CH 20 Cardiac Emergencies Flashcards
H1). What describes the normal contraction, or beating, of the heart? A. Irregular B. Unsteady C. Voluntary D. Rhythmic
D. Rhythmic
The contraction, or beating, of the heart is an automatic, involuntary process that is controlled by the heart’s own natural “pacemaker” and the cardiac conduction system. It is rhythmic when normal, not irregular or unsteady, and the contraction of the heart is never voluntary
2). The first organ perfused by oxygenated blood leaving the heart is the: A. brain. B. heart. C. liver. D. lungs.
B. heart.
3). Which of the following cardiac patients is most likely to present without the typical presentation of chest discomfort? A. Athlete B. Female C. Bariatric patient D. Male
B. Female
Acute coronary syndrome without pain is a relatively common finding in older adult, female, and diabetic patients.
4). Which of the following is true of women who are experiencing cardiac problems?
A.They often do not present with chest pain.
B.They are more likely to experience stress-related chest pain.
C.If they have no chest pain, they are rarely experiencing a heart attack.
D.They often develop cardiac problems earlier in life than do men.
A.They often do not present with chest pain.
5). A 61-year-old female complains of feeling tired over the past 2 days. She also notes difficulty breathing, sweating, and nausea. You should suspect: A. menopause. B. acute coronary syndrome. C. a stroke. D. hypoglycemia.
B. acute coronary syndrome.
Women often have an atypical presentation during ACS, so maintain a high index of suspicion when they present with cardiac signs and symptoms other than the typical chest discomfort. Weakness, nausea, difficulty breathing, and sweating are all signs that point to ACS.
6). Which of the following is true of cardiac compromise?
A. All adult chest pain patients should be given nitroglycerin and aspirin.
B. The AED should be applied to all adult patients who are complaining of chest pain.
C. There are no medications within the EMT scope that can help to limit damage to heart muscle.
D. All adults with chest discomfort should be treated as having a cardiac emergency.
D. All adults with chest discomfort should be treated as having a cardiac emergency.
Treat all adults with chest pain as having a possible cardiac emergency until instructed otherwise by medical direction. There are medications that can be given to limit damage, but these medications should not be given to everyone who is complaining of pain. An AED should not be applied to a conscious patient.
7). The mnemonic to remember when obtaining a description of the patient's chest pain is: A. SAMPLE. B. DCAP-BTLS. C. OPQRST. D. AVPU.
C. OPQRST.
The mnemonic OPQRST stands for onset, provocation, quality, radiation, severity, and time. This is a useful tool to help keep the EMT focused on what questions to ask a patient with chest pain.
8). Nitroglycerin eases chest pain by:
A. increasing the amount of oxygen that is absorbed by the blood in the lungs.
B. relaxing blood vessels and decreasing the workload of the heart.
C. relaxing the patient and reducing anxiety.
D. constricting blood vessels and sending more blood back to the heart.
B. relaxing blood vessels and decreasing the workload of the heart.
The vasodilatory effects of nitroglycerin include coronary vasodilation, which increases blood flow to the heart, and vasodilation of the peripheral vessels, which drops systemic resistance and makes it easier for the heart to eject blood into the aortic root.
9). A 65-year-old male complains of acute-onset chest pain. He says that he is also nauseated and weak. You note that he is sweaty and slightly pale, and his vital signs are P 110, BP 84/60, R 24. His oxygen saturation is 95% on room air. You should first administer: A. 12 lpm oxygen via nonrebreather mask. B. a balloon angioplasty. C. 324 mg of aspirin. D. 0.4 mg of nitroglycerin.
C. 324 mg of aspirin
This patient is demonstrating signs of acute coronary syndrome. You should administer 324 mg of aspirin. Because the patient’s oxygen saturation is normal and his condition is uncomplicated by respiratory distress, you do not need to immediately administer oxygen. His blood pressure is too low for nitroglycerin. A balloon angioplasty is a hospital treatment for AMI.
