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

New LBBB in the context of chest pain may represent STEMI equivalent, as LBBB's wide QRS with its characteristic morphology (broad R in V5-V6, rS in V1) obscures normal ST analysis.

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

LVEF <40% defines HFrEF and triggers guideline-directed medical therapy with beta-blockers, ACE inhibitors/ARBs, and aldosterone antagonists that have proven mortality benefit.

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

Troponin rises over 3–6 hours after myocardial injury; a significant delta (≥20% rise) between serial values confirms acute MI even when the initial value was within normal limits.

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

PCWP reflects left atrial pressure; elevation above 18 mmHg indicates left ventricular dysfunction or mitral valve disease causing increased left-sided filling pressures.

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

An ABI <0.90 indicates significant arterial stenosis in the lower extremity; the lower the ABI, the more severe the PAD, with values <0.40 representing critical limb ischemia.

Cardiac Vascular Nursing Exam Practice Test

Cardiac Vascular Nursing Exam Practice Test

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