cardiology
Which of the following patients would MOST likely present with vague or unusual symptoms of an acute myocardial infarction? A: 72-year-old female with diabetes B: 66-year-old male with angina C: 55-year-old obese female D: 75-year-old male with hypertension
A: 72-year-old female with diabetes
Which of the following statements regarding the automated external defibrillator (AED) is correct? A: AEDs can safely be used in infants and children less than 8 years of age B: The AED should not be used in patients with an implanted defibrillator C: AEDs will analyze the patient's rhythm while CPR is in progress D: The AED should be applied to patients at risk for cardiac arrest
A: AEDs can safely be used in infants and children less than 8 years of age
Which of the following describes pulseless electrical activity (PEA)? A: Any organized cardiac rhythm, slow or fast, that does not produce a palpable pulse B: The presence of a palpable pulse in the absence of any electrical activity in the heart C: A rapid cardiac rhythm that does not produce a pulse, but responds to defibrillation D: A disorganized, chaotic quivering of the heart muscle that does not generate a pulse
A: Any organized cardiac rhythm, slow or fast, that does not produce a palpable pulse
Which of the following describes the MOST appropriate method of performing chest compressions on an adult patient in cardiac arrest? A: Compress the chest at least 2", allow full recoil of the chest after each compression, minimize interruptions in chest compressions B: Allow full recoil of the chest after each compression, compress the chest to a depth of 2", deliver compressions at a rate of at least 80/min C: Do not interrupt chest compressions for any reason, compress the chest no more than 1 1/2", allow partial recoil of the chest after each compression D: Minimize interruptions in chest compressions, provide 70% compression time and 30% relaxation time, deliver compressions at a rate of 100/min
A: Compress the chest at least 2", allow full recoil of the chest after each compression, minimize interruptions in chest compressions
Which of the following is a common side effect of nitroglycerin? A: Headache B: Anxiety C: Nausea D: Hypertension
A: Headache
Which of the following statements regarding ventricular fibrillation (V-Fib) is correct? A: In V-Fib, the heart is not pumping any blood and the patient is pulseless. B: Any patient in V-Fib must receive CPR for 2 minutes prior to defibrillation. C: Loss of consciousness occurs within minutes after the onset of V-Fib. D: Patients in V-Fib should be defibrillated after every 60 seconds of CPR.
A: In V-Fib, the heart is not pumping any blood and the patient is pulseless.
Which of the following is the MOST detrimental effect that tachycardia can have on a patient experiencing a cardiac problem? A: Increased oxygen demand B: Increased stress and anxiety C: Decreased cardiac functioning D: Increased blood pressure
A: Increased oxygen demand
Which of the following is MOST indicative of a primary cardiac problem? A: Irregular pulse B: Tachypnea C: Sudden fainting D: Tachycardia
A: Irregular pulse
Which of the following is an abnormal finding when using the Cincinnati stroke scale to assess a patient who presents with signs of a stroke? A: One arm drifts down compared with the other side. B: Both arms drift slowly and equally down to the patient's side. C: The patient's face is symmetrical when he or she smiles. D: One of the pupils is dilated and does not react to light.
A: One arm drifts down compared with the other side.
Following administration of nitroglycerin to a man with crushing chest pressure, he experiences a significant increase in his heart rate. This is MOST likely the result of: A: a drop in blood pressure. B: preexisting hypertension. C: a cardiac dysrhythmia. D: coronary vasoconstriction.
A: a drop in blood pressure.
While assessing a patient with chest pain, you note that his pulse is irregular. This indicates: A: abnormalities in the heart's electrical conduction system. B: acute myocardial infarction or angina pectoris. C: high blood pressure that is increasing cardiac workload. D: a dysfunction in the left side of the patient's heart
A: abnormalities in the heart's electrical conduction system.
A 65-year-old man has generalized weakness and chest pressure. He has a bottle of prescribed nitroglycerin, but states that he has not taken any of his medication. As your partner prepares to administer oxygen, you should: A: administer up to 325 mg of aspirin if the patient is not allergic to it. B: apply the AED and prepare the patient for immediate transport. C: assist the patient with his nitroglycerin with medical control approval. D: perform a secondary assessment and obtain baseline vital signs.
