NREMT- Cardiology
NREMT- Cardiology
Study online at https://quizlet.com/_1ng0v0
1. In addition to chest pain or C; Chest pain, pressure, or discomfort is the most common
discomfort, a patient experi- symptom of acute coronary syndrome, or ACS (eg, unstable
encing an acute coronary syn- angina, acute myocardial infarction); it occurs in approxi-
drome would MOST likely pre- mately 80% of cases. Patients with ACS are usually anxious
sent with: and may have a feeling of impending doom. Nausea and
A: severe projectile vomiting vomiting are common complaints; however, projectile vom-
and flushed skin. iting, which is typically associated with increased intracranial
B: irregular breathing and low pressure, is uncommon. The skin is often ashen gray and
blood pressure. clammy (diaphoretic) because of poor cardiac output and
C: ashen skin color, diaphore- decreased perfusion. Less commonly, the patient's skin is
sis, and anxiety. cyanotic. Respirations are usually unlabored unless the pa-
D: profound cyanosis, dry skin, tient has congestive heart failure, in which case respirations
and a headache. are rapid and labored; irregular breathing, however, is not
common. Blood pressure may fall as a result of decreased
cardiac output; however, most patients will have a normal
or elevated blood pressure. If the patient complains of a
headache, it is usually a side effect of the nitroglycerin they
took before your arrival; ACS itself usually does not cause a
headache.
2. Which of the following patients C; Not all patients experiencing acute myocardial infarction
would MOST likely present with (AMI) present with the classic signs and symptoms one
vague or unusual symptoms would expect. Middle-aged men often minimize their symp-
of an acute myocardial infarc- toms and attribute their chest pain or discomfort to indiges-
tion? tion. Some patients, however, do not experience any pain.
A: 55-year-old obese female In particular, elderly women with diabetes may present with
B: 66-year-old male with angi- vague, unusual, or atypical symptoms of AMI; their only pre-
Page 1 of 52
, NREMT- Cardiology
NREMT- Cardiology
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na senting complaint may be fatigue or syncope. Do not rule out
C: 72-year-old female with dia- a cardiac problem just because a patient is not experiencing
betes chest pain, pressure, or discomfort; this is especially true in
D: 75-year-old male with hyper- elderly females with diabetes.
tension
3. During your assessment of a D; Patients with chest pain, pressure, or discomfort with a
70-year-old man with crushing systolic BP less than 100 mm Hg should be transported to
chest pain, you note that his the hospital without delay. Hypotension in a patient with
blood pressure is 80/50 mm chest pain indicates cardiogenic shock due to severe cardiac
Hg. Your MOST important ac- damage and requires treatment that can only be given at
tion should be to: the hospital. Any delay in transport delays definitive care and
A: assess his oxygen satura- increases the patient's chance of death. High-flow oxygen,
tion. thermal management, and assessment of oxygen saturation
B: keep the patient warm. are clearly important; however, your primary focus should be
C: give high-flow oxygen. to get the patient to the hospital as soon as possible.
D: transport without delay.
4. A 65-year-old man has gen- A; Aspirin has clearly been shown to reduce mortality and
eralized weakness and chest morbitiy associated with acute coronary syndrome (ACS) and
pressure. He has a bottle of should be given as early as possible; the dose is 160 to
prescribed nitroglycerin, but 325 mg. Even though this patient has chest pain and pre-
states that he has not taken any scribed nitroglycerin, you must first complete a secondary
of his medication. As your part- assessment and obtain baseline vital signs. Medical control
ner prepares to administer oxy- will need this information—specifically the patient's blood
Page 2 of 52
, NREMT- Cardiology
NREMT- Cardiology
Study online at https://quizlet.com/_1ng0v0
gen, you should: pressure—in order to determine whether you should assist
A: administer up to 325 mg of the patient with his nitroglycerin. The AED is not indicated for
aspirin if the patient is not aller- this patient because he is not in cardiac arrest.
gic to it.
B: perform a secondary assess-
ment and obtain baseline vital
signs.
C: apply the AED and pre-
pare the patient for immediate
transport.
D: assist the patient with his
nitroglycerin with medical con-
trol approval.
5. While transporting an elderly B; If a patient is found unresponsive or becomes unrespon-
woman who was complaining sive in your presence, your first action should be to assess
of nausea, vomiting, and weak- for breathing; this should be done by quickly (no more than
ness, she suddenly becomes 10 seconds) looking at the chest for obvious movement.
unresponsive. You should: If the patient is not breathing or only has agonal gasps,
A: analyze her heart rhythm you should check for a pulse for at least 5 seconds but no
with the AED. more than 10 seconds. If the patient has a pulse but is not
B: quickly look at her chest for breathing, open the airway and provide rescue breathing. If
obvious movement. the patient does not have a pulse, begin CPR (starting with
C: feel for a carotid pulse for at chest compressions), and apply the AED as soon as possible.
least 5 seconds. If you are transporting a patient who becomes unresponsive,
D: open her airway and ensure pulseless, and apneic, you should begin CPR and instruct
that it is clear. your partner to stop the ambulance and prepare the AED.
