CSC Practice Questions (2026) — Free Sample Questions with Answers

Answer: C

Ventricular septal rupture causing a new holosystolic murmur: Septal rupture is a mechanical complication of acute MI, not a typical TAVR complication, and it is found by auscultation and echocardiography rather than continuous ECG.

Sinus tachycardia caused by postprocedure anxiety: Tachycardia can occur after any procedure, but it is not the procedure-specific conduction risk that drives monitoring after TAVR.

New left bundle branch block or complete heart block: Correct. The valve frame sits next to the AV node and left bundle, so new LBBB and high-grade AV block are known TAVR complications that may need temporary or permanent pacing.

Prinzmetal angina caused by coronary artery spasm: Vasospastic angina is not a characteristic TAVR complication; coronary obstruction after TAVR is rare and mechanical, not spasm.

After TAVR, watch the rhythm: the valve frame can damage the conduction system, causing new LBBB or complete heart block, so continuous ECG monitoring and pacing readiness are essential.

Answer: A

Urine output of 35 mL/h for 7 consecutive hours: Correct. KDIGO defines AKI as urine output under 0.5 mL/kg/h for 6 hours or more; 35 mL/h ÷ 80 kg = 0.44 mL/kg/h for 7 hours.

Creatinine rise from 1.0 to 1.2 mg/dL over 3 days: KDIGO needs a rise of at least 0.3 mg/dL within 48 hours or 1.5 times baseline within 7 days; 0.2 mg/dL over 3 days meets neither.

Urine output of 45 mL/h for 8 consecutive hours: 45 mL/h ÷ 80 kg = 0.56 mL/kg/h, which is above the 0.5 mL/kg/h threshold.

BUN of 28 mg/dL with creatinine still at 1.0 mg/dL: BUN is not a KDIGO criterion; it rises with catabolism, bleeding or steroids without kidney injury.

KDIGO AKI: creatinine up ≥0.3 mg/dL within 48 h, or ≥1.5 times baseline within 7 days, or urine output <0.5 mL/kg/h for ≥6 h.

Answer: D

Hypovolemia from bleeding; give a rapid crystalloid bolus: Hypovolemia causes low CVP and PAOP; here filling pressures are high, so a bolus is not the main fix.

Left ventricular failure; start an inotrope infusion: LV failure raises PAOP, but CVP is not usually equal to it; equal pressures plus sudden loss of drainage point to tamponade.

Right ventricular failure; start an inhaled pulmonary vasodilator: RV failure raises CVP while left-sided pressures stay lower; here right and left pressures are equal.

Cardiac tamponade; prepare for emergent re-exploration: Correct. Drainage that stops suddenly after heavy bleeding, low BP with narrow pulse pressure, tachycardia, and equal CVP, PAD and PAOP indicate tamponade, which needs surgical decompression.

Postoperative tamponade: chest tube drainage suddenly stops, narrow pulse pressure, low cardiac index and equal right and left filling pressures. Treat with emergent re-exploration.

Answer: A

Keep glucose below 180 mg/dL with an IV insulin infusion: Correct. STS guidance recommends a continuous IV insulin infusion to keep glucose below 180 mg/dL in the early postoperative ICU period to reduce deep sternal wound infection and death.

Keep glucose at 80–110 mg/dL with an IV insulin infusion: Very tight control raises the risk of hypoglycemia without better outcomes (NICE-SUGAR) and is not recommended.

Treat only glucose above 250 mg/dL with subcutaneous insulin: Allowing high glucose increases infection risk, and subcutaneous absorption is unreliable during vasoconstriction and hypothermia.

Hold all insulin until the patient resumes eating: Stress hyperglycemia after bypass needs active treatment whether or not the patient is eating.

Cardiac surgery ICU: use an IV insulin infusion and keep glucose below 180 mg/dL while avoiding hypoglycemia; switch to subcutaneous insulin once the patient is stable and eating.

Answer: C

Begin external chest compressions for 2 minutes before any shock: In witnessed postoperative VF with a defibrillator ready, external compressions are briefly delayed so shocks can be given first; compressions can damage grafts and sternal closure.

Give epinephrine 1 mg IV push, then defibrillate: Cardiac surgery protocols avoid routine 1 mg epinephrine because the rebound hypertension after return of circulation can cause bleeding and graft disruption.

Deliver up to three sequential shocks before starting compressions: Correct. The STS consensus (CALS approach) recommends up to three quick shocks within about 1 minute; if they fail, start CPR, give amiodarone and prepare for emergency resternotomy within 5 minutes.

Open the chest for internal massage before attempting defibrillation: Resternotomy is done when early shocks fail, not before them; rapid defibrillation has the best chance of restoring rhythm.

Post-cardiac surgery VF: up to 3 stacked shocks first, then CPR and amiodarone, with resternotomy within 5 minutes if needed. For asystole or severe bradycardia, pace first.

Answer: B

640 dynes·s·cm⁻⁵: This is half the correct value; it comes from leaving out the ×80 conversion factor or dividing incorrectly.

1,280 dynes·s·cm⁻⁵: Correct. SVR = (MAP − CVP) × 80 ÷ CO = (74 − 10) × 80 ÷ 4.0 = 1,280 dynes·s·cm⁻⁵, slightly above the normal 800–1,200.

1,480 dynes·s·cm⁻⁵: This uses MAP without subtracting CVP (74 × 80 ÷ 4.0); the driving pressure is MAP minus CVP.

1,600 dynes·s·cm⁻⁵: This uses a factor of 100 instead of 80 ((74 − 10) × 100 ÷ 4.0).

SVR = (MAP − CVP) × 80 ÷ CO; normal is about 800–1,200 dynes·s·cm⁻⁵. PVR = (mean PAP − PAOP) × 80 ÷ CO.