A: administer up to 325 mg of aspirin if the patient is not allergic to it.
The automated external defibrillator (AED) should NOT be used in patients who: A: are apneic and have a weak carotid pulse. B: experienced a witnessed cardiac arrest. C: are between 1 and 8 years of age. D: have a nitroglycerin patch applied to the skin.
A: are apneic and have a weak carotid pulse.
You are treating a 60-year-old man in cardiac arrest. After delivering a shock with the AED and performing CPR for 2 minutes, you achieve return of spontaneous circulation. Your next action should be to: A: assess his airway and ventilatory status. B: remove the AED and apply 100% oxygen. C: reanalyze his rhythm for confirmation. D: provide rapid transport to the hospital.
A: assess his airway and ventilatory status.
In patients with heart disease, acute coronary syndrome is MOST often the result of: A: atherosclerosis. B: coronary artery spasm. C: coronary artery rupture. D: atrial damage.
A: atherosclerosis.
A middle-aged male was found unresponsive by his wife. When you arrive at the scene, you assess the patient and determine that he is apneic and pulseless. You should: A: begin CPR starting with chest compressions, apply the AED as soon as possible, and request backup. B: immediately apply the AED, analyze his cardiac rhythm, deliver a shock if indicated, and begin CPR. C: perform CPR with a compression-to-ventilation ratio of 15:2, apply the AED, and request backup. D: immediately begin CPR, reassess for a carotid pulse after 60 seconds, and then apply the AED.
A: begin CPR starting with chest compressions, apply the AED as soon as possible, and request backup.
After applying the AED to an adult patient in cardiac arrest, you analyze her cardiac rhythm and receive a shock advised message. Emergency medical responders, who arrived at the scene before you, tell you that bystander CPR was not in progress upon their arrival. You should: A: deliver the shock as indicated followed immediately by CPR. B: detach the AED and prepare for immediate transport. C: notify medical control and request permission to cease resuscitation. D: perform CPR for 2 minutes and then defibrillate.
A: deliver the shock as indicated followed immediately by CPR.
A patient reports pain in the upper midabdominal area. This region of the abdomen is called the: A: epigastrium. B: mediastinum. C: retroperitoneum. D: peritoneum.
A: epigastrium.
When performing two-rescuer CPR on an adult patient whose airway has not been secured with an advanced device, you should: A: have your partner pause after 30 compressions as you give 2 breaths. B: deliver ventilations at a rate of 8 to 10 breaths/min. C: continue ventilations as the AED analyzes the patient's cardiac rhythm. D: avoid synchronizing compressions with ventilations
A: have your partner pause after 30 compressions as you give 2 breaths.
The pain associated with acute aortic dissection: A: is typically described as a stabbing or tearing sensation. B: is usually preceded by nausea, sweating, and weakness. C: originates in the epigastrium and radiates down both legs. D: typically comes on gradually and progressively worsens.
A: is typically described as a stabbing or tearing sensation.
You are caring for a 66-year-old woman with severe pressure in her chest. As you administer oxygen to her, your partner should: A: obtain a set of vital signs. B: notify medical control. C: gather her medications. D: obtain a SAMPLE history.
A: obtain a set of vital signs.v
Prior to administering nitroglycerin to a patient with chest pain, you should: A: obtain vital signs to detect hypotension. B: elevate the patient's lower extremities. C: inquire about an allergy to salicylates. D: auscultate the patient's breath sounds.
A: obtain vital signs to detect hypotension.
You arrive at the scene of a 56-year-old man who collapsed. The patient's wife tells you that he suddenly grabbed his chest and then passed out. Your assessment reveals that he is apneic and pulseless. As your partner begins one-rescuer CPR, you should: A: prepare the AED for use. B: notify medical control. C: obtain a SAMPLE history. D: insert an airway adjunct.
A: prepare the AED for use.
The chest pain associated with an acute coronary syndrome is often described as: A: pressure. B: sharp. C: stabbing. D: cramping.
A: pressure.
