EMT CARDIOLOGY EXAMINATION GUIDE completed with 100% Correct Answers

EMT CARDIOLOGY EXAMINATION GUIDE completed with 100% Correct Answers EMT CARDIOLOGY EXAMINATION GUIDE completed with 100% Correct Answers EMT CARDIOLOGY EXAMINATION GUIDE completed with 100% Correct Answers EMT CARDIOLOGY EXAMINATION GUIDE completed with 100% Correct Answers EMT CARDIOLOGY EXAMINATION GUIDE completed with 100% Correct Answers EMT CARDIOLOGY EXAMINATION GUIDE 1. What occurs during recoil of the chest in between compressions? A) Positive pressure accumulates in the thoracic cavity B) A vacuum is created and blood returns to the heart C) Excessive amounts of air are expelled from the lungs D) Forward flow of blood moves to the body's vital organs B) A vacuum is created and blood returns to the heart • Which of the following statements regarding one-rescuer CPR is correct? A) You should assess the patient for a pulse after 3 cycles of CPR. B) A compression to ventilation ratio of 15:2 should be delivered. C) Ventilations should be delivered over a period of 2 to 3 seconds. D) The chest should be allowed to fully recoil after each compression. D) The chest should be allowed to fully recoil after each compression. 2. A middle-aged man was found unresponsive by his wife. When you arrive at the scene, you assess the patient and determine that he is apneic and pulseless. You should: A) immediately begin CPR, reassess for a carotid pulse after 60 seconds, and then apply the AED. B) immediately apply the AED, analyze his cardiac rhythm, deliver a shock if indicated, and begin CPR. C) begin CPR starting with chest compressions, apply the AED as soon as possible, and request backup. D) perform CPR with a compression to ventilation ratio of 15:2, apply the AED, and request backup. C) begin CPR starting with chest compressions, apply the AED as soon as possible, and request backup. 3. After restoring a pulse in a cardiac arrest patient, you begin immediate transport. While en route to the hospital, the patient goes back into cardiac arrest. You should: A) advise your partner to stop the ambulance. B) begin CPR and proceed to the hospital. C) begin rescue breathing with a bag-mask device. D) analyze the patient's rhythm with the AED. A) advise your partner to stop the ambulance. 4. Which of the following assessment findings is LEAST suggestive of a cardiac problem? A) Rapid, irregular heart rate B) Anxiety and pale, cool skin C) Palpable pain to the chest D) Nausea and epigastric pain C) Palpable pain to the chest 5. The middle, muscular layer of the heart is called the: A) epicardium. B) pericardium. C) myocardium. D) endocardium. C) myocardium. 6. The pain associated with acute aortic dissection: A) typically comes on gradually and progressively worsens. B) is typically described as a stabbing or tearing sensation. C) is usually preceded by nausea, sweating, and weakness. D) originates in the epigastrium and radiates down both legs. B) is typically described as a stabbing or tearing sensation. 7. When an error occurs while using the AED, it is MOST often the result of: A) battery failure secondary to operator error. B) malfunction of the microchip inside the AED. C) misinterpretation of the patient's cardiac rhythm. D) excess patient movement during the analyze phase. A) battery failure secondary to operator error. 8. Switching compressors during two-rescuer CPR: A) should take no more than 15 seconds to accomplish. B) should occur every 2 minutes throughout the arrest. C) is necessary only if the compressor becomes fatigued. D) is performed after every 10 to 20 cycles of adult CPR. B) should occur every 2 minutes throughout the arrest. 9. All of the following are components of the Cincinnati Stroke Scale, EXCEPT: A) pupil size. B) facial droop. C) speech pattern. D) arm movement. A) pupil size. 10. Which of the following clinical presentations is MOST consistent with right heart failure? A) Tachycardia, poor skin turgor, and hypotension B) Orthopnea, crackles in the lungs, and tachycardia C) Peripheral edema and jugular venous distention D) Paroxysmal nocturnal dyspnea and hypertension C) Peripheral edema and jugular venous distention 11. A 57-year-old man presents with flu-like symptoms. He is conscious and alert; his skin is pink, warm, and dry; and he denies chest pain or respiratory distress. During your assessment, you cannot feel radial or carotid pulses, and are unable to obtain a blood pressure. Which of the following would MOST likely explain this? A) He is in the advanced stages of shock B) He has a left ventricular assist device C) He has a dissecting aortic aneurysm D) He recently had a coronary artery bypass B) He has a left ventricular assist device 12. Which of the following would clearly be detrimental to a patient in cardiac arrest? A) Ventilating just until the chest rises B) Performing CPR before defibrillation C) Interrupting CPR for more than 10 seconds D) Ventilating without supplemental oxygen C) Interrupting CPR for more than 10 seconds 13. Following return of spontaneous circulation, the patient remains apneic. The EMT should: A) ventilate at 10 breaths/min and maintain an oxygen saturation of 92% to 98%. B) ventilate at 15 to 18 breaths/min and maintain an oxygen saturation of 100%. C) elevate the patient's lower extremities and ventilate at a rate of 20 breaths/min. D) remove the AED pads and ventilate the patient at a rate of 24 breaths/min. A) ventilate at 10 breaths/min and maintain an oxygen saturation of 92% to 98%. 14. In which of the following patients is nitroglycerin contraindicated? A) 41-year-old man with crushing substernal chest pressure, a blood pressure of 160/90 mm Hg, and severe nausea B) 53-year-old man with chest discomfort, diaphoresis, a blood pressure of 146/66 mm Hg, and regular use of Levitra C) 58-year-old man with chest pain radiating to the left arm, a blood pressure of 130/64 mm Hg, and prescribed Tegretol D) 66-year-old woman with chest pressure of 6 hours' duration, lightheadedness, and a blood pressure of 110/58 mm Hg B) 53-year-old man with chest discomfort, diaphoresis, a blood pressure of 146/66 mm Hg, and regular use of Levitra 15. When the vital organs of an 85-year-old patient need additional blood flow, the heart may not be able to meet the increased need because: A) stroke volume increases as a person ages. B) blood pressure decreases as a person ages. C) the reserve capacity of the heart is reduced as a person ages. D) the blood vessels become more elastic as a person ages. C) the reserve capacity of the heart is reduced as a person ages. 16. The AED analyzes your pulseless and apneic patient's cardiac rhythm and advises that a shock is NOT indicated. You should: A) assess for a pulse for no more than 10 seconds. B) resume CPR, starting with chest compressions. C) open the patient's airway and check for breathing. D) reanalyze the cardiac rhythm for positive confirmation. B) resume CPR, starting with chest compressions. 