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CMC PRACTICE QUESTIONS – AACN QUESTIONS WITH CORRECT ANSWERS.
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CMC PRACTICE QUESTIONS – AACN QUESTIONS WITH CORRECT ANSWERS.
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CMC PRACTICE QUESTIONS – AACNQUESTIONS WITH CORRECT ANSWERS
While ppcaring ppfor ppa pppatient ppwith ppan ppIABP ppat pp3:1, ppthe ppnurse
ppnotes:
A. ppdecreasing ppurine ppoutput ppas ppwell ppas ppincreasing ppBUN ppand
ppCR pplevels; ppthe ppnurse ppshould ppincrease pptiming ppto pp2:1
B. ppabsent pppulses ppin ppthe ppproximal ppextremity; ppthe ppnurse ppshould
ppapply pppressure ppat ppthe ppinsertion ppsite.
C. ppblood ppin ppthe ppIABP pptubing; ppthe ppnurse ppshould ppdisconnect ppthe
ppballoon ppcatheter ppfrom ppthe ppIABP.
D. ppblood ppoozing ppfrom ppthe ppinsertion ppsite; ppthe ppnurse ppshould
ppanticipate ppthe ppneed ppfor ppan ppemergency ppfasciotomy. pp- ppAnswer ppA.
ppincorrect. ppdecreasing ppurine ppoutput ppwith ppincreasing ppBUN ppand ppCR
pplevels ppwith ppan ppIABP ppin ppplace ppindicates ppobstruction ppof ppthe
pprenal pparteries. ppThe ppnurse ppshould ppplan ppfor ppremoval.
B. ppincorrect. ppabsent pppulses ppdistal ppto ppthe ppinsertion ppsite ppindicates
ppcomplete ppocclusion ppof ppthe ppfemoral ppartery. ppapplication ppof pppressure
ppto ppthe ppinsertion ppsite ppwill ppworsen ppthe ppobstruction.
C. ppcorrect. ppblood ppin ppthe ppIABP pptubing ppindicates ppa pprupture ppof
ppthe ppballoon. ppContinuing ppto ppallow ppthe ppIABP ppto ppinflate ppand
ppdeflate ppwill ppincrease ppthe ppsize ppof ppthe pprupture, ppcausing ppmore
ppbleeding. ppthe ppnurse ppshould ppplan ppfor ppremoval ppor ppexchange ppof
ppthe ppIABP ppcatheter.
D. ppincorrect. ppa ppfasciotomy ppwould ppbe ppindicated ppif ppthe pppatient
pphad ppan ppincrease ppin ppfluid ppaccumulation ppin ppthe ppextremities
ppcausing ppsignificant ppinjury ppto ppthe pplimb.
An ppIABP ppis ppcurrently ppat pp3:1 ppwhen ppthe pppatient ppsuddenly ppgoes
ppinto ppventricular ppfibrillation. ppIn ppaddition ppto ppresuscitative ppmeasures,
ppthe ppnurse ppshould:
A. ppchange ppthe pptrigger ppto ppinternal ppor pppressure ppsupport
ppresuscitative ppmeasures.
B. ppincrease pptiming ppback ppto pp1:1 ppto ppincrease ppcoronary ppartery
ppperfusion pppressure.
C. ppput ppthe pppump ppon ppstandby ppuntil ppthe ppreturn ppof ppspontaneous
ppcirculation.
D. ppassess ppthe ppIABP pptiming ppto ppchest ppcompressions ppat pp1:2. pp-
ppAnswer ppA. ppcorrect. ppthe ppIABP ppwill ppnot ppbe ppable ppto pptime
ppcorrectly ppwhen ppa pppatient ppis ppin ppV-Fib. ppby ppplacing ppthe ppsystem
,ppto pptrigger ppon ppinternal ppor pppressure ppsupport, ppit ppwill ppgenerate ppoff
ppthe pppressure ppcreated ppduring ppcompressions.
B. ppincorrect. ppattempting ppto pptime ppthe ppIABP ppback ppto pp1:1 ppwill
ppbe ppcounterproductive, ppas ppit ppwill ppnot ppbe ppable ppto pptrigger
ppcorrectly.
C. ppincorrect. ppthere ppis ppsignificant pprisk ppof ppclot ppforming ppon ppthe
ppIABP ppwhen ppplaced ppin ppstand ppfor ppan ppindeterminate ppamount ppof
pptime.
D. ppincorrect. ppthe ppprimary ppgoal ppduring ppresuscitative ppmeasures ppis
ppto ppattempt ppto ppcirculate ppblood ppvolume ppas ppeffectively ppas
pppossible. ppassessing ppthe pptiming ppof ppthe ppIABP ppis ppunnecessary.
The ppnurse ppis ppreviewing ppthe pphome ppmedications pplist ppfor ppa
pppatient ppadmitted ppc/o ppsevere ppchest pppain. ppserial ppEKGs ppand ppblood
pptesting ppare ppnegative, ppso ppan ppexercise ppstress pptest ppis ppscheduled.
ppwhich ppof ppthe ppfollowing ppmedications ppmay ppresult ppin ppa ppfalse-
positive ppfinding ppon ppthe ppstress pptest?