While transporting an elderly woman who was complaining of nausea, vomiting, and weakness, she suddenly becomes unresponsive. You should: A: quickly look at her chest for obvious movement. B: feel for a carotid pulse for at least 5 seconds. C: open her airway and ensure that it is clear. D: analyze her heart rhythm with the AED.
A: quickly look at her chest for obvious movement.
You are assessing a 70-year-old male who complains of pain in both of his legs. He is conscious and alert, has a blood pressure of 160/90 mm Hg, a pulse rate of 110 beats/min, and respirations of 14 breaths/min and unlabored. Further assessment reveals edema to both of his feet and legs and jugular venous distention. This patient's primary problem is MOST likely: A: right heart failure. B: left heart failure. C: pulmonary edema. D: chronic hypertension.
A: right heart failure.
The position of comfort for a patient with nontraumatic chest pain MOST commonly is: A: semisitting. B: supine with the legs elevated slightly. C: on the side with the head elevated. D: lateral recumbent.
A: semisitting.
Switching compressors during two-rescuer CPR: A: should occur every 2 minutes throughout the arrest. B: is performed after every 10 to 20 cycles of adult CPR. C: should take no more than 15 seconds to accomplish. D: is only necessary if the compressor becomes fatigued.
A: should occur every 2 minutes throughout the arrest.
After restoring a pulse in a cardiac arrest patient, you begin immediate transport. While en route to the hospital, the patient goes back into cardiac arrest. You should: A: tell your partner to stop the ambulance. B: begin CPR and proceed to the hospital. C: contact medical control for further advice. D: analyze the patient's rhythm with the AED.
A: tell your partner to stop the ambulance.
When assessing a patient with a possible stroke, you should recall that: A: the patient may be unable to communicate, but can often understand. B: fibrinolytic therapy must be given within 6 hours following the stroke. C: right-sided weakness indicates a stroke in the right cerebral hemisphere. D: the majority of strokes involve bleeding into the brain tissue.
A: the patient may be unable to communicate, but can often understand.
Which of the following patients would be the LEAST likely to present with classic signs and symptoms of acute myocardial infarction? A: 55-year-old female with COPD and frequent infections. B: 72-year-old female with diabetes and hypertension. C: 59 year-old male with alcoholism and angina pectoris. D: 64-year-old male with renal disease and depression.
B: 72-year-old female with diabetes and hypertension.
Which of the following patients is the BEST candidate for the administration of nitroglycerin? A: An elderly man with crushing substernal chest pain and a blood pressure of 80/60 mm Hg B: A woman with chest pain, prescribed nitroglycerin, and a blood pressure of 104/76 mm Hg C: A man with chest pain, expired nitroglycerin spray, and a blood pressure of 110/80 mm Hg D: A woman who has taken three doses of prescribed nitroglycerin without relief of chest pain
B: A woman with chest pain, prescribed nitroglycerin, and a blood pressure of 104/76 mm Hg
How can you help maximize cardiac output during CPR? A: Deliver rescue breaths until the chest expands widely B: Allow the chest to fully recoil in between compressions C: Ventilate the patient through an advanced airway device D: Compress the chest at a rate of no more than 100/min
B: Allow the chest to fully recoil in between compressions
A 45-year-old woman calls EMS because of severe chest pain. When you arrive, she advises you that she has taken two of her husband's nitroglycerin (NTG) tablets without relief. What is your MOST appropriate course of action? A: Attach the AED, administer 100% oxygen, and contact medical control for advice. B: Apply supplemental oxygen and transport the patient to the hospital without delay. C: Apply oxygen, assess the patient's blood pressure, and give a third and final NTG tablet. D: Call medical control and request permission to assist the patient with one more NTG tablet.
B: Apply supplemental oxygen and transport the patient to the hospital without delay.
Which of the following types of stroke would MOST likely present with a sudden, severe headache? A: Ischemic B: Hemorrhagic C: Embolic D: Thrombotic
B: Hemorrhagic
Which of the following is the MOST appropriate response when a patient with chest pain asks you if he or she is having a heart attack? A: Yes, so I recommend going to the hospital. B: I don't know, but we will take good care of you. C: Probably not, but we should transport you to be safe. D: I believe you are, but only a physician can tell for sure.
