CMC Cardiac Medicine Certification AACN FINAL EXAM STUDY GUIDE 2025/2026 COMPLETE QUESTIONS BANK AND CORRECT DETAILED ANSWERS WITH RATIONALES || 100% GUARANTEED PASS NEWEST VERSION

CMC Cardiac Medicine Certification AACN FINAL EXAM STUDY GUIDE 2025/2026 COMPLETE QUESTIONS BANK AND CORRECT DETAILED ANSWERS WITH RATIONALES || 100% GUARANTEED PASS NEWEST VERSION 1. What percentage of ventricular filling is passive and what percentage is atrial kick? - ANSWER Passive - 75% Atrial kick -- 25-35% 2. What 3 components make up stroke volume? - ANSWER Preload Afterload Contractility 3. Uses of beta blockers - ANSWER HTN Classic angina (Coronary artery obstruction) Ventricular and Supraventricular arrhythmia's ACS Heart failure Hypertrophic cardiomyopathy 4. Clinical effects of beta blockers - ANSWER Decreased heart rate Decreased contractility Decreased automaticity Decreased conduction velocity Decreased renin release (kidneys) 5. What causes a Type I block? - ANSWER Block at the AV node AV node is suppled by the RCA 6. What causes Second degree Type II blocks? - ANSWER Block at the bundle of his Bundle of his supplied by the LAD 7. What arteries supply the sinus node? - ANSWER RCA (55% of people) LAD (45% of people) 8. What causes a Second degree Type I Block? - ANSWER Block at the AV node Supplied by the RCA 9. Which lead is best to differentiate between LBBB/RBBB and VT/SVT? - ANSWER V1 10. Drugs that can cause bradycardia - ANSWER Beta Blockers Calcium channel Blockers Antidysrhythmics (Amio, Sotalol) Digoxin 11. Second degree type 1 AV block is often seen in what instances? - ANSWER Inferior wall MI AV node blocker agents 12. Second degree type II AV block is often seen in what instances? - ANSWER Anterior wall MI Aortic Valve Surgery or TAVR 13. Treatment of Type 1 AV block - ANSWER Atropine Temp or permanent pacing 14. Treatment of Type 2 AV block - ANSWER Temp or Permanent pacing Atropine doesn't work 15. Treatment of 3rd degree Block - ANSWER Temp or permanent pacing 16. tropine doesn't work 17. 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. 18. An IABP is currently at 3:1 when the patient suddenly goes into ventricular fibrillation. In addition to resuscitative measures, the nurse should: A. change the trigger to internal or pressure support resuscitative measures. B. increase timing back to 1:1 to increase coronary artery perfusion pressure. C. put the pump on standby until the return of spontaneous circulation. D. assess the IABP timing to chest compressions at 1:2. - ANSWER A. correct. the IABP will not be able to time correctly when a patient is in V-Fib. by placing the system to trigger on internal or pressure support, it will generate off the pressure created during compressions. B. incorrect. attempting to time the IABP back to 1:1 will be counterproductive, as it will not be able to trigger correctly. C. incorrect. there is significant risk of clot forming on the IABP when placed in stand for an indeterminate amount of time. D. incorrect. the primary goal during resuscitative measures is to attempt to circulate blood volume as effectively as possible. assessing the timing of the IABP is unnecessary. 19. A patient is reporting a new onset of palpitations. VS are: BP 90/60 ; HR 182 ; RR 20 ; T 98.6F. the cardiac monitor displays a rapid regular rhythm with a QRS complex measuring 0.08 sec. The patient is alert and oriented, denies chest pain and SOB, and has warn, dry skin. when vagal maneuvers fail to restore NSR, the nurse should: A. administer adenosine (Adenocard) B. defibrillate at 200 joules. C. prepare for synchronized cardioversion. D. set up for overdrive pacing. - ANSWER A. correct. the patient is manifesting stable SVT. the initial intervention for stable SVT is attempting vagal maneuvers and if unsuccessful administer adenosine. B. incorrect. defib is reserved for pulseless rhythms such as V-Tach and V Fib. Defibrillating SVT may cause R on T phenomenon producing a more lethal arrhythmia. C. incorrect. if patient becomes unstable, synchronized cardioversion would be indicated as the next intervention. D. incorrect. 