Quiz 2: Cardiology
Nursing
Q 1Q 1
Which of the following risk factors has been proven to increase the risk of cardiovascular disease?
A) Oral contraceptive use
B) Type A personality
C) Stress
D) Lack of exercise
Free
Multiple Choice
D
Q 2Q 2
Public education about cardiovascular disease focuses on:
A) risk factors and signs and symptoms of CVD.
B) CPR and public access defibrillation.
C) CPR and signs and symptoms of CVD.
D) risk factors and public-access defibrillation.
Free
Multiple Choice
A
Q 3Q 3
The valve between the right atrium and right ventricle is the ________ valve.
A) bicuspid
B) pulmonic
C) tricuspid
D) aortic
Free
Multiple Choice
C
Q 4Q 4
Blood entering the left atrium arrives via the:
A) bicuspid valve.
B) superior and inferior vena cava.
C) pulmonary vein.
D) pulmonary artery.
Free
Multiple Choice
Q 5Q 5
The first part of the aorta as it leaves the heart is the:
A) aortic arch.
B) thoracic aorta.
C) descending aorta.
D) ascending aorta.
Free
Multiple Choice
Q 6Q 6
Your patient is a 54-year-old male who is unresponsive and cyanotic and has agonal respirations. A "quick look" shows ventricular tachycardia. Which of the following is most important when determining the immediate treatment of this patient?
A) How long he has been "down"
B) Whether he has a pulse
C) Whether he is allergic to lidocaine
D) Whether he has an implanted cardioverter-defibrillator
Free
Multiple Choice
Q 7Q 7
ECG findings associated with hypokalemia include:
A) U waves and flat T waves.
B) U waves and an Osborn wave.
C) an Osborn wave and a "J" wave.
D) flattened T waves and a widened QRS complex.
Free
Multiple Choice
Q 8Q 8
The presence of inverted T waves on an ECG indicates:
A) myocardial infarction.
B) myocardial necrosis.
C) myocardial ischemia.
D) myocardial injury.
Free
Multiple Choice
Q 9Q 9
The pressure in the left ventricle at the end of diastole is called:
A) after.
B) preload.
C) ejection fraction.
D) stroke volume.
Free
Multiple Choice
Q 10Q 10
Typical stroke volume is about ________ of the volume of the left ventricle.
A) one-third
B) one-half
C) two-thirds
D) three-quarters
Free
Multiple Choice
Q 11Q 11
Which of the following items is most likely to interfere with the function of an implanted cardiac pacemaker?
A) Magnet
B) Cellular telephone
C) Television remote control
D) Hair dryer
Free
Multiple Choice
Q 12Q 12
The first phase of the cardiac cycle is:
A) systole.
B) diastole.
C) contraction.
D) ejection.
Free
Multiple Choice
Q 13Q 13
For a resting potential in a cardiac cell to exist, there must be an:
A) adequate number of potassium ions inside the cell and sodium ions outside the cell.
B) adequate number of sodium ions inside the cell and potassium ions outside the cell.
C) influx of calcium ions into the cell.
D) ionic equilibrium between the inside and outside of the cell.
Free
Multiple Choice
Q 14Q 14
The proportion of the left ventricular volume that is pumped out of the heart during systole is the:
A) ejection fraction.
B) stroke volume.
C) preload.
D) afterload.
Free
Multiple Choice
Q 15Q 15
Beta-blockers generally have which of the following effects?
A) Increased cardiac conduction
B) Decreased myocardial contractility
C) Vasoconstriction
D) Increased myocardial contractility
Free
Multiple Choice
Q 16Q 16
Your patient is found sitting on the edge of the bathtub with cool, diaphoretic skin. She states she became lightheaded and nearly "passed out" while vomiting. Your cardiac monitor shows a sinus bradycardia at a rate of 48. Which of the following is most likely?
A) Sick sinus syndrome
B) Use of sympathomimetic medications
C) Disease of the cardiac conduction system
D) Increased parasympathetic tone
Free
Multiple Choice
Q 17Q 17
When the ECG paper is traveling at the standard rate of 25 mm/sec, a large box in the horizontal direction equals:
A) 0.08 seconds.
B) 0.12 seconds.
C) 0.20 seconds.
D) 0.24 seconds.
Free
Multiple Choice
Q 18Q 18
Which of the following will occur with an increase in peripheral vascular resistance?
A) Decreased stroke volume
B) Increased ejection fraction
C) Increased preload
D) Decreased afterload
Free
Multiple Choice
Q 19Q 19
There are 15 small boxes between R waves on an ECG tracing. What is the heart rate?
A) 150
B) 120
C) 100
D) 20
Free
Multiple Choice
Q 20Q 20
If the stroke volume decreased, which of the following would occur to maintain the blood pressure at its current value?
