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CMC CERTIFICATION QUESTIONS WITH CORRECT ANSWERS
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CMC CERTIFICATION QUESTIONS WITH CORRECT ANSWERS
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CMC PRACTICE QUESTIONS – AACNWITH COMPLETE SOLUTIONS
WhilescaringsforsaspatientswithsansIABPsats3:1,sthesnursesnotes:
A.sdecreasingsurinesoutputsasswellsassincreasingsBUNsandsCRslevels;sthesnursesshouldsin
creasestimingstos2:1
B.sabsentspulsessinsthesproximalsextremity;sthesnursesshouldsapplyspressuresatsthesinserti
onssite.
C.sbloodsinsthesIABPstubing;sthesnursesshouldsdisconnectsthesballoonscathetersfromsthesIA
BP.
D.sbloodsoozingsfromsthesinsertionssite;sthesnursesshouldsanticipatesthesneedsforsansemerg
encysfasciotomy.s-sans--
A.sincorrect.sdecreasingsurinesoutputswithsincreasingsBUNsandsCRslevelsswithsansIABPsins
placesindicatessobstructionsofsthesrenalsarteries.sThesnursesshouldsplansforsremoval.
B.sincorrect.sabsentspulsessdistalstosthesinsertionssitesindicatesscompletesocclusionsofsthes
femoralsartery.sapplicationsofspressurestosthesinsertionssiteswillsworsensthesobstruction.
C.scorrect.sbloodsinsthesIABPstubingsindicatessasrupturesofsthesballoon.sContinuingstosallow
sthesIABPstosinflatesandsdeflateswillsincreasesthessizesofsthesrupture,scausingsmoresbleedin
g.sthesnursesshouldsplansforsremovalsorsexchangesofsthesIABPscatheter.
D.sincorrect.sasfasciotomyswouldsbesindicatedsifsthespatientshadsansincreasesinsfluidsaccum
ulationsinsthesextremitiesscausingssignificantsinjurystostheslimb.
AnsIABPsisscurrentlysats3:1swhensthespatientssuddenlysgoessintosventricularsfibrillation.sIns
additionstosresuscitativesmeasures,sthesnursesshould:
A.schangesthestriggerstosinternalsorspressuressupportsresuscitativesmeasures.
B.sincreasestimingsbackstos1:1stosincreasescoronarysarterysperfusionspressure.
C.sputsthespumpsonsstandbysuntilsthesreturnsofsspontaneousscirculation.
D.sassesssthesIABPstimingstoschestscompressionssats1:2.s-sans--
A.scorrect.sthesIABPswillsnotsbesablestostimescorrectlyswhensaspatientsissinsV-
Fib.sbysplacingsthessystemstostriggersonsinternalsorspressuressupport,sitswillsgeneratesoffsth
espressurescreatedsduringscompressions.
B.sincorrect.sattemptingstostimesthesIABPsbackstos1:1swillsbescounterproductive,sassitswillsn
otsbesablestostriggerscorrectly.
C.sincorrect.stheresisssignificantsrisksofsclotsformingsonsthesIABPswhensplacedsinsstandsfors
ansindeterminatesamountsofstime.
D.sincorrect.sthesprimarysgoalsduringsresuscitativesmeasuressisstosattemptstoscirculatesblo
odsvolumesasseffectivelysasspossible.sassessingsthestimingsofsthesIABPsissunnecessary.
Thesnursesissreviewingstheshomesmedicationsslistsforsaspatientsadmittedsc/ossevereschests
pain.sserialsEKGssandsbloodstestingsaresnegative,ssosansexercisesstressstestsissscheduled.
swhichsofsthesfollowingsmedicationssmaysresultsinsasfalse-
positivesfindingsonsthesstressstest?
A.sdigitaliss(Digoxin)
,B.spotassiumschlorides(K-Dur)
C.ssotalols(Betapace)
D.sdiltiazems(Cardiazem)s-sans--A.scorrect.sdigitalisscanscausesfalse-
positivesEKGschangessduringsasstressstest.stheresissansassociationsbetweensthesdevelop
mentsofsSTssegmentsdepressionsduringsstressstesting.sthesmechanismsofsthissEKGschang
esissnotsclear.sfurther,sdigitalissshouldsbeswithheldsonsthesdaysofsthestestsbecausesofsitssne
gativeschronotropicseffects.
B.sincorrect.
Cs&sD.sincorrect.sbeta-
blockerssandscalciumschannelsblockerssbluntsthesheartsratesresponsestosexercisesandsma
yspreventsachievementsofsmaximumspredictedsheartsrate.stheysshouldsbeswithheldsonsthes
daysofsthestest.
