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CARIDAC > QUIZ QUESTIONS > Flashcards

QUIZ QUESTIONS Flashcards

1
Q

When a person moves from a supine position to a standing position, which of the following compensatory changes occurs?

A

INCREASED CONTRACTILITY

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2
Q

At which site is systolic blood pressure the highest?

A

RENAL ARTERY

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3
Q

If the ejection fraction increases, there will be a decrease in:

A

END-SYSTOLIC VOLUME

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4
Q

An increase in contractility is demonstrated on a Frank-Starling diagram by?

A

INCREASED CARDIAC OUTPUT FOR A GIVEN END-DIASTOLIC VOLUME

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5
Q

An acute decrease in arterial blood pressure elicits which of the following compensatory changes?

A

DECREASED FIRING RATE OF THE CAROTID SINUS NERVE

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6
Q

The tendency for edema to occur will be increased by?

A

INCREASED VENOUS PRESSURE

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7
Q

Inspiration “splits” the second heart sound because

A

THE AORTIC VALVE CLOSES BEFORE THE PULMONIC VAVLE

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8
Q

Which of the following is the result of an inward Na+ current?

A

UPSTROKE OF THE ACTION POTENTIAL IN PURKINJE FIBERS

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9
Q

Pulse pressure is?

A

DETERMINED BY STROKE VOLUME

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10
Q

Myocardial contractility is best correlated with the intracellular concentration of

A

CA2+

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11
Q

Cardiac output of the right side of the heart is what percentage of the left side the heart?

A

100%

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12
Q

Which of the following changes will cause an increase in myocardial 02 consumption?

A

INCREASED SIZE OF THE HEART

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13
Q

A 24-year-old woman presents to the emergency department with severe diarrhea. When she is supine (lying down), her blood pressure is 90/60 mmHg (decreased) and her heart rate is 100 beats/min (increased). When she is moved to a standing position, her heart rate further increases to 120 beats/min. Which of the following accounts for the further increase in heart rate upon standing?

A

DECREASED VENOUS RETURN

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14
Q

During which phase of the ventricular action potential is the membrane potential closest to the K+ equilibrium potential?

A

PHASE 4

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15
Q

If the heart rate is 70 beats/min, then the cardiac output of this ventricle is closest to:

A

5.25 L/min

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16
Q

Which receptor mediates slowing of the heart?

A

MUSCARINIC RECPETORS

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17
Q

Which agent is released or secreted after a hemorrhage and causes an increase in renal Na+ reabsorption?

A

ALDOSTERONE

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18
Q

A 42-year old woman with mitral prolapse is admitted to the hospital for evaluation of her cardiac function. Which of the following values if the best index of the preload on her heart?

A

LEFT VENTRICULAR END-DIASTOLIC VOLUME

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19
Q

A 66-year-old man is referred to a cardiologist for evaluation. Physical examination reveals a diastolic murmur prominent over the left sternal border, a decrease in diastolic pressure, and an increase in pulse pressure. Which of the following is the most likely diagnosis?

A

AORTIC REGURGITATION

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20
Q

A 75-year old woman presents with fatigue, edema, and shortness of breath. Her physician prescribes a diuretic and a positive inotropic agent. Which of the following changes is primarily responsible for the improvement in her condition?

A

A REDUCTION IN HEART SIZE

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21
Q

A cardiac catheterization is performed on a 39-year-old man who presents with angina. The left ventricular pressure-volume curve shows a decreased stroke volume and ejection fraction. Which of the following mechanisms may compromise stroke volume following myocardial infraction?

A

AN INCREASE IN HEART RATE

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22
Q

A 48-year-old sedentary, obese man with four-vessel coronary occlusive disease has a massive
myocardial infraction while shovelling snow, In the blizzard conditions, it takes the ambulance over an hour to reach the man’s home. When the paramedics arrvive, the patient’s radial pulse is rapid and thready, he has pink froth coming from his mouth and he is non responsive. Increasing which of the following would lead to an increased stroke volume in Cardiogenic shock?

A

VENTRICULAR CONTRACTILITY

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23
Q

During which phase of the ventricular action potential is the conductance to CA2+ highest?

A

PHASE 2

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24
Q

Which of the following are considered likely aetiologies for atrial fibrillation?