B: I don't know, but we will take good care of you.
When assessing a patient who complains of chest pain, which of the following questions would you ask to assess the "R" in OPQRST? A: Did the pain begin suddenly or gradually? B: Is the pain in one place or does it move around? C: What were you doing when the pain began? D: Is there anything that makes the pain worse?
B: Is the pain in one place or does it move around?
By which of the following mechanisms does nitroglycerin relieve cardiac-related chest pain or discomfort? A: Vasoconstriction and increased cardiac oxygen demand B: Vasodilation and increased myocardial oxygen supply C: Vasoconstriction and increased myocardial workload D: Vasodilation and decreased myocardial oxygen supply
B: Vasodilation and increased myocardial oxygen supply
Sudden cardiac arrest in the adult population MOST often is the result of: A: respiratory failure. B: a cardiac arrhythmia. C: accidental electrocution. D: myocardial infarction.
B: a cardiac arrhythmia.
While assessing a man who is complaining of chest pain, he suddenly becomes unresponsive. You should: A: open the airway. B: assess for breathing. C: assess for a pulse. D: apply the AED.
B: assess for breathing.
A 56-year-old man is found to be pulseless and apneic. His wife states that he collapsed about 5 minutes ago. As your partner gets the AED from the ambulance, you should: A: ask the wife if the patient has a living will. B: begin CPR, starting with chest compressions. C: provide rescue breaths until the AED is ready. D: open the airway and give 2 rescue breaths.
B: begin CPR, starting with chest compressions.
A 60-year-old man presents with chest pain and difficulty breathing. He is pale, diaphoretic, and in severe pain. As your partner applies supplemental oxygen, you assess his vital signs. His blood pressure is 180/90 mm Hg, pulse is 110 beats/min and irregular, and respirations are 24 breaths/min and labored. You ask him if has taken any nitroglycerin and he tells you that he does not have any but his wife does. You should: A: have him swallow up to four enteric-coated aspirin, continue oxygen therapy, and promptly transport him to the hospital. B: complete your focused physical examination and prepare the patient for immediate transport to an appropriate hospital. C: transport at once, apply the AED in case he develops cardiac arrest, and monitor his vital signs en route to the hospital. D: contact medical control and request permission to assist the patient with up to three doses of his wife's nitroglycerin.
B: complete your focused physical examination and prepare the patient for immediate transport to an appropriate hospital.
Your partner has applied the AED to a cardiac arrest patient and has received a shock advised message. While the AED is charging, you should: A: retrieve the airway equipment and prepare to ventilate the patient. B: continue chest compressions until your partner tells you to stand clear. C: perform rescue breathing only until the AED is charged and ready to shock. D: cease all contact with the patient until the AED has delivered the shock.
B: continue chest compressions until your partner tells you to stand clear.
You should be MOST suspicious that a patient with chest pressure has an underlying cardiac problem if his or her pulse is: A: slow. B: irregular. C: bounding. D: rapid.
B: irregular.
Shortly after assisting a 60-year-old woman with her second nitroglycerin treatment, she tells you that she is lightheaded and feels like she is going to faint. Her symptoms are MOST likely due to: A: a drop in her blood sugar. B: low blood pressure. C: nervousness and anxiety. D: an irregular heartbeat.
B: low blood pressure.
When treating a patient with chest pain, pressure, or discomfort, you should first: A: request an ALS ambulance response to the scene. B: place the patient in a position of comfort. C: administer supplemental oxygen. D: assess the blood pressure and give nitroglycerin.
B: place the patient in a position of comfort.
Your assessment of a middle-aged female with chest pressure reveals that she is confused, diaphoretic, and has a blood pressure of 70/50 mm Hg. In caring for this patient, it is MOST important for you to: A: reassess her vital signs at least every 5 minutes. B: prepare for immediate transport to the hospital. C: request an ALS unit to respond to the scene. D: assist her with her nitroglycerin if she has any.
B: prepare for immediate transport to the hospital.
