Paramedica exam (Cardio)

  1. Damage to the cardiac electrical condution system caused by an acute myocardial infarction Most commonly results in?

    D) bradycardia or heart block.
  2. The appropriate dosing regimen for epinephrine in cardiac arrest is?

    A) 1 mg of a 1:10,000 solution every 3 to 5 minutes.
  3. You are performing CPR on an 80-year-old woman whose cardiac arres was witnessed by her husband. Several intubation attempts have been unsuccessful, but ventilations with a bag-mask device are producing adequate chest rise. IV access has been obtained and 1 mg of epinephrine has been administered. The cardiac monitor displays a narrow QRS complex rhythm at a rated of 70 beats/minutes. according to the patients husband, she has had numerous episodes of diarrhea over the past 24 hours and has not had much of an appetite. The MOST appropriate next action should be to?

    B) continue CPR and administer crystalloid fluid boluses.
  4. Which of the following mechanisms causes hypertension?

    C) Increased afterload stimulates the Frank-Starling reflex, which raises the pressure behind the blood leaving the heart.
  5. A Patient with orthopnea:

    B) experiences worsened dyspnea while lying down.
  6. The point of macimal impulse (PMI) usually can be felt on the:

    D) left anterior chest, in the midclvicular line, at the fifth intercostal space.
  7. The ability of the heart to vary the degree of it contraction without stretching is called:

    A) contractility.
  8. It is MOST important to evaluate a cardiac arrhythmia in the context of the:

    B) patient's overall condition.
  9. Immediate treatment for a patient with an acute myocardial infarction involves:

    C) reducing myocardial oxygen demand.
  10. Which of the following clinical findings is LEAST suggestive of left side heart failure?

    D) Sacral edema
  11. What is the approximate maximum dose of lidocaine for a 200 pound patient?

    B) 275 mg
  12. Repolarization begins when:

    A) the sodium and calcium channels close.
  13. Which of the following patients would MOST likely present with atypical signs and symptoms of an acute myocardial infarction?

    A) 58 year old diabetic woman
  14. Which of the following statements regarding the right side of the heart is MOST correct?

    A) The right side of the heart is a low pressure pump.
  15. Infarctions of the inferior myocardial wall are MOST often caused by:

    B) occlusion of the right coronary artery.
  16. Death in the prehospital setting following an acute myocardial infarction is MOST often the result of:

    B) ventricular fibrillation.
  17. The numerous connectins among the arterioles of the various coronary arteries, which allow for the development of alternate routes of blood flow if a larger coronary artery is blocked, are called:

    C) collateral circulation.
  18. A prolonged Q-T interval indicates that the heart:

    A) is experiencing an extended refractory period, making the ventricles more vulnerable to arrhythmias.
  19. Common complaints in patients experiencing an acute coronary syndrome (ACS) include all of the following EXCEPT:

    D) headache
  20. The downslope of the T wave:

    A) represents a vulnerable period during which a strong impulse could cause depolarization, resulting in a lethal arrhythmia.
  21. A major complication associated with atrial fibrillation is:

    C) clot formation in the fibrillating atria.
  22. The duration of the QRS complex should be less than:

    A) 0.12 seconds.
  23. The heart's anatomic location is MOST accurately described as being:

    D) retrosternal.
  24. A 17 year old man complains of palpitations and light headedness that began suddenly about 20 minutes ago. his blood pressure is 118/74 mm Hg, heart rate is rapid and regular, respirations are 18 breath per minute. The cardiac monitor reveals a narrow QRS complex tachycardia at 180 beats/min. As you are applying supplemental oxygen, the cardiac rhytm spontaneously converts to a sinus rhythm. Closer evaluation of his rhythm reveals a rapid up slope to the R wave immediately after the end of the P wave. Which of the following statements regarding this scenario is most correct?

    B) This patient likely has Wolff-Parkinson-White syndrome.
  25. Common signs of left-sided heart failure include all of the following, EXCEPT:

    B) Hypotension.
  26. In Contrast to the right side of the heart, the left side of the heart:

    B) drives blood out of the heart against the relatively high resistance of the systemic circulation.
  27. You respond to the scene of an assault, where a 20 year old man was struck in the chest with a steel pipe. Your assessment reveals that the patient is unresponsive, apneic, and pulseless. the most appropriate next intervention is to.

    D) perform 5 cycles of well coordinated CPR.
  28. Which of the following differentiates an atrial rhythm from a sinus rhythm?