Page 3 of 52
, NREMT- Cardiology
NREMT- Cardiology
Study online at https://quizlet.com/_1ng0v0
6. A 50-year-old man presents C; All of the interventions and assessments listed in this ques-
with crushing chest pain of tion should be performed on a patient who presents with
sudden onset. He is diaphoret- chest pain, pressure, or discomfort. However, supplemental
ic, apprehensive, and tachyp- oxygen is indicated for any patient with a potential cardiac
neic. You should: problem and should be given as soon as possible; this is
A: obtain baseline vital signs. especially true when the patient has potential respiratory
B: perform a complete physical involvement as well (ie, dyspnea, tachypnea). Administer
exam. oxygen in a concentration sufficient to maintain an oxygen
C: apply supplemental oxygen. saturation of 94% or greater. Aspirin (up to 325 mg) should
D: ask him if he takes nitroglyc- also be administered as soon as possible, unless the patient
erin. is allergic to it. After applying oxygen and administering
aspirin, you should perform a physical exam and obtain
baseline vital signs. You would inquire about any prescrip-
tion medications the patient is taking (eg, NTG) during the
SAMPLE history.
7. You are treating a 60-year-old C; If return of spontaneous circulation (ROSC) occurs (eg,
man in cardiac arrest. After de- a palpable pulse is restored), your first action should be to
livering a shock with the AED reassess the patient's airway and ventilatory status. If the
and performing CPR for 2 min- patient remains apneic, continue rescue breathing. If the pa-
utes, you achieve return of tient is breathing adequately, administer high-flow oxygen.
spontaneous circulation. Your After reassessing airway and breathing, and treating accord-
next action should be to: ingly, you should prepare for immediate transport. Because
A: provide rapid transport to of the high risk that cardiac arrest can recur following resus-
the hospital. citation, you should not remove the AED pads; simply turn
B: remove the AED and apply the AED off instead. Analysis of the patient's cardiac rhythm
100% oxygen. is not indicated because he now has a pulse.
C: assess his airway and venti-
Page 4 of 52
NREMT- Cardiology
Study online at https://quizlet.com/_1ng0v0
1. In addition to chest pain or C; Chest pain, pressure, or discomfort is the most common
discomfort, a patient experi- symptom of acute coronary syndrome, or ACS (eg, unstable
encing an acute coronary syn- angina, acute myocardial infarction); it occurs in approxi-
drome would MOST likely pre- mately 80% of cases. Patients with ACS are usually anxious
sent with: and may have a feeling of impending doom. Nausea and
A: severe projectile vomiting vomiting are common complaints; however, projectile vom-
and flushed skin. iting, which is typically associated with increased intracranial
B: irregular breathing and low pressure, is uncommon. The skin is often ashen gray and
blood pressure. clammy (diaphoretic) because of poor cardiac output and
C: ashen skin color, diaphore- decreased perfusion. Less commonly, the patient's skin is
sis, and anxiety. cyanotic. Respirations are usually unlabored unless the pa-
D: profound cyanosis, dry skin, tient has congestive heart failure, in which case respirations
and a headache. are rapid and labored; irregular breathing, however, is not
common. Blood pressure may fall as a result of decreased
cardiac output; however, most patients will have a normal
or elevated blood pressure. If the patient complains of a
headache, it is usually a side effect of the nitroglycerin they
took before your arrival; ACS itself usually does not cause a
headache.
2. Which of the following patients C; Not all patients experiencing acute myocardial infarction
would MOST likely present with (AMI) present with the classic signs and symptoms one
vague or unusual symptoms would expect. Middle-aged men often minimize their symp-
of an acute myocardial infarc- toms and attribute their chest pain or discomfort to indiges-
tion? tion. Some patients, however, do not experience any pain.
A: 55-year-old obese female In particular, elderly women with diabetes may present with
B: 66-year-old male with angi- vague, unusual, or atypical symptoms of AMI; their only pre-
Page 1 of 52
, NREMT- Cardiology
NREMT- Cardiology
Study online at https://quizlet.com/_1ng0v0
na senting complaint may be fatigue or syncope. Do not rule out
C: 72-year-old female with dia- a cardiac problem just because a patient is not experiencing
betes chest pain, pressure, or discomfort; this is especially true in
D: 75-year-old male with hyper- elderly females with diabetes.
tension
3. During your assessment of a D; Patients with chest pain, pressure, or discomfort with a
70-year-old man with crushing systolic BP less than 100 mm Hg should be transported to
chest pain, you note that his the hospital without delay. Hypotension in a patient with
blood pressure is 80/50 mm chest pain indicates cardiogenic shock due to severe cardiac
Hg. Your MOST important ac- damage and requires treatment that can only be given at
tion should be to: the hospital. Any delay in transport delays definitive care and
A: assess his oxygen satura- increases the patient's chance of death. High-flow oxygen,
tion. thermal management, and assessment of oxygen saturation
B: keep the patient warm. are clearly important; however, your primary focus should be
C: give high-flow oxygen. to get the patient to the hospital as soon as possible.
