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Paramedic > Chapter 40 & 41 > Flashcards

Chapter 40 & 41 Flashcards

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1
Q

Which of the following interventions is emphasized the most in all AHA guidelines for emergency cardiac care since 2005?

A) Abdominal thrust
B) Defibrillation
C) Chest Compressions
D) Epinephrine

A

C) Chest Compressions

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2
Q

The paramedic should consider extending the resuscitation effort of a patient with refectory cardiac arrest if:

A) patient remains in PEA
B) patient shows signs of profound hypoxia
C) patient has fixed and dilated pupils
D) return of spontaneous circulation of any duration occurred

A

D) return of spontaneous circulation of any duration occurred

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3
Q

Your partner returns with an AED as you are performing CPR on a 5 y/0 child. As he opens the AED, he tells you that there are no pediatric pads. You should:

A) instruct him to apply the pads as you continue one-rescuer CPR
B) administer 2mg of adrenaline IM
C) perform defibrillation using adult pads directly on the child’s chest
D) stop CPR and wait for pediatric pads to arrive

A

A) instruct him to apply the pads as you continue one-rescuer CPR

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4
Q

Your assessment of a 68 y/o female reveals an organized cardiac rhythm at a rate of 80 bpm and an absent carotid pulse. Treatment for this patient may include:

A) dopamine
B) atropine
C) cardiomyopathy
D) epinephrine

A

D) epinephrine

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5
Q

After determining that an unresponsive adult patient is not breathing, you should:

A) begin CPR immediately without checking for a pulse
B) perform a head-to-toe assessment on the patient
C) administer oxygen through a non-rebreather mask
D) assess for a carotid pulse for no longer than 10 seconds

A

D) assess for a carotid pulse for no longer than 10 seconds

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6
Q

Defibrillation of a patient who is in asystole is detrimental to the patient because it:

A) reduces the risk of further cardiac complications
B) causes an unnecessary interruption in chest compressions
C) increases the likelihood of spontaneous breathing
D) improves the chances of restoring a normal heart rhythm

A

B) causes an unnecessary interruption in chest compressions

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7
Q

How does CPR change after an advanced airway device is inserted?

A) chest compressions should be increased in rate
B) chest compressions should be paused during ventilations
C) ventilations should be asynchronous with chest compressions
D) ventilations should be delivered after every 10 compressions

A

C) ventilations should be asynchronous with chest compressions

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8
Q

Which of the following interventions is emphasized the most in all AHA guidelines for emergency cardiac care since 2005?

A) Epinephrine
B) Defibrillation
C) Abdominal thrusts
D) Chest compressions

A

D) Chest compressions

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9
Q

What is the current recommendation for the use of epinephrine for patients with ventricular fibrillation or pulseless ventricular tachycardia?

A) Epi should be administered after the second shock
B) Epi should be administered intranasally
C) Epi should not be given in the first 10 minutes
D) Epi should be administered only is the patient is conscious

A

A) Epi should be administered after the second shock

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10
Q

In addition to high-quality CPR, which of the following interventions has clearly made a positive and measurable difference in survival from sudden cardiac arrest?

A) Cardioversion
B) Epinephrine
C) Chest compressions
D) Defibrillation

A

D) Defibrillation

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11
Q

What is a disadvantage of using a crystalloid solution when treating a patient with hemorrhagic shock?

A

They do not have oxygen-carrying capacity

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12
Q

A patient with severe dehydration is found to be hypotensive during your assessment. The most important intervention is this case is:

A

Transport with fluid resuscitation en route

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13
Q

If the left ventricle fills with 85mL of blood and ejects 60 mL during a contraction, what is the ejection fraction?

A

70%

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14
Q

What of the following assessment findings should increase your index of suspicion for obstructive shock?

A

Jugular venous distention

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15
Q

What is an injury or condition would cause obstructive shock?

A

Cardiac tamponade

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16
Q

Which of the following clinical signs would differentiate septic shock from hypovolemic shock?

A

Warm or hot skin

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17
Q

By which of the following mechanisms do patients with septic shock become hypovolemic?

A

Fluid leakage out of the vascular space

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18
Q

Relative bradycardia during neurogenic shock occurs because:

A

the sympathetic system is not stimulated to release catecholamines

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19
Q

Anaerobic metabolism is the process in which:

A

inefficient cellular metabolism produces lactic acid

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20
Q

During anaerobic metabolism, the precapillary sphincters relax in response to which of the following?

A

Lactic acid buildup

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21
Q

A young woman experiences a sudden nervous system reaction that produces temporary, generalized vasodilation and causes her to faint. This is most descriptive of which type of shock?

A

Psychogenic

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22
Q

Baroreceptors function by:

A

sensing decreased blood flow and activating the vasomotor center

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23
Q

Which of the following hemodynamic decreases, regardless of the etiology of the shock?

A

Mean arterial pressure

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24
Q

Carbonic acid is formed by the combination of:

A

water and carbon dioxide

25
Q

Cardiac output is dependent upon:

A

stroke volume and heart rate

26
Q

Disseminated intravascular coagulation is defined as:

A

a pathological condition in which the proteins that normally control blood clotting become inappropriately active

27
Q

During multiple-organ dysfunction syndrome, the release of which of the following leads to tissue hypoperfusion and may contribute to hypotension?

A

Bradykinin

28
Q

What is formed when carbon monoxide binds to the hemoglobin molecule?

A

Carboxyhemoglobin

29
Q

A code runs MOST efficiently when:

A. tracheal intubation is performed early.
B. a designated team leader is assigned.
C. at least five paramedics are participating.
D. the AED replaces manual defibrillation.

