Chapter 16: Cardiac Emergencies

Which of the following is NOT a function of the sympathetic nervous system? a. Constriction of blood vessels in the muscles b. Dilation of blood vessels in the muscles c. Increases in the heart and respiratory rates d. Constriction of blood vessels in the digestive system

a. Constriction of blood vessels in the muscles

What is the function of the left atrium? a. It receives oxygenated blood from the lungs. b. It ejects oxygenated blood into the aorta. c. It receives oxygenated blood from the vena cava. d. It receives blood from the pulmonary arteries.

a. It receives oxygenated blood from the lungs.

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

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

Which of the following statements regarding the AED and defibrillation is correct? a. The AED will not analyze the rhythm of a moving patient. b. The AED will shock any rhythm not accompanied by a pulse. c. CPR should be performed for 5 minutes before using the AED. d. Defibrillation is the first link in the AHA chain of survival.

a. The AED will not analyze the rhythm of a moving patient.

You and your EMT partner are the first to arrive at the scene of an unresponsive 70-year-old man. Your assessment reveals that he is apneic and pulseless. A paramedic unit is en route to the scene and will arrive in approximately 5 minutes. You should: a. begin CPR, apply the AED, and deliver a shock if it is indicated. b. begin CPR and have your partner update the responding paramedics. c. apply the AED while your partner provides rescue breathing. d. perform CPR only and wait for the manual defibrillator to arrive.

a. begin CPR, apply the AED, and deliver a shock if it is indicated.

You are dispatched to a residence for a 56-year-old male with an altered mental status. Upon arrival at the scene, the patient's wife tells you that he complained of chest pain the day before, but would not allow her to call EMS. The patient is semiconscious; has rapid, shallow respirations; and has a thready pulse. You should: a. begin ventilatory assistance. b. obtain baseline vital signs. c. apply a nonrebreathing mask. d. attach the AED immediately.

a. begin ventilatory assistance.

The inferior vena cava returns deoxygenated blood to the right side of the heart from all of the following areas, EXCEPT the: a. brain. b. legs. c. abdomen. d. kidneys.

a. brain.

Ischemic heart disease is defined as: a. decreased blood flow to one or more portions of the myocardium. b. absent myocardial blood flow due to a blocked coronary artery. c. death of a portion of the heart muscle due to a decrease in oxygen. d. decreased blood flow to the heart muscle due to coronary dilation.

a. decreased blood flow to one or more portions of the myocardium.

Major risk factors for AMI include all of the following, EXCEPT: a. hypoglycemia. b. elevated cholesterol. c. hypertension. d. diabetes mellitus.

a. hypoglycemia.

You are assessing a 49-year-old man who complains of chest pressure that began the night before. He is conscious, but anxious, and tells you he has a history of angina and hypertension. After applying high- flow oxygen, you expose his chest to auscultate his lungs and note that he has a nitroglycerin patch on his right upper chest. His skin is cool and pale, his blood pressure is 78/50 mm Hg, and his pulse is 110 beats/min and irregular. You should: a. remove the nitroglycerin patch, place him in a supine position and elevate his lower extremities, and prepare for immediate transport. b. ask him if the nitroglycerin patch he is wearing has improved his chest pressure, complete your secondary assessment, and transport promptly. c. immediately remove the nitroglycerin patch, apply the AED in case he develops cardiac arrest, and transport to the closest hospital. d. move the nitroglycerin patch to the other side of his chest in case you need to apply the AED, keep him warm, and transport without delay.

a. remove the nitroglycerin patch, place him in a supine position and elevate his lower extremities, and prepare for immediate transport.

The MOST common reason that many people experiencing AMI do not seek immediate medical attention is because they: a. do not trust EMTs. b. are in denial. c. cannot afford it. d. are elderly.

b. are in denial.

The head and brain receive their supply of oxygenated blood from the: a. subclavian arteries. b. carotid arteries. c. brachial arteries. d. iliac arteries.

b. carotid arteries.

Nitroglycerin relieves cardiac-related chest pain by: a. constricting the coronary arteries and improving cardiac blood flow. b. dilating the coronary arteries and improving cardiac blood flow. c. increasing the amount of stress that is placed on the myocardium. d. contracting the smooth muscle of the coronary and cerebral arteries.

b. dilating the coronary arteries and improving cardiac blood flow.

