CEN Cardiovascular Emergencies 3

Question 1

A patient on warfarin presents with an INR of 8.5 and is actively bleeding. Which is the fastest-acting reversal agent?

Accepted Answer

4-factor prothrombin complex concentrate (PCC)

Answer

4-factor PCC provides the fastest reversal of warfarin by replacing all four vitamin K-dependent clotting factors, acting within minutes compared to hours for FFP or Vitamin K.

Question 2

Which ECG change is most characteristic of hyperkalemia when the serum potassium level is above 6.5 mEq/L?

Accepted Answer

Peaked tall T waves

Answer

Peaked, tall, narrow T waves are the earliest ECG manifestation of hyperkalemia and typically appear when potassium exceeds 5.5–6.5 mEq/L.

Question 3

A patient presents with wide complex tachycardia. Which clinical feature most supports ventricular tachycardia over SVT with aberrancy?

Accepted Answer

AV dissociation on ECG

Answer

AV dissociation, where P waves and QRS complexes are independent, is a hallmark of ventricular tachycardia and helps distinguish it from SVT with aberrancy.

Question 4

Which vasopressor is recommended as a first-line agent for septic shock when fluid resuscitation is inadequate?

Accepted Answer

Norepinephrine

Answer

Norepinephrine is the first-line vasopressor for septic shock per Surviving Sepsis Campaign guidelines due to its potent alpha-adrenergic effects and favorable safety profile.

Question 5

A patient with a history of heart failure presents with a BP of 70/40 mmHg, cool extremities, and an elevated BNP. Which hemodynamic profile is most consistent with cardiogenic shock?

Accepted Answer

High CVP, high PCWP, low CO

Answer

Cardiogenic shock is characterized by elevated filling pressures (high CVP and PCWP) and reduced cardiac output due to pump failure.

CEN - Certified Emergency Nurse Practice Test

CEN - Certified Emergency Nurse Practice Test

CEN Cardiovascular Emergencies 3