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Exam (elaborations)

CMC Practice Questions - AACN Questions and Answers (100% Correct Answers) Already Graded A+

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CMC Practice Questions - AACN Questions and Answers (100% Correct Answers) Already Graded A+

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CMC Practice Questions - AACN
Questions and Answers (100% Correct
Answers) Already Graded A+


While caring for a patient with an IABP at 3:1, the nurse notes:
A. decreasing urine output as well as increasing BUN and CR
levels; the nurse should increase timing to 2:1
© 2025 Assignment Expert




B. absent pulses in the proximal extremity; the nurse should apply
pressure at the insertion site.
C. blood in the IABP tubing; the nurse should disconnect the
balloon catheter from the IABP.
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D. blood oozing from the insertion site; the nurse should anticipate
the need for an emergency fasciotomy.—Ans: A. incorrect.
decreasing urine output with increasing BUN and CR levels with an
IABP in place indicates obstruction of the renal arteries. The nurse
should plan for removal.
B. incorrect. absent pulses distal to the insertion site indicates
complete occlusion of the femoral artery. application of pressure
to the insertion site will worsen the obstruction.
C. correct. blood in the IABP tubing indicates a rupture of the
balloon. Continuing to allow the IABP to inflate and deflate will
increase the size of the rupture, causing more bleeding. the nurse
should plan for removal or exchange of the IABP catheter.
D. incorrect. a fasciotomy would be indicated if the patient had
an increase in fluid accumulation in the extremities causing
significant injury to the limb.
An IABP is currently at 3:1 when the patient suddenly goes into
ventricular fibrillation. In addition to resuscitative measures, the
nurse should:

, 2
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A. change the trigger to internal or pressure support resuscitative
measures.
B. increase timing back to 1:1 to increase coronary artery
perfusion pressure.
C. put the pump on standby until the return of spontaneous
circulation.
D. assess the IABP timing to chest compressions at 1:2.—Ans: A.
correct. the IABP will not be able to time correctly when a patient
is in V-Fib. by placing the system to trigger on internal or pressure
support, it will generate off the pressure created during
compressions.
© 2025 Assignment Expert




B. incorrect. attempting to time the IABP back to 1:1 will be
counterproductive, as it will not be able to trigger correctly.
C. incorrect. there is significant risk of clot forming on the IABP
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when placed in stand for an indeterminate amount of time.
D. incorrect. the primary goal during resuscitative measures is to
attempt to circulate blood volume as effectively as possible.
assessing the timing of the IABP is unnecessary.
The nurse is reviewing the home medications list for a patient
admitted c/o severe chest pain. serial EKGs and blood testing are
negative, so an exercise stress test is scheduled. which of the
following medications may result in a false-positive finding on the
stress test?
A. digitalis (Digoxin)
B. potassium chloride (K-Dur)
C. sotalol (Betapace)
D. diltiazem (Cardiazem)—Ans: A. correct. digitalis can cause
false-positive EKG changes during a stress test. there is an
association between the development of ST segment depression
during stress testing. the mechanism of this EKG change is not
clear. further, digitalis should be withheld on the day of the test
because of its negative chronotropic effects.

, 3
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B. incorrect.
C & D. incorrect. beta-blockers and calcium channel blockers
blunt the heart rate response to exercise and may prevent
achievement of maximum predicted heart rate. they should be
withheld on the day of the test.
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)
© 2025 Assignment Expert




D. reteplase (Retavase)—Ans: A. incorrect. enoxaparin is an
alternative to heparin in patients with unstable angina, NSTEMI or
DVT.
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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.
Which of the following is a characteristic of diastolic heart failure?
A. inability of the heart muscle to relax.
B. dilation of the ventricular chambers.
C. increased filling of the left ventricle.
D. decreased ability of the ventricle to contract.—Ans: A. correct.
with diastolic heart failure the left ventricle is unable to relax,
leading to signs and symptoms of heart failure, but the patient
maintains a preserved EF as the muscle retains its ability to
contract.
B. incorrect. dilation of the ventricular chambers is a characteristic
of systolic heart failure.

, 4
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C. incorrect. diastolic heart failure is an abnormality with heart
filling. the heart muscle does not relax normally, and the heart
may fill too slowly or asynchronously. if the left ventricle does not
relax properly or is thick and stiff, it does not fill in the usual manner
and blood is drawn back into the left atrium and eventually into
the lungs.
D. incorrect. decreased ability of the ventricle to contract is a
symptom of overextension of the heart muscle in patients with
cardiomyopathy.
Following a STEMI, the nurse auscultates a late systolic murmur at
the apex. The nurse should suspect the finding is r/t the new onset
of a:
© 2025 Assignment Expert




A. right bundle branch block
B. left bundle branch block
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C. papillary muscle rupture
D. calcific plaque rupture—Ans: A. incorrect. a RBBB would cause
an electrical delay in conduction for a wide split S2.
B. incorrect. a LBBB would cause and electrical delay in ventricular
conduction for a paroxical split S2.
C. correct. a papillary muscle chord rupture results from ischemia
to the tissue supplying the mitral valve. a systolic murmur is heard
due to mitral regurgitation.
D. incorrect. plaque rupture would cause an occlusion of the
coronary artery that would not directly cause a new systolic
murmur.
The nurse is reviewing the plan of care for a patient with systolic
heart failure who has enalapril (Vasotec), furosemide (Lasix),
metoprolol (Lopressor), and carvedilol (Coreg) ordered. Which of
the following will provide the most accurate assessment of the
regimen?
A. daily weights
B. strict I&O

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