CMC — Cardiac Medicine Certification
Practice Exam| YEAR 2026–2027 |
Comprehensive 100-Question Practice Test
with Answers & Rationales| Pdf Access
ALREADY GRADED A+.
1.
A client reports crushing substernal chest pain radiating to the left arm. Which action should the
practical nurse take first?
A. Obtain a 12-lead ECG
B. Administer prescribed aspirin
C. Apply oxygen at 6 L/min
D. Ask the client to rate the pain
Answer: A. Obtain a 12-lead ECG
Rationale: A 12-lead ECG should be obtained promptly in suspected acute coronary syndrome
to identify ischemic changes. Oxygen is not routinely indicated unless hypoxemia is present.
2.
Which assessment finding is most concerning in a client with heart failure?
A. 1+ ankle edema
B. Weight gain of 1 kg in 24 hours
C. Heart rate of 88/min
D. Mild fatigue after activity
Answer: B. Weight gain of 1 kg in 24 hours
Rationale: Rapid weight gain indicates fluid retention and may signal worsening heart failure.
,3.
A client taking digoxin has an apical pulse of 52/min. What should the nurse do?
A. Administer the medication
B. Hold the medication and notify the provider
C. Give an additional dose
D. Encourage ambulation
Answer: B. Hold the medication and notify the provider
Rationale: Digoxin can cause bradycardia. The medication should generally be withheld when
the apical pulse is significantly below the prescribed parameter.
4.
Which laboratory value is particularly important for a client taking digoxin?
A. Sodium
B. Potassium
C. Hemoglobin
D. Platelets
Answer: B. Potassium
Rationale: Hypokalemia increases the risk of digoxin toxicity.
5.
Which finding is characteristic of left-sided heart failure?
A. Ascites
B. Peripheral edema
C. Pulmonary crackles
D. Enlarged liver
Answer: C. Pulmonary crackles
Rationale: Left ventricular failure causes pulmonary congestion, producing crackles, dyspnea,
and orthopnea.
,6.
A client with acute pulmonary edema is extremely dyspneic. Which position is most
appropriate?
A. Supine
B. Trendelenburg
C. High-Fowler's
D. Prone
Answer: C. High-Fowler's
Rationale: Upright positioning improves lung expansion and reduces venous return to the heart.
7.
Which symptom is most associated with myocardial infarction?
A. Crushing chest pressure
B. Sharp pain relieved by inspiration
C. Pain only with movement
D. Localized abdominal tenderness
Answer: A. Crushing chest pressure
Rationale: Myocardial ischemia commonly presents with pressure, heaviness, squeezing, or
tightness in the chest.
8.
A client receiving nitroglycerin reports severe dizziness. What should the nurse assess first?
A. Temperature
B. Blood pressure
C. Respiratory rate
D. Blood glucose
Answer: B. Blood pressure
Rationale: Nitroglycerin causes vasodilation and can produce significant hypotension.
, 9.
Which instruction is appropriate for a client prescribed sublingual nitroglycerin?
A. Swallow the tablet whole
B. Place the tablet under the tongue
C. Take it only after meals
D. Store it in a weekly pill organizer
Answer: B. Place the tablet under the tongue
Rationale: Sublingual nitroglycerin is absorbed rapidly through the oral mucosa.
10.
Which medication should generally not be taken concurrently with nitroglycerin?
A. Acetaminophen
B. Sildenafil
C. Aspirin
D. Atorvastatin
Answer: B. Sildenafil
Rationale: Phosphodiesterase-5 inhibitors can cause profound hypotension when combined
with nitrates.
11–20: Cardiac Assessment & Heart Failure
11.
Which heart sound is associated with ventricular filling and is commonly heard in heart failure?
A. S1
B. S2
C. S3
D. S4
Answer: C. S3
Practice Exam| YEAR 2026–2027 |
Comprehensive 100-Question Practice Test
with Answers & Rationales| Pdf Access
ALREADY GRADED A+.
1.
A client reports crushing substernal chest pain radiating to the left arm. Which action should the
practical nurse take first?
A. Obtain a 12-lead ECG
B. Administer prescribed aspirin
C. Apply oxygen at 6 L/min
D. Ask the client to rate the pain
Answer: A. Obtain a 12-lead ECG
Rationale: A 12-lead ECG should be obtained promptly in suspected acute coronary syndrome
to identify ischemic changes. Oxygen is not routinely indicated unless hypoxemia is present.
2.
Which assessment finding is most concerning in a client with heart failure?
A. 1+ ankle edema
B. Weight gain of 1 kg in 24 hours
C. Heart rate of 88/min
D. Mild fatigue after activity
Answer: B. Weight gain of 1 kg in 24 hours
Rationale: Rapid weight gain indicates fluid retention and may signal worsening heart failure.
,3.
A client taking digoxin has an apical pulse of 52/min. What should the nurse do?
A. Administer the medication
B. Hold the medication and notify the provider
C. Give an additional dose
D. Encourage ambulation
Answer: B. Hold the medication and notify the provider
Rationale: Digoxin can cause bradycardia. The medication should generally be withheld when
the apical pulse is significantly below the prescribed parameter.
4.
Which laboratory value is particularly important for a client taking digoxin?
A. Sodium
B. Potassium
C. Hemoglobin
D. Platelets
Answer: B. Potassium
Rationale: Hypokalemia increases the risk of digoxin toxicity.
5.
Which finding is characteristic of left-sided heart failure?
A. Ascites
B. Peripheral edema
C. Pulmonary crackles
D. Enlarged liver
Answer: C. Pulmonary crackles
Rationale: Left ventricular failure causes pulmonary congestion, producing crackles, dyspnea,
and orthopnea.
,6.
A client with acute pulmonary edema is extremely dyspneic. Which position is most
appropriate?
A. Supine
B. Trendelenburg
C. High-Fowler's
D. Prone
Answer: C. High-Fowler's
Rationale: Upright positioning improves lung expansion and reduces venous return to the heart.
7.
Which symptom is most associated with myocardial infarction?
A. Crushing chest pressure
B. Sharp pain relieved by inspiration
C. Pain only with movement
D. Localized abdominal tenderness
Answer: A. Crushing chest pressure
Rationale: Myocardial ischemia commonly presents with pressure, heaviness, squeezing, or
tightness in the chest.
8.
A client receiving nitroglycerin reports severe dizziness. What should the nurse assess first?
A. Temperature
B. Blood pressure
C. Respiratory rate
D. Blood glucose
Answer: B. Blood pressure
Rationale: Nitroglycerin causes vasodilation and can produce significant hypotension.
, 9.
Which instruction is appropriate for a client prescribed sublingual nitroglycerin?
A. Swallow the tablet whole
B. Place the tablet under the tongue
C. Take it only after meals
D. Store it in a weekly pill organizer
Answer: B. Place the tablet under the tongue
Rationale: Sublingual nitroglycerin is absorbed rapidly through the oral mucosa.
10.
Which medication should generally not be taken concurrently with nitroglycerin?
A. Acetaminophen
B. Sildenafil
C. Aspirin
D. Atorvastatin
Answer: B. Sildenafil
Rationale: Phosphodiesterase-5 inhibitors can cause profound hypotension when combined
with nitrates.
11–20: Cardiac Assessment & Heart Failure
11.
Which heart sound is associated with ventricular filling and is commonly heard in heart failure?
A. S1
B. S2
C. S3
D. S4
Answer: C. S3