17. When applying the ECG electrodes, the negative (white) lead is placed on the: A) left arm. B) right arm. C) left leg. D) right leg. B) right arm. 18. Which of the following describes pulseless electrical activity (PEA)? A) disorganized, chaotic quivering of the heart muscle that does not generate a pulse B) The presence of a palpable pulse in the absence of any electrical activity in the heart C) A rapid cardiac rhythm that does not produce a pulse, but responds to defibrillation D) Any organized cardiac rhythm, slow or fast, that does not produce a palpable pulse D) Any organized cardiac rhythm, slow or fast, that does not produce a palpable pulse 19. A 50-year-old man with a history of hypertension began experiencing chest pressure while mowing his lawn. After taking a baby aspirin and resting for approximately 10 minutes, the pressure in his chest completely resolved. Which of the following would BEST explain this? A) The patient's blood pressure increased after he ceased exertion, causing his chest pressure to resolve. B) The cessation of exertion decreased the workload of the heart and blood flow to the myocardium improved. C) The aspirin dissolved a small clot in a coronary artery and reestablished blood flow to that part of the heart. D) Blood flow to a part of the myocardium was restored because of constriction of a diseased coronary artery. B) The cessation of exertion decreased the workload of the heart and blood flow to the myocardium improved. 20. Shortly after assisting a 60-year-old woman with her second nitroglycerin treatment, she tells you that she is lightheaded and feels as if she is going to faint. Her symptoms are MOST likely due to: A) low blood pressure. B) an irregular heartbeat. C) nervousness and anxiety. D) a drop in her blood sugar. A) low blood pressure. 21. Sudden cardiac arrest in the adult population MOST often is the result of: A) myocardial infarction. B) respiratory failure. C) a cardiac dysrhythmia. D) accidental electrocution. C) a cardiac dysrhythmia. 22. You assess an unresponsive 65-year-old man and find that he is apneic and pulseless. The patient's wife tells you that he has an automatic implanted cardioverter/defibrillator. After initiating CPR, you should: A) deactivate the implanted defibrillator by running a magnet over it. B) apply the AED as soon as possible and analyze his cardiac rhythm. C) ask the wife why and when he had the automatic defibrillator implanted. D) avoid using the AED because the implanted defibrillator is more effective. B) apply the AED as soon as possible and analyze his cardiac rhythm. 23. In most people, the inferior aspect of the left ventricle receives its blood supply from the: A) circumflex artery. B) right coronary artery. C) left main coronary artery. D) left anterior descending artery. B) right coronary artery. 24. The EMT is treating a man with chest pain and has assisted him with his nitroglycerin. Which of the following should the EMT anticipate during reassessment of this patient? A) Decreased blood pressure B) Increased level of anxiety C) Increased oxygen saturation D) Burning sensation in the chest A) Decreased blood pressure 25. A 72-year-old woman reports dyspnea that woke her from her sleep. Her feet and ankles are swollen, and auscultation of her lungs reveals crackles to both lung bases. She has a history of hypertension, type 2 diabetes, and a heart attack 2 years ago. Her BP is 170/94 mm Hg, her pulse is 110 beats/min and irregular, her respirations are 24 breaths/min and labored, and her oxygen saturation is 85% on room air. What should you suspect? A) Acute asthma attack B) Congestive heart failure C) Acute hypertensive crisis D) Emphysema exacerbation B) Congestive heart failure 26. A 65-year-old man has generalized weakness and chest pressure. He has a bottle of prescribed nitroglycerin, but states that he has not taken any of his medication. The EMT should: A) apply the AED and prepare the patient for immediate transport. B) administer up to 325 mg of aspirin if the patient is not allergic to it. C) assist the patient with his nitroglycerin with medical control approval. D) perform a secondary assessment and obtain baseline vital signs. B) administer up to 325 mg of aspirin if the patient is not allergic to it. 27. Which of the following is an abnormal finding when using the Cincinnati Stroke Scale to assess a patient who presents with signs of a stroke? A) One arm drifts down compared with the other side. B) One of the pupils is dilated and does not react to light. C) The patient's face is symmetrical when he or she smiles. D) Both arms drift slowly and equally down to the patient's side. A) One arm drifts down compared with the other side. 28. An 88-year-old woman experienced a syncopal episode. She is now conscious, but reports dizziness and generalized weakness. Her pulse is 170 beats/min and irregular. The EMT should recognize that this patient's syncope was MOST likely caused by: A) an acute cardiac dysrhythmia. B) increased parasympathetic tone. C) widespread systemic vasodilation. D) decreased sympathetic tone. A) an acute cardiac dysrhythmia. 29. Which of the following is a common side effect of nitroglycerin? A) Nausea B) Anxiety C) Headache D) Hypertension C) Headache 30. In addition to chest pain or discomfort, a patient experiencing an acute coronary syndrome would MOST likely present with: A) ashen skin color, diaphoresis, and anxiety. B) severe projectile vomiting and flushed skin. C) irregular breathing and low blood pressure. D) profound cyanosis, dry skin, and a headache. A) ashen skin color, diaphoresis, and anxiety. 31. Which of the following is MOST indicative of a primary cardiac problem? A) Tachypnea B) Tachycardia C) Irregular pulse D) Sudden fainting C) Irregular pulse 32. Freshly oxygenated blood returns to the heart via the: A) aorta. B) venae cavae. C) pulmonary veins. D) pulmonary arteries. C) pulmonary veins. 