Download Cardiovascular System: Multiple Choice Questions and Answers and more Exams Cardiology in PDF only on Docsity!
Volume 3 Chapter 2
Which of the following vascular disorders would probably require the least amount of prehospital intervention by the paramedic? - โ
Varicose veins The two superior chambers of the heart are the and they. - โ
atria, pump blood to the ventricles According to current estimates, how many Americans have some form of cardiovascular disease? - โ
>60 million Which of the following best describes afterload? - โ
The resistance against which the ventricle must contract During the management of a patient found in cardiac arrest without a known downtime, which of the following factors should not be considered as either inclusionary or exclusionary criteria for terminating efforts? - โ
The downtime before EMS arrival The rhythm on your ECG shows a rate of 74, PR interval of 0.28 seconds, QTC interval of 0. seconds, and QRS width of 0.08 seconds. What is your best course of action? - โ
Observe, address, and treat any other chief complaints Which of the following is a cause for artifact appearing on the ECG? - โ
Loose electrodes/wires Which of the following factors that contributes to CVD is not the result of lifestyle choices? - โ
Family genetics Successful defibrillation depends upon which of the following? - โ
Decreased chest wall resistance to electricity A phasic variation of the R-R interval that is related to the respiratory cycle and changes in intrathoracic pressure produces which of the following rhythms on the ECG? - โ
Sinus arrhythmia When the administration of epinephrine increases the heart rate, this is called a positive ________ effect. - โ
chronotropic If a patient has a PR interval that is 7 mm (7 small boxes) in duration, what can be said about the overall ECG? - โ
There is a conduction delay in the AV node.
During your treatment of a patient with cardiac type chest pain, you have provided oxygen, IV access, nitroglycerin x3, and morphine x1. The patient is now pain free and the 12 lead ECG changes have resolved. At a minimum, how often should you repeat your reassessment phase during transport? - โ
Every 15 minutes During the assessment of a 12 lead ECG on a patient with chest pain, what type of waveform change is the paramedic assessing for that indicates possible damage? - โ
ST segment elevation A term for describing permanently damaged myocardial tissue that will not heal and may cause the appearance of a pathological Q wave on a 12 lead ECG is which of the following? - โ
Infarct Which of the following risk factors has NOT been proven to increase the risk of cardiovascular disease? - โ
Hypocholesterolemia In which of the following arrest situations should the paramedic withhold resuscitation? - โ
If the arrested patient displays dependent lividity Atropine works by antagonizing which of the following? - โ
Cholinergic response Which of the following risk factors are thought to increase the risk of cardiovascular disease? - โ
Poor diet What procedure is utilized on a patient that has extensive myocardial disease and/or is not a candidate for percutaneous coronary interventions and has thrombocytopenia? - โ
CABG The ECG shows you a regular rhythm at a rate of 40, no P waves are present, and the QRS complex width is 0.16 seconds. Thepatient's blood pressure is 82/44. Which of the following would be most appropriate? - โ
0.5 mg bolus of atropine sulfate Which troponin isoform value is most specific for cardiac injury? - โ
Troponin I The total duration of ventricular depolarization is known as the: - โ
QT interval. When looking at an ECG, the P wave is representative of what? - โ
Atrial depolarization Which of the following statements regarding a patient with ROSC is most accurate? - โ
Postarrest care is almost as important as prearrest care.
