Biloxi EMT CH 17 Cardiovascular Emergencies Flashcards

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1
Q

____________ allows a cardiac muscle to contract spontaneously without a stimulus from a nerve source.

a. Repetition
b. Reactivity
c. Automaticity
d. Autonomy

A

c. Automaticity

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2
Q

The aorta receives its blood supply from the:

a. right atrium
b. left atrium
c. right ventricle
d. left ventricle

A

d. left ventricle

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3
Q

Blood enters the right atrium from the body through the:

a. vena cava
b. aorta
c. pulmonary artery
d. pulmonary vein

A

a. vena cava

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4
Q

The only vein(s) in the body that carry oxygenated blood is/are the:

a. external jugular veins
b. pulmonary veins
c. subclavian veins
d. inferior vena cava

A

b. pulmonary veins

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5
Q

Normal electrical impulses originate in the sinus node, in the upper part of the right:

a. atrium
b. ventricle
c. superior vena cava
d. aortic arch

A

a. atrium

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6
Q

Dilation of the coronary arteries _____________ flood flow.

a. shuts off
b. increases
c. decreases
d. regulates

A

b. increases

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7
Q

The __________ are tiny blood vessels that are approximately one cell thick.

a. arterioles
b. venules
c. capillaries
d. ventricles

A

c. capillaries

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8
Q

_________ carry oxygen to the body’s tissues and then remove carbon dioxide.

a. Red blood cells
b. White blood cells
c. Platelets
d. Veins

A

a. Red blood cells

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9
Q

_________ is the maximum pressure exerted by the left ventricle as it contracts.

a. Cardiac output
b. Diastolic blood pressure
c. Systolic blood pressure
d. Stroke volume

A

c. Systolic blood pressure

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10
Q

Atherosclerosis can lead to a complete __________ of a coronary artery.

a. occlusion
b. disintegration
c. dilation
d. contraction

A

a. occlusion

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11
Q

The lumen of an artery may be partially or completely blocked by the blood-clotting system due to a _________ that exposes the inside of the atherosclerotic wall.

a. tear
b. crack
c. clot
d. rupture

A

b. crack

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12
Q

Tissues downstream from a blood clot will suffer from lack of oxygen. If blood flow is resumed in a short time, the _________ tissues will recover.

a. sclerotic
b. hypoxic
c. necrotic
d. rheumatic

A

b. hypoxic

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13
Q

Risk factors for myocardial infarction include all of the following EXCEPT:

a. male gender
b. high blood pressure
c. stress
d. increased levels of anxiety

A

d. increased levels of anxiety

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14
Q

When, for a brief period of time, heart tissues do not get enough oxygen, the pain is called:

a. necrosis
b. angina
c. ischemia
d. atherosclerosis

A

b. angina

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15
Q

Angina pain may be felt in the:

a. epigastrium
b. legs
c. lower back
d. lower abdomen

A

a. epigastrium

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16
Q

The underlying cause of a dissecting aortic aneurysm is

a. controlled hypertension
b. uncontrolled hypertension
c. transient hypertension
d. benign hypertension

A

b. uncontrolled hypertension

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17
Q

Because of the oxygen supply to the heart is diminished with angina, the ____________ can become compromised, putting the person at risk for significant cardiac rhythm problems.

a. respiratory system
b. clotting cascade
c. electrical system
d. vasculature

A

c. electrical system

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18
Q

About _________ minutes after blood flow is cut off, some heart muscle cells begin to die.

a. 10
b. 20
c. 30
d. 40

A

c. 30

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19
Q

An acute myocardial infarction is more likely to occur in the larger, thick-walled left ventricle, which needs more _________ than the right ventricle.

a. oxygen and glucose
b. force to pump
c. blood and oxygen
d. electrical activity

A

c. blood and oxygen

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20
Q

Which of the following statements regarding congestive heart failure (CHF) Is false?

a. Stridor is a common lung sound heard on exam.
b. It can be caused by diseased heart valves.
c. It can be treated with nitroglycerin.
d. Ankle edema is a common finding.

A

a. Stridor is a common lung sound heard on exam.

