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CMC Practice Questions – AACN Exam Practice Questions and Answers While caring for a patient with an IABP at 3:1, the nurse notes: A. decreasing urine output as well as increasing BUN and CR levels; the nurse should increase timing to 2:1 B. absent pulses in the proximal extremity; the nurse...

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  • November 10, 2024
  • 59
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers

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  • cmc practice questions aacn exam practice questi

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CMC Practice Questions – AACN Exam

Practice Questions and Answers


While caring for a patient with an IABP at 3:1, the nurse notes:


A. decreasing urine output as well as increasing BUN and CR levels; the nurse should increase timing to

2:1


B. absent pulses in the proximal extremity; the nurse should apply pressure at the insertion site.


C. blood in the IABP tubing; the nurse should disconnect the balloon catheter from the IABP.


D. blood oozing from the insertion site; the nurse should anticipate the need for an emergency

fasciotomy. - ANSWER✔✔-A. incorrect. decreasing urine output with increasing BUN and CR levels with

an IABP in place indicates obstruction of the renal arteries. The nurse should plan for removal.


B. incorrect. absent pulses distal to the insertion site indicates complete occlusion of the femoral artery.

application of pressure to the insertion site will worsen the obstruction.


C. correct. blood in the IABP tubing indicates a rupture of the balloon. Continuing to allow the IABP to

inflate and deflate will increase the size of the rupture, causing more bleeding. the nurse should plan for

removal or exchange of the IABP catheter.




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D. incorrect. a fasciotomy would be indicated if the patient had an increase in fluid accumulation in the

extremities causing significant injury to the limb.


An IABP is currently at 3:1 when the patient suddenly goes into ventricular fibrillation. In addition to

resuscitative measures, the nurse should:


A. change the trigger to internal or pressure support resuscitative measures.


B. increase timing back to 1:1 to increase coronary artery perfusion pressure.


C. put the pump on standby until the return of spontaneous circulation.


D. assess the IABP timing to chest compressions at 1:2. - ANSWER✔✔-A. correct. the IABP will not be

able to time correctly when a patient is in V-Fib. by placing the system to trigger on internal or pressure

support, it will generate off the pressure created during compressions.


B. incorrect. attempting to time the IABP back to 1:1 will be counterproductive, as it will not be able to

trigger correctly.


C. incorrect. there is significant risk of clot forming on the IABP when placed in stand for an

indeterminate amount of time.


D. incorrect. the primary goal during resuscitative measures is to attempt to circulate blood volume as

effectively as possible. assessing the timing of the IABP is unnecessary.


The nurse is reviewing the home medications list for a patient admitted c/o severe chest pain. serial EKGs

and blood testing are negative, so an exercise stress test is scheduled. which of the following

medications may result in a false-positive finding on the stress test?


A. digitalis (Digoxin)


B. potassium chloride (K-Dur)

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C. sotalol (Betapace)


D. diltiazem (Cardiazem) - ANSWER✔✔-A. correct. digitalis can cause false-positive EKG changes during a

stress test. there is an association between the development of ST segment depression during stress

testing. the mechanism of this EKG change is not clear. further, digitalis should be withheld on the day of

the test because of its negative chronotropic effects.


B. incorrect.


C & D. incorrect. beta-blockers and calcium channel blockers blunt the heart rate response to exercise

and may prevent achievement of maximum predicted heart rate. they should be withheld on the day of

the test.


A patient is admitted with elevated troponin levels and ST segment elevation in leads II, III, and aVF.

Administration of which of the following should the nurse anticipate initially?


A. enoxaparin (Lovenox)


B. streptokinase (Strepase)


C. alteplase (Activase)


D. reteplase (Retavase) - ANSWER✔✔-A. incorrect. enoxaparin is an alternative to heparin in patients

with unstable angina, NSTEMI or DVT.


B. incorrect. streptokinase is indicated for acute arterial thrombosis or embolism, or occluded AV

cannulas.


C. incorrect. alteplase in indicated for acute ischemic stroke or acute massive pulmonary embolism.


D. correct. reteplase is indicated for AMI when fibrinolytics are indicated.



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Which of the following is a characteristic of diastolic heart failure?


A. inability of the heart muscle to relax.


B. dilation of the ventricular chambers.


C. increased filling of the left ventricle.


D. decreased ability of the ventricle to contract. - ANSWER✔✔-A. correct. with diastolic heart failure the

left ventricle is unable to relax, leading to signs and symptoms of heart failure, but the patient maintains

a preserved EF as the muscle retains its ability to contract.


B. incorrect. dilation of the ventricular chambers is a characteristic of systolic heart failure.


C. incorrect. diastolic heart failure is an abnormality with heart filling. the heart muscle does not relax

normally, and the heart may fill too slowly or asynchronously. if the left ventricle does not relax properly

or is thick and stiff, it does not fill in the usual manner and blood is drawn back into the left atrium and

eventually into the lungs.


D. incorrect. decreased ability of the ventricle to contract is a symptom of overextension of the heart

muscle in patients with cardiomyopathy.


Following a STEMI, the nurse auscultates a late systolic murmur at the apex. The nurse should suspect

the finding is r/t the new onset of a:


A. right bundle branch block


B. left bundle branch block


C. papillary muscle rupture




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