Ch. 27 Quiz Questions

Front 1

Common causes of bradycardia include?

Back 1

Beta blocker use

Front 2

The 6-second method for calculating the rate of a cardiac rhythm?

Back 2

Involves counting the number of QRS complexes in a 6-second-strip and multiplying that number by 10.

Front 3

You receive a call to a skilled nursing facility for an elderly man with generalized weakness. The patients nurse tells you that he has not eaten anything in the past 18 hours. She presents you with his chart, which states that he has a history of atrial fibrillation, CHF, and hypertension. His medications include Vasotec, digoxin, and Warfarin. As you apply the cardiac monitor, your partner takes the patients vital signs, which reveal a blood pressure of 136/76 mmHg, a rapid and irregular pulse, and respirations of 22 breaths/min. The ECG reveals atrial fibrillation with a variable rate between 110 and 130 beats/min, and a 12-lead ECG tracing reveals the same. After applying supplemental oxygen, you should?

Back 3

Start an IV line to keep the vein open, administer diltiazem, and transport.

Front 4

Torsades de pointes?

Back 4

Is a variant of polymorphic ventricular tachycardia and is often caused by a prolonged Q-T interval.

Front 5

Myocardial ischemia occurs when the heart muscle?

Back 5

Is deprived of oxygen because of a blocked coronary artery.

Front 6

Atrial kick is MOST accurately defined as?

Back 6

20% of ventricular filling caused by atrial contraction.

Front 7

Which of the following clinical findings is LEAST suggestive of a peripheral vascular disorder?

Back 7

An S3 sound during auscultation of the heart.

Front 8

Which of the following statements regarding the use of vasopressin in cardiac arrest is MOST correct?

Back 8

A one-time dose of 40 units of vasopressin may be given to replace the first or second dose of epinephrine.

Front 9

Normally, the S-T segment should be?

Back 9

At the level of the isoelectric line.

Front 10

In sinus bradycardia, the?

Back 10

Pacemaker site is the SA node.

Front 11

Epinephrine is used to treat patients in anaphylactic shock because of its effects of?

Back 11

Bronchodilation and vasoconstriction.

Front 12

An electrical impulse is slightly delayed at the AV node so that the?

Back 12

Atria can empty into the ventricles.

Front 13

A cardiac patient with respiratory distress should be assumed to be experiencing?

Back 13

Heart failure with pulmonary edema.

Front 14

A 55-year-old man complains of severe pain between his shoulder blades, which he describes as “ripping” in nature. He tells you that the pain began suddenly and has been intense and unrelenting since its onset. His medical history includes HTN; however, he admits to being noncompliant with his antihypertensive medication. Which of the following assessment findings would MOST likely reinforce your suspicion regarding the cause of his pain?

Back 14

Difference in blood pressure between the two arms.

Front 15

When analyzing a cardiac rhythm strip in lead II, you should routinely evaluate all of the following components, EXCEPT?

Back 15

S-T segment.

Front 16

The MOST important initial pieces of equipment to bring to the side of an unconscious patient are the?

Back 16

Defibrillator and airway management equipment.

Front 17

Which of the following statements regarding second-degree heart block is MOST correct?

Back 17

Second-degree heart block occurs when an impulse reaching the AV node is occasionally prevented from proceeding to the ventricles and causing a QRS complex.

Front 18

The mitral valve:

Back 18

is located on the higher-pressure side of the heart.

Front 19

What is the R-on-T phenomenon?

Back 19

A PVC that occurs when the ventricles are not fully repolarized.

Front 20

You receive a call to a residence for a 44-year-old man who is “ill.” The patient, who receives dialysis treatments three times a week, tells you that he has missed his last two treatments because he was not feeling well. As your partner takes the patient’s vital signs, you apply the ECG, which reveals a sinus rhythm with tall T waves. The 12-lead ECG reveals a sinus rhythm with inverted complexes in lead aVR. On the basis of your clinical findings, you should be MOST suspicious that the patient is:

Back 20

hyperkalemic

Front 21

A classic sign of atrial flutter is:

Back 21

the presence of sawtooth F waves.

