testprep

Question 1

T or F: Fibrinolytic therapy is an essential intervention in the treatment of all patients with unstable angina/non ST elevation myocardial infarction.

Answer 1

False

Question 2

T or F: Angiotensin converting enzyme inhibitors act on beta1 and beta2 receptors to slow sinus rate, depress AAV conduction and reduce blood pressure.

Answer 2

False; They produce vasodilation by blocking conversion of angiotensin I to II; it decreases peripheral vascular resistance reducing pressure the heart must pump against

Question 3

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

Answer 3

B. ST segment depression, T wave inversion

Question 4

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

Answer 4

A. Reduce myocardial contractility

Question 5

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

Answer 5

C. 162-325 mg

Question 6

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

Answer 6

B. is used to increase HR & BP

Question 7

The highest incidence of v fib occurs about ____ hours after ST elevation MI symptom onset.

Answer 7

4 hours

Question 8

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

Answer 8

C. Sinus bradycardia and BB blocks

Question 9

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

Answer 9

C. results in clinical syndrome of chest pain, pericardial friction rub, and ECG changes.

Question 10

A 12 lead ECG should be obtained within ___ minutes of patient discomfort or arrival in ED.

Answer 10

10 minutes

Question 11

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

Answer 11

C. NTG relaxes vascular smooth muscle, including dilation of coronary arteries

Question 12

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.

Answer 12

B. at 3-5 minute intervals to max of 3 doses

Question 13

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

Answer 13

B. injury

Question 14

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

Answer 14

D; Morphine given in 2 mg at 5-15 minute intervals

Question 15

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

Answer 15

b. Heart failure and cardiogenic shock

Question 16

Vasopressor that stimulates dopaminergic, beta, and alpha adrenergic receptor sites is
_______.

Answer 16

dopamine

Question 17

These are contraindicated in the early period less than 7-10 days after MI because they predispose to cardiac rupture?

Answer 17

NSAIDS

Question 18

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

Answer 18

B. PCI

Question 19

Diltiazem (Cardizem), verapamil are examples of what types of medications?
A. Beta blocker
B.  ACE inhibitors
C.  CA channel blocker
D.  Antiarrhythmics

Answer 19

C. CA channel blockers

Question 20

What is the most common cause of stroke?
A.  cerebral hemorrhage
B.  a thrombus
c.  dissecting cerebral aneurysm
D.  cerebral vasospasm

Answer 20

B. a thrombus or blood clot

Question 21

The most common blocked vessel in a stroke is
A.  vertebral artery
B.  middle cerebral artery
c.  posterior cerebral artery
d.  anterior cerebral artery

Answer 21

b. middle cerebral artery

Question 22

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

Answer 22

B. 10 min, 25 min

Question 23

Which dysrhythmia is most likely to precipitate a stroke?
A.  sinus bradycardia
b.  junctional rhythm
c.  atrial fibrillation
d.  ventricular escape rhythm

Answer 23

C. A -Fib

Question 24

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

Answer 24

B. 3 hours

Question 25

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

Answer 25

B. Vital signs, eye opening, and pupil reaction

Question 26

\_\_\_\_\_\_ is an antiplatelet therapy agent that helps prevent platelets from sticking together and forming clots.
A.  Glycoprotein
B.  aspirin
C.  Clopidogrel
D.  ACE inhibitors

Answer 26

C. Clopidogrel

Question 27

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

Answer 27

C. should be preceded by other efforts to ventilate first

Question 28

What is correct dose for amiodarone?

Answer 28

1st dose 300 mg

2nd dose 150 mg

Question 29

If you are unable to give amiodarone which drug can be given & dose?

Answer 29

Lidocaine

1-1.5 mg/kg then 0.5 mg - .75 at 5-10 min with 3 mg max

Question 30

What is dose for Mg Sulfate?

Answer 30

1-2 g IV/IO diluted in 10 mL of D5W over 5-20 minutes

Question 31

During Ischemia, what happens to the ECG?

Answer 31

T wave inverts

Question 32

What rhythm can be lethal when given lidocaine?

Answer 32

Ventricular escape rhythms