AEMT FINAL EXAM PREP ANSWERED 100% CORRECT

Which layer of the blood vessel is composed of elastic tissue and smooth muscle cells, which allow the vessel to expand or contract in response to the body's demands? - ANSWER-tunica media Which of the following MOST accurately describes the correct sequence of events after attaching an AED to a patient in cardiac arrest and pushing the analyze button? - ANSWER-"Shock advised" message, stand clear, defibrillate, immediately resume CPR, reanalyze after 2 minutes Unstable angina pectoris is characterized by: - ANSWER-chest pain or discomfort that may not be relieved by rest or nitroglycerin, and that occurs without a fixed frequency. The aortic valve: - ANSWER-regulates the flow of blood from the left ventricle to the systemic circulation Shortly after administering a second nitroglycerin dose to a 44-year-old male with chest pain, he becomes lightheaded. You take his blood pressure and is reads 80/50 mm Hg. You have already established IV access and are administering oxygen. You should: - ANSWER-place him supine and elevate his legs A middle-aged male presents with classic signs and symptoms of a dissecting aortic aneurysm. The MOST important intervention that you can perform for this patient is: - ANSWER-prompt transport The fifth link in the cardiac chain of survival includes: - ANSWER-temperature regulation and maintenance of glucose levels Which of the following would likely exacerbate pulmonary edema? - ANSWER-Increased cardiac preload You are assessing a 62-year-old female who has an automatic implantable cardiac defibrillator (AICD). As you are applying oxygen to her, she becomes unconscious, pulseless, and apneic. You should: - ANSWER-begin CPR and apply the AED as soon as possible You receive a call for a 40-year-old female with nausea, dizziness, and a headache. During your assessment, you note that her blood pressure is 190/104 mm Hg. The patient, who is conscious and alert, states that she has a history of hypertension, but admits to being noncompliant with her medications. In addition to IV therapy, appropriate treatment for this patient includes: - ANSWER-100% oxygen and transporting to the closest appropriate facility. When peripheral vascular resistance is increased: - ANSWER-afterload increases and stroke volume decreases A 55-year-old male with poorly controlled hypertension presents with respiratory distress and difficulty speaking in complete sentences. He is conscious and alert with a blood pressure of 150/90 mm Hg, a pulse rate of 110 beats/min, and respirations of 28 breaths/min and labored. Auscultation of his lungs reveals diffuse coarse crackles. After placing the position in a comfortable position, you should: - ANSWER-apply the CPAP device One of the MOST common signs of an acute hypertensive emergency is: - ANSWER-One of the MOST common signs of an acute hypertensive emergency is: The _____________ anchors the heart within the thoracic cavity and prevents cardiac overdistention. - ANSWER-pericardium A 56-year-old male with a history of coronary artery disease complains of an acute onset of substernal chest discomfort and diaphoresis while moving a heavy box. After sitting down and taking one nitroglycerin tablet, the discomfort promptly subsides. This episode is MOST consistent with: - ANSWER-stable angina pectoris What part of the cardiac electrical conduction system initiates electrical impulses at the slowest rate? - ANSWER-Areas below the AV node Pulseless electrical activity (PEA) exists when: - ANSWER-a patient is in cardiac arrest despite an organized cardiac rhythm When the papillary muscles contract, the ______________ tighten, preventing blood from regurgitating from the ventricles to the atria. - ANSWER-chordae tendineae Prinzmetal's angina is caused by: - ANSWER-coronary vasospasm Approximately two-thirds of the myocardium lies within the: - ANSWER-mediastinum When applying the AED pads to a patient with a surgically-implanted pacemaker, you should: - ANSWER-apply the pads at least 1" away from the pacemaker Which of the following represents the correct sequence of electrical conduction through the myocardium? - ANSWER-SA node, AV node, bundle of His, bundle branches, and Purkinje fibers After defibrillating an adult patient in cardiac arrest with the AED, you should: - ANSWER-begin or resume CPR starting with chest compressions. You receive a call to a local grocery store for a possible heart attack. Upon arrival at the scene, you find two bystanders performing