Page 1 of 168
CMC AACN EXAM & STUDY GUIDE COMPLETE 600 QUESTIONS
WITH CORRECT DETAILED ANSWERS LATEST UPDATE THIS
YEAR - JUST RELEASED
QUESTION: 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) - ANSWER-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.
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.
1
,Page 2 of 168
QUESTION: 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) - 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.
QUESTION: 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.
2
,Page 3 of 168
D. decreased ability of the ventricle to contract. - ANSWER-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.
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.
QUESTION: 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:
A. right bundle branch block
B. left bundle branch block
C. papillary muscle rupture
D. calcific plaque rupture - ANSWER-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.
3
, Page 4 of 168
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.
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
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.
D. blood oozing from the insertion site; the nurse should anticipate the need for an emergency
fasciotomy. - ANSWER-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.
4
CMC AACN EXAM & STUDY GUIDE COMPLETE 600 QUESTIONS
WITH CORRECT DETAILED ANSWERS LATEST UPDATE THIS
YEAR - JUST RELEASED
QUESTION: 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) - ANSWER-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.
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.
1
,Page 2 of 168
QUESTION: 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) - 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.
QUESTION: 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.
2
,Page 3 of 168
D. decreased ability of the ventricle to contract. - ANSWER-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.
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.
QUESTION: 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:
A. right bundle branch block
B. left bundle branch block
C. papillary muscle rupture
D. calcific plaque rupture - ANSWER-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.
3
, Page 4 of 168
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.
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
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.
D. blood oozing from the insertion site; the nurse should anticipate the need for an emergency
fasciotomy. - ANSWER-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.
4
