Chapter 15 Test Questions

Question 1

The fifth link in the cardiac chain of survival includes:

A. recognition of early warning signs and activation of EMS.

B. temperature regulation and maintenance of glucose levels.

C. early, high-quality CPR with emphasis on chest compressions.

D. defibrillation within the first 2 to 3 minutes of the cardiac arrest.

Answer 1

B. temperature regulation and maintenance of glucose levels.

Question 2

What is the approximate cardiac output of a person with a heart rate of 70 beats/min and a stroke volume of 75 mL?

A. 4 L/min

B. 5 L/min

C. 6 L/min

D. 7 L/min

Answer 2

B. 5 L/min

Question 3

The ability of cells to respond to electrical impulses is referred to as the property of:

A. dromotropy.

B. conductivity.

C. excitability.

D. automaticity.

Answer 3

C. excitability.

Question 4

Approximately 60% to 70% of deaths due to acute myocardial infarction occur:

A. during the first 2 to 3 hours after symptom onset.

B. in the hospital setting and are the result of asystole.

C. while the patient is in the cardiac catheterization lab.

D. in the workplace, even when an AED is readily available.

Answer 4

A. during the first 2 to 3 hours after symptom onset.

Question 5

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:

A. stable angina pectoris.

B. unstable angina pectoris.

C. vasospastic angina pectoris.

D. acute myocardial infarction.

Answer 5

A. stable angina pectoris.

Question 6

The term that refers to the contraction of the ventricular mass and the pumping of blood into the systemic circulation is called:

A. systole.

B. preload.

C. diastole.

D. afterload.

Answer 6

A. systole.

Question 7

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:

A. give oxygen via nasal cannula.

B. apply the CPAP device.

C. administer nitroglycerin.

D. give an IV fluid bolus.

Answer 7

B. apply the CPAP device.

Question 8

You should be MOST suspicious that a patient is experiencing an acute myocardial infarction if he or she presents with:

A. acute pain to the left jaw that is made worse by movement of the head.

B. an acute tearing sensation in the abdomen that radiates to the lower back.

C. an acute onset of weakness, nausea, and sweating without an obvious cause.

D. an acute onset of sharp chest pain that worsens when he or she takes a breath.

Answer 8

C. an acute onset of weakness, nausea, and sweating without an obvious cause.

Question 9

Afterload is defined as the:

A. volume of blood returned to the left or right atrium.

B. amount of blood ejected per ventricular contraction.

C. percentage of blood ejected from the left ventricle.

D. pressure against which the left ventricle must pump.

Answer 9

D. pressure against which the left ventricle must pump.

Question 10

When peripheral vascular resistance is increased:

A. afterload increases and stroke volume decreases.

B. blood return to the heart and cardiac output both increase.

C. systolic blood pressure decreases and cardiac output increases.

D. arterial blood pressure decreases and stroke volume increases.

Answer 10

A. afterload increases and stroke volume decreases.

Question 11

The _____________ anchors the heart within the thoracic cavity and prevents cardiac overdistention.

A. epicardium

B. endocardium

C. pericardium

D. cardiac septum

Answer 11

C. pericardium

Question 12

Damage to the ___________ valve may cause blood to regurgitate into the lungs.

A. mitral

B. tricuspid

C. pulmonic

D. papillary

Answer 12

A. mitral

Question 13

When applying the AED pads to a patient with a surgically-implanted pacemaker, you should:

A. apply the pads no differently than in anyone else.

B. apply the pads at least 1” away from the pacemaker.

C. apply both pads on the posterior aspect of the chest.

D. apply the pad directly over the implanted pacemaker.

Answer 13

B. apply the pads at least 1” away from the pacemaker.

Question 14

What part of the cardiac electrical conduction system initiates electrical impulses at the slowest rate?

A. The sinoatrial node

B. Areas below the AV node

C. Any part of the AV node

D. The atrioventricular node

Answer 14

B. Areas below the AV node

Question 15

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:

A. begin CPR and apply the AED as soon as it is available.

B. begin CPR, start an IV, and give a 20 mL/kg fluid bolus.

C. elevate the patient’s legs, begin CPR, and attach an AED.

D. begin CPR, insert a King airway, and request a paramedic unit.

Answer 15

A. begin CPR and apply the AED as soon as it is available.

Question 16

The _____________ arteries arise from the aorta shortly after they leave the left ventricle.

