ANSWERS|LATEST !!!!2026|GRADED A+| (EXAM
1. A pt presents to the ED experiencing an anterior ST segment elevation MI. The pts vital
signs are normal. The hospital is not equipped with a cardaic catheterization lab. The pt can
be transferred to a cardaic catheterization lab within 60 mins. Which of the following would
you anticipate for this pt?:
A. A bolus of tissue plasminogen activator, followed by an infusion for fibrinolytic therapy
B. Immediate transfer to the hospital with a cardiac catheterization lab for percutaneous
coronary intervention
C. A single bolus of tenecteplase (Tnkase) for fibrinolytic therapy
D. A bolus of reteplase (Retavase), followed by a second bolus of reteplase 30 mins later for
fibrinolytic therapy - ANSWER B. Immediate transfer to the hospital with a cardiac
catheterization lab for percutaneous coronary intervention
In adult pts presenting with a STEMI of a hospital that does not have PCI capability, it is
recommended that the pt be transferred immediately without fibrinolytics to a PCI center,
instead of immediate fibrinolysis at the intial hospital with transfer onlu for ischemia driven
PCI
2. An anxious pt arrives by ambulance following an acute onset of difficulty breathing. The pt
is diaphoretic and denies chest pain. High-flow O2 by non-rebreather mask has been
applied. Vitals: BP 210/140, HR 130, RR 32, SpO2 88%. In addition to initiating noninvasive
ventilation to treat the pts difficulty breathing, the nurse anticipates the administration of
which medication to further treat the pts symptoms?:
A. Morphine (Morphine sulfate)
B. Furosemide (Lasix)
C. Initation of a continuous nitroglycerin infusion
D. Acetylsalicylic acid (Aspirin) - ANSWER C. Initation of a continuous nitroglycerin
infusion
1
,Pts who present with acute pulmonary edema are typically markedly hypertensive and in
acute respiratory distress. Rapid initiation of appropriate treatment is vital to reversing the
neurohormonal surge and rescuing pts from respiratory and complete cardiac failure.
Nitroglycerin is the most important first line medication in treatment of acute pulmonary
edema and respiratory distress. The initation of continuous NTG infusion at low doses acts as
a vasodilator, leading to decreased preload: at higher doses ( >100mcg/min) acts as a potent
afterload reducer
3. An unrestrained driver is brought to the ED following a motor vehicle collision. The pt
reports hitting their chest on the steering wheel and is complaining of chest pain across the
front of their chest. There are no vital sign abnormalities and no other complaints of pain.
The diagnosis of blunt cardiac injury is considered. The nurse anticipates an order for which
of the following?:
A. EKG
B. Cardiac marker evaluation (CK or Troponin)
C. Cardiac monitoring
D. Chest radiograph - ANSWER B. Cardiac marker evaluation (CK or Troponin)
Not all trauma pts with blunt cardiac injury will have acute alterations in cardiac markers,
and other organ injury may cause release of creatinine kinase and confound the diagnosis of
blunt cardiac injury
4. Which of the following is a form of distributive shock?:
A. Neurogenic
B. Metabolic
C. Respiratory
D. Obstructive - ANSWER A. Neurogenic
5. A pt presents following an acute onset of chest pain, dyspnea and severe diaphoresis,
with near syncope. Assessment shows a pt in severe distress, with HR 110, BP 60/40 and RR
36 with bilateral rales. An EKG reveals ST segment elevation across the precordial leads. A
2
,diagnosis of acute MI with cardiogenic shock is made, and the pt is being prepared for
transfer to the cardiac cath lab. The vasopressor of choice, based on this pts degree of
hypotension is:
A. Norepineprhine (Levophed)
B. Dopamine (Inotropin)
C. Dobutamine (Dobutrex)
D. Vasopressin (Pitressin) - ANSWER A. Norepineprhine (Levophed)
The intial use of norepinephrine for marked hypotension, <70mmHg systolic is the current
recommendation from the AHA
6. A pt presents with complaints of chest pain that radiates to the jaw, stating the pain is a
6/10. Other symptoms include nausea, dizziness, shortness of breath with clear lung sounds,
and a sense of impending doom. The pain started 40 mins before arrival. Vitals: BP 116/58,