Front 22

Vasoconstriction occurs following stimulation of:

Back 22

alpha receptors.

Front 23

When applying the precordial leads, lead I should be placed in the:

Back 23

fourth intercostal space at the right sternal border.

Front 24

The inferior wall of the left ventricle is supplied by the:

Back 24

right coronary artery.

Front 25

Common signs of left-sided heart failure include all of the following, EXCEPT:

Back 25

hypotension.

Front 26

In a patient with left heart failure and pulmonary edema:

Back 26

increased pressure in the left atrium and pulmonary veins forces serum out of the pulmonary capillaries and into the alveoli.

Front 27

The proper compression-to-ventilation ratio for two-rescuer adult CPR when an oropharyngeal airway is in place is:

Back 27

30:2

Front 28

The appropriate dosing regimen for epinephrine in cardiac arrest is:

Back 28

1 mg of a 1:10,000 solution every 3 to 5 min

Front 29

HTN is present when the blood pressure:

Back 29

is consistently greater than 140/90 mmHg while at rest.

Front 30

You and an EMT-B are performing CPR on an elderly woman in cardiac arrest as your paramedic partner prepares to intubate her. After the patient has been intubated and proper ET tube placement has been confirmed, you should:

Back 30

perform asynchronous CPR while ventilating the patient at a rate of 8 to 10 breaths/min.

Front 31

A 39-year-old man in asystole has been unresponsive to CPR and 2 doses of epinephrine. The patient is intubated and an intraosseous catheter is in place. What intervention should you perform next?

Back 31

Administer 1 mg of atropine.

Front 32

A hypertensive emergency is MOST accurately defined as:

Back 32

An acute elevation in blood pressure with signs of end-organ damage

Front 33

A regular rhythm with inverted P waves before each QRS complex, a ventricular rate of 70 beats/min, narrow QRS complexes, and a P-R interval of 0.16 seconds should be interpreted as a/an:

Back 33

accelerated junctional rhythm.

Front 34

The preferred antiarrhythmic medication and initial dose for a patient with refractory ventricular fibrillation or pulseless ventricular tachycardia is:

Back 34

amiodarone, 300 mg.

Front 35

Leads V1 to V3 allow you to view ___ wall of the left ventricle.

Back 35

Anteroseptal

Front 36

If the ECG leads are applied correctly, the PQRST configuration should be inverted in lead:

Back 36

aVR

Front 37

Abnormal neurologic signs that accompany hypertensive encephalopathy occur when:

Back 37

pressure causes a breach in the blood brain barrier and fluid leaks out, causing an increase in intracranial pressure.

Front 38

Atherosclerosis is a process in which:

Back 38

plaque infiltrates the arterial wall, decreasing its elasticity and narrowing its lumen.

Front 39

You are assessing a conscious and alert middle-aged male who complains of chest discomfort and nausea. His blood pressure is 112/70 mmHg, pulse is 90 beats/min and regular, and respirations are 20 breaths/min and regular. The patient’s past medical history is significant for hypothyroidism and hyperlipidemia. His medications include Synthroid, Lipitor, Cialis, and 1 baby aspirin per day. Which of the following medications would you LEAST likely administer?

Back 39

Nitroglycerin

Front 40

A patient with a medical condition that requires antiplatelet therapy would MOST likely be taking:

Back 40

Plavix

Front 41

Unlike an idioventricular rhythm, an agonal rhythm:

Back 41

does not produce a palpable pulse.

Front 42

With regard to stroke volume, the healthy heart:

Back 42

can easily increase stroke volume by 50%.

Front 43

If you were unsure whether a conscious cardiac patient requires immediate transport versus continued assessment at the scene, you should:

Back 43

continue with the focused assessment to obtain more information.

Front 44

The precordial leads do NOT view the ___ wall of the heart.

Back 44

Inferior

Front 45

Potential contraindications to fibrinolysis include all of the following, EXCEPT:

Back 45

significant closed head trauma within the past 3 months.

Front 46

Which of the following drugs possesses beta-2-specific properties?

