MEDICAL SURGICAL TELEMETRY AND CARDIAC
TEST PAIN NEWEST ACTUAL EXAM QUESTIONS
AND CORRECT DETAILED ANSWERS LATEST
2026/2027 (100% VERIFIED ANSWERS) ALREADY
GRADED A+
1. A 62-year-old patient presents to the emergency department with crushing substernal
chest pain radiating to the left arm and jaw for the past 30 minutes. Which nursing action
should be performed first?
A. Administer prescribed morphine.
B. Obtain a 12-lead ECG immediately.
C. Prepare the patient for discharge.
D. Encourage the patient to ambulate.
Answer: B. Obtain a 12-lead ECG immediately.
Rationale: A patient with symptoms suggestive of acute coronary syndrome (ACS) should
receive a 12-lead ECG as soon as possible to help identify STEMI or other ischemic changes.
Early ECG evaluation supports timely diagnosis and treatment. Other interventions such as
medications are guided by the patient's assessment, ECG findings, and provider orders.
2. Which assessment finding is most characteristic of myocardial ischemia?
A. Sharp pain that worsens with inspiration.
B. Pressure-like chest discomfort that may radiate to the arm, jaw, shoulder, or back.
C. Localized pain relieved by palpation.
D. Burning pain relieved immediately by eating.
Answer: B. Pressure-like chest discomfort that may radiate to the arm, jaw, shoulder, or back.
,Rationale: Myocardial ischemia commonly presents as pressure, heaviness, squeezing, or
tightness in the chest. The discomfort may radiate to the left arm, neck, jaw, shoulder, or back
and may be accompanied by diaphoresis, nausea, or shortness of breath.
3. Which cardiac biomarker is the most specific indicator of myocardial injury?
A. Myoglobin
B. Lactate dehydrogenase (LDH)
C. Cardiac troponin (Troponin I or Troponin T)
D. Creatine kinase (CK)
Answer: C. Cardiac troponin (Troponin I or Troponin T)
Rationale: Cardiac troponins are the preferred biomarkers for detecting myocardial injury
because of their high sensitivity and specificity. Elevated troponin levels support the diagnosis
of myocardial infarction when interpreted in the appropriate clinical context.
4. A patient reports chest pain rated 8/10. Which assessment question is most important
when applying the PQRST pain assessment?
A. "What is your favorite activity?"
B. "Can you describe what the pain feels like?"
C. "How much do you weigh?"
D. "What did you eat yesterday?"
Answer: B. "Can you describe what the pain feels like?"
Rationale: The PQRST assessment evaluates Provocation/Palliation, Quality,
Region/Radiation, Severity, and Timing. Asking the patient to describe the quality of the pain
helps differentiate cardiac pain from other causes.
5. Which telemetry rhythm requires immediate nursing assessment because it may indicate a
life-threatening condition?
A. Normal sinus rhythm.
B. Sinus arrhythmia.
C. Ventricular tachycardia.
D. Sinus bradycardia in a sleeping patient.
,Answer: C. Ventricular tachycardia.
Rationale: Ventricular tachycardia can significantly reduce cardiac output and may deteriorate
into ventricular fibrillation. The nurse should immediately assess the patient, determine
whether a pulse is present, and follow organizational protocols and Advanced Cardiac Life
Support (ACLS) guidelines as appropriate.
6. Which electrolyte imbalance most commonly increases the risk for ventricular
dysrhythmias?
A. Hypercalcemia
B. Hypermagnesemia
C. Hypokalemia
D. Hypernatremia
Answer: C. Hypokalemia
Rationale: Hypokalemia increases myocardial irritability and can predispose patients to
ventricular ectopy, ventricular tachycardia, and other potentially serious dysrhythmias.
Prompt recognition and correction are important.
7. Which patient statement is most consistent with unstable angina?
A. "The chest discomfort occurs only after strenuous exercise and goes away with rest."
B. "The chest pain started while I was resting and is becoming more frequent."
C. "The pain occurs only after eating spicy foods."
D. "The discomfort is relieved by changing positions."
Answer: B. "The chest pain started while I was resting and is becoming more frequent."
