Cardiac Vascular Nursing Exam Diagnostic Testing & Interpretation Flashcards
6 cards from real Cardiac Vascular Nursing Exam practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
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On a 12-lead ECG, which finding is diagnostic of left bundle branch block (LBBB) that alters management of chest pain?
Answer: Wide QRS >120ms with broad monophasic R wave in V5-V6 and rS pattern in V1
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.
Which echocardiographic measurement is used to diagnose systolic heart failure and guide therapy initiation?
Answer: Left ventricular ejection fraction (LVEF) less than 40% diagnoses HFrEF
LVEF <40% defines HFrEF and triggers guideline-directed medical therapy with beta-blockers, ACE inhibitors/ARBs, and aldosterone antagonists that have proven mortality benefit.
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?
Answer: To detect the rise and fall pattern consistent with myocardial injury when initial values may be negative in early infarction
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.
During cardiac catheterization, a hemodynamic finding of elevated pulmonary capillary wedge pressure (PCWP >18 mmHg) indicates which condition?
Answer: Left heart failure with elevated left atrial filling pressures
PCWP reflects left atrial pressure; elevation above 18 mmHg indicates left ventricular dysfunction or mitral valve disease causing increased left-sided filling pressures.
Which finding on an ankle-brachial index (ABI) test is diagnostic of significant peripheral arterial disease?
Answer: ABI less than 0.90
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.
What does an elevated B-type natriuretic peptide (BNP) level primarily indicate in a dyspneic patient?
Answer: Ventricular wall stress from elevated filling pressures, supporting a diagnosis of heart failure
BNP is released by ventricular myocytes in response to increased wall stretch from elevated filling pressures; elevated levels support heart failure as the cause of dyspnea with high sensitivity.
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