Question 1

Which one of the following patient statements should make an EMT suspect primary hypertension?

Accepted Answer

Primary hypertension, also known as essential hypertension, is high blood pressure with no identifiable cause. Option C indicates that the patient's doctor does not know what is causing their high blood pressure, which could be a hint that the patient is dealing with primary hypertension. The other options suggest that the patient's high blood pressure is secondary to an underlying condition such as kidney disease or heart problems.

Question 2

You are caring for a 69-year-old male who is short of breath and in congestive heart failure. He is alert, anxious, and panicked with an open airway and rapid shallow respirations. His heart rate is tachycardic, and his skin is cool and diaphoretic with cyanosis noted to the lips and fingers. There are crackles noted to both lungs, as well as pedal edema to both feet. He denies chest pain or discomfort, but is having a difficult time speaking due to the shortness of breath. When caring for this patient, you should:

Accepted Answer

The patient is presenting with signs and symptoms of congestive heart failure with respiratory distress. The best choice would be to apply Continuous Positive Airway Pressure (CPAP) to improve oxygenation and reduce dyspnea. Administering aspirin is not indicated in this scenario. The shock position is indicated for patients in shock, which is not the case in this situation. Inserting a nasal airway may be helpful in some cases, but the patient is breathing spontaneously, and CPAP should be considered first.

Question 3

You have just arrived by the side of a male patient who is in cardiac arrest. Emergency Medical Responders have been on scene for 6 minutes performing CPR. Advanced life support (ALS) has been contacted and is 1 minute out. Which one of the following should you do immediately?

Accepted Answer

Given that the patient is in cardiac arrest and ALS is aware and on the way, the best choice would be to apply and use the automated external defibrillator (AED). The AED can help to assess and potentially correct any abnormal heart rhythms, which can improve the patient's chances of survival. Continuing CPR is also important, but the availability of ALS makes using the AED a priority. Checking vital signs and placing the patient on the stretcher can wait until ALS arrives and takes over the care.

Question 4

You have just arrived by the side of a 68-year-old male complaining of chest pain. After determining his airway is patent and breathing adequate, it is imperative that you perform which action next?

Accepted Answer

Checking the radial pulse is crucial to assess circulation and perfusion status, which is a priority in a patient with chest pain.

Question 5

A patient has called 911 for chest pain that he describes as "tearing" and radiating between his shoulders. His airway is patent, breathing accelerated but adequate, and radial pulse intact. Your partner reports the following vital signs: pulse 120, respirations 22, blood pressure 88/64, and SpO₂ at 96% on room air. At this time, you should:

Accepted Answer

The description of chest pain as "tearing" and radiating between the shoulders, along with the provided vital signs, suggests the possibility of an aortic dissection. A significant diagnostic step for aortic dissection is to recheck blood pressure in both arms, as there can be a difference in readings, which is a key indicator of this condition.

Question 6

You are assessing a 73-year-old male complaining of altered mental status and shortness of breath. The patient is conscious, but confused. He is breathing at a rate of 20 breaths per minute. His pulse is rapid and weak, and his skin cool and diaphoretic. An Emergency Medical Responder provides you with the following vital signs: pulse 136, respirations 20, blood pressure 168/88, and SpO₂ at 89%. Family states that he is diabetic and takes insulin. He also has a history of hypertension, colon cancer, irregular heartbeat, and transient ischemic attacks (TIA). Which one of the following should you do next?

Accepted Answer

Given the patient's symptoms of altered mental status, shortness of breath, rapid and weak pulse, cool and diaphoretic skin, and an SpO₂ at 89%, applying supplemental oxygen is the most immediate action to address the patient's hypoxia and support his respiratory function.

Question 7

A patient complaining of shortness of breath has called 911. Her history includes chronic obstructive pulmonary disease (COPD). When assessing the patient, which one of the following causes you to immediately prepare the patient for transport?

Accepted Answer

A pulsating mass in the abdomen could indicate an abdominal aortic aneurysm, which is a life-threatening condition requiring immediate medical intervention. The other options, while concerning for a COPD patient, are not as immediately life-threatening as a potential aneurysm.

Question 8

You are transporting a patient with chest pain to the hospital emergency department. In regards to possible fibrinolytic therapy, which of the following should you relay as a possible relative contraindication to this therapy?

Accepted Answer

Use of anticoagulant medication is a relative contraindication to fibrinolytic therapy as it can increase the risk of bleeding. The other options are not relevant to the use of fibrinolytic therapy.

Question 9

The EMT should most suspect a patient suffers from heart failure when he takes what medication?

Accepted Answer

Lasix is a diuretic medication commonly used to treat heart failure. Its use indicates a possibility of heart failure in the patient. Aspirin is a blood thinner, nitroglycerin is a medication used to relieve chest pain, and Glucophage is a medication for diabetes, which are not specific to heart failure.

Question 10

You suspect that a patient with a history of chronic obstructive pulmonary disease (COPD) is suffering from right ventricular disease. From your assessment, which of the following findings reinforce this suspicion?

