Page 1 of 51
AACN CMC PRACTICE EXAM|| ACTUAL EXAM
WITH ALL QUESTIONS AND 100% CORRECT
ANSWERS GRADED A+|| LATEST AND
COMPLETE UPDATE WITH 100% VERIFIED
SOLUTIONS|| GUARANTEED PASS!!!
Which of the following patients is at risk for acute decompensation of heart
failure? a patient with:
A. alcoholism
B. hypotension
C. Hgb 14.8 gm/dL
D. HR 58 ANSWER- A. correct. alcohol can worsen left ventricular function and
trigger acute decompensation of heart failure.
B. incorrect. any condition that worsens LV function can trigger acute
decompensation of heart failure. HTN can do this but hypotension does not worsen
LV function. C. incorrect.
D. incorrect. tachycardia will increase oxygen demand not low heart rate.
The cardiac cath report of a patient with a new onset chest pain and heart failure
reveals patent coronary arteries and a bulge and the apex of the heart. These
findings are characteristic of A. metabolic syndrome
B. ventricular aneurysm
C. takotsubo cardiomyopathy
D. NSTEMI ANSWER- A. incorrect.
B. incorrect.
C. correct.
D. incorrect.
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The nurse is caring for a patient with cor pulmonale should expect an ECHO and
12-lead EKG to reveal:
A. tricuspid regurgitation and right axis deviation with R-waves in V1.
B. mitral stenosis and right axis deviation with deep Q waves in the V leads.
C. dilated left ventricle and left axis deviation with R wave progression.
D. bulging right atrium and left axis deviation with T wave inversion in the
precordial leads. ANSWER- A. correct. an echo would reveal tricuspid
regurgitation as a result of high pulmonary pressures and resistance to forward
flow of fluid. overtime this pressure will enlarge the right atrial and ventricular
chamber size and muscle causing right ventricular hypertrophy.
B. incorrect. cor pulmonale occurs in the setting of elevated right heart
pressures with chronic pulmonary disease. the left sided mitral valve would not
develop stenosis because of pressure changes.
C. incorrect. left ventricular dilation and left axis deviation would occur in
the setting of left sided heart failure. D. incorrect.
A patient, admitted with chest pain, develops sudden worsening SOB. a pulmonary
artery catheter reveals PAP 25/15 mmHg, CO 3.4L/min, and SVR 1660 dynes/sec.
The nurse should be concerned about:
A. acute aortic insufficiency
B. mitral valve insufficiency
C. mitral valve stenosis
D. aortic stenosis ANSWER- A. correct. in acute aortic insufficiency chest pain
is caused by decreased coronary perfusion due to regurgitant flow through the
incompetent aortic valve. a decrease in cardiac output and increased SVR is due
to sudden onset of left sided failure as the left ventricle is not able to
compensate.
B. incorrect. chest pain is not present in mitral valve insufficiency, but the
patient would experience decreased cardiac output and pulmonary edema.
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C. incorrect. patient with mitral valve stenosis would demonstrate pulmonary
htn due to right sided heart failure.
D. incorrect. similar symptoms occurs with aortic stenosis, but they occur over
time due to chronic injury.
While caring for a patient in cardiogenic shock who is receiving noninvasive
positive pressure ventilation (CPAP) the nurse should anticipate which of the
following effects due to this therapy?
A. capillary refill time of 4 seconds to 2 seconds.
B. HR 90-95 bpm.
C. QT interval 0.42 second to 0.38 second
D. cardiac output 4.8L/min to 3.7 L/min ANSWER- A. incorrect. capillary refill
may increase not decrease. B. incorrect.
C. incorrect. QT interval is not affected by PPV.
D. correct. the decrease in cardiac output is due to lack of sympathetic tone and
decreased venous return from the effects of positive pressure in the chest.
Following rounds by the physician, the nurse notes the patient is scheduled for a
bubble contrast transthoracic echocardiogram. this test is likely to determine if the
patient has a/an:
A. ventricular septal defect
B. atrial aneurysm
C. stenotic pulmonic valve
D. mitral valve regurgitation ANSWER- A. correct. agitated saline is injected
into the venous system during a TTE to detect the presence of a VSD.
B. incorrect. atrial aneurysm would present as an enlarged chamber and would not
be best visualized by a bubble contrast study.