Aspirin is beneficial to patients experiencing an acute coronary syndrome because it: A: decreases cardiac workload by lowering the BP. B: prevents a clot from getting larger. C: effectively relieves their chest pain. D: destroys the clot that is blocking a coronary artery.
B: prevents a clot from getting larger.
A 50-year-old man's implanted defibrillator has fired twice within the last hour. He is conscious and alert and complains of a "sore chest." Further assessment reveals that his chest pain is reproducible to palpation and is localized to the area of his implanted defibrillator. In addition to supplemental oxygen, treatment for him should include: A: deactivating his defibrillator by running a magnet over it. B: prompt transport with continuous monitoring en route. C: up to three doses of nitroglycerin and prompt transport. D: application of the AED and transport to the hospital.
B: prompt transport with continuous monitoring en route.
Freshly oxygenated blood returns to the heart via the: A: vena cavae. B: pulmonary vein. C: aorta. D: pulmonary artery.
B: pulmonary vein.
In addition to supplemental oxygen, one of the MOST effective way to minimize the detrimental effects associated with acute coronary syndrome is to: A: transport the patient rapidly, using lights and siren. B: reassure the patient and provide prompt transport. C: administer nitroglycerin in 15 to 20 minute intervals. D: request ALS support for any patient who has chest pain.
B: reassure the patient and provide prompt transport.
The AED analyzes your pulseless and apneic patient's cardiac rhythm and advises that a shock is NOT indicated. You should: A: reanalyze the cardiac rhythm for positive confirmation. B: resume CPR, starting with chest compressions. C: assess for a pulse for no more than 10 seconds. D: open the patient's airway and check for breathing.
B: resume CPR, starting with chest compressions.
The wall that separates the left and right sides of the heart is called the: A: pericardium. B: septum. C: mediastinum. D: carina.
B: septum.
After delivering one shock with the AED and performing 2 minutes of CPR on a woman in cardiac arrest, you reanalyze her cardiac rhythm and receive a no shock advised message. This means that: A: her rhythm has deteriorated to asystole. B: she is not in a shockable rhythm. C: the first shock restored a rhythm and pulse. D: she has electrical activity but no pulse.
B: she is not in a shockable rhythm.
The quickest way to reduce cardiac ischemia in a patient experiencing an acute coronary syndrome is to: A: give supplemental oxygen. B: sit or lay the patient down. C: keep the patient warm. D: elevate the patient's legs.
B: sit or lay the patient down.
Aspirin may be contraindicated in patients with: A: ibuprofen allergy. B: stomach ulcers. C: glaucoma. D: diabetes.
B: stomach ulcers.
After assisting a patient with his or her prescribed nitroglycerin, you would NOT expect him or her to experience a: A: burning sensation in the mouth. B: syncopal episode. C: fizzing sensation under the tongue. D: pounding headache.
B: syncopal episode.
During your assessment of a 70-year-old man with crushing chest pain, you note that his blood pressure is 80/50 mm Hg. Your MOST important action should be to: A: assess his oxygen saturation. B: transport without delay. C: give high-flow oxygen. D: keep the patient warm.
B: transport without delay.
Treatment for a patient with congestive heart failure and shortness of breath may include: A: supine positioning and elevation of the legs. B: up to three doses of sublingual nitroglycerin. C: hyperventilation with a bag-mask device. D: prophylactic suctioning of the airway.
B: up to three doses of sublingual nitroglycerin.
A patient whose artificial pacemaker has failed would MOST likely experience: A: dizziness and excessive tachycardia B: weakness and bradycardia. C: hypertension and a headache. D: irreversible ventricular fibrillation.
B: weakness and bradycardia.
