Page 1 of 35
AACN CMC EXAM 1 WITH QUESTIONS AND
ACCURATE ANSWERS VERIFIED BY AN EXPERT||
LATEST AND COMPLETE UPDATE 2025-2026 EXPERT
VERIFIED SOLUTIONS GRADED A+
The echocardiogram for a patient with an anterior wall STEMI demonstrates severe
left ventricular dysfunction requiring cardiac output support. the patient would best
benefit from:
A. dobutamine (Dobutrex)
B. phenylephrine (Neosynephrine)
C. nitroprusside (Nipride)
D. dopamine (Intropin) - ANSWER- A. correct. dobutamine increases contractility
which would increase cardiac output.
B. incorrect. Neo would just increase SVR which would increase the workload of the
heart.
C. incorrect. nitroprusside rapidly decreases systemic vascular resistance which
would cause a rapid drop in preload.
D. incorrect. dopamine will increase contractility, but at high doses will also increase
SVR.
A 22 year old athlete is admitted with reports of severe fatigue, dyspnea with
minor exertion and frequent chest palpitations. The EKG reveals non-specific ST-T
wave changes. during a medical history the patient reports being diagnosed with a
confirmed case of the flu 3-4 weeks ago. with this assessment and medical history,
the nurse should suspect:
A. NSTEMI
B. persistent influenza
C. STEMI
D. myocarditis - ANSWER- A. incorrect. patients who present with NSTEMI do not
have EKG changes.
B. incorrect. influenza does not have EKG changes.
C. incorrect. STEMIs present with EKG changes that pinpoint area of injury.
D. correct. myocarditis can follow viral illnesses such as influenza and has a delayed
presentation with nonspecific EKG changes.
Which of the following values would be expected in a patient with restrictive
,Page 2 of 35
cardiomyopathy?
A. SBP of 180mmHg
B. SVR of 500
C. right atrial pressure of 16mmHg
D. pulmonary artery opening pressure of 4mmHg - ANSWER- A. incorrect. not a
hallmark of the disease.
B. incorrect. SVR would be expected to be normal or elevated.
C. correct. one of the hallmarks of restrictive cardiomyopathy is elevated right
atrial pressure. left ventricular diastolic dysfunction occurs with restrictive
cardiomyopathy. this is often associated with a very high end-diastolic pressure.
D. incorrect. elevation would be expected, not a decrease.
an older woman is admitted with chest pain. she states that the pain occurs during
rest and lasts about 15 minutes. a 12 lead EKG reveals ST depression in leads I,
aVL, and V5 and V6. the patient is most likely experiencing:
A. an acute MI
B. unstable angina
C. pericarditis
D. ruptured papillary muscle - ANSWER- A. incorrect. a STEMI would have ST
elevation
B. correct. unstable angina occurs at rest and lasts more than 5 minutes. nonspecific
or ST depression may be present in areas of atherosclerotic plaque instability.
C. incorrect. pericarditis would have ST segment elevation in most leads and worsen
when leaning forward.
D. incorrect. papillary muscle rupture would present with more acute SOB d/t mitral
valve regurgitation.
A patient with a history of heart failure and diabetes is admitted with abdominal
pain, vomiting, and fatigue.
lab values: pH 7.29 ; pCO2 30 ; pO2 73 ; HCO3 17 ; SaO2 93% ; Na+ 150 ;
K+ 2.7 ; Cl 90 ; CO2 19 ; Glucose 1032
vital signs: BP 103/48 ; HR 108 ; RR 32
the nurse should anticipate
A. subcutaneous insulin and sodium bicarbonate
B. continuous insulin and furosemide
C. subcutaneous insulin and glucocorticoids
D. continuous insulin and IV fluids - ANSWER- A. incorrect. sodium bicarbonate is not
indicated.
,Page 3 of 35
B. incorrect. furosemide would harm the patient who is dehydrated.
C. incorrect. glucocorticoids would harm the patient by increasing the blood sugar.
D. correct. in DKA the osmotic shifts lead to intense dehydration. although the
patient has a history of heart failure, IVF hydration is recommended.
Which of the following patients is at risk for developing contrast-induced
nephropathy when admitted for a carotid arteriogram? a patient with:
A. with CVP 18 mmHg
B. with hemoglobin 15.7
C. who takes metformin (Glucophage)
D. who underwent autologous bone marrow transplantation - ANSWER- A. incorrect.
patients who are hypovolemic are at risk, however a CVP of 18 mmHg indicates
fluid overload.
B. incorrect. patients who are anemic are at risk, however a hgb of 15.7 is WNL.
C. correct.
D. incorrect. antirejection medications are not indicated for patients who undergo a
bone marrow transplant, however patients who do take antirejection medications
are at risk for developing ATN.
