A. perform CPR, immobilize his spine, and transport.
B. begin CPR and apply the AED as soon as possible.
C. request a paramedic unit to perform defibrillation.
D. perform CPR and insert a pediatric-sized Combitube.
A. unstable angina with poor perfusion.
B. compensated cardiogenic shock.
C. decompensated cardiogenic shock.
D. acute myocardial infarction and hypovolemia.
B. Increased cardiac preload
C. A positive inotropic drug
D. Decreased cardiac afterload
A. Sinoatrial node
B. Atrioventricular node
C. Interatrial septum
D. Purkinje fibers
A. prompt transport.
B. an IV fluid bolus.
C. high-flow oxygen.
D. thermal management.
A. assess for a carotid pulse for no more than 10 seconds.
B. insert a multilumen airway device and resume CPR.
C. immediately reanalyze the patient’s cardiac rhythm.
D. begin or resume CPR starting with chest compressions.
A. rapidly lowering her blood pressure with nitroglycerin.
B. placing her in a supine position and lowering her head.
C. assisting the patient with her medication and transporting her.
D. 100% oxygen and transporting to the closest appropriate facility.
A. begin CPR and insert a multilumen airway device.
B. deactivate the AICD with a magnet and begin CPR.
C. allow the AICD to defibrillate her and start CPR.
D. begin CPR and apply the AED as soon as possible.
A. request permission to give her morphine.
B. transport at once and closely monitor her.
C. administer one more dose of nitroglycerin.
D. give a 20 mL/kg saline bolus to raise her BP.
A. there is not enough time between beats for the left ventricle to fill with blood.
B. blood from the atria fills the ventricles too quickly due to the rapid heart rate.
C. tachycardia causes widespread vasodilation, which lowers the blood pressure.
D. afterload increases, which causes the ventricles to work against higher pressure.
A. a patient’s heart rate is so weak that it is barely palpable.
B. a patient is in cardiac arrest despite an organized cardiac rhythm
C. the heart is quivering and is not ejecting any blood from the ventricles.
D. a pulse is clearly present, but the cardiac monitor shows a flat line.
C. foramen ovale.
D. coronary sinus.
A. sinoatrial node, 50 to 60
B. bundle of His, 80 to 100
C. sinoatrial node, 60 to 100
D. atrioventricular node, 60 to 80
B. sitting up.
A. Innominate, posterior vertebral, and right subclavian
B. Brachiocephalic, left common carotid, and left subclavian
C. Coronary, internal common carotid, and brachiocephalic
D. Brachiocephalic, common iliac, and right common carotid
A. Vascular smooth muscle contraction and increased venous return
B. Vascular smooth muscle relaxation and coronary artery dilation
C. Coronary artery dilation and increased systemic vascular resistance
D. Decreased venous pooling of blood and coronary vasoconstriction
A. cardiogenic shock.
B. congestive heart failure.
C. a thoracic aortic aneurysm.
D. an acute hypertensive crisis.
A. SA node, AV node, Bundle of His, bundle branches, Purkinje fibers
B. AV node, SA node, bundle branches, Bundle of His, Purkinje fibers
C. SA node, Bundle of His, AV node, bundle branches, Purkinje fibers
D. AV node, Purkinje fibers, SA node, Bundle of His, bundle branches
A. confirm that the patient is in cardiac arrest.
B. apply the AED and analyze his cardiac rhythm.
C. continue CPR and insert a multilumen airway.
D. look, listen, and feel for signs of breathing.
A. Have you ever been told you have low blood pressure?
B. Have you experienced paroxysmal nocturnal dyspnea?
C. Do you have any respiratory diseases, such as emphysema?
D. Do you have diabetes or any problems with your blood sugar?
A. volume of blood returned to the left or right atrium.
B. amount of blood ejected per ventricular contraction.
C. percentage of blood ejected from the left ventricle.
D. pressure against which the left ventricle must pump.
A. often converts V-Fib to a perfusing rhythm.
B. maintains myocardial and cerebral perfusion.
C. enhances perfusion to the body’s periphery.
D. prevents the patient from developing asystole.
A. the right side of her heart is functioning effectively.
B. blood is backing up into her systemic circulation.
C. she has left-sided heart failure and how severe it may be.
D. she experiences sleep apnea, which may explain her fatigue.
A. recognition of early warning signs and activation of EMS.
B. temperature regulation and maintenance of glucose levels.
C. early, high-quality CPR with emphasis on chest compressions.
D. defibrillation within the first 2 to 3 minutes of the cardiac arrest.
A. decreased blood pressure and heart rate.
B. increased blood pressure and heart rate.
C. vasoconstriction and decreased heart rate.
D. vasodilation and a mild heart-rate decrease.
