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Understanding Atrial Fibrillation Treatment

Total questions: 21

Worksheet time: 13mins

Name
Class
Date
1.

What is the most common type of sustained cardiac arrhythmia encountered in adults?

a)

Ventricular fibrillation

b)

Atrial fibrillation

c)

Sinus tachycardia

d)

Supraventricular tachycardia

2.

Atrial fibrillation lasting more than seven days is known as

a)

Paroxysmal

b)

Persistent

c)

Acute

d)

Subacute

3.

Which medication is commonly used by paramedics to control ventricular rate in atrial fibrillation?

a)

Amiodarone

b)

Metoprolol

c)

Atropine

d)

Epinephrine

4.

What is the most common cause of atrial fibrillation?

a)

Advanced age

b)

Alcohol

c)

Smoking

d)

Congenital heart disease

e)

Family history

5.

Atrial fibrillation with Rapid Ventricular Response typically has a heart rate greater than

a)

80

b)

100

c)

110

d)

151

6.

Typically, an initiating trigger excites an ectopic focus in the atria, most commonly around the area of the

a)

Appendage

b)

Pulmonary veins

c)

Carotid arteries

d)

Great arch

e)

Tricuspid valve

7.

Which ECG finding is most characteristic of atrial fibrillation?

a)

Regularly spaced QRS complexes

b)

Absence of P waves and irregularly irregular rhythm

c)

Presence of delta waves

d)

Prolonged QT interval

8.

A 70-year-old female with a history of hypertension and diabetes presents with sudden onset palpitations, dizziness, and shortness of breath. Her ECG shows an irregularly irregular rhythm without discernible P waves, indicative of atrial fibrillation. As a critical care paramedic, what is the most appropriate initial intervention for this patient?

a)

Administer Epinephrine 1mg IV push.

b)

Start an IV and administer Amiodarone 150mg IV push

c)

Perform synchronized cardioversion with 50-200 joules.

d)

Consider administering Diltiazem 0.25 mg/kg IV over 2 minutes.

e)

Administer aspirin 81 mg

9.

Which of the following is an appropriate initial step for a paramedic treating a stable patient with new-onset atrial fibrillation?

a)

Immediate defibrillation

b)

Obtain a 12-lead ECG

c)

Administer epinephrine

d)

Start chest compressions

10.

A paramedic is called to treat a patient with rapid atrial fibrillation. Which medication should be considered to slow the ventricular rate if the patient is stable?

a)

Adenosine

b)

Diltiazem

c)

Lidocaine

d)

Atropine

11.

When preparing for synchronized cardioversion in a patient with atrial fibrillation, what is the most important safety step?

a)

Ensure the patient is fasting

b)

Confirm synchronization mode is selected on the defibrillator

c)

Administer aspirin

d)

Place the patient in a prone position

12.

A patient with atrial fibrillation is experiencing hypotension and altered mental status. What is the most appropriate paramedic intervention?

a)

Administer oral beta-blockers

b)

Prepare for immediate synchronized cardioversion

c)

Give sublingual nitroglycerin

d)

Observe and monitor

13.

Which of the following best explains why atrial fibrillation increases the risk of stroke?

a)

It causes high blood pressure

b)

It leads to blood pooling and clot formation in the atria

c)

It increases heart rate

d)

It causes dehydration

14.

A paramedic is treating a patient with atrial fibrillation and a rapid ventricular response. The patient is allergic to beta-blockers. Which class of medication is an alternative for rate control?

a)

Calcium channel blockers

b)

Nitrates

c)

Antiplatelet agents

d)

Diuretics

15.

A 71-year-old man with chronic non-ischemic cardiomyopathy and hypertension presents to the emergency department with shortness of breath that started 2 days ago. His last known ejection fraction is 40%. His vitals are blood pressure 110/60 mm Hg, heart rate 125 bpm, respiratory rate 20 breaths/min, and oxygen saturation 94% on ambient air. An ECG rhythm strip is shown below. What is the most appropriate treatment for this patient's arrhythmia at this time?

a)

Diltiazem

b)

Amiodarone

c)

Digoxin

d)

Metoprolol

16.

A paramedic is called to a patient with palpitations and an irregularly irregular pulse. The ECG shows no discernible P waves. What is the most likely diagnosis, and what evidence supports this conclusion?

a)

Sinus tachycardia; regular rhythm and visible P waves

b)

Atrial fibrillation; irregular rhythm and absence of P waves

c)

Ventricular tachycardia; wide QRS complexes

d)

Atrial flutter; sawtooth P waves

17.

A patient with atrial fibrillation is hemodynamically unstable. The paramedic must decide between pharmacological and electrical cardioversion. What factors should guide this decision?

a)

Patient’s age and gender

b)

Hemodynamic status and duration of arrhythmia

c)

Patient’s weight and height

d)

Time of day

18.

A paramedic is treating a patient with atrial fibrillation who is on anticoagulation therapy. The patient develops sudden shortness of breath and chest pain. What should the paramedic suspect, and what evidence supports this?

a)

Pulmonary embolism; atrial fibrillation increases risk of thromboembolism

b)

Asthma attack; history of respiratory issues

c)

Myocardial infarction; chest pain only

d)

Pneumonia; shortness of breath only

19.

Explain how the loss of atrial contraction in atrial fibrillation can affect cardiac output, especially in elderly patients or those with heart failure.

a)

It increases cardiac output by improving ventricular filling

b)

It decreases cardiac output due to loss of atrial kick, which is more significant in compromised hearts

c)

It has no effect on cardiac output

d)

It causes bradycardia, which increases output

20.

Which of the following medical disorders increases the risk of developing atrial fibrillation?

a)

Diabetes insipidus

b)

Hyperthyroidism

c)

Renal failure

d)

Hyperkalemia

21.

Which of the following is an antiarrhythmic drug that has a predominant Class III effect and impacts the SA and AV nodes, as well as the His-Purkinje system?

a)

Epinephrine

b)

Metoprolol

c)

Amiodarone

d)

Diltiazem

e)

Digoxin