CPR on the patient, a 49-year-old male. You should: - ANSWER-confirm that the patient is in cardiac arrest Which of the following statements regarding the automated external defibrillator (AED) is NOT correct? - ANSWER-A pulse should be checked immediately after the AED shocks The presence of distended jugular veins that do not collapse, even when the patient is sitting, is consistent with: - ANSWER-congestive heart failure Stimulation of the sympathetic nervous system results in: - ANSWER-increased blood pressure and heart rate A 60-year-old female is in possible cardiogenic shock. She is semiconscious with shallow respirations, an irregular pulse, and hypotension. Appropriate treatment for this patient should include: - ANSWER-assisted ventilation with a bag-mask device, thermal management, 20 mL/kg fluid bolus, and transport When the parasympathetic nervous system is stimulated, it: - ANSWER-slows the heart rate by decreasing SA node discharge. Which of the following cardiac dysrhythmias requires immediate defibrillation? - ANSWER-Non Perfusing ventricular fibrillation You are dispatched to a residence for a 4-year-old male who is not breathing. When you and your partner arrive at the scene, you find the child's father is performing mouth-to-mouth rescue breathing on him. The father tells you that his son stuck a pin in an electrical socket. After assessing the child and determining that he is pulseless and apneic, you should: - ANSWER-begin CPR and apply the AED as soon as possible Which of the following questions would be of LEAST pertinence when obtaining a focused history of a patient with an acute onset of chest discomfort? - ANSWER-Have you ever been told you have low blood pressure Compared to monophasic defibrillation, biphasic defibrillation is advantageous because it: - ANSWER-utilizes less energy to achieve effective defibrillation The visceral pericardium, which lies closely against the heart, is also called the: - ANSWER-epicardium The _____________ arteries arise from the aorta shortly after they leave the left ventricle. - ANSWER-coronary After defibrillating a patient in cardiac arrest with the AED, you should: - ANSWER-Resume chest compressions Following defibrillation with the AED, you have achieved return of spontaneous circulation (ROSC) in a 42-year-old man. However, he remains unresponsive and apneic. You insert a multilumen airway device, continue ventilations, and begin immediate transport to the hospital. En route, you reassess the patient and determine that he is in cardiac arrest. You should: - ANSWER-begin CPR, tell your partner to stop the ambulance, and analyze the patient's cardiac rhythm with the AED Which of the following MOST accurately describes the pathophysiology of angina pectoris? - ANSWER-Reversible process in which myocardial oxygen demand exceeds the supply of available oxygen The ability of a cardiac muscle cell to contract spontaneously without a stimulus from a nerve source is called: - ANSWER-automaticity When treating a 56-year-old female with chest pain, you have placed on her oxygen, established IV access, and administered two doses of sublingual nitroglycerin. However, the patient's pain has not improved. You reassess her blood pressure and note that it is 106/66 mm Hg. You should: - ANSWER-administer one more dose of nitroglycerin In addition to oxygen, which of the following medications would the AEMT be the MOST likely to administer to a patient who is experiencing acute chest pain, pressure, or discomfort? - ANSWER-Aspirin and nitroglycerin When errors associated with the AED occur, it is usually the result of: - ANSWER-failure to ensure the batteries are charged Effectively performed CPR is a crucial treatment for a patient in cardiac arrest because it: - ANSWER-maintains myocardial and cerebral perfusion. Percutaneous coronary intervention (PCI) involves: - ANSWER-mechanically clearing a coronary artery. Afterload is defined as the: - ANSWER-pressure against which the left ventricle must pump. Treatment for a patient experiencing a cardiovascular emergency begins by: - ANSWER-ensuring airway patency and adequate breathing. While treating a patient who is in cardiogenic shock, your paramedic partner makes the comment that the patient needs an inotropic medication. You should recall that this type of medication is intended to: - ANSWER-affect the strength of cardiac contraction Blood enters the right atrium through the: - ANSWER-vena cavae and coronary sinus Damage to the myocardium