CCMA CERTIFICATION EVALUATION STUDY
GUIDE 2026 FULL QUESTIONS AND SOLUTIONS
▶ Variant = Prinzmetal's (vasospasms). Answer: Can happen at rest or
anytime
ST ↘ then ↗ during pain episodes
ST segment goes back to normal and Nitro won't help
Tx: CCB to relax muscles in the vessel
▶ treatment for angina. Answer: Maintain cardiac output
Bed rest
Keep pt calm
Want a HYPOmetabolic state
Pain relief = morphine + nitroglycerin
Both have vasodilatory properties
Cardiac Bundle, educate pt on:
Lipid lowering med - a -statin
Beta blockers - Metoprolol
Long-acting Nitrates - Isosorbide dinitrate, Isosorbide mononitrate
ACE inhibitors - Captopril, Lisinopril, Ramipril
▶ Beta1 BlockeRs (-olol). Answer: always check apical heart rate
▶ ACE Inhibitors → o p r i l. Answer: No NSAIDS
No salt substitute or K+ supplements
▶ nitroglycerin. Answer: Normal adverse effect = patient has a headache
Take 1 tablet, call 911 if not relieved, then take 2 more till ambulance
comes; don't exceed 3
▶ diagnosing acute MI. Answer: unrelieved with nitro
Serum troponin I (< 0.1 mcg/L)
▶ MI priorities. Answer: VS including O2 saturation
12 lead ECG (quickly!)
IV access (large bore in a large vein) - 2 IVs if possible
Blood sample for labs: CBC, cardiac enzymes and coagulation studies
, ▶ acute mi treatment. Answer: MONA
▶ Percutaneous transluminal coronary angioplasty (PTCA). Answer: Goal
- Increase blood flow to myocardium
Balloon catheter is inflated inside the artery
Coronary stent may be placed to keep artery open
▶ meds post- stemi. Answer: Aspirin
Clopidogrel
▶ indications for CABG. Answer: Unstable angina
AMI
Failure of PCI
▶ CABG (Coronary Artery Bypass Graft). Answer: Pre-op teaching
Pt can watch educational movie
Signed consent
Answer questions
Post-op teaching
Monitor rhythm + hemodynamics
Risk of bleeding
Risk of hypervolemia
Monitor chest tube + mediastinal tube
Body temp (they got cold in sx)
Pain Management
Need to cough + deep breathe
Splinting
Neurological
▶ Pacemaker Issues. Answer: Failure to pace: pacer spikes are NOT
there
Biggest cause = low battery
Failure to sense: the pacemaker isn't sensing the pt's HR
Can cause ventricular dysrhythmias (mainly V-tach)
Treat: change pacemaker's sensitivity setting
Failure to capture: not causing contractions
▶ teaching for ICD. Answer: Keep incision dry for 4 days after insertion or
as instructed
Report any s/s of infection at incision site or fever immediately
GUIDE 2026 FULL QUESTIONS AND SOLUTIONS
▶ Variant = Prinzmetal's (vasospasms). Answer: Can happen at rest or
anytime
ST ↘ then ↗ during pain episodes
ST segment goes back to normal and Nitro won't help
Tx: CCB to relax muscles in the vessel
▶ treatment for angina. Answer: Maintain cardiac output
Bed rest
Keep pt calm
Want a HYPOmetabolic state
Pain relief = morphine + nitroglycerin
Both have vasodilatory properties
Cardiac Bundle, educate pt on:
Lipid lowering med - a -statin
Beta blockers - Metoprolol
Long-acting Nitrates - Isosorbide dinitrate, Isosorbide mononitrate
ACE inhibitors - Captopril, Lisinopril, Ramipril
▶ Beta1 BlockeRs (-olol). Answer: always check apical heart rate
▶ ACE Inhibitors → o p r i l. Answer: No NSAIDS
No salt substitute or K+ supplements
▶ nitroglycerin. Answer: Normal adverse effect = patient has a headache
Take 1 tablet, call 911 if not relieved, then take 2 more till ambulance
comes; don't exceed 3
▶ diagnosing acute MI. Answer: unrelieved with nitro
Serum troponin I (< 0.1 mcg/L)
▶ MI priorities. Answer: VS including O2 saturation
12 lead ECG (quickly!)
IV access (large bore in a large vein) - 2 IVs if possible
Blood sample for labs: CBC, cardiac enzymes and coagulation studies
, ▶ acute mi treatment. Answer: MONA
▶ Percutaneous transluminal coronary angioplasty (PTCA). Answer: Goal
- Increase blood flow to myocardium
Balloon catheter is inflated inside the artery
Coronary stent may be placed to keep artery open
▶ meds post- stemi. Answer: Aspirin
Clopidogrel
▶ indications for CABG. Answer: Unstable angina
AMI
Failure of PCI
▶ CABG (Coronary Artery Bypass Graft). Answer: Pre-op teaching
Pt can watch educational movie
Signed consent
Answer questions
Post-op teaching
Monitor rhythm + hemodynamics
Risk of bleeding
Risk of hypervolemia
Monitor chest tube + mediastinal tube
Body temp (they got cold in sx)
Pain Management
Need to cough + deep breathe
Splinting
Neurological
▶ Pacemaker Issues. Answer: Failure to pace: pacer spikes are NOT
there
Biggest cause = low battery
Failure to sense: the pacemaker isn't sensing the pt's HR
Can cause ventricular dysrhythmias (mainly V-tach)
Treat: change pacemaker's sensitivity setting
Failure to capture: not causing contractions
▶ teaching for ICD. Answer: Keep incision dry for 4 days after insertion or
as instructed
Report any s/s of infection at incision site or fever immediately
