chapter 17 emt- Harrison
medical control orders you to administer nitroglycerin to an 82 year old male with chest pain.what is the maximum number of doses you should administer? A.3 B.4 C.1 D.2
3
Signs and symptoms of a hypertensive emergency would MOST likely be delayed in patients who: A. regularly take illegal drugs B. are older than 40 years old of age C. have chronic hypertension D. have had a stroke in the past
Have chronic hypertension.
Major risk factors for AMI include all of the following, EXCEPT: A. elevated cholesterol B. hypoglycemia C. diabetes mellitus D. hypertension
hypoglycemia
A patient tells you that he has a left ventricular assist device (LVAD). Which of the following conditions should you suspect that he has experienced? A. obstructive lung disease B. uncontrolled hypertension C. acute myocardial infarction D. thoracic aortic aneurysm
-Acute myocardial infarction
A 66-year-old female with a history of hypertension and diabetes presents with substernal chest pressure of 2 hours' duration. Her blood pressure is 140/90 mm Hg, her pulse is 100 beats/min and irregular, her respirations are 22 breaths/min, and her oxygen saturation is 92%. The patient does not have prescribed nitroglycerin, but her husband does. You should: A. give her one dose of nitroglycerin and reassess her systolic blood pressure B. administer oxygen, give her 324 mg of aspirin, and assess her further c. give her high flow oxygen, attach the AED and transport at once D. obtain a SAMPLE history and contact medical control for advice
-administer oxygen, give her 324 mg of aspirin, and assess her further.
A patient in cardiac arrest is wearing an external defibrillator vest, which is interfering with effective chest compressions. The EMT should: A. remove the battery from the monitor and leave the vest in place B. remove the battery from the monitor and then remove the vest C. perform ventilations only and allow the vest device to defribillate D. leave the battery attached to the monitor and remove the vest
-remove the battery from the monitor and then remove the vest.
what is the minimum systolic blood pressure necessary to administer nitroglycerin? A. 130 mm Hg B. 120 mm Hg C. 110 mm Hg D. 100 mm Hg
100 mm Hg
which of the following patients is most likely suffering from congestive heart failure? A. A 38 year old female complaining of near syncope, nausea, and vomiting B. a 64 year old male with uncontrolled hypertension, dependent edema, and dyspnea C. a 55 year old female who is jaundiced, tachycardia, and hypotensive D. a 38 year old male with polydipsia and increased glucode levels
A 64 year old male with uncontrolled hypertension, dependent edema, and dyspnea
a 65 year old female is complaining of chest pain. you suspect she is having an acute myocardial infarction. vital signs are BP 110/80, P 90, R 18, and spo2 97%. what should you administer? A. nitrogylcerin B. epipen C. oxygen d. aspirin
Aspirin
Which of the following is the MOST reliable method of estimating a patient's cardiac output? A. listen to heart sounds with a stethoscope B. assess the heart rate and strength of the pulse C. connect the patient to an electrocardiogram D. determine the average diastolic blood pressure
Assess the heart rate and strength of the pulse.
You and your partner have achieved return of spontaneous circulation (ROSC) in a patient who was in cardiac arrest. An ALS unit will arrive in less than 2 minutes. The patient remains unresponsive and has slow, irregular breathing. Further treatment for this patient should include: A. elevation of his lower extremities and covering him with warm blankets B. oxygen via nonrebreathing mask at 15 L/ min and immediate transport C. insertion of an oropharyngeal airway and positioning him on his side D. bag mask ventilation at 10 breaths/min and assessment of oxygen saturation
BVM ventilation at 10-12 breaths/min and assessment of oxygen saturation.
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. begin CPR and have your partner update the responding paramedics B. perform CPR only and wait for the manual defribillator to arrive C. apply the AED while your partner provides rescue breathing D. begin CPR, apply the AED, and deliver a shock if it is indicated
Begin CPR, apply the AED, and deliver a shock if it is indicated.
You and your partner arrive at the scene of a middle-aged man who collapsed about 5 minutes ago. He is unresponsive, apneic, and pulseless. Bystanders are present, but have not provided any care. You should: A. immediately apply the AED pads and analyze his cardiac rhythm B. have your partner perform CPR while you question the bystanders C. perform two rescuer CPR for 5 minutes and request ALS backup D. begin high quality CPR and apply the AED as soon as possible
Begin high-quality CPR and apply the AED as soon as possible.