10). Your 49-year-old male patient complains of crushing substernal chest pain and a feeling of impending doom. He is taking no medications to prevent clotting. He is not allergic to aspirin. After receiving orders for baby aspirin, how many 81-mg tablets would you give? A. 2-4 B. 5-8 C. 1 D. 6
A. 2-4
You should give 2-4 tablets (162-324 mg total) according to local protocols.
11). Cardiac arrest that occurs within 2 hours of the onset of chest pain or other symptoms is known as: A. sudden death. B. acute myocardial infarction. C. asystole. D. pulseless electrical activity.
A. sudden death.
12). Which of the following best describes a blockage of a vessel by a clot or foreign material brought to the site by the blood current? A. Thrombus B. Occlusion C. Aneurysm D. Embolism
D. Embolism
An embolism is a blockage of a vessel by a clot or foreign material brought to the site by the blood current. A thrombus is a clot. An occlusion is simply a blockage, and does not necessarily require blood current to be involved. An aneurysm is the dilation, or ballooning, of a weakened section of the wall of an artery.
13). Which of the following is the most common site for an aneurysm leading to an emergency situation? A. Jugular vein B. Aorta C. Brachial artery D. Femoral artery
B. Aorta
Although aneurysms can occur anywhere, the two most common locations for an aneurysm are the aorta and brain.
14). Heart failure is defined as:
A. the atrium’s decreased volume transfer to the ventricle.
B. the loss of the “atrial kick.”
C. aggravated sinus arrhythmia.
D. the failure of the heart to pump blood with normal efficiency.
D. the failure of the heart to pump blood with normal efficiency.
15). A 58-year-old male complains of shortness of breath and has very little energy. He normally leads a very sedentary lifestyle. You note that he has swelling in the abdomen and buttocks and has edema to his lower extremities. What is most likely his problem? A. Pulmonary embolism B. An aortic aneurism C. Angina pectoris D. Congestive heart failure
D. Congestive heart failure
Patients with congestive heart failure often have breathing difficulty, and pedal edema and swelling in the abdomen or buttocks are associated with inefficient pumping. Angina pectoris is chest pain, and can cause shortness of breath but not the edema and swelling. Pulmonary embolisms can cause shortness of breath but are often accompanied by chest pain. An aneurysm typically causes death from shock.
16). A patient with acute pulmonary edema is suffering from what pathological change to the lungs?
A. Decrease in alveolar capillary bed hydrostatic pressure
B. Increase in amount of fluid filling the alveoli
C. Decrease in surfactant levels in the alveoli
D. Increase in alveolar capillary bed oncotic pressure
B. Increase in amount of fluid filling the alveoli
When the left ventricle fails, pressure builds in the left atria and then in the pulmonary vein. Pressure in the pulmonary vein causes the capillaries surrounding the alveoli in the lungs to leak. Fluid creeps across the one-celled membrane of the capillaries and occupies space around and eventually in the alveoli itself. Fluid around the alveoli can cause the tiny air sacs to collapse. When fluid leaches into the alveoli, it occupies space where gas exchange used to occur.
PT1). Administer oxygen to your chest pain patient to maintain an oxygen saturation level of: A. at least 90%. B. at least 94%. C. up to 94%. D. up to 100%.
B. at least 94%
2) Which of the following is a contraindication for aspirin?
A. Cardiovascular disease
B. Inability to swallow without endangering airway
C. Having taken nitroglycerin
D. Liver disease
B. Inability to swallow without endangering airway
3) Which of the following refers to any condition in which the heart may not be getting enough oxygen? A. Angina pectoris B. Acute myocardial infarction C. Acute coronary syndrome D. Cardiac dysrhythmia
C. Acute coronary syndrome
4). An insufficient supply of oxygenated blood to an area of the body is called: A. ischemia. B. embolism. C. coronary artery disease. D. dyspnea.
A. ischemia.
5) Which of the following refers to chest pain that occurs when blood supply to the heart is reduced and a portion of the heart muscle is not receiving enough oxygen? A. Aneurysm B. Acute myocardial infarction C. Hypertension D. Angina pectoris
D. Angina pectoris
6) Your patient has a weakened section of the arterial wall that is ballooning. This is known as a(n): A. thrombus. B. aneurysm. C. occlusion. D. embolism.
B. aneurysm