A. ppdigitalis pp(Digoxin)
B. pppotassium ppchloride pp(K-Dur)
C. ppsotalol pp(Betapace)
D. ppdiltiazem pp(Cardiazem) pp- ppAnswer ppA. ppcorrect. ppdigitalis ppcan
ppcause ppfalse-positive ppEKG ppchanges ppduring ppa ppstress pptest. ppthere
ppis ppan ppassociation ppbetween ppthe ppdevelopment ppof ppST ppsegment
ppdepression ppduring ppstress pptesting. ppthe ppmechanism ppof ppthis ppEKG
ppchange ppis ppnot ppclear. ppfurther, ppdigitalis ppshould ppbe ppwithheld ppon
ppthe ppday ppof ppthe pptest ppbecause ppof ppits ppnegative ppchronotropic
ppeffects.
B. ppincorrect.
C pp& ppD. ppincorrect. ppbeta-blockers ppand ppcalcium ppchannel ppblockers
ppblunt ppthe ppheart pprate ppresponse ppto ppexercise ppand ppmay ppprevent
ppachievement ppof ppmaximum pppredicted ppheart pprate. ppthey ppshould ppbe
ppwithheld ppon ppthe ppday ppof ppthe pptest.
A pppatient ppis ppadmitted ppwith ppelevated pptroponin pplevels ppand ppST
ppsegment ppelevation ppin ppleads ppII, ppIII, ppand ppaVF. ppAdministration ppof
ppwhich ppof ppthe ppfollowing ppshould ppthe ppnurse ppanticipate ppinitially?
A. ppenoxaparin pp(Lovenox)
B. ppstreptokinase pp(Strepase)
C. ppalteplase pp(Activase)
D. ppreteplase pp(Retavase) pp- ppAnswer ppA. ppincorrect. ppenoxaparin ppis ppan
ppalternative ppto ppheparin ppin pppatients ppwith ppunstable ppangina, ppNSTEMI
ppor ppDVT.
B. ppincorrect. ppstreptokinase ppis ppindicated ppfor ppacute pparterial
ppthrombosis ppor ppembolism, ppor ppoccluded ppAV ppcannulas.
C. ppincorrect. ppalteplase ppin ppindicated ppfor ppacute ppischemic ppstroke ppor
ppacute ppmassive pppulmonary ppembolism.
,D. ppcorrect. ppreteplase ppis ppindicated ppfor ppAMI ppwhen ppfibrinolytics ppare
ppindicated.
Which ppof ppthe ppfollowing ppis ppa ppcharacteristic ppof ppdiastolic ppheart
ppfailure?
A. ppinability ppof ppthe ppheart ppmuscle ppto pprelax.
B. ppdilation ppof ppthe ppventricular ppchambers.
C. ppincreased ppfilling ppof ppthe ppleft ppventricle.
D. ppdecreased ppability ppof ppthe ppventricle ppto ppcontract. pp- ppAnswer ppA.
ppcorrect. ppwith ppdiastolic ppheart ppfailure ppthe ppleft ppventricle ppis ppunable
ppto pprelax, ppleading ppto ppsigns ppand ppsymptoms ppof ppheart ppfailure, ppbut
ppthe pppatient ppmaintains ppa pppreserved ppEF ppas ppthe ppmuscle ppretains
ppits ppability ppto ppcontract.
B. ppincorrect. ppdilation ppof ppthe ppventricular ppchambers ppis ppa
ppcharacteristic ppof ppsystolic ppheart ppfailure.
C. ppincorrect. ppdiastolic ppheart ppfailure ppis ppan ppabnormality ppwith ppheart
ppfilling. ppthe ppheart ppmuscle ppdoes ppnot pprelax ppnormally, ppand ppthe
ppheart ppmay ppfill pptoo ppslowly ppor ppasynchronously. ppif ppthe ppleft
ppventricle ppdoes ppnot pprelax ppproperly ppor ppis ppthick ppand ppstiff, ppit
ppdoes ppnot ppfill ppin ppthe ppusual ppmanner ppand ppblood ppis ppdrawn
ppback ppinto ppthe ppleft ppatrium ppand ppeventually ppinto ppthe pplungs.
D. ppincorrect. ppdecreased ppability ppof ppthe ppventricle ppto ppcontract ppis ppa
ppsymptom ppof ppoverextension ppof ppthe ppheart ppmuscle ppin pppatients ppwith
ppcardiomyopathy.
Following ppa ppSTEMI, ppthe ppnurse ppauscultates ppa pplate ppsystolic
ppmurmur ppat ppthe ppapex. ppThe ppnurse ppshould ppsuspect ppthe ppfinding
ppis ppr/t ppthe ppnew pponset ppof ppa:
A. ppright ppbundle ppbranch ppblock
B. ppleft ppbundle ppbranch ppblock
C. pppapillary ppmuscle pprupture
D. ppcalcific ppplaque pprupture pp- ppAnswer ppA. ppincorrect. ppa ppRBBB
ppwould ppcause ppan ppelectrical ppdelay ppin ppconduction ppfor ppa ppwide
ppsplit ppS2.