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. attach the AED immediately C. begin ventilatory assistance D. obtain baseline vital signs
Begin ventilatory assistance.
It would be MOST appropriate for a patient to take his or her prescribed nitroglycerin when experiencing: A. sharp chest pain that lasts longer than 10 to 15 minutes B. difficulty breathing that awakens the patient from sleep C. chest pain that does not immediately subside with rest D. an acute onset of dizziness during a period of exertion
Chest pain that does not immediately subside with rest.
Which of the following is NOT a function of the sympathetic nervous system? A. constriction of blood vessels in the digestive system B. dilation of blood vessels in the muscles C. increases in the heart and respiratory rates D. constriction of blood vessels in the muscles
Constriction of blood vessels in the muscles.
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 implantable 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. contact medical control and request permission to defribilitate C. avoid defiribilitation because this will damage the patient's AICD D. deliver the shock followed by immediate resumption of CPr
Deliver the shock followed by immediate resumption of CPR
A percutaneous transluminal coronary angioplasty (PTCA) restores blood flow to the ischemic myocardium by... A. scraping fatty deposits off of the lumen of the coronary artery B. placing a stent inside the coronary artery to keep it from narrowing C. dilating the affected coronary artery with a small inflatable balloon D. bypassing the coronary artery with a vessel from the chest or leg
Dilating be affected coronary artery with a small inflatable balloon
A 66-year-old woman presents with a stabbing pain in the middle of her chest that radiates to her back. She tells you that the pain suddenly began about 30 minutes ago and has been severe since the onset. She has a history of hypertension, but admits to not being compliant with her regimen of antihypertensive medications. During the primary assessment, you find that her blood pressure is significantly higher in her left arm then it is in her right arm. What do the signs and symptoms MOST likely indicate? A. acute myocardial infarction B. hypertensive emergency C. dissecting aortic aneurysm D. unstable angina
Dissecting aortic aneurysm
Prior to attaching the AED to a cardiac arrest patient, the EMT should: A> perform CPR for 30 seconds B. contact medical control C. dry the chest if it is wet D. assess for a pulse for 20 seconds
Dry the chest if it is wet.
While obtaining a 12-lead ECG prior to ALS arrival, you note the presence of artifacts on the tracing. Which of the following is the MOST likely cause of this? A. excessive movement of the patient B. abnormal cardiac electrical activity C. irregular patient pulse D. incorrect placement of the leads
Excessive movement of the patient.
Which of the following is LEAST important when obtaining a medical history from a patient complaining of chest discomfort? A. family history of hypertension B. history of cigarette smoking C. history of previous heart attack D. presence of personal risk factors
Family history of hypertension.
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. request a paramedic unit and quickly attach the AED B. have the EMTs stop CPR and assess for a pulse C. quickly attach the AED and push the analyze button D. feel for a pulse while compressions are ongoing
Feel for a pulse while compressions are ongoing.
Which of the following signs or symptoms would you NOT expect to encounter in a patient with congestive heart failure? A. hypertension and tachycardia B. the presence of rales in the lungs C. hypotension and flat jugular veins D. trouble breathing while lying down
Hypotension and flat jugular veins
Which of the following would cause the greatest increase in cardiac output? A> increased heart rate and increased stroke volume B. decreased heart rate and increased stroke volume C. decreased stroke volume and decreased heart rate D. decreased stroke volume and increased heart rate
Increased heart rate and increased stroke volume
Which of the following statements regarding the pain associated with AMI is correct? A. it can occur during exertion or when the patient is at rest B. nitroglycerin usually resolves the pain within 30 minutes C. it is often described by the patient as a sharp feeling D. it often fluctuates in intensity when the patient breathes
It can occur during exertion or when the patient is at rest.
What is the function of the left atrium? A. it ejects oxygenated blood into the aorta B. it receives oxygenated blood from the lungs C. it receives blood from the pulmonary arteries D. it receives oxygenated blood from the vena cava
It receives oxygenated blood from the lungs.
