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!!!
A patient presents to the ED with sharp, stabbing chest pain over the last several
day that improves somewhat when leaning forward. EKG shows diffuse ST
segment elevation with an upward concavity. Which of the following is the best
intervention?
A. start a heparin gtt.
B. arrange immediate transport to the cardiac cath lab.
C. administer 800mg IBU.
D. obtain order for aortogram. ANSWER- A. incorrect. anticoagulants are
contraindicated in patients with pericarditis. anticoagulants should be avoided
unless the pericarditis is secondary to an AMI, as they can cause intrapericardial
bleeding and possibly fatal tamponade.
B. incorrect. these symptoms are not consistent with a STEMI.
C. correct. NSAIDS are helpful in providing symptom relief in patients with
pericarditis.
D. incorrect. aortogram is not indicated in the diagnosis of pericarditis. diagnosis is
made with EKG, CXRY, and laboratory data.
A patient reports left-sided chest pain not associated with SOB or diaphoresis for
the past 12 hours. The pain worsens when lying supine. Serial 12-lead EKGs reveal
ST segment elevation in the anterior, inferior, and lateral leads. Cardiac biomarkers
are negative. administration of which of the following medications should the
nurse anticipate?
,Page 2 of 51
A. NSAIDs
B. thrombolytic therapy.
C. nitroglycerin infusion.
D. diuretic therapy. ANSWER- A. correct. ST segment elevation in all areas of
the heart is associated with pericarditis. NSAIDs are a recommended first line
therapy.
B. incorrect. thrombolytic therapy is harmful in the setting of pericarditis and
may result in hemorrhage.
C. incorrect. nitrates would not prevent fluid from collecting around the hear in
pericarditis.
D. incorrect. the patient does not have SOB, which is typically associated with
an acute heart failure exacerbation. diuresis can potentially worsen the pericarditis.
Which of the following is likely to result in diastolic dysfunction of the left
ventricle?
A. pulmonary artery hypertension
B. A-Fib with RVR
C. cardiogenic shock
D. dilated cardiomyopathy ANSWER- A. incorrect. pulmonary artery
hypertension may cause right ventricular failure not left.
B. correct. reduced atrial contraction and decreased diastolic time result in
reduced filling of the ventricle and diastolic dysfunction.
C. incorrect. cardiogenic shock results in reduced stroke volume from loss of
ventricular contractile force.
D. incorrect. dilated cardiomyopathy results in systolic dysfunction from
decreased contractility.
In which patient should the nurse suspect the presence of infective endocarditis? a
patient with:
,Page 3 of 51
A. T 101.3 F, CVP 14mmHg, and chest pain.
B. T 101.7 F, heart murmur, and signs of heart failure.
C. petechiae, BP 150/96 (114), and increase in activity.
D. headache, CVP 20mmHg, and BP 80/40 (53). ANSWER- A. incorrect.
although fever is present in about 80% of infective endocarditis, chest pain is only
present in about 15%. CVP will be low and not high d/t sepsis.
B. correct. infective endocarditis produces fever, heart murmur, signs of heart
failure, and may produce rapid hemodynamic deterioration.
C. incorrect. petechiae occurs in 20-40% of cases of infective endocarditis.
HTN may occur in the compensatory phase of the septic process. D. incorrect.
CVP would be low d/t sepsis.
A patient arrives at the hospital reporting blurred vision after missing 2 days of
prescribed antihypertensive medications. VS are: BP 195/120 ; HR 100 ; RR 18.
Administration of which of the following medications should the nurse anticipate
initially?
A. nifedipine (Procardia) sublingual
B. clonidine (Catapres) sublingual
C. fenoldapam (Corlopan) IV infusion
D. nitroprusside (Nipride) IV infusion ANSWER- A. incorrect. nifedipine SL is
contraindicated d/t adverse effects of hypotension followed by rebound HTN.
B. incorrect.
C. incorrect.
D. correct. initiation of a nitroprusside IV infusion at 0.25-10mg/kg/min would
allow titration to BP that maintains optimal cerebral and target organ perfusion.
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
, Page 4 of 51
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.
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.
