Cardiac Rhythm Interpretation and Management, Exams of Cardiology

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Chapter 17 exam review cardiac

paramedic

The interior wall of the left ventricle is supplied by the: A) right coronary artery B) circumflex artery C) left coronary artery D) left anterior descending artery - A Stable angina: A) occurs after a predictable amount of exertion B) typically subsides within 10 to 15 minutes C) is characterized by sharp chest pain rather than pressure D) usually requires both rest and nitroglycerin to subside - A Which of the following statements is correct? A) Lead II is contiguous with leads V6 and aVL B) Lead I is contiguous with lead II C) Lead V6 is contigous with leads V4 and V D) Lead III is contiguous with leads II and aVF - D The door-to-balloon time for a patient with an ST elevation myocardial infarction is ____ minutes or less A) 30 B) 60 C) 120 D) 90 - D Takotusbo cardiomyopathy is MOST often associated with: A) multiple coronary occlusions B) unexplained cardiac arrest C) emotional stress D) a low blood pressure - C Sympathetic nerves are regulated primarily by:

A) epinephrine B) choliesterase C) norephinephrine D) adrenaline - C The QRS in lead I is a negative deflection and the QRS in lead aVF is a postive deflection. This indicates: A) extreme right axis devivation V) a normal axis C) right axis deviation D) left axis deviation - C Untreated ventricular tachycardia would MOST likely deteriorate to: A) ventricular fibrillation B) asystole C) pulseless electrical activity D) torase de pointes - A what is the R-on-T phenomenon? A) A PVC that occurs when the ventricles are not fully repolarized B) when the R wave occurs at the J point of the next cardiac cycle C) A PVC that occurs during a time when the ventricles are depolarizing D) A unifocal PVC that occurs during the upslope of any given T wave - A The precordial leads do NOT view the ________ wall of the heart A) anterior B) lateral C) inferior D) septal - C The second half of the T wave: A) represents a vulnerable period during which a strong impulse could cause depolarization, resulting in a lethal arrhythmia B) is the point of ventricular repolarization to which a defibrillator is synchronized to deliver electrical energy C) is the strongest part of ventricular depolarization and is often the origin of dangerous ventricular arrhythmia's

D) represents a state of absolute ventricular refractoriness in which another impulse cannot cause depolarization - A The P wave represents: A) a delay in the AV node B) SA nodal discharge C) contraction of the atria D) atrial depolarization - D Which of the following is NOT characteristic of multifocal atrial tachycardia? A) QRS complexes less than 0.11 seconds in duration B) Nonvisible P waves with a rapid ventricular rate C) Regular R-R intervals with a rate less than 150 beats/min D) Variable PR intervals and P waves of differing size - C Premature ventricular complexes: A) are extra systolic beats that break the regularity of the underlying rhythm B) are in themselves considered arrhythmia's, but are generally insignificant C) occur later than the next expected complex, causing an irregular rhythm D) are ectopic complexes that originate from a different pacemaker site - D Which of the following patients would MOST likely present with atypical signs and symptoms of an acute myocardial infarction? A) 58-year-old diabetic woman B) 49-year-old obese man C) 60 year-old-man with anxiety D) 71-year-old woman with hypertension - A Supraventricular tachycardia is MOST accurately defined as: A) an irregular tachycardic rhythm that originates just below the AV junction B) a regular tachycardic rhythm between 150 and 180 beats/min with P waves buried in the QRS complexes C) any tachycardic rhythm with a heart rate greater than 130 beats/min and absent P waves D) a tachycardic rhythm originating from a pacemaker site above the level of the ventricles - D What 12 lead ECG finding should make you suspect a posterior STEMI? A) ST elevation in leads V3 and V

