Time: 90 Minutes
Exam Covers-
Cardiovascular anatomy and physiology
Cardiac assessment
Acute coronary syndrome (ACS)
Cardiac medications
Other cardiovascular emergencies
Heart failure
Cardiac dysrhythmias
Cardiac arrest
Shock and perfusion
Clinical decision-making
1.
A 58-year-old patient reports crushing substernal chest pressure radiating to his
left arm. He is pale and diaphoretic. What should the EMT suspect?
A. Panic attack
B. Acute coronary syndrome (ACS) — CORRECT
C. Pneumonia
D. Gastroesophageal reflux
Rationale: Crushing substernal pressure with radiation and diaphoresis is highly
concerning for ACS. These symptoms can result from myocardial ischemia. Rapid
assessment and appropriate prehospital management are essential.
2.
Which chamber of the heart pumps oxygenated blood into systemic circulation?
A. Right atrium
,B. Right ventricle
C. Left atrium
D. Left ventricle — CORRECT
Rationale: The left ventricle pumps oxygenated blood through the aorta to the
systemic circulation. It has a thick muscular wall because it must generate high
pressure. This is the chamber responsible for maintaining systemic perfusion.
3.
A patient with chest pain has a blood pressure of 84/56 mmHg and appears pale
and weak. Which finding is most concerning?
A. Mild anxiety
B. Respiratory rate of 18/min
C. Hypotension indicating possible poor perfusion — CORRECT
D. Chest discomfort lasting 5 minutes
Rationale: Significant hypotension suggests inadequate circulating pressure and
potentially inadequate organ perfusion. In a patient with chest pain, this may
indicate serious cardiac dysfunction or cardiogenic shock. The EMT should prioritize
airway, breathing, circulation, and rapid transport.
4.
What is the primary function of the coronary arteries?
A. Carry blood from the lungs to the left atrium
B. Remove carbon dioxide from the blood
C. Supply oxygenated blood to the myocardium — CORRECT
D. Return blood from the body to the right atrium
Rationale: Coronary arteries supply the cardiac muscle with oxygen and nutrients.
Blockage of these vessels can cause myocardial ischemia. Prolonged ischemia can
result in myocardial infarction.
5.
A patient suddenly becomes unresponsive and is not breathing normally. You
cannot feel a pulse. What should you do first?
A. Obtain a blood pressure
B. Administer oral glucose
C. Begin high-quality CPR and use an AED as soon as available — CORRECT
D. Place the patient in the recovery position
Rationale: An unresponsive patient without a pulse is in cardiac arrest. Immediate
CPR and rapid defibrillation when indicated are critical interventions. Every minute
, without effective defibrillation in a shockable rhythm decreases the likelihood of
successful resuscitation.
6.
Which rhythm is most commonly associated with sudden cardiac arrest and is
potentially treatable with an AED?
A. Sinus bradycardia
B. Ventricular fibrillation — CORRECT
C. Sinus tachycardia
D. First-degree AV block
Rationale: Ventricular fibrillation produces chaotic ventricular electrical activity and
ineffective cardiac contractions. It is a shockable rhythm. Rapid defibrillation is one
of the most important treatments.
7.
A patient complains of palpitations and dizziness. The pulse is rapid and irregular.
Which condition should be considered?
A. Sinus bradycardia
B. Atrial fibrillation — CORRECT
C. Asystole
D. Pulseless electrical activity
Rationale: Atrial fibrillation commonly produces an irregularly irregular pulse. The
atria contract chaotically rather than producing coordinated contractions.
Depending on the ventricular rate, the patient may develop weakness, dizziness,
hypotension, or chest discomfort.
8.
Which symptom is particularly concerning for myocardial ischemia in a diabetic
patient?
A. Increased appetite
B. Unexplained shortness of breath — CORRECT
C. Increased urination
D. Mild itching
Rationale: Some patients, particularly those with diabetes, may experience atypical
or minimal chest pain during myocardial ischemia. Shortness of breath can be an
anginal equivalent. EMTs should consider ACS even when classic chest pain is
absent.