A) Increased heart rate and increased peripheral vascular resistance
B) Decreased heart rate and decreased peripheral vascular resistance
C) Increased heart rate and decreased peripheral vascular resistance
D) Decreased heart rate and increased peripheral vascular resistance
Free
Multiple Choice
Q 21Q 21
You have administered a drug with potent beta-1 effects. Which of the following effects should you most anticipate?
A) Smooth muscle relaxation
B) Peripheral vasoconstriction
C) Increased heart rate
D) Peripheral vasodilation
Free
Multiple Choice
Q 22Q 22
You have administered a medication to a patient, resulting in a decreased speed of cardiac impulse conduction. This drug is most accurately described as having a ________ effect.
A) negative dromotropic
B) negative chronotropic
C) positive dromotropic
D) positive chronotropic
Free
Multiple Choice
Q 23Q 23
Which of the following endocrine substances acts as a marker for congestive heart failure?
A) BNP
B) Angiotensin
C) ACTH
D) Troponin
Free
Multiple Choice
Q 24Q 24
To detect life-threatening cardiac dysrhythmias, the paramedic must view the ECG in ________ lead(s).
A) two
B) one
C) three
D) twelve
Free
Multiple Choice
Q 25Q 25
The total duration of ventricular depolarization is represented by the ________ on the ECG.
A) QRS duration
B) QT interval
C) PQ interval
D) R-R interval
Free
Multiple Choice
Q 26Q 26
Which of the following statements concerning Q waves on the ECG is most accurate?
A) Q waves are not a normal finding on the ECG.
B) The absence of a Q wave is a significant pathophysiological finding.
C) A Q wave is significant if it is 0.04 or more seconds wide.
D) A Q wave is only significant in the presence of chest pain.
Free
Multiple Choice
Q 27Q 27
Which of the following is most characteristic of right heart failure?
A) JVD, peripheral edema, and pulmonary edema
B) Rales, cough productive of blood-tinged sputum
C) Ascites, peripheral edema, and cyanosis
D) JVD, peripheral edema, and liver and spleen engorgement
Free
Multiple Choice
Q 28Q 28
The anterior surface of the heart is best viewed by ECG leads:
A) II, III, and aVF.
B) V1-V4.
C) I and aVL.
D) aVR, aVL, and aVF.
Free
Multiple Choice
Q 29Q 29
While monitoring a patient's cardiac rhythm, you note that there is no electrical activity after a PQRST complex for a period equal to exactly three of the previous R-R intervals. This is most accurately described as:
A) sinus arrest.
B) sinus pause.
C) sinus arrhythmia.
D) sinus block.
Free
Multiple Choice
Q 30Q 30
A 48-year-old male is sitting upright in bed in respiratory distress. He describes an acute onset of difficulty breathing and chest pain during the night that has been worsening for the past 3 hours. He also complains of nausea. Pain is described as a substernal pressure radiating to his left shoulder. Physical examination reveals cool, diaphoretic skin and rales on auscultation bilaterally. Medical history includes two prior myocardial infarctions. Medications include Zestril and metoprolol. HR = 132, BP = 140/100, RR = 25, SaO2 = 92%. Which of the following is NOT indicated?
A) Adenosine
B) Enalapril
C) Morphine
D) Nitroglycerin
Free
Multiple Choice
Q 31Q 31
Which of the following is the most likely result of increased pulmonary artery pressure?
A) Increased left ventricular workload and cor pulmonale
B) Increased right ventricular workload and cor pulmonale
C) Decreased right atrial workload and right ventricular hypertrophy
D) Increased left ventricular workload and congestive heart failure
Free
Multiple Choice
Q 32Q 32
The difference between apical and peripheral pulse rates that results from decreased cardiac output when the atria fail to contract is known as:
A) pulsus paradoxus.
B) pulse deficit.
C) pulsus alternans.
D) paroxysmal pulse pressure.
Free
Multiple Choice
Q 33Q 33
Elastic and smooth muscle fibers are primarily found in the tunica ________ of blood vessels.
A) collateralus
B) media
C) adventitia
D) intima
Free
Multiple Choice
Q 34Q 34
________ is a drop in systolic blood pressure of more than 10 mmHg with inspiration.
A) Electrical alternans
B) Pulsus alternans
C) Pulse deficit
D) Pulsus paradoxus
Free
Multiple Choice
Q 35Q 35
Which of the following most accurately differentiates cardioversion from defibrillation?
A) Cardioversion is timed to be synchronous with the patient's R wave.
B) Cardioversion requires fewer than 100 joules.
C) The electrical stimulation of cardioversion travels at a slower rate through the myocardium.
D) Cardioversion cannot be used in patients who have a pulse.
