EMT Chapter 14 Quiz
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Questions and Answers

What should you do for a 66-year-old female with chest pressure and no prescribed nitroglycerin?

Administer oxygen, give her 2 (81mg each tablet) chewable aspirin, and assess her further.

Which of the following blood vessels transports oxygenated blood?

  • Vena cava
  • Pulmonary veins (correct)
  • Pulmonary arteries
  • Aorta

    • What should you begin if a 56-year-old male with chest pain is semiconscious?

    Begin ventilatory assistance.

    What is most important to do upon arriving at a patient with a possible cardiac problem?

    <p>Assess the scene for potential hazards.</p> Signup and view all the answers

    Where does blood ejected from the right ventricle flow?

    <p>Into the pulmonary arteries.</p> Signup and view all the answers

    Why is prompt transport of a patient with a suspected AMI important?

    <p>The patient may be eligible to receive thrombolytic therapy.</p> Signup and view all the answers

    How does a percutaneous transluminal coronary angioplasty (PTCA) restore blood flow?

    <p>By dilating the affected coronary artery with a small inflatable balloon.</p> Signup and view all the answers

    What arteries supply oxygenated blood to the head and brain?

    <p>Carotid arteries.</p> Signup and view all the answers

    When does an acute myocardial infarction (AMI) occur?

    <p>When myocardial tissue dies secondary to an absence of oxygen.</p> Signup and view all the answers

    What do the iliac arteries subdivide into?

    <p>Femoral arteries.</p> Signup and view all the answers

    Where does deoxygenated blood return to the heart?

    <p>Right atrium.</p> Signup and view all the answers

    Which medication is commonly given for chest pain to prevent blood clots?

    <p>Aspirin.</p> Signup and view all the answers

    What should you assess for a patient with crushing chest pain and diaphoresis?

    <p>Assess the adequacy of his respirations.</p> Signup and view all the answers

    Which of the following is NOT a common sign or symptom associated with malfunction of an implanted cardiac pacemaker?

    <p>Rapid heart rate</p> Signup and view all the answers

    What happens when the myocardium requires more oxygen?

    <p>The arteries supplying the heart dilate.</p> Signup and view all the answers

    Which of the following would cause the greatest increase in cardiac output?

    <p>Increased heart rate and increased stroke volume</p> Signup and view all the answers

    Why does ventricular tachycardia cause hypotension?

    <p>The left ventricle does not adequately fill with blood.</p> Signup and view all the answers

    When does angina pectoris most commonly occur?

    <p>When myocardial oxygen demand exceeds the supply.</p> Signup and view all the answers

    At what level does the descending aorta divide into the two iliac arteries?

    <p>Umbilicus.</p> Signup and view all the answers

    Why does chest pain occur in a patient with atherosclerotic heart disease during exertion?

    <p>The lumen of the coronary artery is narrowed and cannot accommodate increased blood flow.</p> Signup and view all the answers

    What should you do after assisting a patient with their nitroglycerin?

    <p>Reassess the blood pressure within 5 minutes to detect hypotension.</p> Signup and view all the answers

    How should defibrillator pads be placed on the patient's chest?

    <p>One pad to the right of the upper sternum and the other pad just to the left and below the left nipple.</p> Signup and view all the answers

    Why should a chest pain patient be assumed to be having an AMI?

    <p>The cause of the pain cannot be diagnosed in the field.</p> Signup and view all the answers

    What is the purpose of defibrillation?

    <p>To stop the chaotic, disorganized contraction of the cardiac cells.</p> Signup and view all the answers

    When is it MOST appropriate for a patient to take prescribed nitroglycerin?

    <p>Chest pain that does not immediately subside with rest.</p> Signup and view all the answers

    Which of the following statements regarding the AED and defibrillation is correct?

    <p>The AED will not analyze the rhythm of a moving patient.</p> Signup and view all the answers

    The myocardium receives oxygenated blood from the __________, which originate(s) from the __________.

    <p>Coronary arteries, aorta</p> Signup and view all the answers

    What can cause cardiac output to decrease?

    <p>If the heart beats too rapidly.</p> Signup and view all the answers

    What should treatment for a conscious patient with chest discomfort and congestive heart failure include?

    <p>Placing her in an upright position.</p> Signup and view all the answers

    How does nitroglycerin relieve cardiac-related chest pain?

    <p>By dilating the coronary arteries and improving cardiac blood flow.</p> Signup and view all the answers

    The inferior vena cava returns deoxygenated blood to the right side of the heart from all of the following areas, EXCEPT the:

    <p>Brain</p> Signup and view all the answers

    Prior to assisting a patient with their prescribed nitroglycerin, what should the EMT do?

