Deck 18: Cardiac Emergencies

Question 1

Which of the following is the EMT's role in caring for a patient with chest pain?

A) Treat the patient as though he were having a heart attack.
B) Provide automatic external defibrillation.
C) Make an interpretation of the patient's cardiac rhythm.
D) Determine the cause of the patient's chest pain.

Answer 1

Treat the patient as though he were having a heart attack.

Question 2

Which of the following is typical of angina pectoris?

A) Does not respond to nitroglycerin
B) Lasts 10 to 30 seconds
C) Does not present following stress
D) Often subsides with rest

Answer 2

Often subsides with rest

Question 3

You suspect that your patient is suffering from angina pectoris.What signs or symptoms would you expect to see with this condition?

A) Chest pain that is relieved with nitroglycerin
B) Chest pain that is not relieved with nitroglycerin
C) Chest pain that is not relieved with rest
D) Chest pain that radiates to the leg

Answer 3

Chest pain that is relieved with nitroglycerin

Question 4

A weakened area of an artery that balloons out and may rupture,causing catastrophic bleeding,is called:

A) angina.
B) asystole.
C) aneurysm.
D) angioplasty.

Question 5

Which of the following may be a symptom of a problem with the heart?

A) Mild chest discomfort
B) Severe, crushing pain in the chest
C) Nausea, with or without vomiting
D) All of the above

Question 6

You are on-scene with a 48-year-old unresponsive male patient.Bystanders state he complained of chest pain and then suddenly collapsed.Vital signs are blood pressure 68/42,pulse 36,and respiratory rate 3.He is unresponsive to painful stimuli.After performing the primary assessment and treating all life threats,what is your next intervention?

A) Insert an oral airway.
B) Administer high-concentration oxygen at 15 lpm by bag-valve mask.
C) Package the patient for rapid transport.
D) Apply the AED.

Question 7

Which of the following cardiac dysrhythmias cannot produce a pulse?

A) Ventricular dysrhythmia
B) Ventricular fibrillation
C) Bradycardia
D) Tachycardia

Question 8

Which of the following statements regarding the administration of nitroglycerin tablets is true?

A) An increase in blood pressure should be expected.
B) The patient may complain of a headache following administration.
C) If a patient's pulse rate changes following nitroglycerin administration, it indicates an allergic reaction.
D) It takes 20 to 30 minutes for nitroglycerin to have an effect.

Question 9

Which of the following is the beneficial action of nitroglycerin in some cardiac emergencies?

A) It relaxes blood vessels throughout the body.
B) It dilates only the coronary arteries.
C) It increases the strength with which the ventricles contract.
D) It slows down the heart.

Question 10

You are treating a male patient with chest pain caused by the complete occlusion of one of the coronary arteries.What would you most likely expect with this patient?

A) His pain will go away with oxygen.
B) His pain will be reduced with aspirin.
C) His pain will be alleviated with nitroglycerin.
D) His pain will not be alleviated with any of the above medications.

Question 11

Which of the following statements concerning heart attacks and cardiac arrest is NOT true?

A) Many patients may mistake their symptoms for other causes such as indigestion.
B) Some patients who have heart attacks live active and healthy lifestyles.
C) Heart attacks present differently among women and men.
D) The most common initial rhythm in sudden cardiac death is asystole.

Question 12

Which of the following BEST describes a fluttering sensation in the chest?

A) Pulseless electrical activity of the heart
B) Palpitations
C) Dysrhythmia
D) Tachycardia

Question 13

Which of the following is the name of the condition in which fatty deposits form in the inner lining of the arteries?

A) Arteriosclerosis
B) Coronary artery disease
C) Coronary thrombosis
D) Aneurysm

Question 14

Which of the following is the general term used to refer to a problem with the heart?

A) Myocardial infarction
B) Cardiac dysrhythmia
C) Cardiac compromise
D) Congestive heart failure

Question 15

In which of the following situations would the administration of aspirin to a cardiac patient be prohibited?

A) The patient does not currently take aspirin.
B) The patient has a history of asthma.
C) The patient has a diastolic blood pressure greater than 90 mmHg.
D) The patient feels dizzy.

Question 16

Assuming your protocol allows the administration of nitroglycerin when certain conditions exist,what is the maximum number of tablets to be administered in the prehospital setting?

A) 2
B) 3
C) 4
D) 1

Question 17

What is NOT part of the cardiovascular system?

A) Arteries
B) Veins
C) Venules
D) Hormones

Question 18

Which of the following statements regarding angina pectoris is true?

A) It can be brought on by exertion or stress.
B) It is generally relieved by over-the-counter medications.
C) It results in death of a smaller portion of myocardium than does a heart attack.
D) It generally lasts 30 to 60 minutes.

Question 19

What is NOT a result of a mechanical malfunction of the heart?

A) Cardiac arrest
B) Dysrhythmia
C) Shock
D) Pulmonary edema

Question 20

You are treating a patient with signs and symptoms of a myocardial infarction (MI).What is the most important drug you should administer?

