Chapter 16 - Cardiac Emergencies

Common signs and symptoms of AMI include all of the following, EXCEPT: a. pain exacerbated by breathing. b. irregular heartbeat. c. sudden unexplained sweating. d. shortness of breath or dyspnea.

a

During your treatment of a woman in cardiac arrest, you apply the AED, analyze her cardiac rhythm, and receive a "no shock advised" message. This indicates that: a. she is not in ventricular fibrillation. b. the AED detected patient motion. c. the AED has detected asystole. d. she has a pulse and does not need CPR.

a

Ischemic heart disease is defined as: a. decreased blood flow to one or more portions of the myocardium. b. absent myocardial blood flow due to a blocked coronary artery. c. decreased blood flow to the heart muscle due to coronary dilation. d. death of a portion of the heart muscle due to a decrease in oxygen.

a

Most patients are instructed by their physician to take up to _______________ doses of nitroglycerin before calling EMS. a. three b. two c. four d. five

a

The MOST common reason that many people experiencing AMI do not seek immediate medical attention is because they: a. are in denial. b. are elderly. c. do not trust EMTs. d. cannot afford it.

a

The inferior vena cava returns deoxygenated blood to the right side of the heart from all of the following areas, EXCEPT the: a. brain. b. abdomen. c. kidneys. d. legs.

a

When treating a patient with chest pain, you should assume that he or she is having an AMI because: a. the cause of the pain cannot be diagnosed in the field. b. angina and AMI present identically. c. most patients with chest pain are experiencing an AMI. d. angina usually occurs after an AMI.

a

Which of the following statements regarding the AED and defibrillation is correct? a. The AED will not analyze the rhythm of a moving patient. b. Defibrillation is the first link in the AHA chain of survival. c. CPR should be performed for 5 minutes before using the AED. d. The AED will shock any rhythm not accompanied by a pulse.

a

You are dispatched to a convenience store for a patient who passed out. Upon arriving at the scene, you find two off-duty EMTs performing CPR on the patient, a 58-year-old male. Your initial action should be to: a. feel for a pulse while compressions are ongoing. b. have the EMTs stop CPR and assess for a pulse. c. quickly attach the AED and push the analyze button. d. request a paramedic unit and quickly attach the AED.

a

Blood that is ejected from the right ventricle: a. has a high concentration of oxygen. b. flows into the pulmonary arteries. c. was received directly from the aorta. d. enters the systemic circulation.

b

Sudden death following AMI is MOST often caused by: a. cardiogenic shock. b. ventricular fibrillation. c. severe bradycardia. d. congestive heart failure.

b

The head and brain receive their supply of oxygenated blood from the: a. subclavian arteries. b. carotid arteries. c. brachial arteries. d. iliac arteries.

b

A 40-year-old man is in cardiac arrest. Your partner is performing CPR. You are attaching the AED when the patient's wife tells you that he has an automatic implanted cardiac defibrillator (AICD). The AED advises that a shock is indicated. What should you do? a. Continue CPR and transport the patient to the closest appropriate hospital. b. Avoid defibrillation as this will damage the patient's AICD. c. Deliver the shock followed by immediate resumption of CPR. d. Contact medical control and request permission to defibrillate.

c

A 67-year-old female presents with difficulty breathing and chest discomfort that awakened her from her sleep. She states that she has congestive heart failure, has had two previous heart attacks, and has been prescribed nitroglycerin. She is conscious and alert with adequate breathing. Her blood pressure is 94/64 mm Hg and her heart rate is 120 beats/min. Treatment for this patient includes: a. ventilations with a BVM. b. oxygen at 2 L/min via nasal cannula. c. placing her in an upright position. d. nitroglycerin for her chest pain.

c

After assisting your patient with prescribed nitroglycerin, you should: a. perform a secondary assessment before administering further doses. b. avoid further dosing if the patient complains of a severe headache. c. reassess his or her blood pressure within 5 minutes to detect hypotension. d. place the patient in a recumbent position in case of fainting.

c

Cardiac output may decrease if the heart beats too rapidly because: a. as the heart rate increases, more blood is pumped from the ventricles than the atria. b. the volume of blood that returns to the heart is not sufficient with fast heart rates. c. there is not enough time in between contractions for the heart to refill completely. d. a rapid heartbeat causes a decrease in the strength of cardiac contractions.

