EMT Cardiology TestPrep Questions
In which of the following patients is nitroglycerin contraindicated?
53-year-oold male with chest discomfort, diaphoresis, a blood pressure of 146/66 mm Hg, and regular use of Levitra
Which of the following patients would MOST likely present with vague or unusual symptoms of an acute myocardial infarction?
72-year-old female with diabetes
Which of the following is the BEST candidate for fibrinolytic therapy?
A 50-year-oldman who has slurred speech and left arm weakness that started 45 minutes ago; history of a heart attack 8 months ago
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 drop in blood pressure
What occurs during the recoil of the chest in between compressions?
A vacuum is created and blood returns to the heart
Which of the following is the BEST candidate for the administration of nitroglycerin?
A woman with chest pain, prescribed nitroglycerin, and a blood pressure of 104/76 mm Hg
Which of the following statements regarding the AED is correct?
AEDs can safely be used in infants and children less than 8 years of age
While assessing a patient with chest pain, you note that the patient's pulse is irregular. This indicates A. acute myocardial infarction or angina pectoris B. a dysfunction in the left side of the patient's heart C. high blood pressure that is increasing cardiac workload D. abnormalities in the heart's electrical conduction system
Abnormalities in the heart's electrical conduction system
Which of the following is an expected finding in patients who have a left ventricular assist device (LVAD) with a continuous flow pump?
Absence of pulses
A 65-year-old woman complains of severe chest pain that radiates to her back, in between her shoulder blades. She tells you that it is the most severe pain she has ever experienced, and that it has been intense since it began. Her past medical history includes hypertension. When you palpate her radial pulses, you note that they are unequal in strength. What should you suspect?
Acute aortic dissection
A 67-year-old woman presents with acute weakness and nausea. She is conscious and alert and her skin is cool and clammy. Her BP is 140/88 mm Hg, pulse is 70 beats/min and regular, and respirations are 16 breaths/min and unlabored. Her medical history includes hypertension and diabetes, and she advises that she has an implanted pacemaker. What should you suspect?
Acute myocardial infarction
A 50-year-old man presents with crushing chest pain that suddenly began about 30 minutes ago. He is diaphoretic and anxious. The EMT should:
Administer chewable aspirin
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. The EMT should:
Administer up to 325 mg of aspirin if the patient is not allergic to it
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:
Advise your partner to stop the ambulance
How can you help maximize cardiac output during CPR?
Allow the chest to fully recoil during compressions
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?
Allowing her to walk to the ambulance
Which of the following describes pulseless electrical activity (PEA)?
Any organized cardiac rhythm, slow or fast, that does not produce a palpable pulse
The myocardium receives its blood supply from the coronary arteries that branch directly from the:
Aorta
The coronary arteries fill with blood when the:
Aortic valve closes
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:apply the AED as soon as possible and analyze his cardiac rhythm. • B:deactivate the implanted defibrillator by running a magnet over it. • C:avoid using the AED because the implanted defibrillator is more effective. • D:ask the wife why and when he had the automatic defibrillator implanted.
Apply the AED as soon as possible and analyze his cardiac rhythm
Use of an AED is contraindicated in patients who:
Are apneic and have a weak carotid pulse
In addition to chest pain or discomfort, a patient experiencing an acute coronary syndrome would MOST likely present with:
Ashen skin color, diaphoresis, and anxiety
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:
Assess his airway and ventilatory status
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:
Assess the patient's breathing effort
In patients with heart disease, acute coronary syndrome is MOST often the result of:
Atherosclerosis
When an error occurs while using the AED, it is MOST often the result of:
Battery failure secondary to operator error
A 56-year-old man is found to be pulseless and apneic. His wife states that he collapsed about 5 minutes ago. As you partner gets the AED from the ambulance, you should:
Begin CPR, starting with chest compressions
A 60-year-old woman presents with chest discomfort, confusion, and weakness. The patient's husband tells you the she vomited once before EMS arrival. The patient's BP is 70/40 mm Hg, her pulse is 45 beats/min and weak, and her respirations are 14 breaths/min and unlabored. Which of the following is MOST likely the cause of her hypotension?
Bradycardia
You should suspect that your patient has pulmonary edema if he or she:
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 911. 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:
Cardiogenic shock
While performing CPR on a patient who is wearing an external defibrillator vest, the device alarms and a voice states that a shock is about to be delivered. What should you do?
Cease patient contact until the shock has been delivered.
Which of the following describes the MOST appropriate method of performing chest compressions on an adult patient in cardiac arrest?
