Ch. 21

Question 1

Which of the following heart chambers pumps oxygenated blood to the body?

A) Left ventricle
B) Left atrium
C) Right ventricle
D) Right atrium

Answer 1

A) Left ventricle

Page Ref: 533-534
Objective: 21.6 Describe the roles of the heart and blood vessels in maintaining normal blood pressure.

Question 2

Which of the following vessels has the least ability to constrict?

A) Arterioles
B) Venules
C) Aorta
D) Vena cava

Answer 2

C) Aorta

Page Ref: 535
Objective: 21.6 Describe the roles of the heart and blood vessels in maintaining normal blood pressure.

Question 3

What is the purpose of valves in the circulatory system?

A) Control the volume of blood moved in each pulse.
B) Prevent the backflow of blood in the vessels.
C) Support the bifurcation of the veins.
D) Allows for expansion and contraction of the veins.

Answer 3

B) Prevent the backflow of blood in the vessels.

Page Ref: 535
Objective: 21.6 Describe the roles of the heart and blood vessels in maintaining normal blood pressure.

Question 4

Which of the following statements regarding the peripheral circulation is TRUE?

A) It provides blood flow to the internal organs.
B) The vessels lay closer to the surface of the body.
C) It contains the large vessels of the body.
D) Vessels vasodilate during hypovolemic shock.

Answer 4

B) The vessels lay closer to the surface of the body.

Page Ref: 535
Objective: 21.6 Describe the roles of the heart and blood vessels in maintaining normal blood pressure.

Question 5

Which of the following statements regarding capillaries is TRUE?

A) They consist of three layers or coats.
B) The thinnest layer is the tunica adventitia.
C) They contain valves to limit back flow of blood.
D) Red blood cells move through in single file.

Answer 5

D) Red blood cells move through in single file.

Page Ref: 535
Objective: 21.6 Describe the roles of the heart and blood vessels in maintaining normal blood pressure.

Question 6

The tricuspid valve prevents blood from:

A) moving between the right and left ventricles.
B) flowing from the right ventricle into the right atrium.
C) bypassing the pulmonary vessels and entering the right heart.
D) flowing backward through the left atrium.

Answer 6

B) flowing from the right ventricle into the right atrium.

Page Ref: 534
Objective: 21.6 Describe the roles of the heart and blood vessels in maintaining normal blood pressure.

Question 7

Which of the following will impair cardiac output?

A) Improperly functioning valves
B) Increased perfusion to the heart
C) Elevated blood pressure
D) Increase in mean arterial pressure

Answer 7

A) Improperly functioning valves

Page Ref: 534
Objective: 21.6 Describe the roles of the heart and blood vessels in maintaining normal blood pressure.

Question 8

The pulse pressure is the:

A) stroke volume times the heart rate.
B) end-systolic volume minus the end-diastolic volume.
C) systolic blood pressure minus the diastolic blood pressure.
D) cardiac output times the systemic vascular resistance.

Answer 8

C) systolic blood pressure minus the diastolic blood pressure.

Page Ref: 536
Objective: 21.6 Describe the roles of the heart and blood vessels in maintaining normal blood pressure.

Question 9

A patient who has been stabbed is losing blood. You know this will make it difficult for him to maintain his blood pressure because:

A) his vessels vasodilate.
B) it decreases his preload.
C) his tissues become hypoxic.
D) it increases his stroke volume.

Answer 9

B) it decreases his preload.

Page Ref: 537
Objective: 21.6 Describe the roles of the heart and blood vessels in maintaining normal blood pressure.

Question 10

You have responded for a 65-year-old man with chest pain. You note that his blood pressure is 88/62 and his heart rate is 136. Which of the following should you suspect?

A) Angina pectoris
B) Pain and anxiety
C) Cardiac tamponade
D) Cardiogenic shock

Answer 10

D) Cardiogenic shock

Page Ref: 549
Objective: 21.13 Given a series of scenarios, demonstrate the management of a variety of patients with cardiovascular emergencies.

Question 11

The normal, regular rate of electrical activity for the heart is set by the:

A) sinoatrial node.
B) atrioventricular node.
C) bundle of His.
D) Purkinje fibers.

Answer 11

A) sinoatrial node.