33. A 69-year-old man is unresponsive. He has a weak carotid pulse at 40 beats/min and his skin is cool and pale. From this information, the EMT should conclude that: A) he is in ventricular fibrillation. B) his cardiac output is reduced. C) he has a blocked coronary artery. D) his systolic BP is at least 90 mm Hg. B) his cardiac output is reduced. 34. Your partner has applied the AED to a cardiac arrest patient and has received a shock advised message. While the AED is charging, you should: A) continue chest compressions until your partner tells you to stand clear. B) perform rescue breathing only until the AED is charged and ready to shock. C) cease all contact with the patient until the AED has delivered the shock. D) retrieve the airway equipment and prepare to ventilate the patient. A) continue chest compressions until your partner tells you to stand clear. 35. Which of the following is the MOST detrimental effect that tachycardia can have on a patient experiencing a cardiac problem? A) Increased blood pressure B) Increased oxygen demand C) Increased stress and anxiety D) Decreased cardiac functionin B) Increased oxygen demand 36. At the end of ventricular relaxation, the left ventricle contains 110 mL of blood. This is referred to as the: A) preload. B) afterload. C) stroke volume. D) cardiac output. A) preload. 37. The chest pain associated with an acute coronary syndrome is often described as: A) sharp. B) stabbing. C) pressure. D) cramping. C) pressure. 38. The MOST important initial treatment for a patient whose cardiac arrest was witnessed is: A) defibrillation. B) cardiac drug therapy. C) rapid transport. D) high-quality CPR. D) high-quality CPR. 39. Blood is returned from the kidneys to the heart by way of the: A) renal arteries. B) splenic arteries. C) coronary sinus. D) inferior vena cava. D) inferior vena cava. 40. Which of the following is the MOST appropriate response when a patient with chest pain asks you if he or she is having a heart attack? A) Yes, so I recommend going to the hospital. B) I don't know, but we will take good care of you. C) Probably not, but we should transport you to be safe. D) I believe you are, but only a physician can tell for sure. B) I don't know, but we will take good care of you. 41. A 62-year-old man with a history of coronary artery disease began experiencing chest pain and nausea while on his daily jog. After sitting down and resting for 5 minutes, his pain and nausea resolve. Which of the following BEST describes this patient's condition? A) Musculoskeletal chest pain B) Acute myocardial infarction C) Unstable angina pectoris D) Stable angina pectoris D) Stable angina pectoris 42. Your assessment of a middle-aged woman with chest pressure reveals that she is confused, is diaphoretic, and has a blood pressure of 70/50 mm Hg. In caring for this patient, it is MOST important for you to: A) request an ALS unit to respond to the scene. B) assist her with her nitroglycerin if she has any. C) reassess her vital signs at least every 5 minutes. D) prepare for immediate transport to the hospital. D) prepare for immediate transport to the hospital. 43. A 50-year-old man's implanted defibrillator has fired twice within the last hour. He is conscious and alert and reports a "sore chest." Further assessment reveals that his chest pain is reproducible to palpation and is localized to the area of his implanted defibrillator. Treatment for him should include: A) application of the AED and transport to the hospital. B) prompt transport with continuous monitoring en route. C) deactivating his defibrillator by running a magnet over it. D) up to three doses of nitroglycerin and prompt transport. B) prompt transport with continuous monitoring en route. 44. After attaching the AED and pushing the analyze button on an adult patient in cardiac arrest, the AED states that a shock is advised. Which cardiac rhythm is the patient MOST likely in? A) Asystole B) Ventricular fibrillation C) Ventricular tachycardia D) Pulseless electrical activity B) Ventricular fibrillation 45. Treatment for a patient with congestive heart failure and shortness of breath may include: A) prophylactic suctioning of the airway. B) hyperventilation with a bag-mask device. C) supine positioning and elevation of the legs. D) up to three doses of sublingual nitroglycerin. D) up to three doses of sublingual nitroglycerin 46. While assessing a patient with chest pain, you note that his pulse is irregular. This indicates: A) acute myocardial infarction or angina pectoris. B) a dysfunction in the left side of the patient's heart C) high blood pressure that is increasing cardiac workload. D) abnormalities in the heart's electrical conduction system. D) abnormalities in the heart's electrical conduction system. 47. Aspirin may be contraindicated in patients with: A) glaucoma. B) diabetes. C) stomach ulcers. D) ibuprofen allergy. C) stomach ulcers 48. A 67-year-old woman presents with acute weakness and nausea. She is conscious and alert and her skin is cool and clammy. Her BP is 140/88 mm Hg, pulse is 70 beats/min and regular, and respirations are 16 breaths/min and unlabored. Her medical history includes hypertension and diabetes, and she advises that she has an implanted pacemaker. What should you suspect? A) Pacemaker malfunction B) Acute hypertensive crisis C) Infection with influenza D) Acute myocardial infarction D) Acute myocardial infarction 49. After administering nitroglycerin to a patient with chest discomfort, it is MOST important for you to: A) ask the patient if the discomfort has improved. B) find out how long the discomfort has been present. C) position the patient supine and transport immediately. D) reassess the patient's blood pressure within 5 minutes. D) reassess the patient's blood pressure within 5 minutes. 50. Ischemic heart disease is a condition in which: A) a portion of the heart muscle dies because of a prolonged lack of oxygen. B) there is a decrease in blood flow to one or more portions of the heart muscle. C) the coronary arteries dilate, thus preventing effective blood flow to the heart. D) an acute event leads to a significant decrease in the pumping force of the heart. B) there is a decrease in blood flow to one or more portions of the heart muscle. 51. Which of the following patients is the BEST candidate for the administration of nitroglycerin? A) woman who has taken three doses of prescribed nitroglycerin without relief of chest pain B) A woman with chest pain, prescribed nitroglycerin, and a blood pressure of 104/76 mm Hg C) A man with chest pain, expired nitroglycerin spray, and a blood pressure of 110/80 mm Hg D) An elderly man with crushing substernal chest pain and a blood pressure of 80/60 mm Hg B) A woman with chest pain, prescribed nitroglycerin, and a blood pressure of 104/76 mm Hg 52. A 71-year-old woman presents with an acute onset of confusion, slurred speech, and left-sided weakness. She is conscious and her airway is patent. Her BP is 180/94 mm Hg, her pulse is 70 beats/min and irregular, her respirations are 14 breaths/min and unlabored, and her oxygen saturation is 97% on room air. What should you do? A) Administer up to 325 mg of chewable aspirin. B) Position her supine, and assist her ventilations. C) Give oxygen via nasal cannula at 4 to 6 L/min. D) Keep her sitting up, and transport without delay. D) Keep her sitting up, and transport without delay. 53. Because of the property of automaticity, cardiac muscle cells are able to: A) contract spontaneously without a stimulus from a nerve source. B) rest for up to 2 minutes before initiating another electrical impulse. C) survive for long periods of time if oxygen does not reach the heart. D) generate an electrical impulse from the same pacemaker every time. A) contract spontaneously without a stimulus from a nerve source. 54. The wall that separates the left and right sides of the heart is called the: A) carina. B) septum. C) pericardium. D) mediastinum. B) septum. 55. Which of the following describes the MOST appropriate method of performing chest compressions on an adult patient in cardiac arrest? A) Compress the chest at least 2 inches, allow full recoil of the chest after each compression, minimize interruptions in chest compressions B) Allow full recoil of the chest after each compression, compress the chest to a depth of 2 inches, deliver compressions at a rate of at least 80/min C) Do not interrupt chest compressions for any reason, compress the chest no more than 1½ inches, allow partial recoil of the chest after each compression D) Minimize interruptions in chest compressions, provide 70% compression time and 30% relaxation time, deliver compressions at a rate of 100/min A) Compress the chest at least 2 inches, allow full recoil of the chest after each compression, minimize interruptions in chest compressions 56. Which of the following types of stroke would MOST likely present with a sudden, severe headache? A) Ischemic B) Hemorrhagic C) Thrombotic D) Embolic B) Hemorrhagic 57. Which of the following statements regarding ventricular fibrillation (V-Fib) is correct? A) Loss of consciousness occurs within minutes after the onset of V-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. B) In V-Fib, the heart is not pumping any blood and the patient is pulseless. 58. With regard to the electrocardiogram (ECG), what is artifact? A) significant abnormality discovered by the paramedic B) The complete absence of electrical activity on the ECG C) Electrical interference that can make diagnosis difficult D) Improper lead placement, resulting in misdiagnosis C) Electrical interference that can make diagnosis difficult 59. When assessing a patient who has stroke-like symptoms, you should recall that: A) the majority strokes are caused by a ruptured cerebral artery. B) the patient may be unable to communicate, but can often understand. C) right-sided weakness indicates a stroke in the right cerebral hemisphere. D) fibrinolytic therapy must be given within 6 hours following the stroke. B) the patient may be unable to communicate, but can often understand. 60. After applying the AED to an adult patient in cardiac arrest, you analyze her cardiac rhythm and receive a shock advised message. Emergency medical responders, who arrived at the scene before you, tell you that bystander CPR was not in progress upon their arrival. You should: A) perform CPR for 2 minutes and then defibrillate. B) detach the AED and prepare for immediate transport. C) deliver the shock as indicated followed immediately by CPR. D) notify medical control and request permission to cease resuscitation. C) deliver the shock as indicated followed immediately by CPR. 61. Which of the following clinical signs would indicate increased sympathetic nervous system activity? A) Tachycardia B) Hypotension C) Constricted pupils D) Slow respiratory rate A) Tachycardia 62. A patient reports pain in the upper midabdominal area. This region of the abdomen is called the: A) peritoneum. B) epigastrium. C) mediastinum. D) retroperitoneum. B) epigastrium. 63. The energy setting for a biphasic AED: A) is typically 360 joules. B) is manufacturer specific. C) must be manually set by the EMT. D) increases by 50 joules with each shock. B) is manufacturer specific. 64. A 58-year-old man is found unresponsive by his wife. According to his wife, he was complaining of a "dull ache" in his chest the day before, but refused to allow her to call 911. His blood pressure is 70/50 mm Hg, his pulse is 120 beats/min and weak, and his respirations are 28 breaths/min and labored. Further assessment reveals that his skin is cool, pale, and clammy. You should suspect: A) cardiogenic shock. B) hypovolemic shock. C) acute septic shock. D) pulmonary embolism. A) cardiogenic shock. 65. When assessing a patient who complains of chest pain, which of the following questions would you ask to assess the "R" in OPQRST? A) Did the pain begin suddenly or gradually? B) What were you doing when the pain began? C) Is there anything that makes the pain worse? D) Is the pain in one place or does it move around? D) Is the pain in one place or does it move around? 66. During your assessment of a 70-year-old man with crushing chest pain, you note that his blood pressure is 80/50 mm Hg. Your MOST important action should be to: A) give high-flow oxygen. B) transport without delay. C) keep the patient warm. D) assess his oxygen saturation. B) transport without delay. 