CCRN - Review Cardiovascular Emergencies Questions and Answers

Question 1

A 58-year-old male is admitted with a hypertensive emergency.
His blood pressure is 220/140 mmHg, and he is complaining of a severe headache and confusion.
Which of the following is the most appropriate initial nursing action?

Accepted Answer

Initiate an IV infusion of sodium nitroprusside and titrate to a goal mean arterial pressure (MAP).

Answer

Administer a rapid IV bolus of 0.9% normal saline.

Answer

Prepare for immediate endotracheal intubation.

Answer

Administer a potent oral antihypertensive agent for rapid effect.

Question 2

A patient is brought to the ICU after a motor vehicle collision, presenting with hypotension, jugular venous distention (JVD), and muffled heart sounds. These findings are most indicative of which cardiovascular emergency?

Accepted Answer

Cardiac tamponade

Answer

Massive pulmonary embolism

Answer

Aortic dissection

Answer

Cardiogenic shock

Question 3

A 65-year-old male presents with sudden, severe, tearing chest pain that radiates to his back. On assessment, the nurse notes a blood pressure of 180/100 mmHg in the right arm and 130/80 mmHg in the left arm. Which of the following is the priority intervention?

Accepted Answer

Administer an IV beta-blocker to lower heart rate and blood pressure.

Answer

Administer morphine for pain control.

Answer

Obtain a 12-lead ECG to rule out myocardial infarction.

Answer

Prepare the patient for an emergent chest x-ray.

Question 4

Which of the following hemodynamic profiles is most consistent with cardiogenic shock?

Accepted Answer

Low cardiac index, high systemic vascular resistance (SVR)

Answer

High cardiac index, low systemic vascular resistance (SVR)

Answer

Low central venous pressure (CVP), low pulmonary artery occlusion pressure (PAOP)

Answer

High cardiac index, high central venous pressure (CVP)

Question 5

A patient is admitted with an ST-segment elevation myocardial infarction (STEMI). According to current guidelines, what is the primary goal for reperfusion therapy?

Accepted Answer

Door-to-balloon time for percutaneous coronary intervention (PCI) within 90 minutes.

Answer

Administration of IV nitroglycerin within 30 minutes of arrival.

Answer

Administration of a beta-blocker within the first 24 hours.

Answer

Door-to-needle time for fibrinolytic therapy within 60 minutes.

Question 6

A patient in the ICU develops cardiogenic shock following a large anterior wall myocardial infarction. The provider orders a dobutamine infusion. The nurse understands the primary therapeutic effect of this medication is to:

Accepted Answer

Increase myocardial contractility and cardiac output.

Answer

Increase systemic vascular resistance to raise blood pressure.

Answer

Decrease heart rate to reduce myocardial oxygen demand.

Answer

Cause potent vasodilation to reduce preload.