2024 EMT JBL Cardiology New Full Questions and Answers ( Included ) 100% Correct
- A 49-year-old woman presents with a headache, nausea, and ringing in her ears. She is
- Place her in a supine position
- Give her one tube of oral glucose
- Prepare for immediate transport
- Summon an ALS unit to the scene
conscious and alert and states that she has hypertension and type 2 diabetes. Her BP is 202/114 mm Hg, her pulse is 60 beats/min, and her respirations are 16 breaths/min. What should you do?
Answer: C
The patient's presentation is indicative of acute hypertensive crisis. Her blood pressure is severely elevated and she is experiencing other symptoms one might expect with such a high blood pressure (ie, headache, nausea, ringing in the ears). You should place her in a position of comfort, which is usually a semisitting position; lying her supine would likely only make her headache worse. Prompt transport to the hospital is essential so her blood pressure can be lowered in a controlled setting.Without knowing her blood glucose level, proceeding with oral glucose would not be appropriate. If it does not delay transport, you could consider summoning an ALS ambulance to the scene. It is far more important, however, to get her to a definitive care facility
2. Freshly oxygenated blood returns to the heart via the:
- aorta.
- vena cavae.
- pulmonary veins.
- pulmonary arteries.
Answer: C
The pulmonary veins are the only veins that carries oxygen-rich blood. They carry blood from the lungs back to the left atrium. All other veins in the human body, including the venae cavae, carry deoxygenated blood back to the heart. The aorta is the largest artery in the body and branches immediately from the left ventricle, carrying freshly oxygenated blood to the rest of the body. The pulmonary arteries carry deoxygenated blood from the right ventricle to the lungs for reoxygenation.
- Your assessment of a middle-aged female with chest pressure reveals that she is confused, is
diaphoretic, and has a blood pressure of 70/50 mm Hg. In caring for this patient, it is MOST
important for you to:
- request an ALS unit to respond to the scene.
- assist her with her nitroglycerin if she has any.
- reassess her vital signs at least every 5 minutes.
- prepare for immediate transport to the hospital.
Answer: D 1 / 4
Your patient is in shock, which is most likely the result of heart failure (cardiogenic shock).Immediate transport to the closest appropriate hospital is critical. Assess for and manage problems with airway, breathing, and circulation, and then get on the road! She needs definitive care that can be provided only at the hospital. Reassess her vital signs at least every 5 minutes, but do it en route! If you can rendezvous with an ALS unit en route, do so. However, you should not remain at the scene to wait for them. Nitroglycerin is clearly contraindicated for this patient; her BP is dangerously low.
- Which of the following questions would be MOST appropriate to ask when assessing a
- What does the pain feel like?
- Does the pain radiate to your arm?
- Would you describe the pain as sharp?
- Is the pain worse when you take a deep breath?
patient with chest pain?
Answer: A
When questioning any patient about any type of pain, you should avoid asking leading questions that can simply be answered yes or no. To obtain the most reliable assessment, open- ended questions should be asked to allow the patient to describe the quality of the pain in his or her own words.
- A 60-year-old woman presents with chest discomfort, confusion, and weak- ness. The
- Bradycardia
- Hypovolemia
- Myocardial ischemia
- Respiratory compromise
patient's husband tells you that she vomited once before EMS arrival. The patient's BP is 70/40 mm Hg, her pulse is 45 beats/min and weak, and her respirations are 14 breaths/min and unlabored. Which of the following is the MOST likely cause of her hypotension?
Answer: A
- You are assessing a 70-year-old male who complains of pain in both of his legs. He is
- Left heart failure
- Right heart failure
- Pulmonary edema
- Chronic hypertension
conscious and alert, has a blood pressure of 160/90 mm Hg, a pulse rate of 110 beats/min, and respirations of 14 breaths/min and unlabored. Further assessment reveals edema to both of his feet and legs and jugular venous distention. What should you suspect?
Answer: B
If the right side of the heart is damaged, fluid collects in the body (edema), often showing in the feet and legs. The collection of fluid in the part of the body that is closest to the ground is called dependent edema. The swelling causes relatively few symptoms other than discomfort.Another feature of right heart failure is jugular venous distention, which is an indication of blood backing up into the systemic circulation. Left heart failure typically presents with 2 / 4
shortness of breath due to fluid in the lungs (pulmonary edema), which indicates blood backing up from the left side of the heart into the lungs. In severe pulmonary edema, the patient may cough up pink, frothy sputum. Right heart failure and/or left heart failure are also referred to as congestive heart failure (CHF). Chronic hypertension cannot be established on the basis of a single blood pressure reading.
