Emergency Nursing Orientation 3.0: Cardiovascular Emergencies Practice Exam

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• Troponin elevations may remain elevated for how long?
• What is the purpose of serial troponin measurements in ACS?
• In ACS planned for PCI, which antiplatelet strategy is typically added?
• During systemic thrombolysis for STEMI, what monitoring is essential?
• A patient with acute coronary syndrome presents a typical scenario for underlying coronary artery disease. Which statement best reflects the underlying cause in this context?
• What is the initial energy setting for biphasic defibrillation in ventricular fibrillation or pulseless VT?
• ECG finding typical of long QT syndrome and why clinically important in the ED?
• Which ECG lead setup provides the most comprehensive view for identifying ST-segment elevations in an acute myocardial infarction?
• When performing right-sided electrocardiography, which lead should you place at the fifth intercostal space in the right midaxillary line?
• What is the first step in suspected cardiogenic shock management in the ED?
• Beck's triad components in cardiac tamponade?
• The Hs and Ts are a mnemonic used to identify potential reversible causes during resuscitation. Which statement accurately describes their purpose?
• What does a troponin elevation indicate in acute coronary syndrome?
• For most ACS patients without hypoxemia, what oxygen strategy is recommended?
• For a patient with suspected acute coronary syndrome, which agent is not part of the recommended management?
• Transcutaneous pacing is indicated in the ED for which scenario?
• Hyperkalemia-induced cardiac arrest requires which treatment in addition to cardiopulmonary resuscitation?
• What are the classic signs of cardiac tamponade and which ECG finding is common?
• Which medication is a first-line agent for managing cardiac arrest?
• Electrical alternans on ECG most strongly indicates which condition, prompting urgent evaluation?
• What safety principle should guide CT imaging in ACS workup?
• Which patient is having a hypertensive emergency?
• What is the purpose of the 12-lead ECG in the context of STEMI?
• Which step is appropriate for suspected massive PE with shock?
• Why is maintaining adequate blood pressure important in ACS?
• Which drug is the go-to option for HR control in suspected aortic dissection before imaging?
• What is the preferred reperfusion strategy for STEMI when PCI is available?
• Which finding on ECG may obscure STEMI diagnosis?
• What is the role of bedside transthoracic echocardiography (POCUS) in suspected ACS?
• A hemodynamically unstable patient with atrial fibrillation and rapid ventricular response, what is the acute management?
• Which agents are commonly used as P2Y12 inhibitors in ACS?
• When is CT angiography preferred for suspected pulmonary embolism, and what are its limitations?
• After an acute myocardial infarction, which cardiac biomarker is released first?
• Which combination of therapies is commonly started early in ACS?
• Which dysrhythmia results from the continuous stimulation of two conduction pathways in the atrioventricular node?
• In the PAAS mnemonic for performing automated external defibrillation, what does the P stand for?
• A transcutaneous pacemaker is most likely an intervention for which dysrhythmia?
• From which point is door-to-balloon time measured in STEMI patients undergoing PCI?
• Which statement best differentiates NSTEMI from unstable angina?
• Essential elements of discharge planning after an ACS event?
• What is the purpose of targeted temperature management after cardiac arrest, and when is it indicated?
• A man with sharp chest pain that worsens with inspiration and fever has ST-segment elevations in all leads except aVR and V1. What is the most likely diagnosis?
• Current stance on routine oxygen therapy for all ACS patients?
• Which feature on presentation suggests aortic dissection rather than ACS?
• Which electrocardiogram leads reflect the inferior wall?
• Which bedside imaging modality helps identify LV wall motion abnormalities and guide treatment in ACS?
• Which of the following constitutes the initial cardiovascular rapid assessment (C-ABCDE) in a patient with chest pain?
• Which of the following is NOT included in the Hs and Ts of ACLS?
• Which disorder is potentially reversible if the cause is immediately treated?
• In ACS, what reperfusion strategy is preferred when PCI-capable facility is available?
• How is stable SVT typically managed in the ED?
• Which premature ventricular complex morphology involves multiple ventricular foci and typically requires monitoring?
• Troponin rise timeline after myocardial injury?
• What is the role of bedside focused echocardiography in acute cardiovascular emergencies?
• Which features raise suspicion for acute aortic dissection in a chest pain patient?
• What telemetry finding would prompt timely intervention?
• Which nursing considerations are important before giving IV contrast for cath in suspected ACS?
• What essential patient education content should be provided before discharge after a chest pain emergency?
• A preexcitation syndrome, such as Wolff-Parkinson-White syndrome, results from which conduction pattern?
• During resuscitation of a patient with ventricular fibrillation who has an implantable cardioverter-defibrillator, what is the recommended defibrillation approach?
