AACN CSC (CARDIAC SURGERY
CERTIFICATION) EXAM QUESTIONS WITH
CORRECT ANSWERS | BRAND NEW!
Question 1
Which hemodynamic profile is indicative of right heart failure?
A) CVP 20 mm Hg, PAOP 17 mm Hg, Cl 2.6 L/min/m2
B) CVP 4 mm Hg, PAOP 18 mm Hg, CI 2.3 L/min/m2
C) CVP 19 mm Hg, PAOP 10 mm Hg, Cl 2.1 L/min/m2
D) CVP 10 mm Hg, PAOP 12 mm Hg, CI 1.6 L/min/m2
Correct Answer
C) CVP 19 mm Hg, PAOP 10 mm Hg, Cl 2.1 L/min/m2
RHF is characterized by elevated CVP, low CO & CI, and a decreased or normal
PAOP. Interventions should focus on optimizing preload.
Question 2
A patient post-CABG was extubated within 4 hours to 6L/min O2 via nasal cannula.
The patient is now experiencing severe incisional pain and has difficulty breathing.
The nurse receives an order to perform an ABG. Which ABG result SHOULD the nurse
anticipate?
a) pH 7.50, PaCO2 31, PaO2 78, HCO3 26, BE +2, SaO2 95%
b) pH 7.48, PaCO2 29, PaO2 76, HCO3 92, BE 0, SaO2 91%
c) pH 7.31, PaCO2 53, PaO2 73, HCO3 25, BE 0, SaO2 93%
d) pH 7.28, PaCO2 40, PaO2 94, HCO3 18, BE -4, SaO2 96%
Correct Answer
c) pH 7.31, PaCO2 53, PaO2 73, HCO3 25, BE 0, SaO2 93%
After extubation patients continue to require vigilant respiratory assessment.
Patients with a median sternotomy tend to splint and take shallow breaths. The
nurse needs to encourage coughing exercises, incentive spirometry every 1 to 2
hours and get the patient out of bed as soon as possible to prevent DVT and
pulmonary complications.
Page 1 of 285
,Question 3
Atrial fibrillation is particularly dangerous in which of these patients:
A. Patient with mitral valve replacement for mitral stenosis.
B. Patient who had 5-vessel CABG.
C. Patient with aortic valve replacement for aortic stenosis.
D. Patient with preoperative LV dysfunction.
Correct Answer
C. Aortic stenosis causes left ventricular hypertrophy with a stiff noncompliant LV
and diastolic failure. A noncompliant LV depends on atrial kick for adequate preload
and stroke volume. Sinus rhythm or AV pacing is especially important in this patient
to maintain AV synchrony and adequate preload. Atrial fibrillation results in a loss of
atrial kick and can lead to profound hemodynamic deterioration.
Atrial fibrillation can occur in any post operative cardiac surgery patient and is
especially common in mitral valve disease because of the increased atrial pressure
and/or volume that occurs. However, it is better tolerated in patients who do not
have LV diastolic dysfunction or LV hypertrophy.
Question 4
When caring for a patient who had the radial artery harvested during CABG surgery
the nurse is aware of the following:
A. The radial artery is the first choice graft to use to bypass the LAD.
B. The radial artery harvest site will require skin grafting as soon as the patient is
stable
C. The patient will need to be on immunosuppressive agents to prevent graft
rejection.
D. The patient will be on a nitrate or calcium channel blocker to prevent spasm.
Correct Answer
D. The radial artery is a graft that has the advantage of being a long graft capable of
reaching distal sites. The primary disadvantage is that it is thick and muscular and
prone to spasm. For this reason perioperative nitrates or calcium channel blockers
are indicated.
Patients do not need immunosuppressants when native grafts are used.
The harvesting sites for grafts involve puncture sites or incisions and do not require
any type of skin grafting because skin is not removed.
Page 2 of 285
,Question 5
A patient is admitted to the unit, the nurse notes the following data:
MAP 55 mm Hg
CVP 18 mm Hg
PAP 42/23 mm Hg Cl 1.5 L/min/m2
SVR 1900 dynes/sec/cm-5
The patient is MOST LIKELY experiencing
A) hemorrhagic shock.