A patient with a prolonged QT interval is at risk for developing:
A. polymorphic V-Tach
B. high-grade AV block
C. junctional rhythm
D. sick sinus syndrome - ANSWER- A. correct.
B. incorrect.
C. incorrect.
D. incorrect.
Which of the following conditions is most likely associated with A-Fib?
A. pulmonary HTN
B. mitral valve stenosis
C. CAD
D. aortic aneurysm - ANSWER- A. incorrect. A-fib more commonly originates from
the pulmonary vein versus the pulmonary artery.
B. correct. mitral valve disease is the most common valvular pathologic cause of A-
Fib.
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C. incorrect.
D. incorrect. A-fib is initiated by thoracic or pulmonary veins, not aortic.
The nurse is called to the room of a patient in distress. the patient reports chest
pressure and is SOB. BP 63/44. A 12 lead EKG reveals Q waves in V1, V2, and
V3 and the patient has a pansystolic murmur that is loudest at the lower left sternal
border. the patient has most likely developed.
A. idiopathic hypertrophic cardiomyopathy
B. a ventricular aneurysm
C. cardiac tamponade
D. a ruptured ventricular septum - ANSWER- A. incorrect. idiopathic hypertrophic
cardiomyopathy would be more commonly associated with a systolic ejection
murmur due to increased left ventricular muscle contractility.
B. incorrect. a ventricular aneurysm would not produce a pansystolic murmur and is
not associated with Q waves unless the patient had a prior MI of the septal wall.
C. incorrect. heart sounds would be muffled.
D. correct. patients who have ventricular septal defect develop a pansystolic
murmur. A VSD is a congenital condition associated with abnormal blood flow
between the right and left ventricles due to a septal shunt.
Which of the following responses by a patient indicates understanding of the
problem of metabolic syndrome?
A. "That means I need to quit smoking and monitor my blood pressure."
B. "I will have to have liposuction to remove my belly and buttock fat."
C. "It can best be controlled by taking medication to lower my cholesterol."
D. "This syndrome increases my risk for developing diabetes and heart disease." -
ANSWER- A. incorrect.
B. incorrect.
C. incorrect.
D. correct.
A nurse caring for a patient with a temporary transvenous pacemaker. The monitor
reveals a pacing spike that is not followed by a QRS complex. which of the
following is indicated?
A. place the patient in the right lateral decubitus position.
B. decrease the mA
AACN CMC EXAM 1 WITH QUESTIONS AND
ACCURATE ANSWERS VERIFIED BY AN EXPERT||
LATEST AND COMPLETE UPDATE 2025-2026 EXPERT
VERIFIED SOLUTIONS GRADED A+
The echocardiogram for a patient with an anterior wall STEMI demonstrates severe
left ventricular dysfunction requiring cardiac output support. the patient would best
benefit from:
A. dobutamine (Dobutrex)
B. phenylephrine (Neosynephrine)
C. nitroprusside (Nipride)
D. dopamine (Intropin) - ANSWER- A. correct. dobutamine increases contractility
which would increase cardiac output.
B. incorrect. Neo would just increase SVR which would increase the workload of the
heart.
C. incorrect. nitroprusside rapidly decreases systemic vascular resistance which
would cause a rapid drop in preload.
D. incorrect. dopamine will increase contractility, but at high doses will also increase
SVR.
A 22 year old athlete is admitted with reports of severe fatigue, dyspnea with
minor exertion and frequent chest palpitations. The EKG reveals non-specific ST-T
wave changes. during a medical history the patient reports being diagnosed with a
confirmed case of the flu 3-4 weeks ago. with this assessment and medical history,
the nurse should suspect:
A. NSTEMI
B. persistent influenza
C. STEMI
D. myocarditis - ANSWER- A. incorrect. patients who present with NSTEMI do not
have EKG changes.
B. incorrect. influenza does not have EKG changes.
C. incorrect. STEMIs present with EKG changes that pinpoint area of injury.
D. correct. myocarditis can follow viral illnesses such as influenza and has a delayed
presentation with nonspecific EKG changes.
Which of the following values would be expected in a patient with restrictive
,Page 2 of 35
cardiomyopathy?
A. SBP of 180mmHg
B. SVR of 500
C. right atrial pressure of 16mmHg
D. pulmonary artery opening pressure of 4mmHg - ANSWER- A. incorrect. not a
hallmark of the disease.
B. incorrect. SVR would be expected to be normal or elevated.
C. correct. one of the hallmarks of restrictive cardiomyopathy is elevated right
atrial pressure. left ventricular diastolic dysfunction occurs with restrictive
cardiomyopathy. this is often associated with a very high end-diastolic pressure.
