ALS (AMERICAN RED CROSS)| 25 QUESTIONS AND ANSWERS.

A patient presents to the emergency department with signs and symptoms suggestive of ACS. The 12-lead ECG shows T-wave inversion of less than 2 mm. To which clinical category would you assign this patient? Which conditions contribute to the pathophysiology of ACS? 1. Development of an occlusive intracoronary thrombus 2. Transient platelet aggregation 3. Plaque erosion 4. Vasospasm When auscultating lung sounds in a patient with left ventricular dysfunction, you will hear _______________________. What changes on an ECG suggest ischemia? 1. ST-segment depression 2. T-wave inversion Which descriptions of chest pain would be associated with ACS? 1. Pain that radiates to one or both arms 2. Pain that comes and goes 3. Pain lasting longer than 3 to 5 minutes 4. Pain that is unrelieved with changes in position Which interventions are appropriate as part of the primary assessment of a patient with suspected ACS? 1. Establish pulse oximetry. 2. Obtain vascular access. 3. Order a 12-lead ECG. 4. Establish cardiac monitoring. After screening for potential contraindications, which medications should be administered as initial therapies to the patient with suspected ACS? 1. Aspirin 2. Nitroglycerin New ST-segment elevation on a 12-lead ECG suggests __________. Myocardial infarction What finding on ECG is diagnostic for ST-segment elevation myocardial infarction (STEMI) in a man 40 years or older? New ST-segment elevation of at least 0.2 mV (≥ 2 mm) at the J point in leads V2 and V3 In addition to myocardial infarction, which are life-threatening causes of chest pain? 1. Ruptured esophagus 2. Pneumothorax 3. Pulmonary embolism 4. Aortic dissection What is the dose of nitroglycerin (sublingual tablet or spray) to be administered to a patient suspected of having an acute coronary syndrome? 0.4 mg every 5 minutes Advance notification of the receiving facility by prehospital providers can improve outcomes for patients with STEMI. True Which conditions are included in the category of non-ST-segment elevation acute coronary syndromes (NSTE-ACS)? 1. Unstable angina (UA) 2. Non-ST-segment elevation myocardial infarction (NSTEMI) What diagnostic test is typically obtained at presentation to rule out other causes of acute chest pain and to identify pulmonary congestion? Chest radiography Patients with low- to intermediate-risk NSTE-ACS may show which changes on an ECG? 1. Nondiagnostic T-wave changes 2. Nondiagnostic ST-segment changes Intravenous nitroglycerin is used to improve pulmonary edema or hypertension. It should be titrated to maintain a systolic blood pressure that is __________% less than the baseline pressure in patients with blood pressure in the normal range. 10 Physical examination findings in patients with ACS may include which conditions? 1. Hypotension 2. Pulmonary edema 3. Crackles What is the ideal time frame for performing percutaneous coronary intervention (PCI) in a patient with STEMI? Within 1.5 to 2 hours of the patient's arrival at the facility When a patient presents with possible ACS, a 12-or 15-lead ECG should be obtained and interpreted within ______. 10 Which conditions are contraindications to therapy with β-blockers in patients with ACS? 1. Recent myocardial infarction 2. Low cardiac output 3. Risk for cardiogenic shock 4. Acute heart failure Cardiac troponin levels should be measured at initial presentation and then ___________ hours later. 6 Which findings on a 12-lead ECG would be expected in a patient with high-risk non-ST-segment elevation acute coronary syndromes (NSTE-ACS)? 1. T-wave inversion in two or more contiguous leads 2. ST-segment depression in two or more contiguous leads What findings on ECG suggest non-ST-segment elevation ACS (NSTE-ACS)? 1. ST-segment depression 2. T-wave inversion 3. Transient T-wave elevation For a patient experiencing STEMI, management focuses on early reperfusion therapy with: 1. Percutaneous coronary intervention (PCI). 2. Fibrinolytic therapy. Which signs and symptoms can indicate myocardial infarction? 1. Nausea and vomiting 2. Retrosternal chest pain 3. Loss of consciousness 4. Fatigue and weakness