Acute Care Nurse Practitioner Cardiovascular Emergencies and Arrhythmia Management 2

Question 1

Which ECG finding is characteristic of Wolff-Parkinson-White (WPW) syndrome?

Accepted Answer

Short PR interval with delta wave and wide QRS

Answer

WPW shows a short PR interval (<120 ms), delta wave (slurred QRS upstroke), and wide QRS from pre-excitation via the accessory pathway.

Question 2

A patient with WPW develops rapid atrial fibrillation. Which drug is CONTRAINDICATED?

Accepted Answer

Adenosine

Answer

Adenosine blocks the AV node in WPW-AF, preferentially routing conduction down the fast accessory pathway and potentially causing ventricular fibrillation.

Question 3

Which parameter is used to decide between synchronized cardioversion and defibrillation?

Accepted Answer

Presence of organized QRS complexes

Answer

Synchronized cardioversion is used when organized QRS complexes are present (AF, flutter, SVT, VT with pulse); defibrillation is for VF/pulseless VT.

Question 4

An ACNP manages a patient with new-onset rapid ventricular response atrial fibrillation and LVEF of 25%. Which rate control agent is preferred?

Accepted Answer

Digoxin IV

Answer

Digoxin is preferred for rate control in AF with reduced EF (HFrEF) because beta-blockers and calcium channel blockers may further depress cardiac output.

Question 5

Which intervention is indicated for a patient in third-degree (complete) AV block with a ventricular rate of 28 bpm and hypotension?

Accepted Answer

Administer atropine 0.5 mg IV and prepare for transvenous pacing

Answer

Atropine is the first-line pharmacologic treatment for symptomatic bradycardia while arranging emergency transvenous pacing.

Acute Care Nurse Practitioner Practice Test

Acute Care Nurse Practitioner Practice Test

Acute Care Nurse Practitioner Cardiovascular Emergencies and Arrhythmia Management 2