AACN CSC EXAM | QUESTIONS AND ANSWERS | VERIFIED AND
WELL DETAILED ANSWERS | ALREADY GRADED A+ | LATEST
EXAM
AACN CSC Exam – Questions 1–50
1. A 65-year-old male post-CABG develops sudden hypotension and
tachycardia. Which is the priority action?
A. Administer IV fluids
B. Call the rapid response team
C. Assess for cardiac tamponade
D. Increase the IV rate of dopamine
Answer: C. Assess for cardiac tamponade
Rationale: Post-CABG, sudden hypotension and tachycardia may indicate
cardiac tamponade. Prompt assessment is critical for life-saving intervention.
2. Which hemodynamic parameter best reflects left ventricular preload?
A. CVP
B. PAOP (Pulmonary artery occlusion pressure)
C. MAP
D. HR
Answer: B. PAOP (Pulmonary artery occlusion pressure)
Rationale: PAOP reflects left ventricular end-diastolic pressure, the best
estimate of left ventricular preload.
3. A patient is on high-dose norepinephrine post-MI. Which assessment is
most important?
A. Blood glucose
B. Capillary refill
C. Tissue perfusion and extremity color
D. Mental status only
Answer: C. Tissue perfusion and extremity color
Rationale: Norepinephrine causes vasoconstriction, increasing risk of
ischemia. Monitoring tissue perfusion is essential.
,4. Which rhythm is most commonly associated with sudden cardiac death
post-MI?
A. Atrial fibrillation
B. Ventricular tachycardia
C. First-degree AV block
D. Sinus bradycardia
Answer: B. Ventricular tachycardia
Rationale: Ventricular tachycardia can rapidly deteriorate to ventricular
fibrillation, a common cause of sudden cardiac death.
5. In a patient with cardiogenic shock, which intervention improves cardiac
output?
A. IV furosemide
B. Positive inotropes (e.g., dobutamine)
C. Beta-blockers
D. Oxygen therapy only
Answer: B. Positive inotropes (e.g., dobutamine)
Rationale: Positive inotropes enhance myocardial contractility and improve
cardiac output in cardiogenic shock.
6. Which lab abnormality is most indicative of acute myocardial injury?
A. BNP
B. CK-MB
C. Troponin I or T
D. Serum potassium
Answer: C. Troponin I or T
Rationale: Troponin is highly specific and sensitive for myocardial injury,
rising within hours of infarction.
7. What is the initial management for asystole in the ICU?
A. Defibrillation
B. Epinephrine and CPR
C. Amiodarone
D. Cardioversion
Answer: B. Epinephrine and CPR
Rationale: Asystole is treated with high-quality CPR and epinephrine.
Defibrillation is ineffective as there is no electrical activity.
8. Which medication is contraindicated in a patient with 2nd-degree AV
block type II?
A. Atropine
B. Dopamine
,C. Epinephrine
D. Adenosine
Answer: D. Adenosine
Rationale: Adenosine can worsen AV block; atropine, dopamine, or
epinephrine may support heart rate temporarily.
9. After valve replacement surgery, the patient has bright red drainage of
200 mL/hr. Priority action?
A. Monitor and reassess in 1 hour
B. Call the surgeon immediately
C. Decrease anticoagulation
D. Administer IV fluids
Answer: B. Call the surgeon immediately
Rationale: Excessive post-operative bleeding after valve replacement is an
emergency requiring surgical evaluation.
10. Which is the first-line drug for ventricular fibrillation?
A. Amiodarone
B. Lidocaine
C. Epinephrine
D. Magnesium
Answer: C. Epinephrine
Rationale: During VF, epinephrine is given after defibrillation to improve
coronary and cerebral perfusion. Amiodarone is used for refractory VF.
11. Which electrolyte imbalance increases the risk of torsades de pointes?
A. Hypernatremia
B. Hypokalemia
C. Hypercalcemia
D. Hypermagnesemia
Answer: B. Hypokalemia
Rationale: Hypokalemia prolongs the QT interval and predisposes patients to
torsades de pointes, a life-threatening ventricular arrhythmia.
12. A patient on mechanical ventilation develops sudden hypotension,
distended neck veins, and muffled heart sounds. What is the most likely
cause?
A. Tension pneumothorax
B. Cardiac tamponade
C. Pulmonary embolism
D. Myocardial infarction
Answer: B. Cardiac tamponade
, Rationale: Beck’s triad—hypotension, muffled heart sounds, and jugular
venous distension—is classic for cardiac tamponade.
13. Which assessment is most sensitive for early detection of sepsis in the
ICU?
A. Fever alone
B. Hypotension
C. Lactate level
D. WBC count
Answer: C. Lactate level
Rationale: Elevated lactate indicates tissue hypoperfusion and is a sensitive
marker for early sepsis.
14. Which hemodynamic parameter indicates right ventricular preload?
A. MAP
B. CVP
C. PAOP
D. Stroke volume
Answer: B. CVP
Rationale: Central venous pressure reflects right ventricular filling pressure
and right-sided preload.
15. For a patient with acute decompensated heart failure and pulmonary
edema, the priority intervention is:
A. IV furosemide
B. IV fluids
C. Beta-blocker
D. Morphine only
Answer: A. IV furosemide
Rationale: Diuretics reduce pulmonary congestion and improve oxygenation
in acute decompensated heart failure.
16. Which is the earliest sign of hypovolemic shock?
A. Hypotension
B. Tachycardia
C. Cold, clammy skin
D. Oliguria
Answer: B. Tachycardia
Rationale: The body initially compensates for hypovolemia with increased
heart rate before hypotension develops.