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21
Q

Cardiogenic shock often occurs soon after a(n):

a. hypertensive emergency
b. acute myocardial infarction
c. aortic aneurysm
d. unstable angina attack

A

b. acute myocardial infarction

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22
Q

Sudden death is usually the result of ___________, in which the heart fails to regenerate an effective blood flow.

a. acute myocardial infarction (AMI)
b. atherosclerosis
c. premature ventricular contractions (PVCs)
d. cardiac arrest

A

d. cardiac arrest

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23
Q

Disorganized, ineffective quivering of the ventricles is known as:

a. ventricular fibrillation
b. asystole
c. ventricular standstill
d. ventricular tachycardia

A

a. ventricular fibrillation

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24
Q

Which of the following is NOT a cause of CHF?

a. Chronic hypotension
b. Heart valve damage
c. Myocardial infarction
d. Long-standing high blood pressure

A

a. Chronic hypotension

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25
Q

Signs and symptoms of shock include all of the following EXCEPT:

a. elevated heart rate
b. pale, clammy skin
c. air hunger
d. elevated blood pressure

A

d. elevated blood pressure

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26
Q

Which of the following changes in heart function occurs in patients with CHF?

a. A decrease in heart rate
b. Enlargement of the left ventricle
c. Enlargement of the right ventricle
d. A decrease in blood pressure

A

b. Enlargement of the left ventricle

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27
Q

Physical findings of AMI include skin that is ___________ because of poor cardiac output and the loss of perfusion.

a. pink
b. white
c. gray
d. red

A

c. gray

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28
Q

All patient assessments begin by determining whether the patient:

a. is breathing
b. can talk
c. is responsive
d. has a pulse

A

c. is responsive

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29
Q

To assess chest pain, use the mnemonic:

a. AVPU
b. OPQRST
c. SAMPLE
d. CHART

A

b. OPQRST

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30
Q

When using the mnemonic OPQRST, the “P” stands for:

a. paresthesia
b. pain
c. provocation
d. predisposing factors

A

c. provocation

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31
Q

In addition to angina and myocardial infarction, nitroglycerin can be used to treat:

a. CHF
b. cardiogenic shock
c. aortic aneurism
d. hypertensive emergency

A

a. CHF

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32
Q

When administering nitroglycerin to a patient, you should make sure the patient has not taken any medications for ___________ in the last 24 hours.

a. angina
b. erectile dysfunction
c. migraine headaches
d. gallbladder infection

A

b. erectile dysfunction

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33
Q

In general, a maximum of ___________ dose(s) of nitroglycerin is/are given for any one episode of chest pain.

a. one
b. two
c. three
d. four

A

c. three

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34
Q

____________ are inserted when the electrical control system of the heart is so damaged that it cannot function properly.

a. Stents
b. Pacemakers
c. Balloon angioplasties
d. Defibrillations

A

b. Pacemakers

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35
Q

When the battery wears out in a pacemaker, the patient may experience:

a. syncope
b. chest pain
c. nausea
d. tachycardia

A

a. syncope

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36
Q

The computer inside the AED is specifically programmed to recognize rhythms that require defibrillation to correct, most commonly:

a. asystole
b. ventricular tachycardia
c. ventricular fibrillation
d. supraventricular tachycardia

A

c. ventricular fibrillation

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37
Q

The AED should be applied only to unresponsive patients with no:

a. significant medical problems
b. cardiac history
c. pulse
d. brain activity

A

c. pulse

38
Q

_________ usually refers to a state of cardiac arrest despite an organized electrical complex.

a. Asystole
b. Pulseless electrical activity
c. Ventricular fibrillation
d. Ventricular tachycardia

A

b. Pulseless electrical activity

39
Q

The links in the chain of survival include all of the following EXCEPT:

a. immediate high-quality CPR
b. ALS and postarrest care
c. administration of nitroglycerin
d. rapid defibrillation

A

c. administration of nitroglycerin

40
Q

Defibrillation works best if it takes place within ____________ minutes of the onset of cardiac arrest.

a. 2
b. 4
c. 6
d. 10

A

a. 2

41
Q

At 0500, you respond to the home of a 76-year-old man complaining of chest pain. On arrival, the patient states that he had been sleeping in the recliner all night due to indigestion. He also tells you he has taken two nitroglycerin tablets. He continues to have pain and reports trouble breathing.

Your first priority is to:

a. apply an AED.
b. provide high-flow oxygen.
c. evaluate the need to administer a third nitroglycerin tablet.
d. size-up the scene.

A

d. size-up the scene.

42
Q

At 0500, you respond to the home of a 76-year-old man complaining of chest pain. On arrival, the patient states that he had been sleeping in the recliner all night due to indigestion. He also tells you he has taken two nitroglycerin tablets. He continues to have pain and reports trouble breathing.

His vital signs are as follows: respirations, 16 breaths/min; pulse, 98 beats/min; blood pressure, 92/76 mm Hg. He is still complaining of chest pain. What actions should you take to intervene?

a. Provide high-flow oxygen.
b. Administer a third nitroglycerin tablet.
c. Apply an AED.
d. Begin chest compressions.

A

a. Provide high-flow oxygen.

43
Q

At 0500, you respond to the home of a 76-year-old man complaining of chest pain. On arrival, the patient states that he had been sleeping in the recliner all night due to indigestion. He also tells you he has taken two nitroglycerin tablets. He continues to have pain and reports trouble breathing.