A) Oxygen
B) Albuterol
C) Epinephrine auto-injector (Epi-Pen®)
D) Aspirin

Question 21

Which of the following is NOT a reason that an AED may indicate that there is "no shock advised? "

A) The patient's heart has no electrical activity; he is "flat line," or in asystole.
B) The patient's heart rhythm is normal.
C) The patient has organized electrical activity in the heart but no pulse.
D) The patient is in ventricular fibrillation or pulseless ventricular tachycardia.

Question 22

Which of the following BEST describes the EMT's intended role in the ideal provision of emergency cardiac care?

A) Early notification
B) Early advanced cardiac life support
C) Early defibrillation
D) Early CPR

Question 23

When using an AED,which of the following people is responsible for calling to "clear" the patient before delivering a shock?

A) EMT supervising bystanders
B) EMT operating the defibrillator
C) EMT managing the airway
D) EMT doing chest compressions

Question 24

Which intervention is proven to be the most effective is obtaining a return of spontaneous circulation (ROSC)in a cardiac arrest patient?

A) Combitube
B) Early CPR
C) High-concentration oxygen by bag-valve mask
D) Early defibrillation

Question 25

You arrive on-scene of a 56-year-old female patient in cardiac arrest.What is the first airway you should administer?

A) Nasopharyngeal airway (NPA)
B) Oropharyngeal airway
C) Combitube
D) Pharyngeal-Tracheal Lumen airway

Question 26

All of the following are elements of adult high performance CPR,except:

A) compression rate of at least 100 per minute.
B) spending half of each compression on the downstroke and half on the upstroke.
C) taking no more than 1 second to deliver each ventilation.
D) compressing the patient's chest about 1 inch in depth before allowing full relaxation.

Question 27

Which of the following BEST describes the continued need for prehospital advanced cardiac life support,even when EMTs in the community carry AEDs?

A) Not all cardiac arrests are due to problems that respond to defibrillation.
B) The patient may need medications to support his cardiac rhythm and blood pressure prior to attempting defibrillation.
C) In cases of refractory or recurrent ventricular fibrillation, the use of medications may decrease the chances of defibrillating successfully.
D) All of the above

Question 28

Which of the following is NOT a typical indication of congestive heart failure (CHF)?

A) Productive cough
B) Wet sounding breath sounds
C) Increased heart rate
D) Low blood pressure

Question 29

Which of the following terms refers to swelling of the lower extremities seen in many cardiac patients?

A) Presacral swelling
B) Crackles
C) Congestive heart failure
D) Pedal edema

Question 30

Which of the following should NOT be done during defibrillation?

A) Pressing the defibrillation pads firmly to the chest to ensure good contact
B) Continued ventilation during the analysis phase to prevent hypoxia
C) Shaving the chest before placing the defibrillation pads to improve contact
D) Performing CPR while the AED is being attached

Question 31

Your patient is a 44-year-old female who has collapsed while jogging.She has been unresponsive for 4 to 5 minutes by the time you arrive.Her husband appears to be performing high-quality CPR.Which of the following should be your first action?

A) Insert an oropharyngeal airway and begin ventilations.
B) Load the patient into the ambulance for further assessment.
C) Apply the AED.
D) Stop CPR and check for a pulse.

Question 32

You are on the scene of a 68-year-old male patient complaining of severe chest pain for the last 20 minutes.He has a previous history of myocardial infarction and states it feels "just like the last time." You have applied oxygen and assisted him in administering aspirin and nitroglycerin with no reduction in the chest pain.Your nearest facility is 5 minutes away,a Level III Trauma Center is 10 minutes away,and a hospital with cardiac catheterization capabilities is 20 minutes away.The patient is requesting to be transported to his cardiologist's hospital,which is 30 minutes away.Which hospital is the best destination?

A) The nearest facility
B) The trauma center
C) The hospital the patient requests
D) The nearest hospital with cardiac catheterization

Question 33

Which of the following people is allowed to continue providing patient care when the patient is to be "cleared" for delivery of a shock via the defibrillator?

A) The EMT performing bag-valve-mask ventilations
B) The provider who is ventilating the patient, so long as the patient has been intubated by a paramedic so the provider does not directly touch the patient
C) Anyone in contact with the patient below the level of the patient's knees
D) None of the above

Question 34

Which of the following is the result of a portion of the heart muscle dying due to a lack of oxygen?

A) Angina pectoris
B) Myocardial infarction
C) Cardiac arrest
D) Heart failure

Question 35

Which of the following is the name given to the condition in which fluid accumulates in the lungs?

A) Chronic obstructive pulmonary disease (COPD)
B) Pulmonary edema
C) Pedal edema
D) Dyspnea

Question 36

Which of the following is NOT a role of the EMT in providing emergency cardiac care?

