Angelina College : EMSP 1381 All Chapters Quizzes | Complete Quiz Bank | Answered Updated 100% 2025/26.

Angelina College : EMSP 1381 All Chapters Quizzes | Complete Quiz Bank | Answered Updated 100% 2025/26. Chapter 11-12 quiz 1. A 29-year-old woman is in active labor. During your visual exam, you see a limb protruding from her vagina. Upon noting this, it is most important to: contact online medical control. prepare for immediate transport. position the patient on her side. start an IV line of normal saline. 2. A bruit is most significant in which location? Femoral artery Carotid artery Brachial artery Jugular vein 3. Adventitious breath sounds include: rales or crackles. whispered ony. vesicular sounds. 4. After performing your primary assessment of a patient, your next action should be to: transport the patient to the closest medical treatment facility. move the patient to the ambulance as expeditiously as possible. perform a secondary assessment to narrow your differential diagnosis. decide what care is needed at the scene versus en route to the hospital. 5. A multisystem trauma patient opens his eyes in response to pain, moans when you ask him his name, and withdraws from painful stimuli. From this information, you should: assign him a Glasgow Coma Scale score of 10. assume that he has an intracerebral hemorrhage. ventilate him with a bag-mask device at 24 breaths/min. conclude that he has severe neurologic dysfunction.6. An inward curve of the lumbar spine just above the buttocks is called: scoliosis. lordosis. kyphosis. sclerosis. 7. Any time you encounter jugular venous distention in a patient, you should determine: where the venous obstruction is that is impeding blood return to the heart. what body cavity the patient is bleeding into that is causing lost volume. what condition the patient has that is causing decreased venous pressure. what is happening to the heart to cause such a large increase in preload. 8. A pathologic fracture occurs when: normal forces are applied to abnormal bone structures. abnormal forces are applied to abnormal bone structures. normal forces are applied to normal bone structures. abnormal forces are applied to normal bone structures.9. A patient in shock due to internal bleeding will benefit most from: oxygen and thermal management. limited scene time and rapid transport. a comprehensive physical examination. two large-bore IV lines of normal saline. 10.A patient is generally considered to have orthostatic vital signs when: the systolic blood pressure increases, and the diastolic blood pressure decreases when going from a lying to a sitting position. the heart rate increases by 20 beats/min or more when going from a supine to a standing position. the respiratory rate becomes fast, and the depth becomes shallow when they suddenly stand up. they experience chest pain and a rapid, irregular heart rate when going from a seated to a standing position. 11.A patient's pulse is a physical expression of: pressure in the vena cavae. left ventricular contraction. the diastolic blood ventricular contraction. 12.A patient who complains of double vision has: ptosis. anisocoria. diplopia. hyperopia. 13.A patient who does not respond to verbal or tactile stimuli is: lethargic. semiconscious. disoriented. unresponsive. 14.A patient with a blood pressure of 210/100 mm Hg would be expected to have a pulse that is: irregular. dy. rapid. 15.A responsive patient who is talking or crying: currently has a patent airway. is breathing adequately. needs supplemental oxygen. does not have an impending airway problem. 16.Assessment of the female genitalia: is not performed by the paramedic. is only necessary in pregnant patients. should be limited to inspection only. is a routine part of the physical exam. 17.Blood pressure is the product of: stroke volume and heart ventricular ejection fraction and afterload. cardiac output and peripheral vascular resistance. right atrial preload and ventricular stroke volume. 18.Clenching of the jaw muscles, as with chewing, is a function of which nerve? Abducens Trigeminal Hypoglossal Trochlear 19.Cognitive function can be defined as: one's state of awareness. the ability to use reasoning. functional use of the extremities. general level of consciousness. 20.Diffuse pain caused by hollow organ obstruction and stretching of the smooth muscle wall is considered to be which type of pain?Somatic Referred Radiating Visceral 21.Distention of the jugular veins indicates: a state of hypovolemia. left-sided heart failure. decreased venous pressure. increased venous capacitance. 22.Documentation of your physical examination should be: subjective in all regards. factual and nonjudgmental. representative of your perceptions. reviewed by the EMS administrator.23.Flushed skin is commonly seen as a result of: high fever. liver dysfunction. excessive blood loss. vasoconstriction. 24.Frank blood or clear, watery fluid draining from the ear canal following head trauma is most suggestive of a(n): basilar skull fracture. orbital blowout fracture. fracture of the cribriform plate. ruptured tympanic membrane. 25.If a hostile family member abruptly terminates a conversation with you and suddenly leaves the room, you should: retreat to a place of safety and notify law enforcement personnel. ignore the family member's departure and continue to assess your patient. have your partner follow the person, while working to defuse the situation. ask the patient to follow the person in an attempt to reason with them.26.If a patient is able to shrug their shoulders and turn their head from left to right, which nerve is likely intact? Trigeminal Abducens Vestibulocochlear Spinal accessory 27.If your patient becomes seductive or makes sexual advances toward you, you should: continue providing care as usual. ensure that a witness is present at all times. ask your partner to assume care of the patient. threaten the patient with a sexual harassment lawsuit. 28.In contrast to dementia, delirium is: an acute change in mental status. characteristic of Alzheimer common in the elderly population. a gradual deterioration in cognitive function. 29.In prehospital care, the priorities of evaluation and treatment are based on: the degree of threat to the patient's life. your overall experience as a paramedic. the receiving physician's online orders. standard treatment guidelines and algorithms. 30.It is most important to identify the age and sex of your patient because: age and sex can change how your patient presents. the differential diagnosis is modified for older patients. this is required information for the patient care report. the patient should be assessed by a medic of the same sex. 31.It would most likely be necessary to ask a patient a direct question if: they are elderly and have more than one medical complaint. they are not providing usable facts about the are having chest pain and a heart attack must be ruled out. there are numerous family members and friends present at the scene. 32.Making your patient aware that you perceive something inconsistent with their behavior is called: clarification. confrontation. facilitation. interpretation. 33.Poor skin turgor in an infant or child is indicative of: shock. hypoxemia. dehydration. elastin deficiency. 34.Proper documentation of your physical examination of a patient is most important because it:becomes a permanent part of the patient's medical record and may be subjected to legal issues. reflects your subjective findings and forms the basis for your working field diagnosis of the patient. facilitates the paramedic's definitive diagnosis of the patient, leading to the most appropriate care. ensures an accurate historical accounting of the patient's problems prior to entering the hospital. 35.Pulse oximetry measures the percentage of: hemoglobin saturation. red blood cells in the blood. white blood cells in the blood. percentage of oxygen that reaches the cells. 36.Structural integrity of the pelvis should be assessed by: carefully rocking the pelvis back and forth. gently pushing in and down on the iliac crests. applying firm upward pressure to the pelvic wings. placing the patient on their side to elicit pain.37.Swollen lymph nodes in the anterior neck usually indicate: malignancy. an infection. viral replication. an allergic state. 