HR 98, RR 20, SpO2 94%, T 98.6F. The 12 lead EKG shows inferior wall myocardial injury
pattern. Which clinical presentations indicate the need to complete a right sided 12 lead
EKG?:
A. Shortness of breath with clear lung sounds
B. Nausea and dizziness
C. Chest pain with radiation to the jaw
D. Sense of impending doom - ANSWER A. Shortness of breath with clear lung
sounds
Classic right ventricular infarcts are associated with the absence of pulmonary congestion
Think: RIGHT to my foot
7. Following the successful resuscitation of a pt in a cardiac arrest, which of the following
findings is the best indicator high-quality CPR?:
A. A compression depth of 1 1/2 inches
3
, B. Palpable pulses with the preformance of chest compressions during CPR
C. A decrease of skin and mucus membrane cyanosis
D. An increasing end tital Co2 level - ANSWER D. An increasing end tital Co2 level
An increasing end-tidal carbon dioxide level indicates increasing cellular perfusion with
effective CPR or ROSC
8. During transcutaneous pacing for a pt in third-degree heart block, there is a loss of
ventricular capture. Which is a significant physiological reason for loss of a pacemaker
capture?:
A. Metabolic alkalosis
B. Hypomagnesemia
C. Lactic acidosis
D. Hypokalemia - ANSWER C. Lactic acidosis
Lactic acidosis alters the contractility of the myocardium, leading to decreased abilty to gain
ventricular capture, this results in lack of tissue perfusion
9. A pt presents with complaints of lightheadedness, weakness and near syncope. The pts 12
lead EKG reveals the presence of 2:1 arterial flutter. The most appropriate intervention for
this presentation with arterial flutter rhythm is to preform:
A. Synchronized cardioversion at 50 joules
B. Unsynchronized cardioversion at 120 joules
C. Unsynchronized cardioversion at 50 joules
D. Synchronized cardioversion at 120 joules - ANSWER A. Synchronized
cardioversion at 50 joules
Synchronized cardioversion is reccomended for rhythms with a normal width QRS complex.
A pt with new onset atrial flutter, who is experiencing chest pain, shortness of breath or
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1. A pt presents to the ED experiencing an anterior ST segment elevation MI. The pts vital
signs are normal. The hospital is not equipped with a cardaic catheterization lab. The pt can
be transferred to a cardaic catheterization lab within 60 mins. Which of the following would
you anticipate for this pt?:
A. A bolus of tissue plasminogen activator, followed by an infusion for fibrinolytic therapy
B. Immediate transfer to the hospital with a cardiac catheterization lab for percutaneous
coronary intervention
C. A single bolus of tenecteplase (Tnkase) for fibrinolytic therapy
D. A bolus of reteplase (Retavase), followed by a second bolus of reteplase 30 mins later for
fibrinolytic therapy - ANSWER B. Immediate transfer to the hospital with a cardiac
catheterization lab for percutaneous coronary intervention
In adult pts presenting with a STEMI of a hospital that does not have PCI capability, it is
recommended that the pt be transferred immediately without fibrinolytics to a PCI center,
instead of immediate fibrinolysis at the intial hospital with transfer onlu for ischemia driven
PCI
2. An anxious pt arrives by ambulance following an acute onset of difficulty breathing. The pt
is diaphoretic and denies chest pain. High-flow O2 by non-rebreather mask has been
applied. Vitals: BP 210/140, HR 130, RR 32, SpO2 88%. In addition to initiating noninvasive
ventilation to treat the pts difficulty breathing, the nurse anticipates the administration of
which medication to further treat the pts symptoms?:
A. Morphine (Morphine sulfate)
B. Furosemide (Lasix)
C. Initation of a continuous nitroglycerin infusion
D. Acetylsalicylic acid (Aspirin) - ANSWER C. Initation of a continuous nitroglycerin
infusion
1
,Pts who present with acute pulmonary edema are typically markedly hypertensive and in
acute respiratory distress. Rapid initiation of appropriate treatment is vital to reversing the
neurohormonal surge and rescuing pts from respiratory and complete cardiac failure.