A. cerebral

B. coronary

C. pulmonary

D. brachiocephalic

Answer 16

B. coronary

Question 17

Ventricular tachycardia often causes hypotension because:

A. there is not enough time between beats for the left ventricle to fill with blood.

B. blood from the atria fills the ventricles too quickly due to the rapid heart rate.

C. tachycardia causes widespread vasodilation, which lowers the blood pressure.

D. afterload increases, which causes the ventricles to work against higher pressure.

Answer 17

A. there is not enough time between beats for the left ventricle to fill with blood.

Question 18

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:

A. a coronary artery bypass graft.

B. coronary artery stent placement.

C. a percutaneous coronary angioplasty.

D. a surgically implanted cardiac pacemaker.

Answer 18

A. a coronary artery bypass graft.

Question 19

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:

A. oxygen via nonrebreathing mask, one chewable baby aspirin, an IV fluid bolus, and prompt transport.

B. oxygen via nasal cannula, up to two more doses of nitroglycerin, saline lock, and transport.

C. oxygen via nonrebreathing mask, up to 324 mg aspirin, supine with his legs elevated, and transport.

D. oxygen via nasal cannula, up to 324 mg aspirin, saline lock, additional nitroglycerin per medical control, and transport.

Answer 19

D. oxygen via nasal cannula, up to 324 mg aspirin, saline lock, additional nitroglycerin per medical control, and transport.

Question 20

When given to a patient who is experiencing an acute coronary syndrome, aspirin works by:

A. preventing an existing clot from getting larger.

B. dissolving a clot and reestablishing blood flow.

C. dilating the coronary arteries and relieving pain.

D. thinning the blood and preventing clot formation.

Answer 20

A. preventing an existing clot from getting larger.

Question 21

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?

A. A rapid, irregular heart rate

B. Jugular venous distention while sitting up

C. Diminished pulses in her lower extremities

D. Radiation of the pain to her arms or jaw

Answer 21

C. Diminished pulses in her lower extremities

Question 22

Asystole has an exceedingly high mortality rate because it:

A. reflects a prolonged period of myocardial ischemia.

B. does not respond favorably to cardiac defibrillation.

C. is usually the result of a massive myocardial infarction.

D. most often occurs in patients with significant heart disease.

Answer 22

A. reflects a prolonged period of myocardial ischemia.

Question 23

Which of the following valves of the heart are semilunar valves?

A. Mitral and aortic

B. Aortic and pulmonic

C. Mitral and pulmonic

D. Pulmonic and tricuspid

Answer 23

B. Aortic and pulmonic

Question 24

Common signs of left-sided congestive heart failure include all of the following, EXCEPT:

A. chronic pedal edema.

B. tachypnea and tachycardia.

C. increased work of breathing.

D. production of blood-tinged sputum.

Answer 24

A. chronic pedal edema.

Question 25

The middle, muscular layer of the heart is called the:

A. epicardium.

B. myocardium.

C. pericardium.

D. endocardium.

Answer 25

B. myocardium.

Question 26

As with angina, the pain associated with acute myocardial infarction is often described as:

A. sharp.

B. pressure.

C. pleuritic.

D. stabbing.

Answer 26

B. pressure.

Question 27

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:

A. prompt transport.

B. an IV fluid bolus.

C. high-flow oxygen.

D. thermal management.

Answer 27

A. prompt transport.

Question 28

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?

A. Tunica intima.

B. Tunica interna.

C. Tunica media.

D. Tunica adventitia.

Answer 28

C. Tunica media.

Question 29

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:

A. the right side of her heart is functioning effectively.

B. blood is backing up into her systemic circulation.

C. she has left-sided heart failure and how severe it may be.

D. she experiences sleep apnea, which may explain her fatigue.

Answer 29

C. she has left-sided heart failure and how severe it may be.

Question 30

Which of the following would likely exacerbate pulmonary edema?

