1. A patient with heart failure has an ejection fraction of 35%. What does
this indicate? A) Normal heart function B) Heart failure with preserved
ejection fraction C) Heart failure with reduced ejection fraction D) Diastolic
dysfunction only
Answer: C - Normal EF is 55-70%. EF <40% indicates heart failure with
reduced ejection fraction (HFrEF).
2. Which medication class is considered first-line for heart failure with
reduced ejection fraction? A) Calcium channel blockers B) ACE inhibitors C)
Digoxin D) Diuretics only
Answer: B - ACE inhibitors (or ARBs) are first-line along with beta-blockers
and aldosterone antagonists for HFrEF.
3. A patient presents with chest pain. Which finding most strongly suggests
myocardial infarction? A) Pain relieved by antacids B) ST-segment elevation
on ECG C) Pain lasting 2 minutes D) Pain with deep breathing
Answer: B - ST-segment elevation indicates acute MI (STEMI) requiring
immediate intervention.
4. What is the priority intervention for a patient with STEMI? A)
Administer morphine B) Start oxygen at 6 L/min C) Reperfusion therapy within
90 minutes D) Obtain cardiac enzymes
Answer: C - Door-to-balloon time should be <90 minutes for PCI or
fibrinolytics within 30 minutes.
5. A patient's troponin level is elevated 6 hours after chest pain. What does
this indicate? A) Normal finding B) Myocardial damage C) Kidney failure D)
Medication side effect
Answer: B - Elevated troponin indicates myocardial cell damage/death.
6. Which symptom is most characteristic of left-sided heart failure? A)
Peripheral edema B) Jugular venous distension C) Pulmonary crackles D)
Hepatomegaly
, Answer: C - Left-sided failure causes pulmonary congestion with crackles,
dyspnea, and orthopnea.
7. A patient has BP of 210/120 mmHg with severe headache and blurred
vision. This represents: A) Hypertensive urgency B) Hypertensive emergency
C) Stage 1 hypertension D) White coat syndrome
Answer: B - BP >180/120 with symptoms of organ damage is a hypertensive
emergency.
8. Which assessment finding indicates cardiac tamponade? A) Bounding
pulses B) Beck's triad C) Loud S3 heart sound D) Bradycardia
Answer: B - Beck's triad: hypotension, muffled heart sounds, and JVD indicate
tamponade.
9. A patient with atrial fibrillation has a CHA2DS2-VASc score of 4. What
is indicated? A) No anticoagulation needed B) Aspirin only C) Anticoagulation
therapy D) Cardioversion only
Answer: C - Score ≥2 in men or ≥3 in women indicates need for
anticoagulation.
10. What is the therapeutic INR range for a patient on warfarin for atrial
fibrillation? A) 1.0-1.5 B) 2.0-3.0 C) 3.0-4.0 D) 4.0-5.0
Answer: B - Therapeutic INR for most indications including AFib is 2.0-3.0.
11. Which finding suggests digoxin toxicity? A) Tachycardia B) Visual
disturbances (yellow-green halos) C) Hypertension D) Increased appetite
Answer: B - Digoxin toxicity causes visual changes, nausea, bradycardia, and
arrhythmias.
12. A patient taking ACE inhibitors should be monitored for: A)
Hyperkalemia B) Hypokalemia C) Hypercalcemia D) Hyponatremia
Answer: A - ACE inhibitors cause potassium retention, leading to
hyperkalemia.
13. What is the most common side effect of ACE inhibitors? A) Diarrhea B)
Dry cough C) Weight gain D) Hypokalemia
Answer: B - Dry, persistent cough occurs in 10-20% of patients on ACE
inhibitors.
14. A patient has an ankle-brachial index (ABI) of 0.6. This indicates: A)
Normal perfusion B) Mild PAD C) Moderate PAD D) Severe PAD
this indicate? A) Normal heart function B) Heart failure with preserved
ejection fraction C) Heart failure with reduced ejection fraction D) Diastolic
dysfunction only
Answer: C - Normal EF is 55-70%. EF <40% indicates heart failure with
reduced ejection fraction (HFrEF).
2. Which medication class is considered first-line for heart failure with
reduced ejection fraction? A) Calcium channel blockers B) ACE inhibitors C)
Digoxin D) Diuretics only
Answer: B - ACE inhibitors (or ARBs) are first-line along with beta-blockers
and aldosterone antagonists for HFrEF.
3. A patient presents with chest pain. Which finding most strongly suggests
myocardial infarction? A) Pain relieved by antacids B) ST-segment elevation
on ECG C) Pain lasting 2 minutes D) Pain with deep breathing
Answer: B - ST-segment elevation indicates acute MI (STEMI) requiring
immediate intervention.
4. What is the priority intervention for a patient with STEMI? A)
Administer morphine B) Start oxygen at 6 L/min C) Reperfusion therapy within
90 minutes D) Obtain cardiac enzymes
Answer: C - Door-to-balloon time should be <90 minutes for PCI or
fibrinolytics within 30 minutes.
5. A patient's troponin level is elevated 6 hours after chest pain. What does
this indicate? A) Normal finding B) Myocardial damage C) Kidney failure D)
Medication side effect
Answer: B - Elevated troponin indicates myocardial cell damage/death.
6. Which symptom is most characteristic of left-sided heart failure? A)
Peripheral edema B) Jugular venous distension C) Pulmonary crackles D)
Hepatomegaly
, Answer: C - Left-sided failure causes pulmonary congestion with crackles,
dyspnea, and orthopnea.
7. A patient has BP of 210/120 mmHg with severe headache and blurred
vision. This represents: A) Hypertensive urgency B) Hypertensive emergency
C) Stage 1 hypertension D) White coat syndrome
Answer: B - BP >180/120 with symptoms of organ damage is a hypertensive
emergency.
8. Which assessment finding indicates cardiac tamponade? A) Bounding
pulses B) Beck's triad C) Loud S3 heart sound D) Bradycardia
Answer: B - Beck's triad: hypotension, muffled heart sounds, and JVD indicate
tamponade.
9. A patient with atrial fibrillation has a CHA2DS2-VASc score of 4. What
is indicated? A) No anticoagulation needed B) Aspirin only C) Anticoagulation
therapy D) Cardioversion only
Answer: C - Score ≥2 in men or ≥3 in women indicates need for
anticoagulation.
10. What is the therapeutic INR range for a patient on warfarin for atrial
fibrillation? A) 1.0-1.5 B) 2.0-3.0 C) 3.0-4.0 D) 4.0-5.0
Answer: B - Therapeutic INR for most indications including AFib is 2.0-3.0.
11. Which finding suggests digoxin toxicity? A) Tachycardia B) Visual
disturbances (yellow-green halos) C) Hypertension D) Increased appetite
Answer: B - Digoxin toxicity causes visual changes, nausea, bradycardia, and
arrhythmias.
12. A patient taking ACE inhibitors should be monitored for: A)
Hyperkalemia B) Hypokalemia C) Hypercalcemia D) Hyponatremia
Answer: A - ACE inhibitors cause potassium retention, leading to
hyperkalemia.
13. What is the most common side effect of ACE inhibitors? A) Diarrhea B)
Dry cough C) Weight gain D) Hypokalemia
Answer: B - Dry, persistent cough occurs in 10-20% of patients on ACE
inhibitors.
14. A patient has an ankle-brachial index (ABI) of 0.6. This indicates: A)
Normal perfusion B) Mild PAD C) Moderate PAD D) Severe PAD
