EMT-Chapter 17- Cardiovascular Emergencies

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. legs. C. kidneys. D. abdomen.

brain

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. Low diastolic blood pressure C. Absence of a palpable pulse D. Distention of the jugular veins

Absence of a palpable pulse

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. acute myocardial infarction B. uncontrolled hypertension C. thoracic aortic aneurysm D. obstructive lung disease

acute myocardial infarction

the Most common reason that many people experiencing AMI do no seek immediate medical attention is because they: A. are in denial. B. do not trust EMTS. C. are elderly. D. cannot afford it.

are in denial

the posterior tibial pulse can be palpated: A. behind the medial malleolus, on the inside of the ankle. B. on the dorsum of the foot. C. in the fossa behind the knee. D. between the trachea and the neck muscle

behind the medial malleolus, on the inside of the ankle

The AED is most advantageous to the EMT because: A. it delivers an unlimited number of shocks with the same amount of energy. B. its use does not require the presence of advanced life support personnel. C. it delivers prompt defibrillation to patients with ventricular fibrillation. D. it is lightweight, easy to use, and safe for the EMT who is using it.

it delivers prompt defibrillation to patients with ventricular fibrillation

which of the following statements regarding nitroglycerin is correct? A. nitroglycerin should be administered between the cheek and gum. B. a maximum of five nitroglycerin doses should be given to a patient. C. nitroglycerin usually relieves anginal chest pain within 5 minutes. D. the potency of nitroglycerin is increased when exposed to light.

nitroglycerin usually relieves anginal chest pain within 5 minutes

your EMS team is performing CPR on a 60-year-old male in cardiac arrest. you connect the AED, push the analyze button, a "no shock advised" message. you should: A. re-analyze the patient's cardiac rhythm. B. determine if a palpable pulse is present. C. immediately assess the patient's airway. D. perform CPR for 2 minutes and reassess.

perform CPR for 2 minutes and reassess

which of the following blood vessels transports oxygenated blood? A. superior vena cava. B. pulmonary veins. C. pulmonary arteries. D. inferior vena cava.

pulmonary veins

the AED has delivered a shock to an elderly male in cardiac arrest. following 2 minutes of CPR, you re-analyze the patients cardiac rhythm and receive a "no shock advised' message. after further resuscitation, you restore a palpable carotid pulse. your next action should be able to: A. transport at one and re-analyze his rhythm en route. B. place him in the recovery position and apply oxygen. C. reassess airway and breathing and treat accordingly. D. obtain a blood pressure and apply the pulse oximeter.

reassess airway and breathing and treat accordingly

in contrast to the sympathetic nervous system, the parasympathetic nervous system: A. dilates the blood vessels in the muscles. B. causes an increase in the heart rate. C. slows the heart and respiratory rates. D. prepares the body to handle stress.

slows the heart and respiratory rates

deoxygenated blood from the body returns to the : A. left ventricle B. right ventricle C. right atrium D. left atrium

right atrium

the right coronary artery supplies blood to the : A. right atrium and posterior wall of the right ventricle. B. left ventricle and posterior wall of the right ventricle. C. left ventricle and inferior wall of the right atrium. D. right ventricle and inferior wall of the left ventricle.

right ventricle and inferior wall of the left ventricle

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. the AED detected patient motion. B. the AED has detected asystole. C. she is not in ventricular fibrillation. D. she has a pulse and does not need CPR.

she is not in ventricular fibrillation.

the electrical impulse generate by the heart originates in the: A. bundle of his. B. coronary sinus . C. sinoatrial node. D. atrioventricular node.

sinoatrial node

A dissecting aortic aneurysm occurs when: A. the inner layers of the aorta become separated. B. all layers of the aorta suddenly contract. C. a weakened area develops in the aortic wall. D. the aorta ruptures

the inner layers of the aorta become separated.

prompt transport of a patient with a suspected AMI is important because: A. nitroglycerin can only be given in the emergency department. B. 90 % of the cardiac cells will die within the first 30 minutes. C. many patients with an AMI die within 6 hours. D. the patient may be eligible to receive thrombolytic therapy.

the patient may be eligible to receive thrombolytic therapy.

when documenting a patients description of his or her chest pain or discomfort , the EMT should: A. document his or her own perception. B. use the patients own words. C. underline the patients quotes. D. use medical terminology.

use the patients own words

Sudden death following AMI is MOST often caused by: A. congestive heart failure. B. ventricular fibrillation. C. severe bradycardia. D. cardiogenic shock.

ventricular fibrillation.

which of the following cardiac dysrhythmias has the greatest chance of deteriorating into a pulseless rhythm? A. ventricular tachycardia B. sinus bradycardia C. extra ventricular beats D. sinus tachycardia

ventricular tachycardia

Nitroglycerin is contraindicated in patients: A. with a history of an ischemic stroke. B. with a systolic blood pressure less than 120 mm Hg. C. who have experienced a head injury. D. who have taken up to two doses.

who have experienced a head injury.

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

The AED will not analyze the rhythm of a moving patient.

Which of the following statements regarding the pain associated with AMI is correct? A. It is often described by the patient as a sharp feeling. B. Nitroglycerin usually resolves the pain within 30 minutes. C. It can occur during exertion or when the patient is at rest. D. It often fluctuates in intensity when the patient breathes

It can occur during exertion or when the patient is at rest.

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 coronary 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.