Free
Multiple Choice
Q 36Q 36
A 67-year-old male is unconscious, is sitting in a chair, and has agonal respirations. His wife states that he was up all night with difficulty breathing and chest discomfort but would not go to the hospital. Physical examination reveals pink, frothy sputum in the airway; cold, diaphoretic skin; and rales audible without a stethoscope. HR = 108, BP = 74 mmHg by palpation, RR = 4, SaO2 = 82%. The monitor shows sinus tachycardia. Which of the following is the highest priority when treating this patient?
A) Immediate transport
B) Determining whether the patient has a Do Not Resuscitate order
C) Dopamine infusion
D) Intubation
Free
Multiple Choice
Q 37Q 37
Measures to treat cardiogenic shock include all of the following EXCEPT:
A) reducing stroke volume.
B) increasing the contractile force.
C) improving preload.
D) reducing peripheral resistance.
Free
Multiple Choice
Q 38Q 38
PSVT is least likely to occur secondary to:
A) stress.
B) Wolff-Parkinson-White syndrome.
C) myocardial infarction.
D) ingestion of caffeine.
Free
Multiple Choice
Q 39Q 39
A 35-year-old male is complaining of a headache, blurred vision, nausea, and vomiting. He has a history of hypertension but is noncompliant with his medications. His pupils are equal and reactive, his skin is warm and dry, and his breath sounds are clear and equal bilaterally. HR = 122, BP = 202/138, RR = 12, SaO2 = 99%. In addition to monitoring his cardiac rhythm, administering oxygen, and starting an IV at a KVO rate, which of the following is most appropriate?
A) Labetalol, IV
B) Diazepam, IV
C) Nitroglycerin, SL
D) Morphine, IV
Free
Multiple Choice
Q 40Q 40
Which of the following most accurately describes the etiology of Wolff-Parkinson-White syndrome?
A) Presence of an accessory conduction pathway
B) Idiopathic
C) Increased automaticity
D) Shifting supraventricular pacemaker sites
Free
Multiple Choice
Q 41Q 41
Which of the following is NOT considered a modifiable risk factor for coronary heart disease?
A) Stress
B) Gender
C) Obesity
D) Diet
Free
Multiple Choice
Q 42Q 42
Signs and symptoms of decreased tissue perfusion secondary to cardiogenic shock include all of the following EXCEPT:
A) altered mental status.
B) cold, diaphoretic skin.
C) constricted pupils.
D) tachypnea.
Free
Multiple Choice
Q 43Q 43
Which of the following rhythms requires transcutaneous pacing?
A) Supraventricular tachycardia
B) Junctional tachycardia
C) Sinus bradycardia
D) Symptomatic third-degree AV block
Free
Multiple Choice
Q 44Q 44
A 64-year-old female is alert and oriented, in moderate respiratory distress, and complaining of chest pain. She describes an acute onset of right-sided chest pain that radiates across her chest. Physical examination reveals cold, diaphoretic skin; lung sounds with crackles bilaterally; JVD; and peripheral edema. Medical history includes hypertension, prior myocardial infarction, and heart failure. HR = 128, BP = 86/56, RR = 26, SaO2 = 92%. Which of the following is appropriate in the prehospital treatment of this patient?
A) Dopamine
B) Nitroglycerin
C) Amiodarone
D) Morphine
Free
Multiple Choice
Q 45Q 45
Which of the following is affected by a properly working pacemaker?
A) Automaticity
B) Stroke volume
C) Cardiac rhythm
D) Ejection fraction
Free
Multiple Choice
Q 46Q 46
An ECG monitor is useful for:
A) determining cardiac output.
B) detecting the total electrical activity within the heart.
C) determining stroke volume.
D) evaluating the effectiveness of cardiac contractions.
Free
Multiple Choice
Q 47Q 47
The heart sound produced by the closing of the aortic and pulmonary valves is:
A) S4.
B) S2.
C) S3.
D) S1.
Free
Multiple Choice
Q 48Q 48
The most common cause of death resulting from myocardial infarction is:
A) end-organ failure.
B) inadequate tissue perfusion.
C) heart failure.
D) dysrhythmia.
Free
Multiple Choice
Q 49Q 49
Which of the following most accurately describes a Valsalva maneuver?
A) Firmly pressing the carotid artery against the transverse process of the vertebra behind it
B) Asking the patient to bear down as if to move his bowels with his nose and mouth closed
C) Digital rectal stimulation
D) Immersing the face in cold water
Free
Multiple Choice
Q 50Q 50
Which of the following is the least likely cause of PEA?