Which of the following is not a cardiovascular cause of chest pain? - โ
Costochondritis A significant finding in the SAMPLE history that will contraindicate the administration of sublingual nitroglycerine to a patient experiencing myocardial chest pain is which of the following? - โ
Erectile dysfunction medication use within 24 hours The three types of ECG leads are bipolar, augmented, and - โ
precordial. Cardiac arrest beyond what time period exceeds the metabolic phase of death? - โ
Ten minutes When obtaining a 15 lead ECG on a patient, how many electrodes are placed on the patient's right thorax? - โ
3 Synchronized cardioversion delivers energy during which part of the cardiac cycle? - โ
On the peak of an R wave You have just regained pulses on a cardiac arrest patient. As of right now, the heart rate is 38/min with sinus bradycardia showing on the monitor with multifocal PVCs, the patient is being ventilated at 10/min with oxygen via ET tube, and the palpable blood pressure is 68/palpation. Given these findings, what should the paramedic focus the next interventions on? - โ
Increasing the heart rate You are managing a patient found in cardiac arrest. Bystander CPR was initiated and the patient was shocked once with an AED. You have determined that the patient is still pulseless and apneic. While one partner is intubating and another is inserting an IO needle into the proximal tibia, what medication should you prepare for administration first via IV push? - โ
Epinephrine After 3-4 minutes of cardiac arrest, what physiological process continues in the heart? - โ
Aerobic metabolism When the sinus node fails to discharge for a brief period, resulting in short periods of cardiac standstill that persists until pacemaker cells lower in the conduction system discharge, this is called: - โ
sinus arrest. Signs and symptoms of isolated right ventricular failure include which of the following? - โ
Tachycardia, JVD, hepatic congestion What is the physiological action of dopamine? - โ
Stimulates alpha and beta receptors
In order for a paramedic to honor an advance directive presented to him at the side of a patient that has just arrested, whose signature MUST appear on the written document? - โ
The patient's physician You are called for a 59-year-old female with chest pain. Her only medical history she tells you is that she was in the hospital once for an allergic reaction to Novocaine after dental surgery. Pulse is 90 and irregular, ventilations 20, blood pressure is 130/80. She takes no medications and her ECG shows sinus rhythm with numerous, multifocal PVCs. What is the most appropriate action? - โ
High flow oxygen therapy A degenerative disease of connective tissue often associated with hypertension and aging is known as: - โ
cystic medial necrosis. Your patient responds only to your voice. He is diaphoretic, pale, and cool, blood pressure is 80/50, ventilations 28, and pulse is 34. The ECG monitor shows a rhythm that has regular, but independent atrial and ventricular rhythms with no consistent PR interval and a QRS width of 0.14 seconds. Select the most appropriate treatment. - โ
Supine position, IV, oxygen, externally pace at a rate greater than 60 The interval that begins at the QRS complex and ends at the apex of the T wave is which of the following? - โ
Absolute refractory period Which of the following can be obtained from a single-lead ECG tracing? - โ
Regularity of heartbeat The majority of out-of-hospital deaths attributed to coronary artery disease are due to what sudden event? - โ
Lethal cardiac rhythm disturbance Which of the following would be a reason to continue a cardiac resuscitation? - โ
Transient return of a pulse Why should the paramedic transport an ROSC patient receiving induced therapeutic hypothermia protocol in the field to an ED that can maintain this therapy? - โ
Because it has been shown that if the patient warms up, survival actually is worse than never starting ITH Which of the following patients would likely have the highest risk for developing cardiovascular disease? - โ
Elderly male who smokes, is obese, and lives a sedentary lifestyle You are treating a patient with substernal, diffuse chest pain that radiates down his left arm. He is nauseated, has vomited twice, and his skin is pale, cool, and diaphoretic. His blood pressure is 118/60, pulse is 128, showing sinus tachycardia with 3 PVCs per minute, SpO2 on room air is 91 percent. Of the following choices, which is the best initial treatment? - โ
Administer oxygen, titrated to attain a pulse oximetry above 94 percent
Your patient is a 63-year-old male complaining of chest pain, stating his pain is an "8" on the 1- scale. His skin is cool and diaphoretic; he is confused and has a productive cough with pink-tinged sputum. ECG shows sinus tachycardia at a rate of 110 and his blood pressure is 74/40, ventilations are
- What is the most appropriate pharmacological intervention? - โ
Dopamine, titrated to maintain blood pressure You see ST segment elevation in leads II, III, and aVf. Why do you switch the precordial leads to the right side of the chest and take another 12 lead? - โ
To rule in or rule out a right ventricular AMI The blood flow through a blood vessel is directly proportional to the fourth power of the vessel's radius. This is the definition of: - โ
Poiseuille's law. Each year, approximately how many Americans die from complications due to heart disease? - โ
610, Your patient is an 85-year-old male who is experiencing a septal wall AMI. Which of the following rhythms would you expect to see on the ECG? - โ
Third degree heart block Your 19-year-old patient admits to drinking a six pack of Red Bull, two Monster drinks, and six Cokes in order to pull an all-nighter. Which of the following rhythms are you most likely to see on an ECG? - โ
Sinus tachycardia with multiple PACs What is the standard speed for ECG paper to move across the stylus when printing out the patient's rhythm? - โ
25 mm/sec The ECG shows a rhythm with regularly-irregular groups of QRS complexes. There are more P waves than QRSs and the PR intervals become progressively longer until a P wave is not followed by a QRS complex. Which of the following would you suspect? - โ