A patient with atherosclerotic heart disease experiences chest pain during exertion because the... A. the coronary arteries suddenly spasm and cause a marked reduction in myocardal blood flow B. tissues of the myocardium undergo necrosis secondary to a prolonged absence of oxygen C. the ragged edge of a tear in the coronary artery lumen causes local blood clotting and arterial narrowing D. the lumen of the coronary artery is narrowed and cannot accomadate increased blood flow
Lumen of the coronary artery is narrowed and cannot accommodate increased blood flow
Which of the following statements regarding nitroglycerin is correct? A. nitroglycerin should be administered between the cheek and gum B. the potency of nitroglycerin is increased when exposed to light C. nitroglycerin usually relieves anginal chest pain within 5 minutes D. A maximum of five nitroglycerin doses should be given to a patient
Nitroglycerin usually relieves anginal chest pain within 5 minutes.
When preparing to obtain a 12-lead ECG, the V1 and V2 electrodes should be placed: A. in the mixaxillary line B. in the midclavicular line C. on either side of the sternum D. on the left and right arms
On either side of the sternum.
When preparing to obtain a 12-lead ECG, the "LL" and "RL" electrodes should be placed: A> on the thighs or ankles B. on the lower abdomen C. on either side of the chest D. anywhere on the arms
On the thighs or ankles.
The EMT should use an AED on a child between 1 month and 8 years of age if: A. his or her condition is rapidly progressing to cardiac arrest B. special pads are used and his child has profound tachycardia C. pediatric pads and an energy reducing device are available D. he or she is not breathing and has a weakly palpable pulse
Pediatric pads and an energy-reducing device are available.
A 67-year-old woman 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 prescribed nitroglycerin. She is conscious and alert with adequate breathing. Her blood pressure is 96/64 mm Hg and her heart rate is 120 breaths/min. Treatment for this patient includes... A. ventilations with a BVM B. nitroglycerin for her chest pain C. placing her in a upright position D. Oxygen at 2 L/min via nasal cannula
Placing her in an upright position
Which of the following is NOT a common sign or symptom associated with malfunction of an implanted cardiac pacemaker? A. rapid heart rate B. heart rate less than 60 beats/min C. syncope or dizziness D. generalized weakness
Rapid heart rate.
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. place him in the recovery position and apply oxygen B. transport at once and re analyze his rhythm en route C. obtain a blood pressure and apply the pulse oximeter D. reassess airway and breathing and treat accordingly
Reassess airway and breathing and treat accordingly.
After assisting your patient with prescribed nitroglycerin, you should: A. place the patient in a recumbent position in case of fainting B. perform a secondary assessment before administering further doses C. reassess his or her blood pressure within 5 minutes to detect hypotension D. avoid further dosing if the patient complains of a severe headache
Reassess the blood pressure within 5 minutes to detect hypotension
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. move the nitroglycerin patch to the other side of his chest and administer oxygen B. remove the nitroglycerin patch and apply the AED in case he develops cardiac arrest C. remove the nitroglycerin patch, administer oxygen, and place him in a supine position
Remove the nitroglycerin patch, administer oxygen, and place him in a supine position
Most AEDs are set up to adjust the voltage based on the impedance, which is the: A> resistance of the body to the flow of electricity B. actual amount of energy that the AED will deliver C. direction that the electrical flow takes in the body D. distance between the two AED pads on the chest
Resistance of the body to the flow of electricity.
The right coronary artery supplies blood to the: A. left ventricle and posterior wall of the right ventricle B. left ventricle and inferior wall of the right atrium C. right atrium and posterior wall of the right ventricle D. right ventricle and inferior wall of the left ventricle
Right ventricle and inferior wall of the left ventricle.
Which of the following veins is located inferior to the trunk? A. subclavian B. cephalic C. saphenous D. axillary
Saphenous.
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 has a pulse and does not need CPr B. the AED detected patient motion C. she is not in ventricular fibrillation D. the AED has detected asystole
She is not in ventricular fibrillation.
In contrast to the sympathetic nervous system, the parasympathetic nervous system: A. Causes an increase in the heart rate B. dilates the blood vessels in the muscles C. slows the heart and respiratory rates d. prepares the body to handle stress
Slows the heart and respiratory rates.
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. defribillation is the first link in the AHA chain of survival C. the AED will shock any rhythm not accmpanied by a pulse D.CPR should be performed for 5 minutes before using the AED
The AED will not analyze the rhythm of a moving patient.
Sudden death following AMI is MOST often caused by: A. CHF B. cardiogenic shock C. ventricular fibrillation D. severe bradycardia
Ventricular fibrillation.