A) Hypertension
B) Hypovolemia
C) Cardiac tamponade
D) Tension pneumothorax
Free
Multiple Choice
Q 51Q 51
Your patient is a 58-year-old female who is confused and dyspneic. Her daughter called EMS because the patient complained of a fluttering sensation in her chest, followed a few minutes later by chest pain and an acute onset of confusion. She is pale and diaphoretic without a palpable radial pulse. The monitor shows a narrow complex rhythm at a rate of 180. Which of the following is most appropriate?
A) Valsalva maneuver
B) IV adenosine
C) Immediate synchronized cardioversion
D) IV diltiazem
Free
Multiple Choice
Q 52Q 52
A junctional escape beat occurs when:
A) the AV junction becomes irritable and temporarily overrides the SA node.
B) there is a conduction block between the SA node and AV node.
C) there is an accessory pathway that causes reentry of the impulse at the AV node.
D) the rate of the SA node is slower than that of the AV node.
Free
Multiple Choice
Q 53Q 53
Release of acetylcholine at the neuroeffector junction would result in a(n):
A) increase of both sympathetic and parasympathetic tone.
B) positive dromotropic effect.
C) negative chronotropic effect.
D) positive inotropic effect.
Free
Multiple Choice
Q 54Q 54
Myocardial ischemia may result in:
A) J waves.
B) ST segment depression.
C) QRS duration greater than 0.12 seconds.
D) inverted P waves.
Free
Multiple Choice
Q 55Q 55
Auscultation of an S3 is associated with:
A) mitral valve prolapse.
B) increased force of atrial contraction.
C) aortic stenosis.
D) congestive heart failure.
Free
Multiple Choice
Q 56Q 56
Which of the following ECG findings is least anticipated in a patient experiencing an acute myocardial infarction?
A) Osborn wave
B) ST elevation
C) ST depression
D) QRS greater than 0.12 seconds
Free
Multiple Choice
Q 57Q 57
Excessive preload over time would lead to:
A) decreased capacity of the left ventricle.
B) strengthening of the left ventricle.
C) increased ejection fraction of the left ventricle.
D) weakening of the left ventricle.
Free
Multiple Choice
Q 58Q 58
The base of the heart lies at the level of the ________ rib.
A) first
B) third
C) second
D) fourth
Free
Multiple Choice
Q 59Q 59
Your patient is a 32-year-old female, 30 weeks' pregnant, complaining of shortness of breath and palpitations. She is alert and oriented, though anxious; her skin is cool and moist, and her radial pulse is weak and rapid, but regular. HR = 180, BP = 100/72, RR = 24. The monitor shows supraventricular tachycardia. After applying oxygen by nonrebreather and starting an IV of normal saline, which of the following is most appropriate?
A) 150 mg of amiodarone
B) Transport without further intervention
C) 6 mg of adenosine
D) 2 mg of Versed and cardioversion beginning at 50 joules
Free
Multiple Choice
Q 60Q 60
Which of the following occurs during depolarization of a cardiac cell?
A) Sodium moves out of the cell.
B) The cell becomes relatively more positively charged.
C) Potassium moves into the cell.
D) The cell becomes negatively charged.
Free
Multiple Choice
Q 61Q 61
Poiseuille's law specifically states that blood flow through a vessel is directly proportional to the ________ of the vessel's radius.
A) fourth power
B) third power
C) square
D) tenth power
Free
Multiple Choice
Q 62Q 62
Which of the following is least likely to be associated with the pain of acute myocardial infarction?
A) Pain described as sharp
B) Discomfort lasting longer than 30 minutes
C) Radiation to arms and neck
D) Pain reproducible with palpation
Free
Multiple Choice
Q 63Q 63
A 63-year-old male is alert and oriented, complaining of dizziness. He describes an acute onset of dizziness and near-syncope that has lasted for 15 minutes. He is also experiencing substernal chest pain radiating to his jaw, as well as nausea and weakness. Physical examination reveals cool, diaphoretic skin; delayed capillary refill; and mild crackles to the bases bilaterally. He has no significant medical history, but he takes 325 mg of aspirin a day. HR = 220, BP = 88/52, RR = 16, SaO2 = 92%. Which of the following should be done first?
A) Start an IV of normal saline
B) Synchronized cardioversion
C) Oxygen by nonrebreathing mask
D) Administer 0.4 mg of nitroglycerin sublingually
Free
Multiple Choice
Q 64Q 64
Your patient in atrial fibrillation has a heart rate of 108 on the monitor, but her radial pulse is 88. The patient is experiencing:
A) paradoxical pulse.
B) pulsus obliterans.
C) pulse deficit.
D) pulsus alternans.
Free
Multiple Choice
Q 65Q 65
Paramedics use all of the following interventions to treat congestive heart failure EXCEPT:
A) sitting the patient upright.
B) decreasing patient anxiety.
