Hi Dan,
In the limiting case, all tests are multidimensional in that each item really represents its own unique factor, though this is useless for understanding the empirical world. On the other hand, a one factor model effectively tries as hard as possible to force all items to be independent after removing one common axis of variation, which could fail if the items have more in common than just a single dominating factor. The local dependence measures like Cramer's V really are just present to detect whether there are any bivariate residual relationships present between items that could be a problem, and might be worth modeling. There's no guarantee that there is more 'in common' over and above bivariate comparisons, but if a common structure can be identified empirically and rationally then a multidimensional model should be considered more plausible. Note that lack of detecting more than 1 factor in the data does suggest that there probably are no other dominant traits that should be modeled (largely a function of statistical/measurement power), but it doesn't patch the problem of residual dependencies between items.
In your case, I might consider fitting a bifactor model with specific bivariate testlet effects (with slopes constrained to be equal to each other for identification) to account for the covariation between residuals, and thereby avoid the bias that could be invoked by these bivariate dependencies in the general trait of interest. At the very least this would address the residual covariation in an attempt to unbias the quasi-unidimensional trait, though of course doing so is not always free (costs degrees of freedom, and suggests a specific, modelable relationship between residuals). HTH.