Which of the following cardiac dysrhythmias has the greatest chance of deteriorating into a pulseless rhythm? A. sinus tachycardia B. ventricular tachycardia C. sinus bradycardia D. extra ventricular beats
Ventricular tachycardia.
Common signs and symptoms of a hypertensive emergency include: A. pallor, cool skin, and a temporary loss of hearing b.tachycardia,pain behind the eyes, and a weakness C. a bounding pulse, a severe headache, and dizziness D. Syncope,l a weak pulse, and bleeding from the ears
a bounding pulse, a severe headache, and dizziness.
Acute coronary syndrome (ACS) is a term used to describe: A. a severe decrease in perfusion caused by changes in heart rate B. the exact moment that a c oronary artery is completely occluded C. the warning signs that occur shortly before a heart attack D. a group of symptoms that are caused by myocardial ischemia
a group of symptoms that are caused by myocardial ischemia.
Acute coronary syndrome (ACS) is a term used to describe: A. the warning signs that occur shortly before a heart attack B. the exact moment that a coronary artetry is completely occluded C. a severe decrease in perfusion caused by changes in heart rate D. a group of symptoms that are caused by myocardial ischemia
a group of symptoms that are caused by myocardial ischemia.
the aorta dilates at a weakened area, which makes it susceptible to rupture. what is this called? A. aneurysm B. angina C. thrombus D. emobli
aneurysm
a patient with a left ventricular assist device (LVAD) tells you that the device's pump flow is continuous. which of the following should you expect to encounter during your assessment A. high systolic blood pressure B. distention of the jugular veins C. absence of a palpable pulse D. low diastolic blood pressure
absence of a palpable pulse
which of the following represents the most appropriate method of assisting a patient with his or her prescribed nitroglycerin tablet or spray? A. encourage the patient to chew the tablet to increase its effectiveness B. wait 15 minutes and reassess the patient's blood pressure prior to adminstering another dose C. administer the medication sublingually and allow it to dissolve or absorb D. place the medication under the tongue and have the patient swallow it
administer the medication sublingually and allow it to dissolve or absorb
a 55 year old male is complaining of chest pain that was relieved with nitroglycerin. vital signs are BP 100/70, R 20, and a P 100. what should you suspect? A. Abdominal aneurysm B. cardiogenic c. congestive heart fialure D. angina pectoris
angina pectoris
which of the following is a major difference between angina pectoris and ami? A. AMI is caused by myocardial ischemia B. anginal pain typically subsides with rest C. nitroglycerin has no effect on angina pectoris D. pain from an AMI subsides within 30 minutes
anginal pain typically subsides with rest
The MOST common reason that many people experiencing AMI do not seek immediate medical attention is because they A. cannot afford it B. do not trust EMTs C. are elderly D. are in denial
are in denial
Which of the following medications is commonly given to patients with chest pain to prevent blood clots from forming or getting bigger? A. aspirin B. metoprolol(toprol) C. oxygen D. Furosemide (Lasix)
aspirin
A 49-year-old male presents with an acute onset of crushing chest pain and diaphoresis. You should: A. administer up to three doses of nitroglycerin B. administer up to 324 mg of baby aspirin C. obtain vital signs and a sample history D. assess the adequacy of his respirations
assess the adequacy of his respirations.
Upon arriving at the residence of a patient with a possible cardiac problem, it is MOST important to: A. determine if you need additional help B. gain immediate access to the patient C. assess the scene for potential hazards D. request a paramedic unit for assistance
assess the scene for potential hazards.
which of the following is the absence of all electrical activity in the heart? A. ventricular fibrillation B. normal sinus C. ventricular tachycardia D. asystole
asystole
Narrowing of the coronary arteries due to a buildup of fatty deposits is called: A. arteriosclerosis B. atherosclerosis C. angina pectoris D. acute ischemia
atherosclerosis
The ability of cardiac muscle cells to contract spontaneously without a stimulus from a nerve source is called... A. automaticity B. excitability C. contractility D. impulsivity
automaticity
The electrical stimulus that originates in the heart's primary pacemaker is controlled by impulses from the brain that arrive by way of the: A. parietal lobe B. pons and medulla C. autonomic nervous system D. somatic nervous system
autonomic nervous system.