B) obstructive shock.
c) cardiogenic shock.
D) distributive shock.
Correct Answer
C) cardiogenic shock. The patient has elevated filling pressures, a low CI, and a high
SVR. All are consistent with cardiogenic shock.
Question 6
A patient with a transvenous pacemaker for 3rd degree heart block is awaiting
permanent pacemaker placement. The patient states, "I feel funny and lightheaded."
Vital signs are:BP 77/50HR 38What should the nurse do FIRST?
a) administer atropine 0.5 mg IV
b) place the patient on the left side
c) obtain 12-lead ECG
d) adjust the pacemaker settings
Correct Answer
b) place the patient on the left side
Loss of capture of a transvenous pacer can be restored through improved lead
contact by placing the patient on the left side. Cardiac output is also improved in
the left lateral position. This positional change addresses the immediate concern of
symptomatic bradycardia and hypotension and allows time for the nurse to evaluate
and address the cause.
Page 3 of 285
, Question 7
A postoperative patient who is hemodynamically stable has a Hct of 30%. The best
INITIAL strategy for the management of new-onset acute kidney injury would be to
A) initiate a low-dose dopamine (Intropin) infusion.
B) administer a dose of chlorothiazide (Diuril).
C) give a 1-liter bolus of NS.
D) infuse 2 units of PRBCs.
Correct Answer
C) give a 1-liter bolus of NS. The patient met acute pericarditis diagnostic criteria of
chest pain and classic ECG changes (diffuse ST elevations and pericardial friction
rub)..
Question 8
A patient post-CABG and the bilateral internal mammary arteries were utilized as
conduits due to the patient's extensive peripheral vascular disease. The nurse should
be MOST vigilant for?
a) upper extremities mobility restrictions
b) assessment of the sternal incision site
c) assessment for neurological changes
d) cough and breathing exercises
Correct Answer
b) assessment of the sternal incision site
The use of both internal mammary arteries is associated with an increased risk of
sternal infection because these arteries provide the major source of blood supply to
the sternum.
Page 4 of 285
CERTIFICATION) EXAM QUESTIONS WITH
CORRECT ANSWERS | BRAND NEW!
Question 1
Which hemodynamic profile is indicative of right heart failure?
A) CVP 20 mm Hg, PAOP 17 mm Hg, Cl 2.6 L/min/m2
B) CVP 4 mm Hg, PAOP 18 mm Hg, CI 2.3 L/min/m2
C) CVP 19 mm Hg, PAOP 10 mm Hg, Cl 2.1 L/min/m2
D) CVP 10 mm Hg, PAOP 12 mm Hg, CI 1.6 L/min/m2
Correct Answer
C) CVP 19 mm Hg, PAOP 10 mm Hg, Cl 2.1 L/min/m2
RHF is characterized by elevated CVP, low CO & CI, and a decreased or normal
PAOP. Interventions should focus on optimizing preload.
Question 2
A patient post-CABG was extubated within 4 hours to 6L/min O2 via nasal cannula.
The patient is now experiencing severe incisional pain and has difficulty breathing.
The nurse receives an order to perform an ABG. Which ABG result SHOULD the nurse
anticipate?
a) pH 7.50, PaCO2 31, PaO2 78, HCO3 26, BE +2, SaO2 95%
b) pH 7.48, PaCO2 29, PaO2 76, HCO3 92, BE 0, SaO2 91%
c) pH 7.31, PaCO2 53, PaO2 73, HCO3 25, BE 0, SaO2 93%
d) pH 7.28, PaCO2 40, PaO2 94, HCO3 18, BE -4, SaO2 96%
Correct Answer
c) pH 7.31, PaCO2 53, PaO2 73, HCO3 25, BE 0, SaO2 93%
After extubation patients continue to require vigilant respiratory assessment.
Patients with a median sternotomy tend to splint and take shallow breaths. The
nurse needs to encourage coughing exercises, incentive spirometry every 1 to 2
hours and get the patient out of bed as soon as possible to prevent DVT and
pulmonary complications.