38.Sympathetic nervous system hyperactivity causes: diaphoresis. bradycardia. vasodilation. warm, moist skin. 39.The Babinski sign, grasping, and sucking are: voluntary motor responses. abnormal findings in infants. examples of primitive of nervous system dysfunction. 40.The body's reaction to increased internal or external temperature would most likely cause the skin to become: warm and dry. hot and dry. pale and hot. hot and moist. 41.The history of present illness is defined as: the reason why the patient called EMS in the first place. a chronologic account of the patient's signs and symptoms. your perception of the severity of the patient's condition. a past medical problem that is causing the chief complaint. 42.The mnemonic OPQRST is a tool that: is only effective when assessing a patient who is experiencing severe pain. allows the paramedic to reach a field diagnosis quickly and initiate treatment. is used commonly to rule out conditions that are immediately life s an easy-to-remember approach to analyzing a patient's chief complaint. 43.The presence of rales during auscultation of the chest can indicate: heart failure. bronchospasm. cholecystitis. dehydration. 44.The presence of rhonchi during auscultation of the lungs is suggestive of: asthma. pneumonia. pneumothorax. toxic inhalation. 45.The residual pressure in the circulatory system while the left ventricle is relaxing is called the: pulse pressure. diastolic lic pressure. mean arterial pressure. 46.When caring for an unresponsive, critical trauma patient, a complete secondary assessment: will probably not be performed in its entirety. must be performed after the primary assessment. should be performed before you begin transport. will enable you to immediately detect life threats. 47.Where can paramedics check for pallor if a patient's natural skin tone is especially dark or light? sclera posterior patella nail beds tongue 48.Given the number of possible diagnoses in any situation and the limited physical and technical resources of the field, you will likely:regularly be treating patients who can only be diagnosed at the hospital. have difficulty providing supportive care secondary to medical ambiguity. regularly be able to formulate a definitive diagnosis of the patient's current condition. not be able to stabilize the patient's condition adequately in the field setting. 49.No matter how sure they are of the working diagnosis, the thinking paramedic must: confer with online medical control to confirm their diagnosis. always keep part of the thought process open to other possibilities. implement a treatment plan based solely on the working diagnosis. remain confident that their working diagnosis is an accurate one. 50.A negative attitude about any patient or patient care situation: constitutes negligence and carries legal ramifications. is usually not sensed by the patient because they are frightened. is often observed in paramedics with many years of experience. suggests that the care you provide will be suboptimalChapter 15 &16 Quiz 1. After inserting an oropharyngeal airway in an unresponsive woman, the patient begins to gag. You should: spray an anesthetic medication into her mouth. suction her oropharynx for up to 15 seconds. turn the patient on her side in case she vomits. remove the airway and have suction ready. 2. After inserting the ET tube between the vocal cords, you should: attach an ETCO2 detector to the tube. inflate the distal cuff with 5 to 10 mL of air. attach the bag-mask device and ventilate. secure the tube with a commercial device 3. After opening an unresponsive patient's airway, you determine that his respirations are rapid, irregular, and shallow. You should: suction his mouth for 15 seconds. apply a nonrebreathing ate him at once. begin positive-pressure ventilations. 4. After placing an ET tube, you suspect that the filter line from the capnography adaptor is occluded by blood or other secretions. What should you do in this situation? Use suctioning to remove the blood or other secretions. Remove half the amount of air from the distal cuff. Slowly retract the tube while simultaneously listening for breath sounds over the left side of the chest. Replace the in-line ETCO2 detector 5. After properly positioning the head for intubation, you should open the patient's mouth and insert the laryngoscope blade: in the midline of the mouth and gently lift upward on the tongue. in the midline of the mouth and gently sweep the tongue to the left. into the right side of the mouth and sweep the tongue to the left. into the left side of the mouth and move the blade to the midline. 6. After tracheobronchial suctioning is complete, you should:visualize the vocal cords to ensure that the tube is still in the correct position. hyperventilate the patient at 24 breaths/min for approximately 3 minutes. reattach the bag-mask device, continue ventilations, and reassess the patient. instill 3 to 5 mL of saline down the tube to loosen any residual secretions. 7. After you have intubated an apneic patient with chest trauma, your partner is auscultating breath sounds and tells you that breath sounds are faint on the right side of the chest. You should: increase the force of your ventilations as your partner reauscultates the lungs. immediately remove the ET tube and oxygenate the patient for 30 seconds. suspect that the patient has a pneumothorax on the right side of the chest. slightly withdraw the tube as your partner auscultates breath sounds. 8. An airway obstruction secondary to a severe allergic reaction: is treated effectively with abdominal thrusts. often responds well to humidified oxygen. is usually the result of pulmonary aspiration. requires specific and aggressive treatment.9. An ET tube that is too large for a patient: will lead to an increased resistance to airflow. is much more likely to enter the esophagus. can be difficult to insert and may cause trauma. will make ventilating the patient more difficult. 10. An increasing peak expiratory flow reading in a patient with respiratory distress suggests that the patient is: no longer experiencing bronchospasm. responding to bronchodilator therapy. in need of further bronchodilator therapy. experiencing worsened hypoxemia. 11. A patient with orthopnea: awakens at night with dyspnea. has blood-tinged sputum. is breathing through pursed dyspnea while lying flat. 12. Approximately 10 seconds into an intubation attempt, you catch a glimpse of the patient's vocal cords, but quickly lose sight of them. You should: gently pry back on the laryngoscope to improve your view of the upper airway. abort the intubation attempt and ventilate the patient with a bag-mask device. ask your partner to apply backward, upward, rightward pressure to the thyroid. sweep the patient's tongue to the right side of the mouth and revisualize. 13. Assessment of a patient in respiratory distress reveals capnographic waveforms that resemble a shark fin. What should you suspect? Hyperventilation Bronchospasm Heart failure Pneumonia 14. Assessment of a spontaneously perfusing patient's ETCO2 reveals small capnographic waveforms and a reading of 22 mm Hg. Which of the following does this indicate?Bradypnea Respiratory acidosis Hyperventilation Metabolic alkalosis 15. Asymmetric chest wall movement is characterized by: a part of the chest wall that bulges during exhalation. chest rise that is minimally visible. alternating movement of the chest and abdomen. one side of the chest moving less than the other. 16. Before intubating a patient who has been chemically sedated and paralyzed, it is most important for the paramedic to: suction the oropharynx to clear any secretions. administer 0.5 mg of atropine sulfate. adequately preoxygenate with 100% ventilate the patient at 24 breaths/min 17. Before performing orotracheal intubation, it is most important for the paramedic to: apply a pulse oximeter to the patient. wear gloves and facial protection. monitor the patient's cardiac rhythm. preoxygenate with a bag-mask device. 18. Biot respirations are characterized by: slow, shallow irregular respirations or occasional gasping breaths. deep, gasping respirations that are often rapid but may be slow. increased respirations followed by apneic periods. an irregular pattern of breathing with intermittent periods of apnea. 19. Capnography can serve as an indicator of: chest compression effectiveness. cerebral perfusion ary perfusion pressure. proper ventilatory depth. 20. Compared to orotracheal intubation, nasotracheal intubation is less likely to result in hypoxia because: it does not involve direct visualization of the vocal cords. patients requiring nasotracheal intubation are usually stable. the procedure should be performed in less than 10 seconds. it must be performed on spontaneously breathing patients. 21. CPAP is not appropriate for patients with: acute or chronic bronchospasm. an oxygen saturation less than 90%. evidence of congestive heart failure. slow, shallow respiratory effort. 22. During tracheobronchial suctioning, it is most important to: apply suction for no longer than 5 seconds in the t 10 mL of saline down the ET tube to loosen secretions. monitor the patient's cardiac rhythm and oxygen saturation. avoid rotating the catheter as you are suctioning the trachea. 23. During ventilation with the LMA, the paramedic should: observe the patient for signs of inadequate ventilation. maintain the patient's head in a slightly flexed position. hyperventilate the patient to maximize tidal volume delivery. suction the patient's oropharynx at least every 2 minutes. 24. Face-to-face intubation may be performed in which of the following situations? When the patient has blood-clotting abnormalities or they are taking anticoagulation medications When the patient is in the supine position and weighs more than 200 pounds When a seated patient suddenly becomes unconscious and apneic When you see a soft-tissue bulge on either side of the airway 25. How does the i-gel differ from the LMA? The i-gel has a noninflatable mask.The lumen of the i-gel is smaller than the LMA. The i-gel comes in only two sizes. The i-gel mask holds more air than the LMA. 26. Hyperventilating an apneic patient: reduces the incidence of gastric distention. may decrease venous return to the heart. is beneficial if the pulse rate is too slow. is appropriate if the patient is an adult. 27. If a patient has a stoma and no tracheostomy tube in place: ventilations can be performed by placing a mask over the stoma. you should not seal the nose and mouth when ventilating. you must perform a head tilt–chin lift maneuver before ventilating. suctioning of the stoma must be performed before ventilating.28. If chest compressions and repositioning of the airway are unsuccessful in removing a severe airway obstruction in an unconscious patient, you should: perform laryngoscopy and use Magill forceps. gain airway access via the cricothyroid membrane. perform a blind finger sweep of the mouth. alternate chest compressions and abdominal thrusts. 29. If return of spontaneous circulation (ROSC) occurs, which of the following ETCO2 findings would you expect to encounter? A progressive decrease in the ETCO2 reading Complete loss of a capnographic waveform An abrupt and sustained increase in ETCO2 Capnographic waveforms that get smaller 30. If the ET tube is placed in the trachea properly, the colorimetric paper inside the carbon dioxide detector should: not change colors. turn yellow during yellow during inhalation. remain purple during ventilations. 31. If the patient's oxygen saturation drops at any point during rapid sequence intubation, you should: abort the intubation attempt and ventilate with a bag-mask device. stop and hyperventilate the patient at a rate of 24 breaths/min. continue the intubation attempt and monitor the cardiac rhythm closely. apply posterior cricoid pressure and continue the intubation attempt. 32. In contrast to a curved laryngoscope blade, a straight laryngoscope blade is designed to: extend beneath the epiglottis and lift it up. fit into the vallecular space at the base of the tongue. move the patient's tongue to the left. indirectly lift the epiglottis to expose the vocal cords. 33. In contrast to a needle cricothyrotomy, a surgical cricothyrotomy: is easier to perform in children younger than 8 years of es the paramedic to provide greater tidal volume. involves the use of a high-pressure jet ventilator. is the preferred technique in patients with short, fat necks. 34. In contrast to negative-pressure ventilation, positive-pressure ventilation occurs when: air is drawn into the lungs. intrathoracic pressure falls. air is forced into the lungs. the diaphragm contracts. 35. In which of the following conditions would you likely encounter pulsus paradoxus? Moderate asthma attack Compensated respiratory acidosis Minor asthma attack Pericardial tamponade36. It would be appropriate to insert a nasopharyngeal airway in patients who: have CSF leakage from the nose and are semiconscious. are unresponsive with multiple facial bone fractures. have an altered mental status with an intact gag reflex. are semiconscious with active vomiting and cyanosis. 37. Laryngospasm is defined as: voluntary closure of the glottic opening. aspiration of foreign material. spontaneous collapsing of the trachea. spasmodic closure of the vocal cords. 38. Neuromuscular blocking agents: have a negative effect on both cardiac and smooth muscle and commonly cause dysrhythmias. are most commonly used as the sole agent to facilitate placement of an ET rt a breathing patient with a marginal airway into an apneic patient with no airway. induce total body paralysis within 10 to 15 minutes following administration via IV push 39. Poor lung compliance during your initial attempt to ventilate an unconscious, apneic adult should be treated by: reopening the airway and reattempting to ventilate. administering 15 subdiaphragmatic thrusts at once. performing 30 chest compressions and reassessing. sweeping the patient's mouth with your fingers. 40. Supplemental oxygen is indicated for any patient with: a syncopal episode. cardiac chest pain. ischemic stroke. respiratory distress. 41. The main disadvantage of the LMA is that it: is associated with significant upper airway aneously dislodges in the majority of patients. does not provide protection against aspiration. is technically more difficult to perform than intubation. 42. The opening on the distal side of an ET tube allows ventilation to occur: even if the ET tube does not enter the patient's trachea fully. even if the tip of the tube is occluded by blood or mucus. whether the tube is in the trachea or in the esophagus. if the tube is inserted into the right mainstem bronchus. 43. Therapeutic effects of CPAP include: forcing of fluid into the alveoli. opening of collapsed alveoli. increased intrathoracic pressure. increased alveolar surface tension. 44. The Venturi mask is most useful in the prehospital setting when:a COPD patient requires a long-range transport. high-flow oxygen is required for severe hypoxia. a patient requires less than 15% oxygen. a patient cannot tolerate a nonrebreathing mask. 45. When inserting a stylet into an ET tube, you must ensure that: the tube is bent in the form of a U to facilitate placement. you use a petroleum-based gel to facilitate easy removal. the stylet is rigid and does not allow the ET tube to bend. the stylet rests at least half an inch back from the end of the tube. 46. When replacing a dislodged tracheostomy tube, it is most important that you: insert the tube 2 cm beyond the cuff. use a tracheostomy tube of the same size. lubricate the tube before insertion. take appropriate standard precautions.47. When the King LT airway is properly placed, the distal cuff seals the: esophagus. oropharynx. larynx. nasopharynx. 