Your patient suddenly becomes unresponsive. Assessment reveals no breathing and no pulse. Your partner begins chest compressions while you apply the AED. When operating an AED, what is the first step in the defibrillation sequence?

a. Plug the pads connector to the AED.
b. Apply the AED pads to the patient’s chest.
c. Remove clothing from the patient’s chest.
d. Turn on the AED.

A

d. Turn on the AED.

44
Q

At 0500, you respond to the home of a 76-year-old man complaining of chest pain. On arrival, the patient states that he had been sleeping in the recliner all night due to indigestion. He also tells you he has taken two nitroglycerin tablets. He continues to have pain and reports trouble breathing.

After applying the AED to this patient, the AED states, “No shock advised.” What is your next step of action?

a. Load and transport the patient.
b. Push to reanalyze.
c. Perform CPR for 2 minutes, starting with chest compressions, then have the AED reanalyze.
d. Consider termination.

A

c. Perform CPR for 2 minutes, starting with chest compressions, then have the AED reanalyze.

45
Q

At 0500, you respond to the home of a 76-year-old man complaining of chest pain. On arrival, the patient states that he had been sleeping in the recliner all night due to indigestion. He also tells you he has taken two nitroglycerin tablets. He continues to have pain and reports trouble breathing.

Your patient is now conscious, and you are en route to the hospital. You are six blocks away when the patient stops breathing again and no longer has a pulse. You should:

a. continue to the hospital
b. continue to the hospital and analyze the rhythm
c. stop the vehicle and analyze the rhythm
d. only perform chest compressions

A

c. stop the vehicle and analyze the rhythm

46
Q

True/False

The right side of the heart pumps oxygen-rich blood to the body.

A

False

47
Q

True/False

In the normal heart, the need for increased blood flow to the myocardium is easily met by an increase in heart rate.

A

False

48
Q

True/False

Atherosclerosis results in narrowing of the lumen of coronary arteries.

A

True

49
Q

True/False

Infarction is a temporary interruption of the blood supply to the tissues.

A

False

50
Q

True/False

Angina can result from a spasm of the artery.

A

True

51
Q

True/False

The pain of angina and the pain of AMI are easily distinguishable.

A

False

52
Q

True/False

Nitroglycerin works in most patients within 5 minutes to relieve the pain of AMI.

A

True

53
Q

True/False

If an AED malfunctions during use, you must report that problem to the manufacturer and the U.S. Food and Drug Administration (FDA).

A

True

54
Q

True/False

Angina occurs when the heart’s need for oxygen exceeds its supply.

A

True

55
Q

True/False

White blood cells are the most numerous cells in the blood and help the blood to clot.

A

False

56
Q

True/False

Cardiac arrest in children is less common than in adults and is usually caused by a breathing problem.

A

True

57
Q

True/False

An AED with special pediatric pads may be used on pediatric medical patients between the ages of 1 month and 8 years who have been assessed to be unresponsive, not breathing, and pulseless.

A

True

58
Q

True/False

Dissecting aortic aneurysms are rarely considered life threatening.

A

False

59
Q

True/False

Heart disease is the number-one killer of women in the United States.

A

True

60
Q

True/False

If a patient complaining of chest pain has a history of a previous AMI, you should ask if this pain feels similar to the previous AMI.

A

True

61
Q

Fill in the blank.

The heart is divided down the middle by a wall called the ____________.

A

Septum

62
Q

Fill in the blank.

The ___________ is the body’s main artery.

A

aorta

63
Q

Fill in the blank.

The ___________ ventricle pumps blood in through the pulmonary circulation.

A

right

64
Q

Fill in the blank.

Electrical impulses spread from the ___________ node to the ventricles.

A

atrioventricular

65
Q

Fill in the blank.

Blood supply to the heart is increased by __________ of the coronary arteries.

A

dilation

66
Q

Fill in the blank.

_______ _______ cells remove carbon dioxide from the body’s tissues.

A

Red blood

67
Q

Fill in the blank.

________ blood pressure reflects the pressure on the walls of the arteries when the ventricle is at rest.

A

diastolic

68
Q

Fill in the blank.

The heart has __________ chambers.

A

four

69
Q

Fill in the blank.

The ________ side of the heart is more muscular because it must pump blood into the aorta and all the other arteries of the body.

A

left

70
Q

Fill in the blank.

_________ is the most effective way to assist a person with CHF to breathe effectively and to prevent an invasive airway management technique.

A

CPAP

71
Q

Fill in the blank.

The collection of fluid in the part of the body that is closest to the ground is called __________ _________.

A

Dependent edema

72
Q

Fill in the blank.

A hypertensive emergency usually occurs only with a systolic pressure greater than____________.

A

180 mm Hg

73
Q

Fill in the blank.