A. Nitroglycerin

B. Increased cardiac preload

C. A positive inotropic drug

D. Decreased cardiac afterload

Answer 30

B. Increased cardiac preload

Question 31

Which of the following represents the correct sequence of electrical conduction through the myocardium?

A. SA node, AV node, Bundle of His, bundle branches, Purkinje fibers

B. AV node, SA node, bundle branches, Bundle of His, Purkinje fibers

C. SA node, Bundle of His, AV node, bundle branches, Purkinje fibers

D. AV node, Purkinje fibers, SA node, Bundle of His, bundle branches

Answer 31

A. SA node, AV node, Bundle of His, bundle branches, Purkinje fibers

Question 32

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:

A. use CPAP to attempt to improve his breathing, insert a saline lock, transport, and be prepared to assist his ventilations.

B. insert a multilumen airway device, ventilate him at a rate of 12 breaths/min, transport, and establish IV access en route to the hospital.

C. administer high-flow oxygen via nonrebreathing mask, place him in a position of comfort, insert a saline lock, and transport.

D. assist his ventilations with a bag-mask device, begin transport, and consider establishing IV access en route to the hospital.

Answer 32

D. assist his ventilations with a bag-mask device, begin transport, and consider establishing IV access en route to the hospital.

Question 33

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:

A. place him supine and elevate his legs.

B. give him a 500 mL normal saline bolus.

C. cover him with a blanket to keep him warm.

D. contact medical control for further guidance.

Answer 33

A. place him supine and elevate his legs.

Question 34

Which of the following cardiac rhythms or conditions requires defibrillation?

A. Asystole

B. Pulseless electrical activity

C. Ventricular tachycardia without a pulse

D. Any tachycardic rhythm with a weak pulse

Answer 34

C. Ventricular tachycardia without a pulse

Question 35

After applying the AED to your cardiac-arrest patient, you receive a “shock advised” message. You should:

A. quickly check to ensure the pads are correctly placed.

B. ensure that all contact with the patient has ceased.

C. deliver one shock and immediately resume CPR.

D. perform CPR for 2 minutes and then deliver a shock.

Answer 35

B. ensure that all contact with the patient has ceased.

Question 36

What are the physiologic effects of nitroglycerin when given to a patient with suspected cardiac-related chest pain?

A. Vascular smooth muscle contraction and increased venous return

B. Vascular smooth muscle relaxation and coronary artery dilation

C. Coronary artery dilation and increased systemic vascular resistance

D. Decreased venous pooling of blood and coronary vasoconstriction

Answer 36

B. Vascular smooth muscle relaxation and coronary artery dilation

Question 37

The tricuspid and mitral valves of the heart are referred to as:

A. semilunar valves.

B. atrioseptal valves.

C. ventriculoseptal valves.

D. atrioventricular valves.

Answer 37

D. atrioventricular valves.

Question 38

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:

A. constrict the blood vessels.

B. increase the patient’s heart rate.

C. affect the strength of cardiac contraction.

D. affect electrical conduction through the heart.

Answer 38

C. affect the strength of cardiac contraction.

Question 39

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?

A. Atypical angina pectoris

B. Artificial pacemaker failure

C. Damaged coronary artery graft

D. Decreased parasympathetic tone

Answer 39

B. Artificial pacemaker failure

Question 40

Stimulation of the sympathetic nervous system results in:

A. decreased blood pressure and heart rate.

B. increased blood pressure and heart rate.

C. vasoconstriction and decreased heart rate.

D. vasodilation and a mild heart-rate decrease.

Answer 40

B. increased blood pressure and heart rate.

Question 41

Blood enters the right atrium through the:

A. left and right coronary arteries.

B. vena cavae and coronary sinus.

C. foramen ovalis and vena cavae.

D. coronary artery and foramen ovale.

Answer 41

B. vena cavae and coronary sinus.

Question 42

The _____________ is the end of the great cardiac vein and collects blood returning from the walls of the heart.