Back 46

Proventil

Front 47

The MOST significant risk associated with the use of fibrinolytic therapy is?

Back 47

Hemorrhage

Front 48

You are dispatched to a residence at 4:00 am for an elderly man with shortness of breath. The patient tells you that he was awakened with the feeling that he was smothering. You note traces of dried blood around his mouth. The patient tells you that he has some type of “breathing problem,” for which he uses a prescribed inhaler. Based on the information you have obtained thus far, you should be MOST suspicious for:

Back 48

left-sided heart failure

Front 49

What is the MOST correct sequence of treatment for a patient with a suspected acute myocardial infarction?

Back 49

Oxygen, aspirin, nitroglycerin, morphine.

Front 50

Which of the following actions should NOT occur while CPR is in progress?

Back 50

Cardiac rhythm assessment

Front 51

In contrast to stable angina, unstable angina:

Back 51

often awakens the patient from his or her sleep.

Front 52

Sinus arrest is characterized by:

Back 52

a dropped PQRST complex.

Front 53

Changes in cardiac contractility may be induced by medications that have a positive or negative ___ effect.

Back 53

Inotropic

Front 54

A 56-year-old man presents with an acute onset of chest pressure and diaphoresis. He has a history of hypertension and insulin-dependent diabetes. His airway is patent and his breathing is adequate. You should:

Back 54

administer high-flow oxygen.

Front 55

A pathologic Q wave:

Back 55

is wider than 0.04 seconds and is seen in 2 or more contiguous leads.

Front 56

Atrial fibrillation can be interpreted by noting:

Back 56

an irregularly irregular rhythm and absent P waves.

Front 57

The S1 heart sounds represent:

Back 57

Closure of the mitral and tricuspid valves.

Front 58

Which of the following statements regarding idioventricular rhythm is MOST correct?

Back 58

Most patients with an idioventricular rhythm are hemodynamically unstable.

Front 59

The firing of an artificial ventricular pacemaker causes:

Back 59

a vertical spike followed by a wide QRS complex.

Front 60

The MOST immediate forms of reperfusion therapy for an injured myocardium are:

Back 60

fibrinolytics and placement of a coronary stent.

Front 61

An unresponsive, pulseless, apneic patient presents with ventricular tachycardia on the cardiac monitor. After defibrillating the patient with 360 joules, you should:

Back 61

resume CPR and reassess the patient after 2 minutes.

Front 62

A pulse that alternates in strength from one beat to the next beat is called:

Back 62

pulsus alternans

Front 63

The initial dose of atropine sulfate for a patient in asystole is:

Back 63

1.0 mg

Front 64

Which of the following drugs is contraindicated in patients with bronchospastic diease?

Back 64

Labetalol

Front 65

Patients experiencing a right ventricular infarction:

Back 65

may present with hypotension

Front 66

A regular cardiac rhythm with a rate of 104 beats/min, upright P waves, a P-R interval of 0.14 seconds, and a narrow QRS complexes should be interpreted as:

Back 66

sinus tachycardia

Front 67

Which of the following statements MOST accurately describes an acute myocardial infarction (AMI)?

Back 67

Necrosis of a portion of the myocardium due to a prolonged lack of oxygen

Front 68

Injury to or disease of the ___ may cause prolapse of a cardiac valve leaflet, allowing blood to regurgitate from the ventricle into the atrium.

Back 68

Cordae tendineae

Front 69

A beta-blocking drug would counteract all of the following medications, EXCEPT:

Back 69

atropine

Front 70

The presence of dizziness in a patient with a suspected myocardial infarction is MOST likely the result of:

Back 70

a reduction in cardiac output

Front 71

The area of conduction tissue in which electrical activity arises at any given time is called the?

Back 71

Pacemaker

Front 72

The brief pause between the P wave and QRS complex represents:

Back 72

A momentary conduction delay at the AV junction.

Front 73

A major complication associated with atrial fibrillation is:

Back 73

clot formation in the fibrillating atria.

Front 74

You have applied the defibrillator pads to a pulseless and apneic 60-year-old woman and observe a slow, wide QRS complex rhythm. Your next action should be to:

Back 74

immediately begin CPR.

