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WorksheetsOutdoor Emergency Care Chapter 15
Total questions: 37
Worksheet time: 37mins
You are called to assist a 62-year-old female who is complaining of fatigue, jaw discomfort, and diaphoresis. When asked, she denies having chest pain or shortness of breath. She tells you that she has a history of hypertension and takes a blood pressure pill. She also has nitroglycerin. Which of the following statements made by your assistant would require intervention on your part?
“I am not going to attach the AED because she is conscious and has a pulse.”
“She is not short of breath, so we don't need to transport her.”
“I am going to call for ALS because she could be having a cardiac event.”
“I am going to check her blood pressure.”
You have been called to treat a 47-year-old man complaining of chest pain. He is alert, oriented, and complaining of pain in his chest that came on suddenly about 15 minutes ago. His skin is diaphoretic and cool. Which of the following actions should you take first?
Apply oxygen at 15 LPM through a nonrebreather mask.
Radio for an ambulance with ALS.
Help him administer his nitroglycerin.
Obtain a SAMPLE history.
Which of the following statements indicates that the speaker has an understanding of chest pain and acute myocardial infarction?
“If the chest pain started during activity, it is most likely cardiac in origin. If the pain started while the patient was at rest, it is most likely not cardiac in origin.”
“If the patient’s chest pain does not go away with nitroglycerin, you can assume that the medication has expired and is no longer effective.”
“If the patient experiences chest pain that radiates into the left arm, it is most likely a heart attack. If the pain radiates anywhere else, it is most likely not cardiac in origin.”
“Some patients experiencing acute myocardial infarction do not have actual chest pain; instead, they experience a sensation of ‘severe heartburn.’ ”
A patient with chest pain informs you that he has "a bad heart". You think he may have congestive heart failure. When performing your secondary assessment, which of the following signs or symptoms does not indicate that the patient is in congestive heart failure?
Swollen ankles
Bradycardia
Bubbling breathing noises
Shortness of breath
Aspirin may be used in a patient who has chest pain suggestive of a heart attack because aspirin may:
break up a blood clot that is occluding a coronary artery.
relieve the headache that is caused by the administration of nitroglycerin.
decrease the ability of platelets to form clots.
decrease the chest pain caused by the possible heart attack.
You are caring for a patient with chest pain who has just taken his nitroglycerin. The patient’s chest pain has been alleviated. You understand that nitroglycerin is effective in treating chest pain because it:
increases the heart rate and gets more blood to the heart muscle.
has a sedative effect, which makes the patient less aware of the pain.
dilates the arteries and veins, which decreases the workload on the heart.
causes the body to relax, decreasing the need for oxygen.
When assisting a patient to take a nitroglycerin tablet, it is:
placed under the tongue.
swallowed with only an ounce of water.
chewed and then allowed to dissolve slowly.
placed between the cheek and teeth.
Before nitroglycerin is administered, you should ensure that:
nitroglycerin is in fact prescribed for the patient.
the patient rates his chest pain as at least 7 on a scale of 1 to 10.
the patient’s systolic blood pressure is at least 110 mmHg.
the patient is standing.
Which of the following medications, if taken in the last 24 hours, would be a contraindication to administering nitroglycerin?
Coumadin
Aspirin
Viagra
Tylenol
You are assisting a 67-year-old patient with chest pain. He has taken two nitroglycerin tablets but his pain remains a 7 out of 10. He is diaphoretic; his respirations are 18 per minute and adequate; his pulse is 72; and his blood pressure 80/62 mmHg. He is on a nonrebreather mask at 15L per minute. You would:
assist him in taking his third and final nitroglycerin tablet.
attach him to an AED.
reassess his vital signs every 5 minutes and transfer him by EMS care.
give him only half of a nitroglycerin tablet.
Which of the following actions is most important before assisting a patient to take prescribed nitroglycerin?
Determine whether the patient has any allergies.
Evaluate the patient’s blood pressure.
Determine whether the patient has a headache.
Attach the patient to an AED.
