Chapter 14 - Cardiovascular Emergencies

The myocardium receives oxygenated blood from the __________, which originate(s) from the __________. Select one: A. coronary arteries, aorta B. coronary sinus, vena cava C. vena cava, coronary veins D. aorta, inferior vena cava

A. coronary arteries, aorta

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

A. family history.

Blood that is ejected from the right ventricle: Select one: A. flows into the pulmonary arteries. B. enters the systemic circulation. C. was received directly from the aorta. D. has a high concentration of oxygen.

A. flows into the pulmonary arteries.

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

A. have chronic hypertension.

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

A. hypertension.

Common signs and symptoms of AMI include all of the following, EXCEPT: Select one: A. pain exacerbated by breathing. B. shortness of breath or dyspnea. C. an irregular heartbeat. D. sudden unexplained sweating.

A. pain exacerbated by breathing.

A 67-year-old woman presents with difficulty breathing and chest discomfort that awakened her from her sleep. She states that she has congestive heart failure, has had two previous heart attacks, and has prescribed nitroglycerin. She is conscious and alert with adequate breathing. Her blood pressure is 94/64 mm Hg and her heart rate is 120 beats/min. Treatment for this patient includes: Select one: A. placing her in an upright position. B. ventilations with a bag-mask device. C. nitroglycerin for her chest pain. D. oxygen at 4 L/min via nasal cannula.

A. placing her in an upright position.

A. reassess the blood pressure within 5 minutes to detect hypotension.

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

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 implantable cardiac defibrillator (AICD). The AED advises that a shock is indicated. What should you do? Select one: A. Avoid defibrillation as this will damage the patient's AICD. B. Deliver the shock followed by immediate resumption of CPR. C. Continue CPR and transport the patient to the closest appropriate hospital. D. Contact medical control and request permission to defibrillate.

B. Deliver the shock followed by immediate resumption of CPR.

The ability of cardiac muscle cells to contract spontaneously without a stimulus from a nerve source is called: Select one: A. excitability. B. automaticity. C. contractility. D. impulsivity.

B. automaticity.

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. immediately apply the AED pads and analyze the cardiac rhythm. B. begin CPR and apply the AED without delay. C. have your partner perform CPR while you question bystanders. D. perform two-rescuer CPR for 5 minutes and request ALS backup.

B. begin CPR and apply the AED without delay.

he inferior vena cava returns deoxygenated blood to the right side of the heart from all of the following areas, EXCEPT the: Select one: A. kidneys. B. brain. C. abdomen. D. legs.

B. brain.

Rapid, labored breathing in a patient with signs and symptoms of AMI should make you suspect: Select one: A. a cardiac arrhythmia. B. congestive heart failure. C. significant hypotension. D. right ventricular failure.

B. congestive heart failure.

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

B. sinoatrial (SA) node.

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

B. umbilicus.

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

B. ventricular fibrillation.

Upon arriving at the residence of a patient with a possible cardiac problem, it is MOST important to: Select one: A. determine if you need additional help. B. request a paramedic unit for assistance. C. assess the scene for potential hazards. D. gain immediate access to the patient.

C. assess the scene for potential hazards.

A percutaneous transluminal coronary angioplasty (PTCA) restores blood flow to the ischemic myocardium by: Select one: A. scraping fatty deposits off of the lumen of the coronary artery. 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. placing a stent inside the coronary artery to keep it from narrowing.

C. dilating the affected coronary artery with a small inflatable balloon.

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 not being compliant with her regimen of antihypertensive medications. During the primary assessment, 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? Select one: A. hypertensive emergency B. unstable angina C. dissecting aortic aneurysm D. AMI

C. dissecting aortic aneurysm

The purpose of defibrillation is to: Select one: A. improve the chance of cardiopulmonary resuscitation (CPR) being successful in resuscitation. B. prevent asystole from deteriorating into ventricular fibrillation. C. stop the chaotic, disorganized contraction of the cardiac cells. D. cause a rapid decrease in the heart rate of a patient in unstable condition.

C. stop the chaotic, disorganized contraction of the cardiac cells.

Cardiac output may decrease if the heart beats too rapidly because: Select one: A. a rapid heart beat 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. there is not enough time in between contractions for the heart to refill completely. D. as the heart rate increases, more blood is pumped from the ventricles than the atria.

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

Which of the following statements regarding nitroglycerin is correct? Select one: A. Nitroglycerin should be administered between the cheek and gum. B. A maximum of five nitroglycerin doses should be given to a patient. C. The potency of nitroglycerin is increased when exposed to light. D. Nitroglycerin usually relieves anginal chest pain within 5 minutes.

D. Nitroglycerin usually relieves anginal chest pain within 5 minutes.

Which of the following is LEAST important when obtaining a medical history from a patient with a chief complaint of chest discomfort? Select one: A. presence of personal risk factors B. history of previous heart attack C. history of cigarette smoking D. family history of hypertension

D. family history of hypertension

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

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

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

D. myocardial oxygen demand exceeds the supply.