ECC Cardiovascular Evaluation & Monitoring 3

Question 1

A patient presents with sudden-onset chest pain radiating to the back, BP 190/110 in the right arm and 145/88 in the left arm. What diagnosis should be considered first?

Accepted Answer

Aortic dissection

Answer

Inter-arm blood pressure discrepancy combined with severe chest pain radiating to the back is a classic presentation of aortic dissection.

Question 2

Which waveform on a pulmonary artery catheter tracing represents right ventricular pressure?

Accepted Answer

A waveform with systolic pressure 15-25 mmHg and diastolic pressure 0-8 mmHg

Answer

Normal right ventricular pressure is 15-25 mmHg systolic and 0-8 mmHg diastolic, distinguishing it from pulmonary artery pressures which have higher diastolic values.

Question 3

On a 12-lead ECG, ST-segment elevation in leads V1-V4 with reciprocal changes in the inferior leads is most consistent with:

Accepted Answer

Anterior STEMI

Answer

ST elevation in V1-V4 corresponds to the anterior wall of the left ventricle, typically caused by LAD occlusion.

Question 4

A patient's continuous SpO2 monitoring shows sudden drop from 98% to 78% with a normal waveform on the plethysmograph. What is the most appropriate next action?

Accepted Answer

Recheck the probe placement and consider arterial blood gas

Answer

A sudden dramatic drop with preserved waveform quality suggests probe artifact or displacement; repositioning and confirming with ABG is appropriate before escalating.

Question 5

Which finding on physical exam is the most specific indicator of elevated left ventricular filling pressure?

Accepted Answer

Crackles at the lung bases

Answer

Bilateral basilar crackles indicate pulmonary edema from elevated left-sided filling pressures causing fluid transudation into the alveoli.

(ECC) Emergency Cardiovascular Care Certification Practice Test

(ECC) Emergency Cardiovascular Care Certification Practice Test

ECC Cardiovascular Evaluation & Monitoring 3