A

EMPHYSEMA & RHEUMATIC HEART DISEASE

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25
Q

The cardiac worker cells or myocytes’ maintain a negative membrane potential because:

A

THE NA+/K+ PUMP, THROUGH ACTIVE TRANSPORT, MOVES 3 SODIUM IONS OUT OF AND 2 POTASSIUM IONS INTO THE CELL

&

THE CELL MEMBRANE IS MORE PERMEABLE TO POTASSIUM IONS LEADING TO A PASSIVE LOSS OF POSITIVE IONS

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26
Q

During which phase of the cardiac cycle is aortic pressure highest?

A

REDUCED VENTICULAR EJECTION

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27
Q

In cardiology, re-entry is defined as:

A

THE ABILITY OF AN IMPULSE TO RE-EXCITE A REGION OF THE HEART WHICH IT HAS ALREADY PASSED THROUGH.

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28
Q

Automaticity is defined as the hearts ability to:

A

GENERATE ITS OWN PULSES

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29
Q

If the ejection fraction increase, there will be a decrease in

A

END-SYSTOLIC VOLUME

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30
Q

You are treating a 19 year old with a BP of 78 / 54 and a pulse of 190. The cardiac monetary shows a wide complex tachycardia. This patient would benefit mostly from.

A

CARDIOVERSION

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31
Q

A conscious 43 year old 60 kilogram male has a wide complex rhythm at a rate of 186 on the monitor and a BP of 154 / 90. The patient has no chest pain but does feel a little weak. You anticipate a BHP order for Amiodarone of Lidocaine:

A

LIDOCAINE 90 mg IV can be administered, initially
&
AFTER AN INIITAL DOES OF AMIODARONE, A SECOND DOSE OF AMOIDARONE 150 MG CAN BE ADMINISTERED OVER 10 MINUTES IF THE TACHYCARDIA PERSISTS

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32
Q

Beta effects will be most pronounced when Dopamine is administered at:

A

5 - 10 UG/KG/MIN

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33
Q

With regard to SA and AV cells:

A

NA+ PERMEABILITY, LEAK CHANNELS, IS RESPONSIBLE THEIR AUTOMATICITY
&
PHASE 3 IS THE REPOLARIZATION PHASE AND DOMINATED BY POTASSIUM EFFLUX

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34
Q

Paroxysmal supra ventricular tachycardias (PSVT) are most often caused by:

A

RE-ENTRANT MECHANISIMS

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35
Q

In cardio version what can be done to help the machine synchronize in the R waves?

A

INCREASE THE GAIN OR SIZE OF THE ECG
CHANGE LEADS
TURN OFF ALL ADJUCT FEATURES IF POSSIBLE 
TURN ON AND TURN OFF THE MACHINE

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36
Q

Blood pressure is equal to which of the following?

A

HEART RATE X STROKE VOLUME X PERIPHERAL VASCULAR RESISTANCE

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37
Q

The most common cause of cardiac implantable pacemaker failure is:

A

BATTERY FAILURE

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38
Q

Approximately 80% of ventricular killing occurs:

A

DURING VENTRICULAR SYSTOLE

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39
Q

Which of the following is NOT a contraindication for the administration of Adenosine?

A

COUMADIN

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40
Q

Which of the following electrolytes has a major role in the depolarization of pacemaker cells and in myocardial contractility?

A

Calcium (Ca+)

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41
Q

The ______ has/have an intrinsic pacing rate of 35 to 40 beats per minute

A

PURKINJE CELLS

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42
Q

______ slow automaticity through the SA node and Purkinje system.

A

BETA-BLOCKERS

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43
Q

A positive chronotropic effect will have what effect on the heart?

A

INCREASED HEART RATE

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44
Q

The relationship between an increased ejection fraction and increased ventricular end-diastolic volume is called:

A

STARLING’S LAW

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45
Q

Which of the following statement are true for the treatment of patients in stable vs unstable tachycardia

A

VAGAL MANEUVERS CAN BE APPLIED TO PATIENTS WITH STABLE SVT
ADENOSINE IS AN APPROPRIATE MEDICATION FOR STABLE SVT
CARDIOVERSION IS APPROPRIATE FOR UNSTABLE SVT AND VT WITH A PULSE


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46
Q

Narrowing pulse pressure with drop in systolic pressure during an AMI is an indication of:

A

A FAILURE OF THE SYMPATHETIC RESPONSE TO COMPENSATE
A POOR EJECTION FRACTION DECREASING STROKE VOLUME 
DEVELOPING CARDIOGENIC SHOCK WITH POTENTIAL FOR CARDIAC ARREST

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47
Q

The most important benefit to decreasing a patient’s anxiety in an AMI situation is it:

A

ALLOWS FOR A REDUCTION IN MYOCARDIAL WORKLOAD AND MYOCARDIAL OXYGEN DEMAND

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48
Q

Regarding angina pectoris which of the following statements are true?