following infarction can be minimized if fibrinolytic therapy is administered no later than _____ hours following the onset of symptoms. - ANSWER-12 When defibrillating a 6-month-old infant, you should recall that: - ANSWER-a manual defibrillator is preferred When assessing a patient for peripheral edema, you should check the sacral area if the patient is: - ANSWER-bedridden A 71-year-old man presents with shortness of breath, facial cyanosis, and a cough that is producing blood. His blood pressure is 144/92 mm Hg, pulse is 130 beats/min and irregular, and respirations of 28 breaths/min and labored. He is confused and is slow follow your commands. You should: - ANSWER-assist his ventilations with a bag-mask device, begin transport, and consider establishing IV access en route to the hospital The term that refers to the contraction of the ventricular mass and the pumping of blood into the systemic circulation is called: - ANSWER-systole When treating a patient with a blood pressure of 80/40 mm Hg due to "pump failure," you should: - ANSWER-give a 20 mL/kg crystalloid fluid bolus to improve perfusion A patient with acute chest discomfort took two of his prescribed nitroglycerin tablets and is now experiencing a pounding headache. However, he tells you that he is still experiencing chest discomfort. You should suspect that: - ANSWER-he is experiencing ongoing myocardial ischemia Asystole has an exceedingly high mortality rate because it: - ANSWER-reflects a prolonged period of myocardial ischemia Which of the following is NOT a component of the cardiac electrical conduction system? - ANSWER-interatrial septum You are transporting a 55-year-old female with chest pain, who has not responded to 3 doses of nitroglycerin. As you are talking to her, she becomes unresponsive and apneic. You should: - ANSWER-assess her pulse, tell your partner to stop the vehicle, begin CPR, and analyze her cardiac rhythm with an AED What are the physiologic effects of nitroglycerin when given to a patient with suspected cardiac-related chest pain? - ANSWER-Vascular smooth muscle relaxation and coronary artery dilation The primary function of the atrioventricular (AV) node is to: - ANSWER-slow conduction from the atria to the ventricles to allow for ventricular filling. Damage to the ___________ valve may cause blood to regurgitate into the lungs - ANSWER-mitral Approximately 60% to 70% of deaths due to acute myocardial infarction occur: - ANSWER-during the first 2 to 3 hours after symptom onset You are dispatched to a residence for a 59-year-old male with an unknown emergency. When you arrive, you find the patient sitting on the couch. He is conscious, noticeably diaphoretic, and complains of dizziness and weakness. During your assessment, you note a large, well-healed vertical scar in the center of his chest and a small bulge just under the skin in the upper left part of his chest. His blood pressure is 90/50 mm Hg, pulse is 44 beats/min and weak, and respirations are 24 breaths/min and unlabored. What is the MOST likely cause of this patient's condition? - ANSWER-Artificial pacemaker failure What three major arteries arise from the aortic arch? - ANSWER-brachiocephalic, left common carotid, left subclavian The left main coronary artery rapidly divides into the: - ANSWER-left anterior descending and circumflex arteries A hypertensive crisis is considered to be a true emergency when: - ANSWER-signs of central nervous system dysfunction are present The middle, muscular layer of the heart is called the: - ANSWER-myocardium What is the approximate cardiac output of a person with a heart rate of 70 beats/min and a stroke volume of 75 mL? - ANSWER-5 L/min A 49-year-old male complains of acute chest discomfort. He is conscious but restless, and he is noticeably diaphoretic. As your partner is applying 100% oxygen, the patient hands you a bottle of nitroglycerin that was prescribed to him by his family physician. Prior to assisting the patient with his medication, you should: - ANSWER-assess his systolic BP to ensure that it is at least 100 mm Hg After applying the AED to your cardiac-arrest patient, you receive a "shock advised" message. You should: - ANSWER-ensure that all contact with the patient has ceased. During your primary assessment of an unresponsive 47-year-old male, you find that he has occasional gasping breaths. You should: - ANSWER-assess for a carotid pulse and begin chest compressions if needed During your assessment of a woman with chronic shortness of breath