Cardiac Vascular Nursing Exam Risk Assessment & Management 3

Question 1

A patient is admitted with a non-ST-elevation myocardial infarction (NSTEMI). Which TIMI risk score finding carries the most weight in predicting 14-day adverse outcomes?

Accepted Answer

ST deviation ≥0.5 mm on presenting ECG

Answer

ST deviation ≥0.5 mm is heavily weighted in the TIMI risk score as it reflects significant myocardial ischemia and predicts adverse outcomes.

Question 2

Which patient characteristic most significantly increases the risk of heparin-induced thrombocytopenia (HIT) in a cardiac unit?

Accepted Answer

Post-cardiac surgery patient receiving unfractionated heparin for >4 days

Answer

Post-cardiac surgery patients exposed to unfractionated heparin for more than 4 days have the highest incidence of HIT due to platelet factor 4 antibody formation.

Question 3

When using the 4T scoring system to assess HIT risk, a score of 6–8 indicates:

Accepted Answer

High probability — stop heparin and start alternative anticoagulation immediately

Answer

A 4T score of 6–8 represents high clinical probability for HIT, requiring immediate cessation of heparin and initiation of a non-heparin anticoagulant such as argatroban.

Question 4

A 72-year-old woman with heart failure (EF 30%) is being evaluated for ICD implantation. Which condition must be optimized for at least how many months before reassessing EF eligibility?

Accepted Answer

3 months of guideline-directed medical therapy

Answer

Current guidelines recommend at least 3 months of guideline-directed medical therapy (GDMT) before reassessing EF, as EF may improve with optimization.

Question 5

Which laboratory value is the most sensitive early marker for acute kidney injury following cardiovascular surgery?

Accepted Answer

Serum cystatin C

Answer

Cystatin C rises within 24 hours of AKI, making it more sensitive than creatinine, which may not rise for 48–72 hours after renal injury.

Cardiac Vascular Nursing Exam Practice Test

Cardiac Vascular Nursing Exam Practice Test

Cardiac Vascular Nursing Exam Risk Assessment & Management 3