A. coronary sinus

B. foramen ovale

C. inferior vena cava

D. superior vena cava

Answer 42

A. coronary sinus

Question 43

Compared to monophasic defibrillation, biphasic defibrillation is advantageous because it:

A. sends the shock in one direction within the heart.

B. utilizes less energy to achieve effective defibrillation.

C. works more effectively when 360 joules are delivered.

D. automatically defibrillates without AEMT intervention.

Answer 43

B. utilizes less energy to achieve effective defibrillation.

Question 44

When treating a patient with a blood pressure of 80/40 mm Hg due to “pump failure,” you should:

A. assist the patient with his or her prescribed nitroglycerin.

B. give a 20 mL/kg crystalloid fluid bolus to improve perfusion.

C. apply a nonrebreathing mask if the patient is breathing shallowly.

D. place the patient in a supine position with his or her legs elevated.

Answer 44

B. give a 20 mL/kg crystalloid fluid bolus to improve perfusion.

Question 45

The coronary arteries of a person with arteriosclerotic heart disease:

A. are thickened and hardened and lose their elasticity.

B. begin to dissect through the layers of the arterial wall.

C. develop plaque deposits from cholesterol and fatty substances.

D. become engorged with blood as cardiac oxygen demand increases.

Answer 45

A. are thickened and hardened and lose their elasticity.

Question 46

A 67-year-old male presents with an altered mental status following two days of severe chest pain. His wife tells you that he would not allow her to call EMS. Your assessment reveals a tachycardic, irregular pulse, diaphoresis, and a blood pressure of 80/50 mm Hg. You should suspect:

A. unstable angina with poor perfusion.

B. compensated cardiogenic shock.

C. decompensated cardiogenic shock.

D. acute myocardial infarction and hypovolemia.

Answer 46

C. decompensated cardiogenic shock.

Question 47

The percentage of blood pumped from the heart is called:

A. afterload.

B. stroke volume.

C. cardiac output.

D. ejection fraction.

Answer 47

D. ejection fraction.

Question 48

The presence of distended jugular veins that do not collapse, even when the patient is sitting, is consistent with:

A. cardiogenic shock.

B. congestive heart failure.

C. a thoracic aortic aneurysm.

D. an acute hypertensive crisis.

Answer 48

B. congestive heart failure.

Question 49

A hypertensive crisis is considered to be a true emergency when:

A. the diastolic blood pressure exceeds 100 mm Hg.

B. the patient is noncompliant with his or her medication.

C. signs of central nervous system dysfunction are present.

D. the patient has a concomitant history of epileptic seizures.

Answer 49

C. signs of central nervous system dysfunction are present.

Question 50

The MOST common cardiac dysrhythmia associated with sudden cardiac death following an acute myocardial infarction is:

A. ventricular tachycardia.

B. ventricular fibrillation.

C. pulseless electrical activity.

D. tachycardia without a pulse.

Answer 50

B. ventricular fibrillation.

Question 51

Which of the following patients would be LEAST likely to experience the classic signs and symptoms of an acute myocardial infarction (AMI)?

A. A 52-year-old female with thyroid cancer

B. A 55-year-old male with mild hypertension

C. A 60-year-old male with two prior AMIs

D. A 67-year-old female with diabetes mellitus

Answer 51

D. A 67-year-old female with diabetes mellitus

Question 52

During your primary assessment of an unresponsive 47-year-old male, you find that he has occasional gasping breaths. You should:

A. insert a multilumen airway device and assess for a carotid pulse.

B. assess for a carotid pulse and begin chest compressions if needed.

C. deliver 2 slow breaths with a bag-mask device and assess for a pulse.

D. perform 30 chest compressions, open the airway, and deliver 2 breaths.

Answer 52

B. assess for a carotid pulse and begin chest compressions if needed.

Question 53

The ability of a cardiac muscle cell to contract spontaneously without a stimulus from a nerve source is called:

A. dromotropy.

B. conductivity.

C. excitability.

D. automaticity.

Answer 53

D. automaticity.

Question 54

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:

A. rapidly lowering her blood pressure with nitroglycerin.

B. placing her in a supine position and lowering her head.

C. assisting the patient with her medication and transporting her.

D. 100% oxygen and transporting to the closest appropriate facility.

Answer 54

D. 100% oxygen and transporting to the closest appropriate facility.

Question 55

The left main coronary artery rapidly divides into the:

A. left anterior descending and circumflex arteries.

B. right coronary artery and acute marginal branch.

C. posterior descending artery and left atrial branch.

D. left posterior ventricular and acute marginal arteries.

Answer 55

A. left anterior descending and circumflex arteries.

Question 56

After defibrillating a patient in cardiac arrest with the AED, you should:

A. give two rescue breaths.

B. insert a multilumen airway.

C. resume chest compressions.

D. briefly check for a carotid pulse.

Answer 56

C. resume chest compressions.

Question 57

Prinzmetal’s angina is caused by:

A. coronary vasospasm.

B. coronary artery rupture.

C. atherosclerotic blockage.

D. an isolated coronary occlusion.

Answer 57

A. coronary vasospasm.

Question 58

Percutaneous coronary intervention (PCI) involves:

A. dilating the coronary artery with drugs.

B. bypassing the blocked coronary artery.

C. mechanically clearing a coronary artery.

D. the administration of a fibrinolytic drug.

Answer 58

C. mechanically clearing a coronary artery.

Question 59

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:

A. begin CPR and insert a multilumen airway device.

B. deactivate the AICD with a magnet and begin CPR.

C. allow the AICD to defibrillate her and start CPR.

D. begin CPR and apply the AED as soon as possible.

Answer 59

D. begin CPR and apply the AED as soon as possible.

Question 60

After defibrillating an adult patient in cardiac arrest with the AED, you should:

A. assess for a carotid pulse for no more than 10 seconds.

B. insert a multilumen airway device and resume CPR.

C. immediately reanalyze the patient’s cardiac rhythm.

D. begin or resume CPR starting with chest compressions.

Answer 60

D. begin or resume CPR starting with chest compressions

Question 61

Effectively performed CPR is a crucial treatment for a patient in cardiac arrest because it:

A. often converts V-Fib to a perfusing rhythm.

B. maintains myocardial and cerebral perfusion.

C. enhances perfusion to the body’s periphery.

D. prevents the patient from developing asystole.

Answer 61

B. maintains myocardial and cerebral perfusion.

Question 62

The term acute coronary syndrome (ACS) is used to describe:

A. a specific condition in which a coronary artery is totally blocked.

B. a variety of cardiac dysrhythmias caused by a myocardial infarction.

C. any change in the pattern or characteristics of a patient’s angina.

D. any group of symptoms consistent with acute myocardial ischemia.

Answer 62

D. any group of symptoms consistent with acute myocardial ischemia.

Question 63

The primary function of the atrioventricular (AV) node is to:

A. serve as the backup pacemaker if the ventricular conduction system fails.

B. regenerate the atrial-initiated electrical impulse before it enters the ventricles.

C. increase conduction from the atria to the ventricles to allow for atrial filling.

D. slow conduction from the atria to the ventricles to allow for ventricular filling.

Answer 63

D. slow conduction from the atria to the ventricles to allow for ventricular filling.

Question 64

Which of the following clinical presentations is consistent with a malfunctioning implanted pacemaker?

A. Weakness and tachycardia

B. Dizziness and hypertension

C. Tachycardia and hypotension

D. Syncope and bradycardia

Answer 64

D. Syncope and bradycardia

Question 65

Pulseless electrical activity (PEA) exists when:

A. a patient’s heart rate is so weak that it is barely palpable.

B. a patient is in cardiac arrest despite an organized cardiac rhythm.

C. the heart is quivering and is not ejecting any blood from the ventricles.

D. a pulse is clearly present, but the cardiac monitor shows a flat line.

Answer 65

B. a patient is in cardiac arrest despite an organized cardiac rhythm.

Question 66

According to Starling’s Law of the Heart:

A. myocardial contractility decreases as the walls are stretched.

B. the heart rate is the sole factor in determining cardiac output.

C. contractility increases as the myocardial walls are stretched.

D. myocardial wall stretching results in decreased chamber emptying.

Answer 66

C. contractility increases as the myocardial walls are stretched.

Question 67

When assessing a patient for peripheral edema, you should check the sacral area if the patient is:

A. bedridden.

B. sitting up.

C. ambulatory.

D. semireclined.

Answer 67

A. bedridden.

Question 68

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?