In which of the following patients is nitroglycerin contraindicated? A: 41-year-old male with crushing substernal chest pressure, a blood pressure of 160/90 mm Hg, and severe nausea B: 58-year-old male with chest pain radiating to the left arm, a blood pressure of 130/64 mm Hg, and prescribed Tegretol C: 53-year-old male with chest discomfort, diaphoresis, a blood pressure of 146/66 mm Hg, and regular use of Levitra D: 66-year-old female with chest pressure of 6 hours' duration, lightheadedness, and a blood pressure of 110/58 mm Hg
C: 53-year-old male with chest discomfort, diaphoresis, a blood pressure of 146/66 mm Hg, and regular use of Levitra
A middle-aged female with a history of hypertension and high cholesterol complains of chest discomfort. She asks you to take her to the hospital where her personal physician practices, which is 15 miles away. Her blood pressure is 130/70 mm Hg, pulse is 84 beats/min and regular, and respirations are 18 breaths/min and unlabored. Which of the following actions is clearly NOT appropriate for this patient? A: Contacting her physician via phone B: Taking her to her choice hospital C: Allowing her to walk to the ambulance D: Giving oxygen via nasal cannula
C: Allowing her to walk to the ambulance
Which of the following questions would be the MOST effective in determining if a patient's chest pain radiates away from his or her chest? A: Is there anything that makes the pain better or worse? B: Is there any other part of your body where you have pain? C: Does the pain stay in your chest or move anywhere else? D: Do you also have pain in your arm, jaw, or back?
C: Does the pain stay in your chest or move anywhere else?
Which of the following interventions would the EMT be the LEAST likely to perform while attempting to resuscitate a cardiac arrest patient? A: Assisting a paramedic with intubation B: Ventilation with a bag-mask device C: Insertion of a supraglottic airway device. D: Rhythm analysis with the AED
C: Insertion of a supraglottic airway device.
Which of the following assessment findings is LEAST suggestive of cardiac compromise? A: Rapid, irregular heart rate B: Nausea and epigastric pain C: Palpable pain to the chest D: Anxiety and pale, cool skin
C: Palpable pain to the chest
Which of the following is the BEST indicator of cardiac output? A: Systolic blood pressure B: Quality of the respirations C: Pulse rate and quality D: Condition and color of the skin
C: Pulse rate and quality
A 60-year-old man is in cardiac arrest. You begin CPR while your partner applies the AED. What should you do if you receive a no shock message? A: Reanalyze his cardiac rhythm after 30 seconds of CPR. B: Assess for a carotid pulse for up to 10 seconds. C: Resume CPR, starting with chest compressions. D: Ensure that the AED electrodes are properly applied.
C: Resume CPR, starting with chest compressions.
Which of the following structures is the primary pacemaker, which sets the normal rate for the heart? A: Atrioventricular node B: Purkinje fibers C: Sinoatrial node D: Bundle of His
C: Sinoatrial node
Which of the following questions would be MOST appropriate to ask when assessing a patient with chest pain? A: Is the pain worse when you take a deep breath? B: Would you describe the pain as sharp? C: What does the pain feel like? D: Does the pain radiate to your arm?
C: What does the pain feel like?
When an error occurs while using the AED, it is MOST often the result of: A: malfunction of the microchip inside the AED. B: misinterpretation of the patient's cardiac rhythm. C: battery failure secondary to operator error. D: excess patient movement during the analyze phase.
C: battery failure secondary to operator error.
You should suspect that your patient has pulmonary edema if he or she: A: has swollen feet and ankles. B: has a dry, nonproductive cough. C: cannot breathe while lying down. D: is hypertensive and tachycardic.
C: cannot breathe while lying down.
A 58-year-old man is found unresponsive by his wife. According to his wife, he was complaining of a "dull ache" in his chest the day before, but refused to allow her to call 9-1-1. His blood pressure is 70/50 mm Hg, his pulse is 120 beats/min and weak, and his respirations are 28 breaths/min and labored. Further assessment reveals that his skin is cool, pale, and clammy. You should suspect: A: hypovolemic shock. B: acute septic shock. C: cardiogenic shock. D: pulmonary embolism.
C: cardiogenic shock.
A patient who is experiencing an acute myocardial infarction: A: often experiences relief of his or her chest pain after taking nitroglycerin. B: most often describes his or her chest pain as being sharp or tearing. C: has chest pain or discomfort that does not change with each breath. D: often complains of a different type of pain than a patient with angina.
C: has chest pain or discomfort that does not change with each breath.
