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I-HUMAN CASES EXAM: EMERGENCY/ACUTE CARE EXAM
2026 QUESTIONS LATEST VERSION QUESTIONS AND
ANSWERS
i-Human Cases Exam: Emergency/Acute Care
70 Questions with Detailed Rationales
Based on Common i-Human Virtual Simulation Scenarios
CASE 1: 45-Year-Old Male with Chest Pain – Myocardial Infarction (Questions 1-12)
Question 1
A 45-year-old male with a history of hypertension and hyperlipidemia presents to the
Emergency Department with crushing substernal chest pain radiating to his left arm.
His pain started 45 minutes ago while he was shoveling snow. He is diaphoretic and
nauseous. What is the priority nursing action?
A) Administer aspirin and obtain a 12-lead ECG
B) Draw blood for cardiac enzymes
C) Administer oxygen via face mask
D) All of the above
Answer: D
Rationale: The priority for a suspected myocardial infarction is a comprehensive approach:
administer aspirin (chewed), obtain a 12-lead ECG, draw cardiac enzymes (troponin), and
administer oxygen if hypoxemic. Rapid assessment and treatment are essential to reduce
mortality. Time is muscle.
Question 2
The patient's ECG shows ST-segment elevation in leads V1-V4. What is the most likely
location of the myocardial infarction?
A) Inferior wall MI
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B) Anterior wall MI
C) Lateral wall MI
D) Posterior wall MI
Answer: B
Rationale: ST-segment elevation in leads V1-V4 indicates an anterior wall myocardial
infarction, which is typically caused by occlusion of the left anterior descending (LAD)
artery. Anterior wall MIs have a higher risk of complications including heart failure and
cardiogenic shock.
Question 3
What is the most appropriate immediate treatment for an ST-elevation myocardial
infarction (STEMI)?
A) Percutaneous coronary intervention (PCI) within 90 minutes
B) Thrombolytic therapy if PCI is not available
C) Aspirin and antiplatelet therapy
D) All of the above
Answer: D
Rationale: STEMI treatment includes PCI (door-to-balloon time <90 minutes), thrombolytic
therapy if PCI is not available, aspirin, and antiplatelet therapy (clopidogrel, ticagrelor). The
goal is to restore blood flow to the affected artery as quickly as possible.
Question 4
What is the most important medication to administer immediately for a STEMI?
A) Aspirin
B) Nitroglycerin
C) Morphine
D) Heparin
Answer: A
Rationale: Aspirin is critical for acute MI, reducing mortality by inhibiting platelet
aggregation. It should be administered as soon as possible. Nitroglycerin and morphine are
used for pain relief; heparin is used for anticoagulation.
Question 5
The patient's troponin I level is elevated. What is the significance of this finding?
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A) Confirms myocardial injury
B) Confirms heart failure
C) Confirms arrhythmia
D) Confirms pulmonary embolism
Answer: A
Rationale: Elevated troponin I indicates myocardial injury. It is the most specific and
sensitive biomarker for MI. Troponin levels rise within 3-4 hours of symptom onset and
remain elevated for up to 2 weeks.
Question 6
What is the most appropriate pain management for a patient with an MI?
A) Morphine IV
B) Fentanyl IV
C) Nitroglycerin sublingual
D) Both A and C
Answer: D
Rationale: Morphine IV and nitroglycerin sublingual are used for pain relief in MI.
Morphine reduces pain and anxiety, and nitroglycerin causes vasodilation, reducing preload
and myocardial oxygen demand.
Question 7
The patient's blood pressure is 90/60 mm Hg and heart rate is 110 bpm. What does this
indicate?
A) Normal vital signs
B) Cardiogenic shock
C) Hypertension
D) Pain
Answer: B
Rationale: Hypotension and tachycardia indicate cardiogenic shock, a life-threatening
complication of MI. This requires immediate intervention with inotropes, vasopressors, and
possibly mechanical circulatory support.
Question 8
What is the most appropriate treatment for cardiogenic shock in a patient with an MI?