20. A patient develops chest pain, nausea, vomiting, and diaphoresis. the 12 lead EKG is negative. if AMI is still suspected despite the absence of ST segment elevation, which should be nurse suspect? A. posterior wall MI. B. anterior wall MI. C. lateral wall MI. D. inferior wall MI. - ANSWER A. correct. detection of a posterior wall MI is difficult to assess on a standard 12 lead EKG. B. incorrect. an anterior wall MI would have evidence on leads V1-V4 (Q waves and ST segment elevation) on EKG. C. incorrect. a lateral wall MI will have changes in leads I, aVL, V5 and V6 (Q waves and ST segment elevation) on EKG. D. incorrect. an inferior wall MI will have changes in leads II, III, and aVF ( Q waves and ST segment elevation) on EKG. 21. A patient is admitted with SOB, jaundice, peripheral edema, and nausea. A pulmonary artery catheter was inserted. On insertion the hemodynamic values are PA 55/33 mmHg and CVP 20mmHg. which of the following should the nurse consider as potential causes of these signs and symptoms? A. peripheral arterial vascular occlusion, mitral regurgitation and LV failure. B. systemic HTN, MI, and endocarditis. C. LV failure, pulmonary embolus, and pulmonary HTN. D. pulmonary edema, abdominal infection, and portal vein occlusion. - ANSWER A. incorrect. peripheral artery vascular occlusion and mitral regurgitation are not direct causes of right heart failure. B. incorrect. systemic HTN and endocarditis are not direct causes of right heart failure. C. correct. patient is demonstrating symptoms of right heart failure. LV failure is the most common cause of RV dysfunction. pulmonary embolus and pulmonary HTN are additional causes. D. incorrect. 22. The nurse is providing discharge instructions to a patient with A-Fib who had a TIA 1 year ago. the patient underwent AV nodal ablation and pacemaker implantation during this admission. Which of the following responses indicates further education is necessary? A. "I will be able to resume playing contact sports." B. "My pacemaker will regulate my heart rate." C. "I may become lightheaded if my blood pressure drops." D. "I will follow up with my provider for blood thinner monitoring." - ANSWER A. correct. the patient will require anticoagulation for emboli prevention. playing contact sports is contraindicated. B, C, & D. incorrect. these statements are all accurate. 23. In addition to statin therapy, recommended treatment for patients with elevated cholesterol, low HDLs, high LDLs and elevated triglycerides should include A. increasing exercise and a low fat diet. B. smoking cessation and a low fat diet. C. increasing exercise and a low cholesterol diet. D. smoking cessation and a low fat diet. - ANSWER A. correct. increasing exercise and reducing fat in diet are essential and help treat patients with hyperlipidemia. B. incorrect. smoking cessation is not on the list of lifestyle changes for hyperlipidemia. C. incorrect. a low cholesterol diet is not on the list of lifestyle changes for hyperlipidemia. D. incorrect. 24. In which of the following patients, who received 2L of NS over the past 2 hours, should the nurse suspect presence of septic shock? A. BP 84/50 (61) ; CO 4.1L/min ; SVR 570 ; Lactate 2.0 ; Glucose 143. B. BP 70/40 (50) ; CO 3.6L/min ; SVR 720 ; Lactate 2.4 ; Glucose 157. C. BP 76/48 (57) ; CO 7.6L/min ; SVR 1600 ; Lactate 3.8 ; Glucose 56. D. BP 82/44 (56) ; CO 8.2L/min ; SVR 1240 ; Lactate 6.3 ; Glucose 48. - ANSWER A. incorrect. B. correct. this patient has septic shock as evidenced by being nonresponsive to fluid resuscitation and elevated lactate with hypotension, decreased CO and SVR, and presence of hyperglycemia. patients with septic shock have a decrease in CO, SVR, and EF. these hemodynamic changes are r/t the stimulation of release of nitric oxide, a potent vasodilator from proinflammatory cytokines. hyperglycemia results from septic shocks hypermetabolic state. C & D. incorrect. this patient does not meet the criteria for septic shock. 25. A patient with a history of recurrent angina and heart failure with an EF of 25% presents with an occluded RCA. A bare metal stent is deployed with successful restoration of flow. The next day the patient reports chest pain. the patient denies SOB, nausea, or dizziness. Skin is warm and dry. VS are BP 106/60 (75) ; HR 82 ; RR 22 ; T 98.6F. The nurse should suspect: A. bleeding at the access site. B. migration of the stent. C. coronary artery dissection. D. thrombosis. - ANSWER A. incorrect. VS are not indicative that the patient is actively bleeding. B. incorrect. C. incorrect. the patient is not diaphoretic and denies SOB, nausea, or dizziness.