Nitroglycerin is contraindicated in all of the following situations, EXCEPT: A: the presence of a head injury. B: recent use of Cialis. C: history of cardiac bypass surgery. D: systolic BP of 80 mm Hg.
C: history of cardiac bypass surgery.
The middle, muscular layer of the heart is called the: A: epicardium. B: endocardium. C: myocardium. D: pericardium.
C: myocardium.
Chest compression effectiveness is MOST effectively assessed by: A: carefully measuring the depth of each compression. B: measuring the systolic blood pressure during compressions. C: palpating for a carotid pulse with each compression. D: listening for a heartbeat with each compression.
C: palpating for a carotid pulse with each compression.
All of the following are components of the Cincinnati stroke scale, EXCEPT: A: arm movement. B: facial droop. C: pupil size. D: speech pattern.
C: pupil size.
A middle-aged woman took three of her prescribed nitroglycerin tablets after she began experiencing chest pain. She complains of a bad headache and is still experiencing chest pain. You should assume that: A: her chest pain is not cardiac-related. B: her nitroglycerin is no longer potent. C: she has ongoing cardiac ischemia. D: her blood pressure is elevated.
C: she has ongoing cardiac ischemia.
You arrive at the scene shortly after a 55-year-old man collapsed. Two bystanders are performing CPR. Your FIRST action should be to: A: check the effectiveness of the CPR in progress. B: insert an oropharyngeal airway and continue CPR C: stop CPR so you can assess breathing and pulse. D: attach the AED and analyze his cardiac rhythm.
C: stop CPR so you can assess breathing and pulse.
A 66-year-old female presents with an acute onset of confusion, slurred speech, and weakness to her right arm and leg. Her airway is patent and she is breathing adequately. The MOST important initial information to determine regarding this patient is: A: whether or not her pupils are equal. B: her initial blood pressure reading. C: when her symptoms were first noted. D: what she was doing when this began.
C: when her symptoms were first noted.
Which of the following statements regarding sudden cardiac arrest and ventricular fibrillation is correct? A: Most patients develop ventricular fibrillation within 10 minutes after the onset of sudden cardiac arrest. B: Patients with ventricular fibrillation are typically unconscious, apneic, and have a weak and irregular pulse. C: High-quality CPR often reverses ventricular fibrillation if it is initiated within 2 minutes of the onset. D: For each minute that defibrillation is delayed, the chance of survival decreases by as much as 10%.
D: For each minute that defibrillation is delayed, the chance of survival decreases by as much as 10%.
Which of the following would clearly be detrimental to a patient in cardiac arrest? A: Ventilating just until the chest rises B: Using a pocket face mask without high-flow oxygen C: Performing CPR before defibrillation D: Interrupting CPR for more than 10 seconds
D: Interrupting CPR for more than 10 seconds
Which of the following chambers of the heart has the thickest walls? A: Right ventricle B: Left atrium C: Right atrium D: Left ventricle
D: Left ventricle
Which of the following statements regarding one-rescuer CPR is correct? A: A compression to ventilation ratio of 15:2 should be delivered. B: Ventilations should be delivered over a period of 2 to 3 seconds. C: You should assess the patient for a pulse after 3 cycles of CPR. D: The chest should be allowed to fully recoil after each compression.
D: The chest should be allowed to fully recoil after each compression.
After attaching the AED and pushing the analyze button on an adult patient in cardiac arrest, the AED states that a shock is advised. What cardiac rhythm is the patient MOST likely in? A: Pulseless electrical activity B: Asystole C: Ventricular tachycardia D: Ventricular fibrillation
D: Ventricular fibrillation
Sudden cardiac arrest in the adult population is MOST often the result of: A: respiratory failure. B: myocardial infarction. C: an acute stroke. D: a cardiac dysrhythmia.
D: a cardiac dysrhythmia.
The myocardium receives its blood supply from the coronary arteries that branch directly from the: A: right ventricle. B: left atrium. C: vena cava. D: aorta.
D: aorta.
A 50-year-old man presents with crushing chest pain of sudden onset. He is diaphoretic, apprehensive, and tachypneic. You should: A: obtain baseline vital signs. B: ask him if he takes nitroglycerin. C: perform a complete physical exam. D: apply supplemental oxygen.
