AACN CMC EXAM 2026 CLINICAL CARDIAC
CARE STUDY GUIDE FULL PAPER AND
ANSWERS FOR EXAM PREPARATION
◉ While reviewing the 12-lead EKG, the nurse notes new changes
with ST-segment elevation in leads 1, aVL, and V2-V6, plus reciprocal
changes in III, aVF, and aVR. The nurse should realize that the area of
infarct involve the:
A. anterior and lateral walls
B. posterior and inferior walls
C. lateral and septal walls
D. septal and posterior walls.
Answer: A. correct. the ST segment elevation and reciprocal changes
are indicative of occlusion of the left anterior descending and left
circumflex arteries. these will affect the anterior and lateral walls.
B. incorrect. an infarct in the posterior and inferior walls would
present via EKG with changes in the II, III, and aVF leads.
C. incorrect. an infarct in the lateral and septal walls would present
via EKG changes in leads I, aVL, V5, and V6.
D. incorrect. an infarct in the septal and posterior walls would
present via EKG changes in V1-V4.
,◉ A patient is being discharged on aspirin therapy following
recovery from an AMI. Which of the following comorbidities puts the
patient at greatest risk for developing a bleeding complication?
A. asthma
B. transient ischemic attack
C. chronic kidney failure
D. cor pulmonale.
Answer: A. incorrect.
B. incorrect.
C. correct. there is an increased risks of bleeding in kidney failure.
this tendency is attributed to impaired platelet aggregation and
adhesion and an altered response to clotting factor VII.
D. incorrect.
◉ A patient is to undergo PCI. in a previous admission the patient
received heparin. the patient initially had a platelet count of
250,000; the platelet count was 115,000 a few days later. which of
the following should the nurse anticipate administering for the
current procedure?
A. dalteparin (Fragmin)
B. bivalirudin (Angiomax)
C. enoxaparin (Lovenox)
D. alteplase (Activase).
,Answer: A. incorrect. dalteparin is low molecular weight heparin.
the patient likely manifested HIT in the past. heparin is
contraindicated.
B. correct. bivalirudin is a direct thrombin inhibitor and may be
administered as an alternative to heparin in patients with HIT.
C. incorrect. contraindicated.
D. incorrect. alteplase is indicated for acute ischemic stroke.
◉ While timing the balloon pump, the nurse should understand that
during the deflation phase the patient will benefit from:
A. increased perfusion of the coronary arteries
B. decreased resistance to closing the aortic valve
C. decreased ventricular preload
D. improved cardiac output..
Answer: A. incorrect. increased perfusion of the coronary arteries
occurs during the inflation phase of the balloon pump timing.
B. incorrect. closing the aortic valve is affected by the preload into
the left ventricle.
C. incorrect. decreased preload indicates the low volume of blood
entering the left ventricle during relaxation of the left ventricle.
D. correct. the relaxation phase of the balloon pump timing reduces
systemic vascular resistance which in turn improves cardiac output.
, ◉ Which of the following monitoring parameters would be the best
choice for evaluating tissue oxygenation?
A. PAOP
B. SvO2
C. SVR
D. EF.
Answer: A. incorrect. PAOP reflects the volume in the left ventricle at
the end of filling.
B. correct. SvO2 is a reflection of the end result of the balance
between oxygen delivery and oxygen consumption. SvO2 can be
used to guide treatment based on adequate oxygenation to the
tissues.
C. incorrect. SVR is a measure of the resistance the left ventricle
must overcome to perfuse the body.
D. incorrect. EF is a measure of what percentage of blood is ejected
from the left ventricle during each contraction.
◉ The nurse should expect which assessment findings for a patient
admitted with arterial occlusion of the limb?
A. reddened extremity, pain, +2 pedal pulses that become non-
palpable when the limb is elevated.
B. pale extremity, swollen, +2 pedal pulse that bounds when limb is
elevated.
C. reddened extremity, no c/o pain, no pedal pulses
CARE STUDY GUIDE FULL PAPER AND
ANSWERS FOR EXAM PREPARATION
◉ While reviewing the 12-lead EKG, the nurse notes new changes
with ST-segment elevation in leads 1, aVL, and V2-V6, plus reciprocal
changes in III, aVF, and aVR. The nurse should realize that the area of
infarct involve the:
A. anterior and lateral walls
B. posterior and inferior walls
C. lateral and septal walls
D. septal and posterior walls.
Answer: A. correct. the ST segment elevation and reciprocal changes
are indicative of occlusion of the left anterior descending and left
circumflex arteries. these will affect the anterior and lateral walls.
B. incorrect. an infarct in the posterior and inferior walls would
present via EKG with changes in the II, III, and aVF leads.
C. incorrect. an infarct in the lateral and septal walls would present
via EKG changes in leads I, aVL, V5, and V6.
D. incorrect. an infarct in the septal and posterior walls would
present via EKG changes in V1-V4.
,◉ A patient is being discharged on aspirin therapy following
recovery from an AMI. Which of the following comorbidities puts the
patient at greatest risk for developing a bleeding complication?
A. asthma
B. transient ischemic attack
C. chronic kidney failure
D. cor pulmonale.
Answer: A. incorrect.
B. incorrect.
C. correct. there is an increased risks of bleeding in kidney failure.
this tendency is attributed to impaired platelet aggregation and
adhesion and an altered response to clotting factor VII.
D. incorrect.
◉ A patient is to undergo PCI. in a previous admission the patient
received heparin. the patient initially had a platelet count of
250,000; the platelet count was 115,000 a few days later. which of
the following should the nurse anticipate administering for the
current procedure?
A. dalteparin (Fragmin)
B. bivalirudin (Angiomax)
C. enoxaparin (Lovenox)
D. alteplase (Activase).
,Answer: A. incorrect. dalteparin is low molecular weight heparin.
the patient likely manifested HIT in the past. heparin is
contraindicated.
B. correct. bivalirudin is a direct thrombin inhibitor and may be
administered as an alternative to heparin in patients with HIT.
C. incorrect. contraindicated.
D. incorrect. alteplase is indicated for acute ischemic stroke.
◉ While timing the balloon pump, the nurse should understand that
during the deflation phase the patient will benefit from:
A. increased perfusion of the coronary arteries
B. decreased resistance to closing the aortic valve
C. decreased ventricular preload
D. improved cardiac output..
Answer: A. incorrect. increased perfusion of the coronary arteries
occurs during the inflation phase of the balloon pump timing.
B. incorrect. closing the aortic valve is affected by the preload into
the left ventricle.
C. incorrect. decreased preload indicates the low volume of blood
entering the left ventricle during relaxation of the left ventricle.
D. correct. the relaxation phase of the balloon pump timing reduces
systemic vascular resistance which in turn improves cardiac output.
, ◉ Which of the following monitoring parameters would be the best
choice for evaluating tissue oxygenation?
A. PAOP
B. SvO2
C. SVR
D. EF.
Answer: A. incorrect. PAOP reflects the volume in the left ventricle at
the end of filling.
B. correct. SvO2 is a reflection of the end result of the balance
between oxygen delivery and oxygen consumption. SvO2 can be
used to guide treatment based on adequate oxygenation to the
tissues.
C. incorrect. SVR is a measure of the resistance the left ventricle
must overcome to perfuse the body.
D. incorrect. EF is a measure of what percentage of blood is ejected
from the left ventricle during each contraction.
◉ The nurse should expect which assessment findings for a patient
admitted with arterial occlusion of the limb?
A. reddened extremity, pain, +2 pedal pulses that become non-
palpable when the limb is elevated.
B. pale extremity, swollen, +2 pedal pulse that bounds when limb is
elevated.
C. reddened extremity, no c/o pain, no pedal pulses
