TEST WITH QUESTIONS AND CORRET
ANSWERS WITH DETAILED RATIONALES
GRADED A+
A 45-year-old woman calls EMS because of severe chest pain.
When you arrive, she advises you that she has taken two of her
husband's
nitroglycerin tablets without relief. Her BP is 110/60 mm Hg, her
pulse is 100 beats/min, her respirations are 16 breaths/min, and
her
oxygen saturation is 95%. You should:
A) attach the AED, administer 100% oxygen, and contact medical
control for advice.
B) transport the patient without delay and monitor her blood
pressure en route.
C) Call medical control and request permission to assist the
patient with one more NTG tablet.
D) Apply oxygen, assess the patient's blood pressure, and give a
third and final NTG tablet. Correct Answer B) transport the patient
without delay and monitor her blood pressure en route.
,Do not administer, or assist a patient with, a medication that
is not prescribed to him or her. In this case, the best course
of action is to transport the patient
without delay and monitor her blood pressure en route.
Additionally, if she has no drug allergies, you should
administer up to 325 mg of chewable aspirin.
Oxygen is not indicated for this patient; there is no evidence
of respiratory compromise and her oxygen saturation is
greater than 94%. The AED is applied
only to patients who are in cardiac arrest; the patient in this
scenario is not in cardiac arrest.
The middle, muscular layer of the heart is called the:
A) epicardium.
B) pericardium.
C) myocardium.
D) endocardium. Correct Answer C) myocardium.
The heart has four layers. The inner layer is called the
endocardium, the middle layer is composed of muscle and is
called the myocardium (myo = muscle),
and the outer layer of the heart itself is called the epicardium.
The pericardium, which is a thin, fibrous membrane,
encapsulates the entire heart.
,Which of the following statements regarding ventricular fibrillation
(V-Fib) is correct?
A) Loss of consciousness occurs within minutes after the onset
ofV-Fib.
B) In V-Fib, the heart is not pumping any blood and the patient is
pulseless.
C) Patients in V-Fib should be defibrillated after every 60 seconds
of CPR.
D) Any patient in V-Fib must receive CPR for 2 minutes prior to
defibrillation. Correct Answer B) In V-Fib, the heart is not pumping
any blood and the patient is pulseless.
Ventricular fibrillation (V-Fib) is a disorganized, ineffective
quivering of the heart muscle. No blood is pumped through
the body and the patient is pulseless.
Loss of consciousness occurs within seconds following the
onset of V- Fib. Patients in V-Fib are treated with high-quality
CPR and defibrillation every 2
minutes if needed. When treating a patient in cardiac arrest,
whether the patient's arrest was witnessed or unwitnessed,
begin immediate CPR and apply the
AED as soon as it is available.
After defibrillating a man in cardiac arrest, you resume CPR. As
you are about to reanalyze his cardiac rhythm 2 minutes later,
your partner
, tells you she can definitely feel a strong carotid pulse. You should:
A) continue with the rhythm analysis.
B) assess the patient's breathing effort.
C) ask her to obtain a blood pressure reading.
D) remove the AED pads from the patient's chest. Correct Answer
B) assess the patient's breathing effort.
If return of spontaneous circulation (ROSC) occurs, your first
action should be to reassess the patient's airway status and
breathing effort. If the patient is
still apneic or is breathing inadequately, continue
ventilations and frequently reassess his or her pulse. If the
patient is breathing adequately, administer
oxygen as needed to maintain an oxygen saturation of
greater than 94%. If the patient is still unresponsive, as is
often the case, insert an appropriate airway
adjunct (if not already done) to assist in maintaining airway
patency. After reassessing airway and breathing, obtain the
patient's blood pressure and treat
hypotension if needed. Do not remove the AED pads from the
patient's chest, even if ROSC has occurred. The risk of
cardiac arrest is still high and the
patient may need further defibrillation. You should, however,
disconnect the pads from the AED or simply turn the AED off.