When treating a patient with chest pain, you should assume that he or she is having an AMI because: a. angina usually occurs after an AMI. b. the cause of the pain cannot be diagnosed in the field. c. most patients with chest pain are experiencing an AMI. d. angina and AMI present identically.

b. the cause of the pain cannot be diagnosed in the field.

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

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

The MOST common error associated with the use of the AED is: a. inappropriately placed adhesive defibrillation electrodes. b. malfunction of the AED's internal computer processor. c. failure of the EMT to ensure the battery is charged. d. inability of the EMT to recognize ventricular fibrillation.

c. failure of the EMT to ensure the battery is charged.

You are dispatched to a convenience store for a patient who passed out. Upon arriving at the scene, you find two off-duty EMTs performing CPR on the patient, a 58-year-old male. Your initial action should be to: a. quickly attach the AED and push the analyze button. b. request a paramedic unit and quickly attach the AED. c. feel for a pulse while compressions are ongoing. d. have the EMTs stop CPR and assess for a pulse.

c. feel for a pulse while compressions are ongoing.

Common side effects of nitroglycerin include all of the following, EXCEPT: a. hypotension. b. bradycardia. c. hypertension. d. severe headache.

c. hypertension.

The AED has delivered a shock to an elderly male in cardiac arrest. Following 2 minutes of CPR, you re-analyze the patient's cardiac rhythm and receive a "no shock advised" message. After further resuscitation, you restore a palpable carotid pulse. Your next action should be to: a. place him in the recovery position and apply oxygen. b. transport at once and re-analyze his rhythm en route. c. reassess airway and breathing and treat accordingly. d. obtain a blood pressure and apply the pulse oximeter.

c. reassess airway and breathing and treat accordingly.

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: a. the AED has detected asystole. b. the AED detected patient motion. c. she is not in ventricular fibrillation. d. she has a pulse and does not need CPR.

c. she is not in ventricular fibrillation.

In contrast to the sympathetic nervous system, the parasympathetic nervous system: a. prepares the body to handle stress. b. dilates the blood vessels in the muscles. c. slows the heart and respiratory rates. d. causes an increase in the heart rate.

c. slows the heart and respiratory rates.

Most patients are instructed by their physician to take up to _______________ doses of nitroglycerin before calling EMS. a. two b. four c. three d. five

c. three

The descending aorta divides into the two iliac arteries at the level of the: a. pubic symphysis. b. nipple line. c. umbilicus. d. iliac crest.

c. umbilicus.

Blood that is ejected from the right ventricle: a. was received directly from the aorta. b. has a high concentration of oxygen. c. enters the systemic circulation. d. flows into the pulmonary arteries.

d. flows into the pulmonary arteries.

Common signs and symptoms of AMI include all of the following, EXCEPT: a. shortness of breath or dyspnea. b. sudden unexplained sweating. c. irregular heartbeat. d. pain exacerbated by breathing.

d. pain exacerbated by breathing.

A 67-year-old female 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 been 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: a. oxygen at 2 L/min via nasal cannula. b. ventilations with a BVM. c. nitroglycerin for her chest pain. d. placing her in an upright position.

d. placing her in an upright position.

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

d. reassess his or her blood pressure within 5 minutes to detect hypotension.

The purpose of defibrillation is to: a. improve the chance of CPR being successful in resuscitation. b. prevent asystole from deteriorating into ventricular fibrillation. c. cause a rapid decrease in the heart rate of an unstable patient. d. stop the chaotic, disorganized contraction of the cardiac cells.

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

Cardiac output may decrease if the heart beats too rapidly because: a. the volume of blood that returns to the heart is not sufficient with fast heart rates. b. as the heart rate increases, more blood is pumped from the ventricles than the atria. c. a rapid heartbeat causes a decrease in the strength of cardiac contractions. d. there is not enough time in between contractions for the heart to refill completely.

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

Sudden death following AMI is MOST often caused by: a. congestive heart failure. b. severe bradycardia. c. cardiogenic shock. d. ventricular fibrillation.

d. ventricular fibrillation.