- A 62-year-old male with a history of coronary artery disease began experiencing chest pain
- Musculoskeletal chest pain
- Acute myocardial infarction
- Unstable angina pectoris
- Stable angina pectoris
and nausea while on his daily jog. After sitting down and resting for 5 minutes, his pain and nausea resolve. Which of the following BEST describes this patient's condition?
Answer: D
Angina pectoris is the principle symptom of coronary artery disease (CAD). It occurs when the heart's demand for oxygen exceeds its supply, usually during periods of physical or emotional stress when the heart is working hard. When the increased oxygen demand goes away, the pain typically resolves. Some patients with angina may also experience shortness of breath, nausea, or diaphoresis.Angina is classified as being "stable" or "unstable." Stable angina is characterized by cardiac- related chest pain that resolves with rest and/or nitroglycerin. Unstable angina is characterized by cardiac-related chest pain that occurs in response to progressively less physical exertion (for example, during rest). Unstable angina is also referred to as pre-infarction angina because it indicates a more severe degree of CAD and can lead to acute myocardial infarction if untreated. In contrast to stable angina, unstable angina typically does not resolve with rest and/or nitroglycerin.Given the patient's medical history, his chest pain should not be assumed to have simply been of a musculoskeletal origin.
- At the end of ventricular relaxation, the left ventricle contains 110 mL of blood. This is
referred to as the:
- preload.
- afterload.
- stroke volume.
- cardiac output.
Answer: A
Preload is the amount of pressure on the ventricular wall at the end of ventricular relaxation (diastole) and is influenced by the volume of blood in the ventricle just before it contracts.Afterload refers to the resistance that the ventricles must contract against. A patient with hypertension, for example, would have an increased afterload due to systemic vasoconstriction; the smaller the arteries, the greater the resistance the heart must contract against. Stroke volume is the volume of blood ejected from the ventricles in a single beat. Cardiac output is the volume of blood pumped by the heart each minute; it is calculated by multiplying the stroke volume and heart rate.
- / 4
- The maximum pressure generated in the arms and legs during contraction of the left
ventricle is called:
- afterload.
- pulse pressure.
- systolic blood pressure.
- diastolic blood pressure.
Answer: C
Blood pressure is the force of circulating blood against the arterial walls. Systolic blood pressure (SBP) is the maximum pressure generated in the arms and legs during contraction of the left ventricle, during the time period known as systole. As the left ventricle relaxes in the stage known as diastole, the arterial pressure falls. When the left ventricle relaxes, the aortic valve closes and blood flow between the left ventricle and the aorta stops. The diastolic blood pressure (DBP) is the pressure exerted against the arterial walls while the left ventricle is at rest, during the time period known as diastole. Pulse pressure is the numeric difference between the SBP and DBP; it represents the force generated by the heart each time it contracts. If the patient's BP is 120/80 mm Hg, the pulse pressure would be 40 mm Hg. Afterload refers to the amount of resistance the left ventricle must contract against. Conditions such as hypertension cause an increase in afterload; as the arteries narrow, the left ventricle must work harder to overcome the increases resistance to forward blood flow.
- A 65-year-old man has generalized weakness and chest pressure. He has
a bottle of prescribed nitroglycerin, but states that he has not taken any of his medication. The
EMT should:
- apply the AED and prepare the patient for immediate transport.
- administer up to 325 mg of aspirin if the patient is not allergic to it.
- assist the patient with his nitroglycerin with medical control approval.
- perform a secondary assessment and obtain baseline vital signs.
Answer: B
Aspirin has clearly been shown to reduce mortality and morbidity associated with acute coronary syndrome (ACS) and should be given as early as possible; the dose is 160 to 325 mg. Even though this patient has chest pain and prescribed nitroglycerin, you must first complete a secondary assessment and obtain baseline vital signs. Medical control will need this information--specifically, the patient's blood pressure--to determine whether you should assist the patient with his nitroglycerin. The AED is not indicated for this patient because he is not in cardiac arrest.
11. A patient who is experiencing an acute myocardial infarction:
- most often describes his or her chest pain as being sharp or tearing.
- has chest pain or discomfort that does not change with each breath.
- often experiences relief of his or her chest pain after taking nitroglycerin.
- often complains of a different type of pain than a patient with angina.
Answer: B
The type of chest pain or discomfort associated with acute myocardial infarction (AMI) is the same that is experienced by patients with angina pectoris (eg, dull, crushing, pressure,
- / 4