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ACS Review Questions Before Lecture

Total questions: 11

Worksheet time: 6mins

Name
Class
Date
1.

A nurse screens a male patient for cardiovascular disease risk during admission. Which factor increases risk for acute coronary syndrome?

a)

Moderate exercise twenty to thirty minutes weekly

b)

BMI of twenty-six, overweight range

c)

Exposure to secondhand cigarette smoke

d)

Blood pressure one-twenty over sixty-six

e)

Triglycerides one-forty milligrams per deciliter

2.

In the diagram showing progression from plaque disruption to myocardial infarction, which scenario best explains why NSTEMI occurs instead of STEMI?

a)

Stable fixed plaque causing exertional ischemia

b)

Complete thrombus occlusion with new LBBB

c)

Partial occluding thrombus causing limited necrosis

d)

Transient non-occlusive thrombus with normal enzymes

3.

A patient with suspected ACS arrives to the ED. Which immediate nursing action aligns with recommended assessment priorities shown in the diagram?

a)

Obtain a 12‑lead ECG within 10 minutes

b)

Order CK‑MB and BNP before ECG

c)

Send patient for chest X‑ray immediately

d)

Administer sublingual nitroglycerin first

e)

Start one IV line and observe

4.

Which precordial lead is correctly positioned at the 5th intercostal space on the midclavicular line, and primarily reflects anterior wall ischemia correlated with the left anterior descending artery?

a)

V5 at 5th intercostal anterior axillary

b)

V2 at 4th intercostal space left sternal

c)

V6 at 5th intercostal midaxillary

d)

V4 at 5th intercostal space midclavicular

5.

In the ECG panels, which finding most strongly indicates a transmural myocardial infarction rather than ischemia alone? Refer to the diagram showing peaked T waves, T-wave inversion, ST elevation, and a deep initial negative deflection labeled Q wave.

a)

Transient J-point elevation with concave morphology

b)

Pathologic Q wave measuring ≥0.04 s and ≥25% R

c)

Diffuse ST-segment depression across multiple leads

d)

Persistent ST-segment elevation in affected leads

e)

Peaked symmetric T waves early after pain

6.

Which sequence represents the core components of the MONA protocol initiated in suspected myocardial infarction?

a)

Morphine, Oxygen, Nitroglycerin, Aspirin

b)

Morphine, Oxygen, Norepinephrine, Amiodarone

c)

Metoprolol, Oxygen, Nitroglycerin, Atropine

d)

Magnesium, Oxygen, Nicardipine, Aspirin

7.

In the prehospital fibrinolytic checklist, which finding is a contraindication to fibrinolysis that should prompt stopping and considering transfer for PCI instead?

a)

Systolic blood pressure between 100 and 110 mm Hg

b)

Recent major surgery within four weeks, including laser eye

c)

Chest discomfort greater than 15 minutes but under 12 hours

d)

ECG showing STEMI or presumably new LBBB

8.

During PCI for a coronary artery lesion, which step immediately restores luminal diameter by compressing plaque against the vessel wall as shown in the diagram?

a)

Deploying drug-eluting stent scaffold

b)

Advancing guide catheter into coronary ostium

c)

Administering peri-procedural IV anticoagulant

d)

Inflating balloon across the stenotic segment

9.

Which laboratory finding is most suggestive of ongoing myocardial injury in a patient presenting with chest pain?

a)

Elevated troponin I above reference range

b)

Normal CK-MB and BNP levels

c)

Elevated D-dimer

d)

Low serum potassium

10.

After successful PCI for STEMI, which nursing intervention is essential to monitor for reperfusion complications as shown in the post-procedure diagram?

a)

Encourage early ambulation within 30 minutes

b)

Administer additional anticoagulants immediately

c)

Discontinue all cardiac medications

d)

Assess for new arrhythmias on cardiac monitor

11.

Which ECG change, as depicted in the diagram, is most characteristic of early ischemia before infarction occurs?

a)

Diffuse U wave appearance

b)

Persistent ST-segment elevation

c)

T-wave inversion in affected leads

d)

Development of pathologic Q waves