HESI Exit Exam Question Bank: Cardiovascular Emergencies & Post-MI Nursing Care

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HESI Exit Exam Question Bank:
Cardiovascular Emergencies & Post-
MI Nursing Care



Table of Contents
Subtopic 1: Acute Coronary Syndrome (ACS) and ST-Elevation Myocardial
Infarction (STEMI).............................................................................................2
Subtopic 2: Cardiogenic Shock and Hemodynamic Monitoring......................10
Subtopic 3: Post-MI Complications and Management....................................18
Subtopic 4: Cardiac Medications and Emergency Pharmacology...................27
Subtopic 5: Cardiac Monitoring and Dysrhythmias Post-MI............................36
Subtopic 6: Heart Failure and Long-Term Management After MI....................44
Subtopic 7: Emergency Procedures and Advanced Cardiac Life Support
(ACLS)............................................................................................................52
Subtopic 8: Anticoagulation, Antiplatelets, and Medication Safety Post-MI. . .61
Subtopic 9: Nursing Priorities and Patient Education After Cardiovascular
Emergencies..................................................................................................69
Subtopic 10: Advanced Practice Considerations and Complications After MI 78

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Subtopic 1: Acute Coronary Syndrome (ACS)
and ST-Elevation Myocardial Infarction (STEMI)
Question 1:

A patient presents with substernal chest pain radiating to the left arm,
shortness of breath, and diaphoresis. ECG shows ST elevation in leads II, III,
and aVF. What is the most appropriate initial treatment?

A. Nitroglycerin patch

B. Aspirin 325 mg orally

C. Intramuscular morphine

D. Immediate stress testing



Correct Answer: B. Aspirin 325 mg orally

Rationale: Aspirin should be administered immediately to inhibit platelet
aggregation and reduce mortality in STEMI. ST elevation in II, III, and aVF
suggests an inferior wall MI.



Question 2:

Which biomarker is most specific and reliable for diagnosing myocardial
infarction within the first 3 hours of symptom onset?

A. CK-MB

B. Cardiac Troponin I

C. Myoglobin

D. LDH



Correct Answer: B. Cardiac Troponin I

Rationale: Cardiac Troponin I is highly specific and sensitive for myocardial
injury and is preferred for early diagnosis.

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Question 3:

A patient diagnosed with STEMI is being considered for thrombolytic therapy.
Which of the following is an absolute contraindication?

A. Active peptic ulcer disease

B. Age > 75

C. History of hemorrhagic stroke

D. Hypertension controlled with medication



Correct Answer: C. History of hemorrhagic stroke

Rationale: A previous hemorrhagic stroke is an absolute contraindication to
thrombolytics due to high risk of re-bleeding.



Question 4:

Which ECG changes are characteristic of a posterior myocardial infarction?

A. ST elevation in V1-V3

B. T wave inversion in V2-V4

C. ST depression in V1-V3

D. Q waves in leads II, III



Correct Answer: C. ST depression in V1-V3

Rationale: Posterior MI presents with reciprocal ST depressions in anterior
leads (V1-V3).



Question 5:

What is the recommended door-to-balloon time for PCI in patients with
STEMI?

A. 120 minutes

B. 60 minutes

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C. 90 minutes

D. 30 minutes



Correct Answer: C. 90 minutes

Rationale: Guidelines recommend PCI within 90 minutes of arrival for STEMI
to minimize myocardial damage.



Question 6:

What is the primary goal of nitroglycerin administration in acute MI?

A. To reduce anxiety

B. To increase heart rate

C. To decrease myocardial oxygen demand

D. To raise blood pressure



Correct Answer: C. To decrease myocardial oxygen demand

Rationale: Nitroglycerin reduces preload and afterload, thereby decreasing
oxygen demand of the heart.



Question 7:

Which of the following medications is typically given first in the MONA
protocol for acute coronary syndrome?

A. Nitroglycerin

B. Oxygen

C. Aspirin

D. Morphine



Correct Answer: B. Oxygen