CMC Practice Questions AACN test
with correct answers
A 17 year old patient who was resuscitated after an episode of sudden cardiac death should be assessed for:
A. hypertrophic cardiomyopathy or long QT syndrome.
B. aortic stenosis or sinus arrest syndrome.
C. pulmonary HTN or atrial septal defect.
D. dilated cardiomyopathy or mitral regurgitation. - CORRECT ANSWER-A. correct. the most common cause of SCD in those younger than age
30 is a preexisting cardiac abnormality, including hypertrophic cardiomyopathy.
B. incorrect. most commonly found in adults.
C. incorrect. ASD would cause right heart failure and is diagnosis in children and teens. symptoms would present as dyspnea and peripheral
edema rather than SCD.
D. incorrect. mitral regurgitation is more common in adults. only 10% of SCD cases are caused by dilated cardiomyopathy.
A 22 year old athlete is admitted with reports of severe fatigue, dyspnea with minor exertion and frequent chest palpitations. The EKG reveals
non-specific ST-T wave changes. during a medical history the patient reports being diagnosed with a confirmed case of the flu 3-4 weeks ago.
with this assessment and medical history, the nurse should suspect:
A. NSTEMI
B. persistent influenza
C. STEMI
D. myocarditis - CORRECT ANSWER-A. incorrect. patients who present with NSTEMI do not have EKG changes.
B. incorrect. influenza does not have EKG changes.
C. incorrect. STEMIs present with EKG changes that pinpoint area of injury.
D. correct. myocarditis can follow viral illnesses such as influenza and has a delayed presentation with nonspecific EKG changes.
A 78 year old is reporting abdominal pain and pain in the lower back radiating to the back of the thighs. which of the following are indicated to
provide the best diagnostic information?
A. a PMH, physical exam, and a CT of the chest and abdomen.
B. an MRI of the spine, physical exam, and an U/S of the abdomen.
C. an U/S of the abdomen, family history and an MRI of the spine.
D. a PMH, physical exam and a CT of the spine. - CORRECT ANSWER-A. correct. due to his age, sex, and location of the pain, an abdominal
aortic aneurysm (AAA) is suspected. a patient history is needed because of patients with an aortic aneurysm 90% have a histor y of systemic
HTN. initial tests recommended for a patient with an AAA are abdominal U/S, if the patient is unstable, or CT of the chest and abdomen is the
patient is stable.
B, C, & D. incorrect. there is no need for an MRI for a suspected AAA.
A nurse caring for a patient with a temporary transvenous pacemaker. The monitor reveals a pacing spike that is not followed by a QRS complex.
which of the following is indicated?
A. place the patient in the right lateral decubitus position.
B. decrease the mA
C. reduce the sensitivity value
D. replace the pulse generator - CORRECT ANSWER-A. incorrect. the patient is manifesting failure to capture and can be placed in the left
lateral decubitus position if caused by lead dislodgement until able to be replaced.
B. incorrect.
C. incorrect. reducing the sensitivity corrects oversensing, not failure to capture.
D. correct. failure to capture may be cause by broken connector pins or connecting cable.
A nurse is establishing alarm limits on a patient admitted to rule out MI. Which of the following patient positions and ST segment alarm settings
should the nurse use?
A. supine position and 1 mm above and below baseline.
B. supine position and 2 mm above and below baseline.
C. upright position and 1 mm above and below baseline.
D. upright position and 2 mm above and below baseline. - CORRECT ANSWER-A. correct. supine position allows for more accurate electrode
placement. ST segment limits are placed 1mm above or below for monitoring patients at high risk for ischemia.
B. incorrect. ST segment may be set 2mm above or below for stable patients without high risk for ischemia.
C. incorrect.
D. incorrect.
A nurse is reviewing orders for a patient experiencing unstable angina who is scheduled for a stress test. the nurse should question the use of
which of the following medications?
A. dopamine (Intropin)
B. dipyridamole (Persantine)
C. adenosine (Adenocard)
, D. lexiscan (Regadenoson) - CORRECT ANSWER-A. correct. dopamine is not one of the recommended drugs for a pharmacologic stress test.
Dobutamine (Dobutrex) is one of the recommended drugs for a pharmacologic stress test.
B, C, & D. incorrect. dipyridamole, adenosine, and lexiscan are recommended drugs for pharmacologic stress testing.
A patient arrives at the hospital reporting blurred vision after missing 2 days of prescribed antihypertensive medications. VS are: BP 195/120 ; HR
100 ; RR 18. Administration of which of the following medications should the nurse anticipate initially?