D: apply supplemental oxygen.
You assess an unresponsive 65-year-old man and find that he is apneic and pulseless. The patient's wife tells you that he has an automatic implanted cardioverter/defibrillator. After initiating CPR, you should: A: ask the wife why and when he had the automatic defibrillator implanted. B: deactivate the implanted defibrillator by running a magnet over it. C: avoid using the AED because the implanted defibrillator is more effective. D: apply the AED as soon as possible and analyze his cardiac rhythm.
D: apply the AED as soon as possible and analyze his cardiac rhythm.
In addition to chest pain or discomfort, a patient experiencing an acute coronary syndrome would MOST likely present with: A: irregular breathing and low blood pressure. B: severe projectile vomiting and flushed skin. C: profound cyanosis, dry skin, and a headache. D: ashen skin color, diaphoresis, and anxiety.
D: ashen skin color, diaphoresis, and anxiety.
After defibrillating a man in cardiac arrest, you resume CPR. As you are about to reanalyze his cardiac rhythm 2 minutes later, your partner tells you she can definitely feel a strong carotid pulse. You should: A: ask her to obtain a blood pressure reading. B: remove the AED pads from the patient's chest. C: continue with the rhythm analysis. D: assess the patient's breathing effort.
D: assess the patient's breathing effort.
An elderly man in unresponsive and has agonal breathing. You should: A: perform rescue breathing at 10 to 12 breaths/min. B: open his airway and deliver 2 rescue breaths. C: begin CPR, starting with chest compressions. D: check for a carotid pulse for up to 10 seconds.
D: check for a carotid pulse for up to 10 seconds.
You have analyzed a cardiac arrest patient's rhythm three times with the AED, separated by 2-minute cycles of CPR, and have received no shock messages each time. You should: A: request a paramedic unit at the scene. B: consider terminating resuscitation. C: remove the AED and continue CPR. D: continue CPR and transport at once.
D: continue CPR and transport at once.
The MOST important initial treatment for a patient whose cardiac arrest was witnessed is: A: cardiac drug therapy. B: defibrillation. C: rapid transport. D: high-quality CPR.
D: high-quality CPR.
Tachycardia can be detrimental to a patient who is experiencing a cardiac problem because it causes: A: an associated increase in breathing difficulty. B: a profound decrease in oxygen consumption. C: increased cardiac filling in between beats. D: increased cardiac oxygen usage and demand.
D: increased cardiac oxygen usage and demand.
The energy setting for a biphasic AED: A: increases by 50 joules with each shock. B: is typically 360 joules. C: must be manually set by the EMT. D: is manufacturer specific.
D: is manufacturer specific.
After administering nitroglycerin to a patient with chest discomfort, it is MOST important for you to: A: find out how long the discomfort has been present. B: place the patient supine and elevate his or her legs. C: ask the patient if the discomfort has improved. D: reassess his or her blood pressure within 5 minutes.
D: reassess his or her blood pressure within 5 minutes.
Common signs and symptoms of a hypertensive emergency include: A: vomiting without nausea and hemiparesis. B: unequal pupils, irregular pulse, and pallor. C: chest discomfort, weak pulses, and cool skin. D: ringing in the ears, headache, and epistaxis.
D: ringing in the ears, headache, and epistaxis.
When the vital organs of an 85-year-old patient need additional blood flow, the heart may not be able to meet the increased need because: A: blood pressure decreases as a person ages. B: stroke volume increases as a person ages. C: the patient's blood vessels become more elastic. D: the reserve capacity of the heart is reduced.
D: the reserve capacity of the heart is reduced.
Ischemic heart disease is a condition in which: A: the coronary arteries dilate, thus preventing effective blood flow to the heart. B: an acute event leads to a significant decrease in the pumping force of the heart. C: a portion of the heart muscle dies because of a prolonged lack of oxygen. D: there is a decrease in blood flow to one or more portions of the heart muscle.
D: there is a decrease in blood flow to one or more portions of the heart muscle.