A

THE PATIENT WILL PRESENT WITH PALE, COOL AND DIAPHORETIC SKIN
CRUSHING SUBSTERNAL PAIN MAY RADIATE TO BACK NECK , ARMS OR JAW
THE PATIENT’S BLOOD PRESSURE MAY BE HIGH, LOW OR NORMAL

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49
Q

An atypical MI event that follows the use of cocaine, releases which of the following chemical mediators to precipitate coronary vasospasm:

A

THROMBOXANE

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50
Q

Which of the following are part of the compensatory response to a decreasing CO?

A

CATECHOLAMINE RELEASE
INCREASE IN ANGIOTENSIN II
ALDOSTERONE RELEASE

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51
Q

Which of the following statement concerning the pathology of myocardial infraction are true?

A

IF THE BLOOD SUPPLY IS NOT RESTORED WITHIN 30 MIN THE HEART TISSUE BECOMES NECROTIC AND AN AREA OF INJURY AND INFLAMMATION DEVELOPS AROUND THE NECROTIC ZONE

BECAUSE THE MYOCARDIUM DOES NOT REGENERATE, THE AREA OF NECROSIS IS GRADUALLY REPLACED BY FIBROUS NONFUNCTIONAL TISSUE.

MOST INFRACTIONS ARE TRANSMURAL INVOLVING ALL THREE LAYERS OF THE HEART WITH THE MAJORITY INVOLVING THE LEFT VENTRICLE.

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52
Q

Complications of myocardial infraction include:

A

ARRHYTHMIAS
CARDIOGENIC SHOCK
VENTICULAR ANEURYSM

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53
Q

In the development of atherosclerosis which of the following statements are true?

A

BIFURCATION POINTS OF HIGH FLOW, HIGH-PRESSURE ARTERIES ARE OFTEN THE MOST COMMON SITES FOR LESIONS

MONOCYTES BECOME MACROPHAGES INGESTING RANCID CHOLESTEROL THAT HAS COLLECTED WITHIN THE INTIMA

CHOLESTEROL-FILLED MACROPHAGES ARE CALLED foam cells, LEADS TO HYPERPLASIA OF THE MEDIA’S SMOOTH MUSCLE CELLS.

54
Q

Which of the following statement concerning the coronary arteries are true?

A

THE LEFT ANTERIOR DESCENDING ARTERY IF OCCLUDED OFTEN RESULTS IN PUMP FAILURE WITH CLASSIC CHEST PAIN RADIATING TO THE MEDIAL ASPECT OF THE LEFT ARM

THE RIGHT CORONARY ARTERY IF OCCLUDED CAN REUSLT IN BRADYCARDIA AND HYPOTENSION WITH CHEST PAIN RADIATING TO THE NECK AND JAW

55
Q

The chest pain associated with myocardial infraction is due to:

A

ABNORMAL MYOCARIDAL STRETCHING
ISCHEMIA AND LACTIC ACID PRODUCTION
INFLAMMATION OF INVOLVED AND ADJACENT TISSUE

56
Q

Which of the following is/are the markers of choice and most specific in determining myocardial cell death:

A

Troponins I & T

57
Q

When a myocardial fiber is in the relative refractory period, the fiber:

A

CAN BE PREMATURELY STIMULATED

58
Q

Target organ damage that can occur from hypertension includes

A

RENAL DYSFUNCTION AND LEFT VENTRICULAR HYPERTROPHY

59
Q

Specific symptoms of aortic dissection vary depending on

A

THE AORTIC BRANCHES AFFECTED IN THE DESCENT OF THE DISSECTION

60
Q

The most common pathological finding in individuals with sudden cardiac death is:

A

ATHEROSCLEROTIC HEART DISEASE

61
Q

The clinical spectrum of acute coronary syndrome includes

A

UNSTABLE ANGINA, STEMI AND NSTEMI

62
Q

The paramedic suspects the presence of a deep vein thrombosis based on the findings of

A

GENERALIZED EDMEA OF THE INVOLVED EXTREMITY

63
Q

The paramedic prepares a patient for electrical cardio version knowing that cardio version differs from defibrillation in that

A

CARDIOVERSION IS MAT BE DONE ON AN EMERGENCY BASIS WITH SEDATION OF THE PATIENT

64
Q

The primary manifestations of systolic ventricular failure include

A

DECREASE EJECTION FRACTION AND INCREASED PULMONARY ARTERY WEDGE PRESSURE

65
Q

Your patient is admitted to the hospital in hypertensive crisis. You recognize that the hypertensive urgency differs from hypertensive emergency in that:

A

HYPERTENSIVE EMERGENCIES ARE ASSOCIATED WITH EVIDENCE OF TARGET ORGAN DAMAGE

66
Q

A patient is being transferred for an abdominal aortic aneurysm repair. The paramedic suspects rupture of the aneurysm when

A

THE CLIENT COMPLAINS OF SUDDEN, SEVERE BACK PAIN

67
Q

The drug used in the management of a client with acute pulmonary edema that will decrease both preload and after load and provide relief of anxiety is

A

MORPHINE

68
Q

A patient with a history of IV cocaine use has acute infective endocarditis. You closely assess the patient for signs and symptoms of

A

PULMONARY EMBOLI

69
Q

In teaching a patient about coronary artery disease, the Community Paramedic explains the changes that occur in this disorder involve

A

FORMATION OF FIBROUS TISSUE AROUND CORONARY ARTERY ORIFICES

70
Q

A client with a deep vein thrombosis suddenly develops dyspnea, tachypnea, and chest pain. Initially the most appropriate action by the nurse is to.

A

ELEVATE THE HEAD OF THE BED 30 TO 45 DEGREES TO FACILITATE BREATHING

71
Q

A compensatory mechanism involved in congestive heart failure that leads to inappropriate fluid retention and additional workload of the heart is

A

NEUROHORMONAL RESPONSE

72
Q

You suspect cardiac tamponade in a patient with acute pericarditis based on the finding of

A

PULSUS PARADOXUS

73
Q

Indication for the use (in medicine, not just the ALSPCS) of the antidysrhythmic amiodarone (Cordarone) include:

A

ALL OF THE ABOVE
INITIAL TREATMENT OF ATRIAL DYSRHYTHMIAS
INITIAL TREATMENT OF VENTRICULAR DYSRHYTHMIAS
TREATMENT OF PAROXYSMAL VENTRICULAR TACHYCARDIA REFRACTORY TO OTHER ANTIDYSRHYTHMICS

74
Q

Match the following drug, lisionpril (Prinivil), used to treat heart failure with its drug class:

A

ACE INHIBITOR

75
Q

Match the following drug, milrinone (Primacor), used to treat heart failure with its drug class:

A

PHOSPHODIESTERASE

76
Q

Which of the following is involved in slowing of heart rate and conduction?

A

MUSCARINIC RECEPTOR ACTIVATION

77
Q

The onset of action for Nitroglycerin is:

A

2 MINTUES

78
Q

Adenosine (Adenocard) works by blocking ____ channels in the heart and has the effect of ____ conduction through the _____ pathways.

A

CALCIUM, SLOWING, AV

79
Q

When used to treat hypertension, diuretics such as hydrochlorothiazide (HydroDIURIL):

A

CAUSE A REDUCTION IN BLOOD VOLUME

80
Q

Which of the following drugs has been shown to increase survival in clients with heart failure?

A

LISINOPRIL (Prinivil)

81
Q

The most effective drugs for lowering cholesterol levels are the:

A

STATINS

82
Q

Which of the following is a Class Ic antiarrhythmics

A

FLECAINIDE (Tambocor)

83
Q

Procainimide (Pronestyl) is an antidysrhythmic that causes ______ blockade, whereas amiodarone (Cardarone) is a drug that causes ______ blockade.