A. nifedipine (Procardia) sublingual
B. clonidine (Catapres) sublingual
C. fenoldapam (Corlopan) IV infusion
D. nitroprusside (Nipride) IV infusion - CORRECT ANSWER-A. incorrect. nifedipine SL is contraindicated d/t adverse effects of hypotension
followed by rebound HTN.
B. incorrect.
C. incorrect.
D. correct. initiation of a nitroprusside IV infusion at 0.25-10mg/kg/min would allow titration to BP that maintains optimal cerebral and target organ
perfusion.
A patient develops chest pain, nausea, vomiting and diaphoresis. the 12-lead EKG is normal. a further cardiac assessment is warranted, as it is
common for ST segment elevation to be absent in:
A. an anterior wall MI
B. a posterior wall MI
C. a lateral wall MI
D. an inferior wall MI - CORRECT ANSWER-A. incorrect. an anterior wall MI would have EKG changes in leads V1-V4
B. correct. in the standard lead setup, the EKG typically does not look at the posterior wall; because of the location of the occlusion, ECG
changes would not be apparent.
C. incorrect. a lateral wall MI would present changes in leads I, aVL, V5, and V6.
D. incorrect. an inferior wall MI would present changes in leads II, III, aVF.
A patient develops chest pain, nausea, vomiting, and diaphoresis. the 12 lead EKG is negative. if AMI is still suspected despite the absence of ST
segment elevation, which should be nurse suspect?
A. posterior wall MI.
B. anterior wall MI.
C. lateral wall MI.
D. inferior wall MI. - CORRECT ANSWER-A. correct. detection of a posterior wall MI is difficult to assess on a standard 12 lead EKG.
B. incorrect. an anterior wall MI would have evidence on leads V1-V4 (Q waves and ST segment elevation) on EKG.
C. incorrect. a lateral wall MI will have changes in leads I, aVL, V5 and V6 (Q waves and ST segment elevation) on EKG.
D. incorrect. an inferior wall MI will have changes in leads II, III, and aVF ( Q waves and ST segment elevation) on EKG.
A patient diagnosed with sick sinus syndrome is at risk for developing
A. A-Fib
B. sinus tachycardia
C. idioventricular rhythm
D. junctional rhythm - CORRECT ANSWER-A. correct. alternating sinus bradycardia with paroxysmal atrial/supraventricular tachyarrhythmia is
known as sick sinus syndrome.
B. incorrect. sick sinus syndrome causes atrial tachycardias due to dysfunction at the sinus node.
C. incorrect. idioventricular rhythms originate below the AV node.
D. incorrect. sick sinus syndrome causes a slowing or pauses at the sinus node.
A patient is admitted with elevated troponin levels and ST segment elevation in leads II, III, and aVF. Administration of which of the following
should the nurse anticipate initially?
A. enoxaparin (Lovenox)
B. streptokinase (Strepase)
C. alteplase (Activase)
D. reteplase (Retavase) - CORRECT ANSWER-A. incorrect. enoxaparin is an alternative to heparin in patients with unstable angina, NSTEMI or
DVT.
B. incorrect. streptokinase is indicated for acute arterial thrombosis or embolism, or occluded AV cannulas.
C. incorrect. alteplase in indicated for acute ischemic stroke or acute massive pulmonary embolism.
D. correct. reteplase is indicated for AMI when fibrinolytics are indicated.
A patient is admitted with intermittent chest pain at rest x1 week. the 12-lead EKG, CK, CKMB, and troponin I are normal. the patient most likely
has:
A. stable angina
B. unstable angina
C. NSTEMI
D. STEMI - CORRECT ANSWER-A. incorrect. it is not stable due to continued intermittent chest pain at rest.
B. correct. unstable because of continued chest pain x1 week at rest.
C. incorrect. lab values are WNL.
D. incorrect. EKG and lab values are WNL.
A patient is admitted with SOB, jaundice, peripheral edema, and nausea. A pulmonary artery catheter was inserted. On insertion the
hemodynamic values are PA 55/33 mmHg and CVP 20mmHg. which of the following should the nurse consider as potential causes of these signs
and symptoms?
A. peripheral arterial vascular occlusion, mitral regurgitation and LV failure.
B. systemic HTN, MI, and endocarditis.
C. LV failure, pulmonary embolus, and pulmonary HTN.
D. pulmonary edema, abdominal infection, and portal vein occlusion. - CORRECT ANSWER-A. incorrect. peripheral artery vascular occlusion and
mitral regurgitation are not direct causes of right heart failure.
B. incorrect. systemic HTN and endocarditis are not direct causes of right heart failure.
C. correct. patient is demonstrating symptoms of right heart failure. LV failure is the most common cause of RV dysfunction. pulmonary embolus
and pulmonary HTN are additional causes.