Compress the chest at least 2 inches, allow full recoil of the chest after each compression, minimize interruptions in chest compressions
A 72-year-old female complains of dyspnea that woke her up from her sleep. Her feet and ankles are swollen, and auscultation of her lungs reveals crackles to both lung bases. She has a history of hypertension, type II diabetes, and a heart attack 2 years ago. Her BP is 170/94 mm Hg, her pulse is 110 beats/min and irregular, her respirations are 24 breaths/min and labored, and her oxygen saturation is 85% on room air. What should you suspect?
Congestive heart failure
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:
Continue CPR and transport at once
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:
Continue chest compressions until your partner tells you to stand clear
Because of the property of automaticity, cardiac muscle cells are able to:
Contract spontaneously without a stimulus from a nerve source
The M+EMT is treating a man with chest pain and has assisted him with his nitroglycerin. Which of the following should the EMT anticipate during reassessment of this patient?
Decreased blood pressure
A 44-year-old male complains of dizziness and lightheadedness. His BP is 88/62 mm Hg; his heart rate is 190 beats/min and weak; and his skin is cool, clammy, and pale. Which of the following would BEST explain why his BP is low?
Decreased ventricular filling time
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:
Deliver the shock as indicated followed by immediate CPR
Which of the following clinical signs should alert the EMT that a patient has left heart failure?
Dyspnea on exertion
With regard to the ECG, what is artifact?
Electrical interference that can make diagnosis difficult
A patient reports pain in the upper midabdominal area. This region of the abdomen is called the:
Epigastrium
Which of the following statements regarding sudden cardiac arrest and ventricular fibrillation is correct?
For each minute that defibrillation is delayed, the chance of survival decreases by as much as 10%
A patient who is experiencing an acute myocardial infarction:
Has chest pain or discomfort that does not change with each breath
A 57-year-old male presents with fli-like symptoms. He is conscious and alert; his skin is pink, warm, and dry; and he denies chest pain or respiratory distress. During your assessment, you cannot feel radial or carotid pulses, and are unable to obtain a blood pressure. Which of the following would MOST likely explain this?
He has a left ventricular assist device
Which of the following is a common side effect of nitroglycerin?
Headache
Which of the following types of stroke would MOST likely present with a sudden, severe headache?
Hemorrhagic
A 69-year-old man is unresponsive. He has a weak carotid pulse at 40 beats/min and his skin is cool and pale. From this information, the EMT should conclude that:
His cardiac output is reduced
In which of the following situations would nitroglycerin MOST likely be administered?
History of cardiac bypass surgery
Which of the following is the MOST appropriate response when a patient with chest pain asks you if her or she is having a heart attack?
I don't know, but we will take good care of you
Which of the following statements regarding ventricular fibrillation (V-fib) is correct?
In V-fib, the heart is not pumping any blood and the patient is pulseless
Tachycardia can be detrimental to a patient who is experiencing a cardiac problem because it causes:
Increased cardiac oxygen usage and demand
Blood is returned from the kidneys to the heart by way of the:
Inferior vena cava
Which of the following would clearly be detrimental to a patient in cardiac arrest?
Interrupting CPR for more than 10 seconds
Which of the following is MOST indicative of a primary cardiac problem?
Irregular pulse
The energy setting for a biphasic AED:
Is manufacturer specific
When assessing a patient who complains of chest pain, which of the following questions would you ask to assess the "R" in OPQRST?
Is the pain in one place or does it move aorund?
The pain associated with acute aortic dissection:
Is typically described as a stabbing or tearing sensation
A 71-year-oldwoman presents with an acute onset of confusion, slurred speech, and left-sided weakness. She is conscious and her airway is patent. Her BP is 180/94 mm Hg, her pulse is 70 beats/min and irregular, her respirations are 14 breaths/min and unlabored, and her oxygen saturation is 97% on room air. What should you do?
Keep her sitting up and transport without delay
Shortly after assisting a 60-year-old with her second nitroglycerin treatment, she tells you that she is lightheaded and feels as if she is going to faint. Her symptoms are most likely due to:
Low blood pressure
The middle, muscular layer of the heart is called the:
Myocardium
Which of the following is an abnormal finding when using the Cincinnati Stroke Scale to assess a patient who presents with signs of stroke?
One arm drifts down compared with the other side
Which of the following assessment findings is LEAST suggestive of a cardiac problem?