A) CPR
B) Early defibrillation
C) Administration of epinephrine
D) Airway management

Question 37

You respond to the scene of a 56-year-old obese female complaining of respiratory distress.She states that she has been feeling weak and a "little sick" for the past two days but the respiratory distress has been getting progressively worse for the past several hours.She states she has "heart problems," suffers from high blood pressure,and takes a "water pill." She is afebrile and has coarse crackles (rales)bilaterally.What is most likely the cause of her respiratory distress?

A) Pneumonia
B) Influenza
C) Aortic aneurysm
D) Congestive heart failure

Question 38

Which of the following is the beneficial action of a beta blocker medication?

A) Causes vasoconstriction, increasing the blood pressure
B) Slows the heart rate
C) Increases the amount of oxygen needed by the myocardium
D) Increases the strength of myocardial contraction

Question 39

Defibrillation is indicated for which of the following situations?

A) Pulseless electrical activity
B) Pulseless bradycardia
C) Asystole
D) Pulseless ventricular tachycardia

Question 40

Which of the following BEST describes an appropriate shock sequence for the patient in pulseless VT?

A) Shock, 2 minutes of CPR, analyze, shock again
B) Shock, shock, shock, pulse check, 2 minutes of CPR, shock, shock, shock
C) Shock, pulse check, shock, pulse check, shock, pulse check
D) Shock, shock, shock, shock

Question 41

Automatic defibrillation is NOT appropriate in most cases of infant cardiac arrest due to which of the following?

A) Ventricular fibrillation is not the primary cause of cardiac arrest in the pediatric patient.
B) The energy delivered by the AED would not be effective on an infant.
C) AEDs cannot effectively determine rhythms on patients weighing less than 20 pounds.
D) None of the above

Question 42

Mechanical CPR devices are used by EMS agencies in order to provide ________.

A) a 100% success rate
B) a faster response time to the scene
C) high-quality compressions
D) more efficient breaths

Question 43

In which of the following ways does cardiac arrest in children differ from cardiac arrest in adults?

A) Cardiac arrest in children is more likely to be due to respiratory failure.
B) Ventricular fibrillation is common in children.
C) Ventricular fibrillation is not common in adults.
D) Cardiac arrest in adults is more likely to be due to respiratory failure.

Question 44

Which of the following patients should have an automated external defibrillator applied?

A) A 67-year-old man with severe, crushing chest pain that is not relieved by nitroglycerin
B) A 6-month-old in severe respiratory distress
C) A 19-year-old college athlete who collapsed during football practice and is pulseless and apneic
D) A 40-year-old female in cardiac arrest due to chest injuries sustained in a motor vehicle crash

Question 45

You are on the scene of a 65-year-old female patient in cardiac arrest.CPR is in progress and the AED has been applied.The AED advises shock.After defibrillating the patient,what is your next intervention?

A) Place in the recovery position.
B) Insert a Combitube.
C) Check for a pulse.
D) Continue CPR.

Question 46

Which of the following BEST describes the purpose of a continuous quality improvement program for AED?

A) Taking disciplinary action for patient care errors
B) Eliminating the need for medical direction
C) Replacing continuing education
D) Improving patient outcomes in the community

Question 47

You are transporting a 50-year-old male patient whom you successfully defibrillated at the scene.You are 5 minutes away from the hospital when the patient goes back into cardiac arrest.Which of the following is the best course of action?

A) Analyze the cardiac rhythm and deliver shocks as necessary.
B) Tell the driver to stop, analyze the cardiac rhythm, and deliver a shock as necessary.
C) Tell the driver to stop and assist you with CPR, and request another unit for assistance.
D) Initiate CPR and continue transporting.

Question 48

You are the first on the scene of a 72-year-old patient in cardiac arrest.You have your medical supply kit,oxygen,and an AED.At least 4 to 5 minutes of high-quality CPR has been provided by the police officer who arrived before you.You have confirmed an open airway,apnea,and pulselessness.Which of the following should you do next?

A) Perform one-rescuer CPR until additional personnel arrive.
B) Apply the defibrillator pads and shock as indicated.
C) Perform bag-valve-mask ventilations with supplemental oxygen for 30 seconds before applying the defibrillator pads.
D) Contact medical direction before taking any action.

Question 49

You are on the scene of a 65-year-old female patient in cardiac arrest.CPR is in progress and the AED has been applied.The AED does not advise shock.What is your next intervention?

A) Stop CPR and place the patient in the recovery position.
B) Insert a Combitube.
C) Continue CPR.
D) Replace the malfunctioning AED.

Question 50

Your patient is a 66-year-old female who has regained a pulse after a shock with an AED; however,she remains unresponsive and is not breathing adequately.Which of the following should be done next?

A) Assist ventilations with a bag-valve-mask device and supplemental oxygen and anticipate that the patient may go back into cardiac arrest.
B) Deliver a fourth shock to improve the patient's respiratory status.
C) Remove the AED and assist the patient's ventilations with a bag-valve mask and supplemental oxygen, and keep re-assessing the pulse.
D) Apply a nonrebreather mask with high-concentration oxygen and keep reassessing the pulse.