# A 46-year-old man reports new chest pressure and diaphoresis. The nurse compares selected current leads with his earlier recording. Click the pair showing new ST elevation in two contiguous precordial leads that supports immediate escalation.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=581194&lang=en  
> language: en  
> subject: Physiological Adaptation  
> category: PA

## Question

A 46-year-old man reports new chest pressure and diaphoresis. The nurse compares selected current leads with his earlier recording. Click the pair showing new ST elevation in two contiguous precordial leads that supports immediate escalation.

![](https://mymerci.kr/data/nclex/hotspot/regen_20260908_2350/HSR531.svg)

## Explanation

C shows a new 0.3-mV ST elevation in V2 and V3 compared with their earlier baseline.

## In-depth explanation

Quick answer
C. C shows a new 0.3-mV ST elevation in V2 and V3 compared with their earlier baseline.
Why this is the best choice
Identify the segment after the QRS complex, compare it with the isoelectric baseline and verify that the change occurs in a contiguous pair. The tall waves in another pair were already present and are not equivalent to a new raised ST segment. These findings with ischemic symptoms require urgent escalation, not waiting for repeat symptoms.
Clinical picture
The observations are fictional teaching data. Apply the stated context; the selected feature does not by itself replace a complete bedside assessment.
Memory hook
Distinguish the ST segment from the QRS and T wave, then compare contiguous leads with baseline.
Decision rule
Distinguish the ST segment from the QRS and T wave, then compare contiguous leads with baseline.
Why the other regions do not fit
A has tall T waves that are unchanged from the prior record. B has slight ST depression rather than elevation. D has T-wave inversion, which also deserves assessment but is not the specific ST-elevation pattern asked about.
**Sources**
- Myocardial ischemia assessment includes new ST changes in contiguous leads, with lead-specific thresholds.

## Key concepts

- **New contiguous ST changes versus pre-existing tall waves** — Distinguish the ST segment from the QRS and T wave, then compare contiguous leads with baseline.
- **Comparison with context** — A has larger absolute waves, but the change is in C’s ST segments rather than wave amplitude alone.

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