D. incorrect.
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
with correct answers
A 17 year old patient who was resuscitated after an episode of sudden cardiac death should be assessed for:
A. hypertrophic cardiomyopathy or long QT syndrome.
B. aortic stenosis or sinus arrest syndrome.
C. pulmonary HTN or atrial septal defect.
D. dilated cardiomyopathy or mitral regurgitation. - CORRECT ANSWER-A. correct. the most common cause of SCD in those younger than age
30 is a preexisting cardiac abnormality, including hypertrophic cardiomyopathy.
B. incorrect. most commonly found in adults.
C. incorrect. ASD would cause right heart failure and is diagnosis in children and teens. symptoms would present as dyspnea and peripheral
edema rather than SCD.
D. incorrect. mitral regurgitation is more common in adults. only 10% of SCD cases are caused by dilated cardiomyopathy.
A 22 year old athlete is admitted with reports of severe fatigue, dyspnea with minor exertion and frequent chest palpitations. The EKG reveals
non-specific ST-T wave changes. during a medical history the patient reports being diagnosed with a confirmed case of the flu 3-4 weeks ago.
with this assessment and medical history, the nurse should suspect:
A. NSTEMI
B. persistent influenza
C. STEMI
D. myocarditis - CORRECT ANSWER-A. incorrect. patients who present with NSTEMI do not have EKG changes.
B. incorrect. influenza does not have EKG changes.
C. incorrect. STEMIs present with EKG changes that pinpoint area of injury.
D. correct. myocarditis can follow viral illnesses such as influenza and has a delayed presentation with nonspecific EKG changes.
A 78 year old is reporting abdominal pain and pain in the lower back radiating to the back of the thighs. which of the following are indicated to
provide the best diagnostic information?
A. a PMH, physical exam, and a CT of the chest and abdomen.
B. an MRI of the spine, physical exam, and an U/S of the abdomen.
C. an U/S of the abdomen, family history and an MRI of the spine.
D. a PMH, physical exam and a CT of the spine. - CORRECT ANSWER-A. correct. due to his age, sex, and location of the pain, an abdominal
aortic aneurysm (AAA) is suspected. a patient history is needed because of patients with an aortic aneurysm 90% have a histor y of systemic
HTN. initial tests recommended for a patient with an AAA are abdominal U/S, if the patient is unstable, or CT of the chest and abdomen is the
patient is stable.
B, C, & D. incorrect. there is no need for an MRI for a suspected AAA.
A nurse caring for a patient with a temporary transvenous pacemaker. The monitor reveals a pacing spike that is not followed by a QRS complex.
which of the following is indicated?
A. place the patient in the right lateral decubitus position.
B. decrease the mA
C. reduce the sensitivity value
D. replace the pulse generator - CORRECT ANSWER-A. incorrect. the patient is manifesting failure to capture and can be placed in the left
lateral decubitus position if caused by lead dislodgement until able to be replaced.
B. incorrect.
C. incorrect. reducing the sensitivity corrects oversensing, not failure to capture.
D. correct. failure to capture may be cause by broken connector pins or connecting cable.
A nurse is establishing alarm limits on a patient admitted to rule out MI. Which of the following patient positions and ST segment alarm settings
should the nurse use?
A. supine position and 1 mm above and below baseline.
B. supine position and 2 mm above and below baseline.
C. upright position and 1 mm above and below baseline.
D. upright position and 2 mm above and below baseline. - CORRECT ANSWER-A. correct. supine position allows for more accurate electrode
placement. ST segment limits are placed 1mm above or below for monitoring patients at high risk for ischemia.
B. incorrect. ST segment may be set 2mm above or below for stable patients without high risk for ischemia.
C. incorrect.
D. incorrect.
A nurse is reviewing orders for a patient experiencing unstable angina who is scheduled for a stress test. the nurse should question the use of
which of the following medications?
A. dopamine (Intropin)
B. dipyridamole (Persantine)
C. adenosine (Adenocard)
, D. lexiscan (Regadenoson) - CORRECT ANSWER-A. correct. dopamine is not one of the recommended drugs for a pharmacologic stress test.
Dobutamine (Dobutrex) is one of the recommended drugs for a pharmacologic stress test.
B, C, & D. incorrect. dipyridamole, adenosine, and lexiscan are recommended drugs for pharmacologic stress testing.
A patient arrives at the hospital reporting blurred vision after missing 2 days of prescribed antihypertensive medications. VS are: BP 195/120 ; HR
100 ; RR 18. Administration of which of the following medications should the nurse anticipate initially?