and fatigue, you ask her how many pillows she sleeps with at night. You are asking her this question to determine if: - ANSWER-she has left-sided heart failure and how severe it may be Which of the following clinical presentations is consistent with a malfunctioning implanted pacemaker? - ANSWER-Syncope and bradycardia Which of the following cardiac rhythms or conditions requires defibrillation? - ANSWER-Ventricular tachycardia without a pulse A 33-year-old male complains of generalized weakness and chest discomfort that began following his morning workout at the gym. He is conscious and alert, but restless. Your assessment reveals a BP of 130/64 mm Hg, pulse of 78 beats/min and occasionally irregular, respirations of 16 breaths/min and unlabored, and an SpO2 of 98% on room air. He has prescribed nitroglycerin tablets and states that he took one without relief. Appropriate treatment for this patient includes: - ANSWER-oxygen via nasal cannula, up to 324 mg aspirin, saline lock, additional nitroglycerin per medical control, and transport An acute myocardial infarction is more apt to occur in the left ventricle because: - ANSWER-it is large and thick and demands more oxygen than the right ventricle. Common signs of left-sided congestive heart failure include all of the following, EXCEPT: - ANSWER-chronic pedal edema When assessing a middle-aged male patient with chest pain, you note a large vertical scar in the center of his chest. This indicates that he has MOST likely had: - ANSWER-coronary artery bypass graft Nitroglycerin is contraindicated for patients who: - ANSWER-have experienced a head injury You should be MOST suspicious that a patient is experiencing an acute myocardial infarction if he or she presents with: - ANSWER-an acute onset of weakness, nausea, and sweating without an obvious cause Erythropoiesis is the ongoing process by which - ANSWER-red blood cells are made You respond to call at a residence for a "man down." Your primary assessment reveals that the patient, a 66-year-old male, is unresponsive, pulseless, and apneic. His wife tells you that he has recently had the flu, and that he collapsed about 10 minutes ago. You should: - ANSWER-begin CPR and apply the AED as soon as it is available. The MOST common cardiac dysrhythmia associated with sudden cardiac death following an acute myocardial infarction is: - ANSWER-ventricular fibrillation The coronary arteries of a person with arteriosclerotic heart disease: - ANSWER-are thickened and hardened and lose their elasticity A 50-year-old female is in cardiac arrest. You attach the AED and receive a "no shock advised" message. You should: - ANSWER-resume CPR and reanalyze her cardiac rhythm after 2 minutes A 62-year-old female with a history of hypertension and diabetes presents with a sudden tearing sensation in her abdomen. She tells you that the pain has been of maximum intensity since its onset. Based on her chief complaint, what additional assessment findings would you expect to encounter? - ANSWER-Diminished pulses in her lower extremities As with angina, the pain associated with acute myocardial infarction is often described as: - ANSWER-pressure The normal site of origin of electrical impulses in the heart is the ____________, which generates ___________ impulses per minute. - ANSWER-sinoatrial node, 60 to 100 The tricuspid and mitral valves of the heart are referred to as: - ANSWER-atrioventricular valves Which of the following valves of the heart are semilunar valves? - ANSWER-aortic and pulmonic Excess glucose is stored in the liver and skeletal muscles in the form of: - ANSWER-glycogen Following the administration of one tube of oral glucose, your 20-year-old female diabetic patient's condition markedly improves. You should: - ANSWER-transport her to the hospital and reassess her blood sugar en route. The primary fuels for cellular metabolism are: - ANSWER-glucose and oxygen In which of the following situations would a diabetic patient MOST likely develop hypoglycemic crisis (insulin shock)? - ANSWER-Heavy exertion following a small meal Kussmaul respirations indicate that the respiratory system is: - ANSWER-excreting ketones from the blood The metabolic conversion of glucose into energy is called: - ANSWER-glycolysis Patients with thrombophilia are at an increased risk for: - ANSWER-pulmonary embolism A young male with sickle cell disease presents with chest pain, fever, and a cough. His vital signs are stable, although he is experiencing mild respiratory distress. You