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Fisdap Cardiology Review (Paramedic)
Questions and Correct Answers/ Latest
Update / Already Graded
You respond to a residence for a 68-year-old male with nausea,
vomiting, and blurred vision. As you are assessing him, he tells you that
he has congestive heart failure and atrial fibrillation, and takes
numerous medications. The cardiac monitor reveals atrial fibrillation
with a ventricular rate of 50 beats/min. Which of the following
medications is MOST likely responsible for this patient's clinical
presentation?
Ans: Digoxin.
This patient has classic signs of digitalis toxicity. Digoxin is
commonly prescribed to patients with congestive heart failure
and atrial fibrillation (A-Fib) or atrial flutter (A-Flutter). Its
positive inotropic effects increase cardiac contractility and
maintain cardiac output, while its negative chronotropic effects
control the ventricular rate of the A-Fib or A-Flutter. Digitalis
preparations (ie, Lanoxin, Digoxin) have a narrow therapeutic
index—that is, there is a fine line between a therapeutic and
toxic dose. You should suspect digitalis toxicity in any patient
who takes Digoxin or Lanoxin and presents with complaints
such as nausea, vomiting, abdominal pain, anorexia, or
blurred/yellow vision. Additionally, virtually any cardiac
dysrhythmia can be caused by the toxic effects of digitalis.
All rights reserved © 2025/ 2026 |
, Page |2
Treatment involves the administration of Digibind, which is
given at the hospital.
Which of the following is an absolute contraindication for fibrinolytic
therapy?
Ans: Subdural hematoma 3 years ago.
According to current emergency cardiac care (ECC) guidelines,
absolute contraindications for fibrinolytic therapy include ANY
prior intracranial hemorrhage (ie, subdural, epidural,
intracerebral hematoma); known structural cerebrovascular
lesion (ie, arteriovenous malformation); known malignant
intracranial tumor (primary or metastatic); ischemic stroke
within the past 3 months, EXCEPT for acute ischemic stroke
within the past 3 hours; suspected aortic dissection; active
bleeding or bleeding disorders (except menses); and significant
closed head trauma or facial trauma within the pa st 3 months.
Relative contraindications (eg, the physician may deem
fibrinolytic therapy appropriate under certain circumstances)
include, a history of chronic, severe, poorly -controlled
hypertension; severe uncontrolled hypertension on
presentation (SBP > 180 mm Hg or DBP > 110 mm Hg); ischemic
stroke greater than 3 months ago; dementia; traumatic or
prolonged (> 10 minutes) CPR or major surgery within the past 3
weeks; recent (within 2 to 4 weeks) internal bleeding;
noncompressible vascular punctures; pregnancy; prior exposure
All rights reserved © 2025/ 2026 |
, Page |3
(> 5 days ago) or prior allergic reaction to streptokinase or
anistreplase; active peptic ulcer; and current use of
anticoagulants (ie, Coumadin).
A middle-aged man presents with chest discomfort, shortness of
breath, and nausea. You give him supplemental oxygen and continue
your assessment. As your partner is attaching the ECG leads, you
should:
Ans: Administer up to 325 mg of aspirin.
Since oxygen has already been administered to this patient and
your partner is attaching the ECG leads, you should administer
aspirin (160 to 325 mg, non-enteric-coated). Early
administration of aspirin has clearly been shown to reduce
mortality and morbidity in patients experiencing an acute
coronary syndrome (ACS). After establishing vascul ar access,
you should assess his vital signs and then administer 0.4 mg of
nitroglycerin (up to 3 doses, 5 minutes apart), provided that his
systolic BP is greater than 90 mm Hg. If 3 doses of nitroglycerin
fail to completely relieve his chest discomfort, consider
administering 2 to 4 mg of morphine IV, provided that his
systolic BP remains above 90 mm Hg.
Which of the following ECG lead configurations is correct?
All rights reserved © 2025/ 2026 |
, Page |4
Ans: To assess lead II, place the negative lead on the right arm
and the positive lead on the left leg.
According to the Einthoven triangle, lead I is assessed by
placing the negative (white) lead on the right arm and the
positive (red) lead on the left arm. Lead II is assessed by placing
the negative lead on the right arm and the positi ve lead on the
left leg. Lead III is assessed by placing the negative lead on the
left arm and the positive lead on the left leg.
A 61-year-old male presents with chest pressure that woke him up
from his nap 30 minutes ago. He is diaphoretic, anxious, and rates his
pain as an an 8 over 10. His past medical history is significant for
hypertension, type II diabetes, and coronary stent placement 2 months
ago. He takes lisinopril, Plavix, and Glucophage, and is wearing a
medical alert bracelet stating "allergic to salicylates." His blood
pressure is 160/100 mm Hg, pulse is 110 beats/min, and respirations are
22 breaths/min. The 12-lead ECG shows sinus tachycardia with 3-mm
ST segment elevation in leads V1 through V5. Which of the following
treatment modalities is MOST appropriate for this patient?
Ans: Supplemental oxygen, vascular access, up to three 0.4 mg
doses of nitroglycerin, and 2 to 4 mg of morphine sulfate if his
systolic BP is greater than 90 mm Hg and he is still experiencing
pain.