Palpable pain to the chest
Chest compression effectiveness is MOST effectively assessed by:
Palpating for a carotid pulse with each compression
When treating a patient with chest pain, pressure, or discomfort, you should FIRST:
Place the patient in a position of comfort
A 49-year-old woman presents with a headache, nausea, and ringing in her ears. She is conscious and alert and states that she has hypertension and type 2 diabetes. Her BP is 202/114 mm Hg, her pulse is 60 beats/min, and her respirations are 16 breaths/min. What should you do?
Prepare for immediate transport
Your assessment of a middle-aged female with chest pressure reveals that she is confused, is diaphoretic, and has a blood pressure of 70/50 mm Hg. In caring for this patient, it is MOST important for you to:
Prepare for immediate transport to the hospital
The chest pain associated with an acute coronary syndrome is often described as:
Pressure
Aspirin is beneficial to patients experiencing an acute coronary syndrome because it:
Prevents a clot from getting bigger
A 50-year-old man's 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 in the area of his implanted defibrillator. Treatment for him should include:
Prompt transport with continuous monitoring en route
Freshly oxygenated blood returns to the heart via the: A. Aorta B. Vena cava C. Pulmonary vein D. Pulmonary artery
Pulmonary veins
All of the following are components of the Cincinnati Stroke Scale, EXCEPT: Pupil size Facial droop Speech patter Arm movement
Pupil size
Which of the following structures stimulates the ventricles and causes them to contract?
Purkinje fibers
A 60-year-old man is in cardiac arrest. You begin CPR while your partner applies the AED. hat should you do if you receive a no shock message?
Resume CPR, starting with chest compressions
The AED analyzes your pulseless and apneic patient's cardiac rhythm and advises that a shock is NOT indicated. You should:
Resume CPR, starting with chest compressions
When applying ECG electrodes, the negative (white) lead is placed on the:
Right arm
In most people, the inferior aspect of the left ventricle receives its blood supply from the:
Right coronary artery
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. What should you suspect?
Right heart failure
Common signs and symptoms of a hypertensive emergency include:
Ringing in the ears, headache, and epistaxis
The wall that separates the left and right sides of the heart is called the:
Septum
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:
She has ongoing cardiac ischemia
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:
She is not in a shockable rhythm
Switching compressions during two-rescuer CPR:
Should occur every 2 minutes throughout the arrest
Which off the following structures is the primary pacemaker, which sets the normal rate for the heart?
Sinoatrial node
A 62-year-old male with a history of coronary artery disease began experiencing chest pain and nausea while on his daily jog. After sitting down and resting for 5 minutes, his pain and nausea resolve. Which of the following BEST describes this patient's condition?
Stable angina pectoris
Aspirin may be contraindicated in patients with:
Stomach ulcers
The maximum pressure generated in the arms and legs during contraction of the left ventricle is called:
Systolic blood pressure
Which of the following clinical signs would indicate increased sympathetic nervous system activity?
Tachycardia
A 50-year-old man with a history of hypertension began experiencing chest pressure while mowing his lawn. After taking baby aspirin and resting for approximately 10 minutes, the pressure in his chest completely resolved. Which of the following would BEST explain this?
The cessation of exertion decreased the workload of the heart and blood flow around a coronary artery clot improved
Which of the following statements regarding one-rescuer CPR is correct?
The chest should be allowed to fully recoil after each compression
When assessing a patient who has stroke-like symptoms, you should recall that:
The patient may be unable to communicate, but can often understand
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:
The reserve capacity of the heart is reduced as a person ages
Ischemic heart disease is a condition in which:
There is a decrease in blood flow to one or more portions of the heart muscle
Prior to being oxygenated in the lungs, blood passes through the:
Tricuspid and pulmonic valves
By which of the following mechanisms does nitroglycerin relieve cardiac-related chest pain or discomfort?
Vasodilation and increased myocardial oxygen supply
Following return of spontaneous circulation, the patient remains apneic. The EMT should:
Ventilate at 12 breaths/min and maintain an oxygen saturation of 95% to 99%
When an electrical impulse reaches the atrioventricular node, it is briefly delayed so that:
Ventricular filling can occur
A patient whose artificial pacemaker has failed would MOST likely experience:
Weakness and bradycardia
Which of the following questions would be MOST appropriate to ask when assessing a patient with chest pain?
What does the pain feel like?
A 66-year-old female presents with an acute onset of confusion, slurred speech, and an inability to move her right arm and leg. Her airway is patent and she is breathing adequately. Which of the following is the MOST important initial information to obtain about this patient?
When she was last seen normal