Rationale: Unstable angina is characterized by new-onset chest pain, pain occurring at rest,
increasing frequency or severity, or pain that is less responsive to rest or nitroglycerin. It
requires prompt medical evaluation.
8. Which medication is commonly administered early in suspected acute coronary syndrome,
unless contraindicated, because of its antiplatelet effect?
A. Furosemide
B. Aspirin
C. Digoxin
, D. Warfarin
Answer: B. Aspirin
Rationale: Aspirin inhibits platelet aggregation and reduces thrombus formation. Early
administration in suspected ACS, when appropriate and not contraindicated, is associated
with improved clinical outcomes.
9. A patient receiving nitroglycerin reports dizziness after administration. What is the nurse's
priority action?
A. Encourage the patient to walk.
B. Administer another dose immediately.
C. Assess blood pressure and ensure patient safety due to the risk of hypotension.
D. Discontinue all cardiac medications permanently.
Answer: C. Assess blood pressure and ensure patient safety due to the risk of hypotension.
Rationale: Nitroglycerin causes vasodilation and may lower blood pressure. The nurse should
monitor blood pressure, assess symptoms, and help prevent falls or injury associated with
hypotension.
10. Which ECG finding is most suggestive of acute ST-elevation myocardial infarction (STEMI)?
A. Flattened P waves.
B. Prolonged PR interval.
C. ST-segment elevation in contiguous leads.
D. Isolated premature atrial contractions.
Answer: C. ST-segment elevation in contiguous leads.
Rationale: ST-segment elevation in anatomically contiguous leads suggests acute transmural
myocardial injury and warrants immediate evaluation for reperfusion therapy when clinically
appropriate.
11. A telemetry alarm sounds. What is the nurse's first action?
A. Silence the alarm permanently.
B. Call the physician before assessing the patient.
C. Assess the patient first to determine clinical status and verify the rhythm.
TEST PAIN NEWEST ACTUAL EXAM QUESTIONS
AND CORRECT DETAILED ANSWERS LATEST
2026/2027 (100% VERIFIED ANSWERS) ALREADY
GRADED A+
1. A 62-year-old patient presents to the emergency department with crushing substernal
chest pain radiating to the left arm and jaw for the past 30 minutes. Which nursing action
should be performed first?
A. Administer prescribed morphine.
B. Obtain a 12-lead ECG immediately.
C. Prepare the patient for discharge.
D. Encourage the patient to ambulate.
Answer: B. Obtain a 12-lead ECG immediately.
Rationale: A patient with symptoms suggestive of acute coronary syndrome (ACS) should
receive a 12-lead ECG as soon as possible to help identify STEMI or other ischemic changes.
Early ECG evaluation supports timely diagnosis and treatment. Other interventions such as
medications are guided by the patient's assessment, ECG findings, and provider orders.
2. Which assessment finding is most characteristic of myocardial ischemia?
A. Sharp pain that worsens with inspiration.
B. Pressure-like chest discomfort that may radiate to the arm, jaw, shoulder, or back.
C. Localized pain relieved by palpation.
D. Burning pain relieved immediately by eating.
Answer: B. Pressure-like chest discomfort that may radiate to the arm, jaw, shoulder, or back.
,Rationale: Myocardial ischemia commonly presents as pressure, heaviness, squeezing, or
tightness in the chest. The discomfort may radiate to the left arm, neck, jaw, shoulder, or back
and may be accompanied by diaphoresis, nausea, or shortness of breath.
3. Which cardiac biomarker is the most specific indicator of myocardial injury?
A. Myoglobin
B. Lactate dehydrogenase (LDH)
C. Cardiac troponin (Troponin I or Troponin T)
D. Creatine kinase (CK)
Answer: C. Cardiac troponin (Troponin I or Troponin T)
Rationale: Cardiac troponins are the preferred biomarkers for detecting myocardial injury
because of their high sensitivity and specificity. Elevated troponin levels support the diagnosis
of myocardial infarction when interpreted in the appropriate clinical context.