67. Which of the following patients would MOST likely present with vague or unusual symptoms of an acute myocardial infarction? A) 55-year-old obese woman B) 66-year-old man with angina C) 72-year-old woman with diabetes D) 75-year-old man with hypertension C) 72-year-old woman with diabetes 68. Which of the following is an expected finding in patients who have a left ventricular assist device (LVAD) with a continuous flow pump? A) cyanotic skin. B) hypertension. C) peripheral edema. D) absence of pulses. D) absence of pulses. 69. You have analyzed a cardiac arrest patient's rhythm three times with the AED, separated by 2-minute cycles of CPR, and have received no shock messages each time. You should: A) consider terminating resuscitation. B) remove the AED and continue CPR. C) continue CPR and transport at once. D) request a paramedic unit at the scene. C) continue CPR and transport at once. 70. Prior to being reoxygenated in the lungs, blood passes through the: A) mitral and tricuspid valves. B) aortic and tricuspid valves. C) aortic and pulmonic valves. D) tricuspid and pulmonic valves. D) tricuspid and pulmonic valves. 71. Prior to administering nitroglycerin to a patient with chest pain, you should: A) elevate the patient's lower extremities. B) obtain vital signs to detect hypotension. C) inquire about an allergy to salicylates. D) auscultate the patient's breath sounds. B) obtain vital signs to detect hypotension. 72. A 60-year-old man is in cardiac arrest. You begin CPR while your partner applies the AED. What should you do if you receive a no shock message? A) Assess for a carotid pulse for up to 10 seconds. B) Resume CPR, starting with chest compressions. C) Ensure that the AED electrodes are properly applied. D) Reanalyze his cardiac rhythm after 30 seconds of CPR. B) Resume CPR, starting with chest compressions. 73. A 44-year-old man reports dizziness and light-headedness. His BP is 88/62 mm Hg; his heart rate is 190 beats/min and weak; and his skin is cool, clammy, and pale. Which of the following would BEST explain why his BP is low? A) Widespread systemic vasoconstriction B) Decreased ventricular filling time C) Increased ventricular stroke volume D) Decreased myocardial oxygen demand B) Decreased ventricular filling time 74. A middle-aged woman took three of her prescribed nitroglycerin tablets after she began experiencing chest pain. She complains of a bad headache and is still experiencing chest pain. You should assume that: A) her blood pressure is elevated. B) she has ongoing cardiac ischemia. C) her nitroglycerin is no longer potent. D) her chest pain is not cardiac related. B) she has ongoing cardiac ischemia. 75. 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. B) assess the patient's breathing effort. 76. Which of the following structures is the primary pacemaker, which sets the normal rate for the heart? A) Bundle of His B) Purkinje fibers C) Sinoatrial node D) Atrioventricular node C) Sinoatrial node 77. Tachycardia can be detrimental to a patient who is experiencing a cardiac problem because it causes: A) increased cardiac filling in between beats. B) a profound decrease in oxygen consumption. C) an associated increase in breathing difficulty. D) increased cardiac oxygen usage and demand. D) increased cardiac oxygen usage and demand. 78. After delivering one shock with the AED and performing 2 minutes of CPR on a woman in cardiac arrest, you reanalyze her cardiac rhythm and receive a no shock advised message. This means that: A) she is not in a shockable rhythm. B) she has electrical activity but no pulse. C) her rhythm has deteriorated to asystole. D) the first shock restored a rhythm and pulse. A) she is not in a shockable rhythm. 79. The myocardium receives its blood supply from the coronary arteries that branch directly from the: A) aorta. B) vena cavae. C) left atrium. D) right ventricle. A) aorta. 80. The maximum pressure generated in the arms and legs during contraction of the left ventricle is called: A) afterload. B) pulse pressure. C) systolic blood pressure. D) diastolic blood pressure. C) systolic blood pressure. 81. When treating a patient with chest pain, pressure, or discomfort, you should FIRST: A) administer supplemental oxygen. B) place the patient in a position of comfort. C) request an ALS ambulance response to the scene. D) assess the blood pressure and give nitroglycerin. B) place the patient in a position of comfort. 82. A patient whose artificial pacemaker has failed would MOST likely experience: A) weakness and bradycardia. B) hypertension and a headache. C) irreversible ventricular fibrillation. D) dizziness and excessive tachycardia. A) weakness and bradycardia. 83. While performing CPR on a patient who is wearing an external defibrillator vest, the device alarms and a voice states that a shock is about to be delivered. What should you do? A) Remove the battery from the device and apply your AED B) Cease patient contact until the shock has been delivered C) Continue CPR because the vest delivers a low energy shock D) Allow it to shock, but immediately check for a carotid pulse B) Cease patient contact until the shock has been delivered 84. A 65-year-old woman reports severe chest pain that radiates to her back, in between her shoulder blades. She tells you that this is the most severe pain that she has ever experienced, and that it has been intense since it began. Her past medical history includes hypertension. When you palpate her radial pulses, you note that they are unequal in strength. What should you suspect? A) Acute aortic dissection B) Unstable angina pectoris C) Acute hypertensive crisis D) Acute myocardial infarction A) Acute aortic dissection 85. Use of the automated external defibrillator is contraindicated in patients who: A) are between 1 and 8 years of age. B) experienced a witnessed cardiac arrest. C) are apneic and have a weak carotid pulse. D) have a nitroglycerin patch applied to the skin. C) are apneic and have a weak carotid pulse. 