C) administering oxygen
D) administering fluid bolus to treat hypotension.
Free
Multiple Choice
Q 66Q 66
A 48-year-old male is complaining of chest pain that he describes as dull, located substernally, but radiating to his neck. He rates the pain a 6 on a scale of 1 to 10 and complains of nausea and lightheadedness. His skin is cool and diaphoretic. HR = 96, BP = 124/82, RR = 14, SaO2 = 97%. The 12-lead ECG is nondiagnostic. In addition to oxygen, an IV of normal saline at a keep open rate, and transport to the emergency department, which of the following would be most appropriate?
A) Nitroglycerin, morphine, and furosemide
B) Reassurance that likely his condition is not cardiac in nature
C) Nitroglycerin
D) Aspirin, nitroglycerin, and morphine
Free
Multiple Choice
Q 67Q 67
The amount of resistance that must be overcome by the left ventricle during systole is called:
A) stroke volume.
B) preload.
C) cardiac output.
D) afterload.
Free
Multiple Choice
Q 68Q 68
Signs and/or symptoms of a dissecting thoracic aneurysm include all of the following EXCEPT:
A) hypotension.
B) chest pain.
C) palpable pulsating mass.
D) difficulty breathing.
Free
Multiple Choice
Q 69Q 69
Your patient is a 73-year-old male who is sitting in a recliner, cyanotic, pulseless, and apneic. The patient's skin is cool and dry. The patient's wife last saw him an hour and a half ago. Which of the following should you do first?
A) Check for rigor mortis.
B) Start CPR.
C) Attach the monitor/defibrillator.
D) Inform the patient's wife that he is dead and nothing can be done for him.
Free
Multiple Choice
Q 70Q 70
The QRS complex represents:
A) ventricular depolarization.
B) atrial repolarization.
C) atrial depolarization.
D) ventricular repolarization.
Free
Multiple Choice
Q 71Q 71
Pharmacological interventions initiated by prehospital care providers in the treatment of congestive heart failure may include all of the following EXCEPT:
A) dopamine.
B) atropine.
C) furosemide.
D) nitroglycerin.
Free
Multiple Choice
Q 72Q 72
Stroke volume × heart rate × systemic vascular resistance =
A) blood pressure.
B) ejection fraction.
C) cardiac output.
D) end-diastolic pressure.
Free
Multiple Choice
Q 73Q 73
Cardioversion can be used to treat all of the following rhythms EXCEPT:
A) ventricular tachycardia with a pulse.
B) rapid atrial fibrillation.
C) ventricular fibrillation.
D) supraventricular tachycardia.
Free
Multiple Choice
Q 74Q 74
You have begun transcutaneous pacing of a 52-year-old male who is in third-degree heart block. He was initially unresponsive to all stimuli, with a pulse of 32, blood pressure 60 by palpation, and a respiratory rate of 12. Which of the following is least helpful when determining the effectiveness of transcutaneous pacing?
A) Evidence of mechanical capture
B) Increased level of consciousness
C) Evidence of electrical capture
D) Increased blood pressure
Free
Multiple Choice
Q 75Q 75
Claudication is significant because it:
A) leads to glaucoma when left untreated.
B) indicates the presence of atherosclerosis.
C) results from inadequate coronary artery perfusion.
D) results in inadequate cerebral perfusion.
Free
Multiple Choice
Q 76Q 76
Common chief complaints and symptoms associated with cardiac disease include all of the following EXCEPT:
A) dyspnea.
B) syncope.
C) chest pain.
D) vertigo.
Free
Multiple Choice
Q 77Q 77
The lead to the left of the sternum at the fourth intercostal space is:
A) V1.
B) V2.
C) V3.
D) V4.
Free
Multiple Choice
Q 78Q 78
An accelerated junctional rhythm has a rate between ________ and ________.
A) 40, 60
B) 20, 40
C) 100, 150
D) 60, 100
Free
Multiple Choice
Q 79Q 79
Which of the following is most commonly associated with multifocal atrial tachycardia?
A) Acute myocardial infarction
B) Digitalis toxicity
C) Pulmonary disease
D) Use of cocaine, amphetamines, or caffeine
Free
Multiple Choice
Q 80Q 80
The mitral valve is also known as the ________ valve.
A) pulmonic
B) right atrioventricular
C) left atrioventricular
D) tricuspid
Free
Multiple Choice
Q 81Q 81
A decrease in preload results in a(n):
A) decrease in afterload.
B) decrease in cardiac output.
C) increase in stroke volume.
D) decrease in peripheral vascular resistance.
Free
Multiple Choice
Q 82Q 82
Your patient has a history of progressively worsening angina that comes on at rest. This most commonly indicates ________ angina.
