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Acute Coronary Syndromes Practice Quiz

Practice Quiz for ACLS Acute Coronary Syndromes Case

Quiz Questions

A 63-year-old woman is brought into the ED. She has pain between her shoulders and complains of lightheadedness and nausea. She thinks she may be having a heart attack and is extremely anxious. She is placed on a cardiac monitor and a pulse oximeter is attached.

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1. Select your first step from the following choices.


  1. Start the fibrinolytic checklist.
  2. Request a chest x-ray.
  3. Request a 12-lead ECG.
  4. Give her heparin.

2. The presence of ST-segment elevation on an ECG for a patient experiencing chest discomfort suggests


  1. Myocardial necrosis.
  2. Myocardial injury.
  3. Myocardial ischemia.
  4. Myocardial infarction.

3. Before giving her nitroglycerin, make sure


  1. The patient's heart rate is at least 89 bpm.
  2. The patient's systolic BP is >105 mm Hg.
  3. There is no evidence of a right ventricular infarction.
  4. The patient has not taken medication for hypertension in the past 24 hours.

The cardiologist reviews her 12-lead ECG, which shows a sinus bradycardia at 54 bpm with ST-segment elevation in leads V2 and V4.

4. The patient is classified as having which of the following?

  1. STEMI
  2. NSTEMI
  3. Unstable angina

5. What is the most important action to take next?


  1. Order a portable chest x-ray.
  2. Order cardiac markers.
  3. Consider adjunctive therapy.
  4. Complete a reperfusion checklist.

6. You reassess her chest pain. She has been given 2 doses of sublingual nitroglycerin, but she still says her pain is 7 out of 10 on a 10-point scale. What should you do now?


  1. Give her another dose of sublingual nitroglycerin.
  2. Give her 2 mg of morphine and repeat the dose in 5 minutes.
  3. Start her on a beta-blocker.
  4. Give her another 325 mg of aspirin.

7. Over an hour has passed since the patient arrived at the ED. What therapy would be recommended for her at this point, if she has no contraindications?


  1. Fibrinolytic therapy
  2. Coronary angioplasty
  3. Watch and wait

Quiz Answers


  1. Answer: C. Request a 12-lead ECG.
  2. Answer: B. myocardial injury.
  3. Answer: C. There is no evidence of a right ventricular infarction.
  4. Answer: A. STEMI
  5. Answer: D. Complete a reperfusion checklist.
  6. Answer: B. Give her 2 mg of morphine and repeat the dose in 5 minutes.
  7. Answer: B. Coronary angioplasty