Nitroglycerin is the most important first line medication in treatment of acute pulmonary
edema and respiratory distress. The initation of continuous NTG infusion at low doses acts as
a vasodilator, leading to decreased preload: at higher doses ( >100mcg/min) acts as a potent
afterload reducer
3. An unrestrained driver is brought to the ED following a motor vehicle collision. The pt
reports hitting their chest on the steering wheel and is complaining of chest pain across the
front of their chest. There are no vital sign abnormalities and no other complaints of pain.
The diagnosis of blunt cardiac injury is considered. The nurse anticipates an order for which
of the following?:
A. EKG
B. Cardiac marker evaluation (CK or Troponin)
C. Cardiac monitoring
D. Chest radiograph - ANSWER B. Cardiac marker evaluation (CK or Troponin)
Not all trauma pts with blunt cardiac injury will have acute alterations in cardiac markers,
and other organ injury may cause release of creatinine kinase and confound the diagnosis of
blunt cardiac injury
4. Which of the following is a form of distributive shock?:
A. Neurogenic
B. Metabolic
C. Respiratory
D. Obstructive - ANSWER A. Neurogenic
5. A pt presents following an acute onset of chest pain, dyspnea and severe diaphoresis,
with near syncope. Assessment shows a pt in severe distress, with HR 110, BP 60/40 and RR
36 with bilateral rales. An EKG reveals ST segment elevation across the precordial leads. A
2
,diagnosis of acute MI with cardiogenic shock is made, and the pt is being prepared for
transfer to the cardiac cath lab. The vasopressor of choice, based on this pts degree of
hypotension is:
A. Norepineprhine (Levophed)
B. Dopamine (Inotropin)
C. Dobutamine (Dobutrex)
D. Vasopressin (Pitressin) - ANSWER A. Norepineprhine (Levophed)
The intial use of norepinephrine for marked hypotension, <70mmHg systolic is the current
recommendation from the AHA
6. A pt presents with complaints of chest pain that radiates to the jaw, stating the pain is a
6/10. Other symptoms include nausea, dizziness, shortness of breath with clear lung sounds,
and a sense of impending doom. The pain started 40 mins before arrival. Vitals: BP 116/58,
HR 98, RR 20, SpO2 94%, T 98.6F. The 12 lead EKG shows inferior wall myocardial injury
pattern. Which clinical presentations indicate the need to complete a right sided 12 lead
EKG?:
A. Shortness of breath with clear lung sounds
B. Nausea and dizziness
C. Chest pain with radiation to the jaw
D. Sense of impending doom - ANSWER A. Shortness of breath with clear lung
sounds
Classic right ventricular infarcts are associated with the absence of pulmonary congestion
Think: RIGHT to my foot
7. Following the successful resuscitation of a pt in a cardiac arrest, which of the following
findings is the best indicator high-quality CPR?:
A. A compression depth of 1 1/2 inches
3
, B. Palpable pulses with the preformance of chest compressions during CPR
C. A decrease of skin and mucus membrane cyanosis
D. An increasing end tital Co2 level - ANSWER D. An increasing end tital Co2 level
An increasing end-tidal carbon dioxide level indicates increasing cellular perfusion with
effective CPR or ROSC
8. During transcutaneous pacing for a pt in third-degree heart block, there is a loss of
ventricular capture. Which is a significant physiological reason for loss of a pacemaker
capture?:
A. Metabolic alkalosis
B. Hypomagnesemia
C. Lactic acidosis
D. Hypokalemia - ANSWER C. Lactic acidosis
Lactic acidosis alters the contractility of the myocardium, leading to decreased abilty to gain
ventricular capture, this results in lack of tissue perfusion
9. A pt presents with complaints of lightheadedness, weakness and near syncope. The pts 12
lead EKG reveals the presence of 2:1 arterial flutter. The most appropriate intervention for
this presentation with arterial flutter rhythm is to preform:
A. Synchronized cardioversion at 50 joules
B. Unsynchronized cardioversion at 120 joules
C. Unsynchronized cardioversion at 50 joules
D. Synchronized cardioversion at 120 joules - ANSWER A. Synchronized
cardioversion at 50 joules
Synchronized cardioversion is reccomended for rhythms with a normal width QRS complex.
A pt with new onset atrial flutter, who is experiencing chest pain, shortness of breath or
4