A) Prinzmetal's
B) Ludwig's
C) decubitus
D) unstable angina
Free
Multiple Choice
Q 83Q 83
An early sign of hyperkalemia is:
A) flat T waves on an ECG.
B) widening of the QT interval.
C) presence of an Osborn wave.
D) tall, peaked T waves on an ECG.
Free
Multiple Choice
Q 84Q 84
The intrinsic firing rate of the AV node is ________ to ________ beats per minute.
A) 40, 60
B) 20, 40
C) 60, 80
D) 80, 100
Free
Multiple Choice
Q 85Q 85
The predominant effect of a drug with primarily alpha properties would result in which of the following?
A) Vasodilation
B) Increased heart rate
C) Decreased heart rate
D) Vasoconstriction
Free
Multiple Choice
Q 86Q 86
Which of the following is the correct sequence of cardiac electrical activity?
1) AV node
2) Internodal pathways
3) Bundle of His
4) SA node
5) Purkinje fibers
6) Bundle branches
A) 1, 2, 4, 3, 6, 5
B) 4, 1, 2, 3, 6, 5
C) 1, 2, 4, 3, 5, 6
D) 4, 2, 1, 3, 6, 5
Free
Multiple Choice
Q 87Q 87
A 12-lead ECG that reveals slight ST segment elevation; Q waves in leads II, III, and aVF; and ST elevation in V1 and V2 most indicate which of the following?
A) The patient is experiencing myocardial ischemia in her inferior wall that is extending into the septum.
B) The patient is experiencing myocardial injury in her lateral wall.
C) The patient has had a myocardial infarction in her inferior wall and is experiencing ischemia extending into the right ventricle.
D) The patient is experiencing ischemia and injury in her left ventricle and septum.
Free
Multiple Choice
Q 88Q 88
The pericardial cavity normally holds about ________ mL of ________.
A) 30, blood
B) 1 to 2, serous fluid
C) 100, blood
D) 25, straw-colored lubricant
Free
Multiple Choice
Q 89Q 89
Your patient is a 55-year-old male who is in moderate distress and complaining of chest pain. He states that he experienced an acute onset of left-sided crushing chest pain while playing basketball with his grandson. He complains of weakness and near-syncope with exertion. His skin is pale, cool, and diaphoretic. HR = 40, BP = 72/40, RR = 20, SaO2 = 95%. The monitor shows a third-degree AV block. Which of the following is most appropriate?
A) Sedation and transcutaneous pacing
B) Atropine, 0.5 mg, up to 2.0 mg
C) Dopamine at 5 mcg/kg/min
D) Aspirin, nitroglycerin, and morphine
Free
Multiple Choice
Q 90Q 90
Increased ________ does NOT occur due to increased venous return to the heart.
A) myocardial stretch
B) afterload
C) stroke volume
D) myocardial contraction
Free
Multiple Choice
Q 91Q 91
Which of the following is NOT a consideration when deciding to withhold resuscitative efforts?
A) Documentation of the patient's wishes
B) Patient's age
C) The nature of injury
D) Indications of the "down time"
Free
Multiple Choice
Q 92Q 92
Which of the following ECG findings would indicate a possible pacemaker failure?
A) Occasional QRS complexes without pacer spikes
B) A QRS duration of 0.20 seconds
C) Pacemaker spikes without associated QRS complexes
D) A pacemaker spike preceding each P wave
Free
Multiple Choice
Q 93Q 93
An elevation of the ST segment is associated with:
A) hyperkalemia.
B) left ventricular hypertrophy.
C) slowed conduction through the AV node.
D) myocardial injury.
Free
Multiple Choice
Q 94Q 94
The single largest killer of Americans each year is:
A) coronary artery disease.
B) suicide.
C) stroke.
D) congestive heart failure.
Free
Multiple Choice
Q 95Q 95
Which of the following has NOT been proven to increase the risk of cardiovascular disease?
A) Smoking
B) Age
C) Hypercholesterolemia
D) Obesity
Free
Multiple Choice
Q 96Q 96
The right atrioventricular valve is referred to as the ________ valve.
A) tricuspid
B) bicuspid
C) aortic
D) pulmonary
Free
Multiple Choice
Q 97Q 97
The left atrioventricular valve is referred to as the ________ valve.
A) tricuspid
B) mitral
C) aortic
D) pulmonary
Free
Multiple Choice
Q 98Q 98
The right ventricle pushes blood to the lungs through the:
A) pulmonary vein.
B) pulmonary artery.
C) pulmonary pathway.
D) pulmonary vena cava.
Free
Multiple Choice
Q 99Q 99
During which phase of the cardiac cycle does ventricular filling begin?
