CMC AACN FINAL EXAM WITH VERIFIED
QUESTIONS AND DETAILED ANSWERS||
GUARANTEED PASS|| ALREADY GRADED A+ ||
LATEST UPDATE 2025
While reconciling the medications for a patient with type 2 diabetes who is
scheduled for PCI in the morning, the nurse should ensure that metformin
(Glucophage) is held to minimize
A. risk of hypoglycemia
B. injury to the kidneys
C. injury to the liver
D. risk of heart block - ANSWER-A. incorrect.
b. correct. the combination of contrast medium during PCI and metformin
should be avoided in patients with renal dysfunction, hepatic dysfunction,
alcohol abuse or severe CHF, because all these conditions limit metformin
excretion, possibly leading to fatal lactic acidosis.
C. incorrect. metformin does not directly affect the liver, but it should be
avoided in patients with known hepatic dysfunction.
D. incorrect. metformin has no effect on the risk of heart block.
A patient is questioning the reason for a scheduled TEE rather than a standard
ECHO. A TEE allows better visualization for patients with:
A. osteoporosis and valve problems.
B. smoking and pulmonary HTN.
C. obesity and emphysema.
D. CAD and a BMI of 18. - ANSWER-A. incorrect.
,B. incorrect. a TEE may worsen ventilation perfusion mismatch and hypoxia in
the patient with pulmonary hypertension.
C. correct. visualization of cardiac structures is challenging in obese patients
due to a greater amount of tissue through which to transmit U/S waves and
receive signals. TEE use omits the need to penetrate a thick chest wall to clearly
visualize cardiac structures. Therefore a TEE would provide better
visualization.
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) - 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.
Which of the following patients is most likely to be successfully extubated
early? a patient with:
A. a CI of 4.0 L/min/m while on IABP
B. a tidal volume of 3.3 mL/kg during a SBT.
C. a minute ventilation of 6L/min while ventilated.
D. a MAP of 59mmHg with dobutamine (Dobutrex) at 5mcg/kg/min infusing. -
ANSWER-A. correct. a CI of 4.0 L/min/m is within range for a patient being
supported by an IABP. this would indicate the patient would likely be able to
tolerate early extubation without increased strain on the system.
B. incorrect. tidal volume is too low.
C. incorrect. minute ventilation of 6L/minute is too low.
,D. a patient with a MAP of 59 mmHg while on a dobutamine gtt would
potentially not tolerate early extubation d/t lack of evidence of adequately
supported cardiac system.
A patient with history of vasculitis and cocaine abuse is admitted with AMS.
CT reveals intracerebral hemorrhagic stroke. which of the following should the
nurse anticipate?
A. immediate administration of fibrinolytic therapy.
B. administration of furosemide (Lasix)
C. avoidance of hypotonic fluids
D. initiation of a sympathomimetic agent - ANSWER-A. incorrect.
contraindicated in hemorrhagic stroke.
B. incorrect. loop diuretics are not indicated. an osmotic diuretic may be used to
decrease cerebral edema.
C. correct. hypotonic fluid administration will cause an increase in ICP.
administration of hypertonic or isotonic fluid is recommended to relief or
prevent increased ICP.
D. incorrect. a sympathomimetic agent will increase blood pressure and is a
cause of hemorrhagic stroke.
While weaning from the ventilator, the patient is placed on synchronized
intermittent mandatory ventilation (SIMV). Pressure support (PS) is added to:
A. increase the functional residual capacity
B. reduce the incidence of bronchospasm
C. open collapsed alveoli
D. decrease tubing resistance - ANSWER-A. incorrect. PS can be added to
minimize alveolar hypoventilation as appropriate, but this is not it's primary
function.
B. incorrect. PS will not reduce the incidence of bronchospasm.
C. incorrect. PS does not open collapsed alveoli.
, D. correct. PS is a spontaneous breathing mode used as the primary method of
ventilation in patient with a stable respiratory drive to overcome any imposed
mechanical resistance.
A patient with a history of heart failure and diabetes is admitted with abdominal
pain, vomiting, and fatigue.
lab values: pH 7.29 ; pCO2 30 ; pO2 73 ; HCO3 17 ; SaO2 93% ; Na+ 150 ; K+
2.7 ; Cl 90 ; CO2 19 ; Glucose 1032
vital signs: BP 103/48 ; HR 108 ; RR 32
the nurse should anticipate
A. subcutaneous insulin and sodium bicarbonate
B. continuous insulin and furosemide
C. subcutaneous insulin and glucocorticoids
D. continuous insulin and IV fluids - ANSWER-A. incorrect. sodium
bicarbonate is not indicated.
B. incorrect. furosemide would harm the patient who is dehydrated.
C. incorrect. glucocorticoids would harm the patient by increasing the blood
sugar.
D. correct. in DKA the osmotic shifts lead to intense dehydration. although the
patient has a history of heart failure, IVF hydration is recommended.
Which of the following patients is at risk for developing contrast-induced
nephropathy when admitted for a carotid arteriogram? a patient with:
A. with CVP 18 mmHg
B. with hemoglobin 15.7
C. who takes metformin (Glucophage)
D. who underwent autologous bone marrow transplantation - ANSWER-A.
incorrect. patients who are hypovolemic are at risk, however a CVP of 18
mmHg indicates fluid overload.
B. incorrect. patients who are anemic are at risk, however a hgb of 15.7 is
WNL.