Page Ref: 538
Objective: 21.3 Describe the events in the normal function of the cardiac conduction system.

Question 12

Your chest pain patient has a pulse of 48. Which pacemaker do you suspect is malfunctioning?

A) Sinoatrial node
B) Atrioventricular node
C) Bundle of His
D) Purkinje fibers

Answer 12

A) Sinoatrial node

Page Ref: 538
Objective: 21.8 Explain the pathophysiology of cardiovascular conditions and emergencies.

Question 13

The term automaticity refers to a cell’s capability of:

A) responding promptly to electrical stimuli.
B) generating an electrical impulse from one cell to another.
C) generating an electrical impulse on its own.
D) contracting or shortening an impulse.

Answer 13

C) generating an electrical impulse on its own.

Page Ref: 538
Objective: 21.3 Describe the events in the normal function of the cardiac conduction system.

Question 14

The AV node has an intrinsic rate of self-excitation, which is ________ beats per minute.

A) 20 to 40
B) 40 to 60
C) 60 to 100
D) 80 to 100

Answer 14

B) 40 to 60

Page Ref: 539
Objective: 21.3 Describe the events in the normal function of the cardiac conduction system.

Question 15

Which one of the following statements about the P wave is TRUE?

A) It represents ventricular depolarization.
B) It is a rounded wave appearing after the QRS complex.
C) It follows the R wave on normal ECGs.
D) It corresponds to atrial depolarization.

Answer 15

D) It corresponds to atrial depolarization.

Page Ref: 540
Objective: 21.4 Relate the waves and intervals of a normal Lead II ECG to the physiologic events they represent.

Question 16

The QRS complex reflects:

A) atrial depolarization.
B) ventricular depolarization.
C) ventricular repolarization.
D) atrial repolarization.

Answer 16

B) ventricular depolarization.

Page Ref: 540
Objective: 21.4 Relate the waves and intervals of a normal Lead II ECG to the physiologic events they represent.

Question 17

Which one of the following statements about the four chambers of the heart is CORRECT?

A) Ventricles are inferior to the atria.
B) Atria are the inferior chambers of the heart.
C) Ventricles receive incoming blood from the body.
D) Atria are the two largest chambers of the heart.

Answer 17

A) Ventricles are inferior to the atria.

Page Ref: 533
Objective: 21.6 Describe the roles of the heart and blood vessels in maintaining normal blood pressure.

Question 18

Which one of the following statements about the circulation of blood is TRUE?

A) Pulmonary arteries are the only arteries that carry oxygenated blood.
B) The right myocardium is thicker than the left myocardium.
C) The right atrium receives oxygenated blood from the vena cava.
D) The left atrium sends oxygenated blood into the left ventricle.

Answer 18

D) The left atrium sends oxygenated blood into the left ventricle.

Page Ref: 533
Objective: 21.6 Describe the roles of the heart and blood vessels in maintaining normal blood pressure.

Question 19

Which of the following statements regarding hemoglobin is TRUE?

A) It contains proteins such as albumin and antibodies.
B) It can carry two oxygen molecules at a time.
C) It is a molecule that consists of protein and iron.
D) It has a greater affinity for oxygen than carbon monoxide.

Answer 19

C) It is a molecule that consists of protein and iron.

Page Ref: 536
Objective: 21.6 Describe the roles of the heart and blood vessels in maintaining normal blood pressure.

Question 20

Which of the following is the only artery that carries deoxygenated blood away from the heart?

A) Aorta
B) Pulmonary
C) Semilunar
D) Coronary

Answer 20

B) Pulmonary

Page Ref: 535
Objective: 21.6 Describe the roles of the heart and blood vessels in maintaining normal blood pressure.

Question 21

The heart receives its nutrients from the:

A) anterior great cardiac vein.
B) blood within its chambers.
C) coronary arteries.
D) aorta.

Answer 21

C) coronary arteries.

Page Ref: 534
Objective: 21.6 Describe the roles of the heart and blood vessels in maintaining normal blood pressure.

Question 22

Pressure in the filled ventricle at the end of diastole is called:

A) afterload.
B) preload.
C) cardiac output.
D) stroke volume.

Answer 22

B) preload.

Page Ref: 537
Objective: 21.6 Describe the roles of the heart and blood vessels in maintaining normal blood pressure.

