EMS chapter 16
assess the adequacy of his respirations.
A 49- year-old male presents with an acute onset of crushing chest pain and diaphoresis. You should:
Family history.
Risk factors for AMI that cannot be controlled include:
The arteries supplying type heart dilate.
When the myocardium requires more oxygen:
The cause cannot be diagnosed in the field.
When treating a patient with chest pain, you should assume that he or she is having an AMI because:
A rapid heart rate
Which of the following is NOT a common sign or symptom associated with malfunction of an implanted cardiac pacemaker?
Nitroglycerin usually relieves anginal chest pain within 5 minutes.
Which of the following statements regarding nitroglycerin correct?
The AED will not analyze the rhythm of a moving patient.
Which of the following statements regarding the AED and defibrillation is correct?
It can occur during exertion or when the patient is at rest
Which of the following statements regarding the pain associated with correct?
have chronic hypertension.
Signs and symptoms of a hypertensive emergency would MOST likely be delayed in patients who:
Ventricular fibrillation
Sudden death following AMI MOST often caused by:
Umbilicus
The descending aorta divides into the two iliac arteries at the level of the:
Dependent edema
Which of the following signs is commonly observed in patients with right-sided heart failure?
The inner layer of the aorta become separated.
A dissecting aortic aneurysm occurs when
Remove the battery from the monitor and then remove the vest.
A patient in cardiac arrest is wearing an external defibrillator vest, which is interfering with effective chest compressions. The EMT should :
A group of symptoms that are caused by myocardial ischemia
Acute coronary syndrome (ACS) a term used to describe:
There is not enough time in between contractions for the heat to refill completely.
Cardiac output may decrease the heart beats too rapidly because:
decreased pumping force of the heart muscle
Cardiogenic shock following caused by:
Often presents with pain that is maximal from the onset.
In contrast to AMI, a dissecting aortic aneurysm: the
Slows the heart and respiratory rates
In contrast to the sympathetic nervous system, the parasympathetic nervous system
Decreased blood flow to one or more portions of the myocardium.
Ischemic heart disease is defined as:
Chest pain that does not immediately subside with rest.
It would be MOST appropriate for a patient to take his or her prescribed nitroglycerin when experiencing:
Hypoglycemia.
Major risk factors for AMI Include all of the following, EXCEPT:
Resistance from the body to the flow of electricity.
Most AEDs are set up to adjust the voltage based on the impedance, which is the:
Three
Most patients are instructed by their physician to take up to ______ doses of nitroglycerin before calling EMS
who have experienced a head injury.
Nitroglycerin is contraindicated in patients:
dilating the coronary arteries and improving cardiac blood flow
Nitroglycerin relieves cardiac-related chest pain by:
Obtain authorization from medical control.
Prior to assisting a patient with his or her prescribed nitroglycerin , the EMT must:
Reassess airway and breathing and treat accordingly.
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:
pediatric pads and an energy-reducing device are available.
The EMT should use an AED on a child between 1 month and 8 years of age if:
femoral arteries
The arteries Immediately subdivide into the:
Begin CPR, apply AED, and deliver a shock if it is indicated.
You and your EMT partner are the first to arrive at the scene of an unresponsive old man. Your assessment reveals that he is apnelc and pulseless. A paramedic is en route to the scene and will arrive in approximately 5 minutes. You should:
begin high-quality CPR and apply the AED as soon as possible.
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:
Feel for a pulse while compressions are ongoing.
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. Deliver the shock followed by immediate resumption of CPR.
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 (AlCD) . The AED advises that a shock is indicated. What should you do?
administer oxygen, give her 324 mg of aspirin, and assess her further.
A 66-year-old female with a history of hypertension and diabetes presents with substernal chest pressure of 2 hours' duration. Her blood pressure is 140/90 mm Hg , her pulse is 100 beats/min and irregular, her respirations are 22 breaths/min, and her oxygen saturation is 92%. The patient does not have prescribed nitroglycerin, but her husband does. You should:
Placing her in an upright position
A 67-year-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 94/64 mm Hg and her heart rate is 120 beats /min. Treatment for this patient includes :
acute myocardial infarction
A patient tells you that he has a left ventricular assist device ( LVAD). Which of the following conditions should you suspect that he has experienced?