B) ST elevation in leads III and aVF C) ST depression in leads V1 and V D) ST depression in leads I and aVL - C Which of the following ECG abnormalilites is MOST consistent with hyperkalemia? A) Prominent U waves B) Prolonged QT interval C) The presence of J wave D) Tall, peaked T waves - D Which of the following ECG waveform represents ventricular depolarization? A) T wave B) ST segment C) QRS complex D) U wave - C Which of the following clinical is LEAST suggestive of a peripheral vascular disorder? A) An S3 sound during auscultation of the heart B) A bruit heard over the carotid artery C) Swelling and pain along the course of a vein D) Pain in the calf muscle while walking - A Which of the following statements regarding oxygen administration for a patient experiencing an acute myocardial infarction is correct? A) Any patient experiencing an acute myocardial infarction should receive high-flow oxygen B) Treatment with oxygen should be individualized and titrated to maintain the SpO2 level above 94% C) Evidence has shown that high (greater than 90%) concentrations of oxygen reduce mortality D) In order to prevent hypoxic injury, do not give any patient with an acute myocardial infarction more than 2 L/min oxygen - B The treatment for sinus tachycardia should focus on: A) relieving pain and anxiety B) administering IV fluid boluses C) correcting the underlying cause D) decreasing the heart rate - C

You have just administered 0.4 mg of sublingual nitroglycerin to a 60 year-old woman with severe chest pain. The patient is receiving supplement oxygen and has an IV line of normal saline in place. After 5 minutes, the patient states that the pain has not subsided. you should: A) administer 2 to 4 mg of morphine B) repeat the nitroglycerin C) give her 250-mL saline bolus D) reassess her blood pressure - D When monitoring a patient's cardiac rhythm, it is important to remember that: A) a heart rate below 60 beats per minute must be treated immediately B) the presence of a QRS complex correlates with the patient's pulse C) the ECG does not provide data regarding the patient's cardiac output D) most patients with acute myocardial infarction experience asystole - C Which of the following statements regarding treatment for a first-degree heart block is correct? A) Treatment is generally not indicated unless the rate is slow and cardiac output is impaired B) Transcutaneous cardiac pacing should be initiated without delay for patients with a first-degree heart block C) Most first-degree heart blocks are associated with significant bradycardia and require atropine D) First-degree heart block is often accompanied by a compensatory tachycardia that requires treatment

• A The recommended first-line treatment for third-degree heart block associated with bradycardia and hemodynamic compromise is: A) an epinephrine infusion B) transcutaneous pacing C) a dopamine infusion D) atropine sulfate - B Regardless of the patient's presenting cardiac arrest rhythm, the first IV or IO drug that should be given is: A) calcium chloride B) an antidysrhythmic C) an inotrope D) a vasopressor - D Which of the following mechanisms causes hypertension?

A) Heart rate that is persistently above 80 beats/min causes an increase in cardiac output and a resultant increases in blood pressure B) Increased afterload stimulates the Frank-Starling reflex, which rises the pressure behind the blood leaving the heart C) Atherosclerotic plaque narrows one or more of the coronary arteries, resulting in increased cardiac perfusion D) Arteriosclerosis results in increased elasticity of the arteries, causing vasodilation and increased arteriolar capacity - B Sinus arrest is characterized by: A) PR intervals greater than 0.12 seconds B) irregularity during the inspiratory phase C) an irregularly irregular rhythm D) a dropped PQRST complex - D You and your partner arrive at the scene of an unresponsive male patient. Your assessment reveals that he is puleless and apneic. The patient's wife tells you that he collapsed about 10 minutes ago. you should: A) ask the patient's wife if her husband has a living will B) begin CPR with a compression to ventilation ratio of 15: C) initiate CPR as your partner applies the defibrillator pads D) apply the defibrillator pads and assess his cardiac rhythm - C You have applied the defibrillator pads to a pulseless and apneic 60-year-old woman and observe a slow, wide QRS complex rhythm. You next action should be to: A) check the carotid pulse B) assess breathing effort C) resume CPR at once D) attempt cardiac pacing - C The proper compression-to-ventilation ratio for two-rescuer adult CPR when an oropharyngeal airway is in place is: A) 5: B) asynchronous C) 30: D) 15:2 - C Which of the following actions should NOT occur while CPR is in progress? A) Assessment for a palpable pulse

B) Establishment of vascular access C) Advanced airway placement D) Cardiac rhythm assessment - D Which of the following clinical signs would you MOST likely observe in a patient with right ventricular failure? A) Splenomegaly B) Accessory muscle use C) Third heart sound D) Hemoptysis - A Torsades de pointes: A) presents with wide QRS complexes that are all of the same shape, size, and vector direction B) is a variant of polymorphic ventricular tachycardia and is often caused by a prolonged QT interval C) is a lethal ventricular rhythm that is usually caused by ingestion or injection of CNS-depressant drugs D) is generally less serious than monomorphic ventricular tachycardia and is usually not treated in the field - B Vasoactive medications for cardiogenic shock should be titrated to achieve a minimum systolic blood pressure of: A) 120 mm Hg B) 100 mm Hg C) 90 mm Hg D) 80 m Hg - C The presence of a J wave (Osborn wave) on the ECG is an indicator of: A) hypothermia B) a delta wave C) hyponatremia D) hypercalcemia - A Unlike a idioventricular rhythm, an agonal rhythm: A) indicates a regular ventricular pacemaker B) is associated with a lower mortality rate C) does not produce a palpable pulse D) is associated with a faster rate - C