Front 75

Which of the following medications is a calcium channel blocker?

Back 75

Cardizem

Front 76

Anatomically contiguous leads view:

Back 76

The same general area of the heart.

Front 77

You are called to a local gym for the patient with nausea. Your patient, a 29-year-old man, tells you that he thinks he has a “stomach bug.” He is conscious and alert, denies CP or SOB, and tells you that he has been nauseated for the last 4 hours, but has not vomited. His blood pressure is 124/66 mmHg, pulse is 46 beats/min and strong, respirations are 20 breaths/min and regular, and room air oxygen saturation is 99%. The cardiac monitor reveals a sinus bradycardia. You should:

Back 77

administer oxygen via nasal cannula, start an IV of normal saline, consider administering an antiemetic, and transport.

Front 78

The ability of the heart to vary the degree of its contraction without stretching is called:

Back 78

contractility.

Front 79

Common complaints in patients experiencing an acute coronary syndrome (ACS) include all of the following, EXCEPT:

Back 79

HA

Front 80

When assessing an anxious patient who presents with tachycardia, you must:

Back 80

determine if the tachycardia is causing hemodynamic instability.

Front 81

Administering a drug that possesses a positive chronotropic effect will have a direct effect on:

Back 81

the heart rate

Front 82

Hypocalcemia and hypomagnesemia would MOST likely result in:

Back 82

increased myocardial irritability.

Front 83

After delivering a shock to a patient in pulseless ventricular tachycardia, you should:

Back 83

resume CPR

Front 84

An early complex that breaks the regularity of the underlying rhythm, and is characterized by a narrow QRS complex and an upright P wave that differs in shape and size from the P waves of the other complexes, MOST accurately describes a/an:

Back 84

premature atrial complex

Front 85

Acute coronary syndrome (ACS) is a term used to describe:

Back 85

any group of clinical symptoms consistent with acute myocardial ischemia

Front 86

Death in the pre-hospital setting following an acute myocardial infarction is MOST often the result of:

Back 86

ventricular fibrillation

Front 87

You have just performed synchronized cardioversion on a patient with unstable ventricular tachycardia. Upon reassessment, you note that the patient is unresponsive, apneic, and pulseless. You should:

Back 87

ensure that the synchronizer is off, defibrillate one time, and check for a pulse.

Front 88

Injury to the inferior wall of the myocardium would present with:

Back 88

ST segment elevation in leads II, III and aVF.

Front 89

If a patient’s aortic aneurysm is not compressing on any adjacent structures:

Back 89

he or she will likely be asymptomatic.

Front 90

Immediate treatment for a patient with acute myocardial infarction involves:

Back 90

reducing myocardial oxygen demand.

Front 91

When assessing lead II via the limb leads, the negative lead should be placed on the:

Back 91

right arm

Front 92

When using limb leads, any impulse moving toward a positive electrode will:

Back 92

cause a positive deflection on the ECG.

Front 93

Depolarization, the process by which muscle fibers are stimulated to contract, occurs when:

Back 93

cell wall permeability changes and sodium rushes into the cell.

Front 94

Thousands of fibrils that are distributed throughout the ventricles, which represent the end of the cardiac condition system, are called the:

Back 94

purkinje fibers.

Front 95

Any electrical impulse that originates in the ventricles will produce:

Back 95

wide QRS complexes and a rate between 20 and 40 beats/min.

Front 96

Normal sinus rhythm (NSR) is characterized by all of the following, EXCEPT:

Back 96

QRS complexes that are less than 0.14 seconds.

Front 97

Lowering of a significantly elevated blood pressure:

Back 97

is best accomplished in a hospital setting.

Front 98

The recommended first-line treatment for third-degree heart block associated with bradycardia is:

Back 98

transcutaneous pacing.

Front 99

Cardiac-related chest pain is often palliated by:

Back 99

nitroglycerin.

Front 100

Which of the following clinical findings is LEAST suggestive of left side heart failure?

Back 100

Sacral edema.