CPEN Cardiac Emergencies 5

Question 1

A 14-year-old presents with chest pain, fever, and a friction rub. ECG shows diffuse ST elevation with PR depression in most leads. The most likely diagnosis is:

Accepted Answer

Pericarditis

Answer

Diffuse saddle-shaped ST elevation with PR depression in most leads, plus a friction rub, is the classic presentation of pericarditis.

Question 2

Beck's triad (hypotension, muffled heart sounds, distended neck veins) in a trauma patient suggests:

Accepted Answer

Cardiac tamponade

Answer

Beck's triad is the hallmark of cardiac tamponade, caused by fluid accumulation in the pericardial sac compressing the heart.

Question 3

The emergency bedside procedure to relieve cardiac tamponade is:

Accepted Answer

Pericardiocentesis

Answer

Pericardiocentesis (needle aspiration of pericardial fluid) rapidly relieves tamponade by decompressing the pericardial space.

Question 4

Which blood pressure finding is classic for cardiac tamponade?

Accepted Answer

Pulsus paradoxus >10 mmHg

Answer

Pulsus paradoxus (>10 mmHg drop in systolic BP with inspiration) occurs in tamponade due to exaggerated ventricular interdependence from pericardial pressure.

Question 5

A 9-year-old with known dilated cardiomyopathy presents with new-onset pulmonary edema. Which finding would indicate cardiogenic shock rather than isolated pulmonary edema?

Accepted Answer

Altered mental status with cool mottled extremities

Answer

Altered mental status with poor perfusion signs (cool, mottled extremities) indicates end-organ hypoperfusion, the defining feature of cardiogenic shock.

CPEN - Certified Pediatric Emergency Nurse Practice Test

CPEN - Certified Pediatric Emergency Nurse Practice Test

CPEN Cardiac Emergencies 5