Acute Care Nurse Practitioner Cardiovascular Emergencies and Arrhythmia Management

Question 1

A patient presents with acute anterior STEMI. What is the preferred reperfusion strategy when PCI can be performed within 90 minutes?

Accepted Answer

Primary percutaneous coronary intervention (PCI)

Answer

Fibrinolytic therapy

Answer

Emergency CABG

Answer

Conservative medical management

Question 2

Which ECG finding is diagnostic of ST-elevation myocardial infarction (STEMI) in two contiguous leads?

Accepted Answer

New LBBB or ST elevation ≥1 mm (≥2 mm in V1-V3)

Answer

ST depression >1 mm

Answer

T-wave inversions >2 mm

Answer

Prolonged QT interval >500 ms

Question 3

A patient with acute decompensated heart failure (ADHF) has an SpO₂ of 85% on room air and BP 150/90. Which is the MOST appropriate initial intervention?

Accepted Answer

Administer IV furosemide and apply NIPPV (BiPAP)

Answer

Intubate immediately

Answer

Give normal saline bolus 500 mL

Answer

Start norepinephrine

Question 4

Which arrhythmia is the MOST common cause of sudden cardiac arrest in adults?

Accepted Answer

Ventricular fibrillation

Answer

Atrial fibrillation

Answer

Third-degree AV block

Answer

Supraventricular tachycardia

Question 5

Which medication is indicated for rate control in atrial fibrillation with preserved ejection fraction and heart rate of 140 bpm?

Accepted Answer

Metoprolol IV

Answer

Adenosine

Answer

Amiodarone

Answer

Digoxin

Question 6

A patient develops torsades de pointes (TdP). Which intervention is MOST appropriate as immediate treatment?

Accepted Answer

IV magnesium sulfate 2 g

Answer

Amiodarone 300 mg IV

Answer

Synchronized cardioversion

Answer

Procainamide infusion