The lumen of the coronary artery is narrowed and cannot accommodate increased blood flow.
A patient with atherosclerotic heart disease experiences chest pain during exertion because:
Dilating the affected coronary artery with a small inflatable ballon
A percutaneous transluminal coronary angloplasty (PTCA) restores blood flow to the ischemic myocardium by :
Reassess his or her blood pressure within 5 minutes to detect hypotension
After assisting your patient with prescribed nitroglycerin, you should:
immediately resume CPR
After the AED has delivered a shock, the EMT should
Myocardial oxygen demand exceeds supply.
Angina pectoris occurs when:
flows into the pulmonary arteries
Blood that is ejected from the right ventricle:
Hypertension
Common side effects of nitroglycerin Include all of the following, EXCEPT:
Pain exacerbated by breathing
Common side effects of nitroglycerin Include all of the following, EXCEPT:
She is not in ventricular fibrillation
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:
right atrium
Deoxygenated blood from the body returns to the:
Dry the chest if it is wet
Prior to attaching the AED to a cardiac arrest patient, the EMT should:
congestive heart failure
Rapid, labored breathing in a patient with signs and symptoms of AMI should make you suspicious for:
Failure if the EMT to ensure the battery is charged.
The MOST common error associated with the use of the AED :
Are in denial
The MOST common reason that many people experiencing AMI do not seek immediate medical attention is because they:
sinoatrial node
The electrical impulse generated by the heart originates in the:
autonomic nervous system
The electrical stimulus that originates in the heart's primary pacemaker is controlled by Impulses from the brain that arrive by way of the:
carotid arteries
The head and brain receive their supply of oxygenated blood from the:
Brain.
The inferior vena cava returns deoxygenated blood to the right side of the heart from all of the following areas , EXCEPT the.
Coronary arteries, aorta
The myocardium receives oxygenated blood from the _______, which originate(s) from the _______.
Behind the medical malleolus, on the inside of the ankle.
The posterior tibial pulse can be palpated:
stop the chaotic, disorganized contraction of the cardiac cells.
The purpose of defibrillation is to:
right ventricle and inferior wall of the left ventricle
The right coronary artery supplies blood to the:
assess the scene for potential hazards.
Upon arriving at the residence of a patient with a possible cardiac problemis MOST important to:
The left ventricle does not adequately fill with blood.
Ventricular tachycardia causes hypotension because:
It receives oxygenated blood from the lungs.
What is the function of the left atrium?
Blood can pass from the atria to the ventricles.
When an electrical impulse reaches the AV node, it is slowed for a brief period of time so that:
Use patients own words
When documenting a patient's description of his or her chest pain or discomfort, the EMT should:
On the thighs or ankles
When preparing to obtain a 12-lead ECG, the "LL" and "RL" electrodes should be placed:
On either side of the sternum
When preparing to obtain a 12-lead ECG, the V1 and V2 electrodes should be placed:
Family history of hypertension
Which of the following LEAST important when obtaining a medical history from a patient complaining of chest discomfort?
ventricular tachycardia
Which of the following cardiac dysrhythmias has the greatest chance of deteriorating into a pulseless rhythm?
Construction of blood vessels in the muscles.
Which of the following is NOT a function of the sympathetic nervous system?
Assess the heart rate and strength of the pulse.
Which of the following is the MOST reliable method of estimating a patient's cardiac output ?
Saphenous
Which of the following veins is located inferior to the trunk?
Excessive movement of the patient
While obtaining a 12-lead ECG prior to ALS arrival, you note the presence of artifacts on the tracing . Which of the following is the MOST likely cause of this?
Remove the nitroglycerin patch, place him in a supine position and elevate his lower extremities, and prepare for immediate transport.
You are assessing 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:
Begin ventilatory assistance.
You are dispatched to a residence for a 56-year-with an altered mental status. Upon arrival at the scene, the patient's wife 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: