Practice Test Geeks(BCEN) Board of Certification of Emergency Nursing Practice Test
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Cardiac Emergencies Flashcards

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  1. A patient presents with chest pain, diaphoresis, and an ECG showing ST elevation in leads II, III, and aVF. Which coronary artery is most likely occluded?

    Answer: Right coronary artery

    ST elevation in leads II, III, and aVF indicates an inferior STEMI, most commonly caused by occlusion of the right coronary artery.

  2. A patient in ventricular fibrillation receives a defibrillation shock. Which action should the nurse take immediately after shock delivery?

    Answer: Resume CPR immediately starting with chest compressions

    After defibrillation, CPR should be resumed immediately without a pulse check, as per current AHA guidelines, starting with chest compressions.

  3. Which of the following best describes the mechanism of action of adenosine when used to treat SVT?

    Answer: Temporarily blocks AV nodal conduction to interrupt reentry circuits

    Adenosine transiently blocks AV nodal conduction, interrupting the reentry circuit responsible for most SVTs.

  4. A patient with acute heart failure has a BP of 88/60 mmHg and bilateral crackles. Which medication is most appropriate to initiate?

    Answer: Dobutamine IV infusion

    In cardiogenic shock with hypotension, dobutamine is the preferred agent as it provides inotropic support without further reducing blood pressure.

  5. A patient is admitted with a serum potassium of 6.8 mEq/L and peaked T waves on ECG. Which intervention should be performed FIRST?

    Answer: Administer calcium gluconate IV

    Calcium gluconate is given first to stabilize the cardiac membrane and protect against life-threatening arrhythmias from hyperkalemia.

  6. During transcutaneous pacing, the nurse notes electrical capture but the patient remains unresponsive. What is the most likely explanation?

    Answer: Mechanical capture has not been achieved

    Electrical capture (pacing spikes followed by wide QRS) does not guarantee mechanical capture; mechanical capture must be confirmed by a palpable pulse or improved blood pressure.

  7. A patient with known coronary artery disease develops new left bundle branch block (LBBB) with chest pain. How should this be managed?

    Answer: Treat as a STEMI equivalent and activate the cath lab

    New LBBB in the setting of chest pain is treated as a STEMI equivalent per AHA/ACC guidelines, requiring urgent reperfusion therapy.

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