AspatientsissadmittedswithselevatedstroponinslevelssandsSTssegmentselevationsinsleadssII,sI
II,sandsaVF.sAdministrationsofswhichsofsthesfollowingsshouldsthesnursesanticipatesinitially?
A.senoxaparins(Lovenox)
B.sstreptokinases(Strepase)
C.salteplases(Activase)
D.sreteplases(Retavase)s-sans--
A.sincorrect.senoxaparinsissansalternativestosheparinsinspatientsswithsunstablesangina,sNST
EMIsorsDVT.
B.sincorrect.sstreptokinasesissindicatedsforsacutesarterialsthrombosissorsembolism,sorsocclu
dedsAVscannulas.
C.sincorrect.salteplasesinsindicatedsforsacutesischemicsstrokesorsacutesmassivespulmonary
sembolism.
D.scorrect.sreteplasesissindicatedsforsAMIswhensfibrinolyticssaresindicated.
Whichsofsthesfollowingsissascharacteristicsofsdiastolicsheartsfailure?
A.sinabilitysofsthesheartsmusclestosrelax.
B.sdilationsofsthesventricularschambers.
C.sincreasedsfillingsofsthesleftsventricle.
D.sdecreasedsabilitysofsthesventriclestoscontract.s-sans--
A.scorrect.swithsdiastolicsheartsfailuresthesleftsventriclesissunablestosrelax,sleadingstossignss
andssymptomssofsheartsfailure,sbutsthespatientsmaintainssaspreservedsEFsassthesmusclesre
tainssitssabilitystoscontract.
B.sincorrect.sdilationsofsthesventricularschamberssissascharacteristicsofssystolicsheartsfailure
.
C.sincorrect.sdiastolicsheartsfailuresissansabnormalityswithsheartsfilling.sthesheartsmusclesdo
essnotsrelaxsnormally,sandsthesheartsmaysfillstoosslowlysorsasynchronously.sifsthesleftsventri
clesdoessnotsrelaxsproperlysorsissthicksandsstiff,sitsdoessnotsfillsinsthesusualsmannersandsblo
odsissdrawnsbacksintosthesleftsatriumsandseventuallysintostheslungs.
D.sincorrect.sdecreasedsabilitysofsthesventriclestoscontractsissassymptomsofsoverextensions
ofsthesheartsmusclesinspatientsswithscardiomyopathy.
FollowingsasSTEMI,sthesnursesauscultatessaslatessystolicsmurmursatsthesapex.sThesnurses
shouldssuspectsthesfindingsissr/tsthesnewsonsetsofsa:
,A.srightsbundlesbranchsblock
B.sleftsbundlesbranchsblock
C.spapillarysmusclesrupture
D.scalcificsplaquesruptures-sans--
A.sincorrect.sasRBBBswouldscausesanselectricalsdelaysinsconductionsforsaswidessplitsS2.
B.sincorrect.sasLBBBswouldscausesandselectricalsdelaysinsventricularsconductionsforsasparo
xicalssplitsS2.
C.scorrect.saspapillarysmuscleschordsrupturesresultssfromsischemiastosthestissuessupplyings
thesmitralsvalve.sassystolicsmurmursissheardsduestosmitralsregurgitation.
D.sincorrect.splaquesruptureswouldscausesansocclusionsofsthescoronarysarterysthatswouldsn
otsdirectlyscausesasnewssystolicsmurmur.
Thesnursesissreviewingsthesplansofscaresforsaspatientswithssystolicsheartsfailureswhoshassen
alaprils(Vasotec),sfurosemides(Lasix),smetoprolols(Lopressor),sandscarvedilols(Coreg)sord
ered.sWhichsofsthesfollowingswillsprovidesthesmostsaccuratesassessmentsofsthesregimen?
A.sdailysweights
B.sstrictsI&O
C.sBMPseverysmorning
D.sserialsCXRYss-sans--
A.scorrect.sassessingsdailysweightssissasnoninvasivesandseasysmethodstosassessscomplia
nceswithstheseffectivenesssofsasmedicalsregimensinspatientsswithsheartsfailure,sobservingst
hespatient'ssabilitystosmaintainsasconsistentsweightsindicatesscompliancesasswellsasstheseff
ectivenesssofsthesmedicalsregimen.
B.sincorrect.sstrictsI&Osissonlysonescomponentsofsasplansofscaresbutsdoessnotsassesssifsasp
atientsadheresstosthesmedicalsregimensorsifsthesregimensisseffective.
C.sincorrect.sasdailysBMPswouldsnotshelpsassessstheseffectivenesssofsthesmedicalsregimen
sassthesmajoritysofsthespanelscomponentssaresnotsaffectedsbysthesdrugsslisted.