The pain assoicated with pericarditis: A) cannot be differentiated from acute myocardial infarction B) is most often described as a crushing feeling C) improves when the patient takes a deep breath D) improves when the patient leans forward - D When performing CPR on an adult patient in cardiac arrest, it is important to: A) deliver at least 80 to 9- compression's per minute B) limit interruptions in chest compression's to 20 seconds C) allow the chest to fully recoil between compression's D) deliver forceful ventilation's between compression's - C Which of the following statements regarding an idioventricular rhythm is correct? A) The most common cause of an idioventricular rhythm is failure of the SA node B) Most patients with an idioventricular rhythm are hemodynamically unstable C) Idoiventricular rhythms are typically accompanied by non-conducted P waves D_ Treatment for an idioventricular rhythm focuses on increasing blood pressure - B The circumflex branch of the left coronary artery supplies the _______ wall of the left ventricle A) anterior B) lateral C) inferior D) septal - B Which of the following underlying medical conditions would be of LEAST pertinence when obtaining the past medical history from a patient who complains o acute chest pain or pressure? A) Renal disease B) Diabetes C) Hypertension D) Cancer - D Which of the following statements regarding second-degree heart block is correct? A) more than half of all second-degree heart blocks cause hemodynamic compromise and require transcutaneous cardiac pacing in the prehospital or hospital setting B) Second-degree heart blocks occurs when an impulse reaching the AV node is occasionally prevented from proceeding to the ventricles and causing a QRS complex C) Second-degree heart block is characterized by inconsistent PR intervals, a QRS complex greater than 0.12 seconds, and a ventricular rate less than 40 beats/min

D) Most second-degree heart blocks are transient in nature and resolve in the prehospital setting without the need for intervention in the emergency department - B ST Elevation Myocardial Infarction (STEMI) should be suspected if: A) ST elevation greater than 1 mm in males is observed in leads V2 and V B) ST elevation greater than 1.5 mm in females is observed in leads V2 and V C) ST elevation greater than 0.5 mm is observed in two or more contiguous leads D) ST elevation greater than 1 mm is at least one contiguous lead is observed - B Your patient has a BP of 220/110/ What is this patient's mean arterial pressure (MAP)? A) 147 mm Hg B) 158 mm Hg C) 129 mm Hg D) 166 mm Hg - A The ___________ represents the end of ventricular depolarication and the beginning of repolarization A) ST segment B) T wave C) J point D) T-P interval - C You and an EMT are performing CPR on an elderly woman in cardiac arrest as your paramedic partner prepares to intubate her. After the patient has been intubated and proper ET tube placement has been confirmed, you should: A) direct your partner to deliver one breath every 3 to 5 seconds as the EMT-B continues chest compression's B) administer 2.5 mg of epinephrine via the ET tube and hyperventilate the patient to ensure drug dispersal C) instruct the EMT-B to pause after 30 compression's so your partner can deliver two ventilation's D) perform asynchronous CPR while ventilating the patient at a rate of 10 breaths/min - D What drug is indicated for patients with refractory ventricular fibrillation? A) Amiodarone B) Sodium bicarbonate C) Calcium D) Procainamide - A When administering aspirin to a patient with an acute coronary syndrome, you should:

A) have him or her chew and swallow 160 to 325 mg of baby aspirin B) give up to 325 mg of enteric-coated aspirin for the patient to swallow C) administer half the usual dose if the patient has a history of stroke D) first check to make sure the patient is not severely hypertensive - A The PR interval should be no shorter than ______ seconds and no longer than ____ seconds in duration A) 0.12, 0. B) 0.18. 2. C) 0.14, 0. D) 0.16, 0.40 - A Under normal conditions, the strength of cardiac contraction is regulated by: A) physical exertion B) the Frank-Starling mechanism C) the heart rate D) the nervous system - D Sinus dysrthythmia is: A) an irregular sinus rhythm B) a sign of myocardial ischemia C) observed in all patients D) most common in hypotensive patients - A When analyzing a cardiac rhythm strip in lead II, you should routinely evaluate all of the following components, EXCEPT the: A) QRS width B) PR interval C) ST segment D) R-R interval - C Ventricular bigeminy occurs when: A) a 6-seconds strip contains at least two PVCs B) at least two differently shaped PVCs occur C) two premature ventricular complexes (PVCs) occur in a row D) every second complex is a PVC - D Which of the following situations would contraindicate the administration of nitroglycerin?

A) Systolic BP less than 110 mm Hg B) The presence of right ventricular infarct C) Hypersensitivity to salicylates D) Use of Plavix within the last 12 hours - B The presence of dizziness in a patient with a suspected myocardial in MOST likely the result of: A) acute left-sided heart failure B) fear and anxiety C) a reduction in cardiac output D) the effects of nitroglycerin - C Which of the following would MOST likely cause bradycardia? A) Hyperthermia B) Exercise C) Amphetamines D) Beta-blocker use - D When assessing an anxious patient who presents with tachycardia, you must: A) obtain a 12-lead ECG tracing before initiating any treatment B) administer diazepam or midazolam to facilitate your assessment C) determine if the tachycardia is causing hemodynamic instability D) prepare for cardioversion if the rate is less than 150 beats/min - C Which of the following differentiates an atrial rhythm from a sinus rhythm? A) Tachycardia B) Profound bradycardia C) Dissociated P waves D) Varying shapes in P waves - D You are dispatched to a grocery store for a 39-year-old woman with a severe headache. The patient advises you that her headache, which was present when she woke up in this morning, is located in the back of her head. She is conscious and alert, with a blood pressure of 194/112 mm Hg, pulse of 10 beats/min and strong, and respiration's of 14 breaths/min and regular. She denies a history of hypertension or any other significant medical problems. The closes appropriate facility is located 15 miles away you should: A) start an IV line of normal saline, give her 0.4 mg of sublingual nitroglycerin, and transport at once. B) administer oxygen as tolerated, give up to 5 mg of morphine IM, and transport promptly C) administer supplemental oxygen, start an IV line of normal saline at a keep-open rate, and transport

D) give high-flow oxygen, establish vascular access, begin transport, and administer labetalol en route - C You are evaluating a 60-year-old woman's 12-lead ECG and note that the R wave height in lead V exceeds the S wave depth. What condition would MOST likely cause this? A) Pulmonary hypertension B) Left ventricular failure C) A tricuspid valve murmur D) Severe systemic h[hypertension - A You are assessing a conscious and alert middle-aged male who complains of chest discomfort and nausea. His blood pressure is 112/70 mm Hg, pulse is 90 beats/min and regular, and respiration's are 20 beats/min and regular. The patient's past medical history is significant for hypothyroidism and hyperlipidemia. His medications include Synthroid, Lipitor, Cialis, and one baby aspirin per day. Which of the following medications would LEAST likely administer? A) Aspirin B) Fentanyl C) Morphine D) Nitroglycerin - D Premature ventricular complexes (PVCs) that originate from different sites in the ventricle: A) are also called fusion PVCs B) will appear differently on the ECG C) are called unifocal PVCs D) produce a palpable pulse - B Thousands of fibrils that are distributed throughout the ventricles, which represent the end of the cardiac conduction system, are called the: A) internodal pathways B) cardiac myocytes C) bundle branches D) Purkinje fibers - D The firing of an artificial ventricular pacemaker causes: A) a wide QRS complex followed by a vertical spike B) a small spike followed by a narrow QRS complex C) a change in the shape of the preceding P waves D) a vertical spike followed by a wide QRS complex - D