A. nifedipine (Procardia) sublingual
B. clonidine (Catapres) sublingual
C. fenoldapam (Corlopan) IV infusion
D. nitroprusside (Nipride) IV infusion - CORRECT ANSWER-A. incorrect. nifedipine SL is contraindicated d/t adverse effects of hypotension
followed by rebound HTN.
B. incorrect.
C. incorrect.
D. correct. initiation of a nitroprusside IV infusion at 0.25-10mg/kg/min would allow titration to BP that maintains optimal cerebral and target organ
perfusion.
A patient develops chest pain, nausea, vomiting and diaphoresis. the 12-lead EKG is normal. a further cardiac assessment is warranted, as it is
common for ST segment elevation to be absent in:
A. an anterior wall MI
B. a posterior wall MI
C. a lateral wall MI
D. an inferior wall MI - CORRECT ANSWER-A. incorrect. an anterior wall MI would have EKG changes in leads V1-V4
B. correct. in the standard lead setup, the EKG typically does not look at the posterior wall; because of the location of the occlusion, ECG
changes would not be apparent.
C. incorrect. a lateral wall MI would present changes in leads I, aVL, V5, and V6.
D. incorrect. an inferior wall MI would present changes in leads II, III, aVF.
A patient develops chest pain, nausea, vomiting, and diaphoresis. the 12 lead EKG is negative. if AMI is still suspected despite the absence of ST
segment elevation, which should be nurse suspect?
A. posterior wall MI.
B. anterior wall MI.
C. lateral wall MI.
D. inferior wall MI. - CORRECT ANSWER-A. correct. detection of a posterior wall MI is difficult to assess on a standard 12 lead EKG.
B. incorrect. an anterior wall MI would have evidence on leads V1-V4 (Q waves and ST segment elevation) on EKG.
C. incorrect. a lateral wall MI will have changes in leads I, aVL, V5 and V6 (Q waves and ST segment elevation) on EKG.
D. incorrect. an inferior wall MI will have changes in leads II, III, and aVF ( Q waves and ST segment elevation) on EKG.
A patient diagnosed with sick sinus syndrome is at risk for developing
A. A-Fib
B. sinus tachycardia
C. idioventricular rhythm
D. junctional rhythm - CORRECT ANSWER-A. correct. alternating sinus bradycardia with paroxysmal atrial/supraventricular tachyarrhythmia is
known as sick sinus syndrome.
B. incorrect. sick sinus syndrome causes atrial tachycardias due to dysfunction at the sinus node.
C. incorrect. idioventricular rhythms originate below the AV node.
D. incorrect. sick sinus syndrome causes a slowing or pauses at the sinus node.
A patient is admitted with elevated troponin levels and ST segment elevation in leads II, III, and aVF. Administration of which of the following
should the nurse anticipate initially?
A. enoxaparin (Lovenox)
B. streptokinase (Strepase)
C. alteplase (Activase)
D. reteplase (Retavase) - CORRECT ANSWER-A. incorrect. enoxaparin is an alternative to heparin in patients with unstable angina, NSTEMI or
DVT.
B. incorrect. streptokinase is indicated for acute arterial thrombosis or embolism, or occluded AV cannulas.
C. incorrect. alteplase in indicated for acute ischemic stroke or acute massive pulmonary embolism.
D. correct. reteplase is indicated for AMI when fibrinolytics are indicated.
A patient is admitted with intermittent chest pain at rest x1 week. the 12-lead EKG, CK, CKMB, and troponin I are normal. the patient most likely
has:
A. stable angina
B. unstable angina
C. NSTEMI
D. STEMI - CORRECT ANSWER-A. incorrect. it is not stable due to continued intermittent chest pain at rest.
B. correct. unstable because of continued chest pain x1 week at rest.
C. incorrect. lab values are WNL.
D. incorrect. EKG and lab values are WNL.
A patient is admitted with SOB, jaundice, peripheral edema, and nausea. A pulmonary artery catheter was inserted. On insertion the
hemodynamic values are PA 55/33 mmHg and CVP 20mmHg. which of the following should the nurse consider as potential causes of these signs
and symptoms?
A. peripheral arterial vascular occlusion, mitral regurgitation and LV failure.
B. systemic HTN, MI, and endocarditis.
C. LV failure, pulmonary embolus, and pulmonary HTN.
D. pulmonary edema, abdominal infection, and portal vein occlusion. - CORRECT ANSWER-A. incorrect. peripheral artery vascular occlusion and
mitral regurgitation are not direct causes of right heart failure.
B. incorrect. systemic HTN and endocarditis are not direct causes of right heart failure.
C. correct. patient is demonstrating symptoms of right heart failure. LV failure is the most common cause of RV dysfunction. pulmonary embolus
and pulmonary HTN are additional causes.
D. incorrect.
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