Question 23

Which of the following would explain why a person might need an implanted pacemaker device?

A) There is a problem with the electrical system in the heart.
B) The heart muscle is damaged and is unable to contract.
C) Their potassium levels are too low, which prevents depolarization.
D) They have malfunctioning valves between the cardiac chambers.

Answer 23

A) There is a problem with the electrical system in the heart.

Page Ref: 552
Objective: 21.2 Explain the relationship between electrical and mechanical events in the heart.

Question 24

You are treating a 48-year-old man who has fallen off a ladder. He is complaining of pain to his right elbow and right ankle. His vital signs are blood pressure 110/74, pulse 48, respirations 18, and blood sugar 88 mg/dL. How should you manage his bradycardia?

A) Provide aspirin and IV fluid bolus for cardiac compromise.
B) He is asymptomatic; therefore, supportive treatment is indicated.
C) Request ALS intercept to administer cardiac medications.
D) Apply transcutaneous pacing pads and begin pacing the patient.

Answer 24

B) He is asymptomatic; therefore, supportive treatment is indicated.

Page Ref: 560
Objective: 21.7 Explain the importance of early recognition of signs and symptoms, and early treatment of patients with cardiac emergencies.

Question 25

You are caring for a 64-year-old woman with chest pain and shortness of breath. She is alert and oriented with an open airway. Her breathing is adequate. She has a normal pulse, and her skin is warm and dry. Which of the following should you do next?

A) Obtain her heart rate and blood pressure.
B) Prepare for immediate transport.
C) Inquire about history of heart problems.
D) Hook up the automatic external defibrillator.

Answer 25

C) Inquire about history of heart problems.

Page Ref: 548
Objective: 21.7 Explain the importance of early recognition of signs and symptoms, and early treatment of patients with cardiac emergencies.

Question 26

For which of the following patients should you call for ALS assistance?

A) A patient with chest pain that is relieved with nitroglycerin
B) A bradycardic patient with chest pain and a blood pressure of 88/62
C) A teenager with shortness of breath and tingling of the lips and fingers
D) A 72-year-old woman with chest pain that subsides when she rests

Answer 26

B) A bradycardic patient with chest pain and a blood pressure of 88/62

Page Ref: 548-550
Objective: 21.15 Decide when circumstances warrant requesting paramedic assistance in caring for patients with cardiovascular emergencies.

Question 27

While gathering a history from a 65-year-old man, you note that he takes a beta blocker. You know this is a cardiac medication which will:

A) cause smooth muscle in the heart to contract.
B) block the beta receptors of the parasympathetic nervous system.
C) interrupt the signals to the vagus nerve.
D) reduce the rate and force of cardiac contractions.

Answer 27

D) reduce the rate and force of cardiac contractions.

Page Ref: 556
Objective: 21.7 Explain the importance of early recognition of signs and symptoms, and early treatment of patients with cardiac emergencies.

Question 28

Which of the following is the beneficial action of nitroglycerin in some cardiac emergencies?

A) It dilates blood vessels throughout the body.
B) It dilates only the coronary arteries.
C) It reduces the strength of ventricular contractions.
D) It slows down the heart rate.

Answer 28

A) It dilates blood vessels throughout the body.

Page Ref: 550
Objective: 21.12 Explain the pharmacology and use of aspirin, nitroglycerin, nitrous oxide, and oxygen in the treatment of cardiovascular emergencies.

Question 29

Which of the following is the result of a portion of the heart muscle dying due to a lack of oxygen?

A) Angina pectoris
B) Cardiac arrest
C) Myocardial infarction
D) Heart failure

Answer 29

C) Myocardial infarction

Page Ref: 545
Objective: 21.8 Explain the pathophysiology of cardiovascular conditions and emergencies.

Question 30

You are assessing a 68-year-old woman with shortness of breath. Your assessment reveals crackles in all quadrants of the lungs as well as some swelling of the ankles. As you take her vital signs you see that she is becoming anxious and her breathing is becoming more shallow. Which of the following should you do?

A) Increase her oxygen flow to 15 lpm via nonrebreather.
B) Apply continuous positive airway pressure (CPAP).
C) Give her another albuterol treatment.
D) Start an IV and consider giving her a fluid bolus of 500 mL.

