Deck 7: Cardiac Resuscitation

Question 1

With respect to hypothermia, the Paramedic should remember the old adage, "The patient is not dead until he is cold and dead."

Answer 1

False

Question 2

Upon arrival at the scene of a possible cardiac arrest, the first question the Paramedic should ask is whether the resuscitation is reasonable.

Answer 2

True

Question 3

In 20% to 40% of the sudden cardiac arrests (SCA), the first recorded ECG rhythm will either show ventricular fibrillation or ____.

A) ventricular bradycardia
B) ventricular tachycardia
C) asystole
D) decreased preload

Answer 3

ventricular tachycardia

Question 4

It is not uncommon for a patient in cardiac arrest to take reflexive or agonal breaths.

Question 5

Addison's disease affects the ____.

A) renal glands
B) perithyroid glands
C) adrenal glands
D) thyroid gland

Question 6

If a DNAR or a similar legally executed document is present, then the Paramedic should not attempt resuscitation unless requested by the family.

Question 7

Along with purpura, the patient with end-stage sepsis may be unconscious, hypotensive, and without palpable pulses, as well as cool to the touch.

Question 8

Errors of ____ generally involve some biochemical derangement at the cellular level within the myocardium.

A) contractility
B) ventilation
C) circulation
D) automaticity

Question 9

There are four identifiable factors which can lead to cardiac arrest and can be traced following the circulatory pathway: decreased preload, decreased contractility, errors of automaticity, and increased afterload.

Question 10

Cardiotoxic medications are considered safe for patients if the dosage does not exceed one pill.

Question 11

Typically in rigor mortis, the shorter muscles, such as those found in the jaw, stiffen last.

Question 12

Studies have demonstrated that even healthcare professionals, including first responders trained in CPR, have difficulty determining pulselessness in a pulseless patient within 10 seconds.

Question 13

____ refers to the force of ventricular ejection of blood.

A) Increased afterload
B) Decreased preload
C) Contractility
D) Automaticity

Question 14

Typically, ____ following cardiac arrest is initially caused by an accumulation of respiratory acids.

A) acidosis
B) hyperkalemia
C) ketoacidosis
D) hypokalemia

Question 15

When making a family notification, the Paramedic should paint a picture of the gravity of the situation and use the words such as "passed away" rather than "dead" or "died" to make the family feel better.

Question 16

Some cultures have specific death rituals and the Paramedic should facilitate the performance of these rituals by the family, providing that these rituals do not violate local regulation.

Question 17

Pulmonary aspiration of gastric contents during resuscitation has been estimated to occur in between 35% and 50% of resuscitations.

Question 18

An Addisonian crisis, or adrenal crisis, can lead to hyperkalemia and sudden cardiac death.

Question 19

Medications implicated in hyperkalemia include angiotensin-converting enzyme (ACE) inhibitors, certain non-steroidal anti-inflammatory drugs, and potassium supplements.

Question 20

Out-of-hospital cardiac arrest occurs about 85,000 times a year.

Question 21

There is a current trend toward treating patients with return of spontaneous circulation with ____.

A) spontaneous hypothermia
B) therapeutic hypothermia
C) modified hypothermia
D) permissive hypothermia

Question 22

____ is a catch all term for a number of rhythms including idioventricular or agonal rhythms, ventricular escape rhythms, bradyasystolic rhythms, and pseudomechanical dissociation (EMD).

A) Unpalpable pulses
B) Weak pulses
C) Shallow pulses
D) Pulseless electrical activity

Question 23

____ is the chaotic and asynchronous firing of multiple irritable ectopic foci.

A) Ventricular fibrillation
B) Atrial fibrillation
C) Ventricular irritability
D) Atrial irritability

Question 24

_____ is the natural cooling of the deceased body to the ambient temperature.

A) Livor mortis
B) Algor mortis
C) Rigor mortis
D) Purpura

Question 25

____ is stiffening of muscles, which makes the body feel rigid.

A) Algor mortis
B) Livor mortis
C) Rigor mortis
D) Dependent lividity

Question 26

Aggressive advanced life support can help convert an uncoordinated ventricular mass into a beating synchrony that produces a pulse and cause the ____.

A) return of spontaneous breathing
B) return of open airway
C) return of spontaneous circulation
D) return of the ability to speak

Question 27

The Paramedic's first objective as team leader of a cardiac resuscitation is to remain focused on ____.

A) answering the questions of family or friends
B) directing the resuscitation effort
C) controlling the situation
D) basic life support

Question 28

The apex of the heart, or the point of maximal intensity (PMI), is typically found at ____.

A) the fourth intercostal space at the midclavicular line
B) the fifth intercostal space at the midclavicular line
C) the third intercostal space at the midclavical line
D) the sixth intercostal space at the midclavical line

Question 29

Livor mortis is also called ____.

A) algor mortis
B) rigor mortis
C) purpura
D) dependent lividity

Question 30

____ is the systemic vascular resistance, an alpha-adrenergic mediated vasoconstriction, that opposes outflow of blood from the heart to the lungs and systemic organs.

A) Baseload
B) Resistance
C) Afterload
D) Preload

Question 31

____ is the pooling of blood in dependant portions of the body, leaving a reddish-blue discoloration on the body's underside.

A) Livor mortis
B) Algor mortis
C) Rigor mortis
D) Purpura

Question 32

Cherri D. Hobgood, MD, and Debbie Weir, MSW, have created a mnemonic, ____, for medical residents that is also useful for Paramedics who are tasked with death notification following termination of resuscitation.

A) GRIEVE_R
B) GRIEVING_
C) GRIEV_ING
D) GRIEVE_S

Question 33

Of the following, which is the most important quality of a good team leader?

A) disciplinarian
B) detailed task monitor
C) delegator
D) authoritarian

Question 34

Some high-risk cardiac patients have an ____ placed inside the body, which is designed to defibrillate the patient if she has a tachyarrhythmia or ventricular fibrillation.

A) implanted pacer/defibrillator
B) automatic implanted cardiovertor-defibrillator (AICD)
C) automatic implanted inverter-defibrillator
D) automatic implanted cardiac-defibrillator

Question 35

The cardiac arrest medications that can be administered via an endotracheal tube can be remembered by the mnemonic ____.

A) NAVEL
B) VELNA
C) ANVEL
D) LEVAN

Question 36

The adrenal glands secrete ____, such as aldosterone, which control electrolyte levels, such as those for potassium.

A) mineralocorticoids
B) steroid
C) predisone
D) adenosine

Question 37

In cases of end-stage sepsis, the integrity of blood vessels is lost and blood collects under the skin in a condition called ____.

A) dependent lividity
B) purpura
C) maximal intensity
D) algor mortis

Question 38

The key finding in PEA is ____.

A) a loss of palpable apical pulse
B) a loss of a palpable femoral pulse
C) a loss of a palpable radial pulse
D) a loss of a palpable carotid pulse

Question 39

Most standard CPR classes teach that the traditional signs of death (the classic triad of signs) are ____.

A) unresponsiveness, apnea, and pulselessness
B) coldness, apnea, and pulselessness
C) unresponsiveness, coldness, and pulselessness
D) dilated pupils, apnea, and pulselessness

Question 40

____ is the electrical resistance of the chest wall to the passage of electricity.

A) Modern biphasic
B) Electromagnetic interference
C) Transthoracic impedance
D) Transthoracic reflectivity

Question 41

The "____________________" during CPR is the time spent in compression and decompression during each set of external cardiac massage.

Question 42

Since the heart muscle depends on sodium, potassium, calcium, and magnesium to properly function, an excess or deficit of any of these substances can lead to errors of automaticity and myocardial ____________________.

Question 43

Decreased preload can be the result of either ____________________ or an obstruction to venous blood flow.

Question 44

Cardiac resuscitation is first and foremost a(n) ____________________ effort.

Question 45

____________________ is amputation at the torso.

Question 46

The main therapeutic goal of resuscitation is a return of ____________________.

Question 47

Some common traits to all PEA, regardless of the etiology, is severe hypoxia and acidosis resulting in global ____________________.

Question 48

An acute thrombosis at an aortic aneurysm, blocking caudal blood flow, can markedly increase the resistance to outflow from the left ventricle, causing increased ____________________.

Question 49

____________________ access must be obtained in order to administer antidysrhythmic medications.

Question 50

An elevated potassium level is known as ____________________.