The 6-second method for calulating the rate of a cardiac rhythm: A) takes longer than other methods of calculating the rate and is thus impractical to use with critical patients B) will yield an estimated heart rate that is typically within 2 to 3 per minute of the actual heart rate C) involves counting the number of QRS complexes in 6-second strip and multiplying that number by 10 D) is an accurate method for calculating that heart rate if the cardiac rhythm is grossly irregular and very fast - C The MOST siginificant risk assoicated with the use of fibrionlytic therapy is: A) hemorrhage B) reocclusion C) coagulation D) anaphylaxis - A The duration of the QRS complex should be _____ milliseconds or less in a healthy adult. A) 130 B) 120 C) 110 D) 100 - C The MOST important initial pieces of equipment to bring to the side of an unresponsive patient are the: A) defbrillator and airway management equipment B) intubation kit and equipment for vascular access C) drug kit and stretcher with a long backboard D) pocket face mask and equipment for intubation - A When viewing the leads V3 and V4, you are lokking at the _______ wall of the _________. A) anterior, left ventricle B) septal, heart C) inferior, right ventricle D) lateral, left ventricle - A Which of the following clinical findings is LEAST suggestive of left-sided heart failure? A) an S3 gallop B) Sacral edema C) Crackles in the lungs

D) Shortness of breath - B The brief pause between the P wave and QRS complex represents: A) full dispersal of electricity throughout both atria B) the period of time when the atria are repolarizing C) depolarization of the inferior part of the atria D) a momentary conduction delay at the AV node - D When managing cardiac arrest, the appropriate dosing regimen for epinephrine is: A) 1 mg of a 1:10,000 solution every 3 to 5 minutes B) 1 mL of a 1:10,000 solution every 3 to 5 minutes C) 0.1 mg/kg of a 1:10,000 solution D) 10 mL of 1:1,000 solution every 3 to 5 minutes - A Which of the following statements regarding asystole is correct? A) Most cases of asystole present with P waves only B) Asystole is the result of prolonged myocardial hypoxia C) Defibrillation if indicated in some cases of asystole D) A disconnected ECG lead often mimics asystole - B The QRS in lead I is a postivie deflection and the QRS in lead aVF is a negative deflection. This indicates: A) a normal axis B) right axis deviation C) left axis deviation D) extreme right axis deviation - C You are dispatched a residence at 2:00 AM for an elderly man with shortness of breath. The patient tells you that he was suddenly awakened with the feeling that he was smothering. You note dried blood on his lips. The patient tells you that he has some type of "breathing problem," for which he uses a prescribed inhaler and takes a "heart pill." you should suspect: A) right ventricular failure B) left ventricular failure C) acute COPD failure D) reactive airway disease - B The normal P wave duration is less than ___ milliseconds and the amplitude is less than ____ millimeters tall

A) 130; 3.

B) 110; 2.

C) 120; 3.

D) 140; 4.0 -

B

Stimulation of the parasympathetic nervous system: A) completely blocks the AV node, preventing ventricular depolarization B) causes a decrease in the production of epinephrine and norepinephrine C) slows SA nodal discharge and decreases conduction through the AV node D) is characterized by a large P wave and a PR interval that is shorter than normal - C Shortly after administering a second dose of 4 mg of morphine to a 49-year-old woman who is experiencing chest pain, the patient's level of consciousness markedly decreases. Further assessment reveals that she is hypotensive, bradycardic, and hypoventilating. You should: A) administer 0.5 mg of atropine and reassess her B) elevate her legs and give a 500-mL saline bolus C) assist her ventilations and administer naloxone D) immediately intubate her to protect her airway - C Which of the following interventions would MOST likely be preformed an route to the hospital during a lengthy transport of a patient with a suspected myocardial infarction? A) IV therapy and analgesia B) Aspirin administration C) 12-lead electrocardiography D) Supplemental oxygen - A When applying the limb leads, the negative lead should be placed on the: A) left leg B) left arm C) right arm D) right leg - C Which of the following statement regarding sinus bradycardia is correct? A) Sinus bradycardia is caused by decreased vagal tone in most patients B) Symptomatic bradycardia is often caused by a decreases atrial rate C) Sinus bradycardia often requires mutiple doses of atropine to correct it D) Treatment focuses on the patient's tolerance to the bradycardia - D