A. dilating the coronary artery with drugs.
B. bypassing the blocked coronary artery.
C. mechanically clearing a coronary artery.
D. the administration of a fibrinolytic drug.
A. preventing an existing clot from getting larger.
B. dissolving a clot and reestablishing blood flow.
C. dilating the coronary arteries and relieving pain.
D. thinning the blood and preventing clot formation.
A. 4 L/min
B. 5 L/min
C. 6 L/min
D. 7 L/min
A. chronic pedal edema.
B. tachypnea and tachycardia.
C. increased work of breathing.
D. production of blood-tinged sputum.
A. a coronary artery bypass graft.
B. coronary artery stent placement.
C. a percutaneous coronary angioplasty.
D. a surgically implanted cardiac pacemaker.
A. begin CPR and apply the AED as soon as it is available.
B. begin CPR, start an IV, and give a 20 mL/kg fluid bolus.
C. elevate the patient’s legs, begin CPR, and attach an AED.
D. begin CPR, insert a King airway, and request a paramedic unit.
A. assess her pulse, begin CPR, analyze her cardiac rhythm with the AED, and tell your partner to stop the vehicle.
B. begin CPR, tell your partner to stop the vehicle, analyze her rhythm with an AED, and defibrillate if needed.
C. assess her pulse, tell your partner to stop the vehicle, begin CPR, and analyze her cardiac rhythm with an AED.
D. immediately analyze her cardiac rhythm with an AED, tell your partner to stop the vehicle, and defibrillate if needed.
A. a posterior nosebleed.
B. a sudden, severe headache.
C. pale, cool, clammy skin.
D. acute pulmonary edema.
A. give oxygen via nasal cannula.
B. apply the CPAP device.
C. administer nitroglycerin.
D. give an IV fluid bolus.
A. ensure that the patient’s heart rate is no greater than 100.
B. ask the patient if he is currently experiencing a headache.
C. assess his systolic BP to ensure that it is at least 100 mm Hg.
D. ensure that he has taken up to 3 doses prior to your arrival.
A. resume CPR and reanalyze her cardiac rhythm after 2 minutes.
B. assess for a carotid pulse and resume CPR if a pulse is not palpable.
C. ensure the pads are placed correctly and reanalyze her cardiac rhythm.
D. perform 10 cycles of CPR and then reanalyze her cardiac rhythm.
A. A 52-year-old female with thyroid cancer
B. A 55-year-old male with mild hypertension
C. A 60-year-old male with two prior AMIs
D. A 67-year-old female with diabetes mellitus
A. give two rescue breaths.
B. insert a multilumen airway.
C. resume chest compressions.
D. briefly check for a carotid pulse.
A. Atypical angina pectoris
B. Artificial pacemaker failure
C. Damaged coronary artery graft
D. Decreased parasympathetic tone
A. assist the patient with his or her prescribed nitroglycerin.
B. give a 20 mL/kg crystalloid fluid bolus to improve perfusion.
C. apply a nonrebreathing mask if the patient is breathing shallowly.
D. place the patient in a supine position with his or her legs elevated.
A. The sinoatrial node
B. Areas below the AV node
C. Any part of the AV node
D. The atrioventricular node
A. “Shock advised” message, stand clear, defibrillate, immediately resume CPR, reanalyze after 2 minutes
B. “No shock advised” message, check pulse for up to 10 seconds, resume CPR, reanalyze after 2 minutes
C. “No shock advised” message, stand clear, reanalyze, “no shock advised” message, perform CPR for 2 minutes
D. “Shock advised” message, stand clear, defibrillate, perform CPR for 1 minute, stand clear, reanalyze, defibrillate if needed
A. A rapid, irregular heart rate
B. Jugular venous distention while sitting up
C. Diminished pulses in her lower extremities
D. Radiation of the pain to her arms or jaw
A. adult AED pads cannot be used.
B. you should only deliver one shock.
C. a manual defibrillator is preferred.
D. all shocks are delivered in sets of three.
B. pleural cavity.
C. left hemithorax.
D. right hemithorax.
A. coronary sinus
B. foramen ovale
C. inferior vena cava
D. superior vena cava
A. apply the pads no differently than in anyone else.
B. apply the pads at least 1″ away from the pacemaker.
C. apply both pads on the posterior aspect of the chest.
D. apply the pad directly over the implanted pacemaker.
A. Mitral and aortic
B. Aortic and pulmonic
C. Mitral and pulmonic
D. Pulmonic and tricuspid
A. are thickened and hardened and lose their elasticity.
B. begin to dissect through the layers of the arterial wall.
C. develop plaque deposits from cholesterol and fatty substances.
D. become engorged with blood as cardiac oxygen demand increases.
A. a fixed frequency of chest pain or pressure that is often relieved by rest and several doses of nitroglycerin.
B. chest pain or discomfort that may not be relieved by rest or nitroglycerin, and that occurs without a fixed frequency.