• What is the primary goal of pharmacologic therapy in acute dissecting aneurysm?
• Which electrolyte abnormalities are most associated with a prolonged QT interval and torsades de pointes?
• Which route is commonly used to administer esmolol in the acute setting?
• Which dysrhythmia does a compensatory pause commonly occur?
• What is a primary goal of beta-blocker therapy in ACS?
• Which cardiac biomarker may result in a more timely and definitive diagnosis of myocardial injury?
• Which statement is true about adenosine use for SVT in patients with asthma or COPD?
• First-line pharmacologic therapy for acute aortic dissection aims to control heart rate and blood pressure; which drug is commonly used for rapid HR control?
• Which is a typical ECG feature of ventricular tachycardia?
• How can unstable angina be differentiated from NSTEMI in the ED?
• Occlusion of which artery is most commonly associated with an anterior wall infarction?
• Hyperkalemia ECG presentation and acute treatment sequence?
• In suspected aortic dissection, what is the immediate management priority?
• To blunt tachycardia and reduce shear during afterload reduction, which drug is used?
• In hypertensive emergency with acute LV failure in the ED, how is it typically managed?
• Which drug is administered to treat acutely decompensated heart failure?
• How is acute decompensated heart failure typically managed in the ED?
• After an initial 120–200 J shock, what energy is typically used for the next shock on a biphasic defibrillator?
• In the ED, what is the initial pharmacologic management for a patient with suspected ACS who is not in shock and has no contraindications to antiplatelet therapy?
• Which imaging modality helps differentiate ACS from aortic dissection in chest pain with suspected dissection?
• If beta-blockers are contraindicated for rate control of AF with RVR in ACS, which option is recommended?
• In suspected pulmonary embolism with shock, what emergent therapy may be considered if there are no contraindications?
• In new-onset atrial fibrillation with rapid ventricular response in ACS, what is first-line rate control if no contraindication?
• Which medication should be administered during resuscitation of a patient with ventricular fibrillation?
• What is the purpose of continuous telemetry monitoring in ACS?
• Which medication is the first one administered to a patient with pulseless electrical activity (PEA)?
• Which statement correctly describes the conduction pattern in Wolff-Parkinson-White syndrome?
• In an acute myocardial infarction, reciprocal ECG changes often appear as which finding?
• Which ECG leads reflect an anterior wall infarction?
• Which of the following is NOT a contraindication to nitroglycerin in ACS?
• In ACS, which scenario is a contraindication to beta-blocker therapy?
• Which leads reflect ischemic changes in the right coronary artery?
• Calcium channel blockers are indicated to treat which dysrhythmia?
• During systemic thrombolysis for STEMI, which procedure should be avoided if possible due to bleeding risk?
• Sodium bicarbonate is used with CPR for cardiac arrest caused by overdose of which class of antidepressants?
• Beck's triad is used to recognize cardiac tamponade. What is the emergent treatment?
• In hypertensive emergencies, what is a key principle for initial BP reduction?
• In acute aortic dissection, which short-acting beta-blocker is preferred for rapid HR control?
• Define cardiogenic shock and one key nursing intervention.
• Which rhythm is a common cause of sudden cardiac arrest?
• PE can mimic ACS; which diagnostic test supports the diagnosis of PE?
• Which score is most commonly used to guide invasive strategy decisions in ACS?
• Which energy level is appropriate for defibrillation in unstable polymorphic ventricular tachycardia?
• Which medication class is used for chest pain relief in ACS provided blood pressure is adequate?
• Damage to which area of the heart is most likely to result in severe heart failure when injured?
• Which electrolyte disturbance is most commonly associated with dangerous ventricular arrhythmias and should be corrected promptly?
• What is the initial management for torsades de pointes when magnesium therapy is not effective?
• How do ST elevations differ between STEMI due to myocardial infarction and diffuse ST elevations due to pericarditis?
• What is the initial aspirin dose in suspected ACS?
• A blockage of the left anterior descending coronary artery causes infarction of which part of the left ventricle?
• Why is exercise treadmill testing contraindicated in the ED when ACS is suspected?
• Which energy setting should be used first for synchronized cardioversion of stable, monomorphic ventricular tachycardia with a biphasic defibrillator?
• Electrical alternans on ECG indicates a large pericardial effusion with tamponade physiology. What is the most appropriate immediate clinical action?
• In a patient with pulseless ventricular tachycardia, what is the recommended sequence of actions?
• Which drug is used to manage a patient with a dissecting aneurysm to rapidly reduce heart rate and shear force?
• ST-segment elevation criteria for STEMI include?
• Which rhythm is commonly managed with calcium channel blockers for rate control?