WELL DETAILED ANSWERS | ALREADY GRADED A+ | LATEST
EXAM
AACN CSC Exam – Questions 1–50
1. A 65-year-old male post-CABG develops sudden hypotension and
tachycardia. Which is the priority action?
A. Administer IV fluids
B. Call the rapid response team
C. Assess for cardiac tamponade
D. Increase the IV rate of dopamine
Answer: C. Assess for cardiac tamponade
Rationale: Post-CABG, sudden hypotension and tachycardia may indicate
cardiac tamponade. Prompt assessment is critical for life-saving intervention.
2. Which hemodynamic parameter best reflects left ventricular preload?
A. CVP
B. PAOP (Pulmonary artery occlusion pressure)
C. MAP
D. HR
Answer: B. PAOP (Pulmonary artery occlusion pressure)
Rationale: PAOP reflects left ventricular end-diastolic pressure, the best
estimate of left ventricular preload.
3. A patient is on high-dose norepinephrine post-MI. Which assessment is
most important?
A. Blood glucose
B. Capillary refill
C. Tissue perfusion and extremity color
D. Mental status only
Answer: C. Tissue perfusion and extremity color
Rationale: Norepinephrine causes vasoconstriction, increasing risk of
ischemia. Monitoring tissue perfusion is essential.
,4. Which rhythm is most commonly associated with sudden cardiac death
post-MI?
A. Atrial fibrillation
B. Ventricular tachycardia
C. First-degree AV block
D. Sinus bradycardia
Answer: B. Ventricular tachycardia
Rationale: Ventricular tachycardia can rapidly deteriorate to ventricular
fibrillation, a common cause of sudden cardiac death.
5. In a patient with cardiogenic shock, which intervention improves cardiac
output?
A. IV furosemide
B. Positive inotropes (e.g., dobutamine)
C. Beta-blockers
D. Oxygen therapy only
Answer: B. Positive inotropes (e.g., dobutamine)
Rationale: Positive inotropes enhance myocardial contractility and improve
cardiac output in cardiogenic shock.
6. Which lab abnormality is most indicative of acute myocardial injury?
A. BNP
B. CK-MB
C. Troponin I or T
D. Serum potassium
Answer: C. Troponin I or T
Rationale: Troponin is highly specific and sensitive for myocardial injury,
rising within hours of infarction.
7. What is the initial management for asystole in the ICU?
A. Defibrillation
B. Epinephrine and CPR
C. Amiodarone
D. Cardioversion
Answer: B. Epinephrine and CPR
Rationale: Asystole is treated with high-quality CPR and epinephrine.
Defibrillation is ineffective as there is no electrical activity.
8. Which medication is contraindicated in a patient with 2nd-degree AV
block type II?
A. Atropine
B. Dopamine
,C. Epinephrine
D. Adenosine
Answer: D. Adenosine
Rationale: Adenosine can worsen AV block; atropine, dopamine, or
epinephrine may support heart rate temporarily.
9. After valve replacement surgery, the patient has bright red drainage of
200 mL/hr. Priority action?
A. Monitor and reassess in 1 hour
B. Call the surgeon immediately
C. Decrease anticoagulation
D. Administer IV fluids
Answer: B. Call the surgeon immediately
Rationale: Excessive post-operative bleeding after valve replacement is an
emergency requiring surgical evaluation.
10. Which is the first-line drug for ventricular fibrillation?
A. Amiodarone
B. Lidocaine
C. Epinephrine
D. Magnesium
Answer: C. Epinephrine
Rationale: During VF, epinephrine is given after defibrillation to improve
coronary and cerebral perfusion. Amiodarone is used for refractory VF.
11. Which electrolyte imbalance increases the risk of torsades de pointes?
A. Hypernatremia
B. Hypokalemia
C. Hypercalcemia
D. Hypermagnesemia
Answer: B. Hypokalemia
Rationale: Hypokalemia prolongs the QT interval and predisposes patients to
torsades de pointes, a life-threatening ventricular arrhythmia.
12. A patient on mechanical ventilation develops sudden hypotension,
distended neck veins, and muffled heart sounds. What is the most likely
cause?
A. Tension pneumothorax
B. Cardiac tamponade
C. Pulmonary embolism
D. Myocardial infarction
Answer: B. Cardiac tamponade
, Rationale: Beck’s triad—hypotension, muffled heart sounds, and jugular
venous distension—is classic for cardiac tamponade.
13. Which assessment is most sensitive for early detection of sepsis in the
ICU?
A. Fever alone
B. Hypotension
C. Lactate level
D. WBC count
Answer: C. Lactate level
Rationale: Elevated lactate indicates tissue hypoperfusion and is a sensitive
marker for early sepsis.
14. Which hemodynamic parameter indicates right ventricular preload?
A. MAP
B. CVP
C. PAOP
D. Stroke volume
Answer: B. CVP
Rationale: Central venous pressure reflects right ventricular filling pressure
and right-sided preload.
15. For a patient with acute decompensated heart failure and pulmonary
edema, the priority intervention is:
A. IV furosemide
B. IV fluids
C. Beta-blocker
D. Morphine only
Answer: A. IV furosemide
Rationale: Diuretics reduce pulmonary congestion and improve oxygenation
in acute decompensated heart failure.
16. Which is the earliest sign of hypovolemic shock?
A. Hypotension
B. Tachycardia
C. Cold, clammy skin
D. Oliguria
Answer: B. Tachycardia
Rationale: The body initially compensates for hypovolemia with increased
heart rate before hypotension develops.
