Chapter 17: Cardiovascular Emergencies

Nitroglycerin is contraindicated in patients:

who have experienced a head injury.

Nitroglycerin is contraindicated in patients:

with a systolic blood pressure less than 100 mm Hg.

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?

Absence of a palpable pulse

A 56-year-old man has an acute myocardial infarction. Which of the following blood vessels became blocked and led to his condition?

Coronary arteries

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 left arm than it is in her right arm. What do these signs and symptoms MOST likely indicate?

Dissecting aortic aneurysm

Which of the following signs or symptoms would you NOT expect to encounter in a patient with congestive heart failure?

Hypotension and flat jugular veins

Which of the following statements regarding the AED and defibrillation is correct?

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

Common signs and symptoms of a hypertensive emergency include:

a bounding pulse, a severe headache, and dizziness.

Acute coronary syndrome (ACS) is a term used to describe:

a group of symptoms that are caused by myocardial ischemia.

Upon arriving at the residence of a patient with a possible cardiac problem, it is MOST important to:

assess the scene for potential hazards.

A 59-year-old woman presents with chest pressure. She is conscious and alert, but her skin is cool, pale, and clammy. Your first step in providing care (treatment) should be:

administer oxygen.

The MOST common reason that many people experiencing AMI do not seek immediate medical attention is because they:

are in denial.

Narrowing of the coronary arteries caused by a buildup of fatty deposits is called:

atherosclerosis.

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:

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:

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

The inferior vena cava returns deoxygenated blood to the right side of the heart from all of the following areas, EXCEPT the:

brain

The head and brain receive their supply of oxygenated blood from the:

carotid arteries.

Major controllable risk factors for an AMI include:

cigarette smoking.

Cardiogenic shock following AMI is caused by:

decreased pumping force of the heart muscle.

A patient with cardiac arrest secondary to ventricular fibrillation has the greatest chance for survival if:

defibrillation is provided within 2 minutes.

A percutaneous transluminal coronary angioplasty (PTCA) restores blood flow to the ischemic myocardium by:

dilating the affected coronary artery with a small inflatable balloon.

While palpating the radial pulse of a 56-year-old man with chest pain, you note that the pulse rate is 86 beats/min and irregular. This indicates:

dysrhythmia.

The iliac arteries immediately subdivide into the:

femoral arteries

Blood that is ejected from the right ventricle:

flows into the pulmonary arteries.

When obtaining a 12-lead ECG, the patient should be:

in a supine position with legs uncrossed.

In contrast to AMI, a dissecting aortic aneurysm:

often presents with pain that is maximal from the onset

The EMT should use an AED on a child between 1 month and 8 years of age if:

pediatric pads and an energy-reducing device are available.

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:

perform CPR for 2 minutes and reassess.

If a patient with an implanted pacemaker is in cardiac arrest, the EMT should:

place the AED pads away from the pacemaker.

After administering a nitroglycerin tablet to a patient, the EMT should:

reassess the patient's blood pressure within 5 minutes.

A patient in cardiac arrest is wearing an external defibrillator vest, which is interfering with effective chest compressions. The EMT should:

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

Most AEDs are set up to adjust the voltage based on the impedance, which is the:

resistance of the body to the flow of electricity.

A 67-year-old female with severe chest pain becomes unresponsive, pulseless, and apneic during transport. You should:

stop the ambulance, begin CPR, and attach the AED as soon as possible.

The purpose of defibrillation is to:

stop the chaotic, disorganized contraction of the cardiac cells.

When the myocardium requires more oxygen:

the arteries supplying the heart dilate.

A patient with atherosclerotic heart disease experiences chest pain during exertion because:

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

Cardiac output may decrease if the heart beats too rapidly because:

there is not enough time in between contractions for the heart to refill completely.