Cardio Chapter 14 Multiple Choice 2

30. Risk factors for AMI that cannot be controlled include: A. B. C. D. excess stress. hyperglycemia. family history. lack of exercise. Answer: C Question Type: General Knowledge Page: 532 31. Acute coronary syndrome (ACS) is a term used to describe: A. the warning signs that occur shortly before a heart attack. B. a group of symptoms that are caused by myocardial ischemia. C. a severe decrease in perfusion caused by changes in heart rate. D. the exact moment that a coronary artery is completely occluded. Answer: B Question Type: General Knowledge Page: 532 32. Angina pectoris occurs when: A. a coronary artery is totally occluded by plaque. B. myocardial oxygen demand exceeds the supply. C. one or more coronary arteries suddenly spasm. D. myocardial oxygen supply exceeds the demand. Answer: B Question Type: General Knowledge Page: 532 33. Which of the following is a major difference between angina pectoris and AMI? A. AMI is caused by myocardial ischemia. B. Anginal pain typically subsides with rest. C. Nitroglycerin has no effect on angina pectoris. D. Pain from an AMI subsides within 30 minutes. Answer: B Question Type: General Knowledge Page: 532 9 34. When treating a patient with chest pain, you should assume that he or she is having an AMI because: A. angina usually occurs after an AMI. B. most patients with chest pain are experiencing an AMI. C. the cause of the pain cannot be diagnosed in the field. D. angina and AMI present identically. Answer: C Question Type: General Knowledge Page: 532 35. Prompt transport of a patient with a suspected AMI is important because: A. the patient may be eligible to receive thrombolytic therapy. B. 90% of the cardiac cells will die within the first 30 minutes. C. nitroglycerin can only be given in the emergency department. D. many patients with an AMI die within 6 hours. Answer: A Question Type: General Knowledge Page: 532 36. Common signs and symptoms of AMI include all of the following, EXCEPT: A. irregular heartbeat. B. sudden unexplained sweating. C. shortness of breath or dyspnea. D. pain exacerbated by breathing. Answer: D Question Type: General Knowledge Page: 532–533 37. Which of the following statements regarding the pain associated with AMI is correct? A. It is often described by the patient as a sharp feeling. B. It often fluctuates in intensity when the patient breathes. C. Nitroglycerin usually resolves the pain within 30 minutes. D. It can occur during exertion or when the patient is at rest. Answer: D Question Type: General Knowledge 10 Page: 533 38. The MOST common reason that many people experiencing AMI do not seek immediate medical attention is because they: A. are elderly. B. are in denial. C. cannot afford it. D. do not trust EMTs. Answer: B Question Type: General Knowledge Page: 533 39. When documenting a patient’s description of his or her chest pain or discomfort, the EMT should: A. use medical terminology. B. use the patient’s own words. C. underline the patient’s quotes. D. document his or her own perception. Answer: B Question Type: General Knowledge Page: 533 40. Rapid, labored breathing in a patient with signs and symptoms of AMI should make you suspicious for: A. a cardiac arrhythmia. B. congestive heart failure. C. significant hypotension. D. right ventricular failure. Answer: B Question Type: General Knowledge Page: 533 41. Sudden death following AMI is MOST often caused by: A. cardiogenic shock. B. severe bradycardia. 11 C. ventricular fibrillation. D. congestive heart failure. Answer: C Question Type: General Knowledge Page: 533 42. Ventricular tachycardia causes hypotension because: A. the volume of blood returning to the atria increases. B. the right ventricle does not adequately pump blood. C. blood backs up into the lungs and causes congestion. D. the left ventricle does not adequately fill with blood. Answer: D Question Type: General Knowledge Page: 534 43. Which of the following cardiac arrhythmias has the greatest chance of deteriorating into a pulseless rhythm? A. sinus tachycardia B. sinus bradycardia C. extra ventricular beats D. ventricular tachycardia Answer: D Question Type: General Knowledge Page: 534 44. The purpose of defibrillation is to: A. stop the chaotic, disorganized contraction of the cardiac cells. B. cause a rapid decrease in the heart rate of an unstable patient. C. improve the chance of cardiopulmonary resuscitation (CPR) being successful in resuscitation. D. prevent asystole from deteriorating into ventricular fibrillation. Answer: A Question Type: General Knowledge Page: 534 12 45. Cardiogenic shock following AMI is caused by: A. decreased pumping force of the heart muscle. B. a profound increase in the patient’s heart rate. C. hypovolemia secondary to severe vomiting. D. widespread dilation of the systemic vasculature. Answer: A Question Type: General Knowledge Page: 535 46. Which of the following signs or symptoms would you NOT expect to encounter in a patient with congestive heart failure? A. hypertension and tachycardia B. hypotension and flat jugular veins C. the presence of rales in the