midterm up to 24 Flashcards
A 49-year-old male presents with an acute onset of crushing chest pain and diaphoresis. You should:
administer up to 324 mg of baby aspirin.
assess the adequacy of his respirations.
obtain vital signs and a SAMPLE history.
administer up to three doses of nitroglycerin.
obtain vital signs and a SAMPLE history.
A 66-year-old female with a history of hypertension and diabetes presents with substernal chest pressure of 2 hours’ duration. Her blood pressure is 140/90 mm Hg, her pulse is 100 beats/min and irregular, her respirations are 22 breaths/min, and her oxygen saturation is 92%. The patient does not have prescribed nitroglycerin, but her husband does. You should:
give her one nitroglycerin and reassess her systolic blood pressure.
administer oxygen, give her 324 mg of aspirin, and assess her further.
obtain a SAMPLE history and contact medical control for advice.
give her high-flow oxygen, attach the AED, and transport at once.
administer oxygen
A 66-year-old woman presents with a stabbing pain in the middle of her chest that radiates to her back. She tells you that the pain suddenly began about 30 minutes ago and has been severe since the onset. She has a history of hypertension, but admits to being noncompliant with her antihypertensive medications. When you assess her, you find that her blood pressure is significantly higher in her left arm than it is in her right arm. What do these signs and symptoms MOST likely indicate?
Hypertensive emergency
Unstable angina
Dissecting aortic aneurysm
Acute myocardial infarction
Dissecting aortic aneurysm
A 67-year-old female with severe chest pain becomes unresponsive, pulseless, and apneic during transport. You should:
defibrillate with the AED while continuing transport to the hospital.
stop the ambulance, begin CPR, and attach the AED as soon as possible.
alert the receiving hospital and perform CPR for the duration of the transport.
perform CPR for 1 to 2 minutes and then analyze her rhythm with an AED.
stop the ambulance
Acute coronary syndrome (ACS) is a term used to describe:
a group of symptoms that are caused by myocardial ischemia.
the exact moment that a coronary artery is completely occluded.
a severe decrease in perfusion caused by changes in heart rate.
the warning signs that occur shortly before a heart attack.
a group of symptoms that are caused by myocardial ischemia.
A dissecting aortic aneurysm occurs when:
all layers of the aorta suddenly contract.
the inner layers of the aorta become separated.
a weakened area develops in the aortic wall.
the aorta ruptures, resulting in profound bleeding.
the inner layers of the aorta become separated.
After assisting your patient with prescribed nitroglycerin, you should:
avoid further dosing if the patient complains of a severe headache.
perform a secondary assessment before administering further doses.
reassess his or her blood pressure within 5 minutes to detect hypotension.
place the patient in a recumbent position in case of fainting.
reassess his or her blood pressure within 5 minutes to detect hypotension.
After the AED has delivered a shock, the EMT should:
transport the patient at once.
assess for a carotid pulse.
re-analyze the cardiac rhythm.
immediately resume CPR.
immediately resume CPR.
An acute myocardial infarction (AMI) occurs when:
coronary artery dilation decreases blood flow to the heart.
the heart muscle progressively weakens and dysfunctions.
myocardial tissue dies secondary to an absence of oxygen.
the entire left ventricle is damaged and cannot pump blood.
myocardial tissue dies secondary to an absence of oxygen.
Angina pectoris occurs when:
a coronary artery is totally occluded by plaque.
myocardial oxygen supply exceeds the demand.
myocardial oxygen demand exceeds supply.
one or more coronary arteries suddenly spasm.
myocardial oxygen demand exceeds supply.
A patient with a left ventricular assist device (LVAD) tells you that the device’s pump flow is continuous. Which of the following should you expect to encounter during your assessment?
Absence of a palpable pulse
Distention of the jugular veins
Low diastolic blood pressure
High systolic blood pressure
Absence of a palpable pulse
Blood that is ejected from the right ventricle:
enters the systemic circulation.
flows into the pulmonary arteries.
was received directly from the aorta.
has a high concentration of oxygen.
flows into the pulmonary arteries.
Common side effects of nitroglycerin include all of the following, EXCEPT:
hypertension.
bradycardia.
hypotension.
severe headache.
hypertension.
Deoxygenated blood from the body returns to the:
left ventricle.
left atrium.
right ventricle.
right atrium.
right atrium.
During your treatment of a woman in cardiac arrest, you apply the AED, analyze her cardiac rhythm, and receive a “no shock advised” message. This indicates that:
she is not in ventricular fibrillation.
the AED detected patient motion.
the AED has detected asystole.
she has a pulse and does not need CPR.
she is not in ventricular fibrillation.
Most AEDs are set up to adjust the voltage based on the impedance, which is the:
actual amount of energy that the AED will deliver.
direction that the electrical flow takes in the body.
distance between the two AED pads on the chest.
resistance of the body to the flow of electricity.
resistance of the body to the flow of electricity.
Nitroglycerin relieves cardiac-related chest pain by:
dilating the coronary arteries and improving cardiac blood flow.
contracting the smooth muscle of the coronary and cerebral arteries.
increasing the amount of stress that is placed on the myocardium.
constricting the coronary arteries and improving cardiac blood flow.
dilating the coronary arteries and improving cardiac blood flow.
A 40-year-old man is in cardiac arrest. Your partner is performing CPR. You are attaching the AED when the patient’s wife tells you that he has an automatic implantable cardiac defibrillator (AICD). The AED advises that a shock is indicated. What should you do?
Deliver the shock followed by immediate resumption of CPR.
Continue CPR and transport the patient to the closest appropriate hospital.
Avoid defibrillation because this will damage the patient’s AICD.
Contact medical control and request permission to defibrillate.
Deliver the shock followed by immediate resumption of CPR.
Cardiac output may decrease if the heart beats too rapidly because:
there is not enough time in between contractions for the heart to refill completely.
a rapid heartbeat causes a decrease in the strength of cardiac contractions.
as the heart rate increases, more blood is pumped from the ventricles than the atria
the volume of blood that returns to the heart is not sufficient with fast heart rates.
there is not enough time in between contractions for the heart to refill completely.
Common signs and symptoms of AMI include all of the following, EXCEPT:
sudden unexplained sweating.
irregular heartbeat.
pain exacerbated by breathing.
shortness of breath or dyspnea.
pain exacerbated by breathing.
A dissecting aortic aneurysm occurs when:
the aorta ruptures, resulting in profound bleeding.
all layers of the aorta suddenly contract.
the inner layers of the aorta become separated.
a weakened area develops in the aortic wall.
the inner layers of the aorta become separated.
A patient with atherosclerotic heart disease experiences chest pain during exertion because:
the coronary arteries suddenly spasm and cause a marked reduction in myocardial blood flow.
tissues of the myocardium undergo necrosis secondary to a prolonged absence of oxygen.
the ragged edge of a tear in the coronary artery lumen causes local blood clotting and arterial narrowing.
the lumen of the coronary artery is narrowed and cannot accommodate increased blood flow.
the lumen of the coronary artery is narrowed and cannot accommodate increased blood flow.
Acute coronary syndrome (ACS) is a term used to describe:
the exact moment that a coronary artery is completely occluded.
a group of symptoms that are caused by myocardial ischemia.
a severe decrease in perfusion caused by changes in heart rate.
the warning signs that occur shortly before a heart attack.
a group of symptoms that are caused by myocardial ischemia.
Blood that is ejected from the right ventricle:
has a high concentration of oxygen.
flows into the pulmonary arteries.
was received directly from the aorta.
enters the systemic circulation.
flows into the pulmonary arteries.