EMT - Chapter 16

What is the most important medication that should be administered to a patient experiencing chest pain with difficulty breathing? A) Aspirin B) Oxygen C) Nitroglycerin D) Albuterol

A) Aspirin

Common signs and symptoms of a hypertensive emergency include: A. A bounding pulse, a severe headache, and dizziness. B. Pallor, cool skin, and a temporary loss of hearing. C. Tachycardia, pain behind the eyes, and weakness. D. Syncope, a weak pulse, and bleeding from the ears.

A. A bounding pulse, a severe headache, and dizziness.

Which of the following signs is commonly observed in patients with right-sided heart failure? A. Dependent edema B. Flat jugular veins C. Pulmonary edema D. Labored breathing

A. Dependent edema

Blood that is ejected from the right ventricle: A. Flows into the pulmonary arteries. B. Has a high concentration of oxygen. C. Was received directly from the aorta. D. Enters the systemic circulation.

A. Flows into the pulmonary arteries.

A patient in cardiac arrest is wearing an external defibrillator vest, which is interfering with effective chest compressions. The EMT should: A. Remove the battery from the monitor and then remove the vest. B. Leave the battery attached to the monitor and remove the vest. C. Perform ventilations only and allow the vest device to defibrillate. D. Remove the battery from the monitor and leave the vest in place.

A. Remove the battery from the monitor and then remove the vest.

Deoxygenated blood from the body returns to the: A. Right atrium. B. Left ventricle. C. Right ventricle. D. Left atrium.

A. Right atrium.

Nitroglycerin is contraindicated in patients: A. With a systolic blood pressure less than 100 mm Hg. B. With chest pain of greater than 30 minutes duration. C. Who are currently taking antibiotics for an infection. D. Who are younger than 40 years of age and have diabetes.

A. With a systolic blood pressure less than 100 mm Hg.

AMI v Angina

AMI - Not always due to exertion -Last 30 min to several hours -not always relieved by rest or nitro

Aortic aneurysm

Aorta bursts -Dissecting aneurysm: Lining of aorta separated Primary cause: uncontrolled hypertension Symptoms: -chest pain -different bp in arms -tearing/ripping sensation

What is the first step in giving aerosol medications? A) Contact medical control to receive permission to give the medication B) Determine that the inhaler actually belongs to the patient C) Make sure the patient is suffering from asthma, emphysema, or bronchitis D)Complete the primary assessment and take vital signs.

B) Determine that the inhaler actually belongs to the patient

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: A. Immediately apply the AED pads and analyze his cardiac rhythm. B. Begin high-quality CPR and apply the AED as soon as possible. C. Have your partner perform CPR while you question the bystanders. D. Perform two-rescuer CPR for 5 minutes and request ALS backup.

B. Begin high-quality CPR and apply the AED as soon as possible.

A 56-year-old man has an acute myocardial infarction. Which of the following blood vessels became blocked and led to his condition? A. Coronary veins B. Coronary arteries C. Pulmonary veins D. Pulmonary arteries

B. Coronary arteries

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

B. Have chronic hypertension.

In contrast to AMI, a dissecting aortic aneurysm: A. Usually presents gradually, often over a period of hours. B. Often presents with pain that is maximal from the onset. C. Is typically preceded by other symptoms, such as nausea. D. Is more commonly associated with pressure in the chest.

B. Often presents with pain that is maximal from the onset.

Common signs and symptoms of AMI include all of the following, EXCEPT: A. Shortness of breath or dyspnea. B. Pain exacerbated by breathing. C. Irregular heartbeat. D. Sudden unexplained sweating.

B. Pain exacerbated by breathing.

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

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

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. There is not enough time in between contractions for the heart to refill completely. C. A rapid heart beat causes a decrease in the strength of cardiac contractions. D. As the heart rate increases, more blood is pumped from the ventricles than the atria.

B. There is not enough time in between contractions for the heart to refill completely.

Which of the following is a potential side effect of nitroglycerin? A) Sudden increase in heart rate B) Difficulty breathing C) Decreased blood pressure D) All of the above

C) Decreased blood pressure

How does aspirin actually reduce the chances that a patient suffering a heart attack will die? A) It prevents a deadly fever from developing B) It reduces the amount of pain in the heart C) It reduces the ability of the blood to form clots D) It reduces the inflammation in the heart.