lungs D. trouble breathing while lying down Answer: B Question Type: General Knowledge Page: 536 47. You are dispatched to a residence for a 56-year-old male with an altered mental status. Upon arrival at the scene, the patient’s wife tells you that he complained of chest pain the day before, but would not allow her to call EMS. The patient is semiconscious; has rapid, shallow respirations; and has a thready pulse. You should: A. obtain baseline vital signs. B. begin ventilatory assistance. C. attach the automated external defibrillator (AED) immediately. D. apply a nonrebreathing mask. Answer: B Question Type: Critical Thinking Page: 536 48. A 67-year-old female presents with difficulty breathing and chest discomfort that awakened her from her sleep. She states that she has congestive heart failure, has had two previous heart attacks, and has prescribed nitroglycerin. She is conscious and alert with adequate breathing. Her blood pressure is 94/64 mm Hg and her heart rate is 120 beats/min. Treatment for this patient includes: 13 A. B. C. D. nitroglycerin for her chest pain. ventilations with a bag-mask device. oxygen at 4 L/min via nasal cannula. placing her in an upright position. Answer: D Question Type: Critical Thinking Page: 536 49. You are assessing a 49-year-old man who complains of chest pressure that began the night before. He is conscious, but anxious, and tells you he has a history of angina and hypertension. After applying high-flow oxygen, you expose his chest to auscultate his lungs and note that he has a nitroglycerin patch on his right upper chest. His skin is cool and pale, his blood pressure is 78/50 mm Hg, and his pulse is 110 beats/min and irregular. You should: A. remove the nitroglycerin patch, place him in a supine position and elevate his lower extremities, and prepare for immediate transport. B. immediately remove the nitroglycerin patch, apply the AED in case he develops cardiac arrest, and transport to the closest hospital. C. move the nitroglycerin patch to the other side of his chest in case you need to apply the AED, keep him warm, and transport without delay. D. ask him if the nitroglycerin patch he is wearing has improved his chest pressure, complete your secondary assessment, and transport promptly. Answer: A Question Type: Critical Thinking Page: 536 50. Which of the following signs is commonly observed in patients with right-sided heart failure? A. labored breathing B. dependent edema C. pulmonary edema D. flat jugular veins Answer: B Question Type: General Knowledge Page: 537 14 51. Signs and symptoms of a hypertensive emergency would MOST likely be delayed in patients who: A. have chronic hypertension. B. regularly take illegal drugs. C. have had a stroke in the past. D. are older than 40 years of age. Answer: A Question Type: General Knowledge Page: 537 52. Common signs and symptoms of a hypertensive emergency include: A. pallor, cool skin, and a temporary loss of hearing. B. syncope, a weak pulse, and bleeding from the ears. C. tachycardia, pain behind the eyes, and weakness. D. a bounding pulse, a severe headache, and dizziness. Answer: D Question Type: General Knowledge Page: 537 53. A dissecting aortic aneurysm occurs when: A. all layers of the aorta suddenly contract. B. a weakened area develops in the aortic wall. C. the inner layers of the aorta become separated. D. the aorta ruptures, resulting in profound bleeding. Answer: C Question Type: General Knowledge Page: 537 54. In contrast to AMI, a dissecting aortic aneurysm: A. is more commonly associated with pressure in the chest. B. often presents with pain that is maximal from the onset. C. usually presents gradually, often over a period of hours. D. is typically preceded by other symptoms, such as nausea. Answer: B Question Type: General Knowledge Page: 537 15 55. A 66-year-old woman presents with a stabbing pain in the middle of her chest that radiates to her back. She tells you that the pain suddenly began about 30 minutes ago and has been severe since the onset. She has a history of hypertension, but admits to being noncompliant with her antihypertensive medications. When you assess her, you find that her blood pressure is significantly higher in her left arm than it is in her right arm. What are her signs and symptoms MOST indicative of? A. unstable angina B. dissecting aortic aneurysm C. AMI D. hypertensive emergency Answer: B Question Type: Critical Thinking Page: 537 56. Upon arriving at the residence of a patient with a possible cardiac problem, it is MOST important to: A. assess the scene for potential hazards. B. determine if you need additional help. C. request a paramedic unit for assistance. D. gain immediate access to the patient. Answer: A Question Type: General Knowledge Page: 538 57. A 49-year-old male presents with an acute onset of crushing chest pain and diaphoresis. You should: A. administer up to 324 mg of baby aspirin. B. administer up to three doses of nitroglycerin. C. obtain vital signs and a SAMPLE history. D. assess the adequacy of his respirations. Answer: D Question Type: Critical Thinking Page: 538 16