ANCC Cardiac Vascular Nursing

Question 1

A patient presents with sudden tearing chest pain radiating to the back and unequal blood pressures between arms (160/90 right vs 120/70 left). Which diagnosis is most likely?

Accepted Answer

Aortic dissection

Answer

Tearing chest/back pain with unequal blood pressures between arms is the classic presentation of aortic dissection — a surgical emergency.

Question 2

A patient with HFrEF (EF 30%) is being discharged. Which medication combination has the strongest evidence for reducing mortality?

Accepted Answer

ACE inhibitor or ARNI, beta-blocker, aldosterone antagonist, and SGLT2 inhibitor

Answer

The four pillars of HFrEF therapy with mortality benefit are: ACE inhibitor or ARNI (sacubitril/valsartan), beta-blocker, aldosterone antagonist, and SGLT2 inhibitor.

Question 3

A patient with complete heart block shows ventricular rate 32 bpm and hemodynamic instability. What is the immediate treatment?

Accepted Answer

Transcutaneous pacing followed by transvenous pacing

Answer

Symptomatic third-degree AV block requires immediate transcutaneous pacing as a bridge to transvenous pacing. Amiodarone and beta-blockers are contraindicated as they worsen bradycardia.

Question 4

A patient underwent PCI via the right radial artery. Which complication should the nurse assess for first post-procedure?

Accepted Answer

Radial artery occlusion and hand ischemia

Answer

Radial artery occlusion is the most common complication of transradial PCI, occurring in 1-10% of cases. Assessment of radial pulse, capillary refill, and hand perfusion is the priority.

Question 5

A stable patient with new-onset atrial flutter (rate 150 bpm) has estimated onset greater than 48 hours ago. What is the priority before electrical cardioversion?

Accepted Answer

Rate control followed by anticoagulation for at least 3 weeks before cardioversion

Answer

For AF/flutter with onset greater than 48 hours or unknown duration in a stable patient, at least 3 weeks of therapeutic anticoagulation is required before cardioversion, or a TEE must rule out left atrial thrombus.

ANCC - American Nurses Credentialing Center Practice Test

ANCC - American Nurses Credentialing Center Practice Test

ANCC Cardiac Vascular Nursing