Cardiac Vascular Nursing Exam Cardiac Vascular Nursing Exam Diagnostic Testing & Interpretation

Question 1

On a 12-lead ECG, which finding is diagnostic of left bundle branch block (LBBB) that alters management of chest pain?

Accepted Answer

Wide QRS >120ms with broad monophasic R wave in V5-V6 and rS pattern in V1

Answer

Narrow QRS with ST elevation in inferior leads only

Answer

Prolonged PR interval >200ms with normal QRS morphology

Answer

Right axis deviation with RSR' pattern in V1 and wide S wave in V6

Question 2

Which echocardiographic measurement is used to diagnose systolic heart failure and guide therapy initiation?

Accepted Answer

Left ventricular ejection fraction (LVEF) less than 40% diagnoses HFrEF

Answer

Left ventricular end-diastolic volume greater than 150 mL

Answer

E/A ratio less than 1.0 indicating diastolic dysfunction

Answer

Tricuspid annular plane systolic excursion (TAPSE) less than 17mm

Question 3

A troponin I level is drawn at presentation for chest pain, and a repeat level is ordered 3 hours later. What is the clinical purpose of serial troponin measurement?

Accepted Answer

To detect the rise and fall pattern consistent with myocardial injury when initial values may be negative in early infarction

Answer

To monitor response to antiplatelet therapy during ACS treatment

Answer

Serial troponin is only needed if the initial value is above the normal reference range

Answer

To determine the exact size of the myocardial infarction in square centimeters

Question 4

During cardiac catheterization, a hemodynamic finding of elevated pulmonary capillary wedge pressure (PCWP >18 mmHg) indicates which condition?

Accepted Answer

Left heart failure with elevated left atrial filling pressures

Answer

Right ventricular failure with normal left heart pressures

Answer

Hypovolemia requiring fluid administration

Answer

Pulmonary arterial hypertension from primary lung disease

Question 5

Which finding on an ankle-brachial index (ABI) test is diagnostic of significant peripheral arterial disease?

Accepted Answer

ABI less than 0.90

Answer

ABI of 1.0 to 1.3

Answer

ABI greater than 1.4 with non-compressible vessels

Answer

ABI of 0.91 to 1.0 indicating borderline normal

Question 6

What does an elevated B-type natriuretic peptide (BNP) level primarily indicate in a dyspneic patient?

Accepted Answer

Ventricular wall stress from elevated filling pressures, supporting a diagnosis of heart failure

Answer

Acute pulmonary embolism as the primary cause of dyspnea

Answer

Pneumonia with systemic inflammatory response

Answer

Asthma exacerbation with hyperinflation