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 high-flow oxygen, attach the AED, and transport at once. B. administer oxygen, give her 324 mg of aspirin, and assess her further. C. obtain a SAMPLE history and contact medical control for advice. D. give her one nitroglycerin and reassess her systolic blood pressure.

administer oxygen, give her 324 mg of aspirin, and assess her further.

which of the following represents the Most appropriate method of assisting a patient with his or her prescribed nitroglycerin tablet or spray? A. wait 15 minutes and reassess the patient's blood pressure prior to administering another dose. B. place the medication under the tongue and have patient swallow it. C. administer the medication sublingually and allow it to dissolve or absorb. D. Encourage the patient to chew the tablet to increase its effectiveness.

administer the medication sublingually and allow it to dissolve or absorb

which of the following medications is commonly given to patients with chest pain to prevent blood clots from forming or getting bigger? A. oxygen. B. aspirin. C. furosemide (Lasix) D. metoprolol (Toprol)

aspirin

upon arriving at the residence of a patient with possible cardiac problem, it is Most important to: A. assess the scene for potential hazards. B. gain immediate access to the patient. C. determine if you need additional help. D. request a paramedic unit for assistance.

assess the scene for potential hazards

narrowing of the coronary arteries caused by a buildup of fatty deposits is called: A. atherosclerosis B. arteriosclerosis 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. contractility B. automaticity C. impulsivity D. excitability

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. pons and medulla. B. somatic nervous system. C. autonomic nervous system. D. parietal lobe.

autonomic nervous system.

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, apply AED, and deliver shock if it is indicated. B. apply the AED while your partner provides rescue breathing. C. begin CPR and have your partner update the responding paramedics. D. perform CPR only and wait for the manual defibrillator to arrive.

begin CPR, apply AED and shock if it is indicated

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. the SA node can reset and generate another impulse. C. the impulse can spread through the Purkinje fibers. D. blood returning from the body can fill the atria.

blood can pass from the atria to the ventricles

it would be most appropriate for a patient to take his or her prescribed nitroglycerin when experiencing: A. an acute onset dizziness during a period of exertion. B. difficulty breathing that awakens the patient from sleep. C sharp chest pain that lasts longer than 10 to 15 minutes. D. chest pain that does not immediately subside with rest.

chest pain that does not immediately subside with rest

Rapid, labored breathing in a patient with signs and symptoms of AMI should make you suspicious for: A. significant hypotension. B. a cardiac arrhythmia. C. congestive heart failure. D. right ventricular failure.

congestive heart failure.

ischemic heart disease is defined as: A. absent myocardial blood flow due to a blocked coronary artery. B. decreased blood flow to one or more portions of the myocardium. C. death of a portion of the heart muscle due to decrease in oxygen. D. decreased blood flow to the heart muscle due to a coronary dilation.

decreased blood flow to one or more portions of the myocardium

cardiogenic shock following AMI is caused by: A. decreased pumping force of the heart muscle. B. widespread dilation of the systemic vasculature. C. hypovolemia secondary to severe vomiting. D. a profound increase in the patients heart rate.

decreased pumping force of the heart muscle

which of the following signs is commonly observed in patients with right -sided heart failure? A. pulmonary edema. B. dependent edema. C. flat jugular veins. D. labored breathing.

dependent edema

a percutaneous transluminal coronary angioplasty (PTCA) restores blood flow to the ischemic myocardium by: A. bypassing the coronary artery with a vessel from the chest or leg. B. dilating the affected coronary artery with a small inflatable balloon. C. placing a stent inside the coronary artery to keep it from narrowing. D. scraping fatty deposits off of the lumen of the coronary artery.

dilating the 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 being noncompliant with her antihypertensive medications. when you assess her, you find that her blood pressure is significantly higher in her right arm. what do these 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. assess for a pulse for 20 seconds. B. dry the chest if it is wet. C. perform CPR for 30 seconds. D. contact medical control.

dry the chest if it is wet

the main legal risk in using the AED is: A. negligence on the part of the manufacturer. B. failure of the AED's internal computer chip. C. failing to deliver a shock when one is needed. D. not assessing for a pulse after a shock is delivered.

failing to deliver a shock when one is needed

which of the following is LEAST important when obtaining a medical history from a patient complaining of chest discomfort? A. history of cigarette smoking. B. history of previous heart attack C. family history of hypertension D. presence of personal risk factors

family history of hypertension

the iliac arteries immediately subdivide into the : A. peroneal arteries. B. femoral arteries. C. posterior tibial arteries. D. anterior tibial arteries.

femoral arteries

angina pectoris occurs when: A. a coronary artery is totally occluded by plaque. B. myocardial oxygen supply exceeds the demand. C. myocardial oxygen demand exceeds supply. D. one or more coronary arteries suddenly spasm.

myocardial oxygen demand exceeds supply

prior to assisting a patient with his or her prescribed nitroglycerin, the EMT must: A. wait at least 5 minutes after assessing the blood pressure. B. obtain authorization from medical control. C. determine who described the nitroglycerin. D. ensure the medication is in tablet form.

obtain authorization from medical control

when preparing to obtain a 12-lead ECG, the LL and RL electrodes should be placed: A. on either side of the chest . B. on the thighs or ankles. C. on the lower abdomen. D. anywhere on the arms.

on the thighs or ankles

common signs and symptoms of AMI include all of the following, EXCEPT: A. sudden unexplained sweating. B. irregular heartbeat. C. shortness of breath or dyspnea. D. pain exacerbated by breathing.

pain exacerbated by breathing

most patients are instructed by their physician to take up to_____ doses of nitroglycerin before calling EMS. A. three B. four C. two D. five

three

The descending aorta divides into the two iliac arteries at the level of the: A. pubic symphysis. B. iliac crest. C. nipple line. D. umbilicus.

umbilicus.