The posterior tibial pulse can be palpated A. in the fossa behind the knee B. on the dorsum of the foot C. between the trachea and the neck muscle D. behind the medial malleolus, on the inside of the ankle
behind the medial malleolus, on the inside of the ankle.
when an electrical impulse reaches the AV node, it is slowed for a brief period of time so that A. blood can pass from the atria to the ventricles. B. blood returning from the body can fill the atria C. the impulse can spread through the purkinje fibers D. the SA node can reset and generate another impulse
blood returning from the body can fill the atria
The inferior vena cava returns deoxygenated blood to the right side of the heart from all of the following areas, EXCEPT the: A. abdomen B. brain C. kidneys D. legs
brain
the volume of blood that passes through the heart in 1 minute is known as the: A. minute volume B. cardiac output C. stroke volume D. heart rate
cardiac output
The head and brain receive their supply of oxygenated blood from the: A> iliac arteries B. carotid arteries C. brachial arteries D. subclavian arteries
carotid arteries.
Rapid, labored breathing in a patient with signs and symptoms of AMI should make you suspicious for: A. CHF B. Right ventircular failure C. a cardiac arrhythmia D. significant hypotension
congestive heart failure
a 70 year old female is complaining of difficulty breathing. she has rales (crackles) bilaterally with dependent edema. what should you suspect? A. CHF B. influenza C. Pneumonia D. acute myocardial Infarction
congestive heart failure
a 65 year old male is not breathing and is pulseless. high quality cpr has been in progress for approximately 2 minutes. the AED states,"no shock advised". what should you do A. Check the patient's pulse B. continue CPR C. defribiliate the patient D. ventilate the patient
continue cpr
The myocardium receives oxygenated blood from the __________, which originate(s) from the __________. A. vena cava, coronary veins B. coronary arteries, aorta C. aorta, inferior vena cava D. coronary sinus, vena cava
coronary arteries, aorta
The electrical impulse generated by the heart originates in the: A> atrioventricular node B. sinoatrial node C. bundle of his D. coronary sinus
coronary sinus
Ischemic heart disease is MOST accurately defined as: A. death of a portion of the heart muscle due to a decrease in oxygen B. absent myocardial blood flow due to a blocked coronary artery C. decreased blood flow to the heart muscle due to coronary dilation D. decreased blood flow to one or more porrtions of the myocardium
decreased blood flow to one or more portions of the myocardium.
cadiogenic shock following AMI is caused by: A. widespread dilation of the systemic vasculature B. decreased pumping force of the heart mucle C. a profound increase in the patient's heart rate D. hypovolemia secondary to severe vomiting
decreased pumping force of the heart muscle.
In contrast to an automatic implantable cardiac defibrillator (AICD), an external defibrillator vest: A> does not require the EMt to stand clear when it shocks B. does not warn when a shock is about to be delivered C. delivers high-energy shocks, similar to an AED D. will only deliver a shock if ventircular fibrillation occurs
delivers high-energy shocks, similar to an AED.
Which of the following signs is commonly observed in patients with right-sided heart failure? A. pulmonary edema B. flat jugular veins C. labored breathing D. dependent edema
dependent edema
Nitroglycerin relieves cardiac-related chest pain by A. dilating the coronary arteries and improving cardiac blood flow B. contracting the smooth muscle of the coronary and cerebral arteries C. increasing the amount of stress that is placed on the myocardium D. constricting the coronary arteries and improving cardiac blood flow
dilating the coronary arteries and improving cardiac blood flow
Prior to defibrillating a patient with an AED, it is MOST important that you: A. perform up to 5 minutes of effective CPr B. properly position the defribillation pads C. ensure that no one is touching the patient D. confirm that the patient is in cardiac arrest
ensure that no one is touching the patient.
the main legal risk in using the AED is: A. failing to deliver a shock when one is needed B. negligence on the part of the manufacturer C. not asessing for a pulse after a shock is delivered D. failure of the AED's internal computer chip
failing to deliver a shock when one is needed.
