Progressive Care Nursing Certification (PCCN) Practice Exam

What should a nurse suspect in a patient post-STEMI who suddenly develops decreased consciousness and hypotension?

1. CVA

2. Cardiogenic shock

3. Pulmonary embolus

4. ARDS

The correct answer is: Cardiogenic shock

In the context of a patient who has recently experienced a STEMI (ST-Elevation Myocardial Infarction), the sudden onset of decreased consciousness and hypotension strongly suggests the development of cardiogenic shock. After a myocardial infarction, particularly a STEMI, the heart's ability to pump effectively can be severely compromised. This can lead to decreased cardiac output and inadequate perfusion to vital organs, resulting in hypotension and symptoms of altered mental status, such as decreased consciousness. Cardiogenic shock is characterized by severe hypotension and signs of end-organ dysfunction due to the heart's inability to maintain sufficient blood flow. The acute nature of these symptoms following a cardiac event points to cardiogenic shock as a likely complication, particularly if the patient had a significant loss of myocardial tissue resulting from the STEMI. While conditions like a cerebrovascular accident (CVA), pulmonary embolus, and acute respiratory distress syndrome (ARDS) could also be considered in a patient with sudden changes, the specific scenario of post-STEMI patients developing altered mental status and hypotension is more closely aligned with the physiological consequences of cardiogenic dysfunction. In particular, altered consciousness can arise from decreased cerebral perfusion secondary to low cardiac output, further implicating cardiogenic shock as the