• Which ECG finding is diagnostic of STEMI?
• Which medications started in the ED after ACS have mortality benefits and are standard of care?
• Why should nitrates be avoided in suspected right ventricular infarction?
• What ECG finding is characteristic of hyperkalemia, and how does it progress?
• When initiating dual antiplatelet therapy in ACS, which sequence and agents are typical?
• In a patient with ventricular fibrillation who has an implanted defibrillator, what is the recommended immediate intervention?
• Which sign or symptom is not expected in a patient with acute heart failure?
• In STEMI management when PCI is not immediately available, what is the next best reperfusion option?
• Which of the following criteria indicates readiness for discharge or observation vs admission after ACS evaluation?
• How can you differentiate acute pericarditis from ACS on ECG?
• What biomarker is useful for differentiating acute decompensated heart failure as a cause of chest pain or dyspnea?
• Drugs from which category reduce preload and afterload?
• Imaging confirms pericardial effusion with tamponade?
• What is the first-line ED therapy for acute decompensated heart failure with pulmonary edema?
• Which drug reduces preload and afterload?
• In addition to CPR, sodium bicarbonate is the treatment for cardiac arrest caused by which disorder?
• Urgent CABG is considered in ACS patients with multivessel disease when which condition is met?
• Which patients require dual antiplatelet therapy after STEMI or high-risk NSTEMI treated with PCI, and for how long?
• In acute decompensated heart failure, which therapy improves oxygenation and reduces work of breathing?
• What is the purpose of ALARA in imaging?
• Which rhythm often presents with P waves that are hidden, absent, or occur near the QRS and is associated with AV nodal pacing?
• What is the guideline-recommended door-to-balloon time for STEMI?
• In the acute setting of ACS, which statement about DOACs is true?
• Which disorder is likely to produce a delta wave on the cardiac monitor?
• Name an electrolyte abnormality that predisposes to arrhythmias and its correction.
• In an inferior STEMI, which artery is most commonly involved?
• Which ECG finding is most indicative of an acute STEMI?
• ACS with initially negative troponin: Next step?
• What does a positive troponin indicate in suspected ACS?
• A patient presents with suspected dissecting aneurysm; which IV agent is used to rapidly decrease heart rate?
• SVT with aberrant conduction may respond to which medication?
• Contraindications to nitroglycerin in ACS?
• Which statement best describes how esmolol works in acute dissecting aneurysm management?
• Which statement accurately describes the pathogenesis of atherosclerosis?
• For ACS patients who are not hypoxic, what SpO2 target is recommended?
• Name two P2Y12 inhibitors used in ACS and a key consideration for one of them.
• What is a potential adverse effect of esmolol in this setting?
• Right-sided infarction signs include?
• When should a patient with ACS be referred for catheterization and potential PCI?
• What are the main anticoagulant options used during ACS in the acute setting?
• Which statement reflects the safety consideration for CT imaging in women of childbearing age during ACS workup?
• In pregnancy-associated chest pain, which management approach is prioritized in the ED?
• In awake, cooperative patients with acute pulmonary edema, what is the role of CPAP or BiPAP?
• Which drug may be used to convert new-onset atrial fibrillation?
• What imaging or exam findings support a diagnosis of cardiac tamponade?
• Which statement does not accurately characterize intravenous nitroglycerin administration?
• Which chest-pain risk stratification tool is commonly used in ED to predict adverse cardiac events?
• In acute aortic dissection, which pharmacologic strategy reduces aortic wall shear stress?
• If PCI-capable facility is not available within an appropriate time window, what is an alternative reperfusion strategy?
• Which agent is commonly used in combination with esmolol to achieve blood pressure reduction in an acute aortic dissection?
• In acute aortic dissection management, after beta-blockade a vasodilator is used to achieve what?
• In an anterior STEMI, which artery is most commonly involved?
• Which disorder can initiate atrial flutter?
• Which characteristic of esmolol makes it especially suitable for acute management in a dissecting aneurysm?
• What is the initial management for unstable ventricular tachycardia?
• Patients with which type of premature complexes require close monitoring?
• Which rare mechanical complication of myocardial infarction can lead to tamponade?
• Which statement accurately describes targeted temperature management (TTM) after cardiac arrest?
• A patient presents with a headache, blurred vision, and a blood pressure of 280/150 mm Hg. Which drug is the most effective in rapidly managing this hypertensive crisis?
• What are the standard ECG criteria for diagnosing STEMI?
• In pregnancy-associated chest pain, which imaging approach best minimizes radiation exposure?
• The left circumflex branch supplies which area of the heart?
• A man, age 65, presents with chest pain and changes on his 12-lead electrocardiogram tracing. Which change suggests an acute myocardial infarction?