Accepted Answer

Edema to the feet is a common finding in right ventricular disease because the right ventricle is not able to pump blood effectively, causing fluid buildup in the body's lower extremities. Elevated blood pressure, crackles in both lungs, and a bounding radial pulse are not specific to right ventricular disease and can be present in various other conditions.

Question 11

You have been called for a 58-year-old male with an unknown medical emergency. On scene you find the alert and oriented patient to be complaining of headache as well as weakness and "tingling" to his right arm and leg. He is diabetic and suffers from high blood pressure, for which he takes the appropriate medications. When asked, he states that he thinks he may have passed out earlier in the day, immediately after taking his morning dose of insulin. His pulse is 96, respirations 16, and blood pressure 180/106 mmHg. Based on this presentation, you should treat the patient for:

Accepted Answer

The patient's complaints of weakness and "tingling" to his right arm and leg, along with passing out earlier in the day after taking insulin, are concerning for a possible stroke. The elevated blood pressure also supports this diagnosis. Time is critical in treating a stroke, so the patient should be transported to the hospital as soon as possible for further evaluation and treatment.

Question 12

Which of the following patient statements should cause the EMT to suspect an abdominal aortic aneurysm?

Accepted Answer

Abdominal aortic aneurysm can present with abdominal pain that radiates to the back.

Question 13

Which of the following statements regarding cardiac compromise or acute coronary syndrome should the EMT recognize as true?

Accepted Answer

Chest discomfort is a common symptom of cardiac compromise, and it may not always present as pain. As such, any patient experiencing chest discomfort warrants suspicion of a cardiac event and prompt evaluation by EMS.

Answer: None of the Above
 None of the other statements are accurate. Patients experiencing acute coronary syndrome may experience discomfort, pressure, tightness, or pain; the presence or absence of radiation to the arms cannot definitively rule in or rule out a cardiac cause; and physical activity may trigger symptoms but is not a requirement for the onset of acute coronary syndrome.

Question 14

You are assessing a patient in heart failure. Which of the following signs or symptoms seemingly indicates that the left ventricle is the cause of the heart failure?

Accepted Answer

Crackles in the bases of both lungs is a sign of fluid accumulation in the lungs, which is a common result of left ventricular heart failure.

Question 15

The EMT recognizes the cause of heart failure as:

Accepted Answer

Heart failure is a condition where the heart is unable to pump enough blood to meet the body's needs. Inadequate ejection of blood is the primary cause of heart failure. Poor gas exchange in the lungs, fluid accumulation within the lung tissue, and backup of fluid in the lower extremities are all possible effects or symptoms of heart failure.

Question 16

A 71-year-old female patient is lying in bed and complaining of respiratory distress. She exhibits moderate dyspnea, crackles in both lungs, and edema to the abdomen and lower extremities. Supplemental oxygen is being provided to the patient by Emergency Medical Responders. Her vital signs are: pulse 132, respirations 18, blood pressure 138/86, and SpO₂ at 95%. Which one of the following would be the most benefit to the patient?

Accepted Answer

Positioning the patient upright will help to improve oxygenation and ease respiratory distress. This will allow for better lung expansion and decrease the work of breathing. Administering aspirin may be appropriate depending on the patient's medical history, but it is not the most immediate need in this situation. Elevating the legs may help with swelling but it will not improve the patient's respiratory distress. Obtaining a medical history is important, but not the most urgent need in this acute situation.

Question 17

Your patient is complaining of chest pain that radiates into his neck and arms. The primary assessment reveals a patent airway, adequate breathing, and a strong, regular radial pulse. His skin is warm and dry, and reveals no signs of inadequate perfusion. Which of the following should you do next?

Accepted Answer

The answer of Your patient is complaining of chest pain...

Question 18

An alert and oriented patient presents with shortness of breath, crackles in both lungs, jugular venous distention, and edema to the feet and ankles. Her pulse is 132, respirations 26, blood pressure 160/86, and SpO₂ at 88%. Based on this, the EMT should suspect:

Accepted Answer

The patient presents with classic signs and symptoms of congestive heart failure such as shortness of breath, crackles in both lungs, jugular venous distention, and edema to the feet and ankles. The elevated heart rate and blood pressure can also be indicative of this condition. Additionally, the low SpO₂ level indicates that the patient is not getting enough oxygen, which can be a result of a buildup of fluid in the lungs, another indication of congestive heart failure.

Question 19

Immediately after assisting a diabetic patient with her nitroglycerin, she states that she feels weak, dizzy, and nauseated. Which of the following should the EMT do next?

Accepted Answer

Nitroglycerin can cause vasodilation leading to decreased blood pressure, which can manifest as weakness, dizziness, and nausea. Checking the patient's blood pressure is the next appropriate step to assess for hypotension.

Question 20

Which one of the following statements should the EMT associate with the condition of congestive heart failure?

Accepted Answer

Congestive heart failure typically presents with shortness of breath, especially when lying down or at rest. This is due to fluid buildup in the lungs, which makes it difficult to breathe. None of the other statements specifically describe symptoms of congestive heart failure.

Quiz 17: Cardiovascular Emergencies