You are in the first-aid area assisting a patient who just arrived with chest pain. He relates a history of angina that usually resolves with nitroglycerin. The patient states that the pain started when he was skiing through the bumps. Over the last 20 minutes, he has taken three nitroglycerin tablets and rested, but the pain has not gone away. Your next action would be to:
try one more nitroglycerin tablet because nitroglycerin usually relieves his pain.
attach an AED in case he goes into cardiac arrest.
place him on high-flow oxygen.
check his blood pressure because he has taken three nitroglycerin tablets.
Which of the following signs or symptoms is suggestive of right-sided congestive heart failure?
Elevated blood pressure
Edema in the legs and feet
A bounding pulse
An irregular heart rate
An alert and oriented 65-year-old woman presents with shortness of breath, noisy respirations, jugular vein distention, and edema in her feet and ankles. Her pulse is 132, her respirations are 24, and her blood pressure is 86/68. Based on these findings, you would suspect that the patient:
has an aortic dissection/aneurysm.
is having a hypertensive emergency.
is experiencing congestive heart failure.
Has pericardial tamponade.
You have just arrived with an AED at a scene where fellow OEC Technicians are treating a patient in cardiac arrest. ALS has been contacted and is about 1 minute away. Which of the following actions would you take?
Let the OEC Technicians continue CPR and wait for ALS.
Apply and use the AED.
Relieve the OEC Technician doing chest compressions.
Go outside to direct ALS when they arrive.
Which of the following statements made by a patient would cause you to suspect an abdominal aortic aneurysm?
“I have really bad belly pain that I also feel in my back.”
“My heart is beating so hard, you can feel it on my chest.”
“The pain is sharp and spreads to both arms.”
“I seem to be vomiting up some blood.”
You are assessing a 68-year-old man with a history of abdominal aortic aneurysm. How far might pain be radiating?
Groin
Knee
Ankles
Toes
Blood in the right ventricle is pumped into the:
left ventricle.
pulmonary artery.
left atrium.
aorta.
Which of the following statements concerning arteries is true?
They carry blood away from the heart.
They have a lower pressure than veins.
They always carry oxygenated blood.
They drain into the venae cavae.
Which of the following statements concerning the cardiovascular system is true?
It consists of four major components: the heart, the lungs, the blood vessels, and blood.
The heart is a muscular organ located behind and to the right of the sternum.
An electrical impulse that starts in the right atrium stimulates contraction of the heart muscle.
The subclavian arteries supply blood to the pelvis and legs.
The largest artery in the body is the:
carotid artery.
femoral artery.
aorta.
jugular artery.
The walls of the capillaries are only one cell thick. This allows the exchange of nutrients and oxygen and waste products. The capillaries serve as the bridge between:
arterioles and venules.
the atrium right and the left atrium.
the pulmonary vein and the pulmonary artery.
arteries and veins.
Which of the following statements concerning the flow of blood to and through the right side of the heart is correct?
Blood reaches the right atrium from the aorta, is pumped through the mitral valve into the right ventricle, and is then pumped through the pulmonary veins to the lungs.
Poorly oxygenated blood reaches the right ventricle from the venae cavae, is pumped through the pulmonic valve into the pulmonary artery, and then enters the right atrium and is pumped into the lungs.
Oxygenated blood reaches the right atrium from the pulmonary veins, is pumped through the tricuspid valve into the right ventricle, and is then pumped into the aorta and throughout the body.
Poorly oxygenated blood reaches the right atrium from the venae cavae, is pumped through the tricuspid valve into the right ventricle, and is then pumped through the pulmonic valve and on to the lungs through the pulmonary arteries.
The left side of the heart:
receives poorly oxygenated blood from the body.
pumps oxygenated blood to the body.
contains the pulmonic and tricuspid valves.
pumps poorly oxygenated blood to the lungs.
A patient tells you that he has been diagnosed with coronary artery disease. You recognize this diagnosis to mean that the patient has:
a history of acute myocardial infarction.
had an operation known as coronary artery bypass grafting.
a failure of the heart to efficiently pump blood.
narrowing of the small arteries that supply blood and oxygen to the heart.
