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EMSTA block 1 (Cardiology)

Terms in this set (63)

Which of the following patients would most likely present with bag or unusual symptoms of an acute myocardial infraction?

A. 55-year-old obese female
B. 66-year-old male with angina
C. 72-year-old female with diabetes
D. 75-year-old male with hypertension
72-year-old female with diabetes
Ischemic heart disease is a condition in which:

A. A portion of the heart muscle dies because of a prolonged lack of oxygen
B. There is a decrease in blood flow to one or more portions of the heart muscle
C. The coronary arteries dilate, thus preventing effective blood flow to the heart
D. An acute event leads to a significant decrease in the pumping force of the heart
There is a decrease in blood flow to one or more portions of the heart muscle
All of the following are components of the Cincinnati stroke scale, except:

A. Pupil size
B. Facial droop
C. Speech pattern
D. Arm movement
Pupil size
Hey 56-year-old man is found to be pulseless and apneic. His wife states that he collapse about five minutes ago. I was your partner gets the AED from the ambulance, you should:

A. Provide rescue breaths until the AED is ready
B. Open the airway and give 2 rescue breaths
C. Begin CPR, starting with chest compressions
D. Ask the wife if the patient has a living will
Begin CPR, starting with chest compressions
You arrive on the scene shortly after a 55-year-old man collapsed. To bystanders are performing CPR. Your first action should be to:

A. Attach the AED and analyze his cardiac rhythm
B. Check the effectiveness of the CPR in progress
C. Insert an oropharyngeal airway and continue CPR
D. Stop CPR so you can assess breathing and pulse
Stop CPR so you can assess breathing and pulse
You should be most suspicious that a patient with chest pressure has an underlying cardiac problem if his or her pulse is:

A. Slow
B. Rapid
C. Bounding
D. Irregular
Irregular
A 60-year-old woman presents with chest discomfort, confusion, and weakness. The patient's husband tells you that she vomited twice before EMS arrival. The patients BP is 70/40 mmHg, her pulse is at 45 bpm and weak, and her respirations are at 14 breaths/minute and unlabored. Which of the following is the most likely cause of her hypotension?

A. Bradycardia
B. Hypovolemia
C. Myocardial ischemia
D. Respiratory compromise
Bradycardia
Aspirin is beneficial to patients experiencing an acute coronary syndrome because it:

A. Prevents a clot from getting larger
B. Effectively relieves their chest pain
C. Decreases cardiac workload by lowering the BP
D. Destroys the clot that is blocking a coronary artery
Prevents a clot from getting larger
A middle-aged woman took three of her prescribed nitroglycerin tablets after she began experiencing chest pain. She complains of a bad headache and is still experiencing chest pain. You should assume that:

A. her blood pressure is elevated
b. she has ongoing cardiac ischemia
c. her nitroglycerin is no longer potent
d. her chest pain is not cardiac related
A. her blood pressure is elevated
After applying an AED to an adult patient in cardiac arrest, you analyze her cardiac rhythm and receive a shock advised message. Emergency medical responders, who arrived at the scene before you, tell you that bystander CPR was not in progress upon their arrival. You should:

a. perform CPR for 2 minutes and the defibrillate
b. detach the AED and prepare immediate transport
c. deliver the shock as indicated followed immediately by CPR
d. notify medical control and request permission to cease resuscitation
c. deliver the shock as indicated followed immediately by CPR
A 50-year-old man presents with crushing chest pain that suddenly began about 30 minutes ago. He is diaphoretic and anxious. The EMT should:

a. obtain baseline vitals
b. apply supplemental oxygen
c. administer chewable aspirin
d. perform a complete medical exam
c. administer chewable aspirin
Which of the following is MOST indicative of a primary cardiac problem?

a. Tachypnea
b. Tachycardia
c. Irregular pulse
d. Sudden fainting
c. Irregular pulse
A 50-year-old man's implanted defibrillator has fired twice within the last hour. He is conscious and alert and complains of a "sore chest." Further assessment reveals that his chest pain is reducible to palpation and is localized to the area of his implanted defibrillator. Treatment for him should include:

a. application of the AED and transport to the hospital
b. prompt transport with continuous monitoring en route
c. deactivation his defibrillator by running a magnet over it
d. up to three doses of nitroglycerin and prompt transport
b. prompt transport with continuous monitoring en route
Which of the following patients would be least likely to present with classic signs and symptoms of acute myocardial infraction?

