Page 1 of 156
CMC AACN EXAM ALL 500 QUESTIONS AND
DETAILED SOLUTIONS LATEST UPDATE THIS
YEAR
CMC AACN EXAM 1
QUESTION: A patient develops chest pain, nausea, vomiting and diaphoresis. the 12-lead EKG is
normal. a further cardiac assessment is warranted, as it is common for ST segment elevation to
be absent in:
A. an anterior wall MI
B. a posterior wall MI
C. a lateral wall MI
D. an inferior wall MI - ANSWER-A. incorrect. an anterior wall MI would have EKG changes in
leads V1-V4
B. correct. in the standard lead setup, the EKG typically does not look at the posterior wall;
because of the location of the occlusion, ECG changes would not be apparent.
C. incorrect. a lateral wall MI would present changes in leads I, aVL, V5, and V6.
D. incorrect. an inferior wall MI would present changes in leads II, III, aVF.
QUESTION: While reviewing the 12-lead EKG, the nurse notes new changes with ST-segment
elevation in leads 1, aVL, and V2-V6, plus reciprocal changes in III, aVF, and aVR. The nurse
should realize that the area of infarct involve the:
1
,Page 2 of 156
A. anterior and lateral walls
B. posterior and inferior walls
C. lateral and septal walls
D. septal and posterior walls - ANSWER-A. correct. the ST segment elevation and reciprocal
changes are indicative of occlusion of the left anterior descending and left circumflex arteries.
these will affect the anterior and lateral walls.
B. incorrect. an infarct in the posterior and inferior walls would present via EKG with changes in
the II, III, and aVF leads.
C. incorrect. an infarct in the lateral and septal walls would present via EKG changes in leads I,
aVL, V5, and V6.
D. incorrect. an infarct in the septal and posterior walls would present via EKG changes in V1-
V4.
QUESTION: A patient is being discharged on aspirin therapy following recovery from an AMI.
Which of the following comorbidities puts the patient at greatest risk for developing a bleeding
complication?
A. asthma
B. transient ischemic attack
C. chronic kidney failure
D. cor pulmonale - ANSWER-A. incorrect.
B. incorrect.
2
,Page 3 of 156
C. correct. there is an increased risks of bleeding in kidney failure. this tendency is attributed to
impaired platelet aggregation and adhesion and an altered response to clotting factor VII.
D. incorrect.
QUESTION: A patient is to undergo PCI. in a previous admission the patient received heparin.
the patient initially had a platelet count of 250,000; the platelet count was 115,000 a few days
later. which of the following should the nurse anticipate administering for the current
procedure?
A. dalteparin (Fragmin)
B. bivalirudin (Angiomax)
C. enoxaparin (Lovenox)
D. alteplase (Activase) - ANSWER-A. incorrect. dalteparin is low molecular weight heparin. the
patient likely manifested HIT in the past. heparin is contraindicated.
B. correct. bivalirudin is a direct thrombin inhibitor and may be administered as an alternative
to heparin in patients with HIT.
C. incorrect. contraindicated.
D. incorrect. alteplase is indicated for acute ischemic stroke.
QUESTION: While timing the balloon pump, the nurse should understand that during the
deflation phase the patient will benefit from:
A. increased perfusion of the coronary arteries
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, Page 4 of 156
B. decreased resistance to closing the aortic valve
C. decreased ventricular preload
D. improved cardiac output. - ANSWER-A. incorrect. increased perfusion of the coronary
arteries occurs during the inflation phase of the balloon pump timing.
B. incorrect. closing the aortic valve is affected by the preload into the left ventricle.
C. incorrect. decreased preload indicates the low volume of blood entering the left ventricle
during relaxation of the left ventricle.
D. correct. the relaxation phase of the balloon pump timing reduces systemic vascular
resistance which in turn improves cardiac output.
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.
4
CMC AACN EXAM ALL 500 QUESTIONS AND
DETAILED SOLUTIONS LATEST UPDATE THIS
YEAR
CMC AACN EXAM 1
QUESTION: A patient develops chest pain, nausea, vomiting and diaphoresis. the 12-lead EKG is
normal. a further cardiac assessment is warranted, as it is common for ST segment elevation to
be absent in:
A. an anterior wall MI
B. a posterior wall MI
C. a lateral wall MI
D. an inferior wall MI - ANSWER-A. incorrect. an anterior wall MI would have EKG changes in
leads V1-V4
B. correct. in the standard lead setup, the EKG typically does not look at the posterior wall;
because of the location of the occlusion, ECG changes would not be apparent.
C. incorrect. a lateral wall MI would present changes in leads I, aVL, V5, and V6.
D. incorrect. an inferior wall MI would present changes in leads II, III, aVF.
QUESTION: While reviewing the 12-lead EKG, the nurse notes new changes with ST-segment
elevation in leads 1, aVL, and V2-V6, plus reciprocal changes in III, aVF, and aVR. The nurse
should realize that the area of infarct involve the:
1
,Page 2 of 156
A. anterior and lateral walls
B. posterior and inferior walls
C. lateral and septal walls
D. septal and posterior walls - ANSWER-A. correct. the ST segment elevation and reciprocal
changes are indicative of occlusion of the left anterior descending and left circumflex arteries.
these will affect the anterior and lateral walls.
B. incorrect. an infarct in the posterior and inferior walls would present via EKG with changes in
the II, III, and aVF leads.
C. incorrect. an infarct in the lateral and septal walls would present via EKG changes in leads I,
aVL, V5, and V6.
D. incorrect. an infarct in the septal and posterior walls would present via EKG changes in V1-
V4.
QUESTION: A patient is being discharged on aspirin therapy following recovery from an AMI.
Which of the following comorbidities puts the patient at greatest risk for developing a bleeding
complication?
A. asthma
B. transient ischemic attack
C. chronic kidney failure
D. cor pulmonale - ANSWER-A. incorrect.
B. incorrect.
2
,Page 3 of 156
C. correct. there is an increased risks of bleeding in kidney failure. this tendency is attributed to
impaired platelet aggregation and adhesion and an altered response to clotting factor VII.
D. incorrect.
QUESTION: A patient is to undergo PCI. in a previous admission the patient received heparin.
the patient initially had a platelet count of 250,000; the platelet count was 115,000 a few days
later. which of the following should the nurse anticipate administering for the current
procedure?
A. dalteparin (Fragmin)
B. bivalirudin (Angiomax)
C. enoxaparin (Lovenox)
D. alteplase (Activase) - ANSWER-A. incorrect. dalteparin is low molecular weight heparin. the
patient likely manifested HIT in the past. heparin is contraindicated.
B. correct. bivalirudin is a direct thrombin inhibitor and may be administered as an alternative
to heparin in patients with HIT.
C. incorrect. contraindicated.
D. incorrect. alteplase is indicated for acute ischemic stroke.
QUESTION: While timing the balloon pump, the nurse should understand that during the
deflation phase the patient will benefit from:
A. increased perfusion of the coronary arteries
3
, Page 4 of 156
B. decreased resistance to closing the aortic valve
C. decreased ventricular preload
D. improved cardiac output. - ANSWER-A. incorrect. increased perfusion of the coronary
arteries occurs during the inflation phase of the balloon pump timing.
B. incorrect. closing the aortic valve is affected by the preload into the left ventricle.
C. incorrect. decreased preload indicates the low volume of blood entering the left ventricle
during relaxation of the left ventricle.
D. correct. the relaxation phase of the balloon pump timing reduces systemic vascular
resistance which in turn improves cardiac output.
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.
4
