West Coast EMT Chapter 16 -- Cardiovascular Emergencies

A 49-year-old male presents with an acute onset of crushing chest pain and diaphoresis. You should:

Select one:

A. administer up to three doses of nitroglycerin.

B. administer up to 324 mg of baby aspirin.

C. obtain vital signs and a SAMPLE history.

D. assess the adequacy of his respirations.

D. assess the adequacy of his respirations.

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:

Select one:

A. give her one nitroglycerin and reassess her systolic blood pressure.

B. administer oxygen, give her 324 mg of aspirin, and assess her further.

C. obtain a SAMPLE history and contact medical control for advice.

D. give her high-flow oxygen, attach the AED, and transport at once.

B. administer oxygen, give her 324 mg of aspirin, and assess her further.

A dissecting aortic aneurysm occurs when:

Select one:

A. a weakened area develops in the aortic wall.

B. the aorta ruptures, resulting in profound bleeding.

C. the inner layers of the aorta become separated.

D. all layers of the aorta suddenly contract.

C. the inner layers of the aorta become separated.

A patient in cardiac arrest is wearing an external defibrillator vest, which is interfering with effective chest compressions. The EMT should:

Select one:

A. perform ventilations only and allow the vest device to defibrillate.

B. remove the battery from the monitor and then remove the vest.

C. leave the battery attached to the monitor and remove the vest.

D. remove the battery from the monitor and leave the vest in place.

B. remove the battery from the monitor and then remove the vest.

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?

Select one:

A. Thoracic aortic aneurysm

B. Acute myocardial infarction

C. Uncontrolled hypertension

D. Obstructive lung disease

B. Acute myocardial infarction

A patient with atherosclerotic heart disease experiences chest pain during exertion because:

Select one:

A. the ragged edge of a tear in the coronary artery lumen causes local blood clotting and arterial narrowing.

B. tissues of the myocardium undergo necrosis secondary to a prolonged absence of oxygen.

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

D. the coronary arteries suddenly spasm and cause a marked reduction in myocardial blood flow.

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

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

Select one:

A. transport the patient at once.

B. assess for a carotid pulse.

C. immediately resume CPR.

D. re-analyze the cardiac rhythm.

C. immediately resume CPR.

Angina pectoris occurs when:

Select one:

A. myocardial oxygen demand exceeds supply.

B. a coronary artery is totally occluded by plaque.

C. myocardial oxygen supply exceeds the demand.

D. one or more coronary arteries suddenly spasm.

A. myocardial oxygen demand exceeds supply.

Deoxygenated blood from the body returns to the:

Select one:

A. left ventricle.

B. right atrium.

C. right ventricle.

D. left atrium.

B. right atrium.

Most AEDs are set up to adjust the voltage based on the impedance, which is the:

Select one:

A. distance between the two AED pads on the chest.

B. direction that the electrical flow takes in the body.

C. actual amount of energy that the AED will deliver.

D. resistance of the body to the flow of electricity.

D. resistance of the body to the flow of electricity.

Nitroglycerin is contraindicated in patients:

Select one:

A. who have taken up to two doses.

B. who have experienced a head injury.

C. with a systolic blood pressure less than 120 mm Hg.

D. with a history of an ischemic stroke.

B. who have experienced a head injury.

Prior to attaching the AED to a cardiac arrest patient, the EMT should:

Select one:

A. assess for a pulse for 20 seconds.

B. contact medical control.

C. dry the chest if it is wet.

D. perform CPR for 30 seconds.

C. dry the chest if it is wet.

Risk factors for AMI that cannot be controlled include:

Select one:

A. family history.

B. lack of exercise.

C. hyperglycemia.

D. excess stress.

A. family history.

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

Select one:

A. are older than 40 years of age.

B. regularly take illegal drugs.

C. have chronic hypertension.

D. have had a stroke in the past.

C. have chronic hypertension.

The electrical impulse generated by the heart originates in the:

Select one:

A. atrioventricular node.

B. bundle of His.

C. sinoatrial node.

D. coronary sinus.

C. sinoatrial node.

The EMT should use an AED on a child between 1 month and 8 years of age if:

Select one:

A. special pads are used and the child has profound tachycardia.

B. his or her condition is rapidly progressing to cardiac arrest.

C. pediatric pads and an energy-reducing device are available.

D. he or she is not breathing and has a weakly palpable pulse.

C. pediatric pads and an energy-reducing device are available.

When preparing to obtain a 12-lead ECG, the "LL" and "RL" electrodes should be placed:

Select one:

A. anywhere on the arms.

B. on either side of the chest.

C. on the thighs or ankles.

D. on the lower abdomen.

C. on the thighs or ankles.

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

Select one:

A. Generalized weakness

B. A rapid heart rate

C. Syncope or dizziness

D. Heart rate less than 60 beats/min

B. A rapid heart rate

Which of the following signs is commonly observed in patients with right-sided heart failure?

Select one:

A. Labored breathing

B. Dependent edema

C. Pulmonary edema

D. Flat jugular veins

B. Dependent edema

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. perform two-rescuer CPR for 5 minutes and request ALS backup.

B. have your partner perform CPR while you question the bystanders.

C. immediately apply the AED pads and analyze his cardiac rhythm.

D. begin high-quality CPR and apply the AED as soon as possible.

D. begin high-quality CPR and apply the AED as soon as possible.