    C) Varying shapes in P waves
  29. The MOST common cause of cardiac arrest in adult patients is:

    B) an arrhythmia.
  30. Supraventricular tachycardia (SVT) is MOST accurately defined as:

    B) a tachycardic rhythm originating from a pacemaker site above the level of the ventricles.
  31. Cardiac related chest pain is often palliated by:

    D) Nitroglycerin.
  32. To increase myocardial contractility and heart rate and to relax the bronchial smooth muscle, you must give a drug that:

    A) stimulates beta-1 and beta-2 recptors.
  33. Stable angina:

    B) occurs after a predictable amount of exertion.
  34. Jugular venous distention in a patient sitting at a 45o angle:

    C) indicates right heart compromise.
  35. The area of conduction tissue in which electrical activity arises at any given time is called the:

    C) Pacemaker.
  36. 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 vitals 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 VR. On the basis of your clinical findings, you should be most suspicious that the patient is:

    D) hyperkalemic.
  37. Premature ventricular complexes (PVCs) that originate from different sites in the ventricle:

    A) will appear differently on the ECG.
  38. In a patient with left heart failure and pulmonary edema:

    C) increased pressure in the left atrium and pulmonary veins forces serum out of the pulmonary capillaries and into the alveoli.
  39. You are dispatched to a grocery store for a 39 year old woman with a severe headache. The patient advises you that her headache, which was present when she woke up this morning,k is located in the back of her head. She is conscious and alert, with a blood pressure of 194/112 mm Hg, pulse of 100 beats/min and strong, and respirations of 14 breaths/min and regular. She denies a history of hypertension or any other significant medical problems. The closest appropriate facility is located 15 miles away. You should:

    A) administer supplemental oxygen, start an IV line of normal saline at a keep open rate, and transport.
  40. Patients with a heart rate greater than 150 beats/min usually become unstable because of:

    C) reduced ventricular filling.
  41. In contrast to stable angina, unstable angina:

    D) often awakens the patient from his or her sleep.
  42. The right atrium, right ventricle, and part of the left ventricle are supplied by the:

    C) right coronary artery.
  43. A woman found her 48 year old husband semiconscious on the couch. As she is escorting you to the patient, she tells you that he had an episode of chest pain the day before but refused to go to the hospital. The patient is responsive to pain only and is markedly diaphoretic. His blood pressure is 70/50 mm Hg, pulse is 140 beats/min and thready, and respirations are 28 breaths/min and shallow. The cardiac monitor reveals sinus tachycardia in lead II and a 12 lead ECG reveals signs of myocardial injury. your should:

    C) keep the patient in a supine position, insert a nasal airway, assist his ventilations with a bag-mask device, begin transport, establish vascular access en route, consider a 100-200 ml saline bolus, and start an infusion of dopamine.
  44. A 56 year old man complains of chest tightness, shortness of breath, and nausea. During your assessment, you note that he appears confused. He is profusely diaphoretic, and has a blood pressure of 98/68 mm Hg and a rapid radial pulse. The cardiac monitor reveals a wide QRS complex tachycardia at a rate of 200 beats.min. After administering high-flow oxygen, your should:

    C) establish IV access, consider sedation, and perform synchronized cardioversion.
  45. A patient in cardiogenic shock without cardiac arrhythmias will benefit MOST from:

    D) Rapid transport to an appropriate hospital.
  46. Acute Coronary syndrome (ACS) is a term to describe:

    B) any group of clinical symptoms comsistent with acute myocardial ischemia.
  47. In contrast to a patient with asthma, a patient with left-sided heart failure:

    C) experiences acute weight gain and takes medications such as digoxin and a diuretic.
  48. 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:

    A) immediately begin CPR.
  49. Hypertensive disease is characterized by:

    A) persistent elevation of the diastolic pressure.
  50. a 70 year old man called 9-1-1 becuase of generalized weakness. When you arrive at the scene, you find the patient seated in his recliner. He is conscious and alert and is breathing without difficulty. Your physical exam reveals tenderness to his right upper abdominal quadrant, edema to his ankles, and distended jugular veins. The patient tells you that he takes Vasotec for hypertension and Maxide for his swollen ankles. His vital signs are stable. The MOST appropriate treatment for this patient includes:

    A) oxygen, cardiac monitoring, an IV line at a keep open rate, and transport.
  51. In contrast to coarse ventricular vibrillation, fine ventricular fivrillation indicates that:

    B) energy reserves of the cardiac cells have been expended.
  52. A patient with cardiogenic pulmonary edema and shock should be positioned:

    B) in a semi-Fowler's position.
  53. The administration of dopamine or any other vasopressor drug requires:

    C) careful titration and blood pressure monitoring.
  54. a Loud S3 heart sound, when heard in older adults,often signifies:

    B) heart failure.
  55. 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:

    B) ensure that the synchronizer is off, defibrillate, and immediately begin CPR.
  56. The MOST common cause of right sided heart failure is:

    C) left sided heart failure.
  57. 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:

    A) administer high flow oxygen.
  58. When assessing a patient's 12 lead ECG, it is MOST important to remember that:

    C) it may take hours for changes to appear on the ECG.
  59. Cardiogenic shock occurs when:

    C) more than 40% of the left ventricle has infarcted.
  60. Injury to the inferior wall of the myocardium would present with:

    D) ST segment elevation in leads II, III, and AVF.
  61. When monitoring a patient's cardiac rhythm, it is MOST important to remember that:

    A) the ECG does not provide data regarding the patient's cardiac output.
Card Set
Paramedica exam (Cardio)
Cardiac Exam for Paramedic test.