B. ppincorrect. ppa ppLBBB ppwould ppcause ppand ppelectrical ppdelay ppin
ppventricular ppconduction ppfor ppa ppparoxical ppsplit ppS2.
C. ppcorrect. ppa pppapillary ppmuscle ppchord pprupture ppresults ppfrom
ppischemia ppto ppthe pptissue ppsupplying ppthe ppmitral ppvalve. ppa ppsystolic
ppmurmur ppis ppheard ppdue ppto ppmitral ppregurgitation.
D. ppincorrect. ppplaque pprupture ppwould ppcause ppan ppocclusion ppof ppthe
ppcoronary ppartery ppthat ppwould ppnot ppdirectly ppcause ppa ppnew ppsystolic
ppmurmur.
The ppnurse ppis ppreviewing ppthe ppplan ppof ppcare ppfor ppa pppatient ppwith
ppsystolic ppheart ppfailure ppwho pphas ppenalapril pp(Vasotec), ppfurosemide
pp(Lasix), ppmetoprolol pp(Lopressor), ppand ppcarvedilol pp(Coreg) ppordered.
, ppWhich ppof ppthe ppfollowing ppwill ppprovide ppthe ppmost ppaccurate
ppassessment ppof ppthe ppregimen?
A. ppdaily ppweights
B. ppstrict ppI&O
C. ppBMP ppevery ppmorning
D. ppserial ppCXRYs pp- ppAnswer ppA. ppcorrect. ppassessing ppdaily ppweights
ppis ppa ppnoninvasive ppand ppeasy ppmethod ppto ppassess ppcompliance ppwith
ppthe ppeffectiveness ppof ppa ppmedical ppregimen ppin pppatients ppwith ppheart
ppfailure, ppobserving ppthe pppatient's ppability ppto ppmaintain ppa ppconsistent
ppweight ppindicates ppcompliance ppas ppwell ppas ppthe ppeffectiveness ppof
ppthe ppmedical ppregimen.
B. ppincorrect. ppstrict ppI&O ppis pponly ppone ppcomponent ppof ppa ppplan ppof
ppcare ppbut ppdoes ppnot ppassess ppif ppa pppatient ppadheres ppto ppthe
ppmedical ppregimen ppor ppif ppthe ppregimen ppis ppeffective.
C. ppincorrect. ppa ppdaily ppBMP ppwould ppnot pphelp ppassess ppthe
ppeffectiveness ppof ppthe ppmedical ppregimen ppas ppthe ppmajority ppof ppthe
pppanel ppcomponents ppare ppnot ppaffected ppby ppthe ppdrugs pplisted.
D. ppincorrect. ppserial ppCXRYs ppcould ppreveal ppworsening ppheart ppfailure,
ppbut ppassessing ppdaily ppweights ppis ppfar ppeasier, ppnoninvasive ppand
ppcost-effective.
Which ppof ppthe ppfollowing pppatient ppsituations ppmight ppbe ppbest pptreated
ppwith ppthe ppmaze ppprocedure?
A. pprecurrent ppventricular pptachycardia pprefractory ppto ppcardioversion
B. pprecurrent ppatrial ppfibrillation pprefractory ppto ppdrug pptherapy
C. ppcardiomyopathy ppwith ppan ppEF pp<20%
D. ppcoronary ppartery pprestenosis ppfollowing ppPCI pp- ppAnswer ppA.
ppincorrect. pprecurrent ppventricular pptachycardia pprefractory ppto ppcardioversion
ppwould ppbe ppbest pptreated ppwith ppthe ppinsertion ppof ppan ppautomatic
ppimplantable ppcardioverter ppdefibrillator.
B. ppcorrect. ppin ppa ppmaze ppprocedure, ppnumerous ppincisions ppare ppmade
ppon ppthe ppleft ppand ppright ppatrium ppso ppthat ppscar pptissue ppforms. ppthis
ppscar pptissue ppdoes ppnot ppconduct ppelectricity, ppwhich ppdisrupts ppthe
pppath ppof ppabnormal ppelectrical ppimpulses.
C. ppincorrect. ppcardiomyopathy ppwith ppan ppEF pp<20% ppwould ppbe ppbest
pptreated ppwith ppeither ppinotropic ppor ppmechanical ppcirculatory ppsupport.
D. ppincorrect. ppcoronary ppartery pprestenosis ppfollowing ppPCI ppwould ppbe
ppbest pptreated ppwith ppantiplatelet pptherapy.
A pppatient ppdevelops ppchest pppain, ppnausea, ppvomiting ppand ppdiaphoresis.
ppthe pp12-lead ppEKG ppis ppnormal. ppa ppfurther ppcardiac ppassessment ppis
ppwarranted, ppas ppit ppis ppcommon ppfor ppST ppsegment ppelevation ppto ppbe
ppabsent ppin:
A. ppan ppanterior ppwall ppMI
B. ppa ppposterior ppwall ppMI
C. ppa pplateral ppwall ppMI
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