Answer 30

B) Apply continuous positive airway pressure (CPAP).

Page Ref: 556
Objective: 21.10 Differentiate between patients with adequate perfusion and patients with inadequate perfusion.

Question 31

hich of the following statements regarding the administration of nitroglycerin tablets is TRUE?

A) An increase in blood pressure should be expected.
B) The patient may complain of a headache after administration.
C) It should not be administered intravenously.
D) Dilation of the coronary arteries worsens myocardial perfusion.

Answer 31

B) The patient may complain of a headache after administration.

Page Ref: 549
Objective: 21.12 Explain the pharmacology and use of aspirin, nitroglycerin, nitrous oxide, and oxygen in the treatment of cardiovascular emergencies.

Question 32

Which of the following statements regarding stable angina pectoris is TRUE?

A) It can be brought on by exertion or stress.
B) It is generally relieved by over-the-counter medications.
C) It results in death of myocardial cells.
D) It generally lasts 30 to 60 minutes.

Answer 32

A) It can be brought on by exertion or stress.

Page Ref: 544
Objective: 21.13 Given a series of scenarios, demonstrate the management of a variety of patients with cardiovascular emergencies.

Question 33

Your protocol allows the administration of nitroglycerin to patients with chest pain under certain circumstances. To which of the following patients should you administer nitroglycerin?

A) A man who has chest pain from a fall from a ladder
B) A patient with chest pain and a blood pressure of 80/40
C) A patient who has taken three of his own nitroglycerin tablets
D) A patient who has chest pain after taking Cialis

Answer 33

C) A patient who has taken three of his own nitroglycerin tablets

Page Ref: 549
Objective: 21.12 Explain the pharmacology and use of aspirin, nitroglycerin, nitrous oxide, and oxygen in the treatment of cardiovascular emergencies.

Question 34

In which of the following situations would the administration of aspirin to a cardiac patient be prohibited?

A) The patient does not currently take aspirin.
B) The patient has a known allergy to aspirin.
C) The patient has a diastolic blood pressure greater than 100 mmHg.
D) The patient has chest pain.

Answer 34

B) The patient has a known allergy to aspirin.

Page Ref: 549
Objective: 21.12 Explain the pharmacology and use of aspirin, nitroglycerin, nitrous oxide, and oxygen in the treatment of cardiovascular emergencies.

Question 35

Which of the following patients would be MOST likely to present with atypical symptoms of acute coronary syndrome?

A) A 56-year-old with asthma
B) A 72-year-old man
C) A 32-year-old woman
D) A 68-year-old diabetic

Answer 35

D) A 68-year-old diabetic

Page Ref: 547
Objective: 21.9 Recognize both typical and atypical presentations of cardiovascular emergencies.

Question 36

Which of the following patients shows signs of inadequate perfusion?

A) A five-year-old child with a capillary refill of two seconds and a seal bark cough
B) A 65-year-old complaining of indigestion who is diaphoretic
C) A 52-year-old woman with congestive heart failure who is very lethargic
D) A teenager with shortness of breath and tingling of the lips and fingers

Answer 36

C) A 52-year-old woman with congestive heart failure who is very lethargic

Page Ref: 550
Objective: 21.10 Differentiate between patients with adequate perfusion and patients with inadequate perfusion.

Question 37

Which of the following patients demonstrates clearly that they can maintain their own airway and breathing?

A) An 18-year-old man vomiting in his sleep after drinking too much at a party
B) A 62-year-old woman with shortness of breath from an acute onset of pulmonary edema
C) A 28-year-old man who is hypotensive and is complaining of palpitations
D) A 42-year-old man who appropriately answers all of your questions with full sentences

Answer 37

D) A 42-year-old man who appropriately answers all of your questions with full sentences

Page Ref: 555-556
Objective: 21.11 Explain the importance of managing the airway, ventilation, and circulation in patients with cardiac problems.

Question 38

Your 59-year-old patient is suffering an acute myocardial infarction and is a candidate for fibrinolytic therapy. How do fibrinolytics work?

A) They cause platelets to become sticky.
B) They break down blood clots.
C) They reduce cardiac dysrhythmias.
D) They increase the blood pressure.

Answer 38

B) They break down blood clots.