A

B. a designated team leader is assigned.

30
Q

After determining that an unresponsive adult patient is not breathing, you should:

A. reposition the patient’s airway and reassess for breathing.
B. assess for a carotid pulse for no longer than 10 seconds.
C. perform a finger sweep of the patient’s mouth to remove any debris.
D. give two rescue breaths that make the chest visibly rise.

A

B. assess for a carotid pulse for no longer than 10 seconds.

31
Q

You and your partner arrive at the scene of an unresponsive middle-aged man. Your primary assessment reveals that he is apneic and pulseless. Which of the following interventions will provide the BEST chance of survival for this patient?

A. Five minutes of CPR prior to analyzing his cardiac rhythm
B. Prompt insertion of an advanced airway to prevent aspiration
C. Immediate defibrillation for presumed ventricular fibrillation
D. CPR at the appropriate rate and with minimal interruptions

A

D. CPR at the appropriate rate and with minimal interruptions

32
Q

When responding to a field code with a five-person team, what is one of the roles of the ventilator?

A

To suction the patient, as necessary

33
Q

Which of the following should occur when integrating a mechanical CPR device into your resuscitation attempt of an adult patient?

A. One breath should be given every 6 to 8 seconds until an advanced airway is inserted.
B. Compressions should be continuous after an advanced airway device is inserted.
C. Compression depth should be at least 1½ inches after the device is applied.
D. The compression rate should be set to deliver at least 80 compressions per minute.

A

B. Compressions should be continuous after an advanced airway device is inserted.

34
Q

You and your team are attempting to resuscitate a 45-year-old man who is in cardiac arrest. After 2 minutes, you assess his cardiac rhythm and determine that he is in asystole. After instructing your team to resume CPR, you should:

A. insert an advanced airway device and then resume cycles of CPR.
B. administer 1 mg of epinephrine 1:10,000 after obtaining vascular access.
C. establish IV or IO access and administer 1 mg of atropine sulfate rapidly.
D. perform endotracheal intubation and ventilate at a rate of 15 breaths/min.

A

B. administer 1 mg of epinephrine 1:10,000 after obtaining vascular access.

35
Q

You are the team leader in the attempted resuscitation of an adult man in ventricular fibrillation. An advanced airway device has been inserted and vascular access has been obtained. As you observe the actions of your team members, you should ensure that:

A. compressions are hard and fast, with full chest recoil between compressions.
B. the patient is defibrillated one time every 60 seconds as necessary.
C. the person managing the airway delivers one breath every 3 to 5 seconds.
D. no one person performs chest compressions for more than 5 minutes at a time.

A

A. compressions are hard and fast, with full chest recoil between compressions.

36
Q

Your assessment of a 68-year-old man reveals an organized cardiac rhythm at a rate of 80 beats per minute and an absent carotid pulse. Treatment for this patient may include all of the following EXCEPT:

A. epinephrine.
B. IV fluid boluses.
C. vasopressin.
D. cardiac pacing

A

D. cardiac pacing

37
Q

A 40 y/o male had a syncopal episode after receiving news of the death of a loved one. He complains of a headache and is unable to walk without becoming dizzy. You should be most suspicious for:

A

a head injury

38
Q

A patient with suspected internal bleeding has a systolic blood pressure of 104 mm Hg. What is the appropriate fluid management?

A

Fluid challenge is not necessary

39
Q

Accumulating acids and other waste products in the blood:

A

inhibit hemoglobin from binding with and carrying oxygen

40
Q

Adequately perfused kidneys put out at least how man milliliters of urine per hour?

A

30 to 50 mL

41
Q

Afterload is increased following alpha-1 stimulation because of:

A

arteriolar constriction

42
Q

Clinical indicators of sympathetic nervous system discharge include:

A

pupillary dilation

43
Q

Hypotension during anaphylactic shock is caused primarily by:

A

relative hypovolemia

44
Q

If you can feel a pulse over the femoral artery of an adult, but are unable to feel a pulse over the radial artery, the patient’s systolic blood pressure likely falls within which range?

A

70 to 80 mm Hg

45
Q

In medicine, intuition would most likely be used to:

A

triage a patient to a higher category

46
Q

Incomplete glucose breakdown leads to an accumulation of:

A

pyruvic acid

47
Q

Intrinsic causes of cardiogenic shock include:

A

cardiomyopathy

48
Q

Shock in the trauma patient should be considered which type until proven otherwise?

A

Hemorrhagic

49
Q

Signs and symptoms of multiple-organ dysfunction syndrome may include:

A

uncontrollable bleeding

50
Q

The capillary “washout” phase occurs when:

A

postcapillary sphincters relax, releasing accumulated hydrogen, potassium, carbon dioxide, and thrombosed red blood cells

51
Q

The most common cause of cardiogenic shock is:

A

myocardial infarction

52
Q

The most immediate treatment for the patient with a tension pneumothorax is to:

A

evacuate air from the pleural space

53
Q

The negative target-organ effects of anaphylactic shock are revered with:

A

epinephrine

54
Q

What effect would the restoration of normotension have on a patient with internal bleeding and a blood pressure of 70/54 mm Hg?

A

Formed clot dislodgement and worsened internal bleeding

55
Q

What is the mean arterial pressure of a person who has a blood pressure of 140/90 mm Hg?

A

107 mm Hg

56
Q

When an adult patient with hemorrhagic stroke loses more than 40% of their blood volume:

A

cardiovascular deterioration cannot be reversed by compensatory mechanisms

57
Q

Which of the following components represent the perfusion triangle?

A

Heart, blood, blood vessels

58
Q

Which of the following blood pressures is most consistent with a pericardial tamponade?

A

90/70 mm Hg

Paramedic (7 decks)

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