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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. ---------CORRECT ANSWER-----------------A
Feedback :
An artificial pacemaker is implanted in a person whose own cardiac electrical
conduction system cannot maintain a regular rhythm and rate. If a pacemaker
stops working, as when the battery wears out or an internal lead becomes
detached, the patient often experiences syncope, dizziness, or weakness
because of an excessively slow heart rate (bradycardia). The pulse rate is
typically less than 60 beats/min because the heart is beating without the
stimulus of the pacemaker and without regulation of its own electrical
conduction system, which may be damaged. In these circumstances, the heart
tends to assume a fixed slow rate that may not be fast enough to maintain
adequate cardiac output. In some cases, the patient's heart rate may be so low
that he or she becomes hypotensive.
,You arrive at the scene of a 56-year-old man who collapsed. The patient's wife
tells you that he suddenly grabbed his chest and then passed out. Your
assessment reveals that he is apneic and pulseless. As your partner 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. ---------CORRECT ANSWER-----------------C
Feedback :
Immediate treatment for a patient in cardiac arrest involves performing CPR
and applying the AED as soon as possible. After applying the AED pads to the
patient's chest (around your partner's compressing hands), analyze his cardiac
rhythm, deliver a shock if indicated, and immediately resume CPR (starting with
chest compressions). Management of the airway, including insertion of an
airway adjunct, should occur during the 2-minute period of CPR in between
cardiac rhythm analysis and defibrillation. While CPR is in progress, obtain as
much of the patient's medical history from his wife as possible, and notify
medical control when it is practical (ie, you have more help at the scene).
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. ---------CORRECT
ANSWER-----------------B
Feedback :
Rescuer fatigue may lead to inadequate chest compression rate and/or depth.
Fatigue is common after 1 minute of CPR, although the rescuer may not
recognize it for 5 minutes or longer. Therefore, compressors should be changed
every 2 minutes (after 5 cycles of CPR at a 30:2 ratio) throughout the
resuscitation attempt. If the compressor is not switched until he or she
recognizes the fatigue, the patient has likely been without effective chest
compressions for at least 4 or 5 minutes. In general, interruptions in CPR should
be infrequent and should not exceed 10 seconds. However, every effort should
be made to switch compressors in less than 5 seconds.
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. ---------
CORRECT ANSWER-----------------B
Feedback :
The type of chest pain or discomfort associated with acute myocardial infarction
(AMI) is the same that is experienced by patients with angina pectoris (eg, dull,
crushing, pressure, heaviness); thus, you cannot distinguish AMI from angina
pectoris based solely on the type or quality of pain. Furthermore, the pain
associated with AMI, like that of angina, often radiates to the arm, jaw, back, or
, epigastrium. Relative to other causes of chest pain or discomfort (eg, pleurisy,
pneumothorax), the pain associated with AMI and angina does not worsen or
improve when the patient takes a breath. Rest and nitroglycerin often relieve
the pain associated with stable angina, but are less likely to relieve the pain
associated with unstable angina or AMI.
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? ---------CORRECT ANSWER------
-----------A
Feedback :
When questioning any patient about any type of pain, you should avoid asking
leading questions that can simply be answered yes or no. To obtain the most
reliable assessment, open-ended questions should be asked to allow the patient
to describe the quality of the pain in his or her own words.
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.