Page Ref: 550
Objective: 21.14 Discuss the rationale for fibrinolytic therapy and percutaneous coronary interventions (PCIs) in patients with cardiac emergencies.

Question 39

When assessing a patient, which of the following should you recognize as an indication for aspirin therapy?

A) A complaint of a headache after taking nitroglycerin
B) The patient takes an aspirin a day to prevent heart attacks.
C) A systolic blood pressure above 100 mmHg
D) Chest discomfort that is suggestive of a heart attack

Answer 39

D) Chest discomfort that is suggestive of a heart attack

Page Ref: 549
Objective: 21.12 Explain the pharmacology and use of aspirin, nitroglycerin, nitrous oxide, and oxygen in the treatment of cardiovascular emergencies.

Question 40

Your patient has severe respiratory distress from an acute onset of pulmonary edema. Why do you want to treat her with CPAP?

A) It can reduce the amount of fluid that can cross into the alveoli.
B) It increases the oxygen concentration of the inspired oxygen.
C) It reduces the inflammation of the lower airways.
D) It has an analgesic to help reduce the patient’s anxiety.

Answer 40

A) It can reduce the amount of fluid that can cross into the alveoli.

Page Ref: 556
Objective: 21.16 Describe the rationale for using CPAP in patients with pulmonary edema.

Question 41

You are told after delivering your chest pain patient to the emergency department that he is on his way to the cardiac catheterization lab. How does this help the patient?

A) The surgeon can place a stent to open an occluded artery.
B) The patient has some blood drawn to check for cardiac enzyme levels.
C) The patient can have some aberrant conduction pathways cauterized.
D) An X-ray is taken to determine if the left ventricle is enlarged.

Answer 41

A) The surgeon can place a stent to open an occluded artery.

Page Ref: 561
Objective: 21.14 Discuss the rationale for fibrinolytic therapy and percutaneous coronary interventions (PCIs) in patients with cardiac emergencies.

Question 42

A non-pacemaker heart cell that automatically depolarizes is called ________.

A) ischemic
B) irritable
C) ectopic
D) reentry

Answer 42

C) ectopic

Page Ref: 539
Objective: 21.4 Relate the waves and intervals of a normal Lead II ECG to the physiologic events they represent.

Question 43

Which of the following may be used in the treatment of symptomatic paroxysmal supraventricular tachycardia (PSVT)?

A) Lidocaine
B) Defibrillation
C) Epinephrine
D) Valsalva maneuvers

Answer 43

D) Valsalva maneuvers

Page Ref: 561
Objective: 21.13 Given a series of scenarios, demonstrate the management of a variety of patients with cardiovascular emergencies.

Question 44

Ventricular fibrillation should be treated with immediate:

A) synchronized cardioversion.
B) defibrillation.
C) intubation.
D) antidysrhythmics.

Answer 44

B) defibrillation.

Page Ref: 552
Objective: 21.13 Given a series of scenarios, demonstrate the management of a variety of patients with cardiovascular emergencies.

Question 45

Aspirin is used in the treatment of myocardial ischemia because it:

A) inhibits the aggregation of platelets.
B) is a thrombolytic.
C) has analgesic effects.
D) can cause gastric upset and bleeding.

Answer 45

A) inhibits the aggregation of platelets.

Page Ref: 549
Objective: 21.12 Explain the pharmacology and use of aspirin, nitroglycerin, nitrous oxide, and oxygen in the treatment of cardiovascular emergencies.

Question 46

A major difference between stable and unstable angina is that unstable angina:

A) indicates the patient’s condition is improving.
B) responds more readily to treatment.
C) is generally not relieved by rest.
D) causes cardiac muscle cell death.

Answer 46

C) is generally not relieved by rest.

Page Ref: 544-545
Objective: 21.8 Explain the pathophysiology of cardiovascular conditions and emergencies.

Question 47

To determine specifics about chest pain, use ________ to help you.

A) SAMPLE
B) DCAP-BTLS
C) AEIOU-TIPS
D) OPQRST

Answer 47

D) OPQRST

Page Ref: 543
Objective: 21.7 Explain the importance of early recognition of signs and symptoms, and early treatment of patients with cardiac emergencies.

