Final Exam Questions with Answers 2024, Exams of Medicine

Download Final Exam Questions with Answers 2024 and more Exams Medicine in PDF only on Docsity!

Final Exam Questions with Answers

A patient with STEMI is experiencing chest pain that is refractory to sublingual nitroglycerin. IV nitro is prescribed. When administering the medication, it would be titrated to maintain which systolic BP? ✔ 90 mmHg. The resuscitation team suspects that hyperkalemia is the cause of cardiac arrest in a patient brought to the ED. Which finding on a 12-lead ECG would confirm this suspicion? ✔ Wide-complex ventricular rhythm and tall, peaked T waves. A 40 year old patient in the waiting room of the primary care provider's office approaches a staff member and says, 'I am having really severe, crushing chest pain that is moving to both my arms.' The patient is diaphoretic and dyspneic. Which action would be appropriate for the staff member to take? ✔ Activate the emergency medical services system. A patient arrives at the emergency department complaining of SOB. The patient has a long history of COPD. Assessment reveals respiratory failure. Which action would be the initial priority? ✔ Assisted ventilation with BVM resuscitator. The ED team is providing care to a patient who is experiencing ventricular tachycardia. The patient's serum electrolyte levels are a contributing cause of the patient's current condition. Which electrolyte imbalances would most likely be involved? ✔ Hypomagnesemia, hypocalcemia. The ECG rhythm strip of a patient who arrived in the ED complaining of dizziness, syncope and SOB reveals sinus bradycardia. When reviewing the patient's medication history, the healthcare provider identifies which agents as a potential cause of the patient's current condition? ✔ Metoprolol, digoxin, verapamil. A healthcare provider is establishing cardiac monitoring using a five-electrode system. The healthcare provider demonstrates proper use of the system by placing the green electrode in which location? ✔ On the lower right abdomen. A patient with a diagnosis of ACS is experiencing cariogenic shock. Which adjuvant therapy would be contraindicated? ✔ Beta blockers.

The stroke team is assessing a patient with a suspected stroke. That patient is alert and able to carry on a conversation, although the patient has difficulty getting the words out. Testing confirms that the patient has had an ischemic stroke. Based on the patient's medical history, a history of which arrhythmia would alert the team to the patient's increased risk for stroke? ✔ Atrial fibrillation. A member of the resuscitation team is preparing to administer medications IV to a patient in cardiac arrest. The team member follows each medication administration with a bolus of fluid. How much would the team give? ✔ 10-20 ml. An ECG strip of a patient in the ED reveals the following rhythm. Which feature would the healthcare provider interpret as indicating atrial fibrillation? ✔ Absence of discrete P waves and presence of irregularly irregular QRS complexes. A patient experiencing an unstable bradyarrhythmia does not respond to atropine. Which interventions could the healthcare provider use next? ✔ Epinephrine or dopamine infusion, transcutaneous pacing. A patient experiences cardiac arrest, and the resuscitation team initiates ventilations using a BVM. The development of which condition during the provision of care would lead the team to suspect that improper BVM technique is being used? ✔ Pneumothorax. A person suddenly collapses while sitting in the sunroom of a healthcare facility. A healthcare provider observes the event and hurries over to assess the situation. The healthcare provider performs which assessment first? ✔ Rapid assessment. A patient with suspected ACS is placed on a cardiac monitor. The patient is complaining of dyspnea and is given supplemental oxygen. The provider determines that the supplemental oxygen dose is correct based on which SaO2 level? ✔ 95%. A patient in cardiac arrest experiences return of spontaneous circulation. As part of post cardiac arrest care, the patient is receiving mechanical ventilation. Which findings would indicate the need for change in the ventilator settings to optimize the patient's ventilation and oxygenation? ✔ ETCO2 of 50 mmHg, SaO2 of 92%, PaCO2 of 35 mmHg. A patient presents to the ED with suspected ACS. ECG and cardiac biomarkers show the patient has STEMI. Physical examination reveals signs of left ventricular dysfunction. Which findings would support this? ✔ Weak peripheral pulses, hypotension, crackles.