48. Which of the following findings is most significant in a patient with acute respiratory distress? A regular heart rate of 110 beats/min Low-grade fever and flulike symptoms Prior ICU admission for the same problem A family history of pulmonary embolism 49. Which of the following statements regarding anemia is correct? Patients with anemia have a chronically high level of hemoglobin. Anemia is a condition caused exclusively by a deficiency of iron.Anemia results in a decreased ability of the blood to carry oxygen. Anemic patients typically present with flushed skin and bradycardia. 50. You should be suspicious of tube misplacement following a surgical cricothyrotomy if: a crackling sensation is noted when palpating the neck. there is minimal rise of the chest during ventilations. bleeding from the subcutaneous tissues is observed. progressive redness is noted around the insertion site.Chapter 17 Quiz 1. A 21-year-old woman experienced an acute onset of pleuritic chest pain and dyspnea while playing softball. She is noticeably dyspneic, has an oxygen saturation of 93% on room air, and has diminished breath sounds to the upper right lobe. Appropriate treatment for this patient involves: applying a CPAP unit and starting an IV line en route to the hospital. administering high-flow supplemental oxygen and transporting at once. assisting with ventilations in order to increase her oxygen saturation. performing a needle decompression to the right side of her chest. 2. A 36-year-old man with a history of asthma presents with severe respiratory distress. You attempt to administer a nebulized beta-2 agonist, but his poor respiratory effort is inhibiting effective drug delivery via the nebulizer and his mental status is deteriorating. You should: start an IV of normal saline and administer a steroid. apply high-flow oxygen via a nonrebreathing mask. assist him with a metered-dose inhaler bronchodilator. assist his ventilations and establish vascular access. 3. A 66-year-old man with chronic bronchitis presents with severe respiratory distress. The patient's wife tells you that he takes medications for high blood pressure and bronchitis, is on home oxygen therapy, and has recently been taking an over-the-counter antitussive. She further tells you that he has not been compliant with his oxygen therapy. Auscultation of his lungs reveals diffuse rhonchi. What is the likely cause of this patient's respiratory distress?Recent antitussive use Oxygen noncompliance An underlying infection Acute right heart failure 4. A 76-year-old woman lying in bed presents with respiratory distress that has worsened progressively over the past 2 days. She is breathing through pursed lips and has a prolonged expiratory phase and an oxygen saturation of 76%. She has emphysema and is on home oxygen at 2 L/min. Your initial action should be to: increase her oxygen flow rate to 6 L/min. place her in a position that facilitates breathing. administer a beta-2 agonist via nebulizer. auscultate her lungs for adventitious breath sounds. 5. Abnormal breath sounds associated with pneumonia and congestive heart failure are most often heard in the: apices of the lungs. right middle lobe. bases of the illary line. 6. A hyperventilating patient: may be acidotic and trying to increase their pH level. should rebreathe their carbon dioxide to effect resolution. is most effectively treated by administering a sedative drug. presents with tachypnea and marked use of accessory muscles. 7. A known heroin abuser is found unconscious on a park bench. Your assessment reveals that his respirations are slow and shallow, and his pulse is slow and weak. You should: suction his oropharynx, perform intubation, and then administer naloxone via slow IV push. preoxygenate him with a bag-mask device for 2 to 3 minutes and then intubate his trachea. assist ventilations with a bag-mask device, administer naloxone, and reassess his ventilatory status. apply oxygen via nonrebreathing mask, administer naloxone, and be prepared to assist ventilations. 8. An elderly woman with COPD presents with peripheral edema. The patient is conscious but agitated. She is breathing with slight difficulty but has adequate tidal volume. During your assessment, you note that her jugular veins engorge when you apply pressure to her right upper abdominal quadrant. She tells you that she takes a “water pill” and Vasotec for high blood pressure. You should: expect to hear crackles when you auscultate her ude that she has been noncompliant with her diuretic. suspect acute right-sided heart failure and administer oxygen. start an IV of normal saline and give her a 250-mL bolus 9. A patent airway: does not equate to adequate ventilation. should be prophylactically suctioned. is evidenced by visible chest rise. is characterized by adequate tidal volume. 10.A patient who is coughing up purulent sputum is likely experiencing: dehydration. an infection. pulmonary edema. emphysema. 11.A patient with a history of asthma is at greatest risk for respiratory arrest if they: have used their inhaler twice in the previous a bronchodilator and a corticosteroid. were recently evaluated in an emergency department. were previously intubated for their condition. 12.A patient with quiet tachypnea suggests: asthma. airway swelling. alkalosis. shock. 13.A patient with respiratory distress who is willing to lie flat: has minimal fluid in the lungs. should be intubated at once. may be acutely deteriorating. likely has basilar pneumonia. 14.A patient with status asthmaticus commonly presents with:compensatory respiratory alkalosis and stridor. audible expiratory wheezing and severe cyanosis. accessory muscle use and inspiratory wheezing. physical exhaustion and inaudible breath sounds. 15.A pulse oximetry reading would be least accurate in a patient: with poor peripheral perfusion. with persistent tachycardia. with chronic hypoxia. whose extremities are cool. 16.Bedridden patients who are immunocompromised and have excessive pulmonary secretions are prone to developing: pneumonia. a pulmonary embolism. a pneumothorax. bronchospasm. 17.COPD is characterized by:widespread alveolar collapse due to increased pressure during the exhalation phase. small airway spasms during the inhalation phase, resulting in progressive hypoxia. changes in pulmonary structure and function that are progressive and irreversible. narrowing of the smaller airways that is often reversible with prompt treatment 18.CPAP is used to treat patients with sleep apnea by: increasing the rate and depth of ventilation, thus improving minute volume and mitigating hypoxia. improving patency of the lower airway through the use of positive end-expiratory pressure. maintaining stability of the posterior pharynx, thereby preventing upper airway obstruction. delivering one pressure during the inspiratory phase and a different pressure during the expiratory phase. 19.Digital clubbing is indicative of: right heart failure. peripheral vascular disease. acute hypoxemia. chronic hypoxia. 20.Frothy sputum that has a pink tinge indicates:chronic bronchitis. tuberculosis. congestive heart failure. antihistamine use. 21.Hepatojugular reflux occurs when: a patient's jugular veins are markedly engorged when lying in a supine position. the jugular veins collapse in response to palpation of the right upper quadrant. left-sided heart failure causes blood to accumulate in the patient's liver. mild pressure placed on the patient's liver further engorges the jugular veins 22.Hepatomegaly and jugular venous distention are suggestive of: severe pneumonia. pulmonary edema. right-sided heart failure. left-sided heart failure. 23.If a patient's hemoglobin level is 8 g/dL due to hemorrhage and all of the hemoglobin molecules are attached to oxygen, the patient's oxygen saturation would likely read:significantly lower than 85%. between 85% and 90%. between 90% and 95%. above 95%. 