EMT: Chapter 16 Review
B
Risk factors for AMI that cannot be controlled include: Select one: A. hyperglycemia. B. family history. C. lack of exercise. D. excess stress.
A
Signs and symptoms of a hypertensive emergency would MOST likely be delayed in patients who: Select one: A. have chronic hypertension. B. are older than 40 years of age. C. have had a stroke in the past. D. regularly take illegal drugs.
B
The EMT should use an AED on a child between 1 month and 8 years of age if: Select one: A. he or she is not breathing and has a weakly palpable pulse. B. pediatric pads and an energy-reducing device are available. C. his or her condition is rapidly progressing to cardiac arrest. D. special pads are used and the child has profound tachycardia.
D
"PASTE" is an alternate assessment tool for ___________. Select one: A. cardiac patients B. seizure patients C. stroke patients D. respiratory patients
B
A 30-year-old male presents with acute shortness of breath, widespread hives, and facial swelling. He denies any past medical history and takes no medications. During your assessment, you hear wheezing over all the lung fields. His blood pressure is 90/50 mm Hg and his heart rate is 110 beats/min. In addition to giving him high-flow oxygen, the MOST important treatment for this patient is: Select one: A. albuterol. B. epinephrine. C. an antihistamine. D. a beta-antagonist.
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? Select one: A. Continue CPR and transport the patient to the closest appropriate hospital. B. Deliver the shock followed by immediate resumption of CPR. C. Contact medical control and request permission to defibrillate. D. Avoid defibrillation as this will damage the patient's AICD.
A
A 49-year-old male presents with an acute onset of crushing chest pain and diaphoresis. You should: Select one: A. assess the adequacy of his respirations. B. administer up to three doses of nitroglycerin. C. administer up to 324 mg of baby aspirin. D. obtain vital signs and a SAMPLE history.
A
A 59-year-old male with a history of emphysema complains of an acute worsening of his dyspnea and pleuritic chest pain following a forceful cough. Your assessment reveals that he has a barrel-shaped chest, unilaterally diminished breath sounds, and tachycardia. What is the MOST likely cause of this patient's condition? Select one: A. Spontaneous pneumothorax B. Rupture of the diaphragm C. Acute pulmonary embolism D. Exacerbation of his COPD
A
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: Select one: A. placing her in an upright position. B. ventilations with a BVM. C. nitroglycerin for her chest pain. D. oxygen at 2 L/min via nasal cannula.
A
A dissecting aortic aneurysm occurs when: Select one: A. the inner layers of the aorta become separated. B. the aorta ruptures, resulting in profound bleeding. C. all layers of the aorta suddenly contract. D. a weakened area develops in the aortic wall.
C
A patient in cardiac arrest is wearing an external defibrillator vest, which is interfering with effective chest compressions. The EMT should: Select one: A. remove the battery from the monitor and leave the vest in place. B. perform ventilations only and allow the vest device to defibrillate. C. remove the battery from the monitor and then remove the vest. D. leave the battery attached to the monitor and remove the vest.
B
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? Select one: A. Thoracic aortic aneurysm B. Acute myocardial infarction C. Obstructive lung disease D. Uncontrolled hypertension
B
A patient with atherosclerotic heart disease experiences chest pain during exertion because: Select one: A. the ragged edge of a tear in the coronary artery lumen causes local blood clotting and arterial narrowing. B. the lumen of the coronary artery is narrowed and cannot accommodate increased blood flow. C. the coronary arteries suddenly spasm and cause a marked reduction in myocardial blood flow. D. tissues of the myocardium undergo necrosis secondary to a prolonged absence of oxygen.
A
A percutaneous transluminal coronary angioplasty (PTCA) restores blood flow to the ischemic myocardium by: Select one: A. dilating the affected coronary artery with a small inflatable balloon. B. scraping fatty deposits off of the lumen of the coronary artery. C. bypassing the coronary artery with a vessel from the chest or leg. D. placing a stent inside the coronary artery to keep it from narrowing.
A
A pleural effusion is MOST accurately defined as: Select one: A. fluid accumulation outside the lung. B. a bacterial infection of the lung tissue. C. a unilaterally collapsed lung. D. diffuse collapsing of the alveoli.
B
After assisting your patient with prescribed nitroglycerin, you should: Select one: A. avoid further dosing if the patient complains of a severe headache. B. reassess his or her blood pressure within 5 minutes to detect hypotension. C. perform a secondary assessment before administering further doses. D. place the patient in a recumbent position in case of fainting.