A. “Shock advised” message, stand clear, defibrillate, immediately resume CPR, reanalyze after 2 minutes

B. “No shock advised” message, check pulse for up to 10 seconds, resume CPR, reanalyze after 2 minutes

C. “No shock advised” message, stand clear, reanalyze, “no shock advised” message, perform CPR for 2 minutes

D. “Shock advised” message, stand clear, defibrillate, perform CPR for 1 minute, stand clear, reanalyze, defibrillate if needed

Answer 68

A. “Shock advised” message, stand clear, defibrillate, immediately resume CPR, reanalyze after 2 minutes

Question 69

What three major arteries arise from the aortic arch?

A. Innominate, posterior vertebral, and right subclavian

B. Brachiocephalic, left common carotid, and left subclavian

C. Coronary, internal common carotid, and brachiocephalic

D. Brachiocephalic, common iliac, and right common carotid

Answer 69

B. Brachiocephalic, left common carotid, and left subclavian

Question 70

Treatment for a patient experiencing a cardiovascular emergency begins by:

A. assessing the rate and regularity of the pulse.

B. applying 100% oxygen via nonrebreathing mask.

C. administering prescribed nitroglycerin if needed.

D. ensuring airway patency and adequate breathing.

Answer 70

D. ensuring airway patency and adequate breathing.

Question 71

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:

A. his prescribed nitroglycerin has lost its potency.

B. the nitroglycerin has caused severe hypotension.

C. he has stable angina, but still requires transport.

D. he is experiencing ongoing myocardial ischemia.

Answer 71

D. he is experiencing ongoing myocardial ischemia.

Question 72

When the parasympathetic nervous system is stimulated, it:

A. enhances conduction through the atrioventricular node.

B. slows the heart rate by decreasing SA node discharge.

C. produces epinephrine and increases cardiac contractility.

D. increases the heart rate by increasing SA node discharge.

Answer 72

B. slows the heart rate by decreasing SA node discharge.

Question 73

Which of the following cardiac dysrhythmias requires immediate defibrillation?

A. Sinus tachycardia with a low BP

B. Sinus bradycardia without a pulse

C. Perfusing ventricular tachycardia

D. Nonperfusing ventricular fibrillation

Answer 73

D. Nonperfusing ventricular fibrillation

Question 74

Erythropoiesis is the ongoing process by which:

A. red blood cells are made.

B. red blood cells and hemoglobin unite.

C. old red blood cells are sent to the spleen.

D. red blood cells are destroyed by macrophages.

Answer 74

A. red blood cells are made.

Question 75

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?

A. Aspirin only

B. Morphine and aspirin

C. Aspirin and nitroglycerin

D. Nitroglycerin and morphine

Answer 75

C. Aspirin and nitroglycerin

Question 76

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:

A. high-flow oxygen via nonrebreathing mask, a saline lock, thermal management, and transport.

B. continuous positive airway pressure, a 500 mL saline bolus, thermal management, and transport.

C. assisted ventilation with a bag-mask device, thermal management, 20 mL/kg fluid bolus, and transport.

D. insertion of multilumen airway device, mild hyperventilation, a saline lock, and prompt transport.

Answer 76

C. assisted ventilation with a bag-mask device, thermal management, 20 mL/kg fluid bolus, and transport.

Question 77

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:

A. perform CPR, immobilize his spine, and transport.

B. begin CPR and apply the AED as soon as possible.

C. request a paramedic unit to perform defibrillation.

D. perform CPR and insert a pediatric-sized Combitube.

Answer 77

B. begin CPR and apply the AED as soon as possible.

Question 78

The normal site of origin of electrical impulses in the heart is the ____________, which generates ___________ impulses per minute.