A) Systole
B) Diastole
C) Refractory
D) Absolute refractory
Free
Multiple Choice
Q 100Q 100
The pressure in the ventricle at the end of diastole is called:
A) afterload.
B) Starling's law.
C) stroke volume.
D) preload.
Free
Multiple Choice
Q 101Q 101
Starling's law states that:
A) the greater the contraction, the higher the afterload.
B) the preload determines the cardiac output.
C) the more the myocardial muscle is stretched, the greater the contraction.
D) for every action, there is an equal and opposite reaction.
Free
Multiple Choice
Q 102Q 102
Cardiac output is:
A) stroke volume × heart rate.
B) stroke volume × diastolic pressure.
C) heart rate × preload.
D) afterload × preload.
Free
Multiple Choice
Q 103Q 103
Blood pressure is defined as:
A) stroke volume × heart rate × SVR.
B) stroke volume × diastolic pressure × SVE.
C) heart rate × preload × SVR.
D) afterload × preload × SVE.
Free
Multiple Choice
Q 104Q 104
Brain natriuretic peptide (BNP) levels are useful in determining:
A) CAD.
B) CVA.
C) CHF.
D) COPD.
Free
Multiple Choice
Q 105Q 105
Cardiac muscle is different from smooth muscle in the fact that it has:
A) different nerve pathways.
B) automaticity.
C) peristalsis.
D) There is no difference.
Free
Multiple Choice
Q 106Q 106
The intrinsic rate of the SA node is:
A) set by the sympathetic nervous system.
B) 15-40 bpm.
C) 60-100 bpm.
D) 40-60 bpm.
Free
Multiple Choice
Q 107Q 107
The intrinsic rate of the AV node is:
A) set by the sympathetic nervous system.
B) 15-40 bpm.
C) 60-100 bpm.
D) 40-60 bpm.
Free
Multiple Choice
Q 108Q 108
The intrinsic rate of the Purkinje system is:
A) set by the sympathetic nervous system.
B) 15-40 bpm.
C) 60-100 bpm.
D) 40-60 bpm.
Free
Multiple Choice
Q 109Q 109
On an ECG tracing, positive impulses are seen as:
A) downward deflections.
B) upward deflections.
C) ST segment.
D) J point.
Free
Multiple Choice
Q 110Q 110
On an ECG tracing, negative impulses are seen as:
A) downward deflections.
B) upward deflections.
C) ST segment.
D) J point.
Free
Multiple Choice
Q 111Q 111
You are evaluating your patient's ECG under fluorescent lights. You notice significant artifact due to:
A) machine malfunction.
B) 60 hertz interference.
C) poor eyesight.
D) road noise.
Free
Multiple Choice
Q 112Q 112
One small box on the ECG paper indicates:
A) 0.20 seconds.
B) 0.04 seconds.
C) 2 seconds.
D) 4 seconds.
Free
Multiple Choice
Q 113Q 113
One large box on the ECG paper indicates:
A) 0.20 seconds.
B) 0.04 seconds.
C) 2 seconds.
D) 4 seconds.
Free
Multiple Choice
Q 114Q 114
Atrial depolarization is represented on the ECG by the:
A) P wave.
B) ORS.
C) T wave.
D) J point.
Free
Multiple Choice
Q 115Q 115
Ventricular depolarization is represented on the ECG by the:
A) P wave.
B) QRS complex.
C) T wave.
D) J point.
Free
Multiple Choice
Q 116Q 116
Ventricular repolarization is represented on the ECG by the:
A) P wave.
B) QRS complex.
C) T wave.
D) J point.
Free
Multiple Choice
Q 117Q 117
Normal interval time for the PR interval is:
A) 0.04-0.12 second.
B) 0.33-0.42 second.
C) 0.12-0.20 second.
D) 1.20-2.00 seconds.
Free
Multiple Choice
Q 118Q 118
Normal interval time for the QRS complex is:
A) 0.04-0.12 second.
B) 0.33-0.42 second.
C) 0.12-0.20 second.
D) 1.20-2.00 seconds.
Free
Multiple Choice
Q 119Q 119
Normal interval time for the QT interval is:
A) 0.04-0.12 second.
B) 0.33-0.42 second.
C) 0.12-0.20 second.
D) 1.20-2.00 seconds.
Free
Multiple Choice
Q 120Q 120
The five-step procedure for analyzing ECGs includes all of the following EXCEPT:
A) rate.
B) P wave.
C) QRS complex.
D) V1.
Free
Multiple Choice
Q 121Q 121
Treatment of sinus tachycardia is aimed at:
A) adenosine.
B) calcium channel blockers.
C) beta blockers.
D) treating the underlying cause.