24.In which situation would Cheyne-Stokes respirations be considered an ominous finding? Obstructive sleep apnea Apneic periods less than 5 seconds Traumatic brain injury Alcohol intoxication 25.Paradoxical respiratory movement is characterized by: bulging of the intercostal muscles during deep inhalation. the epigastrium and thorax moving in opposite directions. a marked decrease in movement in one of the hemithoraces. pulling upward of the suprasternal notch during inhalation.26.Patients with COPD typically experience an acute exacerbation of their condition because of: chronic noncompliance with their prescribed medications and home oxygen. progressively worsening pneumonia that results in a diminished cough reflex. a secondary condition such as congestive heart failure or a pneumothorax. environmental changes such as weather or the inhalation of trigger substances. 27.Patients with decompensated asthma or COPD who require positive-pressure ventilation: should be ventilated routinely at a rate that is slightly faster than the rate for a patient without an underlying pulmonary disease. should be given forceful positive-pressure breaths because their primary problem is difficulty with inhalation. should be intubated promptly and ventilated at a rate of 20 to 24 breaths/min to eliminate excess carbon dioxide. may develop a pneumothorax or experience a decrease in venous return to the heart if they are ventilated too rapidly. 28.Patients with respiratory failure require immediate: ventilation support. tracheal intubation. passive oxygenation. bronchodilator therapy.29.Pickwickian syndrome is a condition in which respiratory compromise results from: pulmonary edema. extreme obesity. cervical spine injury. diaphragmatic rupture. 30.Pneumonitis is especially common in older patients with: a history of a stroke. immunocompromise. chronic food aspiration. frequent infections. 31.Residual corticosteroid in the pharynx following a metered-dose inhaler treatment can predispose the patient to: thrush. bronchospasm. gospasm. 32.The barrel-chest appearance classically seen in patients with emphysema is secondary to: widespread atelectasis. chest wall hypertrophy. carbon dioxide retention. air trapping in the lungs. 33.The classic presentation of chronic bronchitis is: a dry, hacking cough and a barrel chest due to chronic pulmonary air trapping. expiratory wheezing and jugular venous distention due to pulmonary hypertension. excessive mucus production and a chronic or recurrent productive cough. a thin adult with pursed-lip breathing and a history of heavy cigarette smoking. 34.The most clinically significant finding when questioning a patient with a chronic respiratory disease is: prior intubation for the same problem. a recent emergency department visit. medication use prior to your arrival.a recent medication regimen change. 35.The presence of diffuse rhonchi (low-pitched crackles) in the lungs indicates: thick secretions in the large airways. air being forced through narrowed airways. right-sided congestive heart failure. isolated consolidation of secretions. 36.The primary treatment of bronchospasm is: corticosteroid therapy. humidified oxygen. assisted ventilation. bronchodilator therapy. 37.Use of an automated transport ventilator is contraindicated for patients who are: breathing spontaneously. apneic with a pulse. chemically cardiac arrest. 38.Use of a spacer device in conjunction with a metered-dose inhaler: collects medication as it is released from the canister, allowing more to be delivered to the lungs and less to be lost to the environment. requires the patient to time their inhalation to coincide with the discharge of the metered-dose inhaler. is only indicated in children younger than 6 years of age, who are generally not able to use the inhaler effectively. may be required when assisting a patient who is breathing inadequately, but generally results in less medication delivery to the lungs. 39.Wheezing is resolved with medications that: relax the smooth muscle of the bronchioles. reduce soft-tissue swelling in the larynx. dry up secretions in the lower airway. cause bronchoconstriction and improved airflow. 40.When auscultating the lungs of a patient with early pulmonary edema, you will likely hear: faint rhonchi to all lung fields on inspiration and expiration. inspiratory rhonchi to the bilateral apices of the e crackles to the bases of the lungs during inspiration. crackles in the bases of the lungs at the end of inspiration. 41.When present at low levels, oxygen binds easily to hemoglobin molecules, resulting in: small changes in oxygen saturation when small changes in PaO2 occur. large changes in oxygen saturation when small changes in PaO2 occur. small changes in oxygen saturation when large changes in PaO2 occur. large changes in oxygen saturation when large changes in PaO2 occur. 42.Which of the following conditions would likely cause hyperpnea? Heroin overdose Hypoglycemia Increased intracranial pressure Overdose of prescribed insulin 43.Which of the following conditions would likely present with a rapid onset of dyspnea? COPD Pulmonary embolismPneumonia Asthma 44.Which of the following is a common clinical finding in patients with obstructive lung disease? Pursed-lip breathing Respiratory acidosis Hyperventilation Decreased expiratory phase 45.Which of the following statements regarding epiglottitis is correct? Epiglottitis has become relatively rare in children due to vaccinations against the Haemophilus influenzae type b bacterium. Most cases of epiglottitis are progressive in their onset and result in severe swelling of the larynx, trachea, and bronchi. Characteristic signs of epiglottitis include a low-grade fever, a seal-like barking cough, and varying degrees of respiratory distress. Unlike croup, epiglottitis most commonly occurs in the middle of the night, when the outside temperature is cool. 46.Which of the following types of medications are contraindicated for patients who are coughing up thick pulmonary secretions? DiureticsBronchodilators Antihistamines Antitussives 47.Which type of respirations are characterized by a grossly irregular pattern of breathing that may be accompanied by lengthy periods of apnea? Biot Agonal Eupneic Cheyne-Stokes 48.With regard to pulse oximetry, the more hypoxic a patient becomes: the faster they will desaturate. the slower their PaO2 will fall. the slower they will desaturate. the less reliable the pulse oximeter is. 49.You are dispatched to a residence for a 59-year-old man with difficulty breathing. The patient, who has a history of COPD, is conscious and alert. During your assessment, he tells you that he developed chills, fever, and a productive cough 2 days ago. Auscultation of his lungs reveals rhonchi to the left lower lobe. This patient is likely experiencing:end-stage COPD. bronchitis. COPD exacerbation. pneumonia. 50.You would likely observe a grossly low respiratory rate and volume in a patient who overdosed on: heroin. ibuprofen. LSD. ProzacChapter 18 Quiz 1 1. A 40-year-old man is in cardiac arrest. Your partner is performing CPR. You are attaching the AED when the patient's wife tells you that he has an automatic implantable cardiac defibrillator (AICD). The AED advises that a shock is indicated. What should you do? Continue CPR and transport the patient to the closest appropriate hospital. Deliver the shock followed by immediate resumption of CPR. Avoid defibrillation because this will damage the patient's AICD. Contact medical control and request permission to defibrillate. 2. A 49-year-old male presents with an acute onset of crushing chest pain and diaphoresis. You should: obtain vital signs and a SAMPLE history. assess the adequacy of his respirations. administer up to 324 mg of baby aspirin. administer up to three doses of nitroglycerin. 3. A 66-year-old woman presents with a stabbing pain in the middle of her chest that radiates to her back. She tells you that the pain suddenly began about 30 minutes ago and has been severe since the onset. She has a history of hypertension, but admits to being noncompliant with her antihypertensive medications. When you assess her, you find that her blood pressure is significantly higher in her left arm than it is in her right arm. What do these signs and symptoms MOST likely indicate? Unstable anginaAcute myocardial infarction Dissecting aortic aneurysm Hypertensive emergency 4. A 67-year-old female with severe chest pain becomes unresponsive, pulseless, and apneic during transport. You should: alert the receiving hospital and perform CPR for the duration of the transport. defibrillate with the AED while continuing transport to the hospital. stop the ambulance, begin CPR, and attach the AED as soon as possible. perform CPR for 1 to 2 minutes and then analyze her rhythm with an AED. 5. Acute coronary syndrome (ACS) is a term used to describe: a severe decrease in perfusion caused by changes in heart rate. the exact moment that a coronary artery is completely occluded. the warning signs that occur shortly before a heart attack. a group of symptoms that are caused by myocardial ischemia. 