Question 48

The clinical syndrome in which the heart’s mechanical performance is compromised so that cardiac output cannot meet the body’s needs is called:

A) cardiogenic shock.
B) angina pectoris.
C) cardiac tamponade.
D) pneumothorax.

Answer 48

A) cardiogenic shock.

Page Ref: 557
Objective: 21.8 Explain the pathophysiology of cardiovascular conditions and emergencies.

Question 49

The condition in which the heart’s reduced stroke volume causes an overload of fluid in the lungs is called:

A) Prinzmetal’s angina.
B) acute heart failure.
C) angina pectoris.
D) myocardial infarction.

Answer 49

B) acute heart failure.

Page Ref: 553-554
Objective: 21.8 Explain the pathophysiology of cardiovascular conditions and emergencies.

Question 50

Management of the responsive adult patient with a history acute heart failure who presents with respiratory distress with pulmonary edema, respiratory rate of 32, and SpO2 of 88 percent includes:

A) placing the patient supine position with legs slightly raised.
B) administration of aspirin and epinephrine.
C) use of continuous positive airway pressure.
D) establishing an IV and administering a fluid bolus.

Answer 50

C) use of continuous positive airway pressure.

Page Ref: 554-555
Objective: 21.13 Given a series of scenarios, demonstrate the management of a variety of patients with cardiovascular emergencies.

Question 51

Your patient is extremely hypertensive with a diastolic reading of over 130 mmHg. He complains of a severe headache, vomiting, and dizziness. You should suspect:

A) noncardiogenic pulmonary edema.
B) hypertensive encephalopathy.
C) dissecting aortic aneurysm.
D) spinal meningitis.

Answer 51

B) hypertensive encephalopathy.

Page Ref: 558
Objective: 21.13 Given a series of scenarios, demonstrate the management of a variety of patients with cardiovascular emergencies.

Question 52

A condition in which fatty plaque builds up in arteries, eventually narrowing the lumen and restricting blood flow, is called:

A) arteriosclerosis.
B) claudication.
C) atherosclerosis.
D) an aneurysm.

Answer 52

C) atherosclerosis.

Page Ref: 544
Objective: 21.1 Define key terms introduced in this chapter.

Question 53

Which one of the following statements about an abdominal aortic aneurysm is TRUE?

A) It is more common in women than in men.
B) It is most prevalent in older patients.
C) It is very painful in the early stages.
D) Symptoms include pain in the calf muscles.

Answer 53

B) It is most prevalent in older patients.

Page Ref: 559
Objective: 21.7 Explain the importance of early recognition of signs and symptoms, and early treatment of patients with cardiac emergencies.

Question 54

You are transporting a patient who had an episode of chest pain. You administered two doses of nitroglycerin, which relieved the patient’s pain. He asks you why the nitroglycerin alleviated the pain. Which of the following is the BEST answer to his question?

A) It decreases the heart rate, which allows the heart muscle to rest more.
B) It has a sedative effect on the brain, which makes you less aware of the pain.
C) It dilates the blood vessels, which decreases the workload on the heart.
D) It causes the body to relax, which decreases the need for oxygen.

Answer 54

C) It dilates the blood vessels, which decreases the workload on the heart.

Page Ref: 550
Objective: 21.12 Explain the pharmacology and use of aspirin, nitroglycerin, nitrous oxide, and oxygen in the treatment of cardiovascular emergencies.

Question 55

The AEMT should recognize the root cause of heart failure is:

A) inadequate cardiac output.
B) poor gas exchange in the lungs.
C) fluid accumulation in the lung tissue.
D) backup of fluid in the lower extremities.

Answer 55

A) inadequate cardiac output.

Page Ref: 552
Objective: 21.8 Explain the pathophysiology of cardiovascular conditions and emergencies.

Question 56

If you suspect aortic dissection, which of the following are considered appropriate interventions?

A) Ensure a patent airway with adequate ventilation and oxygenation.
B) Ask the patient to perform a Valsalva maneuver.
C) Administer nitroglycerin.
D) Administer IV fluids to obtain a systolic BP of at least 100 mmHg.

Answer 56

A) Ensure a patent airway with adequate ventilation and oxygenation.

Page Ref: 560
Objective: 21.13 Given a series of scenarios, demonstrate the management of a variety of patients with cardiovascular emergencies.