EMT Chapter 14

The electrical stimulus that originates in the heart's primary pacemaker is controlled by impulses from the brain that arrive by way of the:

autonomic nervous system.

When would it be MOST appropriate for a patient to take his or her prescribed nitroglycerin?

chest pain that does not immediately subside with rest

A percutaneous transluminal coronary angioplasty (PTCA) restores blood flow to the ischemic myocardium by:

dilating the affected coronary artery with a small inflatable balloon.

Nitroglycerin relieves cardiac-related chest pain by:

dilating the coronary arteries and improving cardiac blood flow.

The MOST common error associated with the use of the AED is:

failure of the EMT to ensure the battery is charged.

Which of the following is of LEAST pertinence when obtaining medical history information from a patient complaining of chest discomfort?

family history of hypertension.

Risk factors for AMI that cannot be controlled include:

family history.

Signs and symptoms of a hypertensive emergency would MOST likely be delayed in patients who:

have chronic hypertension.

The left ventricle has the thickest walls because it:

pumps blood into the aorta and systemic circulation.

The electrical impulse generated by the heart originates in the:

sinoatrial (SA) node.

Ventricular tachycardia causes hypotension because:

the left ventricle does not adequately fill with blood.

Sudden death following AMI is MOST often caused by:

ventricular fibrillation.

Which of the following cardiac arrhythmias has the greatest chance of deteriorating into a pulseless rhythm?

ventricular tachycardia

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?

Deliver the shock followed by immediate resumption of CPR.

Which of the following veins is located inferior to the trunk?

saphenous

When the myocardium requires more oxygen:

the arteries supplying the heart dilate.

Which of the following represents the MOST appropriate method of assisting a patient with his or her prescribed nitroglycerin tablet or spray?

Administer the medication sublingually and allow it to dissolve or absorb. Correct

Which of the following is the MOST reliable method of estimating a patient's cardiac output?

Assess the heart rate and strength of the pulse.

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:

Perform five cycles of high-quality CPR and then apply the AED.

The MOST common reason that many people experiencing AMI do not seek immediate medical attention is because they:

are in denial.

Acute coronary syndrome (ACS) is a term used to describe:

a group of symptoms that are caused by myocardial ischemia.

Which of the following is NOT a common sign or symptom associated with malfunction of an implanted cardiac pacemaker?

a rapid heart rate

Narrowing of the coronary arteries due to a buildup of fatty deposits is called:

atherosclerosis.

The ability of cardiac muscle cells to contract spontaneously without a stimulus from a nerve source is called:

automaticity.

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:

begin ventilatory assistance.

The posterior tibial pulse can be palpated:

behind the medial malleolus.

The inferior vena cava returns deoxygenated blood to the right side of the heart from all of the following areas, EXCEPT the:

brain.

Rapid, labored breathing in a patient with signs and symptoms of AMI should make you suspicious for:

congestive heart failure.

Which of the following is NOT a function of the sympathetic nervous system?

constriction of blood vessels in the muscles.

Cardiogenic shock following AMI is caused by:

decreased pumping force of the heart muscle.

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 being noncompliant with her antihypertensive medications. When you assess her, you find that her blood pressure is significantly higher in her left arm than it is in her right arm. What are her signs and symptoms MOST indicative of?

dissecting aortic aneurysm

You are dispatched to a convenience store for a patient who passed out. Upon arriving at the scene, you find two bystanders performing CPR on the patient, a 58-year-old male. Your initial action should be to:

have the bystanders stop CPR and assess the patient.

Common side effects of nitroglycerin include all of the following, EXCEPT:

hypertension.

Which of the following signs or symptoms would you NOT expect to encounter in a patient with congestive heart failure?

hypotension and flat jugular veins

After the AED has delivered a shock, the EMT should:

immediately resume CPR.

Which of the following would cause the greatest increase in cardiac output?

increased heart rate and increased stroke volume

When afterload increases:

it becomes harder for the ventricle to push blood through the blood vessels.

Angina pectoris occurs when:

myocardial oxygen demand exceeds the supply.

Common signs and symptoms of AMI include all of the following, EXCEPT:

pain exacerbated by breathing.

The EMT should use an AED on a child older than 1 year if:

pediatric pads and an energy-reducing device are available.

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 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:

placing her in an upright position.

The AED has delivered a shock to an elderly male in cardiac arrest. Following 2 minutes of CPR, you reanalyze 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:

reassess airway and breathing and treat accordingly.

After assisting your patient with his or her nitroglycerin, you should:

reassess the blood pressure within 5 minutes to detect hypotension.

In contrast to monophasic defibrillation, biphasic defibrillation:

requires a lower energy setting.

Defibrillator pads are placed on the patient's chest with one pad to the:

right of the upper sternum and the other pad just to the left and below the left nipple.

The right coronary artery supplies blood to the:

right ventricle and inferior wall of the left ventricle.

A 67-year-old female with severe chest pain becomes unresponsive, pulseless, and apneic during transport. You should:

stop the ambulance, begin CPR, and attach the AED as soon as possible.

The purpose of defibrillation is to:

stop the chaotic, disorganized contraction of the cardiac cells.

Most patients are instructed by their physician to take up to _______ doses of nitroglycerin before calling EMS.

three

When documenting a patient's description of his or her chest pain or discomfort, the EMT should:

use the patient's own words.