AACN 2026/2027 UPDATED EXAM | GRADED A+
Pericarditis - ANSWER Often present w/ friction rub, sharp CP w/ inspiration, low-grade fever,
muffled heart tones, hypotension. Tx w/ colchicine.
Pulmonary edema - ANSWER Pink/frothy sputum. Tachypnea, dyspnea, b/l wheeze. CXR shows
alveolar infiltrates, kerley B lines, and pleural effusions.
Cardiac tamponade - ANSWER Becks Triad= muffled tones, JVD, HoTN. Narrow pulse pressure. Low
C.O., low BP, tachy, high RR, JVD, pulsus paradoxus.
Diagnose w/ Echo
CPGs for hypertensive urgency BP reduction - ANSWER 10-25% in the 1st hour, then 160/100 within
6h, then to normal over next 24h.
Septal MI - ANSWER V1, V2
LAD
Anterior MI - ANSWER V3, V4
LAD
Inferior/posterior MI - ANSWER II, III, aVF
RCA
Lateral MI - ANSWER I, aVL, V5, V6
Circumflex
Endocarditis - ANSWER Echo shows vegetation, abscess, or valve dysfunction. Tx ABX
Pulsus paradoxus - ANSWER Fall in SBP >10 mmHg during inspiration
S4 gallop - ANSWER Common in aortic stenosis
,A-FIb ablation - ANSWER >90% pulmonary veins. Anticoags for 2-3 months following.
NYHA HF Classification - ANSWER Stages of HF:
Class I (mild): no sx, no limitations
Class II (mild): no sx @ rest, slight limitation, ordinary activity leads to sx
Class III (moderate): no sx @ rest, marked limitation w/ physical activity, less than ordinary activity
results in sx
Class IV (severe): sx @ rest, unable to do any physical activity w/o discomfort
Nitroglycerin - ANSWER Vasodilator, causes hypotension, HA.
AHA guideline statin therapy - ANSWER Age 40-75 w/ DM and LDL >/= 70 should get moderate to
high intensity statin therapy
Hyperkalemia ECG changes - ANSWER • Tall/peaked T wave
• Prolonged PR
• ST depression
• Wide QRS
• Loss of P wave
• V-FIb
• Ventricular standstill
Common complication of carotid endarterectomy - ANSWER Hypoglossal nerve damage, tongue
deviation ipsilateral side of surgery.
Common rhythm w/ TOF - ANSWER V-Tach
, Statin side effect - ANSWER Causes painful muscle spasms 2/2 skeletal muscle breakdown, increased
CK levels.
ACS medications - ANSWER Aspirin 1st (antiplatelet), nitroglycerin for ischemia, beta blocker to
reduce cardiac workload by reducing HR.
Cardiac resynchronization therapy - ANSWER Uses 3 leads (RA, RV, LV) to improve ventricular filling
and cardiac output.
Clopidogrel (Plavix) - ANSWER Antiplatelet;
Loading dose 300 mg, then 75 mg daily
Digoxin toxicity - ANSWER Brady, PVCs, LBBB.
*Diltiazem known to increase digoxin levels, worsening toxicity. Tx= digibind.
SVT - ANSWER tachy 100-300 bpm, generally narrow QRS complexes, and P wave often buried in or
after the QRS complex.
Postural orthostatic tachycardia syndrome (POTS) - ANSWER Usually triggered lying to standing. Sx=
lightheadedness, fainting, and rapid HR.
Tx= increase Na+ and fluids, add beta blocker.
Target Temp Management (TTM) - ANSWER Reduce mortality and improve neurological outcomes in
unresponsive patients who achieve ROSC after cardiac arrest.
Contraindications; hemorrhagic stroke, GCS > 8, uncontrolled bleeding, uncontrolled
hemodynamically unstable rhythms, and cardiac arrest due to trauma.
Pulmonary Embolism - ANSWER CP, dyspnea, tachycardia, tachypnea, hemoptysis. Trop/BNP often
elevated 2/2 R heart strain. CTPA gold standard diagnostic. Tx w/ Hep gtt, unless thrombectomy or
tPA.
Pulmonary HTN - ANSWER Dyspnea, ECG= R axis deviation, RV hypertrophy, tricuspid regurg.