a. 72-year-old female with diabetes and hypertension
b. 64-year-old male with renal disease and depression
c. 59-year-old male with alcoholism and angina pectoris
d. 55-year-old female with COPD and frequent infections
a. 72-year-old female with diabetes and hypertension
The pain associated with acute aortic dissection:

a. typically comes on gradually and progressively worsens
b. is typically described as a stabbing or tearing sensation
c. is usually preceded by nausea, sweating, and weakness
d. originates in the epigastrium and radiates down both legs
b. is typically described as a stabbing or tearing sensation
When performing two-rescuer CPR on an adult patient whose airway has not been secured with an advanced device, you should:

a. deliver ventilations at a rate of 10 breaths/ min
b. avoid synchronizing compressions w/ ventilations
c. have your partner after 30 compressions as you give 2 breaths
d. continue ventilations as the AED analyzes the patient's cardiac rhythm
c. have your partner after 30 compressions as you give 2 breaths
Your partner has applied the AED to a cardiac arrest patient and has received a shock advised message. While the AED is charging, you should:

a. continue chest compressions until your partner tells you to stand clear
b. perform rescue breathing only until the AED is charged and ready to shock
c. cease all contact with the patient until the AED has delivered the shock
d. retrieve the airway equipment and prepare to ventilate the patient
a. continue chest compressions until your partner tells you to stand clear
Use of the automated external defibrillator is contraindicated in patients who:

a. are between 1 and 8 years of age
b. experienced a witnessed cardiac arrest
c. are apneic and have a weak carotid pulse
d. have a nitroglycerin patch applied to the skin
c. are apneic and have a weak carotid pulse
Which of the following statements regarding sudden cardiac arrest and ventricular fibrillation is correct?

a. for each minute that defibrillation is delayed, the chance of survival decreases by as much as 10%
b. High-quality CPR often reverses ventricular fibrillation if it is initiated within 2 minutes of the onset
c. most patients develop ventricular fibrillation within 10 minutes after the onset of sudden cardiac arrest
d. patients with ventricular fibrillation are typically unconscious, are apneic, and have a weak irregular pulse
a. for each minute that defibrillation is delayed, the chance of survival decreases by as much as 10%
A middle-aged male was found unresponsive by his wife. When you arrive at the scene, you assess the patient and determine that he is apneic and pulseless. You should:

a. immediately begin CPR, reassess for a carotid pulse after 60 seconds, and then apply the AED
b. immediately apply the AED, analyze his cardiac rhythm, deliver a shock if indicated, and begin CPR
c. begin CPR starting with chest compressions, apply the AED as soon as possible, and request backup
d. perform CPR with a chest compression to ventilation ratio of 15:2, apply the AED, and request back up
c. begin CPR starting with chest compressions, apply the AED as soon as possible, and request backup
Which of the following statements regarding ventricular fibrillation (V-fib) is correct?

a. loss of consciousness occurs within minutes after the onset of V-fib
b. In v-fib, the heart is not pumping any blood and the patient is pulseless
c. patients in v-fib should be defibrillated after every 60 seconds of CPR
d. any patient in v-fib must receive CPR for 2 minutes prior to defibrillation
b. In v-fib, the heart is not pumping any blood and the patient is pulseless
Which of the following statement regarding one-rescuer CPR is correct?