The MOST common error associated with the use of the AED is A> malfunction of the AED's internal computer processor B. inappropriately placed adhesive defribillation dlectrodes C. inability of the EMT to recognize ventricular fibrillation D. failure of the EMT to ensure that the battery is charged
failure of the EMT to ensure the battery is charged
Risk factors for AMI that cannot be controlled include: A. excess stress B. lack of exercise C. family history D. hyperglycemia
family history
The iliac arteries immediately subdivide into the A> posterior tibial arteries B. femoral arteries C. anterior tibial arteries D. peroneal arteries
femoral arteries
Blood that is ejected from the right ventricle: A. has a high concentration of oxygen B. enters the systemic circulation C. flows into the pulmonary arteries D. was received directly from the aorta
flows into the pulmonary arteries.
common side effects of nitroglycerin include all of the following, EXCEPT: A. severe headcache B. bradycardia C. hypertension D. hypotension
hypertension
After the AED has delivered a shock, the EMT should: A. transport the patient at once B. immediately resume CPR C. assess for a carotid pulse D. re-analyze the cardiac rhythm
immediately resume CPR
when obtaining a 12-lead ECG, the patient should be: A. in a semi-fowler's position with leg crossed B. in a supine position with legs uncrossed C. in a semi fowler's position with arms raised D. in a supine position with legs elevated
in a supine position with legs uncrossed
The AED is MOST advantageous to the EMT because: A. it is lightweight, easy to use, and safe for the EMT who is using it B. it delivers prompt defribillation to patients with ventircular fibrillation C. it delivers an unlimited number of shocks with the same amount of energy D. its use does not require the presence of advanced life support personnel
it delivers prompt defibrillation to patients with ventricular fibrillation.
which statement regarding the right side of the heart is true? A. it moves oxygenated blood B. it is the thickest ventricle C. it pumps blood into the pulmonary veins D. it receives blood from the vena cava
it receives blood from the vena cava
Angina pectoris occurs when: A. a coronary artery is totally occluded by plaque B. myocardial oxygen demand exceeds supply C. one or more coronary arteries suddenly spasm D. myocardial oxygen supply exceeds the demand
myocardial oxygen demand exceeds the supply
An acute myocardial infarction (AMI) occurs when: A. the heart muscle progressively weakens and dysfunction B. the entire left ventricle is damaged and cannot pump blood C. myocardial tissue dies secondary to an absence of oxygen D. coronary artery dilation decreases blood flow to the heart
myocardial tissue dies secondary to an absence of oxygen.
Prior to assisting a patient with his or her prescribed nitroglycerin, the EMT must: A. ensure the medication is in tablet form B. determine who prescribed the nitroglycerin C. wait at least 5 minutes after assessing the blood pressure D. obtain authorization from medical control
obtain authorization from medical control
In contrast to AMI, a dissecting aortic aneurysm: A. is typically preceded by other symptoms, such as nausea B. often presents with pain that is maximal from the onset C. usually presents gradiually, often over a period of hours D. is more commonly associated with pressure in the chest
often presents with pain that is maximal from the onset.
the left side of the heart receives ______ through the _________. A> oxygen poor blood, pulmonary artery B. oxygen rich blood pulmonary artery C. oxygen rich blood pulmonary vein D. oxygen poor blood , pulmonary vein
oxygen-rich blood, pulmonary vein
Common signs and symptoms of AMI include all of the following, EXCEPT... A. sudden unexplained sweating B. pain exacerbated by breathing C.. irregular heartbeat D. shortness of breath or dyspnea
pain exacerbated by breathing
Your EMS team is performing CPR on a 60-year-old male in cardiac arrest. You connect the AED, push the analyze button, and receive a "no shock advised" message. You should: A. determine if a palpable pulse is present B. immediately assess the patient's airway C. perform CPr for 2 minutes and reassess D. re analyze the patient's cardiac rhythm
perform CPR for 2 minutes and reassess.
Which of the following blood vessels transports oxygenated blood? A. pulmonary arteries B. inferior vena cava C. pulmonary veins D. superior vena cava
pulmonary veins
the left ventricle has the thickest walls because it: A> uses less oxygen than other chambers of the heart B. pumps blood to the lungs to be reoxygenated C. pumps blood into the aorta and systemic circulation D. receives blood directly from the systemic circulation
pumps blood into the aorta and systemic circulation
Deoxygenated blood from the body returns to the: A. left ventricle B. right ventricle C. right atrium D. left atrium
right atrium
Which artery supplies blood to the right atrium, the right ventricle, and part of the left ventricle? A> right anterior descending B. interventricular C. left coronary D. right coronary
right coronary
what is area of conduction in the heart where normal electrical impulses originate? A. bundle of his B. sinus node C. pacemaker D. myocyte
sinus node
A 67-year-old female with severe chest pain becomes unresponsive, pulseless, and apneic during transport. You should: A> alert the receiving hospital and perform CPR for the duration of the transport B. Perform CPR to 1 to 2 minutes and then analyze her rhyhytm with an AED C. defribilitate with the AED while contionuing transport to the hospital D. stop the ambulance, begin CPR, and attach the AED as soon as possible
stop the ambulance, begin CPR, and attach the AED as soon as possible.