QUESTIONS AND DETAILED ANSWERS||
GUARANTEED PASS|| ALREADY GRADED A+ ||
LATEST UPDATE 2025
While reconciling the medications for a patient with type 2 diabetes who is
scheduled for PCI in the morning, the nurse should ensure that metformin
(Glucophage) is held to minimize
A. risk of hypoglycemia
B. injury to the kidneys
C. injury to the liver
D. risk of heart block - ANSWER-A. incorrect.
b. correct. the combination of contrast medium during PCI and metformin
should be avoided in patients with renal dysfunction, hepatic dysfunction,
alcohol abuse or severe CHF, because all these conditions limit metformin
excretion, possibly leading to fatal lactic acidosis.
C. incorrect. metformin does not directly affect the liver, but it should be
avoided in patients with known hepatic dysfunction.
D. incorrect. metformin has no effect on the risk of heart block.
A patient is questioning the reason for a scheduled TEE rather than a standard
ECHO. A TEE allows better visualization for patients with:
A. osteoporosis and valve problems.
B. smoking and pulmonary HTN.
C. obesity and emphysema.
D. CAD and a BMI of 18. - ANSWER-A. incorrect.
,B. incorrect. a TEE may worsen ventilation perfusion mismatch and hypoxia in
the patient with pulmonary hypertension.
C. correct. visualization of cardiac structures is challenging in obese patients
due to a greater amount of tissue through which to transmit U/S waves and
receive signals. TEE use omits the need to penetrate a thick chest wall to clearly
visualize cardiac structures. Therefore a TEE would provide better
visualization.
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) - 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.
Which of the following patients is most likely to be successfully extubated
early? a patient with:
A. a CI of 4.0 L/min/m while on IABP
B. a tidal volume of 3.3 mL/kg during a SBT.
C. a minute ventilation of 6L/min while ventilated.
D. a MAP of 59mmHg with dobutamine (Dobutrex) at 5mcg/kg/min infusing. -
ANSWER-A. correct. a CI of 4.0 L/min/m is within range for a patient being
supported by an IABP. this would indicate the patient would likely be able to
tolerate early extubation without increased strain on the system.
B. incorrect. tidal volume is too low.
C. incorrect. minute ventilation of 6L/minute is too low.
,D. a patient with a MAP of 59 mmHg while on a dobutamine gtt would
potentially not tolerate early extubation d/t lack of evidence of adequately
supported cardiac system.
A patient with history of vasculitis and cocaine abuse is admitted with AMS.
CT reveals intracerebral hemorrhagic stroke. which of the following should the
nurse anticipate?
A. immediate administration of fibrinolytic therapy.
B. administration of furosemide (Lasix)
C. avoidance of hypotonic fluids
D. initiation of a sympathomimetic agent - ANSWER-A. incorrect.
contraindicated in hemorrhagic stroke.
B. incorrect. loop diuretics are not indicated. an osmotic diuretic may be used to
decrease cerebral edema.
C. correct. hypotonic fluid administration will cause an increase in ICP.
administration of hypertonic or isotonic fluid is recommended to relief or
prevent increased ICP.
D. incorrect. a sympathomimetic agent will increase blood pressure and is a
cause of hemorrhagic stroke.
While weaning from the ventilator, the patient is placed on synchronized
intermittent mandatory ventilation (SIMV). Pressure support (PS) is added to:
A. increase the functional residual capacity
B. reduce the incidence of bronchospasm
C. open collapsed alveoli
D. decrease tubing resistance - ANSWER-A. incorrect. PS can be added to
minimize alveolar hypoventilation as appropriate, but this is not it's primary
function.
B. incorrect. PS will not reduce the incidence of bronchospasm.
C. incorrect. PS does not open collapsed alveoli.
, D. correct. PS is a spontaneous breathing mode used as the primary method of
ventilation in patient with a stable respiratory drive to overcome any imposed
mechanical resistance.
A patient with a history of heart failure and diabetes is admitted with abdominal
pain, vomiting, and fatigue.
lab values: pH 7.29 ; pCO2 30 ; pO2 73 ; HCO3 17 ; SaO2 93% ; Na+ 150 ; K+
2.7 ; Cl 90 ; CO2 19 ; Glucose 1032
vital signs: BP 103/48 ; HR 108 ; RR 32
the nurse should anticipate
A. subcutaneous insulin and sodium bicarbonate
B. continuous insulin and furosemide
C. subcutaneous insulin and glucocorticoids
D. continuous insulin and IV fluids - ANSWER-A. incorrect. sodium
bicarbonate is not indicated.
B. incorrect. furosemide would harm the patient who is dehydrated.
C. incorrect. glucocorticoids would harm the patient by increasing the blood
sugar.
D. correct. in DKA the osmotic shifts lead to intense dehydration. although the
patient has a history of heart failure, IVF hydration is recommended.
Which of the following patients is at risk for developing contrast-induced
nephropathy when admitted for a carotid arteriogram? a patient with:
A. with CVP 18 mmHg
B. with hemoglobin 15.7
C. who takes metformin (Glucophage)
D. who underwent autologous bone marrow transplantation - ANSWER-A.
incorrect. patients who are hypovolemic are at risk, however a CVP of 18
mmHg indicates fluid overload.
B. incorrect. patients who are anemic are at risk, however a hgb of 15.7 is
WNL.
