ST-elevation myocardial infarction (STEMI) reflects transmural necrosis from complete coronary occlusion. Nursing priorities: fastest reperfusion ( PCI or fibrinolysis ), continuous monitoring, IV access, antiplatelet/anticoagulant therapy, and complication surveillance (arrhythmias, shock, mechanical complications). Connect STEMI – Acute to bedside cues you will reassess first: vitals trends, work of breathing, perfusion, mentation, and pain or ischemic equivalents when relevant. NCLEX items often reward recognizing when subtle instability outweighs reassurance, then selecting nursing actions that protect airway, circulation, and neurologic status before routine tasks.