SCRIBE AMERICA FINAL EXAM RETAKE
ACTUAL EXAM QUESTIONS AND
CORRECT DETAILED ANSWERS WITH
RATIONALES|A GRADE
What is the number one risk factor for MI? - ✔✔CAD
How do you test for the severity of CAD? - ✔✔Stress Test or Cardiac
Catheterization
PMHx of angina, MI, CABG, Cardiac Stents, or angioplasty (Balloon) - ✔✔pt also
has CAD
CABG - ✔✔Coronary Artery Bypass Graft
If pt is experiencing chest pain, they will always be given
____________________, unless _______________________________________.
- ✔✔325 mg ASA, it was given PTA or if pain is a result of bleeding or if there is
an allergy
Coronary Artery Disease (CAD) - ✔✔Narrowing of the coronary arteries limits
blood supply to the heart muscle causing angina
Angina - ✔✔chest pain specifically due to heart-muscle ischemia
How is CAD Dx? - ✔✔Cardiac Catherization
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©JOSHCLAY 2025/2026. YEAR PUBLISHED 2025.
,"I am having chest pain with physical exertion" - ✔✔investigate CAD
Chest pain or pressure which is worsen by exertion and improved with NTG or
rest - ✔✔CAD
Associated Meds for CAD - ✔✔Aspirin (ASA) and Nitroglycerin (NTG)
Myocardial Infarction (MI) - ✔✔Acute blockage of the coronary arteries results
in ischemia and infarct of the heart muscle
What is the Ddx? "I am having chest pressure, I feel really sick, I threw up this
morning and I am really winded" - ✔✔Myocardial Infarction (MI)
What tests should be ordered with ddx of MI? - ✔✔EKG and blood test
What is the difference between STEMI and NON-STEMI? - ✔✔STEMI - ST
Elevation on the EKG and (+) Troponin
NON-STEMI - No ST wave elevation on EKG and (+) Troponin
How do you differentiate between a pt with MI and a pt without MI? - ✔✔order
EKG and blood test, look for elevated ST wave and elevated Troponin levels. If
yes, MI, if normal not MI
Congestive Heart Failure (CHF) - ✔✔The heart becomes enlarged, inefficient,
and congested with excess fluid
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©JOSHCLAY 2025/2026. YEAR PUBLISHED 2025.
, What is the DDx? "I have shortness of breath that gets worse when I am lying
down, and my legs are swelling up." PE finds rales in the lungs and JVD in the
neck, and pitting pedal edema. - ✔✔Congestive Heart Failure (CHF), Dr. should
run an EKG and get blood work, Cardiac Catheterization is not done in the ER so
pt should also follow up with PCP or cardiologist
BNP is what? - ✔✔B-Type Natriuretic Peptide
Marker for ventricle, used to dx CHF
What is done immediately for acute MI pts? - ✔✔given 325 mg of ASA
What is done for STEMI pts? - ✔✔Must be transferred to the cath lab within 90
mins of arrival. Always document pt arrival and depart times!!
What does an elevated ST dx? - ✔✔STEMI-MI
CCs with CHF - ✔✔SOB, Orthopnea, paroxysmal nocturnal dyspnea (PND), and
Dyspnea on Exertion (DOE)
DOE - ✔✔dyspnea on exertion - shortness of breath with exertion... commonly
found with CHF
PND - ✔✔Paroxysmal Nocturnal Dyspnea, sensation of shortness of breath that
awakens the patient, often after 1 or 2 hours of sleep and is usually relieved in
the upright position.
3|Page
©JOSHCLAY 2025/2026. YEAR PUBLISHED 2025.
ACTUAL EXAM QUESTIONS AND
CORRECT DETAILED ANSWERS WITH
RATIONALES|A GRADE
What is the number one risk factor for MI? - ✔✔CAD
How do you test for the severity of CAD? - ✔✔Stress Test or Cardiac
Catheterization
PMHx of angina, MI, CABG, Cardiac Stents, or angioplasty (Balloon) - ✔✔pt also
has CAD
CABG - ✔✔Coronary Artery Bypass Graft
If pt is experiencing chest pain, they will always be given
____________________, unless _______________________________________.
- ✔✔325 mg ASA, it was given PTA or if pain is a result of bleeding or if there is
an allergy
Coronary Artery Disease (CAD) - ✔✔Narrowing of the coronary arteries limits
blood supply to the heart muscle causing angina
Angina - ✔✔chest pain specifically due to heart-muscle ischemia
How is CAD Dx? - ✔✔Cardiac Catherization
1|Page
©JOSHCLAY 2025/2026. YEAR PUBLISHED 2025.
,"I am having chest pain with physical exertion" - ✔✔investigate CAD
Chest pain or pressure which is worsen by exertion and improved with NTG or
rest - ✔✔CAD
Associated Meds for CAD - ✔✔Aspirin (ASA) and Nitroglycerin (NTG)
Myocardial Infarction (MI) - ✔✔Acute blockage of the coronary arteries results
in ischemia and infarct of the heart muscle
What is the Ddx? "I am having chest pressure, I feel really sick, I threw up this
morning and I am really winded" - ✔✔Myocardial Infarction (MI)
What tests should be ordered with ddx of MI? - ✔✔EKG and blood test
What is the difference between STEMI and NON-STEMI? - ✔✔STEMI - ST
Elevation on the EKG and (+) Troponin
NON-STEMI - No ST wave elevation on EKG and (+) Troponin
How do you differentiate between a pt with MI and a pt without MI? - ✔✔order
EKG and blood test, look for elevated ST wave and elevated Troponin levels. If
yes, MI, if normal not MI
Congestive Heart Failure (CHF) - ✔✔The heart becomes enlarged, inefficient,
and congested with excess fluid
2|Page
©JOSHCLAY 2025/2026. YEAR PUBLISHED 2025.
, What is the DDx? "I have shortness of breath that gets worse when I am lying
down, and my legs are swelling up." PE finds rales in the lungs and JVD in the
neck, and pitting pedal edema. - ✔✔Congestive Heart Failure (CHF), Dr. should
run an EKG and get blood work, Cardiac Catheterization is not done in the ER so
pt should also follow up with PCP or cardiologist
BNP is what? - ✔✔B-Type Natriuretic Peptide
Marker for ventricle, used to dx CHF
What is done immediately for acute MI pts? - ✔✔given 325 mg of ASA
What is done for STEMI pts? - ✔✔Must be transferred to the cath lab within 90
mins of arrival. Always document pt arrival and depart times!!
What does an elevated ST dx? - ✔✔STEMI-MI
CCs with CHF - ✔✔SOB, Orthopnea, paroxysmal nocturnal dyspnea (PND), and
Dyspnea on Exertion (DOE)
DOE - ✔✔dyspnea on exertion - shortness of breath with exertion... commonly
found with CHF
PND - ✔✔Paroxysmal Nocturnal Dyspnea, sensation of shortness of breath that
awakens the patient, often after 1 or 2 hours of sleep and is usually relieved in
the upright position.
3|Page
©JOSHCLAY 2025/2026. YEAR PUBLISHED 2025.
