American Nurses Credentialing Center (ANCC) Practice Exam

The electrocardiogram (ECG or EKG) is commonly the first diagnostic test ordered for a patient presenting with chest pain due to its critical role in identifying acute cardiac conditions such as myocardial infarction (heart attack) or other arrhythmias. The ECG provides immediate information about the electrical activity of the heart, allowing healthcare providers to quickly assess for abnormalities that could indicate serious cardiac issues. In the context of chest pain, the timely interpretation of an EKG can help in determining whether the pain is due to a cardiac origin and guide subsequent management. It helps in differentiating between cardiac and non-cardiac causes of chest pain, ensuring that the patient receives appropriate and prompt care. Other tests like the echocardiogram and CT scan, while useful in specific scenarios, are generally not first-line tests in this situation. An echocardiogram is valuable for assessing heart structure and function but is typically performed after an initial ECG if there are indications for further investigation. A chest X-ray can provide information about the lungs and thoracic structures but does not assess the heart's electrical activity or detect ischemia. Therefore, the electrocardiogram is the most relevant initial diagnostic tool for evaluating the urgent nature of chest pain.