Diagnose w/ R heart cath.
Pericarditis - ANSWER Often present w/ friction rub, sharp CP w/ inspiration, low-grade fever,
muffled heart tones, hypotension. Tx w/ colchicine.
Pulmonary edema - ANSWER Pink/frothy sputum. Tachypnea, dyspnea, b/l wheeze. CXR shows
alveolar infiltrates, kerley B lines, and pleural effusions.
Cardiac tamponade - ANSWER Becks Triad= muffled tones, JVD, HoTN. Narrow pulse pressure. Low
C.O., low BP, tachy, high RR, JVD, pulsus paradoxus.
Diagnose w/ Echo
CPGs for hypertensive urgency BP reduction - ANSWER 10-25% in the 1st hour, then 160/100 within
6h, then to normal over next 24h.
Septal MI - ANSWER V1, V2
LAD
Anterior MI - ANSWER V3, V4
LAD
Inferior/posterior MI - ANSWER II, III, aVF
RCA
Lateral MI - ANSWER I, aVL, V5, V6
Circumflex
Endocarditis - ANSWER Echo shows vegetation, abscess, or valve dysfunction. Tx ABX
Pulsus paradoxus - ANSWER Fall in SBP >10 mmHg during inspiration
S4 gallop - ANSWER Common in aortic stenosis
,A-FIb ablation - ANSWER >90% pulmonary veins. Anticoags for 2-3 months following.
NYHA HF Classification - ANSWER Stages of HF:
Class I (mild): no sx, no limitations
Class II (mild): no sx @ rest, slight limitation, ordinary activity leads to sx
Class III (moderate): no sx @ rest, marked limitation w/ physical activity, less than ordinary activity
results in sx
Class IV (severe): sx @ rest, unable to do any physical activity w/o discomfort
Nitroglycerin - ANSWER Vasodilator, causes hypotension, HA.
AHA guideline statin therapy - ANSWER Age 40-75 w/ DM and LDL >/= 70 should get moderate to
high intensity statin therapy
Hyperkalemia ECG changes - ANSWER • Tall/peaked T wave
• Prolonged PR
• ST depression
• Wide QRS
• Loss of P wave
• V-FIb
• Ventricular standstill
Common complication of carotid endarterectomy - ANSWER Hypoglossal nerve damage, tongue
deviation ipsilateral side of surgery.
Common rhythm w/ TOF - ANSWER V-Tach
, Statin side effect - ANSWER Causes painful muscle spasms 2/2 skeletal muscle breakdown, increased
CK levels.
ACS medications - ANSWER Aspirin 1st (antiplatelet), nitroglycerin for ischemia, beta blocker to
reduce cardiac workload by reducing HR.
Cardiac resynchronization therapy - ANSWER Uses 3 leads (RA, RV, LV) to improve ventricular filling
and cardiac output.
Clopidogrel (Plavix) - ANSWER Antiplatelet;
Loading dose 300 mg, then 75 mg daily
Digoxin toxicity - ANSWER Brady, PVCs, LBBB.
*Diltiazem known to increase digoxin levels, worsening toxicity. Tx= digibind.
SVT - ANSWER tachy 100-300 bpm, generally narrow QRS complexes, and P wave often buried in or
after the QRS complex.
Postural orthostatic tachycardia syndrome (POTS) - ANSWER Usually triggered lying to standing. Sx=
lightheadedness, fainting, and rapid HR.
Tx= increase Na+ and fluids, add beta blocker.
Target Temp Management (TTM) - ANSWER Reduce mortality and improve neurological outcomes in
unresponsive patients who achieve ROSC after cardiac arrest.
Contraindications; hemorrhagic stroke, GCS > 8, uncontrolled bleeding, uncontrolled
hemodynamically unstable rhythms, and cardiac arrest due to trauma.
Pulmonary Embolism - ANSWER CP, dyspnea, tachycardia, tachypnea, hemoptysis. Trop/BNP often
elevated 2/2 R heart strain. CTPA gold standard diagnostic. Tx w/ Hep gtt, unless thrombectomy or
tPA.
Pulmonary HTN - ANSWER Dyspnea, ECG= R axis deviation, RV hypertrophy, tricuspid regurg.
Diagnose w/ R heart cath.