C. chest pain or pressure that lasts longer than 15 minutes and is associated with myocardial necrosis.
D. chest pain or pressure that occurs during periods of strenuous activity and promptly subsides with rest.
A. place him supine and elevate his legs.
B. give him a 500 mL normal saline bolus.
C. cover him with a blanket to keep him warm.
D. contact medical control for further guidance.
A. red blood cells are made.
B. red blood cells and hemoglobin unite.
C. old red blood cells are sent to the spleen.
D. red blood cells are destroyed by macrophages.
A. closes during ventricular systole and facilitates adequate ventricular filling.
B. contains five cusps that prevent the backflow of blood into the left ventricle.
C. regulates the flow of blood from the left ventricle to the systemic circulation.
D. attaches to papillary muscles that contract and tighten the chordae tendineae.
A. Aspirin only
B. Morphine and aspirin
C. Aspirin and nitroglycerin
D. Nitroglycerin and morphine
A. constrict the blood vessels.
B. increase the patient’s heart rate.
C. affect the strength of cardiac contraction.
D. affect electrical conduction through the heart.
A. quickly check to ensure the pads are correctly placed.
B. ensure that all contact with the patient has ceased.
C. deliver one shock and immediately resume CPR.
D. perform CPR for 2 minutes and then deliver a shock.
A. reflects a prolonged period of myocardial ischemia.
B. does not respond favorably to cardiac defibrillation.
C. is usually the result of a massive myocardial infarction.
D. most often occurs in patients with significant heart disease.
A. use CPAP to attempt to improve his breathing, insert a saline lock, transport, and be prepared to assist his ventilations.
B. insert a multilumen airway device, ventilate him at a rate of 12 breaths/min, transport, and establish IV access en route to the hospital.
C. administer high-flow oxygen via nonrebreathing mask, place him in a position of comfort, insert a saline lock, and transport.
D. assist his ventilations with a bag-mask device, begin transport, and consider establishing IV access en route to the hospital.