should suspect: - ANSWER-pneumonia Which of the following conditions would result in the MOST rapid loss of consciousness? - ANSWER-Acute hypoglycemia A 39-year-old male with a history of type 1 diabetes is found unresponsive by his wife. When obtaining initial information from the wife, which of the following questions would be LEAST pertinent? - ANSWER-"Was your husband hospitalized for this problem in the past?" Glycogenolysis is a metabolic process in which: - ANSWER-glucagon converts stored glycogen into glucose Type 1 diabetes: - ANSWER-is a metabolic condition in which no insulin is produced by the body The normal range for blood glucose levels in nonfasting adults and children ranges from: - ANSWER-80-120 mg/dL When a patient's blood glucose level increases significantly, the: - ANSWER-kidneys excrete excess glucose via water. An acute accelerated drop in the hemoglobin level, which is caused by red blood cells breaking down at a faster rate than normal, occurs during a(n) __________ crisis. - ANSWER-hemolytic You respond to a movie theater for a 70-year-old male who is confused. His wife tells you he has type 2 diabetes but refuses to take his pills. Your assessment reveals that he is diaphoretic, tachycardic, and tachypneic. Initial treatment for this patient should include: - ANSWER-applying a nonrebreathing mask at 15 L/min. You are caring for a 27-year-old male with suspected ketoacidosis. He is unresponsive and his blood glucose level, as measured by glucometer, reads "high." His blood pressure is 80/50 mm Hg, pulse is 130 beats/min and weak, and respirations are 40 breaths/min and shallow. Which of the following represents the MOST appropriate treatment approach? - ANSWER-Assisted ventilation, 20 mL/kg crystalloid boluses to maintain perfusion, transport, and consider an advanced airway Which of the following statements regarding hyperosmolar hyperglycemic nonketotic coma (HHNC) is correct? - ANSWER-HHNC is not associated with a fruity odor on the patient's breath. A potential complication associated with the administration of D50 is: - ANSWER-tissue necrosis if it extravasates into the soft tissues Prior to administering glucagon, you must: - ANSWER-reconstitute it with diluent. Glucagon will NOT be effective if: - ANSWER-glycogen stores in the liver are depleted You respond to a residence for a patient who is "not acting right." As you approach the door, the patient, a 35-year-old male, begins shouting profanities at you and your partner while holding a baseball bat. The man is confused and diaphoretic, and is wearing a medical identification bracelet. You should: - ANSWER-retreat at once and call law enforcement. Which of the following complications is MOST commonly associated with hypoglycemic crisis (insulin shock)? - ANSWER-seizures The anterior pituitary gland secretes thyroid-stimulating hormone (TSH) in response to the: - ANSWER-hypothalamus' secretion of thyrotropin-releasing hormone (TRH) Which of the following statements regarding sickle cell disease is correct? - ANSWER-In sickle cell disease, the red blood cells are abnormally shaped and are less able to carry oxygen. Signs and symptoms of hyperthyroidism include: - ANSWER-tachycardia, weight loss, and hyperactive reflexes Excessive eating caused by cellular "hunger" is called: - ANSWER-polyphagia A 22-year-old female with type 1 diabetes is unresponsive and has a blood glucose level of 29 mg/dL. She is receiving high-flow oxygen and several attempts to establish IV access have failed. You should: - ANSWER-administer 0.5 to 1 mg of glucagon via the intramuscular route Insulin maintains homeostasis by: - ANSWER-facilitating cellular glucose uptake. A common clinical finding in patients with hypo- or hyperglycemic crisis is: - ANSWER-an altered mental status. Patients with hypothyroidism often gain weight because of: - ANSWER-decreased metabolism A 29-year-old male with a history of type 1 diabetes presents with excessive urination and marked thirst. These signs indicate that the: - ANSWER-renal system is excreting excess glucose Which of the following statements regarding Kussmaul respirations is correct? - ANSWER-The SpO2 may be normal due to an increase in respiratory rate and depth Elderly patients with diabetes commonly develop neuropathy, which predisposes them to: - ANSWER-atypical acute coronary syndrome In which of the following patients would it be MOST appropriate to administer oral glucose? - ANSWER-Confused diabetic patient who is breathing adequately