c

The MOST common error associated with the use of the AED is: a. malfunction of the AED's internal computer processor. b. inability of the EMT to recognize ventricular fibrillation. c. failure of the EMT to ensure the battery is charged. d. inappropriately placed adhesive defibrillation electrodes.

c

The descending aorta divides into the two iliac arteries at the level of the: a. pubic symphysis. b. iliac crest. c. umbilicus. d. nipple line.

c

You and your EMT partner are the first to arrive at the scene of an unresponsive 70-year-old man. Your assessment reveals that he is apneic and pulseless. A paramedic unit is en route to the scene and will arrive in approximately 5 minutes. You should: a. perform CPR only and wait for the manual defibrillator to arrive. b. begin CPR and have your partner update the responding paramedics. c. begin CPR, apply the AED, and deliver a shock if it is indicated. d. apply the AED while your partner provides rescue breathing.

c

Common side effects of nitroglycerin include all of the following, EXCEPT: a. bradycardia. b. severe headache. c. hypotension. d. hypertension.

d

In contrast to the sympathetic nervous system, the parasympathetic nervous system: a. prepares the body to handle stress. b. dilates the blood vessels in the muscles. c. causes an increase in the heart rate. d. slows the heart and respiratory rates.

d

Major risk factors for AMI include all of the following, EXCEPT: a. hypertension. b. diabetes mellitus. c. elevated cholesterol. d. hypoglycemia.

d

Nitroglycerin relieves cardiac-related chest pain by: a. increasing the amount of stress that is placed on the myocardium. b. contracting the smooth muscle of the coronary and cerebral arteries. c. constricting the coronary arteries and improving cardiac blood flow. d. dilating the coronary arteries and improving cardiac blood flow.

d

The AED has delivered a shock to an elderly male in cardiac arrest. Following 2 minutes of CPR, you re-analyze the patient's cardiac rhythm and receive a "no shock advised" message. After further resuscitation, you restore a palpable carotid pulse. Your next action should be to: a. obtain a blood pressure and apply the pulse oximeter. b. place him in the recovery position and apply oxygen. c. transport at once and re-analyze his rhythm en route. d. reassess airway and breathing and treat accordingly.

d

The purpose of defibrillation is to: a. cause a rapid decrease in the heart rate of an unstable patient. b. prevent asystole from deteriorating into ventricular fibrillation. c. improve the chance of CPR being successful in resuscitation. d. stop the chaotic, disorganized contraction of the cardiac cells.

d

What is the function of the left atrium? a. It ejects oxygenated blood into the aorta. b. It receives oxygenated blood from the vena cava. c. It receives blood from the pulmonary arteries. d. It receives oxygenated blood from the lungs.

d

Which of the following is NOT a function of the sympathetic nervous system? a. Increases in the heart and respiratory rates b. Dilation of blood vessels in the muscles c. Constriction of blood vessels in the digestive system d. Constriction of blood vessels in the muscles

d

Which of the following statements regarding nitroglycerin is correct? a. A maximum of five nitroglycerin doses should be given to a patient. b. Nitroglycerin should be administered between the cheek and gum. c. The potency of nitroglycerin is increased when exposed to light. d. Nitroglycerin usually relieves anginal chest pain within 5 minutes.

d

You are assessing a 49-year-old man who complains of chest pressure that began the night before. He is conscious, but anxious, and tells you he has a history of angina and hypertension. After applying high- flow oxygen, you expose his chest to auscultate his lungs and note that he has a nitroglycerin patch on his right upper chest. His skin is cool and pale, his blood pressure is 78/50 mm Hg, and his pulse is 110 beats/min and irregular. You should: a. immediately remove the nitroglycerin patch, apply the AED in case he develops cardiac arrest, and transport to the closest hospital. b. move the nitroglycerin patch to the other side of his chest in case you need to apply the AED, keep him warm, and transport without delay. c. ask him if the nitroglycerin patch he is wearing has improved his chest pressure, complete your secondary assessment, and transport promptly. d. remove the nitroglycerin patch, place him in a supine position and elevate his lower extremities, and prepare for immediate transport.

d

You are dispatched to a residence for a 56-year-old male with an altered mental status. Upon arrival at the scene, the patient's wife tells you that he complained of chest pain the day before, but would not allow her to call EMS. The patient is semiconscious; has rapid, shallow respirations; and has a thready pulse. You should: a. apply a nonrebreathing mask. b. obtain baseline vital signs. c. attach the AED immediately. d. begin ventilatory assistance.

d