C
After the AED has delivered a shock, the EMT should: Select one: A. assess for a carotid pulse. B. re-analyze the cardiac rhythm. C. immediately resume CPR. D. transport the patient at once.
A
Angina pectoris occurs when: Select one: A. myocardial oxygen demand exceeds supply. B. one or more coronary arteries suddenly spasm. C. myocardial oxygen supply exceeds the demand. D. a coronary artery is totally occluded by plaque.
C
Asthma is caused by a response of the: Select one: A. cardiovascular system. B. respiratory system. C. immune system. D. endocrine system.
B
Blood that is ejected from the right ventricle: Select one: A. enters the systemic circulation. B. flows into the pulmonary arteries. C. has a high concentration of oxygen. D. was received directly from the aorta.
B
Cardiac output may decrease if the heart beats too rapidly because: Select one: A. a rapid heartbeat causes a decrease in the strength of cardiac contractions. B. there is not enough time in between contractions for the heart to refill completely. C. as the heart rate increases, more blood is pumped from the ventricles than the atria. D. the volume of blood that returns to the heart is not sufficient with fast heart rates.
D
Cardiogenic shock following AMI is caused by: Select one: A. widespread dilation of the systemic vasculature. B. a profound increase in the patient's heart rate. C. hypovolemia secondary to severe vomiting. D. decreased pumping force of the heart muscle.
C
Common side effects of nitroglycerin include all of the following, EXCEPT: Select one: A. bradycardia. B. hypotension. C. hypertension. D. severe headache.
B
Common signs and symptoms of AMI include all of the following, EXCEPT: Select one: A. irregular heartbeat. B. pain exacerbated by breathing. C. sudden unexplained sweating. D. shortness of breath or dyspnea.
D
Crackles (rales) are caused by _________. Select one: A. narrowing of the upper airways B. severe bronchoconstriction C. mucus in the larger airways D. air passing through fluid
D
Deoxygenated blood from the body returns to the: Select one: A. left atrium. B. left ventricle. C. right ventricle. D. right atrium.
B
Rapid, labored breathing in a patient with signs and symptoms of AMI should make you suspicious for: Select one: A. a cardiac arrhythmia. B. congestive heart failure. C. right ventricular failure. D. significant hypotension.
C
His parents tell you that their son has had a chest infection for the past two days and when they took him to their family doctor, they were told it was likely due to the respiratory syncytial virus (RSV). They have kept him well hydrated, but the infection seems to have gotten worse. On auscultation, you hear decreased air entry bilaterally with fine expiratory wheezes and the occasional coarse wet crackle. Based on this information, your patient is most likely suffering from: Select one: A. epiglottitis. B. pertussis. C. bronchiolitis. D. croup.
A
In contrast to AMI, a dissecting aortic aneurysm: Select one: A. often presents with pain that is maximal from the onset. B. usually presents gradually, often over a period of hours. C. is more commonly associated with pressure in the chest. D. is typically preceded by other symptoms, such as nausea.
A
In contrast to the sympathetic nervous system, the parasympathetic nervous system: Select one: A. slows the heart and respiratory rates. B. prepares the body to handle stress. C. dilates the blood vessels in the muscles. D. causes an increase in the heart rate.
C
In order for efficient pulmonary gas exchange to occur: Select one: A. the percentage of inhaled carbon dioxide must exceed the percentage of inhaled oxygen. B. the pulmonary capillaries must be completely constricted and the alveoli must be collapsed. C. oxygen and carbon dioxide must be able to freely diffuse across the alveolar-capillary membrane. D. there must be low quantities of pulmonary surfactant to allow for full alveolar expansion.
D
In what area of the lungs does respiration occur? Select one: A. Trachea B. Capillaries C. Bronchi D. Alveoli
D
Ischemic heart disease is defined as: Select one: A. absent myocardial blood flow due to a blocked coronary artery. B. death of a portion of the heart muscle due to a decrease in oxygen. C. decreased blood flow to the heart muscle due to coronary dilation. D. decreased blood flow to one or more portions of the myocardium.
A
Major risk factors for AMI include all of the following, EXCEPT: Select one: A. hypoglycemia. B. elevated cholesterol. C. diabetes mellitus. D. hypertension.