D. incorrect. elevation would be expected, not a decrease.
an older woman is admitted with chest pain. she states that the pain occurs during
rest and lasts about 15 minutes. a 12 lead EKG reveals ST depression in leads I,
aVL, and V5 and V6. the patient is most likely experiencing:
A. an acute MI
B. unstable angina
C. pericarditis
D. ruptured papillary muscle - ANSWER- A. incorrect. a STEMI would have ST
elevation
B. correct. unstable angina occurs at rest and lasts more than 5 minutes. nonspecific
or ST depression may be present in areas of atherosclerotic plaque instability.
C. incorrect. pericarditis would have ST segment elevation in most leads and worsen
when leaning forward.
D. incorrect. papillary muscle rupture would present with more acute SOB d/t mitral
valve regurgitation.
A patient with a history of heart failure and diabetes is admitted with abdominal
pain, vomiting, and fatigue.
lab values: pH 7.29 ; pCO2 30 ; pO2 73 ; HCO3 17 ; SaO2 93% ; Na+ 150 ;
K+ 2.7 ; Cl 90 ; CO2 19 ; Glucose 1032
vital signs: BP 103/48 ; HR 108 ; RR 32
the nurse should anticipate
A. subcutaneous insulin and sodium bicarbonate
B. continuous insulin and furosemide
C. subcutaneous insulin and glucocorticoids
D. continuous insulin and IV fluids - ANSWER- A. incorrect. sodium bicarbonate is not
indicated.
,Page 3 of 35
B. incorrect. furosemide would harm the patient who is dehydrated.
C. incorrect. glucocorticoids would harm the patient by increasing the blood sugar.
D. correct. in DKA the osmotic shifts lead to intense dehydration. although the
patient has a history of heart failure, IVF hydration is recommended.
Which of the following patients is at risk for developing contrast-induced
nephropathy when admitted for a carotid arteriogram? a patient with:
A. with CVP 18 mmHg
B. with hemoglobin 15.7
C. who takes metformin (Glucophage)
D. who underwent autologous bone marrow transplantation - ANSWER- A. incorrect.
patients who are hypovolemic are at risk, however a CVP of 18 mmHg indicates
fluid overload.
B. incorrect. patients who are anemic are at risk, however a hgb of 15.7 is WNL.
C. correct.
D. incorrect. antirejection medications are not indicated for patients who undergo a
bone marrow transplant, however patients who do take antirejection medications
are at risk for developing ATN.
A patient with a prolonged QT interval is at risk for developing:
A. polymorphic V-Tach
B. high-grade AV block
C. junctional rhythm
D. sick sinus syndrome - ANSWER- A. correct.
B. incorrect.
C. incorrect.
D. incorrect.
Which of the following conditions is most likely associated with A-Fib?
A. pulmonary HTN
B. mitral valve stenosis
C. CAD
D. aortic aneurysm - ANSWER- A. incorrect. A-fib more commonly originates from
the pulmonary vein versus the pulmonary artery.
B. correct. mitral valve disease is the most common valvular pathologic cause of A-
Fib.
, Page 4 of 35
C. incorrect.
D. incorrect. A-fib is initiated by thoracic or pulmonary veins, not aortic.
The nurse is called to the room of a patient in distress. the patient reports chest
pressure and is SOB. BP 63/44. A 12 lead EKG reveals Q waves in V1, V2, and
V3 and the patient has a pansystolic murmur that is loudest at the lower left sternal
border. the patient has most likely developed.
A. idiopathic hypertrophic cardiomyopathy
B. a ventricular aneurysm
C. cardiac tamponade
D. a ruptured ventricular septum - ANSWER- A. incorrect. idiopathic hypertrophic
cardiomyopathy would be more commonly associated with a systolic ejection
murmur due to increased left ventricular muscle contractility.
B. incorrect. a ventricular aneurysm would not produce a pansystolic murmur and is
not associated with Q waves unless the patient had a prior MI of the septal wall.
C. incorrect. heart sounds would be muffled.
D. correct. patients who have ventricular septal defect develop a pansystolic
murmur. A VSD is a congenital condition associated with abnormal blood flow
between the right and left ventricles due to a septal shunt.
Which of the following responses by a patient indicates understanding of the
problem of metabolic syndrome?
A. "That means I need to quit smoking and monitor my blood pressure."
B. "I will have to have liposuction to remove my belly and buttock fat."
C. "It can best be controlled by taking medication to lower my cholesterol."
D. "This syndrome increases my risk for developing diabetes and heart disease." -
ANSWER- A. incorrect.
B. incorrect.
C. incorrect.
D. correct.
A nurse caring for a patient with a temporary transvenous pacemaker. The monitor
reveals a pacing spike that is not followed by a QRS complex. which of the
following is indicated?
A. place the patient in the right lateral decubitus position.
B. decrease the mA
