CEN Cardiovascular Emergencies 2

Question 1

A patient arrives in rapid atrial fibrillation with a rate of 160 bpm and is hemodynamically unstable. What is the most appropriate immediate intervention?

Accepted Answer

Perform synchronized cardioversion

Answer

An unstable patient with tachyarrhythmia requires immediate synchronized cardioversion rather than pharmacological management.

Question 2

Which serum biomarker is most specific for myocardial necrosis and is elevated within 3–6 hours of an acute MI?

Accepted Answer

Troponin I

Answer

Cardiac troponin I is the most specific biomarker for myocardial necrosis, rising within 3–6 hours and remaining elevated for up to 14 days.

Question 3

A patient with chest pain has a 12-lead ECG showing ST depression in V1–V4. Which condition should be considered first?

Accepted Answer

Posterior MI

Answer

ST depression in V1–V4 can represent a posterior MI, which appears as a mirror image; applying posterior leads (V7–V9) will reveal ST elevation.

Question 4

What is the initial energy setting for defibrillation of ventricular fibrillation using a biphasic defibrillator?

Accepted Answer

200 J

Answer

For biphasic defibrillators, the initial energy for defibrillation of VF is 120–200 J (commonly 200 J), while monophasic uses 360 J.

Question 5

Which sign is associated with cardiac tamponade in addition to hypotension and muffled heart sounds?

Accepted Answer

Jugular venous distension

Answer

Beck's triad for cardiac tamponade includes hypotension, muffled heart sounds, and jugular venous distension (JVD) due to impaired venous return.

CEN - Certified Emergency Nurse Practice Test

CEN - Certified Emergency Nurse Practice Test

CEN Cardiovascular Emergencies 2