NR 571 MIDTERM STUDY SET EXAM
QUESTIONS AND ANSWERS 2026
VERIFIED.
What is high sensitivity troponin and when to use? - ANS first line test for cardiac cell
damage
used for initial injury
What is CKMB - ANS CK isoenzyme specific to cardiac muscle tissue (MI)
When should CKMB be used? - ANS for suspicion of secondary ischemia after an initial
infarct
normal level for Troponin I - ANS <0.04
normal level for CKMB - ANS 3-5% of total CK
What is BNP - ANS B-type natriuretic peptide
Normal BNP levels - ANS <100 pg/mL
1
,Differential for chest pain - ANS Consider:
Myocardium- angina, MI, myocarditis, heart failure
Pericardium- pericarditis
Aorta- dissecting aortic aneurysm
Trachea and bronchi- bronchitis
Parietal pleura- pericarditis, pneumonia, pneumothorax, pleural effusion, pulmonary embolus
Chest wall- costochondritis, herpes zoster
Esophagus- reflux, esophageal spasm, esophageal tear
Referred pain from elsewhere- cervical arthritis, biliary colic, gastritis
Psych: anxiety attacks
Revascularization in under ____ minutes - ANS 90
Initial diagnostics for chest pain - ANS 12-lead EKG
Troponin q3h x3 at least
BNP - HF
CBC - baseline H&H and Plts
PTT, PT/INR - baseline coagulation status
BMP - renal function and lytes
TSH, Mg, and Phos
ECHO
Cath
Requirements for STEMI dx - ANS new ST elevation in 2 contiguous leads of >0.1 mV
except V2&V3
elevated troponin
2
,STEMI findings in V2-V3 - ANS >0.2mV in >40yo M
>0.25 mV in <40 yo M
>0.15 mV in women
Difference between NSTEMI and unstable angina - ANS NSTEMI involves Elevated Cardiac
Bio markers (cell death)
NSTEMI & unstable angina tx - ANS Dual antiplatelet therapy
Full-dose AC
High-intensity statin
BB
Nitrates
oxygen
pain medication
Dual antiplatelet therapy - ANS DAPT
Aspirin (325 x1 = daily 81mg)
AND
P2Y2 inhibitor
clopidogrel or ticagrelor
full dose AC - ANS SQ lovenox 1mg/kg BID
if PCI planned of low GFR use heparin gtt
50-70 units/kg bolus plus 12units/kg/hr titrated to PTT 1.5-2.5 x baseline
3
, High-intensity statin - ANS atorvastatin 40-80 mg or rosuvastatin 20-40 mg
Considerations for BB avoiding BB use - ANS HR <60
SBP <100
EF <30%
PR >240 ms
2nd or 3rd degree HB
active asthma or reactive airway disease
COPD
Cocaine use
When is NGT contraindicated? - ANS RV infarct b/c it reduces preload
Absolute contraindications for fibrinolytic therapy - ANS Any prior ICH
known structural cerebral vascular lesions
known malignant intracranial neoplasm
Ischemic stroke <3mo unless <4.5 h
suspected aortic dissection
active bleeding
significant closed head or facial trauma within 3mo
severe uncontrolled hypertension (unresponsive to therapy)
Identification of LBBB - ANS QRS is negatively deflected in V1
Identification of RBBB - ANS QRS is positively deflected in V1
4
QUESTIONS AND ANSWERS 2026
VERIFIED.
What is high sensitivity troponin and when to use? - ANS first line test for cardiac cell
damage
used for initial injury
What is CKMB - ANS CK isoenzyme specific to cardiac muscle tissue (MI)
When should CKMB be used? - ANS for suspicion of secondary ischemia after an initial
infarct
normal level for Troponin I - ANS <0.04
normal level for CKMB - ANS 3-5% of total CK
What is BNP - ANS B-type natriuretic peptide
Normal BNP levels - ANS <100 pg/mL
1
,Differential for chest pain - ANS Consider:
Myocardium- angina, MI, myocarditis, heart failure
Pericardium- pericarditis
Aorta- dissecting aortic aneurysm
Trachea and bronchi- bronchitis
Parietal pleura- pericarditis, pneumonia, pneumothorax, pleural effusion, pulmonary embolus
Chest wall- costochondritis, herpes zoster
Esophagus- reflux, esophageal spasm, esophageal tear
Referred pain from elsewhere- cervical arthritis, biliary colic, gastritis
Psych: anxiety attacks
Revascularization in under ____ minutes - ANS 90
Initial diagnostics for chest pain - ANS 12-lead EKG
Troponin q3h x3 at least
BNP - HF
CBC - baseline H&H and Plts
PTT, PT/INR - baseline coagulation status
BMP - renal function and lytes
TSH, Mg, and Phos
ECHO
Cath
Requirements for STEMI dx - ANS new ST elevation in 2 contiguous leads of >0.1 mV
except V2&V3
elevated troponin
2
,STEMI findings in V2-V3 - ANS >0.2mV in >40yo M
>0.25 mV in <40 yo M
>0.15 mV in women
Difference between NSTEMI and unstable angina - ANS NSTEMI involves Elevated Cardiac
Bio markers (cell death)
NSTEMI & unstable angina tx - ANS Dual antiplatelet therapy
Full-dose AC
High-intensity statin
BB
Nitrates
oxygen
pain medication
Dual antiplatelet therapy - ANS DAPT
Aspirin (325 x1 = daily 81mg)
AND
P2Y2 inhibitor
clopidogrel or ticagrelor
full dose AC - ANS SQ lovenox 1mg/kg BID
if PCI planned of low GFR use heparin gtt
50-70 units/kg bolus plus 12units/kg/hr titrated to PTT 1.5-2.5 x baseline
3
, High-intensity statin - ANS atorvastatin 40-80 mg or rosuvastatin 20-40 mg
Considerations for BB avoiding BB use - ANS HR <60
SBP <100
EF <30%
PR >240 ms
2nd or 3rd degree HB
active asthma or reactive airway disease
COPD
Cocaine use
When is NGT contraindicated? - ANS RV infarct b/c it reduces preload
Absolute contraindications for fibrinolytic therapy - ANS Any prior ICH
known structural cerebral vascular lesions
known malignant intracranial neoplasm
Ischemic stroke <3mo unless <4.5 h
suspected aortic dissection
active bleeding
significant closed head or facial trauma within 3mo
severe uncontrolled hypertension (unresponsive to therapy)
Identification of LBBB - ANS QRS is negatively deflected in V1
Identification of RBBB - ANS QRS is positively deflected in V1
4
