SPEX Practice Test 5
10 free SPEX practice questions in the real exam format, covering the official content areas, with an explanation for every answer.
Question 1 of 10
Patient Care: DiagnosisA 63-year-old man is brought to the emergency department 80 minutes after the onset of crushing substernal pressure that began while he was shoveling snow. He has hypertension and type 2 diabetes mellitus and has smoked 1 pack of cigarettes daily for 40 years. He is pale and diaphoretic. Temperature is 36.8°C (98.2°F), pulse is 52/min, respirations are 20/min, and blood pressure is 84/52 mm Hg. Oxygen saturation is 95% on room air. The jugular venous pressure is 13 cm H₂O. The lungs are clear to auscultation. Heart sounds are regular, and there are no murmurs. An ECG shows 3-mm ST-segment elevations in leads II, III, and aVF with reciprocal ST-segment depressions in leads I and aVL. Laboratory studies show:
| Test | Result |
|---|---|
| Serum | |
| Troponin I (high-sensitivity) | 310 ng/L |
| Potassium | 4.4 mEq/L |
| Creatinine | 1.1 mg/dL |
| Glucose | 212 mg/dL |
Which of the following is the most likely cause of this patient's hypotension?