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AACN CSC EXAM NEWEST 2026 ACTUAL EXAM
QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) ALL ANSWERED {295 Q & A}
ALREADY GRADED A+/ CARDIAC SURGERY
CERTIFICATION AACN EXAM PREP | BRAND NEW! |
100% GUARANTEED PASS
Which of the following patients is likely to have the dangerous
form of heparin induced thrombocytopenia:
A. A patient who is 5 days post CABG whose platelet count has
decreased by 60%.
B. A patient who is 4 hours post CABG with a platelet count of
200,000.
C. A patient who is 2 days post CABG with a platelet count of
100,000.
D. Any patient post CABG with a 20% decrease in platelet count. -
✔✔✔ Correct Answer > A. Heparin induced thrombocytopenia can be a
life threatening clinical condition. However, thrombocytopenia is
a common clinical condition for many patients after CABG due to
a variety of factors including heparin administration and the
effects of cardiopulmonary bypass and use of intra-aortic
balloon pump therapy. There are two types of heparin induced
thrombocytopenia (HIT), Type 1 and Type 2. Type 1 HIT is common,
is not immune related, usually develops within 48 hours of
administration, results in a mild reduction in platelets. Heparin
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therapy can usually be continued in Type 1 HIT. Type 2 HIT is
immune mediated and typically results in a decrease in platelets
by 50% or more starting 4 to 10 days after the initiation of
therapy, or as soon as within 10 hours of administration if the
patient has had heparin within the last 100 days. Type 2 HIT can
result in a procoagulant state leading to both venous and arterial
thrombosis. The mortality rate associated with type 2 heparin
induced thrombocytopenia is approximately 20 to 30 %.
Inotropic support is often needed for the first few hours following
CABG surgery when there is left ventricular dysfunction present.
Which of the following drugs are appropriate for inotropic
support:
A. Nitroglycerine or nitroprusside.
B. Norepinephrine or vasopressin.
C. Milrinone, dobutamine, dopamine, or epinephrine.
D. Esmolol, metoprolol, or nicardipine. - ✔✔✔ Correct Answer > C.
Milrinone, dobutamine, dopamine, and epinephrine all increase
contractility. Milrinone is also a vasodilator so would be indicated
when inotropic support is needed in the presence of a high SVR.
Dobutamine, dopamine, and epinephrine all have beta adrenergic
effects to increase contractility. Epinephrine is often the
preferred inotropic agent because it causes less tachycardia
than dopamine or dobutamine and also has some peripheral
vasoconstrictor effects that can help support the blood pressure.
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Nitroglycerin and nitroprusside are both vasodilators with no
inotropic effect. Nitroglycerin is primarily a venous dilator and is
used for preload reduction. Nitroprusside has both venous and
arterial vasodilating effects with somewhat more arterial effect
and is used to manage postoperative hypertension.
Esmolol and metoprolol are beta blockers and nicardipine is a
calcium channel blocker. Beta blockers and calcium channel
blockers are negative inotropic drugs and decrease contractility.
Nicardipine is also a peripheral vasodilator and can be used to
treat postoperative hypertension.
Your patient post CABG has a BP of 192/96. Which of the following
drugs would be appropriate for BP control:
A. Nitroprusside.
B. Epinephrine.
C. Milrinone.
D. Norepinephrine. - ✔✔✔ Correct Answer > A. Nitroprusside is a
vasodilator that causes dilation of both arteries and veins, with
somewhat more arterial than venous dilation. It is usually the
drug of choice for management of postoperative hypertension
because of its short onset and duration of action which makes it
easy to titrate. Some patients are extremely sensitive to
nitroprusside, so the infusion should be started at a very low
dose and increased as tolerated for BP control. In the immediate
postoperative period, hypertension can be due at least partially
to hypothermia associated with CPB and anesthesia. The BP
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must be monitored continuously because as the patient
rewarms, blood vessels will dilate and SVR and BP will begin to
fall.
Epinephrine and norepinephrine are commonly used after
cardiac surgery to increase BP because they cause
vasoconstriction and increased contractility.
Milrinone (Primacor) is a vasodilator and a positive inotropic
drug. Its vasodilation effects could help lower BP but the positive
inotropic effect would increase contractility which could
contribute to an increase in BP. A drug like nitroprusside with
pure vasodilator effect would be preferable for BP control in a
hypertensive patient.
Fresh frozen plasma or cryoprecipitate would most likely be
administered to a post cardiac surgery patient who is bleeding
from which of the following causes:
A. Heparin rebound.
B. A graft leak at the anastomosis site.
C. Clotting factor depletion related to effects of prolonged CBP or
liver dysfunction.