9.
Exam Covers-
Cardiovascular anatomy and physiology
Cardiac assessment
Acute coronary syndrome (ACS)
Cardiac medications
Other cardiovascular emergencies
Heart failure
Cardiac dysrhythmias
Cardiac arrest
Shock and perfusion
Clinical decision-making
1.
A 58-year-old patient reports crushing substernal chest pressure radiating to his
left arm. He is pale and diaphoretic. What should the EMT suspect?
A. Panic attack
B. Acute coronary syndrome (ACS) — CORRECT
C. Pneumonia
D. Gastroesophageal reflux
Rationale: Crushing substernal pressure with radiation and diaphoresis is highly
concerning for ACS. These symptoms can result from myocardial ischemia. Rapid
assessment and appropriate prehospital management are essential.
2.
Which chamber of the heart pumps oxygenated blood into systemic circulation?
A. Right atrium
,B. Right ventricle
C. Left atrium
D. Left ventricle — CORRECT
Rationale: The left ventricle pumps oxygenated blood through the aorta to the
systemic circulation. It has a thick muscular wall because it must generate high
pressure. This is the chamber responsible for maintaining systemic perfusion.
3.
A patient with chest pain has a blood pressure of 84/56 mmHg and appears pale
and weak. Which finding is most concerning?
A. Mild anxiety
B. Respiratory rate of 18/min
C. Hypotension indicating possible poor perfusion — CORRECT
D. Chest discomfort lasting 5 minutes
Rationale: Significant hypotension suggests inadequate circulating pressure and
potentially inadequate organ perfusion. In a patient with chest pain, this may
indicate serious cardiac dysfunction or cardiogenic shock. The EMT should prioritize
airway, breathing, circulation, and rapid transport.
4.
What is the primary function of the coronary arteries?
A. Carry blood from the lungs to the left atrium
B. Remove carbon dioxide from the blood
C. Supply oxygenated blood to the myocardium — CORRECT
D. Return blood from the body to the right atrium
Rationale: Coronary arteries supply the cardiac muscle with oxygen and nutrients.
Blockage of these vessels can cause myocardial ischemia. Prolonged ischemia can
result in myocardial infarction.
5.
A patient suddenly becomes unresponsive and is not breathing normally. You
cannot feel a pulse. What should you do first?
A. Obtain a blood pressure
B. Administer oral glucose
C. Begin high-quality CPR and use an AED as soon as available — CORRECT
D. Place the patient in the recovery position
Rationale: An unresponsive patient without a pulse is in cardiac arrest. Immediate
CPR and rapid defibrillation when indicated are critical interventions. Every minute
, without effective defibrillation in a shockable rhythm decreases the likelihood of
successful resuscitation.
6.
Which rhythm is most commonly associated with sudden cardiac arrest and is
potentially treatable with an AED?
A. Sinus bradycardia
B. Ventricular fibrillation — CORRECT
C. Sinus tachycardia
D. First-degree AV block
Rationale: Ventricular fibrillation produces chaotic ventricular electrical activity and
ineffective cardiac contractions. It is a shockable rhythm. Rapid defibrillation is one
of the most important treatments.
7.
A patient complains of palpitations and dizziness. The pulse is rapid and irregular.
Which condition should be considered?
A. Sinus bradycardia
B. Atrial fibrillation — CORRECT
C. Asystole
D. Pulseless electrical activity
Rationale: Atrial fibrillation commonly produces an irregularly irregular pulse. The
atria contract chaotically rather than producing coordinated contractions.
Depending on the ventricular rate, the patient may develop weakness, dizziness,
hypotension, or chest discomfort.
8.
Which symptom is particularly concerning for myocardial ischemia in a diabetic
patient?
A. Increased appetite
B. Unexplained shortness of breath — CORRECT
C. Increased urination
D. Mild itching
Rationale: Some patients, particularly those with diabetes, may experience atypical
or minimal chest pain during myocardial ischemia. Shortness of breath can be an
anginal equivalent. EMTs should consider ACS even when classic chest pain is
absent.
9.