a. you should assess the patient for a pulse after 3 cycle of CPR
b. a compression to ventilation ratio of 15:2 should be delivered
c. ventilations should be delivered over a period of 2 to 3 seconds
d. the chest should be allowed to fully recoil after each compression
d. the chest should be allowed to fully recoil after each compression
In addition to chest pain or discomfort, a patient experiencing an acute coronary syndrome would MOST likely present with:

a. ashen skin color, diaphoresis, and anxiety
b. severe projectile vomiting and flushed skin
c. irregular breathing and low blood pressure
d. profound cyanosis, dry skin, and a headache
a. ashen skin color, diaphoresis, and anxiety
A 65-year-old man has generalized weakness and chest pressure. He has a bottle of prescribed nitroglycerin, but states that he has not taken any of his medication. The EMT should:

a. apply the AED and prepare the patient for immediate transport
b. administer up to 325 mg of aspirin if the patient is not allergic to it
c. assist the patient with his nitroglycerin with medical control approval
d. perform a secondary assessment and obtain baseline vitals
b. administer up to 325 mg of aspirin if the patient is not allergic to it
Shortly after assisting a 65-year-old woman with her second nitroglycerin treatment, she tells you she is lightheaded and feels as if she is going to faint. Her symptoms are MOST likely due to:

a. low blood pressure
b. an irregular heartbeat
c. nervousness and anxiety
d. a drop in her blood sugar
a. low blood pressure
Which of the following describes the MOST appropriate method of performing chest compressions on an adult patient in cardiac arrest?

a. compress the chest at least 2 inches, allow full recoil of the chest after each compression, minimize interruptions in the chest compressions
b. allow full recoil of the chest after each compression, compress the chest to a depth of 2 inches, deliver compressions at a rate of at least 80/min
c. do not interrupt chest compressions for any reason, compress the chest no more than 1 1/2 inches, allow partial recoil of the chest after each compression
d. minimize interruptions in chest compressions, provide 70% compression time and 30% relaxation time, deliver compressions at a rate of 100/min
a. compress the chest at least 2 inches, allow full recoil of the chest after each compression, minimize interruptions in the chest compressions
Sudden cardiac arrest in the adult population is MOST often the result of:

a. an acute stroke
b. respiratory failure
c. a cardiac dysrhythmia
d. myocardial infraction
c. a cardiac dysrhythmia
A 50-year-old man with a history of hypertension began experiencing chest pressure while mowing his lawn. After taking a baby aspirin and resting for approximately 10 minutes, the pressure in his chest completely resolved. Which of the following would BEST explain this?

a. the patient's blood pressure increased after he ceased exertion, causing his chest pressure to resolve
b. the cessation of exertion decreased the workload of the heart and blood flow around the coronary clot improved
c. the aspirin dissolved a small clot in a coronary artery and reestablished blood flow to that part of the heart
d. blood flow to a part of the myocardium was restored because constriction of a diseased coronary artery
b. the cessation of exertion decreased the workload of the heart and blood flow around the coronary clot improved
The chest pain associated with an acute coronary syndrome is often described as:

a. sharp
b. stabbing
c. pressure
d. cramping
c. pressure
In which of the following situations would nitroglycerin MOST likely be administered?

a. recent use of Cialis
b. systolic BP of 90 mm Hg
c. the presence of a head injury
d. history of cardiac bypass surgery
d. history of cardiac bypass surgery
By which of the following mechanisms does nitroglycerin relieve cardiac-related chest pain or discomfort?

a. Vasodilation and increased myocardial oxygen supply
b. Vasodilation and decreased myocardial oxygen supply
c. Vasoconstriction and increased myocardial workload
d. Vasoconstriction and increased cardiac oxygen demand
a. Vasodilation and increased myocardial oxygen supply
Which of the following patients is the BEST candidate for the administration of nitroglycerin?

a. woman who has taken three doses of prescribed nitroglycerin without relief of chest pain
b. A woman with chest pain, prescribed nitroglycerin, and a blood pressure of 104/76 mm Hg
c. A man with chest pain, expired nitroglycerin spray, and blood pressure of 110/80 mm Hg
d. An elderly man with crushing substernal chest pain and a blood pressure of 80/60 mm Hg
b. A woman with chest pain, prescribed nitroglycerin, and a blood pressure of 104/76 mm Hg
When an error occurs while using the AED, it is MOST often the result of:

a. battery failure secondary to operator failure
b. malfunction of the microchip inside the AED
c. misinterpretation of the patient's cardiac rhythm
d. excess patient movement during the analyze phase
a. battery failure secondary to operator failure
Prior to being reoxygenated in the lungs, blood passes through the:

a. mitral and tricuspid valves
b. aortic and tricuspid valves
c. aortic and pulmonic valves
d. tricuspid and pulmonic valves
d. tricuspid and pulmonic valves
When the vital organs of an 85-year-old patient need additional blood flow, the heart may not be able to meet the increased need because:

A. Stroke volume increases as a person ages
B. Blood pressure decreases as a person ages
C. The reserve capacity of the heart is reduced as a person ages
D. The blood vessels become more elastic as a person ages
C. The reserve capacity of the heart is reduced as a person ages
Which of the following would be the most effective way of minimizing the detrimental effects associated with acute coronary syndrome?

