NRNP6566 Week 5 Knowledge Check - Walden
University AGACNP Program 2026-2027 -
Advanced Acute Care Adults
30 items | 100 % guideline-driven next step | 45 min
SECTION 1 Acute Coronary Syndrome & Heart Failure (Q 1 – 12)
Q1
58-y/o M, 45 min crushing chest pain → jaw, ECG: 3 mm STE V2-V4, pain-free post NTG,
stable vitals. ACC/AHA next priority?
A. Aspirin 325 mg chew
B. Activate cath lab for primary PCI
C. Start heparin drip
D. More NTG
Answer: B – STEMI: door-to-balloon < 90 min; activation precedes other meds.
,Q2
72-y/o F, ADHF, dyspnea at rest, crackles, BP 180/110, SpO₂ 88 % RA, CXR pulmonary
edema. First-line rapid preload/afterload reduction?
A. IV furosemide
B. SL/IV nitroglycerin
C. PO lisinopril
D. IV morphine
Answer: B – NTG: venodilator → ↓ preload; arterial dilator → ↓ afterload; works in
minutes.
Q3
65-y/o, narrow-complex tachycardia 160 bpm, regular, no P waves, BP 118/70, alert.
ACLS first maneuver?
A. Adenosine 6 mg IV push
B. Vagal maneuvers
C. Diltiazem drip
D. Synchronized cardioversion
, Answer: B – stable SVT: vagal first; adenosine if vagals fail.
Q4
HEART score 4 (moderate risk), negative initial troponin. Next step?
A. Discharge home
B. Admit for serial troponins
C. Immediate CTA
D. Stress test today
Answer: B – moderate risk → observation ± serial biomarkers; stress test if low-risk
later.
Q5
NSTEMI, TIMI score 5, CrCl 40 mL/min. Which anticoagulant?
A. Enoxaparin 1 mg/kg SC q12h
B. Enoxaparin 1 mg/kg SC daily
C. Bivalirudin IV
D. Fondaparinux 2.5 mg SC daily
University AGACNP Program 2026-2027 -
Advanced Acute Care Adults
30 items | 100 % guideline-driven next step | 45 min
SECTION 1 Acute Coronary Syndrome & Heart Failure (Q 1 – 12)
Q1
58-y/o M, 45 min crushing chest pain → jaw, ECG: 3 mm STE V2-V4, pain-free post NTG,
stable vitals. ACC/AHA next priority?
A. Aspirin 325 mg chew
B. Activate cath lab for primary PCI
C. Start heparin drip
D. More NTG
Answer: B – STEMI: door-to-balloon < 90 min; activation precedes other meds.
,Q2
72-y/o F, ADHF, dyspnea at rest, crackles, BP 180/110, SpO₂ 88 % RA, CXR pulmonary
edema. First-line rapid preload/afterload reduction?
A. IV furosemide
B. SL/IV nitroglycerin
C. PO lisinopril
D. IV morphine
Answer: B – NTG: venodilator → ↓ preload; arterial dilator → ↓ afterload; works in
minutes.
Q3
65-y/o, narrow-complex tachycardia 160 bpm, regular, no P waves, BP 118/70, alert.
ACLS first maneuver?
A. Adenosine 6 mg IV push
B. Vagal maneuvers
C. Diltiazem drip
D. Synchronized cardioversion
, Answer: B – stable SVT: vagal first; adenosine if vagals fail.
Q4
HEART score 4 (moderate risk), negative initial troponin. Next step?
A. Discharge home
B. Admit for serial troponins
C. Immediate CTA
D. Stress test today
Answer: B – moderate risk → observation ± serial biomarkers; stress test if low-risk
later.
Q5
NSTEMI, TIMI score 5, CrCl 40 mL/min. Which anticoagulant?
A. Enoxaparin 1 mg/kg SC q12h
B. Enoxaparin 1 mg/kg SC daily
C. Bivalirudin IV
D. Fondaparinux 2.5 mg SC daily
