Page 1 of 246
AACN CSC TEST BANK 2 NEWEST 2026 ACTUAL
EXAM TEST BANK| CARDIAC SURGERY
CERTIFICATION AACN EXAM REVIEW WITH 350
REAL EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) ALREADY GRADED
A+ (BRAND NEW!!)
When caring for a patient who is post CABG the nurse knows the
following is true regarding hypertension in the immediate post operative
period:
A. Hypertension increases myocardial oxygen demand.
B. Hypertension increases left ventricular afterload.
C. Hypertension increases the risk of bleeding.
D. All of the above. - Correct Answer -D.
Hypertension increases the risk of graft dehiscence at the anastomoses
site, bleeding, myocardial ischemia, stroke, and cardiac arrhythmias.
Myocardial oxygen demand is affected by the same parameters that
affect cardiac output (preload, afterload, contractility, and heart rate). An
increase in any one of these four parameters will increase myocardial
oxygen demand and consumption.
Post-operative wound infection is a serious complication resulting in
increased post-operative mortality. Patient characteristics that place the
patient at high risk for the development of post-operative wound
infections include all of the following EXCEPT:
A. Diabetes.
pg. 1
,Page 2 of 246
B. Obesity.
C. Race.
D. Excessive use of electrocautery.
E. End stage renal disease. - Correct Answer -C.
Risk factors for the development of infection include: obesity, diabetes,
end stage renal disease, re-operation, excessive use of electrocautery,
prolonged mechanical ventilation, and use of both internal mammary
arteries (decreased blood flow to the sternum).
Your post-op CABG/ AVR patient develops 2nd degree type II AV block
with an associated drop in systolic blood pressure. The patient has atrial
and ventricular epicardial pacing wires. The best pacing mode in this
situation would be:
A. AAI.
B. DVI.
C. DDD.
D. VVI. - Correct Answer -C.
DDD pacing mode is the best option because it maintains AV synchrony.
This mode allows for tracking of atrial activity when it is present and
paces the ventricle after every sensed P wave. It also paces the atrium
when the sinus rate is too low.
The AAI pacing mode would most likely be used in a postoperative
cardiac surgery patient with which of the following situations resulting
in hemodynamic compromise:
pg. 2
,Page 3 of 246
A. 2nd degree type II heart block.
B. Ventricular tachycardia.
C. Sinus bradycardia.
D. Complete heart block. - Correct Answer -C.
The AAI pacing mode is only utilized when there is intact AV
conduction. In sinus bradycardia, the problem is the slow sinus rate - not
AV block, so pacing the atrium would fix the problem. AAI mode is
used most frequently in the post-operative cardiac patient to increase
heart rate to enhance cardiac output when the risk of AV block is small.
You are caring for a post CABG patient who has developed a
monomorphic wide QRS tachycardia seen in the lead III rhythm strip on
top in this example. His BP is 110/70 and he is tolerating the rhythm, but
there is disagreement among physicians as to the mechanism of the
tachycardia. You obtain the unipolar atrial electrogram seen in the
bottom strip (p waves not followed by qrs waves). The atrial electrogram
confirms the diagnosis of:
A. Sinus tachycardia.
B. Atrial flutter.
C. VT.
D. SVT with aberrant conduction. - Correct Answer -C.
A unipolar atrial electrogram shows very large P waves because it is
recorded directly from the atrium. In this AEG, the large spikes are the P
waves and they are dissociated from the smaller and faster QRS
complexes (these strips are not simultaneously recorded), confirming the
diagnosis of ventricular tachycardia.
pg. 3
, Page 4 of 246
A complication seen in patients who have received a CABG using the
LIMA or a radial artery graft that is not seen with saphenous vein grafts
is:
A. Graft aneurysm.
B. Bleeding at graft suture lines.
C. Graft spasm.
D. Acute MI due to graft thrombosis. - Correct Answer -C.
Arterial conduits, such as the LIMA, RIMA, or radial artery are prone to
spasm because of their thicker arterial walls. All grafts can thrombose or
bleed at suture lines, and aneurysm formation is more common in veins
harvested from the arms. IMA grafts have excellent long term patency
and are preferred conduits in most patients.
You are caring for a CABG patient who received a radial artery graft to
the RCA. Which of the following drugs do you expect to administer to
prevent spasm of the graft:
A. Beta blockers.
B. Nitroprusside.
C. Amiodarone.
D. Nitrates or calcium channel blockers. - Correct Answer -D.
Arterial grafts are prone to vasospasm because of their thick muscular
wall. Calcium channel blockers and nitroglycerin are arterial dilators and
can be used to prevent graft spasm.