Ischemia at the AV junction What pacemaker site in the heart serves as the primary pacemaker? - โ
Sinoatrial node Which of the following is a modifiable risk factor for developing cardiovascular disease? - โ
Hypertension The ECG monitor shows the following: no rate, no rhythm, P waves that are regular in spacing, no QRS complexes. What would you call this rhythm? - โ
Cardiac standstill Looking at an ECG strip, you count 14 QRS complexes in two 3-second marks. Your estimate for the heart rate would be: - โ
140
Which of the following rhythms has an indication for defibrillation as part of its treatment? - โ
Ventricular fibrillation Which of the following blood values may be raised if the patient is suffering from congestive heart failure? - โ
ANP During your assessment of a patient with CHF, what position should he be in prior to the paramedic evaluating for the presence or absence of JVD? - โ
In a sitting-up position of about 45 degrees Which of the following descriptors of pain is common in a patient suffering from chest pain secondary to a heart attack? - โ
"Heavy" When a coronary artery is blocked completely and the result is damage to the full thickness of the myocardium, this is known as a______infarction. - โ
transmural You are managing a patient with systemic hypotension, alterations in mental status, and poor peripheral perfusion. You have already assessed for and corrected disturbances pertaining to the heart rhythm, vascular volume, and vascular tone. What is the remaining reason for the hypotension? - โ
Cardiogenic shock During your assessment, you have determined that the patient is likely suffering from deep venous thrombosis. Which of the following clinical signs is least likely to support this field impression? - โ
Calf pain or tenderness What is the therapeutic endpoint for reducing the blood pressure in a patient with a hypertensive emergency with a severely elevated blood pressure and evidence of end-organ dysfunction? - โ
Reduce MAP by no more than 25 percent initially Your patient experiencing an MI has ST segment elevation in V1 and V2, with ST depression and T wave inversion in V5 and V6. Given this, what should be your first suspicion as to the ventricular wall injured? - โ
Septal wall Which of the following ECG leads would best indicate the presence of a right ventricular myocardial infarction? - โ
V4R You are transporting a patient with ECG changes and a clinical presentation consistent with an acute coronary event. Assuming that all of the following receiving facilities are roughly the same distance from your location, which receiving facility would you transport to? - โ
The hospital with PCI capability
You are looking at an ECG that displays normal P waves at 80/min with a 1:1 relationship with the QRS, a PRI with a 0.24 secondconduction, and the width of the QRS is 0.14 seconds. The T wave is positively deflected. What is the most likely name of thisrhythm? - โ
Sinus rhythm with a first-degree AV block and a bundle branch block Your cardiac arrest patent has an implanted defibrillator that is not functioning, and you see ventricular fibrillation on the ECG. Which of the following is the most appropriate treatment? - โ
Defibrillate the patient using your pads/paddles but avoid placing them on the implanted defibrillator site Your patient is complaining of chest pain that is sharp and "ripping," going straight through to his back. He is pale, diaphoretic, and his extremities are mottled. Pulses are weaker on the left arm compared to the right. Blood pressure in the left arm is 80/40 and in the right arm is 170/90. He tells you he has had heart problems in the past, but this doesn't feel like any of his previous heart problems. He has taken four of his nitroglycerin tablets within the last fifteen minutes, with no relief. Based upon this information, what is likely this condition? - โ
Dissecting thoracic aneurysm What is the purpose of defibrillation? - โ
Depolarize the entire mass of the myocardium and allow it to repolarize uniformly What is the pathophysiological difference between someone experiencing chest pain from an ischemic episode versus an infarctionepisode? - โ
Infarction is commonly from a totally occluded coronary blood vessel. During your exam of a known CHF patient, you auscultate some minor lung congestion, observe peripheral edema to her anklesbilaterally, and a small amount of JVD while sitting upright. The family states these findings are normal for her. The patient complains of a slight headache. What should be your course of treatment? - โ
Position of comfort, venous access, 12 lead ECG, oxygen to maintain SpO2 greater than 94 percent When obtaining an 18 lead ECG on a patient with chest pain, which lead locations would likely show the ST elevation from a posterior wall infarction? - โ
V7, V8, V What is the benefit to transport a patient experiencing a myocardial infarction to a center with a catheter lab that performs percutaneous coronary intervention? - โ
It provides the possibility of rapid reperfusion to distal myocardium by dilating the lumen of a blocked coronary artery with a balloon. You arrive on scene to find a middle-aged male pulseless and apenic. Downtime is unknown. Your partner immediately begins CPR and you attach your defibrillator. Your next action should be to: - โ
continue and support high quality CPR for at least 90 seconds. What postarrest treatment intervention has been shown to be beneficial in improving neurological outcome by slowing metabolism and minimizing oxidative stress? -
โ
Induced therapeutic hypothermia Which of the following conditions, if present during the management of a patient in cardiac arrest, is not sufficient cause to terminate the resuscitative efforts in the field by the paramedic? - โ
The patient has a rescue airway in place. You analyze a 12 lead and see a negative QRS deflection in lead I and a positive QRS deflection in lead aVf. What is the axis? - โ
Right axis deviation You are treating a 40-year-old male for a sudden onset of chest pain during his daily run. He presents sitting on a park bench in no outward distress. He says the pain started in his chest about 10 minutes ago, but when he stopped his run and sat down, it went away. What do you suspect the underlying problem to be? - โ
Stable angina attack