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!!!
A patient presents to the ED with sharp, stabbing chest pain over the last several
day that improves somewhat when leaning forward. EKG shows diffuse ST
segment elevation with an upward concavity. Which of the following is the best
intervention?
A. start a heparin gtt.
B. arrange immediate transport to the cardiac cath lab.
C. administer 800mg IBU.
D. obtain order for aortogram. ANSWER- A. incorrect. anticoagulants are
contraindicated in patients with pericarditis. anticoagulants should be avoided
unless the pericarditis is secondary to an AMI, as they can cause intrapericardial
bleeding and possibly fatal tamponade.
B. incorrect. these symptoms are not consistent with a STEMI.
C. correct. NSAIDS are helpful in providing symptom relief in patients with
pericarditis.
D. incorrect. aortogram is not indicated in the diagnosis of pericarditis. diagnosis is
made with EKG, CXRY, and laboratory data.
A patient reports left-sided chest pain not associated with SOB or diaphoresis for
the past 12 hours. The pain worsens when lying supine. Serial 12-lead EKGs reveal
ST segment elevation in the anterior, inferior, and lateral leads. Cardiac biomarkers
are negative. administration of which of the following medications should the
nurse anticipate?
,Page 2 of 51
A. NSAIDs
B. thrombolytic therapy.
C. nitroglycerin infusion.
D. diuretic therapy. ANSWER- A. correct. ST segment elevation in all areas of
the heart is associated with pericarditis. NSAIDs are a recommended first line
therapy.
B. incorrect. thrombolytic therapy is harmful in the setting of pericarditis and
may result in hemorrhage.
C. incorrect. nitrates would not prevent fluid from collecting around the hear in
pericarditis.
D. incorrect. the patient does not have SOB, which is typically associated with
an acute heart failure exacerbation. diuresis can potentially worsen the pericarditis.
Which of the following is likely to result in diastolic dysfunction of the left
ventricle?
A. pulmonary artery hypertension
B. A-Fib with RVR
C. cardiogenic shock
D. dilated cardiomyopathy ANSWER- A. incorrect. pulmonary artery
hypertension may cause right ventricular failure not left.
B. correct. reduced atrial contraction and decreased diastolic time result in
reduced filling of the ventricle and diastolic dysfunction.
C. incorrect. cardiogenic shock results in reduced stroke volume from loss of
ventricular contractile force.
D. incorrect. dilated cardiomyopathy results in systolic dysfunction from
decreased contractility.
In which patient should the nurse suspect the presence of infective endocarditis? a
patient with:
,Page 3 of 51
A. T 101.3 F, CVP 14mmHg, and chest pain.
B. T 101.7 F, heart murmur, and signs of heart failure.
C. petechiae, BP 150/96 (114), and increase in activity.
D. headache, CVP 20mmHg, and BP 80/40 (53). ANSWER- A. incorrect.
although fever is present in about 80% of infective endocarditis, chest pain is only
present in about 15%. CVP will be low and not high d/t sepsis.
B. correct. infective endocarditis produces fever, heart murmur, signs of heart
failure, and may produce rapid hemodynamic deterioration.
C. incorrect. petechiae occurs in 20-40% of cases of infective endocarditis.
HTN may occur in the compensatory phase of the septic process. D. incorrect.
CVP would be low d/t sepsis.
A patient arrives at the hospital reporting blurred vision after missing 2 days of
prescribed antihypertensive medications. VS are: BP 195/120 ; HR 100 ; RR 18.
Administration of which of the following medications should the nurse anticipate
initially?
A. nifedipine (Procardia) sublingual
B. clonidine (Catapres) sublingual
C. fenoldapam (Corlopan) IV infusion
D. nitroprusside (Nipride) IV infusion ANSWER- A. incorrect. nifedipine SL is
contraindicated d/t adverse effects of hypotension followed by rebound HTN.
B. incorrect.
C. incorrect.
D. correct. initiation of a nitroprusside IV infusion at 0.25-10mg/kg/min would
allow titration to BP that maintains optimal cerebral and target organ perfusion.
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
, Page 4 of 51
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.
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.
