Want to test your diagnostics knowledge before the CEN exam? Below are free sample flashcards from the 50-card diagnostics section of our 1120-card CEN (Certified Emergency Nurse) deck.
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A 55-year-old male presents with epigastric pain and diaphoresis. The 12-lead ECG shows ST-segment elevation in leads II, III, and aVF. Which coronary artery is the most likely culprit, and which myocardial wall is affected?
Show answer →Culprit: Right Coronary Artery (RCA); Wall: Inferior Wall. Leads II, III, and aVF visualize the inferior surface of the heart. In approximately 85% of the population, the RCA is the dominant vessel supplying this area. CEN Strategy Tip: Inferior MIs are frequently associated with bradyarrhythmias (due to SA/AV node involvement) and autonomic symptoms like nausea. Always assess for Right Ventricular (RV) involvement with a right-sided ECG (V4R) when inferior changes are present.
A 62-year-old female presents with crushing substernal chest pain. The ECG reveals ST-segment elevation in leads V3 and V4. Which vascular territory and specific wall are involved?
Show answer →Vessel: Left Anterior Descending (LAD) artery; Wall: Anterior wall. Leads V3 and V4 are placed directly over the anterior precordium and specifically reflect the health of the anterior wall of the left ventricle. CEN Strategy Tip: The LAD is often referred to as the widow maker because it supplies a massive portion of the left ventricular myocardium. Anterior MIs carry a high risk for cardiogenic shock and new-onset bundle branch blocks. BCEN often tests the correlation between V3-V4 and the LAD.
A patient's ECG shows ST-segment elevation in leads I, aVL, V5, and V6. Which coronary artery is primarily responsible for this territory?
Show answer →Culprit: Left Circumflex (LCx) artery (or a large diagonal branch of the LAD); Wall: Lateral wall. Leads I and aVL represent the high lateral wall, while V5 and V6 represent the low lateral wall. CEN Strategy Tip: Isolated lateral MIs are less common than combined patterns (e.g., anterolateral). When you see elevation in I and aVL, look for reciprocal ST-segment depression in the inferior leads (II, III, aVF).
An ECG displays ST-segment elevation isolated to leads V1 and V2. Which anatomical area of the heart is being visualized, and which artery supplies it?
Show answer →Area: Interventricular Septum (Septal Wall); Vessel: Left Anterior Descending (LAD) artery. V1 and V2 are the septal leads. CEN Strategy Tip: Septal MIs rarely occur in isolation; they are usually associated with anterior wall changes (V3-V4), termed an anteroseptal MI. Watch for mechanical complications such as a ventricular septal defect (VSD), which presents as a new, harsh holosystolic murmur.
When evaluating an ECG for an acute Inferior MI (leads II, III, aVF), where would the nurse expect to see the most prominent reciprocal ST-segment depression?
Show answer →Reciprocal changes would be seen in the High Lateral leads (I and aVL). Reciprocal changes are mirror images of the injury. CEN Strategy Tip: Reciprocal changes are a key diagnostic feature that helps confirm an acute STEMI and differentiate it from mimics like pericarditis (which typically shows diffuse ST elevation without reciprocal depression). BCEN emphasizes that reciprocal changes in I and aVL are highly sensitive for identifying early inferior wall injury.
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Try 30 free CEN cards firstThe full CEN deck contains 1120 flashcards, and 50 of them focus on diagnostics. This page shows 5 free samples.
Our CEN deck dedicates 50 of 1120 cards (4%) to diagnostics — always cross-check the official BCEN exam outline for the current blueprint weighting.
Yes — the samples on this page are free, and the CEN preview page has 30 more free cards. Full access to all 1120 cards is a one-time $7.
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