D.sincorrect.sserialsCXRYsscouldsrevealsworseningsheartsfailure,sbutsassessingsdailysweig
htssissfarseasier,snoninvasivesandscost-effective.
Whichsofsthesfollowingspatientssituationssmightsbesbeststreatedswithsthesmazesprocedure?
A.srecurrentsventricularstachycardiasrefractorystoscardioversion
B.srecurrentsatrialsfibrillationsrefractorystosdrugstherapy
C.scardiomyopathyswithsansEFs<20%
D.scoronarysarterysrestenosissfollowingsPCIs-sans--
A.sincorrect.srecurrentsventricularstachycardiasrefractorystoscardioversionswouldsbesbeststr
eatedswithsthesinsertionsofsansautomaticsimplantablescardiovertersdefibrillator.
B.scorrect.sinsasmazesprocedure,snumeroussincisionssaresmadesonsthesleftsandsrightsatriu
mssosthatsscarstissuesforms.sthissscarstissuesdoessnotsconductselectricity,swhichsdisruptsst
hespathsofsabnormalselectricalsimpulses.
C.sincorrect.scardiomyopathyswithsansEFs<20%swouldsbesbeststreatedswithseithersinotropic
sorsmechanicalscirculatoryssupport.
D.sincorrect.scoronarysarterysrestenosissfollowingsPCIswouldsbesbeststreatedswithsantiplate
letstherapy.
, Aspatientsdevelopsschestspain,snausea,svomitingsandsdiaphoresis.sthes12-
leadsEKGsissnormal.sasfurtherscardiacsassessmentsisswarranted,sassitsisscommonsforsSTss
egmentselevationstosbesabsentsin:
A.sansanteriorswallsMI
B.sasposteriorswallsMI
C.saslateralswallsMI
D.sansinferiorswallsMIs-sans--
A.sincorrect.sansanteriorswallsMIswouldshavesEKGschangessinsleadssV1-V4
B.scorrect.sinsthesstandardsleadssetup,sthesEKGstypicallysdoessnotslooksatsthesposteriorswa
ll;sbecausesofstheslocationsofsthesocclusion,sECGschangesswouldsnotsbesapparent.
C.sincorrect.saslateralswallsMIswouldspresentschangessinsleadssI,saVL,sV5,sandsV6.
D.sincorrect.sansinferiorswallsMIswouldspresentschangessinsleadssII,sIII,saVF.
Whilesreviewingsthes12-leadsEKG,sthesnursesnotessnewschangesswithsST-
segmentselevationsinsleadss1,saVL,sandsV2-
V6,splussreciprocalschangessinsIII,saVF,sandsaVR.sThesnursesshouldsrealizesthatsthesareas
ofsinfarctsinvolvesthe:
A.santeriorsandslateralswalls
B.sposteriorsandsinferiorswalls
C.slateralsandsseptalswalls
D.sseptalsandsposteriorswallss-sans--
A.scorrect.sthesSTssegmentselevationsandsreciprocalschangessaresindicativesofsocclusionso
fsthesleftsanteriorsdescendingsandsleftscircumflexsarteries.stheseswillsaffectsthesanteriorsand
slateralswalls.
B.sincorrect.sansinfarctsinsthesposteriorsandsinferiorswallsswouldspresentsviasEKGswithschan
gessinsthesII,sIII,sandsaVFsleads.
C.sincorrect.sansinfarctsinstheslateralsandsseptalswallsswouldspresentsviasEKGschangessinsl
eadssI,saVL,sV5,sandsV6.
D.sincorrect.sansinfarctsinsthesseptalsandsposteriorswallsswouldspresentsviasEKGschangessi
nsV1-V4.
AspatientsissbeingsdischargedsonsaspirinstherapysfollowingsrecoverysfromsansAMI.sWhichso
fsthesfollowingscomorbiditiessputssthespatientsatsgreatestsrisksforsdevelopingsasbleedingsco
mplication?
A.sasthma
B.stransientsischemicsattack
C.schronicskidneysfailure
D.scorspulmonales-sans--A.sincorrect.
B.sincorrect.
C.scorrect.stheresissansincreasedsriskssofsbleedingsinskidneysfailure.sthisstendencysissattribu
tedstosimpairedsplateletsaggregationsandsadhesionsandsansalteredsresponsestosclottingsfac
torsVII.
D.sincorrect.
AspatientsisstosundergosPCI.sinsasprevioussadmissionsthespatientsreceivedsheparin.sthespati
entsinitiallyshadsasplateletscountsofs250,000;sthesplateletscountswass115,000sasfewsdaysslat
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