All rights reserved © 2025/ 2026 |
Fisdap Cardiology Review (Paramedic)
Questions and Correct Answers/ Latest
Update / Already Graded
You respond to a residence for a 68-year-old male with nausea,
vomiting, and blurred vision. As you are assessing him, he tells you that
he has congestive heart failure and atrial fibrillation, and takes
numerous medications. The cardiac monitor reveals atrial fibrillation
with a ventricular rate of 50 beats/min. Which of the following
medications is MOST likely responsible for this patient's clinical
presentation?
Ans: Digoxin.
This patient has classic signs of digitalis toxicity. Digoxin is
commonly prescribed to patients with congestive heart failure
and atrial fibrillation (A-Fib) or atrial flutter (A-Flutter). Its
positive inotropic effects increase cardiac contractility and
maintain cardiac output, while its negative chronotropic effects
control the ventricular rate of the A-Fib or A-Flutter. Digitalis
preparations (ie, Lanoxin, Digoxin) have a narrow therapeutic
index—that is, there is a fine line between a therapeutic and
toxic dose. You should suspect digitalis toxicity in any patient
who takes Digoxin or Lanoxin and presents with complaints
such as nausea, vomiting, abdominal pain, anorexia, or
blurred/yellow vision. Additionally, virtually any cardiac
dysrhythmia can be caused by the toxic effects of digitalis.
All rights reserved © 2025/ 2026 |
, Page |2
Treatment involves the administration of Digibind, which is
given at the hospital.
Which of the following is an absolute contraindication for fibrinolytic
therapy?
Ans: Subdural hematoma 3 years ago.
According to current emergency cardiac care (ECC) guidelines,
absolute contraindications for fibrinolytic therapy include ANY
prior intracranial hemorrhage (ie, subdural, epidural,
intracerebral hematoma); known structural cerebrovascular
lesion (ie, arteriovenous malformation); known malignant
intracranial tumor (primary or metastatic); ischemic stroke
within the past 3 months, EXCEPT for acute ischemic stroke
within the past 3 hours; suspected aortic dissection; active
bleeding or bleeding disorders (except menses); and significant
closed head trauma or facial trauma within the pa st 3 months.
Relative contraindications (eg, the physician may deem
fibrinolytic therapy appropriate under certain circumstances)
include, a history of chronic, severe, poorly -controlled
hypertension; severe uncontrolled hypertension on
presentation (SBP > 180 mm Hg or DBP > 110 mm Hg); ischemic
stroke greater than 3 months ago; dementia; traumatic or
prolonged (> 10 minutes) CPR or major surgery within the past 3
weeks; recent (within 2 to 4 weeks) internal bleeding;
noncompressible vascular punctures; pregnancy; prior exposure
All rights reserved © 2025/ 2026 |
, Page |3
(> 5 days ago) or prior allergic reaction to streptokinase or
anistreplase; active peptic ulcer; and current use of
anticoagulants (ie, Coumadin).
A middle-aged man presents with chest discomfort, shortness of
breath, and nausea. You give him supplemental oxygen and continue
your assessment. As your partner is attaching the ECG leads, you
should:
Ans: Administer up to 325 mg of aspirin.
Since oxygen has already been administered to this patient and
your partner is attaching the ECG leads, you should administer
aspirin (160 to 325 mg, non-enteric-coated). Early
administration of aspirin has clearly been shown to reduce
mortality and morbidity in patients experiencing an acute
coronary syndrome (ACS). After establishing vascul ar access,
you should assess his vital signs and then administer 0.4 mg of
nitroglycerin (up to 3 doses, 5 minutes apart), provided that his
systolic BP is greater than 90 mm Hg. If 3 doses of nitroglycerin
fail to completely relieve his chest discomfort, consider
administering 2 to 4 mg of morphine IV, provided that his
systolic BP remains above 90 mm Hg.
Which of the following ECG lead configurations is correct?
All rights reserved © 2025/ 2026 |
, Page |4
Ans: To assess lead II, place the negative lead on the right arm
and the positive lead on the left leg.
According to the Einthoven triangle, lead I is assessed by
placing the negative (white) lead on the right arm and the
positive (red) lead on the left arm. Lead II is assessed by placing
the negative lead on the right arm and the positi ve lead on the
left leg. Lead III is assessed by placing the negative lead on the
left arm and the positive lead on the left leg.
A 61-year-old male presents with chest pressure that woke him up
from his nap 30 minutes ago. He is diaphoretic, anxious, and rates his
pain as an an 8 over 10. His past medical history is significant for
hypertension, type II diabetes, and coronary stent placement 2 months
ago. He takes lisinopril, Plavix, and Glucophage, and is wearing a
medical alert bracelet stating "allergic to salicylates." His blood
pressure is 160/100 mm Hg, pulse is 110 beats/min, and respirations are
22 breaths/min. The 12-lead ECG shows sinus tachycardia with 3-mm
ST segment elevation in leads V1 through V5. Which of the following
treatment modalities is MOST appropriate for this patient?
Ans: Supplemental oxygen, vascular access, up to three 0.4 mg
doses of nitroglycerin, and 2 to 4 mg of morphine sulfate if his
systolic BP is greater than 90 mm Hg and he is still experiencing
pain.
All rights reserved © 2025/ 2026 |