Free
Multiple Choice
Q 122Q 122
You are transporting a patient who is having wild changes in his heart rate, an irregular R-R interval, and a history of taking Lanoxin. The patient is now becoming pale, cool, and clammy, with an MAP of 60. You should:
A) not worry, as this is a normal presentation.
B) begin TCP and consider a catecholamine infusion.
C) infuse a calcium channel blocker.
D) start an amiodarone drip.
Free
Multiple Choice
Q 123Q 123
A potassium level of 3.0 would commonly be associated with which ECG finding?
A) T wave merging with QRS
B) Delta wave
C) U wave
D) Flattening T wave
Free
Multiple Choice
Q 124Q 124
A potassium level of 8.0 would commonly be associated with which ECG finding?
A) T wave merging with QRS
B) Delta wave
C) U wave
D) Flattening T wave
Free
Multiple Choice
Q 125Q 125
Diaphoresis exhibited in a patient actively having an MI is due to:
A) sympathetic response.
B) parasympathetic response.
C) increased metabolism.
D) increased myocardial demand.
Free
Multiple Choice
Q 126Q 126
A parasympatholytic agent used to treat symptomatic bradycardia is:
A) Atrovent.
B) atropine.
C) epinephrine.
D) Levophed.
Free
Multiple Choice
Q 127Q 127
The loading dose of norepinephrine is:
A) 2-4 mcg/min.
B) 2-4 mg/ min.
C) 8-10 mcg/min.
D) 8-10 mg/min.
Free
Multiple Choice
Q 128Q 128
Myocardial ischemia is caused by an imbalance of:
A) oxygen supply and demand.
B) oxygen bioavailability.
C) free radical oxygen.
D) sodium bicarbonate.
Free
Multiple Choice
Q 129Q 129
Vasospasms associated with chest pain are known as:
A) stable angina.
B) Prinzmetal's angina.
C) variant angina.
D) James' angina.
Free
Multiple Choice
Q 130Q 130
A patient with known arteriosclerosis was outside doing lawn work when he started experiencing chest pain. Upon your arrival, the patient states that he has been resting and took a prescribed nitroglycerin tablet 5 minutes ago. The patient states that the pain is subsiding. You suspect:
A) unstable angina.
B) stable angina.
C) Prinzmetal's angina.
D) myocardial infarction.
Free
Multiple Choice
Q 131Q 131
Life-threatening arrhythmias can result in death of the AMI patient as soon as:
A) 3 hours after onset.
B) 4 hours after onset.
C) 2 hours after onset.
D) 1 hour after onset.
Free
Multiple Choice
Q 132Q 132
A pathological Q wave indicating infarction should measure:
A) 0.004 second.
B) 0.12 second.
C) 0.32 second.
D) 0.04 second.
Free
Multiple Choice
Q 133Q 133
The maximum window of time a fibrinolytic can be administered is:
A) 8 hours after onset of symptoms.
B) 12 hours after onset of symptoms.
C) 24 hours after onset of symptoms.
D) 6 hours after onset of symptoms.
Free
Multiple Choice
Q 134Q 134
Sudden death is described as:
A) any death without a direct known cause.
B) any death occurring within 1 hour of onset of symptoms.
C) any death occurring within 3 hours of onset of symptoms.
D) All death is sudden death.
Free
Multiple Choice
Q 135Q 135
Which of the following is NOT a phase of cardiac arrest?
A) Electrical phase
B) Circulatory phase
C) Rigor mortis phase
D) Metabolic phase
Free
Multiple Choice
Q 136Q 136
You are transporting a cardiac arrest when you achieve ROSC. You now want to keep the patient's systolic blood pressure in the range of:
A) 120-130 mmHg.
B) 60-70 mmHg.
C) 80-100 mmHg.
D) 20-40 mmHg.
Free
Multiple Choice
Q 137Q 137
You have been on the scene of a 55-year-old cardiac arrest patient for 30 minutes. You have full ALS care initiated, with no response to therapy. You should:
A) consider termination of the arrest.
B) transport immediately.
C) keep working until you get a change.
D) consider defibrillating at 360 joules.
Free
Multiple Choice
Q 138Q 138
You run a 12-lead ECG on a patient exhibiting chest pain. It reveals ST segment elevation in leads II, III, and aVF, with reciprocal in leads aVL and I. You suspect:
A) anterior MI.
B) lateral MI.
C) inferior MI.
D) high lateral wall MI.
Free
Multiple Choice
Q 139Q 139
You are called for a patient experiencing SOB. The patient is also a diabetic, so you perform a 12-lead ECG. It shows ST segment elevation in leads V1, V2, V3, and V4 with reciprocal changes in leads V5, V6, II, III, and aVF. You suspect:
A) septal-anterior MI.
B) inferoseptal MI.
C) lateral MI.
D) inferior MI.
Free
Multiple Choice