Which of the following statements about cardiovascular disease (CVD) is false?
CVD involves a number of diseases that affect either the heart or blood vessels.
CVD is the leading cause of death worldwide.
Most cases of CVD are congenital and could be prevented with improved prenatal care.
The underlying cause of most cases of CVD is coronary artery disease or atherosclerosis of the coronary arteries.”
Hypotension, distended neck veins, and muffled or distant heart tones in which the heartbeat is difficult to auscultate are hallmark signs of:
pericarditis.
congestive heart failure.
aortic aneurysm.
pericardial tamponade.
A 62-year-old man presents with a complaint of abdominal pain radiating to his groin. He also complains of dizziness. On examination, his abdomen is tender and you feel a large pulsatile mass. His signs and symptoms are suggestive of:
acute embolism.
an abdominal aortic aneurysm.
a ruptured spleen.
cardiogenic shock.
Your neighbor tells you that he is concerned about his 70-year-old wife. She is at home recovering from a heart attack that occurred about 3 weeks ago. He explains that over the last few days her ankles and lower legs have been gradually swelling and are painful to touch. Today she seems to be a little short of breath. You recommend that your neighbor seek immediate medical attention because these findings are suggestive of:
congestive heart failure.
tension pneumothorax.
an acute myocardial infarction.
pericarditis.
You are out shopping when a middle-aged man suddenly falls to the ground. You quickly run to assist him and note that he is not breathing and does not have a carotid pulse. You begin CPR because you know that prompt intervention with an AED is needed. Which of the following statements is not a reason that prompt intervention with an AED is needed?
Since AED was first used by trained and lay rescuers, patient survival from sudden cardiac arrest has doubled.
Two common arrhythmias that are associated with sudden cardiac death—ventricular fibrillation and pulseless ventricular tachycardia—can respond to AED use.
Asystole, which can accompany an acute MI, is often reversed by the use of an AED.
Studies show that after 10 minutes of pulseless cardiac arrest due to V-fib or V-tach, the heart is less responsive to electrical stimulation.
Which of the following is not a reason to stop CPR?
The patient has the spontaneous return of a pulse and breathing.
You are ready to use an AED.
It has been 25 minutes, so brain damage has occurred.
Rescuers are too tired to continue administering CPR.
Three commonly used cardiac medications are:
Plavix, Nitroglycerine, and Albuterol.
Nitroglycerine, Coumadin, and Lasix.
Lipitor, Dilantin, and Tenormin.
Coumadin, Zesteril, and an Epi-pen.
You are assessing a 38-year-old woman who is complaining of the sudden onset of chest pain and dyspnea. She describes the pain as sharp and states that it increases when she takes a deep breath. You note that she is tachypneic. Her BP is 130/82 and her pulse is 100. Based on her presentation, you suspect that she may have:
pulmonary embolism.
pericardial effusion.
unstable angina.
an aortic dissection/aneurysm.
After jogging with your friend for about 30 minutes, she stops and asks why your heart rate increases and your heart feels like it is pumping harder after you exercise for a while. Based on your understanding of the cardiovascular system, your best response would be which of the following statements?
“You’re out of shape. Those things wouldn’t happen if you exercised more.”
“Exercise makes your body need more nutrients and oxygen; your heart pumps harder and faster to deliver more blood containing those things to your muscles.”
“When you exercise, your blood pressure increases, so your heart has to work harder to overcome the higher blood pressure.”
“Exercise pushes more blood into your heart, so your heart has to work harder and faster to pump the blood out so you don’t go into heart failure.”
When performing CPR, your philosophy should be:
“Don't break ribs.”
“Push hard, push fast.”
“Always be careful.”
“Obtain informed consent.”
The only reason to delay transport in case of a cardiac emergency is:
to use an AED.
to take a complete history.
to provide nitroglycerin.
to make the patient comfortable.
How do most problems with heart valves originate?
From medication errors
Due to injury
Congenitally
Due to viral infection
