A 54-year-old male was rushed to the emergency department.

History reveals chest pain characterized by stabbing pain radiating to the jaw and shoulder for more than 45 minutes. The nurse immediately secures ECG of the patient. 1. You were the first ER nurse to respond to the patient. Which of the following actions would be done initially? A. Have the client rest with head of bed elevated. B. Have the patient secure an informed consent for possible aggressive management (angioplasty). C. Perform a quick assessment including brief history taking and records review. D. Secure an ECG rhythm. 2. Which of the following statements is correct for the case of the patient? A. Morphine sulfate is given to manage the chest pain and anxiety B. Myoglobin is expected to be below normal range C. The chest pain of the patient is expected to be relieved by NTG and rest D. Troponin T elevation is expected at this point 3. In taking care of a patient suffering from myocardial infarction. The nurse must remember which of the following concepts? A. Chest pain in this condition usually lasts for 30 minutes or more. B. Elevation of Troponin T or I is expected within the first 2 hours after the onset of the injury or chest pain. C. NTG can be used to relieve the patients chest pain and anxiety. D. Promoting rest and relaxation can easily manage the patients chest pain. 4. Morphine is administered to patients after administering 3 tablets of NTG. Morphine is administered primarily to A. Increase cardiac workload B. Increase myocardial oxygen demand C. Relieve anxiety D. Relieve chest pain (Possible answers: A & B if D is not in the choice) 5. Since the patients chest pain was not relieved after 3 doses of nitroglycerin, the nurse would anticipate that the physician will order which of the following? 1. Continuous cardiac and VS monitoring 2. Continuous monitoring of serum Magnesium to determine Torsades de Pointes 3. Epinephrine 1 mg every 3 to 5 minutes 4. Examine cardiac markers specifically Troponin T 5. Morphine suflate and aspirin

6. Preparing the manual defibrillator for possible cardiac arrest (1, 4, 5, 6 are all correct) A. 1 only B. 1 & 5 C. 1, 3, 5 D. 1, 2, 4, 5 ______________________________________________________________ A 62-year-old retired government employee was admitted to the intensive care unit due to unstable premature atrial contractions. During the 10 th day of confinement, the nurse in-charge of the care of the patient observed the ECG rhythm (Malabo yung picture kaya hindi ko na ininsert :|) 6. You will interpret the ECG rhythm as: A. Atrial Fibrillation B. Atrial Flutter C. Atrial Tachycardia D. Premature Atrial Contraction 7. Digoxin was immediately prescribed to the patient. This drug will act to: A. Increase heart rate and rhythm B. Prevent clothing that may cause serious complications C. Reset the fibrillations D. Strengthen and intensify cardiac contractions 8. The physician orders for emergency cardioversion. Which of the following statements is true about this treatment and that of this condition? A. Defibrillation should be performed instead of cardioversion B. Sedation is not a priority even is the patient is conscious C. The highest T-wave will be considered when synchronizing the delivery of shocks D. The initial dose of shock is 50 to 100 joules

9. You will interpret the ECG rhythm as:

A. First degree AV block B. Second degree AV block (Mobitz I) C. Second degree AV block (Mobitz II) D. Third degree AV block 10. Which of the following is/are expected signs and symptoms to this condition? A. BP of 80/50 mmHg B. Shortness of breath while at rest C. No evident signs and symptoms D. Irregular heart and skip beats 11. In interpreting ECG rhythm, PR interval correspond to: A. Beginning of atrial depolarization to the beginning of ventricular depolarization B. Atrial depolarization C. End of atrial depolarization to the end of ventricular depolarization D. End of ventricular depolarization and beginning of ventricular repolarization 12. The goal of treatment for this condition is: A. Aggressive return to normal state B. Lifestyle modification to prevent DM 2 and stroke C. Palliative and supportive with the signs and symptoms D. Prevention of progression to more serious AV junction dysrythmias

13. Which of the following is true regarding the management of the management of this dysrhythmia? A. Administration of class III and IV is important B. Encourage as much ADL is needed C. No treatment if PVC is isolated or asymptomatic D. Prompt cardioversion or defibrillation is necessary ______________________________________________________________

14. The physician ordered for the admission of the patient in the intensive care unit due to unstable appearance of ECG rhythms. At the ICU the patient presented this ECG rhythm. What should be the initial action of the nurse? A. Call for help from the residents on duty B. Assess the pulse of the patient C. Cardiovert the patient D. Continue monitoring