C) It reduces the ability of the blood to form clots

Your patient is a 59-year-old woman with a history of emphysema. Per protocol, you have assisted the patient in using her medication inhaler. Which of the following must be documented? A) Chemical name of the medication B) Expiration date of the medication C) Patient's response to the medication D) All of the above

C) Patient's response to the medication

Acute coronary syndrome (ACS) is a term used to describe: A. A severe decrease in perfusion caused by changes in heart rate. B. The exact moment that a coronary artery is completely occluded. C. A group of symptoms that are caused by myocardial ischemia. D. The warning signs that occur shortly before a heart attack.

C. 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. Heart rate less than 60 beats/min B. Syncope or dizziness C. A rapid heart rate D. Generalized weakness

C. A rapid heart rate

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: A. Obtain a SAMPLE history and contact medical control for advice. B. Give her high-flow oxygen, attach the AED, and transport at once. C. Administer oxygen, give her 324 mg of aspirin, and assess her further. D. Give her one nitroglycerin and reassess her systolic blood pressure.

C. Administer oxygen, give her 324 mg of aspirin, and assess her further.

Narrowing of the coronary arteries due to a buildup of fatty deposits is called: A. Arteriosclerosis. B. Angina pectoris. C. Atherosclerosis. D. Acute ischemia.

C. Atherosclerosis.

Which of the following is a desired action of epinephrine delivered by​ auto-injector? A. Decrease in blood pressure B. Constriction of coronary arteries C. Constriction of blood vessels D. Dilation of coronary arteries

C. Constriction of blood vessels

A patient with cardiac arrest secondary to ventricular fibrillation has the greatest chance for survival if: A. CPR is initiated within 10 minutes. B. Oxygen and rapid transport are provided. C. Defibrillation is provided within 2 minutes. D. Paramedics arrive at the scene within 5 minutes.

C. Defibrillation is provided within 2 minutes.

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

C. Myocardial oxygen demand exceeds supply.

If a patient with an implanted pacemaker is in cardiac arrest, the EMT should: A. Avoid defibrillation with the AED and transport at once. B. Not apply the AED until he or she contacts medical control. C. Place the AED pads away from the pacemaker. D. Apply the AED pads directly over the implanted pacemaker.

C. Place the AED pads away from the pacemaker.

The epinephrine auto-injector is given via the ________ route. A) Oral B) Enteral C) Digestive D) Parenteral

D) Parenteral

You respond to a medical call for a 59-year-old female complaining of tightness in her chest. You place her on a high concentration of oxygen and prepare for a short 5-minute transport to the hospital. The patient tells you she is on nitroglycerin, which she has not taken. Your partner tells you that you can give aspirin per protocol. Should you delay the patient transport to give the medication and why? A) No, any delay will cause the patient more stress; she needs to be in a definitive care facility B) No, any delay will cause the patient more heart damage; each delay weakens the myocardium C) Yes, the nitroglycerin will cause the heart to beat stronger and restore some blood flow, and the aspirin will ease the pain D) Yes, the nitroglycerin will cause the blood vessels to dilate and restore some blood flow, and the aspirin will slow the clotting process.

D) Yes, the nitroglycerin will cause the blood vessels to dilate and restore some blood flow, and the aspirin will slow the clotting process.

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

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

An acute myocardial infarction (AMI) occurs when: A. The heart muscle progressively weakens and dysfunctions. B. Coronary artery dilation decreases blood flow to the heart. C. The entire left ventricle is damaged and cannot pump blood. D. Myocardial tissue dies secondary to an absence of oxygen.

D. Myocardial tissue dies secondary to an absence of oxygen.

The electrical impulse generated by the heart originates in the: A. Atrioventricular node. B. Coronary sinus. C. Bundle of His. D. Sinoatrial node.

D. Sinoatrial node.

Nitroglycerin is contraindicated in patients: A. Who have taken up to two doses. B. With a history of an ischemic stroke. C. With a systolic blood pressure less than 120 mm Hg. D. Who have experienced a head injury.

D. Who have experienced a head injury.

Hypertensive emergencies

Systolic bp is more than 160; Sympotoms: -severe headache -strong, bounding pulse -ringing in ears -dizziness -nose bleeds ** Can lead to stroke or aortic aneurism