6. A dissecting aortic aneurysm occurs when: a weakened area develops in the aortic layers of the aorta suddenly contract. the aorta ruptures, resulting in profound bleeding. the inner layers of the aorta become separated. 7. After the AED has delivered a shock, you should: transport the patient at once. re-analyze the cardiac rhythm. immediately resume CPR. assess for a carotid pulse. 8. An acute myocardial infarction (AMI) occurs when: myocardial tissue dies secondary to an absence of oxygen. the entire left ventricle is damaged and cannot pump blood. coronary artery dilation decreases blood flow to the heart. the heart muscle progressively weakens and dysfunctions. 9. Angina pectoris occurs when: myocardial oxygen demand exceeds rdial oxygen supply exceeds the demand. one or more coronary arteries suddenly spasm. a coronary artery is totally occluded by plaque. 10.A patient tells you that he has a left ventricular assist device (LVAD). Which of the following conditions should you suspect that he has experienced in the past? Uncontrolled hypertension Acute myocardial infarction Thoracic aortic aneurysm Obstructive lung disease 11.A patient with a left ventricular assist device (LVAD) tells you that the device's pump flow is continuous. Which of the following should you expect to encounter during your assessment? Absence of a palpable pulse High systolic blood pressure Distention of the jugular veins Low diastolic blood pressure 12.A patient with atherosclerotic heart disease experiences chest pain during exertion because:the lumen of the coronary artery is narrowed and cannot accommodate increased blood flow. the coronary arteries suddenly spasm and cause a marked reduction in myocardial blood flow. the ragged edge of a tear in the coronary artery lumen causes local blood clotting and arterial narrowing. tissues of the myocardium undergo necrosis secondary to a prolonged absence of oxygen 13.A percutaneous transluminal coronary angioplasty (PTCA) restores blood flow to the ischemic myocardium by: scraping fatty deposits off of the lumen of the coronary artery. placing a stent inside the coronary artery to keep it from narrowing. bypassing the coronary artery with a vessel from the chest or leg. dilating the affected coronary artery with a small inflatable balloon. 14.Blood that is ejected from the right ventricle: has a high concentration of oxygen. flows into the pulmonary arteries. enters the systemic circulation. was received directly from the aorta. 15.Cardiac output may decrease if the heart beats too rapidly because:the volume of blood that returns to the heart is not sufficient with fast heart rates. a rapid heartbeat causes a decrease in the strength of cardiac contractions. there is not enough time in between contractions for the heart to refill completely. as the heart rate increases, more blood is pumped from the ventricles than the atria 16.Cardiogenic shock following AMI is caused by: decreased pumping force of the heart muscle. hypovolemia secondary to severe vomiting. a profound increase in the patient's heart rate. widespread dilation of the systemic vasculature. 17.Common side effects of nitroglycerin include all of the following, EXCEPT: hypertension. hypotension. severe headache. bradycardia. 18.Common signs and symptoms of a hypertensive emergency include: tachycardia, pain behind the eyes, and r, cool skin, and a temporary loss of hearing. a bounding pulse, a severe headache, and dizziness. syncope, a weak pulse, and bleeding from the ears. 19.Deoxygenated blood from the body returns to the: left ventricle. right atrium. right ventricle. left atrium. 20.During your treatment of a woman in cardiac arrest, you apply the AED, analyze her cardiac rhythm, and receive a "no shock advised" message. This indicates that: she is not in ventricular fibrillation. she has a pulse and does not need CPR. the AED has detected asystole. the AED detected patient motion. 21.In contrast to AMI, a dissecting aortic aneurysm: is more commonly associated with pressure in the typically preceded by other symptoms, such as nausea. usually presents gradually, often over a period of hours. often presents with pain that is maximal from the onset 22.In contrast to an automatic implantable cardiac defibrillator (AICD), an external defibrillator vest: delivers high-energy shocks, similar to an AED. does not warn when a shock is about to be delivered. will only deliver a shock if ventricular fibrillation occurs. does not require the EMT to stand clear when it shocks. 23.In contrast to the sympathetic nervous system, the parasympathetic nervous system: causes an increase in the heart rate. dilates the blood vessels in the muscles. slows the heart and respiratory rates. prepares the body to handle stress. 24.Ischemic heart disease is defined as:death of a portion of the heart muscle due to a decrease in oxygen. decreased blood flow to the heart muscle due to coronary dilation. decreased blood flow to one or more portions of the myocardium. absent myocardial blood flow due to a blocked coronary artery. 25.Most AEDs are set up to adjust the voltage based on the impedance, which is the: distance between the two AED pads on the chest. actual amount of energy that the AED will deliver. direction that the electrical flow takes in the body. resistance of the body to the flow of electricity. 26.Narrowing of the coronary arteries caused by a buildup of fatty deposits is called: angina pectoris. arteriosclerosis. atherosclerosis. acute ischemia. 27.Nitroglycerin relieves cardiac-related chest pain by:increasing the amount of stress that is placed on the myocardium. dilating the coronary arteries and improving cardiac blood flow. constricting the coronary arteries and improving cardiac blood flow. contracting the smooth muscle of the coronary and cerebral arteries. 28.Risk factors for AMI that cannot be controlled include: lack of exercise. hyperglycemia. family history. excess stress. 29.The ability of cardiac muscle cells to contract spontaneously without a stimulus from a nerve source is called: impulsivity. automaticity. contractility. excitability. 30.The electrical stimulus that originates in the heart's primary pacemaker is controlled by impulses from the brain that arrive by way of the:parietal lobe. somatic nervous system. pons and medulla. autonomic nervous system. 31.The head and brain receive their supply of oxygenated blood from the: brachial arteries. carotid arteries. iliac arteries. subclavian arteries. 32.The inferior vena cava returns deoxygenated blood to the right side of the heart from all of the following areas, EXCEPT the: kidneys. brain. legs. abdomen. 33.The left ventricle has the thickest walls because it:pumps blood into the aorta and systemic circulation. receives blood directly from the systemic circulation. pumps blood to the lungs to be reoxygenated. uses less oxygen than other chambers of the heart. 34.The myocardium receives oxygenated blood from the __________, which originate(s) from the __________. aorta, inferior vena cava coronary arteries, aorta coronary sinus, vena cava vena cava, coronary veins 35.The posterior tibial pulse can be palpated: between the trachea and the neck muscle. behind the medial malleolus, on the inside of the ankle. in the fossa behind the knee. on the dorsum of the foot. 36.The purpose of defibrillation is to:cause a rapid decrease in the heart rate of an unstable patient. prevent asystole from deteriorating into ventricular fibrillation. improve the chance of CPR being successful in resuscitation. stop the chaotic, disorganized contraction of the cardiac cells. 