A resuscitation team is debriefing following a recent event. A patient experienced cardiac arrest, and ACLS was initiated. The patient required the placement of an advanced airway to maintain latency. Which statement indicates that the team performed high-quality CPR? ✔ 'We delivered 1 ventilation every 6 seconds and chest compressions at a rate of 100- 120 compressions per minute' Assessment of a patient reveals an ETCO2 level of 55 mmHg and an arterial oxygen saturation level of 88%. The provider would interpret these findings as indicative of which condition? ✔ Respiratory failure. A patient is brought into the ED with a suspected opioid overdose. The patient is in cardiac arrest. Which action would be the team's priority? ✔ Initiating high-quality CPR. A patient is being treated in the ED and is determined to have NSTE-ACS. Invasive management is planned based on which finding? ✔ Ventricular tachycardia. Cardiac monitoring indicates that a patient has a ventricular tachyarrhythmia. The patient has pulse and is not showing any signs of hemodynamic compromise. A 12-lead ECG reveals an irregular rhythm with QRS complexes greater than 0.12 seconds in duration. Which action would be appropriate at this time? ✔ Consider an anti arrhythmic infusion and expert consultation. A patient with an ischemic stroke arrives at the ED at 0200, the patient's symptoms started at about 0030. After completing the necessary assessments, the healthcare team diagnoses an ischemic stroke, and the patient is determined to be a candidate for fibrinolytic therapy. To achieve the best outcomes, the team should initiate therapy no later than? ✔ 0300. A 35 year old female patient's ECG is consistent with STEMI. The ECG reveals a new ST-segment elevation at the J point in leads V2 and V3 of at least which size? ✔ 0.15 mV. A patient enters the ED in respiratory compromise. The team is monitoring the patient using capnography and identifies that ETCO2 levels are initially 33 mmHg and later 40 mmHg. From these readings, the team identifies that the patient is progressing in what stage of respiratory compromise? ✔ Respiratory distress. A patient's ECG reveals tachyarrhythmia. The patient is hemodynamically stable and has a heart rate ranging from 120-135. Based on the findings of the secondary

assessment, which statements by the patient would the team interpret as possible contributing cause? ✔ 'I have been vomiting for the past 2 days from a GI bug' 'I have been so anxious lately because I lost my job' 'I have had a terrible cold with a horrible cough and fever the past week' A patient in the telemetry unit is receiving continuous cardiac monitoring. The patient has a history of MI. The patient's ECG rhythm strip is shown in the following figure. The provider interprets this strip as which arrhythmia? ✔ Third degree AV block. A 20 year old man with respiratory depression is brought to the ED by his parents. The parents state that 'they found him at home with various needles and syringes around him, but they had no idea what he took.' Opioid overdose is suspected, and an initial dose of naloxone is administered at 2200. The patient does not respond to the dose. The team would expect to administer a second dose after how many minutes? ✔ 4 minutes. A patient is brought to the ED by their spouse. The spouse says, 'I think its a stroke.' The stroke team assesses the patient using the NIHSS. Which areas would the team include? ✔ Language deficits, visual function, level of consciousness. A patient with acute renal failure experiences cardiac arrest. Just Before the cardiac arrest, the patient's ECG showed peaked T waves. What might be causing the cardiac arrest? ✔ Hyperkalemia. The following capnogram is from a patient experiencing respiratory distress. At which point in the waveform would the patient's ETCO2 level be measured? ✔ Point D. Cardiac monitoring of a patient in cardiac arrest reveals ventricular fibrillation. What interventions would the team perform next? ✔ Administer 1 shock. A patient has experienced a ROSC after cardiac arrest. The team is conducting a secondary assessment to determine the possible cause of the cardiac arrest. The history reveals that before the arrest, the patient exhibited JVD, cyanosis, apnea, and hyper resonance on percussion. The patient is also difficult to ventilate during the response. The team would most likely suspect which condition? ✔ Tension pneumothorax. A patient is experiencing respiratory distress secondary to an exacerbation of COPD. The patient begins to exhibit signs and symptoms of worsening respiratory function and

experiences respiratory arrest. The team intervenes, delivering ventilations via BVM. The team would deliver 1 ventilation at which interval? ✔ Every 5-6 seconds. A healthcare provider initiates ventilations to ensure adequate breathing and oxygenation. While ventilations are being performed, capnography is established to evaluate the adequacy of the ventilations. The provider determines that ventilations are adequate based on which ETCO2 value? ✔ 35-45 mmHg. A patient presents to the ED with mild to moderate recurrent chest pain, without any nausea or vomiting. A 12-lead ECG is obtained and shows ST-segment depression with transient T-wave elevation indicative of NSTEM-ACS. Cardiac serum markers are obtained and are not elevated. The patient's risk stratification score indicates low risk. These finding suggest which condition? ✔ Unstable angina. A 30 year old patient has been brought to the ED in cardiac arrest. The monitor shoes the following rhythm. Interpretation of this rhythm would suggest which of the following precipitating factors? ✔ Electrocution. Assessment of a patient in the ED reveals the patient is experiencing respiratory compromise. From the assessment, the team identifies that the patient is in the earliest stage of this condition. Which stage would this be? ✔ Respiratory distress. A patient is brought into the ED. The patient does not have a pulse. The cardiac monitor shows the following rhythm. The team interprets this as which condition? ✔ Ventricular tachycardia. A patient with dyspnea and a change in mental status arrives to the ED. The team completes the necessary assessments and begins to care for the patient, including initiating cardiac monitoring and pulse oximetry; providing supplemental oxygen and ensuring adequate ventilation; and obtaining vascular access. The team reviews the ECG. Which agent would the team most likely administer? ✔ Atropine 0.5 mg every 3-5 minutes. A patient's capnogram reveals the following waveform. Which segment would the healthcare provider interpret as reflecting the beginning of exhalation? ✔ A-B