    <p>Obtain authorization from medical control.</p> Signup and view all the answers

    What should you do for a patient who becomes unresponsive and pulseless during transport?

    <p>Stop the ambulance, begin CPR, and attach the AED as soon as possible.</p> Signup and view all the answers

    What is termed the ability of cardiac muscle cells to contract spontaneously without nerve source stimulation?

    <p>Automaticity.</p> Signup and view all the answers

    What occurs when the myocardium requires more oxygen?

    <p>The arteries supplying the heart dilate.</p> Signup and view all the answers

    What is a dissecting aortic aneurysm?

    <p>When the inner layers of the aorta become separated.</p> Signup and view all the answers

    In contrast to monophasic defibrillation, what does biphasic defibrillation require?

    <p>A lower energy setting.</p> Signup and view all the answers

    What should you do upon arriving at a collapsed patient?

    <p>Begin high-quality CPR and apply the AED without delay.</p> Signup and view all the answers

    What is the MOST common error associated with the use of the AED?

    <p>Failure of the EMT to ensure the battery is charged.</p> Signup and view all the answers

    Which cardiac arrhythmia has the greatest chance of deteriorating into a pulseless rhythm?

    <p>Ventricular tachycardia</p> Signup and view all the answers

    What term describes a group of symptoms caused by myocardial ischemia?

    <p>Acute coronary syndrome (ACS).</p> Signup and view all the answers

    Why would signs and symptoms of a hypertensive emergency be delayed?

    <p>In patients who have chronic hypertension.</p> Signup and view all the answers

    Where can the posterior tibial pulse be palpated?

    <p>Behind the medial malleolus.</p> Signup and view all the answers

    What advantage does the AED provide to the EMT?

    <p>It delivers prompt defibrillation to patients with ventricular fibrillation.</p> Signup and view all the answers

    What does rapid, labored breathing in a patient with AMI signify?

    <p>Congestive heart failure.</p> Signup and view all the answers

    What is the function of the left atrium?

    <p>It receives oxygenated blood from the lungs.</p> Signup and view all the answers

    How does a percutaneous transluminal coronary angioplasty (PTCA) restore blood flow?

    <p>By dilating the affected coronary artery with a small inflatable balloon.</p> Signup and view all the answers

    What are risk factors for AMI that cannot be controlled?

    <p>Family history.</p> Signup and view all the answers

    How does the parasympathetic nervous system affect heart and respiratory rates?

    <p>It slows the heart and respiratory rates.</p> Signup and view all the answers

    What is the purpose of defibrillation?

    <p>To stop the chaotic, disorganized contraction of the cardiac cells.</p> Signup and view all the answers

    Which statement is true about major risk factors for AMI?

    <p>Family history can't be controlled.</p> Signup and view all the answers

    What is nitroglycerin contraindicated for?

    <p>Patients who have experienced a head injury.</p> Signup and view all the answers

    When an electrical impulse reaches the AV node, it is slowed for a brief period of time so that: __________.

    <p>Sinoatrial (SA) node can reset and generate another impulse.</p> Signup and view all the answers

    What must be ensured prior to defibrillating a patient with an AED?

    <p>No one is touching the patient.</p> Signup and view all the answers

    Which signs or symptoms would you NOT expect in a patient with congestive heart failure?

    <p>Flat jugular veins</p> Signup and view all the answers

    What controls the primary pacemaker of the heart?

    <p>Impulses from the brain via the autonomic nervous system.</p> Signup and view all the answers

    Which common side effect of nitroglycerin is NOT expected?

    <p>Hypertension</p> Signup and view all the answers

    What should be done immediately after an AED shock is delivered?

    <p>Resume CPR.</p> Signup and view all the answers

    Why might many people experiencing AMI not seek immediate medical attention?

    <p>They are in denial.</p> Signup and view all the answers

    Most patients are instructed to take up to _______ doses of nitroglycerin before calling EMS.

    <p>Three.</p> Signup and view all the answers

    Which statement regarding nitroglycerin is correct?

    <p>Nitroglycerin usually relieves anginal chest pain within 5 minutes.</p> Signup and view all the answers

    What should be done if an AED advises a shock for a patient with an implanted pacemaker?

    <p>Deliver the shock followed by immediate resumption of CPR.</p> Signup and view all the answers

    What causes sudden death following AMI?

