechanism is most likely:
a. Arrhythmia triggered by exercise
b. Fixed cardiac output with peripheral vasodilation during exercise
c. Increased vagal tone during valsalva
d. Embolic stroke from calcific emboli
- Correct Answer- B
3|Page
, Rationale: In severe aortic stenosis, cardiac output is fixed. During exercise,
peripheral vasodilation occurs without a compensatory increase in output,
causing hypotension and syncope.
8 A patient with chronic heart failure is being managed with carvedilol. The
primary benefit of carvedilol in heart failure is:
a. Positive inotropy
b. Reduction of preload
c. Reduction of sympathetic nervous system activation and remodeling
d. Diuresis
- Correct Answer- C
Rationale: Carvedilol is a beta-blocker that reduces sympathetic activation, heart
rate, and myocardial remodeling, improving survival in heart failure with reduced
ejection fraction.
9 A patient presents with chest pain, fever, and a pericardial friction rub. An
echocardiogram shows a moderate pericardial effusion without tamponade. The
most appropriate initial treatment is:
a. Pericardiocentesis
b. High-dose aspirin or ibuprofen
c. Colchicine alone
d. Intravenous heparin
- Correct Answer- B
Rationale: NSAIDs are first-line for acute pericarditis without high-risk features.
Colchicine may be added. Pericardiocentesis is for tamponade or purulent
pericarditis.
4|Page