37.The right coronary artery supplies blood to the: left ventricle and inferior wall of the right atrium. right atrium and posterior wall of the right ventricle. right ventricle and inferior wall of the left ventricle. left ventricle and posterior wall of the right ventricle. 38.Ventricular tachycardia causes hypotension because: blood backs up into the lungs and causes congestion. the volume of blood returning to the atria increases. the right ventricle does not adequately pump blood. the left ventricle does not adequately fill with blood. 39.When an electrical impulse reaches the AV node, it is slowed for a brief period of time so that:the impulse can spread through the Purkinje fibers. blood returning from the body can fill the atria. blood can pass from the atria to the ventricles. the SA node can reset and generate another impulse. 40.When preparing to obtain a 12-lead ECG, the V 1 and V 2 electrodes should be placed: on either side of the sternum. in the midaxillary line. on the left and right arms. in the midclavicular line. 41.Which of the following blood vessels transports oxygenated blood? Superior vena cava Inferior vena cava Pulmonary veins Pulmonary arteries 42.Which of the following cardiac dysrhythmias has the greatest chance of deteriorating into a pulseless rhythm?Sinus bradycardia Sinus tachycardia Ventricular tachycardia Extra ventricular beats 43.Which of the following is the MOST likely cause of artifact on an ECG tracing? Abnormal cardiac electrical activity Excessive movement of the patient Irregular patient pulse Incorrect placement of the leads 44.Which of the following is the MOST reliable method of estimating a patient's cardiac output? Listen to heart sounds with a stethoscope. Assess the heart rate and strength of the pulse. Determine the average diastolic blood pressure. Connect the patient to an electrocardiogram. 45.Which of the following signs is commonly observed in patients with rightsided heart failure?Pulmonary edema Flat jugular veins Labored breathing Dependent edema 46.Which of the following veins is located inferior to the trunk? Subclavian Saphenous Cephalic Axillary 47.Which of the following would cause the greatest increase in cardiac output? Decreased stroke volume and increased heart rate Decreased stroke volume and decreased heart rate Increased heart rate and increased stroke volume Decreased heart rate and increased stroke volume 48.You and your partner arrive at the scene of a middle-aged man who collapsed about 5 minutes ago. He is unresponsive, apneic, and pulseless. Bystanders are present, but have not provided any care. You should:begin high-quality CPR and apply the monitor as soon as possible. perform two-rescuer CPR for 5 minutes and request backup. immediately apply the EKG and analyze his cardiac rhythm. have your partner perform CPR while you question the bystanders. 49.You are assessing a 49-year-old man who complains of chest pressure that began the night before. He is conscious, but anxious, and tells you he has a history of angina and hypertension. You expose his chest to auscultate his lungs and note that he has a nitroglycerin patch on his right upper chest. His skin is cool and pale, his blood pressure is 78/50 mm Hg, and his pulse is 110 beats/min and irregular. You should: move the nitroglycerin patch to the other side of his chest and administer oxygen. remove the nitroglycerin patch, administer oxygen, and place him in a supine position. remove the nitroglycerin patch and apply the AED in case he develops cardiac arrest. complete your secondary assessment and reassess his blood pressure in 5 minutes. 50.You are dispatched to a residence for a 56-year-old male with an altered mental status. Upon arrival at the scene, the patient's wife tells you that he complained of chest pain the day before, but would not allow her to call EMS. The patient is semiconscious; has rapid, shallow respirations; and has a thready pulse. You should: attach the AED immediately. obtain baseline vital signs. apply a nonrebreathing ventilatory assistanceChapter 18 Quiz 2 1. Which of the following risk factors is most strongly correlated with risk of cardiovascular disease? Oral contraceptive use Stress Type A personality Lack of exercise 2. Public health prevention efforts for cardiovascular disease focus on these education topics: Risk factors and signs and symptoms of CVD. CPR and public access defibrillation. CPR and signs and symptoms of CVD. Risk factors and public-access defibrillation. 3. Blood entering the left atrium arrives via the: bicuspid valve. pulmonary nary artery. superior and inferior vena cava. 4. The pressure in the left ventricle at the end of diastole is called: afterload. preload. stroke volume. ejection fraction. 5. For a resting potential in a cardiac cell to exist, there must be an: adequate number of potassium ions inside the cell and sodium ions outside the cell. ionic equilibrium between the inside and outside of the cell. adequate number of sodium ions inside the cell and potassium ions outside the cell. influx of calcium ions into the cell. 6. The proportion of the left ventricular volume that is pumped out of the heart during systole is the: e volume. afterload. ejection fraction. 7. Beta-blockers generally have which of the following effects? Increased myocardial contractility. Decreased myocardial contractility. Vasoconstriction. Increased cardiac conduction. 8. When the ECG paper is traveling at the standard rate of 25 mm/sec, a large box in the horizontal direction equals: 0.20 seconds. 0.08 seconds. 0.12 seconds. 0.24 seconds. 9. Prior to any compensation, which of the following will most likely occur due to an increase in peripheral vascular resistance? Increased preload.Increased ejection fraction. Decreased afterload. Decreased stroke volume. 10.If the stroke volume decreased, which of the following would occur to maintain the blood pressure at its current value? Increased heart rate and increased peripheral vascular resistance. Decreased heart rate and increased peripheral vascular resistance. Decreased heart rate and decreased peripheral vascular resistance. Increased heart rate and decreased peripheral vascular resistance. 11.You have administered a drug with potent beta-1 effects. Which of the following effects should you most anticipate? Peripheral vasoconstriction. Increased heart rate. Smooth muscle relaxation. Peripheral vasodilation. 12.You have administered a medication to a patient, resulting in a decreased speed of cardiac impulse conduction. This drug is most accurately described as having a ________ ive dromotropic positive chronotropic negative dromotropic negative chronotropic 13.Which of the following endocrine substances acts as a marker for congestive heart failure? Angiotensin ACTH Troponin BNP 14.To detect life-threatening cardiac dysrhythmias, the paramedic should view which lead? one twelve three two15.The total duration of ventricular depolarization is represented by the ________ on the ECG. PQ interval QRS duration R-R interval QT interval 16.Which of the following statements concerning Q waves on the ECG is most accurate? The absence of a Q wave is a significant pathophysiological finding. Q waves are never a normal finding on the ECG. A Q wave is only significant in the presence of chest pain. A Q wave is significant if it is 0.04 or more seconds wide. 17.Which of the following is most characteristic of right heart failure? Rales, cough productive of blood-tinged sputum. JVD, peripheral edema, and pulmonary edema. JVD, peripheral edema, and liver and spleen engorgement. Ascites, peripheral edema, and cyanosis.18.Elastic and smooth muscle fibers are primarily found in the tunica ________ of blood vessels. intima adventitia media collateralus 19.Measures to treat cardiogenic shock include all of the following EXCEPT: increasing the contractile force. reducing peripheral resistance. reducing stroke volume. improving preload. 