Page 1 of 285
,Question 3
Atrial fibrillation is particularly dangerous in which of these patients:
A. Patient with mitral valve replacement for mitral stenosis.
B. Patient who had 5-vessel CABG.
C. Patient with aortic valve replacement for aortic stenosis.
D. Patient with preoperative LV dysfunction.
Correct Answer
C. Aortic stenosis causes left ventricular hypertrophy with a stiff noncompliant LV
and diastolic failure. A noncompliant LV depends on atrial kick for adequate preload
and stroke volume. Sinus rhythm or AV pacing is especially important in this patient
to maintain AV synchrony and adequate preload. Atrial fibrillation results in a loss of
atrial kick and can lead to profound hemodynamic deterioration.
Atrial fibrillation can occur in any post operative cardiac surgery patient and is
especially common in mitral valve disease because of the increased atrial pressure
and/or volume that occurs. However, it is better tolerated in patients who do not
have LV diastolic dysfunction or LV hypertrophy.
Question 4
When caring for a patient who had the radial artery harvested during CABG surgery
the nurse is aware of the following:
A. The radial artery is the first choice graft to use to bypass the LAD.
B. The radial artery harvest site will require skin grafting as soon as the patient is
stable
C. The patient will need to be on immunosuppressive agents to prevent graft
rejection.
D. The patient will be on a nitrate or calcium channel blocker to prevent spasm.
Correct Answer
D. The radial artery is a graft that has the advantage of being a long graft capable of
reaching distal sites. The primary disadvantage is that it is thick and muscular and
prone to spasm. For this reason perioperative nitrates or calcium channel blockers
are indicated.
Patients do not need immunosuppressants when native grafts are used.
The harvesting sites for grafts involve puncture sites or incisions and do not require
any type of skin grafting because skin is not removed.
Page 2 of 285
,Question 5
A patient is admitted to the unit, the nurse notes the following data:
MAP 55 mm Hg
CVP 18 mm Hg
PAP 42/23 mm Hg Cl 1.5 L/min/m2
SVR 1900 dynes/sec/cm-5
The patient is MOST LIKELY experiencing
A) hemorrhagic shock.
B) obstructive shock.
c) cardiogenic shock.
D) distributive shock.
Correct Answer
C) cardiogenic shock. The patient has elevated filling pressures, a low CI, and a high
SVR. All are consistent with cardiogenic shock.
Question 6
A patient with a transvenous pacemaker for 3rd degree heart block is awaiting
permanent pacemaker placement. The patient states, "I feel funny and lightheaded."
Vital signs are:BP 77/50HR 38What should the nurse do FIRST?
a) administer atropine 0.5 mg IV
b) place the patient on the left side
c) obtain 12-lead ECG
d) adjust the pacemaker settings
Correct Answer
b) place the patient on the left side
Loss of capture of a transvenous pacer can be restored through improved lead
contact by placing the patient on the left side. Cardiac output is also improved in
the left lateral position. This positional change addresses the immediate concern of
symptomatic bradycardia and hypotension and allows time for the nurse to evaluate
and address the cause.
Page 3 of 285
, Question 7
A postoperative patient who is hemodynamically stable has a Hct of 30%. The best
INITIAL strategy for the management of new-onset acute kidney injury would be to
A) initiate a low-dose dopamine (Intropin) infusion.
B) administer a dose of chlorothiazide (Diuril).
C) give a 1-liter bolus of NS.
D) infuse 2 units of PRBCs.
Correct Answer
C) give a 1-liter bolus of NS. The patient met acute pericarditis diagnostic criteria of
chest pain and classic ECG changes (diffuse ST elevations and pericardial friction
rub)..
Question 8
A patient post-CABG and the bilateral internal mammary arteries were utilized as
conduits due to the patient's extensive peripheral vascular disease. The nurse should
be MOST vigilant for?
a) upper extremities mobility restrictions
b) assessment of the sternal incision site
c) assessment for neurological changes
d) cough and breathing exercises
Correct Answer
b) assessment of the sternal incision site
The use of both internal mammary arteries is associated with an increased risk of
sternal infection because these arteries provide the major source of blood supply to
the sternum.
Page 4 of 285
