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Registered Nurse Comprehensive Predictor Practice Test

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ECG shows ST-segment elevation in leads II, III, and aVF. Most likely diagnosis?
Correct Answer:
Acute inferior myocardial infarction (STEMI)
Explanation:
ST-segment elevation in the inferior leads (II, III, and aVF) localizes the problem to the inferior wall of the heart. When the ECG shows this pattern, it points to an acute inferior myocardial infarction caused by a sudden occlusion of a coronary artery, most often the right coronary artery. This is a STEMI, meaning the injury is transmural and requires urgent reperfusion. In contrast, an acute anterior MI would produce ST elevations in the chest leads (V1–V4), not the inferior leads. Non-ST-elevation MI would not have ST elevation, instead showing ST depression or T-wave changes. Aortic dissection isn’t diagnosed from this pattern and would present differently with symptoms and diagnostic clues beyond the ECG.

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