A

SODIUM, POTASSIUM

84
Q

You are treating a patient for chest discomfort concurrent with hypotension that has been unresponsive to oxygen and fluid replacement therapy. The patient is pale and cool to the touch, ECG shows an apparent sinus bradycardia. You decide to treat the patient with atropine. Shortly after, your patient begins to exhibit signs and symptoms different from the initial complaint. Of the following, which would be considered a “normal” side effect of the drug?

A

ALL OF THE ABOVE
CARDIAC PALPITATIONS
DILATED PUPILS
ANXIETY

85
Q

While interviewing your patient you discover that they have stopped taking their captopril (Capoten) because of an annoying cough. Which drug do you think would be a good replacement?

A

LOSARTAN

86
Q

Clonidine (Catapress) acts mainly on the:

A

ALPHA-ADRENERGIC RECEPTORS

87
Q

You learn that your patient has been started on amiodarone (Cordarone). What is the most likely rationale for this?

A

SERIOUS VENTRICULAR DYSRHYTHMIA

88
Q

Using critical thinking, select the underlying effect that results from taking propranolol (Inderal).

A

DECREASE IN OXYGEN CONSUMPTION BY THE HEART

89
Q

Class III antiarrhythmics interfere with:

A

POTASSIUM OUTFLOW

90
Q

Tirofiban (Aggrastat) and clopidogrel (Plavix) share the following attributes. They:

A

INHIBIT COAGULATION OF BLOOD AND AGGREGATION OF PLATELETS

91
Q

The dihydropyridine calcium channel blockers lower blood pressure by:

A

REDUCING TOTAL PERIPHERAL RESISTANCE

92
Q

Patient teaching regarding the use of beta blockers in treatment of MI includes beta blockers’ ability to cause:

A

NEGATIVE INOTROPIC EFFECT

93
Q

Which of the following is a therapeutic strategy for patients with heart failure?

A

DECREASE CARDIAC PRELOAD

94
Q

How do angiotensin converting enzyme inhibitors decrease blood pressure?

A 
ALL OF THE ABOVE 
DECREASING BLOOD VOLUME
INCREASING RENAL SODIUM EXCRETION
BLOCKING THE CONVERSION OF ANGIOTENSIN I TO ANGIOTENSIN II
DILATING ARTERIES
95
Q

Beta-blocking agents will introduce:

A

BOTH NEGATIVE INOTROPIC AND CHRONOTROPHIC EFFECTS

96
Q

Which of the following drugs has a positive inotropic effect in clients with heart failure?

A

DIGOXIN (LANOXIN)

97
Q

Your patient is about to receive alteplase recombinant (Activase) after being diagnosed with an acute MI. You know this medication is given to:

A

DISSOLVE PRE-EXISTING CLOTS

98
Q

Known actions of Lidocaine (Xylocaine) include:

A

SUPPRESSION OF ISCHEMIC ECTOPIC FOCI

99
Q

Class IV antiarrythmic medications are?

A

NONE OF THE ABOVE

100
Q

All of the following are calcium channel blocker drugs EXCEPT:

A

LIDOCAINE (XYLOCAINE)

101
Q

Antianginal drugs accomplish therapeutic effects by doing which of the following?

A 
ALL OF THE ABOVE
SLOWING THE HEART RATE
LOWERING BLOOD PRESSURE
REDUCE AFTERLOAD
DILATING VEINS
102
Q

A woman with essential hypertension requires a drug that reduces both cardiac output and peripheral resistance

A

LABETALOL

103
Q

Aspirin acts to inhibit platelet aggregation by:

A

DECREASING SYNTHESIS OF COAGULATION FACTORS

104
Q

Drugs used to treat angina pectoris include all of the following EXCEPT:

A

ANTIARRHYTHMIC DRUGS

105
Q

Which of the following medications could be used to manage atrial fibrillation?

A

DIGOXIN (LANOXIN)

106
Q

The group of drugs that reduce the heart’s oxygen demand by decreasing the heart rate is known as the:

A

BETA-ADRENERGIC BLOCKERS

107
Q

Compensatory mechanisms that come into play in heart failure include:

A 
ALL OF THE ABOVE 
MYOCARDIAL HYPERTROPHY 
INCREASED SYMPATHETIC STIMULATION 
RENIN-ANGIOTENSIN-ALDOSTERONE MECHANISM 
ADH RELEASE AND ACTIVATION
108
Q

One critically important effect that the arrhythmia SVT can have is:

A

DECREASED CORONARY PERFUSION OF MYOCARDIUM

109
Q

Clinical presentation of right ventricular failure resulting from pulmonic stenosis includes

A

NONE OF THE ABOVE

110
Q

The most common cause of secondary hypertension is:

A

RENAL VASCULAR DISEASE

111
Q

Signs and symptoms of right-sided heart failure often include:

A

ASCITES, PERIPHERAL EDEMA

112
Q

Which of the following statements on the aetiology and pathology of heart failure are true?