86. You are assessing a 70-year-old man who reports pain in both of his legs. He is conscious and alert, has a blood pressure of 160/90 mm Hg, a pulse rate of 110 beats/min, and respirations of 14 breaths/min and unlabored. Further assessment reveals edema to both of his feet and legs and jugular venous distention. What should you suspect? A) Left heart failure B) Right heart failure C) Pulmonary edema D) Chronic hypertension B) Right heart failure 87. Which of the following statements regarding the automated external defibrillator (AED) is correct? A) The AED should be applied to patients at risk for cardiac arrest. B) AEDs will analyze the patient's rhythm while CPR is in progress. C) The AED should not be used in patients with an implanted defibrillator. D) AEDs can safely be used in infants and children less than 8 years of age. D) AEDs can safely be used in infants and children less than 8 years of age. 88. Which of the following questions would be MOST appropriate to ask when assessing a patient with chest pain? A) What does the pain feel like? B) Does the pain radiate to your arm? C) Would you describe the pain as sharp? D) Is the pain worse when you take a deep breath? A) What does the pain feel like? 89. A 56-year-old man is found to be pulseless and apneic. His wife states that he collapsed about 5 minutes ago. As your partner gets the AED from the ambulance, you should: A) provide rescue breaths until the AED is ready. B) open the airway and give 2 rescue breaths. C) begin CPR, starting with chest compressions. D) ask the wife if the patient has a living will. C) begin CPR, starting with chest compressions. 90. The coronary arteries fill with blood when the: A) aortic valve closes. B) left ventricle contracts. C) aortic valve opens. D) right ventricle contracts. A) aortic valve closes. 91. Which of the following clinical signs indicates left heart failure? A) An irregular pulse B) Dyspnea on exertion C) Severe peripheral edema D) Jugular venous distention B) Dyspnea on exertion 92. Chest compression effectiveness is MOST effectively assessed by: A) listening for a heartbeat with each compression. B) carefully measuring the depth of each compression. C) palpating for a carotid pulse with each compression. D) measuring the systolic blood pressure during compressions. C) palpating for a carotid pulse with each compression. 93. A rapid heart rhythm, usually at a rate of 150 to 200 beats/min, that originates in the ventricles and can cause hemodynamic compromise is called: A) asystole. B) ventricular fibrillation. C) ventricular tachycardia. D) pulseless electrical activity. C) ventricular tachycardia. 94. How can you help maximize cardiac output during CPR? A) Compress the chest at a rate of no more than 100/min B) Ventilate the patient through an advanced airway device C) Deliver rescue breaths until the chest expands widely D) Allow the chest to fully recoil in between compressions D) Allow the chest to fully recoil in between compressions 95. While transporting an elderly woman who was complaining of nausea, vomiting, and weakness, she suddenly becomes unresponsive. You should: A) analyze her cardiac rhythm with the AED. B) open her airway and ensure that it is clear. C) assess for signs of breathing and a pulse. D) place her on her side in case she vomits. C) assess for signs of breathing and a pulse. 96. Which of the following statements regarding sudden cardiac arrest and ventricular fibrillation is correct? A) For each minute that defibrillation is delayed, the chance of survival decreases by as much as 10%. B) High-quality CPR often reverses ventricular fibrillation if it is initiated within 2 minutes of the onset. C) Most patients develop ventricular fibrillation within 10 minutes after the onset of sudden cardiac arrest. D) Patients with ventricular fibrillation are typically unconscious, are apneic, and have a weak and irregular pulse. A) For each minute that defibrillation is delayed, the chance of survival decreases by as much as 10%. 97. Aspirin is beneficial to patients experiencing an acute coronary syndrome because it: A) prevents a clot from getting larger. B) effectively relieves their chest pain. C) decreases cardiac workload by lowering the BP. D) destroys the clot that is blocking a coronary artery. A) prevents a clot from getting larger. 98. You should suspect that your patient has pulmonary edema if he or she: A) has swollen feet and ankles. B) cannot breathe while lying down. C) is hypertensive and tachycardic. D) has a dry, nonproductive cough. B) cannot breathe while lying down. 99. A patient who is experiencing an acute myocardial infarction: A) most often describes his or her chest pain as being sharp or tearing. B) has chest pain or discomfort that does not change with each breath. C) often experiences relief of his or her chest pain after taking nitroglycerin. D) often complains of a different type of pain than a patient with angina. B) has chest pain or discomfort that does not change with each breath. 100. Common signs and symptoms of a hypertensive emergency include: A) unequal pupils, irregular pulse, and pallor. B) ringing in the ears, headache, and epistaxis. C) chest discomfort, weak pulses, and cool skin. D) vomiting without nausea and hemiparesis. B) ringing in the ears, headache, and epistaxis. 101. A middle-aged woman with a history of hypertension and high cholesterol complains of chest discomfort. She asks you to take her to the hospital where her personal physician practices, which is 15 miles away. Her blood pressure is 130/70 mm Hg, pulse is 84 beats/min and regular, and respirations are 18 breaths/min and unlabored. Which of the following actions is clearly NOT appropriate for this patient? A) Giving oxygen via nasal cannula B) Taking her to her choice hospital C) Contacting her physician via phone D) Allowing her to walk to the ambulance D) Allowing her to walk to the ambulance 102. In patients with heart disease, acute coronary syndrome is MOST often the result of: A) atrial damage. B) atherosclerosis. C) coronary artery spasm. D) coronary artery rupture. B) atherosclerosis. 103. In which of the following situations would nitroglycerin MOST likely be administered? A) Recent use of Cialis B) Systolic BP of 90 mm Hg C) The presence of a head injury D) History of cardiac bypass surgery D) History of cardiac bypass surgery 104. A 49-year-old woman presents with a headache, nausea, and ringing in her ears. She is conscious and alert and states that she has hypertension and type 2 diabetes. Her BP is 202/114 mm Hg, her pulse is 60 beats/min, and her respirations are 16 breaths/min. What should you do? A) Place her in a supine position. B) Give her one tube of oral glucose. C) Prepare for immediate transport. D) Summon an ALS unit to the scene. C) Prepare for immediate transport. 