A. sinoatrial node, 50 to 60

B. bundle of His, 80 to 100

C. sinoatrial node, 60 to 100

D. atrioventricular node, 60 to 80

Answer 78

C. sinoatrial node, 60 to 100

Question 79

An acute myocardial infarction is more apt to occur in the left ventricle because:

A. its inherently low oxygen demand predisposes it to injury or infarct.

B. its coronary arteries are more susceptible to atherosclerotic disease.

C. it is large and thick and demands more oxygen than the right ventricle.

D. it is a fairly small chamber that is quickly depleted of oxygenated blood.

Answer 79

C. it is large and thick and demands more oxygen than the right ventricle.

Question 80

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:

A. confirm that the patient is in cardiac arrest.

B. apply the AED and analyze his cardiac rhythm.

C. continue CPR and insert a multilumen airway.

D. look, listen, and feel for signs of breathing.

Answer 80

A. confirm that the patient is in cardiac arrest.

Question 81

When errors associated with the AED occur, it is usually the result of:

A. failure of the AED’s internal memory card.

B. failure of the internal analyzing mechanism.

C. inappropriate placement of the chest pads.

D. failure to ensure the batteries are charged.

Answer 81

D. failure to ensure the batteries are charged.

Question 82

The visceral pericardium, which lies closely against the heart, is also called the:

A. epicardium.

B. endocardium.

C. foramen ovale.

D. coronary sinus.

Answer 82

A. epicardium.

Question 83

One of the MOST common signs of an acute hypertensive emergency is:

A. a posterior nosebleed.

B. a sudden, severe headache.

C. pale, cool, clammy skin.

D. acute pulmonary edema.

Answer 83

B. a sudden, severe headache.

Question 84

Unstable angina pectoris is characterized by:

A. a fixed frequency of chest pain or pressure that is often relieved by rest and several doses of nitroglycerin.

B. chest pain or discomfort that may not be relieved by rest or nitroglycerin, and that occurs without a fixed frequency.

C. chest pain or pressure that lasts longer than 15 minutes and is associated with myocardial necrosis.

D. chest pain or pressure that occurs during periods of strenuous activity and promptly subsides with rest.

Answer 84

B. chest pain or discomfort that may not be relieved by rest or nitroglycerin, and that occurs without a fixed frequency.

Question 85

Which of the following is NOT a component of the cardiac electrical conduction system?

A. Sinoatrial node

B. Atrioventricular node

C. Interatrial septum

D. Purkinje fibers

Answer 85

C. Interatrial septum

Question 86

When defibrillating a 6-month-old infant, you should recall that:

A. adult AED pads cannot be used.

B. you should only deliver one shock.

C. a manual defibrillator is preferred.

D. all shocks are delivered in sets of three.

Answer 86

C. a manual defibrillator is preferred.

Question 87

Which of the following MOST accurately describes the pathophysiology of angina pectoris?

A. Irreversible process in which one or more coronary arteries spasm and decrease myocardial blood supply

B. Reversible process in which a brittle intracoronary plaque ruptures and activates the blood-clotting system

C. Irreversible process in which the lumen of the coronary artery is completely occluded with plaque

D. Reversible process in which myocardial oxygen demand exceeds the supply of available oxygen

Answer 87

D. Reversible process in which myocardial oxygen demand exceeds the supply of available oxygen

Question 88

If the heart’s natural pacemaker is not functioning properly:

A. the atria will be electrically stimulated but will not contract.

B. the AV node may take over and pace the heart at 40 to 60 beats/min.

C. the electrical stimulus will not be received by the ventricles.

D. the SA node will take over as the heart’s primary pacemaker.

Answer 88

B. the AV node may take over and pace the heart at 40 to 60 beats/min.

Question 89

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:

A. ensure that the patient’s heart rate is no greater than 100.

B. ask the patient if he is currently experiencing a headache.

C. assess his systolic BP to ensure that it is at least 100 mm Hg.

D. ensure that he has taken up to 3 doses prior to your arrival.

Answer 89

C. assess his systolic BP to ensure that it is at least 100 mm Hg.

Question 90

Nitroglycerin is contraindicated for patients who:

A. have an irregular pulse.

B. have experienced a head injury.

C. took an erectile dysfunction drug within the past week.

D. have a systolic blood pressure less than 120 mm Hg.

Answer 90

B. have experienced a head injury.