Beta blockers can leave alpha vasoconstrictor receptors unopposed and
are not indicated for preventing arterial spasm.
pg. 4
AACN CSC TEST BANK 2 NEWEST 2026 ACTUAL
EXAM TEST BANK| CARDIAC SURGERY
CERTIFICATION AACN EXAM REVIEW WITH 350
REAL EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) ALREADY GRADED
A+ (BRAND NEW!!)
When caring for a patient who is post CABG the nurse knows the
following is true regarding hypertension in the immediate post operative
period:
A. Hypertension increases myocardial oxygen demand.
B. Hypertension increases left ventricular afterload.
C. Hypertension increases the risk of bleeding.
D. All of the above. - Correct Answer -D.
Hypertension increases the risk of graft dehiscence at the anastomoses
site, bleeding, myocardial ischemia, stroke, and cardiac arrhythmias.
Myocardial oxygen demand is affected by the same parameters that
affect cardiac output (preload, afterload, contractility, and heart rate). An
increase in any one of these four parameters will increase myocardial
oxygen demand and consumption.
Post-operative wound infection is a serious complication resulting in
increased post-operative mortality. Patient characteristics that place the
patient at high risk for the development of post-operative wound
infections include all of the following EXCEPT:
A. Diabetes.
pg. 1
,Page 2 of 246
B. Obesity.
C. Race.
D. Excessive use of electrocautery.
E. End stage renal disease. - Correct Answer -C.
Risk factors for the development of infection include: obesity, diabetes,
end stage renal disease, re-operation, excessive use of electrocautery,
prolonged mechanical ventilation, and use of both internal mammary
arteries (decreased blood flow to the sternum).
Your post-op CABG/ AVR patient develops 2nd degree type II AV block
with an associated drop in systolic blood pressure. The patient has atrial
and ventricular epicardial pacing wires. The best pacing mode in this
situation would be:
A. AAI.
B. DVI.
C. DDD.
D. VVI. - Correct Answer -C.
DDD pacing mode is the best option because it maintains AV synchrony.
This mode allows for tracking of atrial activity when it is present and
paces the ventricle after every sensed P wave. It also paces the atrium
when the sinus rate is too low.
The AAI pacing mode would most likely be used in a postoperative
cardiac surgery patient with which of the following situations resulting
in hemodynamic compromise:
pg. 2
,Page 3 of 246
A. 2nd degree type II heart block.
B. Ventricular tachycardia.
C. Sinus bradycardia.
D. Complete heart block. - Correct Answer -C.
The AAI pacing mode is only utilized when there is intact AV
conduction. In sinus bradycardia, the problem is the slow sinus rate - not
AV block, so pacing the atrium would fix the problem. AAI mode is
used most frequently in the post-operative cardiac patient to increase
heart rate to enhance cardiac output when the risk of AV block is small.
You are caring for a post CABG patient who has developed a
monomorphic wide QRS tachycardia seen in the lead III rhythm strip on
top in this example. His BP is 110/70 and he is tolerating the rhythm, but
there is disagreement among physicians as to the mechanism of the
tachycardia. You obtain the unipolar atrial electrogram seen in the
bottom strip (p waves not followed by qrs waves). The atrial electrogram
confirms the diagnosis of:
A. Sinus tachycardia.
B. Atrial flutter.
C. VT.
D. SVT with aberrant conduction. - Correct Answer -C.
A unipolar atrial electrogram shows very large P waves because it is
recorded directly from the atrium. In this AEG, the large spikes are the P
waves and they are dissociated from the smaller and faster QRS
complexes (these strips are not simultaneously recorded), confirming the
diagnosis of ventricular tachycardia.
pg. 3
, Page 4 of 246
A complication seen in patients who have received a CABG using the
LIMA or a radial artery graft that is not seen with saphenous vein grafts
is:
A. Graft aneurysm.
B. Bleeding at graft suture lines.
C. Graft spasm.
D. Acute MI due to graft thrombosis. - Correct Answer -C.
Arterial conduits, such as the LIMA, RIMA, or radial artery are prone to
spasm because of their thicker arterial walls. All grafts can thrombose or
bleed at suture lines, and aneurysm formation is more common in veins
harvested from the arms. IMA grafts have excellent long term patency
and are preferred conduits in most patients.
You are caring for a CABG patient who received a radial artery graft to
the RCA. Which of the following drugs do you expect to administer to
prevent spasm of the graft:
A. Beta blockers.
B. Nitroprusside.
C. Amiodarone.
D. Nitrates or calcium channel blockers. - Correct Answer -D.
Arterial grafts are prone to vasospasm because of their thick muscular
wall. Calcium channel blockers and nitroglycerin are arterial dilators and
can be used to prevent graft spasm.
Beta blockers can leave alpha vasoconstrictor receptors unopposed and
are not indicated for preventing arterial spasm.
pg. 4