A
Most AEDs are set up to adjust the voltage based on the impedance, which is the: Select one: A. resistance of the body to the flow of electricity. B. direction that the electrical flow takes in the body. C. actual amount of energy that the AED will deliver. D. distance between the two AED pads on the chest.
D
Most patients are instructed by their physician to take up to _______ doses of nitroglycerin before calling EMS. Select one: A. two B. four C. five D. three
C
Nitroglycerin is contraindicated in patients: Select one: A. with a systolic blood pressure less than 120 mm Hg. B. with a history of an ischemic stroke. C. who have experienced a head injury. D. who have taken up to two doses.
C
Nitroglycerin relieves cardiac-related chest pain by: Select one: A. increasing the amount of stress that is placed on the myocardium. B. contracting the smooth muscle of the coronary and cerebral arteries. C. dilating the coronary arteries and improving cardiac blood flow. D. constricting the coronary arteries and improving cardiac blood flow.
D
Prior to assisting a patient with his or her prescribed nitroglycerin, the EMT must: Select one: A. ensure the medication is in tablet form. B. wait at least 5 minutes after assessing the blood pressure. C. determine who prescribed the nitroglycerin. D. obtain authorization from medical control.
A
Prior to attaching the AED to a cardiac arrest patient, the EMT should: Select one: A. dry the chest if it is wet. B. contact medical control. C. perform CPR for 30 seconds. D. assess for a pulse for 20 seconds.
d. ensure that no one is touching the patient.
Prior to defibrillating a patient with an AED, it is MOST important that you: a. properly position the defibrillation pads. b. confirm that the patient is in cardiac arrest. c. perform up to 5 minutes of effective CPR. d. ensure that no one is touching the patient.
C
The MOST common error associated with the use of the AED is: Select one: 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.
B
The MOST common reason that many people experiencing AMI do not seek immediate medical attention is because they: Select one: A. cannot afford it. B. are in denial. C. are elderly. D. do not trust EMTs.
A
The descending aorta divides into the two iliac arteries at the level of the: Select one: A. umbilicus. B. nipple line. C. pubic symphysis. D. iliac crest.
C
The electrical impulse generated by the heart originates in the: Select one: A. bundle of His. B. atrioventricular node. C. sinoatrial node. D. coronary sinus.
A
The electrical stimulus that originates in the heart's primary pacemaker is controlled by impulses from the brain that arrive by way of the: Select one: A. autonomic nervous system. B. parietal lobe. C. somatic nervous system. D. pons and medulla.
B
The head and brain receive their supply of oxygenated blood from the: Select one: A. subclavian arteries. B. carotid arteries. C. iliac arteries. D. brachial arteries.
A
The iliac arteries immediately subdivide into the: Select one: A. femoral arteries. B. posterior tibial arteries. C. anterior tibial arteries. D. peroneal arteries.
B
The inferior vena cava returns deoxygenated blood to the right side of the heart from all of the following areas, EXCEPT the: Select one: A. legs. B. brain. C. abdomen. D. kidneys.
D
The myocardium receives oxygenated blood from the __________, which originate(s) from the __________. Select one: A. aorta, inferior vena cava B. coronary sinus, vena cava C. vena cava, coronary veins D. coronary arteries, aorta
B
The posterior tibial pulse can be palpated: Select one: A. in the fossa behind the knee. B. behind the medial malleolus, on the inside of the ankle. C. between the trachea and the neck muscle. D. on the dorsum of the foot.
B
The purpose of defibrillation is to: Select one: A. improve the chance of CPR being successful in resuscitation. B. stop the chaotic, disorganized contraction of the cardiac cells. C. cause a rapid decrease in the heart rate of an unstable patient. D. prevent asystole from deteriorating into ventricular fibrillation.
D
The right coronary artery supplies blood to the: Select one: A. left ventricle and posterior wall of the right ventricle. B. right atrium 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.
B
Treatment with continuous positive airway pressure (CPAP) would MOST likely be contraindicated in which of the following situations? Select one: A. Conscious and alert patient with an oxygen saturation of 85% B. Shortness of breath and a blood pressure of 76/56 mm Hg C. Difficulty breathing, two-word dyspnea, and tachycardia D. Pulmonary edema, history of hypertension, and anxiety
C
Upon arriving at the residence of a patient with a possible cardiac problem, it is MOST important to: Select one: A. gain immediate access to the patient. B. determine if you need additional help. C. assess the scene for potential hazards. D. request a paramedic unit for assistance.