A. Administer nitroglycerin in 15 to 20 minute intervals
B. Reassure the patient and provide prompt transport
C. Transport the patient rapidly, using lights and sirens
D. Request ALS support for any patient who has chest pain
B. Reassure the patient and provide prompt transport
Which of the following is a common side effect of nitroglycerin?

A. Nausea
B. Anxiety
C. Headache
D. Hypertension
C. Headache
A patient who is experiencing an acute myocardial infraction:

A. Most often describes his or her chest pain as being sharp or tearing
B. Has chest pain or discomfort that does not change with each breath
C. Often experiences relief of his or her chest pain after taking nitroglycerin
D. Often complains of a different type of pain than a patient with angina
B. Has chest pain or discomfort that does not change with each breath
The middle, muscular layer of the heart is called the:

A. Epicardium
B. Pericardium
C. Myocardium
D. Endocardium
C. Myocardium
Switching compressors during two-rescuer CPR:

• A:should take no more than 15 seconds to accomplish.
• B:is performed after every 10 to 20 cycles of adult CPR.
• C:is only necessary if the compressor becomes fatigued.
• D:should occur every 2 minutes throughout the arrest.
D. Should occur every two minutes throughout the rest
Which of the following structures is the primary pacemaker, which sets the normal rate for the heart?

A. Bundle of his
B. Purkinje fibers
C. Sinoatrial node
D. Atrioventricular node
C. sinoatrial node
After delivering one shock with the AED and performing two minutes of CPR on a woman in cardiac arrest, you re-analyze her cardiac rhythm and receive a no shock advised message. This means that:

A. She is not in a shockable rhythm
B. She has electrical activity but no pulse
C. Her rhythm has deteriorated to asystole
D. The first shock restored a rhythm and pulse
She is not in a shockable rhythm
The position of comfort for a patient with nontraumatic chest pain most commonly is

A. semisitting
B. lateral recumbent
C. on the side with the head elevated
D. supine with the legs elevate slightly
A. Semisitting
Which of the following questions would be most appropriate to ask when accessing a patient with chest pain?

A. What does the pain feel like?
B. Does the pain radiate to your arm?
C. Would you describe the pain as sharp?
D. Is the pain worse when you take a deep breath?
A. What does the pain feel like?
A patient reports pain in the upper midabdominal area. This region of the abdomen is called the:

A. Peritoneum
B. Epigastrium
C. Mediastinum
D. Retroperitonium
B. Epigastrium
You arrive at the scene of a 56-year-old woman who collapsed. The patient's wife tells you that he suddenly grabbed his chest and then passed out. Your assessment reveals that he is apneic and pulseless. As your partner begins one rescuer CPR, you should:

A. Notify medical control
B. Insert an airway adjunct
C. Prepare the AED for use
D. Obtain a sample history
C. Prepare the AED for use
In most people, the inferior aspect of the left ventricle receives its blood supply from the:

A. Circumflex artery
B. Right coronary artery
C. Left main coronary artery
D. Left anterior descending artery
B. Right coronary artery
Treatment for a patient with congestive heart failure and shortness of breath may include:

A. Prophylactic suctioning of the airway
B. Hyperventilation with bag valve mask
C. Supine positioning and elevation of the legs
D. Up to three doses of sublingual nitroglycerin
Up to three doses of sublingual nitroglycerin
The myocardium receives its blood supply from the coronary arteries that branch directly from the:

A. Aorta
B. Vena cava
C. Left atrium
D. Right ventricle
A. Aorta
The wall that separates the left and right sides of the heart is called:

A. Carina
B. Septum
C. Pericardium
D. Mediastinum
B. Septum
During your assessment of a 70-year-old man with crushing chest pain, you note that his blood pressure is 80/50 mm Hg. Your most important action should be to:

A. Give high flow oxygen
B. Transport without delay
C. Keep the patient warm
D. Assess his oxygen saturation
B. Transport without delay
After attaching the AED and pushing the analyze button on an adult patient in cardiac arrest, the AED states that a shock is advised. Which cardiac rhythm is the patient MOST likely in?