20.Which of the following is NOT considered a modifiable risk factor for coronary heart disease? Stress Obesity AgeDiet 21.An ECG monitor is useful for: detecting the total electrical activity within the heart. determining cardiac output. determining stroke volume. evaluating the effectiveness of cardiac contractions. 22.The heart sound produced by the closing of the aortic and pulmonary valves is: S4. S1. S2. S3. 23.Release of acetylcholine at the neuroeffector junction would result in a(n): increase of both sympathetic and parasympathetic tone. positive dromotropic ive inotropic effect. negative chronotropic effect. 24.Auscultation of an S3 is associated with: congestive heart failure. increased force of atrial contraction. aortic stenosis. mitral valve prolapse. 25.The base of the heart lies at the level of the ________ rib. third fourth first second 26.Which of the following occurs during depolarization of a cardiac cell? The cell becomes relatively more positively charged. Sodium moves out of the cell.The cell becomes negatively charged. Potassium moves into the cell. 27.The amount of resistance that must be overcome by the left ventricle during systole is called: stroke volume. afterload. cardiac output. preload. 28.The QRS complex represents: ventricular repolarization. atrial repolarization. atrial depolarization. ventricular depolarization. 29.Stroke volume × heart rate × systemic vascular resistance = cardiac output. ejection -diastolic pressure. blood pressure. 30.Common chief complaints and symptoms associated with cardiac disease include all of the following EXCEPT: dyspnea. chest pain. syncope. vertigo. 31.The mitral valve is also known as the ________ valve. pulmonic tricuspid left atrioventricular right atrioventricular 32.A decrease in preload results in a(n): increase in stroke ase in afterload. decrease in cardiac output. decrease in peripheral vascular resistance. 33.The predominant effect of a drug with primarily alpha properties would result in which of the following? Vasoconstriction Increased heart rate Decreased heart rate Vasodilation 34.Which of the following is the correct sequence of cardiac electrical activity? 1. AV node 2. Internodal pathways 3. Bundle of His 4. SA node 5. Purkinje fibers 6. Bundle branches 1, 2, 4, 3, 6, 5 4, 2, 1, 3, 6, 5 4, 1, 2, 3, 6, 5 1, 2, 4, 3, 5, 635.Increased ________ does NOT occur due to increased venous return to the heart. afterload myocardial contraction stroke volume myocardial stretch 36.The single largest killer of Americans each year is: congestive heart failure. stroke. coronary artery disease. suicide. 37.The right atrioventricular valve is referred to as the ________ valve. aortic pulmonary bicuspid tricuspid38.The left atrioventricular valve is referred to as the ________ valve. pulmonary tricuspid aortic mitral 39.The right ventricle pushes blood to the lungs through the: pulmonary vena cava. pulmonary pathway. pulmonary artery. pulmonary vein. 40.Starling's law states that: the more the myocardial muscle is stretched, the greater the contraction. the preload determines the cardiac output. for every action, there is an equal and opposite reaction. the greater the contraction, the higher the afterload.41.Cardiac output is: stroke volume × heart rate. stroke volume × diastolic pressure. afterload × preload. heart rate × preload. 42.Blood pressure is defined as: stroke volume × diastolic pressure × SVE. heart rate × preload × SVR. afterload × preload × SVE. stroke volume × heart rate × SVR. 43.Cardiac muscle is different from smooth muscle in the fact that it has: different nerve pathways. peristalsis. There is no difference. automaticity.44.On an ECG tracing, positive impulses are seen as: ST segment. upward deflections. J point. downward deflections. 45.On an ECG tracing, negative impulses are seen as: ST segment. J point. upward deflections. downward deflections. 46.One small box on the ECG paper indicates: 0.20 seconds. 0.04 seconds. 4 seconds.2 seconds. 47.Atrial depolarization is represented on the ECG by the: J point. T wave. ORS. P wave. 48.Ventricular repolarization is represented on the ECG by the: J point. QRS complex. P wave. T wave. 49.Normal interval time for the PR interval is: 0.33-0.42 second. 1.20-2.00 seconds. 0.12-0.20 second.0.04-0.12 second. 50.Normal interval time for the QRS complex is: 0.12-0.20 second. 1.20-2.00 seconds. 0.04-0.12 second. 0.33-0.42 secondChapter 18 Quiz 3 1. According to the Einthoven triangle, lead II is assessed by placing the: positive lead on the left arm and the negative lead on the right arm. negative lead on the right arm and the positive lead on the left leg. positive lead on the left leg and the negative lead on the right arm. negative lead on the left arm and the positive lead on the left leg. 2. Acetylcholinesterase is a naturally occurring chemical that: increases epinephrine production. breaks down acetylcholine in the body. causes a natural slowing of the heart rate. stimulates activity of the vagus nerve. 3. A classic sign of atrial flutter is: an irregular but consistent R-R interval. the presence of sawtooth F waves.a ventricular rate less than 100 beats/min. a constant 2:1 conduction ratio. 4. A decreased cardiac output secondary to a heart rate greater than 150 beats/min is caused by: myocardial stretching due to increased preload. ectopic pacemaker sites in the atria or ventricles. decreases in stroke volume and ventricular filling. increased automaticity of the cardiac pacemaker. 5. A major complication associated with atrial fibrillation is: pulmonary congestion and hypoxemia. a profound increase in the atrial kick. clot formation in the fibrillating atria. a significant reduction in atrial filling. 6. An electrical wave moving in the direction of a positive electrode will: cause a negative deflection on the ECG.manifest with narrow QRS complexes. cause a positive deflection on the ECG. produce a significant amount of artifact. 7. A positive QRS deflection in lead I means the vector is heading toward the: left arm. left leg. right leg. right arm. 8. Approximately 70% to 80% of ventricular filling occurs: during systole. when the semilunar valves are open. when the AV valves close. passively.9. A regular cardiac rhythm with a rate of 104 beats/min, upright P waves, a PR interval of 0.14 seconds, and QRS complexes that measure 0.10 seconds should be interpreted as: sinus tachycardia. supraventricular tachycardia. normal sinus rhythm. junctional tachycardia. 10. A regular rhythm with inverted P waves before each QRS complex, a ventricular rate of 70 beats/min, narrow QRS complexes, and a PR interval of 0.16 seconds should be interpreted as a(n): supraventricular tachycardia. junctional escape rhythm. ectopic atrial rhythm. accelerated junctional rhythm. 11. Atrial fibrillation can be interpreted by noting: PR intervals that vary from complex to complex. an irregularly irregular rhythm and absent P presence of wide QRS complexes and a rapid rate. a regularly irregular rhythm with abnormal P waves. 12. A wandering atrial pacemaker: is generally faster than 100 beats/min. is generally treated with atropine. may have variable PR intervals. has consistent P-wave shapes. 13. Bombardment of the AV node by more than one impulse, potentially blocking the pathway for one impulse and allowing the other impulse to stimulate cardiac cells that have already depolarized, is called: excitability. fusion. ectopy. reentry. 14. During the refractory period:the heart is in a state of partial repolarization. the heart muscle is depleted of energy and needs to recharge. the cell is depolarized or in the process of repolarizing. the heart is partially charged but cannot contract. 15. If a patient's ECG rhythm shows any artifact, you should: reverse the limb leads to obtain a clearer ECG tracing. place the ground lead in a different anatomic location. remove the negative lead and reassess the cardiac rhythm. ensure the electrodes are applied firmly to the skin. 16. In order to call a cardiac rhythm “paroxysmal” supraventricular tachycardia, you would have to: ask the patient when they began feeling palpitations. witness its onset and/or spontaneous termination. observe a consistent heart rate great