Chapter 16 EMT

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

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

Signs and symptoms of a hypertensive emergency would MOST likely be delayed in patients who: Selected Answer: 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.

A. have chronic hypertension.

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

A. on the thighs or ankles.

A patient in cardiac arrest is wearing an external defibrillator vest, which is interfering with effective chest compressions. The EMT should: Selected Answer: CorrectA. remove the battery from the monitor and then remove the vest. Answers: A. remove the battery from the monitor and then remove the vest. B. leave the battery attached to the monitor and remove the vest. C. perform ventilations only and allow the vest device to defibrillate. D. remove the battery from the monitor and leave the vest in place.

A. remove the battery from the monitor and then remove the vest.

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

A. right atrium.

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

A. the inner layers of the aorta become separated.

A patient with atherosclerotic heart disease experiences chest pain during exertion because: Selected Answer: A. the lumen of the coronary artery is narrowed and cannot accommodate increased blood flow. B. the coronary arteries suddenly spasm and cause a marked reduction in myocardial blood flow. C. tissues of the myocardium undergo necrosis secondary to a prolonged absence of oxygen. D. the ragged edge of a tear in the coronary artery lumen causes local blood clotting and arterial narrowing.

A. the lumen of the coronary artery is narrowed and cannot accommodate increased blood flow.

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

B. sinoatrial node.

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

B. who have experienced a head injury.

Which of the following signs is commonly observed in patients with right-sided heart failure? A. Flat jugular veins B. Pulmonary edema C. Dependent edema D. Labored breathing

C. Dependent edema

Prior to attaching the AED to a cardiac arrest patient, the EMT should: A. contact medical control. B. perform CPR for 30 seconds. C. dry the chest if it is wet. D. assess for a pulse for 20 seconds.

C. dry the chest if it is wet.

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 the 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.

C. pediatric pads and an energy-reducing device are available.

Most AEDs are set up to adjust the voltage based on the impedance, which is the: A. direction that the electrical flow takes in the body. B. distance between the two AED pads on the chest. C. resistance of the body to the flow of electricity. D. actual amount of energy that the AED will deliver.

C. resistance of the body to the flow of electricity.

Which of the following is NOT a common sign or symptom associated with malfunction of an implanted cardiac pacemaker? A. Heart rate less than 60 beats/min B. Generalized weakness C. Syncope or dizziness D. A rapid heart rate

D. A rapid heart rate

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. Thoracic aortic aneurysm C. Uncontrolled hypertension D. Acute myocardial infarction

D. Acute myocardial infarction

A 49-year-old male presents with an acute onset of crushing chest pain and diaphoresis. You should: A. administer up to 324 mg of baby aspirin. B. administer up to three doses of nitroglycerin. C. obtain vital signs and a SAMPLE history. D. assess the adequacy of his respirations.

D. assess the adequacy of his respirations.

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. 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. begin high-quality CPR and apply the AED as soon as possible.

Risk factors for AMI that cannot be controlled include: A. lack of exercise. B. hyperglycemia. C. excess stress. D. family history.

D. family history.

After the AED has delivered a shock, the EMT should: A. assess for a carotid pulse. B. transport the patient at once. C. re-analyze the cardiac rhythm. D. immediately resume CPR.

D. immediately resume CPR.

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

D. myocardial oxygen demand exceeds supply.