AACN CMC PRACTICE EXAM|| ACTUAL EXAM
WITH ALL QUESTIONS AND 100% CORRECT
ANSWERS GRADED A+|| LATEST AND
COMPLETE UPDATE WITH 100% VERIFIED
SOLUTIONS|| GUARANTEED PASS!!!
Which of the following patients is at risk for acute decompensation of heart
failure? a patient with:
A. alcoholism
B. hypotension
C. Hgb 14.8 gm/dL
D. HR 58 ANSWER- A. correct. alcohol can worsen left ventricular function and
trigger acute decompensation of heart failure.
B. incorrect. any condition that worsens LV function can trigger acute
decompensation of heart failure. HTN can do this but hypotension does not worsen
LV function. C. incorrect.
D. incorrect. tachycardia will increase oxygen demand not low heart rate.
The cardiac cath report of a patient with a new onset chest pain and heart failure
reveals patent coronary arteries and a bulge and the apex of the heart. These
findings are characteristic of A. metabolic syndrome
B. ventricular aneurysm
C. takotsubo cardiomyopathy
D. NSTEMI ANSWER- A. incorrect.
B. incorrect.
C. correct.
D. incorrect.
,Page 2 of 51
The nurse is caring for a patient with cor pulmonale should expect an ECHO and
12-lead EKG to reveal:
A. tricuspid regurgitation and right axis deviation with R-waves in V1.
B. mitral stenosis and right axis deviation with deep Q waves in the V leads.
C. dilated left ventricle and left axis deviation with R wave progression.
D. bulging right atrium and left axis deviation with T wave inversion in the
precordial leads. ANSWER- A. correct. an echo would reveal tricuspid
regurgitation as a result of high pulmonary pressures and resistance to forward
flow of fluid. overtime this pressure will enlarge the right atrial and ventricular
chamber size and muscle causing right ventricular hypertrophy.
B. incorrect. cor pulmonale occurs in the setting of elevated right heart
pressures with chronic pulmonary disease. the left sided mitral valve would not
develop stenosis because of pressure changes.
C. incorrect. left ventricular dilation and left axis deviation would occur in
the setting of left sided heart failure. D. incorrect.
A patient, admitted with chest pain, develops sudden worsening SOB. a pulmonary
artery catheter reveals PAP 25/15 mmHg, CO 3.4L/min, and SVR 1660 dynes/sec.
The nurse should be concerned about:
A. acute aortic insufficiency
B. mitral valve insufficiency
C. mitral valve stenosis
D. aortic stenosis ANSWER- A. correct. in acute aortic insufficiency chest pain
is caused by decreased coronary perfusion due to regurgitant flow through the
incompetent aortic valve. a decrease in cardiac output and increased SVR is due
to sudden onset of left sided failure as the left ventricle is not able to
compensate.
B. incorrect. chest pain is not present in mitral valve insufficiency, but the
patient would experience decreased cardiac output and pulmonary edema.
, Page 3 of 51
C. incorrect. patient with mitral valve stenosis would demonstrate pulmonary
htn due to right sided heart failure.
D. incorrect. similar symptoms occurs with aortic stenosis, but they occur over
time due to chronic injury.
While caring for a patient in cardiogenic shock who is receiving noninvasive
positive pressure ventilation (CPAP) the nurse should anticipate which of the
following effects due to this therapy?
A. capillary refill time of 4 seconds to 2 seconds.
B. HR 90-95 bpm.
C. QT interval 0.42 second to 0.38 second
D. cardiac output 4.8L/min to 3.7 L/min ANSWER- A. incorrect. capillary refill
may increase not decrease. B. incorrect.
C. incorrect. QT interval is not affected by PPV.
D. correct. the decrease in cardiac output is due to lack of sympathetic tone and
decreased venous return from the effects of positive pressure in the chest.
Following rounds by the physician, the nurse notes the patient is scheduled for a
bubble contrast transthoracic echocardiogram. this test is likely to determine if the
patient has a/an:
A. ventricular septal defect
B. atrial aneurysm
C. stenotic pulmonic valve
D. mitral valve regurgitation ANSWER- A. correct. agitated saline is injected
into the venous system during a TTE to detect the presence of a VSD.
B. incorrect. atrial aneurysm would present as an enlarged chamber and would not
be best visualized by a bubble contrast study.