    <p>Ventricular fibrillation.</p> Signup and view all the answers

    What should be noted when a patient describes their chest pain?

    <p>Use the patient's own words.</p> Signup and view all the answers

    What is correct regarding the pain associated with AMI?

    <p>It can occur during rest.</p> Signup and view all the answers

    What should be done prior to attaching the AED to a patient in cardiac arrest?

    <p>Dry the chest off if it is wet.</p> Signup and view all the answers

    What is of LEAST pertinence when obtaining medical history from a patient with chest discomfort?

    <p>Family history of hypertension</p> Signup and view all the answers

    What should be done if an EMS team gets a 'no shock advised' message following AED analysis?

    <p>Perform CPR for 2 minutes and reassess.</p> Signup and view all the answers

    What causes cardiogenic shock following AMI?

    <p>Decreased pumping force of the heart muscle.</p> Signup and view all the answers

    What should be done after an AED delivers a shock and a carotid pulse is restored?

    <p>Reassess airway and breathing and treat accordingly.</p> Signup and view all the answers

    What is a major difference between angina pectoris and AMI?

    <p>Angina pain usually subsides with rest.</p> Signup and view all the answers

    What are the signs and symptoms indicative of a dissecting aortic aneurysm?

    <p>Severe chest pain radiating to the back, hypertension in one arm compared to the other.</p> Signup and view all the answers

    Which sign is commonly observed in patients with right-sided heart failure?

    <p>Dependent edema</p> Signup and view all the answers

    Where does the electrical impulse generated by the heart originate?

    <p>Sinoatrial (SA) node.</p> Signup and view all the answers

    How does a dissecting aortic aneurysm present differently than AMI?

    <p>Maximal pain occurs from onset.</p> Signup and view all the answers

    Study Notes

    Cardiology Overview

    • Acute myocardial infarction (AMI) occurs when myocardial tissue dies due to oxygen deprivation.
    • Signs of chest pain could indicate an AMI; assume this diagnosis until proven otherwise.
    • An acute coronary syndrome (ACS) encompasses symptoms from myocardial ischemia.

    Patient Assessment

    • Assess the scene for hazards before approaching a patient with potential cardiac issues.
    • Quick evaluation of vital signs: blood pressure, pulse, and respiration are crucial.
    • In respiratory distress, prioritize assessing and assisting adequate ventilation.

    Vital Sign Thresholds

    • Blood pressure of 94/64 mm Hg indicates hypotension, which may affect treatment decisions.
    • A heart rate of 120 beats/min suggests tachycardia, which may warrant further intervention.

    Treatment Protocols

    • Administer oxygen and aspirin (2 chewable 81mg) for chest pain; reassess quickly.
    • Use nitroglycerin to relieve cardiac-related chest pain by dilating coronary arteries, but confirm authorization before use.
    • Position the patient upright to ease breathing, particularly in cases of heart failure.

    AED and Defibrillation

    • AED pads placement: right upper sternum and left side below the nipple.
    • Ensure no one is touching the patient when delivering a shock to prevent injury.

    Cardiac Function and Risks

    • Ventricular tachycardia can lead to hypotension due to inadequate left ventricle filling.
    • The heart has a natural pacemaker in the sinoatrial (SA) node, coordinating heartbeat.
    • A dissecting aortic aneurysm results when the aorta's inner layers separate, leading to severe pain.

    Medication Guidelines

    • Aspirin is key for preventing blood clots during an AMI event.
    • Nitroglycerin is contraindicated in patients with recent head injuries; it usually alleviates anginal pain in about five minutes.

    Recognizing Symptoms and Signs

    • Dependent edema is a common sign of right-sided heart failure.
    • Symptoms of hypertension emergencies may be masked in patients with chronic hypertension.
    • Pain associated with angina typically subsides with rest; AMI pain persists.

    Complications of AMI

    • Ventricular fibrillation is a leading cause of sudden death post-AMI.
    • Cardiogenic shock occurs due to decreased heart muscle pumping ability after an AMI event.
    • Patients may not seek help immediately during an AMI due to denial.

    Historical and Biological Context

    • Coronary arteries supply the heart muscle with oxygenated blood; their blockage can lead to significant ischemia.
    • Deoxygenated blood returns to the right atrium from the body via the inferior vena cava.

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    Description

    Test your knowledge on emergency medical treatment with this quiz based on Chapter 14. You'll encounter scenarios like managing chest pain in patients with underlying conditions. Challenge yourself to apply what you’ve learned about assessment and immediate care.

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