Emt ch16 Cardiovascular Emergencies

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

The correct answer is: 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? Select one: A. Uncontrolled hypertension B. Thoracic aortic aneurysm C. Acute myocardial infarction D. Obstructive lung disease

The correct answer is: Acute myocardial infarction

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. Deliver the shock followed by immediate resumption of CPR. B. Contact medical control and request permission to defibrillate. C. Continue CPR and transport the patient to the closest appropriate hospital. D. Avoid defibrillation as this will damage the patient's AICD.

The correct answer is: Deliver the shock followed by immediate resumption of CPR.

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

The correct answer is: Dependent edema

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

The correct answer is: administer oxygen, give her 324 mg of aspirin, and assess her further.

The MOST common reason that many people experiencing AMI do not seek immediate medical attention is because they: Select one: A. do not trust EMTs. B. are in denial. C. are elderly. D. cannot afford it.

The correct answer is: are in denial.

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

The correct answer is: 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: 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.

The correct answer is: 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: Select one: A. legs. B. brain. C. kidneys. D. abdomen.

The correct answer is: brain.

The head and brain receive their supply of oxygenated blood from the: Select one: A. carotid arteries. B. subclavian arteries. C. brachial arteries. D. iliac arteries.

The correct answer is: carotid arteries.

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

The correct answer is: chest pain that does not immediately subside with rest.

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

The correct answer is: dilating the affected coronary artery with a small inflatable balloon.

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

The correct answer is: dry the chest if it is wet.

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

The correct answer is: family history.

Signs and symptoms of a hypertensive emergency would MOST likely be delayed in patients who: Select one: A. are older than 40 years of age. B. have chronic hypertension. C. regularly take illegal drugs. D. have had a stroke in the past.

The correct answer is: have chronic hypertension.

Common side effects of nitroglycerin include all of the following, EXCEPT: Select one: A. severe headache. B. bradycardia. C. hypertension. D. hypotension.

The correct answer is: hypertension.

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

The correct answer is: immediately resume CPR.

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

The correct answer is: myocardial oxygen demand exceeds supply.

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

The correct answer is: obtain authorization from medical control.

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

The correct answer is: on the thighs or ankles.

The EMT should use an AED on a child between 1 month and 8 years of age if: Select one: A. pediatric pads and an energy-reducing device are available. B. he or she is not breathing and has a weakly palpable pulse. C. special pads are used and the child has profound tachycardia. D. his or her condition is rapidly progressing to cardiac arrest.

The correct answer is: pediatric pads and an energy-reducing device are available.

After assisting your patient with prescribed nitroglycerin, you should: Select one: A. perform a secondary assessment before administering further doses. B. avoid further dosing if the patient complains of a severe headache. C. reassess his or her blood pressure within 5 minutes to detect hypotension. D. place the patient in a recumbent position in case of fainting.

The correct answer is: reassess his or her blood pressure within 5 minutes to detect hypotension.

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

The correct answer is: 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: Select one: A. actual amount of energy that the AED will deliver. B. direction that the electrical flow takes in the body. C. distance between the two AED pads on the chest. D. resistance of the body to the flow of electricity.

The correct answer is: resistance of the body to the flow of electricity.

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

The correct answer is: right atrium.

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

The correct answer is: she is not in ventricular fibrillation.

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

The correct answer is: sinoatrial node.

In contrast to the sympathetic nervous system, the parasympathetic nervous system: Select one: 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.

The correct answer is: slows the heart and respiratory rates.

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

The correct answer is: the inner layers of the aorta become separated.

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

The correct answer is: 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: Select one: A. a rapid heartbeat causes a decrease in the strength of cardiac contractions. B. the volume of blood that returns to the heart is not sufficient with fast heart rates. C. as the heart rate increases, more blood is pumped from the ventricles than the atria. D. there is not enough time in between contractions for the heart to refill completely.

The correct answer is: there is not enough time in 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. Select one: A. four B. two C. three D. five

The correct answer is: three

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

The correct answer is: umbilicus.

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

The correct answer is: ventricular fibrillation.

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

The correct answer is: who have experienced a head injury.