I-HUMAN CASES EXAM: EMERGENCY/ACUTE CARE EXAM
2026 QUESTIONS LATEST VERSION QUESTIONS AND
ANSWERS
i-Human Cases Exam: Emergency/Acute Care
70 Questions with Detailed Rationales
Based on Common i-Human Virtual Simulation Scenarios
CASE 1: 45-Year-Old Male with Chest Pain – Myocardial Infarction (Questions 1-12)
Question 1
A 45-year-old male with a history of hypertension and hyperlipidemia presents to the
Emergency Department with crushing substernal chest pain radiating to his left arm.
His pain started 45 minutes ago while he was shoveling snow. He is diaphoretic and
nauseous. What is the priority nursing action?
A) Administer aspirin and obtain a 12-lead ECG
B) Draw blood for cardiac enzymes
C) Administer oxygen via face mask
D) All of the above
Answer: D
Rationale: The priority for a suspected myocardial infarction is a comprehensive approach:
administer aspirin (chewed), obtain a 12-lead ECG, draw cardiac enzymes (troponin), and
administer oxygen if hypoxemic. Rapid assessment and treatment are essential to reduce
mortality. Time is muscle.
Question 2
The patient's ECG shows ST-segment elevation in leads V1-V4. What is the most likely
location of the myocardial infarction?
A) Inferior wall MI
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B) Anterior wall MI
C) Lateral wall MI
D) Posterior wall MI
Answer: B
Rationale: ST-segment elevation in leads V1-V4 indicates an anterior wall myocardial
infarction, which is typically caused by occlusion of the left anterior descending (LAD)
artery. Anterior wall MIs have a higher risk of complications including heart failure and
cardiogenic shock.
Question 3
What is the most appropriate immediate treatment for an ST-elevation myocardial
infarction (STEMI)?
A) Percutaneous coronary intervention (PCI) within 90 minutes
B) Thrombolytic therapy if PCI is not available
C) Aspirin and antiplatelet therapy
D) All of the above
Answer: D
Rationale: STEMI treatment includes PCI (door-to-balloon time <90 minutes), thrombolytic
therapy if PCI is not available, aspirin, and antiplatelet therapy (clopidogrel, ticagrelor). The
goal is to restore blood flow to the affected artery as quickly as possible.
Question 4
What is the most important medication to administer immediately for a STEMI?
A) Aspirin
B) Nitroglycerin
C) Morphine
D) Heparin
Answer: A
Rationale: Aspirin is critical for acute MI, reducing mortality by inhibiting platelet
aggregation. It should be administered as soon as possible. Nitroglycerin and morphine are
used for pain relief; heparin is used for anticoagulation.
Question 5
The patient's troponin I level is elevated. What is the significance of this finding?
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A) Confirms myocardial injury
B) Confirms heart failure
C) Confirms arrhythmia
D) Confirms pulmonary embolism
Answer: A
Rationale: Elevated troponin I indicates myocardial injury. It is the most specific and
sensitive biomarker for MI. Troponin levels rise within 3-4 hours of symptom onset and
remain elevated for up to 2 weeks.
Question 6
What is the most appropriate pain management for a patient with an MI?
A) Morphine IV
B) Fentanyl IV
C) Nitroglycerin sublingual
D) Both A and C
Answer: D
Rationale: Morphine IV and nitroglycerin sublingual are used for pain relief in MI.
Morphine reduces pain and anxiety, and nitroglycerin causes vasodilation, reducing preload
and myocardial oxygen demand.
Question 7
The patient's blood pressure is 90/60 mm Hg and heart rate is 110 bpm. What does this
indicate?
A) Normal vital signs
B) Cardiogenic shock
C) Hypertension
D) Pain
Answer: B
Rationale: Hypotension and tachycardia indicate cardiogenic shock, a life-threatening
complication of MI. This requires immediate intervention with inotropes, vasopressors, and
possibly mechanical circulatory support.
Question 8
What is the most appropriate treatment for cardiogenic shock in a patient with an MI?