105. A 66-year-old woman presents with an acute onset of confusion, slurred speech, and an inability to move her right arm and leg. Her airway is patent and she is breathing adequately. Which of the following is the MOST important initial information to obtain about this patient? A) Her initial blood pressure reading B) What she was doing when this began C) When she was last seen normal D) Whether or not her pupils are equal C) When she was last seen normal 106. A 60-year-old woman presents with chest discomfort, confusion, and weakness. The patient's husband tells you that she vomited once before EMS arrival. The patient's BP is 70/40 mm Hg, her pulse is 45 beats/min and weak, and her respirations are 14 breaths/min and unlabored. Which of the following is the MOST likely cause of her hypotension? A) Bradycardia B) Hypovolemia C) Myocardial ischemia D) Respiratory compromise A) Bradycardia 107. 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. B) transport the patient without delay and monitor her blood pressure en route. 108. Following administration of nitroglycerin to a man with crushing chest pressure, he experiences a significant increase in his heart rate. This is MOST likely the result of: A) a cardiac dysrhythmia. B) preexisting hypertension. C) a drop in blood pressure. D) coronary vasoconstriction. C) a drop in blood pressure. 109. Which of the following structures stimulates the ventricles and causes them to contract? A) Sinus node B) Sinoatrial node C) Purkinje fibers D) Atrioventricular node C) Purkinje fibers 110. A 50-year-old man presents with crushing chest pain that suddenly began about 30 minutes ago. He is diaphoretic and anxious. The EMT should: A) obtain baseline vital signs. B) apply supplemental oxygen. C) administer chewable aspirin. D) perform a complete physical exam. C) administer chewable aspirin. 111. When an electrical impulse reaches the atrioventricular node, it is briefly delayed so that: A) the aortic valve can open. B) both of the atria can relax. C) the ventricles can contract. D) ventricular filling can occur. D) ventricular filling can occur. 112. By which of the following mechanisms does nitroglycerin relieve cardiac-related chest pain or discomfort? A) Vasodilation and increased myocardial oxygen supply B) Vasodilation and decreased myocardial oxygen supply C) Vasoconstriction and increased myocardial workload D) Vasoconstriction and increased cardiac oxygen demand A) Vasodilation and increased myocardial oxygen supply 113. You are treating a 60-year-old man in cardiac arrest. After delivering a shock with the AED and performing CPR for 2 minutes, you achieve return of spontaneous circulation. Your next action should be to: A) provide rapid transport to the hospital. B) reanalyze his rhythm for confirmation. C) assess his airway and ventilatory status. D) remove the AED and apply 100% oxygen. C) assess his airway and ventilatory status. 114. Which of the following patients is the BEST candidate for fibrinolytic therapy? A) 50-year-old man who has slurred speech and left arm weakness that started 45 minutes ago; history of a heart attack 8 months ago B) 53-year-old woman who experienced a sudden, severe headache and is now unresponsive; history of a hemorrhagic stroke 3 years ago C) 59-year-old man whose mental status has declined over the past 12 hours; history of renal failure, hypertension, and type 2 diabetes D) 63-year-old woman had a syncopal episode and is now confused; she takes blood thinners and has a history of deep vein thrombosis A) 50-year-old man who has slurred speech and left arm weakness that started 45 minutes ago; history of a heart attack 8 months ago 115. Which of the following assessment findings would most likely indicate cardiac compromise? A. Tachypnea B. Tachycardia C. Irregular pulse D. Sudden fainting C. Irregular pulse 116. A 50-year old man presents with "crushing" chest pain of sudden onset. He is diaphoretic and nauseated. You should A. obtain baseline vital signs B. apply supplemental oxygen C. ask him if he takes nitroglycerin D. perform a focused physical exam B. apply supplemental oxygen 117. As you are assessing an elderly man who is complaining of chest pain, the patient suddenly loses consciousness. Your first step should be to A. attach the AED B. open the airway C. assess for a pulse D. assess for breathing B. open the airway 118. Freshly oxygenated blood returns to the heart via which of the following blood vessels? A. Aorta B. Vena cava C. Pulmonary vein D. Pulmonary artery C. Pulmonary vein 119. Which of the following statements regarding the automated external defibrillator is true? A. It should be applied to patients at risk for cardiac arrest B. It will analyze a patient's rhythm while CPR is in progress C. It should not be used in patients with an implanted pacemaker D. It can safely be used in children between 1 and 8 years of age. D. It can safely be used in children between 1 and 8 years of age. 120. Nitroglycerin possesses which of the following effects when administered to patients with suspected cardiac chest pain? A. Vasodilation and increased myocardial oxygen supply B. Vasodilation and decreased myocardial oxygen supply C. Vasoconstriction and increased cardiac workload D. Vasoconstriction and increased cardiac oxygen demand A. Vasodilation and increased myocardial oxygen supply 121. You arrive at the scene of a 56 year old man who is not breathing. Your initial assessment reveals that the patient is pulseless and apneic. The patient's wife tells you that her husband suddenly grabbed his chest and then passed out. As your partner confirms cardiac arrest and begins one-rescuer CPR, you should A. notify medical control B. insert an airway adjunct C. prepare the AED for use D. obtain a SAMPLE history C. prepare the AED for use 122. You arrive at the scene of a 56 year old man who is not breathing. Your initial assessment reveals that the patient is pulseless and apneic. The patient's wife tells you that her husband suddenly grabbed his chest and then passed out. When performing two-rescuer CPR on this patient, you should A. slowly compress the chest to a depth of about 1" to 1 1/2". B. not attempt to synchronize compressions with ventilations. C. have your partner pause after 30 compressions as you give two breaths. D. continue ventilations as the AED analyzes the patient's cardiac rhythm. C. have your partner pause after 30 compressions as you give two breaths. 