A. asystole
B. ventricular fibrillation
C. ventricular tachycardia
D. pulseless electrical activity
B. ventricular fibrillation
Your assessment of a middle-aged female with chest pressure reveals that she is confused, is diaphoretic, and has a blood pressure of 70/50 mm Hg. In caring for this patient, it is MOST important for you to:

A. request an ALS unit to respond to the scene
B. assist her with her nitroglycerin if she has any
C. reassess her vital signs at least every 5 minutes
D. prepare for immediate transport to the hospital
D. prepare for immediate transport to the hospital
You are assessing a 70-year-old male who complains of pain in both of his legs. He is conscious and alert, has a blood pressure of 160/90 mm Hg, a pulse rate of 110 beats/min, and respirations of 14 breaths/min and unlabored. Further assessment reveals edema to both of his feet and legs and jugular venous distension. This patient's primary problem is MOST likely:

A. left heart failure
B. right heart failure
C. pulmonary edema
D. chronic hypertension
B. right heart failure
You should suspect that your patient has pulmonary edema if he or she:

A. has swollen feet and ankles
B. cannot breathe while lying down
C. is hypertensive and tachycardia
D. has a dry, nonproductive cough
B. cannot breathe while lying down
When treating a patient with chest pain, pressure, or discomfort, you should first:

A. administer supplemental oxygen
B. place the patient in a position of comfort
C. request ALS ambulance response to the scene
D. assess the blood pressure and give nitroglycerin
...
After applying the AED to an adult patient in cardiac arrest, you analyze her cardiac rhythm and receive a shock advised message. Emergency medical responder's, whoever arrived at the scene before you, tell you that bystander CPR was not in progress upon their arrival you should:

A. Perform CPR for two minutes and then defibrillate
B. Detach the AED and prepare for immediate transport
C. Deliver the shock as indicated followed immediately by CPR
D. Notify medical control and request permission to cease resuscitation
Delivered the shock is indicated followed immediately by CPR
A 60-year-old woman presents with chest discomfort, confusion, and weakness. The patient husband tells you that she vomited twice before EMS arrival. The patients BP is 70/40 mm Hg, her pulse is 45 bpm and weak, and her respirations are 14 breaths/minute and unlabored. Which of the following is most likely cause of her hypotension?

A. Bradycardia
B. Hypovolemia
C. Myocardial ischemia
D. Respiratory Compromise
Bradycardia
Following administration of nitroglycerin to a man with crushing chest pressure, he experiences a significant increase in his heart rate. This is most likely a result of:

A. A cardiac dysrhythmia
B. Pre-existing hypertension
C. A drop in blood pressure
D. Coronary vasoconstriction
C. A drop in blood pressure
In patients with heart disease, acute coronary syndrome is most often the result of:

A. Atrial damage
B. Atherosclerosis
C. Coronary artery spasm
D. Coronary artery rupture
b. atherosclerosis
Which of the following structures is the primary pacemaker, which sets the normal rate for the heart?

A. Bundle of his
B. Purkinje fibers
C. Sinoatrial node
D. Atrioventricular node
C. Sinoatrial node
Ischemic heart disease is a condition in which:

A. A portion of the heart muscle dies because of prolonged lack of oxygen
B. There is a decrease in blood flow to one or more portions of the heart muscle
C. The coronary arteries dilate, thus preventing effective blood flow to the heart
D. And a cute event leads to a significant decrease in the pump in force of the heart
B. There is a decrease in blood flow to one or more portions of the heart muscle
The myocardium receives its blood supply from the coronary arteries that branch directly from the:

A. Aorta
B. Vena cava
C. Left atrium
D. Right ventricle
A. Aorta
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