CEN FINAL EXAM 2 VERSIONS | PRACTICE EXAM
QUESTIONS WITH DETAILED 100% CORRECT
ANSWERS | ALREADY GRADED A+
1. A pt presents to the ED complaining of a 2 day history of a dull
substernal ache that has continued to increase in intensity. The pt states
that they had some relief after taking nitro yesterday. Vitals: 114/68 BP, 68
HR, 22RR. The EKG demonstrates a new onset of left bundle branch
block. The priority intervention for this pt is:
A. Continue monitoring for development of ST segment elevation
B. Serial cardiac markers
C. Preparing the pt for transport to interventional cardiology
D. Admission to a telemetry unit for observation - Correct Answer C.
Preparing the pt for transport to interventional cardiology
New onset of a left bundle branch block is treated as ST segment elevation
MI. The pt should be prepared for percutaneous transluminal coronary
angioplasty and early reperfusion of the myocardium
,2. During the completion of a 12 lead EKG, the nurse identifies excessive
artifact in lead II and III. To resolve this technical difficulty, the nurse
should:
A. Change the R arm electrode
B. Check for cable movement
C. Change the L Leg electrode
D. Instruct the pt to momentarily hold their breath - Correct Answer C.
Change the L leg electrode
The L leg electrode is common to both lead II and III. The development of
artifact and decreased conductivity results when the conducting gel in the
electrode becomes dry
3. When determining the presence of ST segment elevation on an EKG,
the ST segment is compared to which interval or segment of the EKG?
A. P-R interval
B. T-P interval
C. Q-T interval
D. P-R segment - Correct Answer B. T-P interval
,T-P interval represents the interval between the end of ventricular re-
polarization and the beginning of atrial depolarization. This interval
represents an absence of electrical heart activity and therefore is used as
the isoelectric reference for the presence of ST segment elevation or
depression
4. A middle aged pt presents to the ED via EMS. The pt states that they
were awoken from sleep with midsternal chest pain approx 4-5 hours ago.
In the presence of an acute MI, the initial elevation of the troponin cardiac
biomarkers occur within:
A. 1-2 hours after onset of an AMI
B. 4-8 hours after onset of an AMI
C. 24-30 hours after onset of an AMI
D. 10-24 hours after onset of an AMI - Correct Answer B. 4-8 hours after
onset of an AMI
Troponin biomarkers provide a bioassay to measure proteins found in the
myofibrils of the heart muscle. Troponin are detectable based on assay 4-8
hours after the AMI. Troponin levels will peak at 18-24 hours following AMI
, 5. The nurse suspects a patient may have an acute aortic-dissection when,
during the history taking process, the pt describes the pain as:
A. Squeezing, burning epigastric pain that may radiate to the middle back
area
B. Right upper quadrant pain referred to right scapula and shoulder
C. Sudden, severe tearing or ripping chest, interscapular or back pain
D. Sharp, stabbing chest pain radiating to neck, arms or left shoulder -
Correct Answer C. Sudden, severe tearing or ripping chest, intrscapular or
back pain
This is a presentation of AAA
6. You are assisting in the resuscitation of an elderly patient in cardiac
arrest. A waveform capnography is in place and high-quality CPR is being
preformed. A sudden increase in the level of the end-total CO2 indicates:
A. Need for deeper and faster chest compressions
B. Need for additional dose of vasopressor, such as IV bolus EPI
C. Presence of an irreversible cardiac arrest
D. Return of spontaneous circulation - Correct Answer D. Return of
spontaneous circulation
QUESTIONS WITH DETAILED 100% CORRECT
ANSWERS | ALREADY GRADED A+
1. A pt presents to the ED complaining of a 2 day history of a dull
substernal ache that has continued to increase in intensity. The pt states
that they had some relief after taking nitro yesterday. Vitals: 114/68 BP, 68
HR, 22RR. The EKG demonstrates a new onset of left bundle branch
block. The priority intervention for this pt is:
A. Continue monitoring for development of ST segment elevation
B. Serial cardiac markers
C. Preparing the pt for transport to interventional cardiology
D. Admission to a telemetry unit for observation - Correct Answer C.
Preparing the pt for transport to interventional cardiology
New onset of a left bundle branch block is treated as ST segment elevation
MI. The pt should be prepared for percutaneous transluminal coronary
angioplasty and early reperfusion of the myocardium
,2. During the completion of a 12 lead EKG, the nurse identifies excessive
artifact in lead II and III. To resolve this technical difficulty, the nurse
should:
A. Change the R arm electrode
B. Check for cable movement
C. Change the L Leg electrode
D. Instruct the pt to momentarily hold their breath - Correct Answer C.
Change the L leg electrode
The L leg electrode is common to both lead II and III. The development of
artifact and decreased conductivity results when the conducting gel in the
electrode becomes dry
3. When determining the presence of ST segment elevation on an EKG,
the ST segment is compared to which interval or segment of the EKG?
A. P-R interval
B. T-P interval
C. Q-T interval
D. P-R segment - Correct Answer B. T-P interval
,T-P interval represents the interval between the end of ventricular re-
polarization and the beginning of atrial depolarization. This interval
represents an absence of electrical heart activity and therefore is used as
the isoelectric reference for the presence of ST segment elevation or
depression
4. A middle aged pt presents to the ED via EMS. The pt states that they
were awoken from sleep with midsternal chest pain approx 4-5 hours ago.
In the presence of an acute MI, the initial elevation of the troponin cardiac
biomarkers occur within:
A. 1-2 hours after onset of an AMI
B. 4-8 hours after onset of an AMI
C. 24-30 hours after onset of an AMI
D. 10-24 hours after onset of an AMI - Correct Answer B. 4-8 hours after
onset of an AMI
Troponin biomarkers provide a bioassay to measure proteins found in the
myofibrils of the heart muscle. Troponin are detectable based on assay 4-8
hours after the AMI. Troponin levels will peak at 18-24 hours following AMI
, 5. The nurse suspects a patient may have an acute aortic-dissection when,
during the history taking process, the pt describes the pain as:
A. Squeezing, burning epigastric pain that may radiate to the middle back
area
B. Right upper quadrant pain referred to right scapula and shoulder
C. Sudden, severe tearing or ripping chest, interscapular or back pain
D. Sharp, stabbing chest pain radiating to neck, arms or left shoulder -
Correct Answer C. Sudden, severe tearing or ripping chest, intrscapular or
back pain
This is a presentation of AAA
6. You are assisting in the resuscitation of an elderly patient in cardiac
arrest. A waveform capnography is in place and high-quality CPR is being
preformed. A sudden increase in the level of the end-total CO2 indicates:
A. Need for deeper and faster chest compressions
B. Need for additional dose of vasopressor, such as IV bolus EPI
C. Presence of an irreversible cardiac arrest
D. Return of spontaneous circulation - Correct Answer D. Return of
spontaneous circulation