4. A patient reports chest pain rated 8/10. Which assessment question is most important
when applying the PQRST pain assessment?
A. "What is your favorite activity?"
B. "Can you describe what the pain feels like?"
C. "How much do you weigh?"
D. "What did you eat yesterday?"
Answer: B. "Can you describe what the pain feels like?"
Rationale: The PQRST assessment evaluates Provocation/Palliation, Quality,
Region/Radiation, Severity, and Timing. Asking the patient to describe the quality of the pain
helps differentiate cardiac pain from other causes.
5. Which telemetry rhythm requires immediate nursing assessment because it may indicate a
life-threatening condition?
A. Normal sinus rhythm.
B. Sinus arrhythmia.
C. Ventricular tachycardia.
D. Sinus bradycardia in a sleeping patient.
,Answer: C. Ventricular tachycardia.
Rationale: Ventricular tachycardia can significantly reduce cardiac output and may deteriorate
into ventricular fibrillation. The nurse should immediately assess the patient, determine
whether a pulse is present, and follow organizational protocols and Advanced Cardiac Life
Support (ACLS) guidelines as appropriate.
6. Which electrolyte imbalance most commonly increases the risk for ventricular
dysrhythmias?
A. Hypercalcemia
B. Hypermagnesemia
C. Hypokalemia
D. Hypernatremia
Answer: C. Hypokalemia
Rationale: Hypokalemia increases myocardial irritability and can predispose patients to
ventricular ectopy, ventricular tachycardia, and other potentially serious dysrhythmias.
Prompt recognition and correction are important.
7. Which patient statement is most consistent with unstable angina?
A. "The chest discomfort occurs only after strenuous exercise and goes away with rest."
B. "The chest pain started while I was resting and is becoming more frequent."
C. "The pain occurs only after eating spicy foods."
D. "The discomfort is relieved by changing positions."
Answer: B. "The chest pain started while I was resting and is becoming more frequent."
Rationale: Unstable angina is characterized by new-onset chest pain, pain occurring at rest,
increasing frequency or severity, or pain that is less responsive to rest or nitroglycerin. It
requires prompt medical evaluation.
8. Which medication is commonly administered early in suspected acute coronary syndrome,
unless contraindicated, because of its antiplatelet effect?
A. Furosemide
B. Aspirin
C. Digoxin
, D. Warfarin
Answer: B. Aspirin
Rationale: Aspirin inhibits platelet aggregation and reduces thrombus formation. Early
administration in suspected ACS, when appropriate and not contraindicated, is associated
with improved clinical outcomes.
9. A patient receiving nitroglycerin reports dizziness after administration. What is the nurse's
priority action?
A. Encourage the patient to walk.
B. Administer another dose immediately.
C. Assess blood pressure and ensure patient safety due to the risk of hypotension.
D. Discontinue all cardiac medications permanently.
Answer: C. Assess blood pressure and ensure patient safety due to the risk of hypotension.
Rationale: Nitroglycerin causes vasodilation and may lower blood pressure. The nurse should
monitor blood pressure, assess symptoms, and help prevent falls or injury associated with
hypotension.
10. Which ECG finding is most suggestive of acute ST-elevation myocardial infarction (STEMI)?
A. Flattened P waves.
B. Prolonged PR interval.
C. ST-segment elevation in contiguous leads.
D. Isolated premature atrial contractions.
Answer: C. ST-segment elevation in contiguous leads.
Rationale: ST-segment elevation in anatomically contiguous leads suggests acute transmural
myocardial injury and warrants immediate evaluation for reperfusion therapy when clinically
appropriate.
11. A telemetry alarm sounds. What is the nurse's first action?
A. Silence the alarm permanently.
B. Call the physician before assessing the patient.
C. Assess the patient first to determine clinical status and verify the rhythm.