Which of the following leads provides the BEST view of the anterolateral wall of the left ventricle? A) V5 to V B) V4 to V C) V2 ro V D) V4 to V5 - B Which of the following would be considered an anginal equivalent in a patient with myocardial ischemia? A) Bilateral leg pain B) Generalized weakness C) Severe headache D) Acute hyperactivity - B Treatment for a patient with bradycarida and siginigicantly compromised cardiac output includes: A) 1 mg of epinephrine 1:10, B) 1 mg of atropine via IV push C) transcutaneous cardiac pacing D) a dopamine infusion at 20 mg/min - C You are performing CPR on a 80 year old woman whose cardiac arrest was witnessed by her husband. Several intubation attempts have been unsuccessful, but ventilation's with a bag-mask device are producing adequate chest rise. IV access has been obtained and 1 mg of epinephrine has been administered. The cardiac monitor displays a narrow QRS complex rhythm at a rate of 70 beats/min. According to the patient's husband, she has had numerous episodes of diarrhea over the past 23 hours and has not had much of an appetite. The MOST appropriate next action should be to: A) continue CPR and administer crystalloid fluid boluses B) administer 1 mg of atropine while CPR in ongoing C) assess the rhythm and pulse after 3 minutes of CPR D) administer 50% dextrose for presumed hypoglycemia - A The Levine sign is defined as: A) pushing on the sternum with the fingertips B) rubbing the arm to which pain is radiating C) a subconsciously clenched fish over the chest D) a state of denial in patients with an acute myocardial infarction - C you respond to the scene of an assault, where a 20-year-old man was struck in the chest with a steel pipe. Your assessment reveals that the patient is unresponsive, apneic, and pulesless. the MOST appropriate next intervention is to:

A) perform 5 cycles of well-coordinated CPR B) look for evidence of a pericardial tamponade C) give 2 minutes of 15 compressions and 2 breaths D) immediately assess the patient's cardiac rhythm - a The process of aortic dissection begins when: A) blood accumulates between the layers of the aorta B) the aorta is weakened due to excessive pressure C) the intimal layer of the aortic wall if torn D) hypertension causes acute rupture of the aorta - C The MOST immediate forms of reperfusion therapy for an injured myocardium are: A) angioplasty and coronary artery bypass grafting B) fibrinolytics and percutaneous coronary intervention C) high-dose aspirin and high flow supplemental oxygen D) supplemental oxygen and an infusion of nitroglycerin - B Which of the following prescribed medications would be a patient with chronic atrial fibrillation MOST likely take? A) Lisinopril and aspirin B) Cordarone and furosemide C) Plavix and Vascotec D) Digitalis and Coumadin - D Why may fentanly (Sublimaze) be preferred over morphine sulfate for pain management in patients experiencing acute myocardial infarction? A) Relatively short duration B) Longer half-life C) Not a narcotic D) More easily reversed with naloxone - A Which of the following medications would be the MOST acceptable alternative to morphine for analgesia in patients with an acute coronary syndrome? A) Versed B) Fentanyl C) Ibuprofen D) Diazepam - B

Which of the following pulseless rhythms is NOT treated as pulseless eletrical activity? A) Idioventricular rhythm B) Junctional escape rhythm C) Ventricular tachycardia D) Sinus bradycardia - C The pain associated with an acute myocardial infarction: A) is often relieved by two or three doses of sublingual nitroglycerin B) is most often described as a sharp sensation in the chest C) radiates to the left or right arm in the majority of cases D) is not influenced by deep breathing or body movement - D Q waves are considered abnormal or pathologic if they are: A) greater than 0.02 seconds wide and consistently precede the R wave B) more than one-third the overall height of the QRS complex in lead II C) Not visible in leads I or II when the QRS gain sensitivity is increased D) present in a patient who is experiencing chest pressure or discomfort - B Which of the following variables has the greatest impact on the efficacy of myocardial reperfusion therapy? A) The duration from symptom onset to treatment B) Whether or not aspirin was given by paramedics C) The patient's blood pressure upon presentation D) the patient's past medical and surgical histories - A Ventricular fibrillation occurs when: A) the ventricles quiver rather than contact normally, while organized atrial contactions continue as normal B) many different cells in the heart depolarize independently rather than in response to an impulse from the SA node C) the ventricles become the primary pacemaker for the heart, resulting in a rapid and irregular ventricular rhythm D) cardiac cells in the ventricles fail to completely repolarize, resulting in a decrease in ventricular automaticity - B The treatment for cardiogenic shock is generally focused on: A) strengthening cardiac contractility without increasing the heart rate

B) increasing the heart rate to improve cardiac output and cerebral perfusion C) administering nitroglycerin to improve perfusion to the myocardium D) infusing enough IV fluid to maintain a systolic BP of 110 mm Hg - A