which of the following equations represents cardiac output? A. preload x afterload B. ejection fraction x blood pressure C. peripheral vascular resistance x contractility D. stroke volume x heart rate
stroke volume x heart rate
which of the following routes should you use to administer nitroglycerin? A. sublingual B. intramuscular C. intranasal D. transverse
sublingual
When the myocardium requires more oxygen A. the heart rate decreases significantly B. the heart contracts with less force C. the AV node conducts fewer impulses D. the arteries supplying the heart dilate
the arteries supplying the heart dilate.
When treating a patient with chest pain, you should assume that he or she is having an AMI because: A. angina and AMI present identically B. angina usually occurs after an AMI C. most patients with chest pain are experiencing an AMI D. the cause of the pain cannot be diagnosed in the field
the cause of the pain cannot be diagnosed in the field.
A dissecting aortic aneurysm occurs when: A. a weakened area develops in the aortic wall B., all layers of the aorta suddenly contract C. the inner layers of the aorta become separated D. the aorta ruptures, resulting in profound bleeding
the inner layers of the aorta become separated.
Ventricular tachycardia causes hypotension because: A. the volume of blood returning to the atria increases B. blood backs up into the lungs and causes congestion C. the right ventricle does not adequately pump blood D. the left ventricle does not adequately fill with blood
the left ventricle does not adequately fill with blood
Prompt transport of a patient with a suspected AMI is important because: A. 90% of the cardiac cells will die within the first 30 minutes B. the patient may be eligigble to receive thrombolytic therapy C. many patients with an AMI die within 6 hours D. nitroglycerin can only be given in the emergency department
the patient may be eligible to receive thrombolytic therapy.
cardiac output may decrease if the heart beats too rapidly because: A. as the heart rate increases, more blood is pupmped from the ventircles than the atria B. a rapid heartbeat causes a decrease in the strength of cardiac contractions C. there is not enough time in between contractions for the heart to refill completely D. the volume of blood that returns to the heart is not sufficient with fast heart rates
there is not enough time inn between contractions for the heart to refill completely
Most patients are instructed by their physician to take up to _______ doses of nitroglycerin before calling EMS. A.three B.five C.two D.four
three
The descending aorta divides into the two iliac arteries at the level of the A. iliac crest B. umbilicus C. pubic symphysis D. nipple line
umbilicus
what is the primary cause of a dissecting aneurysm? A. uncontrolled hypertension B. acute myocardial infarction C. chronic alcoholism D. atherosclerosis
uncontrolled hypertension
When documenting a patient's description of his or her chest pain or discomfort, the EMT should: A. document his or her own perception B. use the patient's own words C. underline the patient's quotes D. use medical terminology
use the patient's own words.
an automated external defibrillator is designed to detect and defibrillate which rhythm? A. pulseless electrical activity B. atrial fibrillation C. sinus tachycardia D. ventricular fibrillation
ventricular fibrillation
what heart rhythm is a disorganized, ineffective quivering of the ventricles and does not pump blood through the body? A. pulseless electrical activity B. asystole C. ventricular tachycardia D. ventricular fibrillation
ventricular fibrillation
Nitroglycerin is contraindicated in patients: A> who have experienced a head injury B. with a history of an ischemic stroke C. who have taken up to two doeses D. with a systolic blood pressure less than 120 mm Hg
who have experienced a head injury.
Defibrillator pads are placed on the patient's chest: A. with one pad to the left of the upper sternum and the other pad to the right lower chest below the armpit B. with one pad to the right of the upper sternum and theo hter pad to the left lower chest below the armpt C. with one pad to the right of the uper sternum and the other pad just to the righto fhte right nipple D. with one pad to the left of the upper sternum and the other pad just to the right of the left nipple
with one pad to the right of the upper sternum and the other pad to the left lower chest below the armpit.