In CHF blood tends to back up in the __________ __________, increasing the pressure in the capillaries of the lungs.

A

pulmonary veins

74
Q

Fill in the blank.

A late finding in cardiogenic shock would be a systolic blood pressure of less than ___________.

A

90 mm Hg

75
Q

Fill in the blank.

Damage to the __________ area of the heart often presents with bradycardia.

A

Inferior

76
Q

In contrast to the sympathetic nervous system, the parasympathetic nervous system:

a. prepares the body to handle stress.
b. causes an increase in the heart rate.
c. slows the heart and respiratory rates.
d. dilates the blood vessels in the muscles.

A

c. slows the heart and respiratory rates.

77
Q

The right coronary artery supplies blood to the:

a. left ventricle and inferior wall of the right atrium.
b. right ventricle and inferior wall of the left ventricle.
c. right atrium and posterior wall of the right ventricle.
d. left ventricle and posterior wall of the right ventricle.

A

b. right ventricle and inferior wall of the left ventricle.

78
Q

The iliac arteries immediately subdivide into the:

a. femoral arteries.
b. peroneal arteries.
c. anterior tibial arteries.
d. posterior tibial arteries.

A

a. femoral arteries.

79
Q

Narrowing of the coronary arteries caused by a buildup of fatty deposits called:

a. angina pectoris.
b. arteriosclerosis.
c. acute ischemia.
d. atherosclerosis.

A

d. atherosclerosis.

80
Q

Angina pectoris occurs when:

a. a coronary artery is totally occluded by plaque.
b. myocardial oxygen demand exceeds supply.
c. one or more coronary arteries suddenly spasm.
d. myocardial oxygen supply exceeds the demand.

A

b. myocardial oxygen demand exceeds supply.

81
Q

The MOST common reason that many people experiencing AMI do not seek immediate medical attention is because they:

a. are elderly.
b. are in denial.
c. cannot afford it.
d. do not trust EMTs.

A

b. are in denial.

82
Q

When documenting a patient’s description of his or her chest pain or discomfort, the EMT should:

a. use medical terminology.
b. use the patient’s own words.
c. underline the patient’s quotes
d. document his or her own perception

A

b. use the patient’s own words.

83
Q

Which of the following signs is commonly observed in patients with right-sided heart failure?

a. Labored breathing
b. Dependent edema
c. Pulmonary edema
d. Flat jugular veins

A

b. Dependent edema

84
Q

A dissecting aortic aneurysm occurs when:

a. all layers of the aorta suddenly contract.
b. a weakened area develops in the aortic wall.
c. the inner layers of the aorta become separated.
d. the aorta ruptures, resulting in profound bleeding.

A

c. the inner layers of the aorta become separated.

85
Q

Upon arriving at the residence of a patient with a possible cardiac problem, it is MOST important to:

a. assess the scene for potential hazards.
b. determine if you need additional help.
c. request a paramedic unit for assistance.
d. gain immediate access to the patient.

A

a. assess the scene for potential hazards.

86
Q

Which of the following medications is commonly given to patients with chest pain to prevent blood clots from forming or getting bigger?

a. Furosemide (Lasix)
b. Aspirin
c. Oxygen
d. Metoprolol (Toprol)

A

b. Aspirin

87
Q

Which of the following statements regarding nitroglycerin is correct?

a. The potency of nitroglycerin is increased when exposed to light.
b. A maximum of five nitroglycerin is doses should be given to a patient.
c. Nitroglycerin should be administered between the cheek and gum.
d. Nitroglycerin usually relieves anginal chest pain within 5 minutes.

A

d. Nitroglycerin usually relieves anginal chest pain within 5 minutes.

88
Q

Most patients are instructed by their physician to take up to ___________ doses of nitroglycerin before calling EMS.

a. 2
b. 3
c. 4
d. 5

A

b. 3

89
Q

The AED is MOST advantageous to the EMT because:

a. it is lightweight, easy to use, and safe for the EMT who is using it.
b. it delivers prompt defibrillation to patients with ventricular fibrillation.
c. its use does not require the presence of advanced life support personnel.
d. it delivers an unlimited number of shocks with the same amount of energy.

A

b. it delivers prompt defibrillation to patients with ventricular fibrillation.

90
Q

Prior to attaching the AED to a cardiac arrest patient, the EMT should:

a. contact medical control.
b. dry the chest if it is wet.
c. perform CPR for 30 seconds.
d. assess for a pulse for 20 seconds.

A

b. dry the chest if it is wet.

91
Q

Cardiogenic shock following AMI is caused by:

a. decreased pumping force of the heart muscle.
b. a profound increase in the patient’s heart rate.
c. hypovolemia secondary to severe vomiting.
d. widespread dilation of the systemic vasculature.

A

a. decreased pumping force of the heart muscle.