B. Pulseless electrical activity
C. Ventricular tachycardia without a pulse
D. Any tachycardic rhythm with a weak pulse
A. failure of the AED’s internal memory card.
B. failure of the internal analyzing mechanism.
C. inappropriate placement of the chest pads.
D. failure to ensure the batteries are charged.
A. coronary vasospasm.
B. coronary artery rupture.
C. atherosclerotic blockage.
D. an isolated coronary occlusion.
A. during the first 2 to 3 hours after symptom onset.
B. in the hospital setting and are the result of asystole.
C. while the patient is in the cardiac catheterization lab.
D. in the workplace, even when an AED is readily available.
A. assessing the rate and regularity of the pulse.
B. applying 100% oxygen via nonrebreathing mask.
C. administering prescribed nitroglycerin if needed.
D. ensuring airway patency and adequate breathing.
A. high-flow oxygen via nonrebreathing mask, a saline lock, thermal management, and transport.
B. continuous positive airway pressure, a 500 mL saline bolus, thermal management, and transport.
C. assisted ventilation with a bag-mask device, thermal management, 20 mL/kg fluid bolus, and transport.
D. insertion of multilumen airway device, mild hyperventilation, a saline lock, and prompt transport.
A. ventricular tachycardia.
B. ventricular fibrillation.
C. pulseless electrical activity.
D. tachycardia without a pulse.
A. Tunica intima.
B. Tunica interna.
C. Tunica media.
D. Tunica adventitia.
A. have an irregular pulse.
B. have experienced a head injury.
C. took an erectile dysfunction drug within the past week.
D. have a systolic blood pressure less than 120 mm Hg.
A. serve as the backup pacemaker if the ventricular conduction system fails.
B. regenerate the atrial-initiated electrical impulse before it enters the ventricles.
C. increase conduction from the atria to the ventricles to allow for atrial filling.
D. slow conduction from the atria to the ventricles to allow for ventricular filling.
A. afterload increases and stroke volume decreases.
B. blood return to the heart and cardiac output both increase.
C. systolic blood pressure decreases and cardiac output increases.
D. arterial blood pressure decreases and stroke volume increases.
A. Weakness and tachycardia
B. Dizziness and hypertension
C. Tachycardia and hypotension
D. Syncope and bradycardia
A. its inherently low oxygen demand predisposes it to injury or infarct.
B. its coronary arteries are more susceptible to atherosclerotic disease.
C. it is large and thick and demands more oxygen than the right ventricle.
D. it is a fairly small chamber that is quickly depleted of oxygenated blood.
A. left and right coronary arteries.
B. vena cavae and coronary sinus.
C. foramen ovalis and vena cavae.
D. coronary artery and foramen ovale.
A. enhances conduction through the atrioventricular node.
B. slows the heart rate by decreasing SA node discharge.
C. produces epinephrine and increases cardiac contractility.
D. increases the heart rate by increasing SA node discharge.
A. stable angina pectoris.
B. unstable angina pectoris.
C. vasospastic angina pectoris.
D. acute myocardial infarction.
A. insert a multilumen airway device and assess for a carotid pulse.
B. assess for a carotid pulse and begin chest compressions if needed.
C. deliver 2 slow breaths with a bag-mask device and assess for a pulse.
D. perform 30 chest compressions, open the airway, and deliver 2 breaths.
A. Human error is the most common reason for AED failure.
B. A pulse should be checked immediately after the AED shocks.
C. The AED will deliver one shock every 2 minutes as needed.
D. Pulseless V-tach may respond to defibrillation with an AED.
A. begin CPR, tell your partner to stop the ambulance, and analyze the patient’s cardiac rhythm with the AED.
B. analyze the patient’s rhythm with the AED, defibrillate if indicated, and tell your partner to stop the ambulance.
C. tell your partner to stop the ambulance, perform CPR for 2 minutes, and analyze the patient’s cardiac rhythm with the AED.
D. tell your partner to continue to the hospital, perform 2 minutes of CPR, and analyze the patient’s cardiac rhythm with the AED.
A. sends the shock in one direction within the heart.
B. utilizes less energy to achieve effective defibrillation.
C. works more effectively when 360 joules are delivered.
D. automatically defibrillates without AEMT intervention.
A. oxygen via nonrebreathing mask, one chewable baby aspirin, an IV fluid bolus, and prompt transport.
B. oxygen via nasal cannula, up to two more doses of nitroglycerin, saline lock, and transport.
C. oxygen via nonrebreathing mask, up to 324 mg aspirin, supine with his legs elevated, and transport.
D. oxygen via nasal cannula, up to 324 mg aspirin, saline lock, additional nitroglycerin per medical control, and transport.
B. stroke volume.
C. cardiac output.
D. ejection fraction.
A. the atria will be electrically stimulated but will not contract.
B. the AV node may take over and pace the heart at 40 to 60 beats/min.
C. the electrical stimulus will not be received by the ventricles.
D. the SA node will take over as the heart’s primary pacemaker.
A. acute pain to the left jaw that is made worse by movement of the head.
B. an acute tearing sensation in the abdomen that radiates to the lower back.
C. an acute onset of weakness, nausea, and sweating without an obvious cause.
D. an acute onset of sharp chest pain that worsens when he or she takes a breath.
A. Sinus tachycardia with a low BP
B. Sinus bradycardia without a pulse
C. Perfusing ventricular tachycardia
D. Nonperfusing ventricular fibrillation
A. semilunar valves
B. chordae tendineae
C. coronary sinuses
D. tricuspid valves
A. the diastolic blood pressure exceeds 100 mm Hg.
B. the patient is noncompliant with his or her medication.
C. signs of central nervous system dysfunction are present.
D. the patient has a concomitant history of epileptic seizures.
A. Irreversible process in which one or more coronary arteries spasm and decrease myocardial blood supply
B. Reversible process in which a brittle intracoronary plaque ruptures and activates the blood-clotting system
C. Irreversible process in which the lumen of the coronary artery is completely occluded with plaque
D. Reversible process in which myocardial oxygen demand exceeds the supply of available oxygen
A. a specific condition in which a coronary artery is totally blocked.
B. a variety of cardiac dysrhythmias caused by a myocardial infarction.
C. any change in the pattern or characteristics of a patient’s angina.
D. any group of symptoms consistent with acute myocardial ischemia.
A. his prescribed nitroglycerin has lost its potency.
B. the nitroglycerin has caused severe hypotension.
C. he has stable angina, but still requires transport.
D. he is experiencing ongoing myocardial ischemia.
A. semilunar valves.
B. atrioseptal valves.
C. ventriculoseptal valves.
D. atrioventricular valves.
A. left anterior descending and circumflex arteries.
B. right coronary artery and acute marginal branch.
C. posterior descending artery and left atrial branch.
D. left posterior ventricular and acute marginal arteries.
D. cardiac septum