123. You arrive at the scene of a 56 year old man who is not breathing. Your initial assessment reveals that the patient is pulseless and apneic. The patient's wife tells you that her husband suddenly grabbed his chest and then passed out. After successfully resuscitating the patient, you provide immediate transport. While en route to the hospital, the patient goes back into cardiac arrest. Your next step should be A. tell your partner to stop the ambulance. B. Begin CPR and proceed to the hospital C. contact medical control for further advice. D. analyze the patient's rhythm with the AED. A. tell your partner to stop the ambulance. 124. Cardiac arrest in the adult population most often is the result of A. myocardial infarction B. respiratory failure C. a cardiac arrhythmia D. accidental electrocution C. a cardiac arrhythmia 125. The chest pain associated with cardiac compromise often is described as A. sharp B. stabbing C. pressure D. cramping C. pressure 126. As you are attempting to resuscitate an adult man with cardiac arrest, you receive a "o shock advised" message from the AED. What should you do next? A. continue CPR B. Check for a pulse C. Assess for breathing D. Reanalyze the rhythm B. Check for a pulse 127. The myocardium receives its blood supply from the coronary arteries that branch directly from the A. aorta B. vena cava C. left atrium D. right ventricle A. aorta 128. The EMT-B should consider performing 2 minutes of CPR prior to attaching the AED to adult victims of cardiac arrest when A. the arrest is caused by a traumatic injury B. the patient's cardiac arrest was witnessed C. the call-to-arrival time is more than 5 minutes. D. the patient has known coronary artery disease C. the call-to-arrival time is more than 5 minutes. 129. Which of the following are side effects of nitroglycerin? A. Nausea B. Anxiety C. Headache D. Hypertension C. Headache 130. Which of the following patients would be the best candidate for the administration of nitroglycerin? A. A woman who has taken 3 doses of prescribed nitroglycerin without relief of chest pain B. A woman with chest pain, prescribed nitroglycerin, and a blood pressure of 102/76 mm Hg C. A man with chest pain, a bottle of expired nitroglycerin, and a blood pressure of 110/80 mm Hg D. An elderly man with crushing chest pain and a blood pressure of 90/60 mm Hg B. A woman with chest pain, prescribed nitroglycerin, and a blood pressure of 102/76 mm Hg 131. Which of the following chambers of the heart has the thickest walls? A. Left atrium B. Right atrium C. Left ventricle D. Right ventricle Left ventricle 132. In addition to oxygen therapy; the most effective way to minimize the detrimental effects associated with cardiac compromise is to A. give the patient up to 4 doses of nitroglycerin B. reassure the patient and provide prompt transport C. transport the patient rapidly, using lights and siren D. request ALS support for all patients who have chest pain. B. reassure the patient and provide prompt transport 133. Which of the following questions would be most appropriate to ask when assessing a patient with chest pain? A. What does the pain feel like? B. Does the pain radiate to your arm? C. Would you describe the pain as sharp? D. Is the pain worse when you take a deep breath? A. What does the pain feel like? 134. You are caring for a 66-year-old woman with sever pressure in her chest. As you initiate oxygen therapy, your partner should A. notify medical control B. obtain a SAMPLE history C. measure the blood pressure D. gather the patient's medications. C. measure the blood pressure 135. When managing a patient with chest pain, you should first A. administer high-concentration oxygen B. place the patient in a position of comfort C. request an ALS ambulance to respond to the scene. D. measure the blood pressure and administer nitroglycerin B. place the patient in a position of comfort **I don't like this question. 136. After applying the AED to a 56-year old female in cardiac arrest, you analyze her cardiac rhythm and receive a "shock advised" message. First responders, who arrived at the scene before you, tell you that the patient was without CPR for about 10 minutes. You should: A. perform 2 minutes of CPR and then defibrillate B. detach the AED and prepare for immediate transport C. deliver the shock as indicated followed immediately by CPR. D. notify medical control and request permission to cease resuscitation. C. deliver the shock as indicated followed immediately by CPR. Pulseless electrical activity (PEA) is a condition in which the heart produces organized electrical activity (slow or fast), despite the absence of a palpable pulse. 137. A 60-year-old man complains of chest pain and difficulty breathing. He is pale, diaphoretic, and in severe pain. As your partner applies supplemental oxygen, you assess his vital signs. His blood pressure is 180/90 mm Hg, pulse is 110 beats/min and irregular, respirations are 24 breaths/min and labored, and oxygen saturation is 93%. You ask him if has taken any nitroglycerin and he tells you that he does not have any but his wife does. You should: A. contact medical control and request permission to assist the patient with up to three doses of his wife's nitroglycerin B. complete your focused physical examination and prepare the patient for immediate transport to an appropriate hospital C. transport at once, apply the AED in case he develops cardiac arrest, and monitor his vital signs en route to hospital D. Have him swallow up to four enteric coated aspirin, continue oxygen therapy and promptly transport him to the hospital B. complete your focused physical examination and prepare the patient for immediate transport to an appropriate hospital 138. You arrive at the scene shortly after a 55-year-old man collapsed. Two bystanders are performing CPR. Your FIRST action should be to: A. attach the AED and analyze his cardiac rhythm B. check the effectiveness of the CPR in progress C. insert an oropharyngeal airway and continue CPR D. stop CPR so you can assess breathing and pulse D. stop CPR so you can assess breathing and pulse 139. After assisting a patient with his or her prescribed nitroglycerin, you would NOT expect him or her to experience a: A) syncopal episode. B) pounding headache. C) burning sensation in the mouth. D) fizzing sensation under the tongue. :A) syncopal episode.