D
Ventricular tachycardia causes hypotension because: Select one: A. blood backs up into the lungs and causes congestion. B. the volume of blood returning to the atria increases. C. the right ventricle does not adequately pump blood. D. the left ventricle does not adequately fill with blood.
D
What is the function of the left atrium? Select one: A. It receives blood from the pulmonary arteries. B. It receives oxygenated blood from the vena cava. C. It ejects oxygenated blood into the aorta. D. It receives oxygenated blood from the lungs.
B
When an electrical impulse reaches the AV node, it is slowed for a brief period of time so that: Select one: A. the impulse can spread through the Purkinje fibers. B. blood can pass from the atria to the ventricles. C. the SA node can reset and generate another impulse. D. blood returning from the body can fill the atria.
C
When auscultating the lungs of a patient with respiratory distress, you hear adventitious sounds. This means that the patient has: Select one: A. diminished breath sounds. B. normal breath sounds. C. abnormal breath sounds. D. an absence of breath sounds.
B
When documenting a patient's description of his or her chest pain or discomfort, the EMT should: Select one: A. use medical terminology. B. use the patient's own words. C. underline the patient's quotes. D. document his or her own perception.
C
When preparing to obtain a 12-lead ECG, the "LL" and "RL" electrodes should be placed: Select one: A. on either side of the chest. B. on the lower abdomen. C. on the thighs or ankles. D. anywhere on the arms.
B
When preparing to obtain a 12-lead ECG, the V1 and V2 electrodes should be placed: Select one: A. on the left and right arms. B. on either side of the sternum. C. in the midclavicular line. D. in the midaxillary line.
B
When the myocardium requires more oxygen: Select one: A. the heart contracts with less force. B. the arteries supplying the heart dilate. C. the AV node conducts fewer impulses. D. the heart rate decreases significantly.
B
When treating a patient with chest pain, you should assume that he or she is having an AMI because: Select one: A. angina and AMI present identically. B. the cause of the pain cannot be diagnosed in the field. C. angina usually occurs after an AMI. D. most patients with chest pain are experiencing an AMI.
A
Which of the following cardiac dysrhythmias has the greatest chance of deteriorating into a pulseless rhythm? Select one: A. Ventricular tachycardia B. Sinus tachycardia C. Sinus bradycardia D. Extra ventricular beats
A
Which of the following conditions would be LEAST likely to result in hypoxia? Select one: A. Severe anxiety B. Pleural effusion C. Narcotic overdose D. Pulmonary edema
A
Which of the following is LEAST important when obtaining a medical history from a patient complaining of chest discomfort? Select one: A. Family history of hypertension B. History of cigarette smoking C. History of previous heart attack D. Presence of personal risk factors
B
Which of the following is MOST characteristic of adequate breathing? Select one: A. 20 breaths/min with shallow movement of the chest wall and pallor B. 24 breaths/min with bilaterally equal breath sounds and pink skin C. 30 breaths/min with supraclavicular retractions and clammy skin D. 22 breaths/min with an irregular pattern of breathing and cyanosis
D
Which of the following is NOT a common sign or symptom associated with malfunction of an implanted cardiac pacemaker? Select one: A. Heart rate less than 60 beats/min B. Generalized weakness C. Syncope or dizziness D. A rapid heart rate
B
Which of the following is NOT a function of the sympathetic nervous system? Select one: A. Increases in the heart and respiratory rates B. Constriction of blood vessels in the muscles C. Constriction of blood vessels in the digestive system D. Dilation of blood vessels in the muscles
D
Which of the following is a genetic disorder that predisposes the patient to repeated lung infections? Select one: A. Celiac sprue B. Multiple sclerosis C. Severe acute respiratory syndrome D. Cystic fibrosis
B
Which of the following is the MOST reliable method of estimating a patient's cardiac output? Select one: A. Connect the patient to an electrocardiogram. B. Assess the heart rate and strength of the pulse. C. Determine the average diastolic blood pressure. D. Listen to heart sounds with a stethoscope.
