Cardiology

In which of the following patients is nitroglycerin contraindicated?

53-year-old 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 patients would be the LEAST likely to present with classic signs and symptoms of acute myocardial infarction?

72-year-old female with diabetes and hypertension.

Which of the following patients 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 automated external defibrillator (AED) is correct?

AEDs can safely be used in infants and children less than 8 years of age

How can you help maximize cardiac output during CPR?

Allow the chest to fully recoil in between compressions

Which of the following describes pulseless electrical activity (PEA)?

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?

Compress the chest at least 2", allow full recoil of the chest after each compression, minimize interruptions in chest compressions

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?

Does the pain stay in your chest or move anywhere else?

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%.

Which of the following is a common side effect of nitroglycerin?

Headache

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.

Which of the following is MOST indicative of a primary cardiac problem?

Irregular pulse

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 around?

Which of the following chambers of the heart has the thickest walls?

Left ventricle

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?

One arm drifts down compared with the other side.

Which of the following assessment findings is LEAST suggestive of cardiac compromise?

Palpable pain to the chest

Which of the following is the BEST indicator of cardiac output?

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?

Resume CPR, starting with chest compressions.

Which of the following structures is the primary pacemaker, which sets the normal rate for the heart?

Sinoatrial node

By which of the following mechanisms does nitroglycerin relieve cardiac-related chest pain or discomfort?

Vasodilation and increased myocardial oxygen supply

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?

Ventricular fibrillation

Which of the following questions would be MOST appropriate to ask when assessing a patient with chest pain?

What does the pain feel like?

Sudden cardiac arrest in the adult population MOST often is the result of:

a cardiac arrhythmia.

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.

While assessing a patient with chest pain, you note that his pulse is irregular. This indicates:

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:

administer up to 325 mg of aspirin if the patient is not allergic to it.

The myocardium receives its blood supply from the coronary arteries that branch directly from the:

aorta.

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:

apply the AED as soon as possible and analyze his cardiac rhythm.

The automated external defibrillator (AED) should NOT be used 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.

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 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:

begin CPR starting with chest compressions, apply the AED as soon as possible, and request backup.

You should suspect that your patient has pulmonary edema if he or she:

cannot breathe while lying down.

An elderly man in unresponsive and has agonal breathing. You should:

check for a carotid pulse for up to 10 seconds.

When performing two-rescuer CPR on an adult patient whose airway has not been secured with an advanced device, you should:

have your partner pause after 30 compressions as you give 2 breaths.

The MOST important initial treatment for a patient whose cardiac arrest was witnessed is:

high-quality CPR.

Nitroglycerin is contraindicated in all of the following situations, EXCEPT:

history of cardiac bypass surgery.

The pain associated with acute aortic dissection:

is typically described as a stabbing or tearing sensation.

The middle, muscular layer of the heart is called the:

myocardium.

Prior to administering nitroglycerin to a patient with chest pain, you should:

obtain vital signs to detect hypotension.

Chest compression effectiveness is MOST effectively assessed by:

palpating for a carotid pulse with each compression.

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 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:

prompt transport with continuous monitoring en route.

Freshly oxygenated blood returns to the heart via the:

pulmonary vein

All of the following are components of the Cincinnati stroke scale, EXCEPT:

pupil size.

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 compressors during two-rescuer CPR:

should occur every 2 minutes throughout the arrest.

After assisting a patient with his or her prescribed nitroglycerin, you would NOT expect him or her to experience a:

syncopal episode.

Ischemic heart disease is a condition in which:

there is a decrease in blood flow to one or more portions of the heart muscle.

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:

transport without delay.

Treatment for a patient with congestive heart failure and shortness of breath may include:

up to three doses of sublingual nitroglycerin.

A patient whose artificial pacemaker has failed would MOST likely experience:

weakness and bradycardia.

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:

when her symptoms were first noted.

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:

prepare the AED for use.

While transporting an elderly woman who was complaining of nausea, vomiting, and weakness, she suddenly becomes unresponsive. You should:

quickly look at her chest for obvious movement.

After administering nitroglycerin to a patient with chest discomfort, it is MOST important for you to:

reassess his or her blood pressure within 5 minutes.

In addition to supplemental oxygen, one of the MOST effective way to minimize the detrimental effects associated with acute coronary syndrome is to:

reassure the patient and provide prompt transport.

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

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?

Apply supplemental oxygen and transport the patient to the hospital without delay.

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.

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?

I don't know, but we will take good care of you.

Which of the following types of stroke would MOST likely present with a sudden, severe headache?

Hemorrhagic

Which of the following is the MOST detrimental effect that tachycardia can have on a patient experiencing a cardiac problem?

Increased oxygen demand

Which of the following interventions would the EMT be the LEAST likely to perform while attempting to resuscitate a cardiac arrest patient?

Insertion of a supraglottic airway device.

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 statements regarding one-rescuer CPR is correct?

The chest should be allowed to fully recoil after each compression.

Sudden cardiac arrest in the adult population is MOST often the result of:

a cardiac dysrhythmia.

A 50-year-old man presents with crushing chest pain of sudden onset. He is diaphoretic, apprehensive, and tachypneic. You should:

apply supplemental oxygen

While assessing a man who is complaining of chest pain, he suddenly becomes unresponsive. You should:

assess for breathing.

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.

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:

begin CPR, starting with chest compressions.

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:

cardiogenic shock.

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:

complete your focused physical examination and prepare the patient for immediate transport to an appropriate hospital.

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.

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 immediately by CPR.

A patient reports pain in the upper midabdominal area. This region of the abdomen is called the:

epigastrium.

A patient who is experiencing an acute myocardial infarction:

has chest pain or discomfort that does not change with each breath.

Tachycardia can be detrimental to a patient who is experiencing a cardiac problem because it causes:

increased cardiac oxygen usage and demand.

You should be MOST suspicious that a patient with chest pressure has an underlying cardiac problem if his or her pulse is:

irregular.

The energy setting for a biphasic AED:

is manufacturer specific.

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:

low blood pressure.

You are caring for a 66-year-old woman with severe pressure in her chest. As you administer oxygen to her, your partner should:

obtain a set of vital signs.

When treating a patient with chest pain, pressure, or discomfort, you should first:

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:

prepare for immediate transport to the hospital.

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:

right heart failure.

Common signs and symptoms of a hypertensive emergency include:

ringing in the ears, headache, and epistaxis.

The position of comfort for a patient with nontraumatic chest pain MOST commonly is

semisitting.

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.

The quickest way to reduce cardiac ischemia in a patient experiencing an acute coronary syndrome is to:

sit or lay the patient down.

Aspirin may be contraindicated in patients with:

stomach ulcers.

You arrive at the scene shortly after a 55-year-old man collapsed. Two bystanders are performing CPR. Your FIRST action should be to:

stop CPR so you can assess breathing and pulse.

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:

tell your partner to stop the ambulance.

When assessing a patient with a possible stroke, 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.