CMC AACN EXAM LATEST
A patient reports left-sided chest pain not associated with SOB or
diaphoresis for the past 12 hours. The pain worsens when lying supine.
Serial 12-lead EKGs reveal ST segment elevation in the anterior,
inferior, and lateral leads. Cardiac biomarkers are negative.
administration of which of the following medications should the nurse
anticipate?
A. NSAIDs
B. thrombolytic therapy.
C. nitroglycerin infusion.
D. diuretic therapy. - ANSWERS-A. correct. ST segment elevation in all
areas of the heart is associated with pericarditis. NSAIDs are a
recommended first line therapy.
B. incorrect. thrombolytic therapy is harmful in the setting of pericarditis
and may result in hemorrhage.
C. incorrect. nitrates would not prevent fluid from collecting around the
hear in pericarditis.
D. incorrect. the patient does not have SOB, which is typically
associated with an acute heart failure exacerbation. diuresis can
potentially worsen the pericarditis.
Which of the following is likely to result in diastolic dysfunction of the
left ventricle?
A. pulmonary artery hypertension
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1
, CMC AACN EXAM LATEST
B. A-Fib with RVR
C. cardiogenic shock
D. dilated cardiomyopathy - ANSWERS-A. incorrect. pulmonary artery
hypertension may cause right ventricular failure not left.
B. correct. reduced atrial contraction and decreased diastolic time result
in reduced filling of the ventricle and diastolic dysfunction.
C. incorrect. cardiogenic shock results in reduced stroke volume from
loss of ventricular contractile force.
D. incorrect. dilated cardiomyopathy results in systolic dysfunction from
decreased contractility.
In which patient should the nurse suspect the presence of infective
endocarditis? a patient with:
A. T 101.3 F, CVP 14mmHg, and chest pain.
B. T 101.7 F, heart murmur, and signs of heart failure.
C. petechiae, BP 150/96 (114), and increase in activity.
D. headache, CVP 20mmHg, and BP 80/40 (53). - ANSWERS-A.
incorrect. although fever is present in about 80% of infective
endocarditis, chest pain is only present in about 15%. CVP will be low
and not high d/t sepsis.
B. correct. infective endocarditis produces fever, heart murmur, signs of
heart failure, and may produce rapid hemodynamic deterioration.
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PAGE
2
, CMC AACN EXAM LATEST
C. incorrect. petechiae occurs in 20-40% of cases of infective
endocarditis. HTN may occur in the compensatory phase of the septic
process.
D. incorrect. CVP would be low d/t sepsis.
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 - ANSWERS-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.
END OF
PAGE
3
, CMC AACN EXAM LATEST
A patient is reporting a new onset of palpitations. VS are: BP 90/60 ; HR
182 ; RR 20 ; T 98.6F. the cardiac monitor displays a rapid regular
rhythm with a QRS complex measuring 0.08 sec. The patient is alert and
oriented, denies chest pain and SOB, and has warn, dry skin. when vagal
maneuvers fail to restore NSR, the nurse should:
A. administer adenosine (Adenocard)
B. defibrillate at 200 joules.
C. prepare for synchronized cardioversion.
D. set up for overdrive pacing. - ANSWERS-A. correct. the patient is
manifesting stable SVT. the initial intervention for stable SVT is
attempting vagal maneuvers and if unsuccessful administer adenosine.
B. incorrect. defib is reserved for pulseless rhythms such as V-Tach and
V-Fib. Defibrillating SVT may cause R on T phenomenon producing a
more lethal arrhythmia.
C. incorrect. if patient becomes unstable, synchronized cardioversion
would be indicated as the next intervention.
D. incorrect.
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.
END OF
PAGE
4
A patient reports left-sided chest pain not associated with SOB or
diaphoresis for the past 12 hours. The pain worsens when lying supine.
Serial 12-lead EKGs reveal ST segment elevation in the anterior,
inferior, and lateral leads. Cardiac biomarkers are negative.
administration of which of the following medications should the nurse
anticipate?
A. NSAIDs
B. thrombolytic therapy.
C. nitroglycerin infusion.
D. diuretic therapy. - ANSWERS-A. correct. ST segment elevation in all
areas of the heart is associated with pericarditis. NSAIDs are a
recommended first line therapy.
B. incorrect. thrombolytic therapy is harmful in the setting of pericarditis
and may result in hemorrhage.
C. incorrect. nitrates would not prevent fluid from collecting around the
hear in pericarditis.
D. incorrect. the patient does not have SOB, which is typically
associated with an acute heart failure exacerbation. diuresis can
potentially worsen the pericarditis.
Which of the following is likely to result in diastolic dysfunction of the
left ventricle?
A. pulmonary artery hypertension
END OF
PAGE
1
, CMC AACN EXAM LATEST
B. A-Fib with RVR
C. cardiogenic shock
D. dilated cardiomyopathy - ANSWERS-A. incorrect. pulmonary artery
hypertension may cause right ventricular failure not left.
B. correct. reduced atrial contraction and decreased diastolic time result
in reduced filling of the ventricle and diastolic dysfunction.
C. incorrect. cardiogenic shock results in reduced stroke volume from
loss of ventricular contractile force.
D. incorrect. dilated cardiomyopathy results in systolic dysfunction from
decreased contractility.
In which patient should the nurse suspect the presence of infective
endocarditis? a patient with:
A. T 101.3 F, CVP 14mmHg, and chest pain.
B. T 101.7 F, heart murmur, and signs of heart failure.
C. petechiae, BP 150/96 (114), and increase in activity.
D. headache, CVP 20mmHg, and BP 80/40 (53). - ANSWERS-A.
incorrect. although fever is present in about 80% of infective
endocarditis, chest pain is only present in about 15%. CVP will be low
and not high d/t sepsis.
B. correct. infective endocarditis produces fever, heart murmur, signs of
heart failure, and may produce rapid hemodynamic deterioration.
END OF
PAGE
2
, CMC AACN EXAM LATEST
C. incorrect. petechiae occurs in 20-40% of cases of infective
endocarditis. HTN may occur in the compensatory phase of the septic
process.
D. incorrect. CVP would be low d/t sepsis.
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 - ANSWERS-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.
END OF
PAGE
3
, CMC AACN EXAM LATEST
A patient is reporting a new onset of palpitations. VS are: BP 90/60 ; HR
182 ; RR 20 ; T 98.6F. the cardiac monitor displays a rapid regular
rhythm with a QRS complex measuring 0.08 sec. The patient is alert and
oriented, denies chest pain and SOB, and has warn, dry skin. when vagal
maneuvers fail to restore NSR, the nurse should:
A. administer adenosine (Adenocard)
B. defibrillate at 200 joules.
C. prepare for synchronized cardioversion.
D. set up for overdrive pacing. - ANSWERS-A. correct. the patient is
manifesting stable SVT. the initial intervention for stable SVT is
attempting vagal maneuvers and if unsuccessful administer adenosine.
B. incorrect. defib is reserved for pulseless rhythms such as V-Tach and
V-Fib. Defibrillating SVT may cause R on T phenomenon producing a
more lethal arrhythmia.
C. incorrect. if patient becomes unstable, synchronized cardioversion
would be indicated as the next intervention.
D. incorrect.
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.
END OF
PAGE
4