B
Which of the following must be assessed in every respiratory patient? Select one: A. Distal pulse, motor, sensation B. Lung sounds C. Blood glucose levels D. Orthostatic vital signs
A
Which of the following signs is commonly observed in patients with right-sided heart failure? Select one: A. Dependent edema B. Flat jugular veins C. Pulmonary edema D. Labored breathing
B
Which of the following statements regarding nitroglycerin is correct? Select one: A. A maximum of five nitroglycerin doses should be given to a patient. B. Nitroglycerin usually relieves anginal chest pain within 5 minutes. C. The potency of nitroglycerin is increased when exposed to light. D. Nitroglycerin should be administered between the cheek and gum.
B
Which of the following statements regarding the AED and defibrillation is correct? Select one: A. CPR should be performed for 5 minutes before using the AED. B. The AED will not analyze the rhythm of a moving patient. C. The AED will shock any rhythm not accompanied by a pulse. D. Defibrillation is the first link in the AHA chain of survival.
C
Which of the following statements regarding the pain associated with AMI is correct? Select one: A. It often fluctuates in intensity when the patient breathes. B. Nitroglycerin usually resolves the pain within 30 minutes. C. It can occur during exertion or when the patient is at rest. D. It is often described by the patient as a sharp feeling.
B
Which of the following veins is located inferior to the trunk? Select one: A. Axillary B. Saphenous C. Subclavian D. Cephalic
D
While auscultating an elderly woman's breath sounds, you hear low-pitched "rattling" sounds at the bases of both of her lungs. This finding is MOST consistent with which of the following conditions? Select one: A. Acute asthma attack B. Widespread atelectasis C. Early pulmonary edema D. Aspiration pneumonia
B
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? Select one: A. Incorrect placement of the leads B. Excessive movement of the patient C. Abnormal cardiac electrical activity D. The patient's pulse is irregular.
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: Select one: A. perform CPR only and wait for the manual defibrillator to arrive. B. apply the AED while your partner provides rescue breathing. C. begin CPR, apply the AED, and deliver a shock if it is indicated. D. begin CPR and have your partner update the responding paramedics.
D
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: Select one: A. perform two-rescuer CPR for 5 minutes and request ALS backup. B. immediately apply the AED pads and analyze his cardiac rhythm. C. have your partner perform CPR while you question the bystanders. D. begin high-quality CPR and apply the AED as soon as possible.
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: Select one: A. immediately remove the nitroglycerin patch, apply the AED in case he develops cardiac arrest, and transport to the closest hospital. B. ask him if the nitroglycerin patch he is wearing has improved his chest pressure, complete your secondary assessment, and transport promptly. C. 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. D. remove the nitroglycerin patch, place him in a supine position and elevate his lower extremities, and prepare for immediate transport.
C
You are assisting an asthma patient with his prescribed metered-dose inhaler. After the patient takes a deep breath and depresses the inhaler, you should: Select one: A. advise him to exhale forcefully to ensure medication absorption. B. allow him to breathe room air and assess his oxygen saturation. C. instruct him to hold his breath for as long as he comfortably can. D. immediately reapply the oxygen mask and reassess his condition.
D
You are attending to a 3-year-old male patient who is presenting with severe shortness of breath. His parents report that he has had a cough and cold with a low grade fever for the past two days. They became worried today, as his level of distress has increased dramatically. On assessment, the patient is sitting upright and making high-pitched noises with each breath. Based on this information, the patient is most likely suffering from: Select one: A. inflammation of the bronchioles. B. inflammation of the lower respiratory tract and bronchospasm. C. bacterial infection of the epiglottis. D. viral infection of the upper respiratory tract.
B
You are attending to a 54-year-old female patient in a homeless shelter. The patient tells you that she had the flu a couple of weeks ago, and she has not gotten over it. She has been tired and keeps waking up at night, sweating. She has been coughing up green sputum occasionally and has been experiencing episodes of chest pain that get worse when she breathes. Based on this information, your patient is most likely suffering from: Select one: A. pneumonia. B. tuberculosis. C. chronic obstructive pulmonary disease (COPD). D. influenza Type A.
C
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: Select one: A. request a paramedic unit and quickly attach the AED. B. have the EMTs stop CPR and assess for a pulse. C. feel for a pulse while compressions are ongoing. D. quickly attach the AED and push the analyze button.
C
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: Select one: A. attach the AED immediately. B. obtain baseline vital signs. C. begin ventilatory assistance. D. apply a nonrebreathing mask.
A
Your patient has a chronic respiratory condition. His stimulus to breathe is triggered by low oxygen levels in the blood. This is known as the ___________. Select one: A. hypoxic drive B. CO2 drive C. alternate drive D. COPD drive