testprep Flashcards
T or F: Fibrinolytic therapy is an essential intervention in the treatment of all patients with unstable angina/non ST elevation myocardial infarction.
False
T or F: Angiotensin converting enzyme inhibitors act on beta1 and beta2 receptors to slow sinus rate, depress AAV conduction and reduce blood pressure.
False; They produce vasodilation by blocking conversion of angiotensin I to II; it decreases peripheral vascular resistance reducing pressure the heart must pump against
Which of the following reflects the ECG hallmarks of ischemia:
a. Pathologic q waves, s-t segment elevation
B. ST segment depression, T wave inversion
C. Pathologic Q waves, ST segment depression
D. ST segment elevation, t wave inversion
B. ST segment depression, T wave inversion
Beta Blockers: A. reduce myocardial contractility B. Increase myocardial O2 demand C. Increase AV node conduction velocity D. Increase rate of discharge of the SA node
A. Reduce myocardial contractility
The recommended initial dose of aspirin is? A. 35 to 75 mg B. 75-162 mg C. 162-325 mg D. 325 to 500 mg
C. 162-325 mg
Dopamine:
A. suppresses ventricular ectopy
B. Is used to increase HR & BP
C. should be given until the qrs lengthens to more than 50% of its original width
D. is useful in relieving chest discomfort associated with ACS
B. is used to increase HR & BP
The highest incidence of v fib occurs about ____ hours after ST elevation MI symptom onset.
4 hours
Examples of electrical complications of an acute myocardial infarction include:
A. Acute stroke and pulmonary embolism
B. Ventricular aneurysm & pericarditis
C. Sinus bradycardia and BB blocks
D. Papillary muscle disorders and left ventricular failure
C. Sinus bradycardia and BB blocks
Acute pericarditis:
A. occurs most often because of chest trauma
B. is usually intensified when sitting forward and lessened by lying supine
C. typically results in a clinical syndrome of chest pain, pericardial friction rub, and ECG changes
D. is usually associated with discomfort over widespread area that cannot be localized with one finger
C. results in clinical syndrome of chest pain, pericardial friction rub, and ECG changes.
A 12 lead ECG should be obtained within ___ minutes of patient discomfort or arrival in ED.
10 minutes
Sublingual nitroglycerin is ordered what is the rationale for giving NTG to patient with ACS?
A. NTG is a potent narcotic analgesic
B. NTG increases myocardial O2 consumption
C. NTG relaxes vascular smooth muscle, including dilation of coronary arteries
D. NTG blocks the formation of thromboxane A12, which causes platelets to clump and arteries to constrict
C. NTG relaxes vascular smooth muscle, including dilation of coronary arteries
NTG siblingual tablets or spray may be given:
A. every 5 minutes until discomfort relieved
B. At 3-5 minute intervals to a max of 3 doses
C. only once, if no relief after one dose move to morphine
D. At 15 minute intervals to max of two doses.
B. at 3-5 minute intervals to max of 3 doses
When viewing 12 leads for ACS patient, the presence of ST segment elevation in the leads facing the affected area suggests myocardial A. Ischemia B. Injury C. Infarction D. Necrosis
B. injury
A patient rates pain at a “9” despite siblingual NTG therapy. BY is 140/70 pulse 120, ventilation is 18; Assuming patient is stable with vitals, which of the following is true:
A. Give morphine at 10 mg slow IV push & repeat every 90 minutes as needed
B. Give morphine at 5 mg IV and reassess the degree of patients pain every 30 min
C. Give morphine 8 mg IV, repeat every 30 minutes until patient is pain free, and obtain 12 lead ECG
D. Give morphine 2 mg IV, reassess vitals and discomfort and give additional dose 5-15 minute intervals until pain free
D; Morphine given in 2 mg at 5-15 minute intervals
A patient is diagnosed with an anteroseptal myocardial infraction. Which of the following complications can be anticipated? A. A fib and stroke B. Heart failure and cardiogenic shock C. Bradycardias and pulmonary embolism D. Tension pneumothorax and BB blocks
b. Heart failure and cardiogenic shock
Vasopressor that stimulates dopaminergic, beta, and alpha adrenergic receptor sites is
_______.
dopamine
These are contraindicated in the early period less than 7-10 days after MI because they predispose to cardiac rupture?
NSAIDS
A procedure in which a catheter is used to open a coronary aretery blocked or narrowed by coronary artery disease? A. angioplasty B. PCI C. Electrocardiogram D. coronary bypass
B. PCI
Diltiazem (Cardizem), verapamil are examples of what types of medications? A. Beta blocker B. ACE inhibitors C. CA channel blocker D. Antiarrhythmics
C. CA channel blockers
What is the most common cause of stroke? A. cerebral hemorrhage B. a thrombus c. dissecting cerebral aneurysm D. cerebral vasospasm
B. a thrombus or blood clot
The most common blocked vessel in a stroke is A. vertebral artery B. middle cerebral artery c. posterior cerebral artery d. anterior cerebral artery
b. middle cerebral artery
current stroke protocals suggest a possible stroke patient be seen by a dr within \_\_\_ minutes of arrival and a CT scan done within \_\_\_\_ minutes. A. 5 minutes, 15 B. 10 min, 25 min C. 30 min, 45 min D. 45 min, 60 min
B. 10 min, 25 min
Which dysrhythmia is most likely to precipitate a stroke? A. sinus bradycardia b. junctional rhythm c. atrial fibrillation d. ventricular escape rhythm
C. A -Fib
The window of opportunity to use IV rtPA to treat most eschemic stroke is A. 1 hour B. 3 hours C. 6 hours D. 12 hours
B. 3 hours
The 3 areas measured with Glasgow Coma Scale are:
A. eye opening, verbal response, and motor response
B. Vital signs, eye opening, and pupil reaction
C. Level of consciousness, vital signs and breathing pattern
D. Open wounds, peripheral pulses and motor response
B. Vital signs, eye opening, and pupil reaction
\_\_\_\_\_\_ is an antiplatelet therapy agent that helps prevent platelets from sticking together and forming clots. A. Glycoprotein B. aspirin C. Clopidogrel D. ACE inhibitors
C. Clopidogrel
Tracheal intubation:
A. is contraindicated in unresponsive patients
B. Eliminates the risk of aspiration of gastric contents
C. Should be preceded by efforts to ventilate by another method
D. When attempted, should be performed in less than 60 seconds
C. should be preceded by other efforts to ventilate first
What is correct dose for amiodarone?
1st dose 300 mg
2nd dose 150 mg
If you are unable to give amiodarone which drug can be given & dose?
Lidocaine
1-1.5 mg/kg then 0.5 mg - .75 at 5-10 min with 3 mg max
What is dose for Mg Sulfate?
1-2 g IV/IO diluted in 10 mL of D5W over 5-20 minutes
During Ischemia, what happens to the ECG?
T wave inverts
What rhythm can be lethal when given lidocaine?
Ventricular escape rhythms