D: transport without delay.
4. A 65-year-old man has gen- A; Aspirin has clearly been shown to reduce mortality and
eralized weakness and chest morbitiy associated with acute coronary syndrome (ACS) and
pressure. He has a bottle of should be given as early as possible; the dose is 160 to
prescribed nitroglycerin, but 325 mg. Even though this patient has chest pain and pre-
states that he has not taken any scribed nitroglycerin, you must first complete a secondary
of his medication. As your part- assessment and obtain baseline vital signs. Medical control
ner prepares to administer oxy- will need this information—specifically the patient's blood
Page 2 of 52
, NREMT- Cardiology
NREMT- Cardiology
Study online at https://quizlet.com/_1ng0v0
gen, you should: pressure—in order to determine whether you should assist
A: administer up to 325 mg of the patient with his nitroglycerin. The AED is not indicated for
aspirin if the patient is not aller- this patient because he is not in cardiac arrest.
gic to it.
B: perform a secondary assess-
ment and obtain baseline vital
signs.
C: apply the AED and pre-
pare the patient for immediate
transport.
D: assist the patient with his
nitroglycerin with medical con-
trol approval.
5. While transporting an elderly B; If a patient is found unresponsive or becomes unrespon-
woman who was complaining sive in your presence, your first action should be to assess
of nausea, vomiting, and weak- for breathing; this should be done by quickly (no more than
ness, she suddenly becomes 10 seconds) looking at the chest for obvious movement.
unresponsive. You should: If the patient is not breathing or only has agonal gasps,
A: analyze her heart rhythm you should check for a pulse for at least 5 seconds but no
with the AED. more than 10 seconds. If the patient has a pulse but is not
B: quickly look at her chest for breathing, open the airway and provide rescue breathing. If
obvious movement. the patient does not have a pulse, begin CPR (starting with
C: feel for a carotid pulse for at chest compressions), and apply the AED as soon as possible.
least 5 seconds. If you are transporting a patient who becomes unresponsive,
D: open her airway and ensure pulseless, and apneic, you should begin CPR and instruct
that it is clear. your partner to stop the ambulance and prepare the AED.
Page 3 of 52
, NREMT- Cardiology
NREMT- Cardiology
Study online at https://quizlet.com/_1ng0v0
6. A 50-year-old man presents C; All of the interventions and assessments listed in this ques-
with crushing chest pain of tion should be performed on a patient who presents with
sudden onset. He is diaphoret- chest pain, pressure, or discomfort. However, supplemental
ic, apprehensive, and tachyp- oxygen is indicated for any patient with a potential cardiac
neic. You should: problem and should be given as soon as possible; this is
A: obtain baseline vital signs. especially true when the patient has potential respiratory
B: perform a complete physical involvement as well (ie, dyspnea, tachypnea). Administer
exam. oxygen in a concentration sufficient to maintain an oxygen
C: apply supplemental oxygen. saturation of 94% or greater. Aspirin (up to 325 mg) should
D: ask him if he takes nitroglyc- also be administered as soon as possible, unless the patient
erin. is allergic to it. After applying oxygen and administering
aspirin, you should perform a physical exam and obtain
baseline vital signs. You would inquire about any prescrip-
tion medications the patient is taking (eg, NTG) during the
SAMPLE history.
7. You are treating a 60-year-old C; If return of spontaneous circulation (ROSC) occurs (eg,
man in cardiac arrest. After de- a palpable pulse is restored), your first action should be to
livering a shock with the AED reassess the patient's airway and ventilatory status. If the
and performing CPR for 2 min- patient remains apneic, continue rescue breathing. If the pa-
utes, you achieve return of tient is breathing adequately, administer high-flow oxygen.
spontaneous circulation. Your After reassessing airway and breathing, and treating accord-
next action should be to: ingly, you should prepare for immediate transport. Because
A: provide rapid transport to of the high risk that cardiac arrest can recur following resus-
the hospital. citation, you should not remove the AED pads; simply turn
B: remove the AED and apply the AED off instead. Analysis of the patient's cardiac rhythm
100% oxygen. is not indicated because he now has a pulse.
C: assess his airway and venti-
Page 4 of 52