• Which intravenous vasodilator is commonly used in hypertensive emergencies to rapidly reduce afterload?
• Which biomarker rises earliest after myocardial infarction?
• Which leads reflect an inferior wall ischemia commonly associated with the right coronary artery?
• When is thrombolytic therapy indicated in STEMI, and what are key contraindications?
• In NSTEMI, what is the initial management priority in the ED?
• In a patient with suspected STEMI, what is the highest-priority initial action in the ED?
• Which medications are commonly prescribed after acute coronary syndrome for secondary prevention?
• Which finding on ECG favors ventricular tachycardia over SVT with aberrant conduction?
• In suspected massive PE with hemodynamic instability, what emergent management steps are indicated?
• What hemodynamic profile defines cardiogenic shock and which initial pharmacologic strategies are used?
• Which statement describes the role of noninvasive ventilation in heart failure management?
• In the initial management of suspected acute coronary syndrome, which medication is commonly given as an antiplatelet?
• Which adjunct is specifically used with CPR for hyperkalemia-induced cardiac arrest?
• Which drug is the prime example of the rapid-acting beta-blocker used in dissecting aneurysm management?
• In which dysrhythmia does the P wave disappear or occur just before or after the QRS complex?
• What is the purpose of performing a 12-lead ECG within 10 minutes of ED arrival for patients with chest pain?
• Which finding on the ECG is most consistent with an anterior wall myocardial infarction?
• Which dysrhythmia does an impulse originate in the AV junction before the next expected sinus impulse?
• Which disorder results from the inflammation, rupture, or erosion of atheromatous plaque in the coronary arteries?
• Troponin elevation indicates which condition in ACS evaluation?
• In suspected ACS, oxygen therapy should be administered?
• Which type of block causes one P wave to precede each QRS complex until a QRS complex is dropped in a regular pattern?
• Which anticoagulant is sometimes used in the catheterization lab during ACS?
• Nesiritide (Natrecor) is a medication used to treat acutely decompensated heart failure.
• Torsades de pointes due to QT prolongation: proper management?
• Atropine is most likely to restore adequate perfusion in which situation?
• A patient with electrocardiogram changes in leads V3 and V4 that reflect an infarction is experiencing an injury to which area of the heart?
• For synchronized cardioversion of stable monomorphic VT, what energy is recommended?
• A 52-year-old woman is found unresponsive and pulseless shortly after returning from lunch. What is the most likely cause of her cardiac arrest?
• Which non-ACS conditions can cause troponin elevations?
• Which bedside focused echo finding would prompt immediate management in an acute cardiovascular emergency?
• Which premature complex requires monitoring and is characterized by a single, premature beat from the ventricles that can be followed by a pause?
• List two mechanical complications of myocardial infarction that nurses must recognize early.
• Which dysrhythmia has an irregularly irregular ventricular response?
• Why should you avoid beta-blockers in ACS patients with signs of shock or severe bradycardia?
• Which energy strategy is described as delivering energy without synchronization to the heart during emergency rhythm management?
• The left circumflex artery supplies which area of the heart?
• What is the door-to-balloon time target for STEMI reperfusion with PCI?
• How does a right-sided infarction typically present and how should it be treated?
• Post-ACS discharge medications should typically include which combination?
• During CPR, what chest compression rate is recommended for adults?
• Which method delivers nonsynchronous energy to the myocardium?
• ACLS algorithm for pulseless VT/VF in ACS?
• Esmolol is best described as what type of drug?
• Which risk-scoring tools are commonly used in ACS to guide management decisions?
• For a patient suspected of having an aortic dissection, which intervention is appropriate?
• An unstable patient with polymorphic ventricular tachycardia requires which electrical treatment with a biphasic defibrillator?
• In an inferior STEMI suspected to involve the right coronary artery, which condition must be ruled out before giving nitrates?
• What is a typical heart rate goal when using esmolol for dissection management?
• Which element is NOT part of the HEART score?
• Which ECG finding supports discharge with outpatient follow-up after ACS evaluation?
• Ibuprofen (Motrin) is expected to be administered to a patient with which disorder?
• Which risk score is generally more predictive of mortality in ACS and is often used to guide invasive strategies and disposition?
• In suspected pulmonary embolism evaluated in the ED, which sequence of steps is appropriate?
• In ACLS, which antiarrhythmic is recommended for VT/VF if defibrillation is not converting the rhythm?
• In a patient with atrial fibrillation with rapid ventricular response who is unstable, what is the recommended intervention?
• Which syndrome causes a preexcitation ECG pattern due to an accessory conduction pathway?
• Role of CPAP/BiPAP in acute pulmonary edema due to heart failure?