15. Which of the following is not true about the appearance of the ECG rhythm? A. Absent P waves B. Absent P-R interval C. The polarity of the T-wave is opposite to the polarity of the QRS complex D. Wide and bizarre QRS complex 16. Which of the following drugs is known to be the drug of choice for this ventricular dysrythmia? A. Adenosine B. Amiodarone C. Epinephrine D. Vasopressin 17. While at the mall you passed by a crowd looking at a couple of untrained responders perform cardiopulmonary resuscitation to an adult victim. You looked closely at what was happening and determined that they are incorrectly performing CPR if you witnessed which of the following? A. Chest compressions provided were at least 2 inches in depth. B. During chest compression, hands of the compressor were located at the center of the chest. C. The second rescuer was in-charge of providing rescue breaths. D. Two rescue breaths were given over 1 second. 18. While witnessing CPR at the mall, you remembered the highlights of the 2010 guidelines released by the American Heart Association (AHA) concerning the delivery of basic life support (BLS). You are correct by remembering which of the following? A. Circulation-Airway-Breathing (C-A-B) is the new arrangement of assessment of the victim. B. Compression-only-CPR was developed to further increase the survival rate of patients. C. CPR is essentially the key intervention in the reversal or resolution of cardiac arrest. D. Laymen are not encouraged to perform any of the CPR type to prevent errors that will only hasten death of the victim 19. When responding to an emergency situation involving an unresponsive patient. Which of the following actions by the nurse must be prioritized? A. Assess area for presence of bystanders who can help B. Activate EMS immediately C. Decide between calling for help first or performing CPR first D. Determine safety of the area

20. One of the most difficult areas in the performance of CPR is the maintenance of airway and the provision of rescue breaths. According to the latest recommendation of AHA, in the proper ventilation of the patient, which of these techniques is unnecessary? A. Ensure that the victim exhales first before blowing the second rescue breath. B. Pinch the nose of the client when performing mouth-to-mouth resuscitation C. Placing pressure over the cricoid cartilage to facilitate ease in the passage of air into the lungs. D. Watch the chest rise and fall during provision of rescue breaths 21. As a health care provided (HCP), you would know that you can only stop CPR when: A. All rescuers are thirsty B. The first rescuer in a two (2) rescuer CPR is already tired C. The patient remains unresponsive after 5 cycles of CPR D. The patient shows signs of return of spontaneous circulation 22. A health care provided decided to call the EMS first before performing CPR. Calling for EMS is most appropriate if the patient: A. Has foreign airway obstruction B. Has ventricular fibrillation C. Is a victim of drowning D. Is an unresponsive, apneic 10-year old 23. Hyperventilation is avoided for several reasons because: A. It can cause splenic rupture B. It causes decreased ventricular filling C. It decreases compression depth D. Renal circulation is reduced during inspiration 24. Which of the following circumstances would give a victim of sudden cardiac arrest the greatest chance of survival? A. When activation of emergency medical service (EMS) is done within an hour after the arrest. B. When defibrillation is done 5 minutes before providing CPR. C. When 5 cycles of quality CPR are accomplished within 2 minutes. D. When 5 cycles of CPR is done after successful defibrillation. 25. Which among the following are considered components of ACLS? 1. Defibrillation/cardioversion 2. Advanced airway placement

3. High quality CPR provision 4. Cardiac and vital signs monitoring 5. Establishment of an intravenous access ALL! 26. The nurse who is about to defibrillate an arrested patient should remember which of the following? A. It is best indicated for atrial tachycardia and fibrillation B. That premedication is not necessary C. To time shocks delivery with the commencement of ventricular contractions D. To use a synchronized mode 27. When performing CPR to a patient who is intubated, which of the following considerations must be followed correctly? A. Compressions rate must at least be 100 per minute B. Providing 15:2 compression ventilation ratio once the tube is patent C. Providing 30:2 compression ventilation ratio once the tube is patent D. Rescue breaths are delivered at a rate of 6 to 8 breaths per minute 28. As a nurse administering defibrillation or cardioversion, which among the following should be given the highest priority? A. If chest hair cannot be shaved off, do not apply conduction gel. B. During cardioversion, clearing the bed and oxygen is not necessary. C. Once asystole is seen in the monitor, prepare the patient for cardioversion, instead of defibrillation. D. Prior to administration of shocks, ensure that oxygen is not being delivered. 29. Which of the following is an example of a natural disaster? A. Bioterrorism B. Nuclear explosion C. Oil spill D. Tsunami 30. A team of health care providers created collaborative actions concerning risk assessment, prevention, mitigation, response, and recovery towards disaster. This refers to: A. Disaster assessment B. Disaster management C. Disaster planning D. Disaster evaluation

31. During field triage, if an adult client is found unresponsive on the ground with RR of 39 cycles per minute, which action must be done next? A. Give client a red tag B. Check for radial pulse or capillary refill C. Place client in recovery position D. Position victims airway 32. During field triage, if an adult client is found unresponsive after positioning the airway. Which action must be done next? A. Give client a red tag B. Consider the patient as expectant C. Check for radial pulses D. Provide rescue breaths 33. A client who experienced radiation exposure must be: A. Avoided by healthcare providers B. Bathed with sterile water everyday C. Instructed to wear gloves, mask and gown while at the hospital D. Placed on reverse isolation 34. Medication error, development of bedsores and falls are examples of: A. Assault B. False imprisonment C. Felony D. Unintentional tort 35. The nurse on duty took a picture of the patients buttocks during hemorrhoidectomy and uploaded it to a social network with the real name of the patient. This is A. Assault B. Defamation C. Extortion D. Invasion of privacy 36. These are our personal beliefs about the worth or essence of things, people or events A. Ethics B. Morals C. Values D. Virtues