D. Thrombocytopenia. - ✔✔✔ Correct Answer > C.FFP is separated from
the cellular components of blood (white cells, red cells, and
platelets) and contains all of the coagulation factors and other
proteins present in the original unit of blood. Cryoprecipitate is a
small volume (10-15 ml) of insoluble protein from one unit of FFP
and contains von Willebrand factor, factor VIII, factor XIII,
AACN CSC EXAM NEWEST 2026 ACTUAL EXAM
QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) ALL ANSWERED {295 Q & A}
ALREADY GRADED A+/ CARDIAC SURGERY
CERTIFICATION AACN EXAM PREP | BRAND NEW! |
100% GUARANTEED PASS
Which of the following patients is likely to have the dangerous
form of heparin induced thrombocytopenia:
A. A patient who is 5 days post CABG whose platelet count has
decreased by 60%.
B. A patient who is 4 hours post CABG with a platelet count of
200,000.
C. A patient who is 2 days post CABG with a platelet count of
100,000.
D. Any patient post CABG with a 20% decrease in platelet count. -
✔✔✔ Correct Answer > A. Heparin induced thrombocytopenia can be a
life threatening clinical condition. However, thrombocytopenia is
a common clinical condition for many patients after CABG due to
a variety of factors including heparin administration and the
effects of cardiopulmonary bypass and use of intra-aortic
balloon pump therapy. There are two types of heparin induced
thrombocytopenia (HIT), Type 1 and Type 2. Type 1 HIT is common,
is not immune related, usually develops within 48 hours of
administration, results in a mild reduction in platelets. Heparin
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therapy can usually be continued in Type 1 HIT. Type 2 HIT is
immune mediated and typically results in a decrease in platelets
by 50% or more starting 4 to 10 days after the initiation of
therapy, or as soon as within 10 hours of administration if the
patient has had heparin within the last 100 days. Type 2 HIT can
result in a procoagulant state leading to both venous and arterial
thrombosis. The mortality rate associated with type 2 heparin
induced thrombocytopenia is approximately 20 to 30 %.
Inotropic support is often needed for the first few hours following
CABG surgery when there is left ventricular dysfunction present.
Which of the following drugs are appropriate for inotropic
support:
A. Nitroglycerine or nitroprusside.
B. Norepinephrine or vasopressin.
C. Milrinone, dobutamine, dopamine, or epinephrine.
D. Esmolol, metoprolol, or nicardipine. - ✔✔✔ Correct Answer > C.
Milrinone, dobutamine, dopamine, and epinephrine all increase
contractility. Milrinone is also a vasodilator so would be indicated
when inotropic support is needed in the presence of a high SVR.
Dobutamine, dopamine, and epinephrine all have beta adrenergic
effects to increase contractility. Epinephrine is often the
preferred inotropic agent because it causes less tachycardia
than dopamine or dobutamine and also has some peripheral
vasoconstrictor effects that can help support the blood pressure.
,Page 3 of 262
Nitroglycerin and nitroprusside are both vasodilators with no
inotropic effect. Nitroglycerin is primarily a venous dilator and is
used for preload reduction. Nitroprusside has both venous and
arterial vasodilating effects with somewhat more arterial effect
and is used to manage postoperative hypertension.
Esmolol and metoprolol are beta blockers and nicardipine is a
calcium channel blocker. Beta blockers and calcium channel
blockers are negative inotropic drugs and decrease contractility.
Nicardipine is also a peripheral vasodilator and can be used to
treat postoperative hypertension.
Your patient post CABG has a BP of 192/96. Which of the following
drugs would be appropriate for BP control:
A. Nitroprusside.
B. Epinephrine.
C. Milrinone.
D. Norepinephrine. - ✔✔✔ Correct Answer > A. Nitroprusside is a
vasodilator that causes dilation of both arteries and veins, with
somewhat more arterial than venous dilation. It is usually the
drug of choice for management of postoperative hypertension
because of its short onset and duration of action which makes it
easy to titrate. Some patients are extremely sensitive to
nitroprusside, so the infusion should be started at a very low
dose and increased as tolerated for BP control. In the immediate
postoperative period, hypertension can be due at least partially
to hypothermia associated with CPB and anesthesia. The BP
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must be monitored continuously because as the patient
rewarms, blood vessels will dilate and SVR and BP will begin to
fall.
Epinephrine and norepinephrine are commonly used after
cardiac surgery to increase BP because they cause
vasoconstriction and increased contractility.
Milrinone (Primacor) is a vasodilator and a positive inotropic
drug. Its vasodilation effects could help lower BP but the positive
inotropic effect would increase contractility which could
contribute to an increase in BP. A drug like nitroprusside with
pure vasodilator effect would be preferable for BP control in a
hypertensive patient.
Fresh frozen plasma or cryoprecipitate would most likely be
administered to a post cardiac surgery patient who is bleeding
from which of the following causes:
A. Heparin rebound.
B. A graft leak at the anastomosis site.
C. Clotting factor depletion related to effects of prolonged CBP or
liver dysfunction.
D. Thrombocytopenia. - ✔✔✔ Correct Answer > C.FFP is separated from
the cellular components of blood (white cells, red cells, and
platelets) and contains all of the coagulation factors and other
proteins present in the original unit of blood. Cryoprecipitate is a
small volume (10-15 ml) of insoluble protein from one unit of FFP
and contains von Willebrand factor, factor VIII, factor XIII,
