JBL CARDIOLOGY QUESTIONS AND ANSWERS

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 - Answer- C The patient's presentation is indicative of acute hypertensive crisis. Her blood pressure is severely elevated and she is experiencing other symptoms one might expect with such a high blood pressure (ie, headache, nausea, ringing in the ears). You should place her in a position of comfort, which is usually a semisitting position; lying her supine would likely only make her headache worse. Prompt transport to the hospital is essential so her blood pressure can be lowered in a controlled setting. Without knowing her blood glucose level, proceeding with oral glucose would not be appropriate. If it does not delay transport, you could consider summoning an ALS ambulance to the scene. It is far more important, however, to get her to a definitive care facility Freshly oxygenated blood returns to the heart via the: A) aorta. B) vena cavae. C) pulmonary veins. D) pulmonary arteries. - Answer- C The pulmonary veins are the only veins that carries oxygen-rich blood. They carry blood from the lungs back to the left atrium. All other veins in the human body, including the venae cavae, carry deoxygenated blood back to the heart. The aorta is the largest artery in the body and branches immediately from the left ventricle, carrying freshly oxygenated blood to the rest of the body. The pulmonary arteries carry deoxygenated blood from the right ventricle to the lungs for reoxygenation. Your assessment of a middle-aged female 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. - Answer- D Your patient is in shock, which is most likely the result of heart failure (cardiogenic shock). Immediate transport to the closest appropriate hospital is critical. Assess for and manage problems with airway, breathing, and circulation, and then get on the road! She needs definitive care that can be provided only at the hospital. Reassess her vital signs at least every 5 minutes, but do it en route! If you can rendezvous with an ALS unit en route, do so. However, you should not remain at the scene to wait for them. Nitrog