A

VALVULAR DISEASE LEADS TO COMPLETE VENTRICULAR CLEARING AND A DECREASED AFTER LOAD

CHF MAY BE PRIMARILY A SYSTOLIC DYSFUNCTION CAUSED BY VOLUME OVERLOAD

113
Q

Which of the following statements concerning the coronary arteries are true?

A

THE LEFT ANTERIOR DESCENDING ARTERY IF OCCLUDED OFTEN RESULTS IN PUMP FAILURE WITH CLASSIC CHEST PAIN RADIATING TO THE MEDIAL ASPECT OF THE LEFT ARM.

THE RIGHT CORONARY ARTERY IF OCCLUDED CAN RESULT IN BRADYCARDIA AND HYPOTENSION WITH CHEST PAIN RADIATING TO THE NECK AND JAW

114
Q

Starling’s law is generally expressed as follows:

A

AN INCREASE IN DIASTOLIC FILLING WILL INCREASE THE FORCE OF CONTRACTION

115
Q

Collateral circulation is the body’s mechanism for increasing blood flow to deprived areas of the myocardium. This increase is accomplished by:

A

THE FORMATION OF NEW CAPILLARIES BYPASSING OBSTRUCTED ARTERIOLES

116
Q

A normal time interval for the QRS complex can be:

A

0.08 to 0.10 second

117
Q

Conductivity between the SA and AV node can be enhanced by administration of:

A

ATROPINE

118
Q

The most frequent complication encountered during an AMI is:

A

DYSRHYTHMIAS

119
Q

The most reliable indicator of impending Cardiogenic shock is:

A

A NARROWING PULSE PRESSURE

120
Q

Which of the following are considered etiologies for PEA

A 
HYPOVOLEMIA
HYPOXIA
HYPOTHERMIA
CARIDAC TAMPONADE
MASSIVE PULMONARY EMBOLISM 
DRUG OVERDOSE 
HYPERKALEMIA
TENSION PNEUMOTHRORAX
121
Q

All of the following are associated with atrial fibrillation expect one

A

AORTIC STENOSIS

122
Q

Time to defibrillation is key with the probably of defibrillating back to a perfusing rhythm approaching zero after:

A

15 MINUTES

123
Q

ST elevation in leads V5, V6 represents possible occlusion of:

A

CIRCUMFLEX BRACH OF LEFT CORONARY ARTERY

124
Q

The normal S2 heart sound is produced by:

A

CLOSING OF THE SEMILUNAR VALVES

125
Q

Your patient presents with an anterior wall MI. Their vital signs are: HR 92, BP 134/74, RR 14 and SpO2 of 95%. During transport they become pale, diaphoretic with increasing dyspnea. You notice that their cardiac rhythm has now changed to a second degree heart block type II at a rate of 38 bpm with a BP of 92/70 mmHg. The most appropriate therapy indicated for the patient is:

A

IMMEDIATE TRANSCUTANEOUS PACING WITH APPROPRIATE SEDATION

126
Q

The use of vasopressor drugs has a “risk/benefit” component that includes:

A

INCREASED CARDIAC COMPLICATIONS AND INCREASED END-ORGAN PERFUSION

127
Q

For lidocaine administrations to a patient with a perfusing rhythm, the ALSPCS dosing for adults and paediatrics are:

A

1.5 mg/kg IV and 1 mg/kg IV

128
Q

Adenosine works by blocking _______channels in the heart and has the effect of _____conduction through the ______ pathways.

A

POTASSIUM, SLOWING, AV

129
Q

Which of the following are considered causes for an idioventricular rhythm?

A

HYPOXIA
SEVERE HYPERKALEMIA
COMPLETE AV BLOCK

130
Q

Which of the following are indications for synchronized cardioversion?

A

Ventricular tachycardia with a pulse

Unstable SVT

CARIDAC (3 decks)

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