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1. You are teaching a class on cardiovascular disease and need to describe what atherosclerosis is.

Which of the following statements is the most appropriate explanation? a. b. c. d. It affects the arteries of the heart and is caused by a heart attack. !he walls of the coronary arteries lose elasticity" which leads to a heart attack. #holesterol and lipid material accumulate within the walls of arteries. It affects veins and is caused by untreated high blood pressure.

$nswer% c &b'ective% 1()* +eference% *,* -. You are called to assist a ,-)year)old female who is complaining of fatigue" 'aw discomfort" and diaphoresis. When asked" she denies having chest pain or shortness of breath. .he tells you that she has a history of hypertension and takes a blood pressure pill. .he also has nitroglycerin. Which statement is inappropriate for this event? a. b. c. d. I am not going to attach the $/0 because she is conscious and has a pulse. .he is not short of breath" so we don1t need to transport her. I am going to call for $2. because she could be having a cardiac event. I am going to check her blood pressure.

$nswer% b &b'ective% 1()( +eference% *3, 4. You have been called to treat a *3)year)old man complaining of chest pain. 5e is alert" oriented" and complaining of pain in his chest that came on suddenly about 1( minutes ago. 5is skin is diaphoretic and cool. Which of the following actions should you take first? a. b. c. d. $pply oxygen at 1( 267 through a nonrebreather mask. +adio for an ambulance with $2.. 5elp him administer his nitroglycerin. &btain a .$762/ history.

$nswer% a &b'ective% 1()8 +eference% *8( *. Which of the following statements indicates that the speaker has an understanding of chest pain and acute myocardial infarction? a. 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. b. If the patient9s chest pain does not go away with nitroglycerin" you can assume that the medication has expired and is no longer effective. c. 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. d. .ome patients experiencing acute myocardial infarction do not have actual chest pain: instead" they may experience a sensation of ;severe heartburn.9

$nswer% d &b'ective% 1()( +eference% *3* (. $ 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? a. b. c. d. .wollen ankles <radycardia <ubbling breathing noises .hortness of breath

$nswer% b &b'ective% 1()( +eference% *3( ,. $spirin may be used in a patient who has chest pain suggestive of a heart attack because aspirin may% a. b. c. d. 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.

$nswer% c &b'ective% 1()8 +eference% *8, 3. You are with a patient who is complaining of chest pain that radiates into his arm and neck. 5e is alert and oriented and has an open airway and ade=uate breathing. 5is pulse is strong and his skin is cool and slightly diaphoretic. 5is pulse is 8*" his respirations are 18" and his blood pressure is >?@,- mm5g. +esponses to .$762/ =uestioning include a history of a previous heart attack and chronic lung disease: an allergy to aspirin: possession of nitroglycerin: and last ate about , hours ago. <ased on this information" you would not: a. b. c. d. assist the patient to take a nitroglycerin tablet. place the patient on oxygen. let him assume a position of comfort. reassess his blood pressure in ( minutes.

$nswer% a &b'ective% 1()8 +eference% *8( 8. You are caring for a patient with chest pain who has 'ust taken his nitroglycerin. !he patient9s chest pain has been alleviated. You understand that nitroglycerin is effective in treating chest pain because it%

a. b. c. d.

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.

$nswer% c &b'ective% 1()8 +eference% *3>. When assisting a patient to take a nitroglycerin tablet" it is% a. b. c. d. placed under the tongue. swallowed with only an ounce of water. chewed and then allowed to dissolve slowly. placed between the cheek and teeth.

$nswer% a &b'ective% 1()8 +eference% *8, 1?. <efore nitroglycerin is administered" you should ensure that% a. b. c. d. nitroglycerin is in fact prescribed for the patient. the patient rates his chest pain as at least 3 on a scale of 1 to 1?. the patient9s systolic blood pressure is at least 11? mm5g. the patient is standing.

$nswer% a &b'ective% 1()8 +eference% *8, 11. Which of the following medications" if taken in the last -* hours" would be a contraindication to administering nitroglycerin? a. b. c. d. #oumadin $spirin Aiagra !ylenol

$nswer% c &b'ective% 1()8 +eference% *8, 1-. You are assisting a ,3)year)old patient with chest pain. 5e has taken two nitroglycerin tablets but his pain remains a 3 out of 1?. 5e is diaphoretic: his respirations are 18 per minute and ade=uate: his pulse is 3-: and his blood pressure 8?@,- mm5g. 5e is on a nonrebreather mask at 1(2 per minute. You would% a. assist him in taking his third and final nitroglycerin tablet. b. attach him to an $/0.

c. reassess his vital signs every ( minutes and transfer him by $2. care. d. give him only half of a nitroglycerin tablet. $nswer% c &b'ective% 1()8 +eference% *8, 14. Which of the following actions is most important before assisting a patient to take prescribed nitroglycerin? a. b. c. d. 0etermine whether the patient has any allergies. /valuate the patient9s blood pressure. 0etermine whether the patient has a headache. $ttach the patient to an $/0.

$nswer% b &b'ective% 1()8 +eference% *8, 1*. When obtaining a medical history" which of the following statement made by a patient is classic for a patient with stable angina? a. b. c. d. I took three nitroglycerin over 1( minutes" but I still have pain. When I stopped exercising" the pain went away. !he pain started when I was sitting down and reading the newspaper. !he pain lasted about *( minutes before it gradually went away.

$nswer% b &b'ective% .upplemental +eference% *,,)*,3 1(. You are in the first)aid area assisting a patient who 'ust arrived with chest pain. 5e relates a history of angina that usually resolves with nitroglycerin. !he patient states that the pain started when he was skiing through the bumps. &ver the last -? minutes" he has taken three nitroglycerin tablets and rested" but the pain has not gone away. Your next action would be to% a. b. c. d. try one more nitroglycerin tablet because nitroglycerin usually relieves his pain. attach an $/0 in case he goes into cardiac arrest. place him on high)flow oxygen. check his blood pressure because he has taken three nitroglycerin tablets.

$nswer% c &b'ective% 1()8 +eference% *8( 1,. $n &/# !echnician indicates that she understands the difference between stable angina and an acute myocardial infarction B7IC when she states% a. .table angina occurs when the heart rate becomes too high: an acute 7I is the result of coronary artery disease.

b. .table angina is not accompanied by other symptoms such as shortness of breath: the chest pain of an acute 7I is. c. !he pain in an acute 7I is typically described as stabbing : the pain with stable angina is more akin to pressure. d. $n acute myocardial infarction results in the death of cardiac tissue: stable angina causes ischemia to the heart muscle. $nswer% d &b'ective% 1()* +eference% *,, 13. Which of the following signs or symptoms is suggestive of right)sided congestive heart failure? a. b. c. d. /levated blood pressure /dema in the legs and feet $ bounding pulse $n irregular heart rate

$nswer% b &b'ective% 1()( +eference% *,( 18. $n alert and oriented ,()year)old woman presents with shortness of breath" noisy respirations" 'ugular vein distention" and edema in her feet and ankles. 5er pulse is 14-" her respirations are -*" and her blood pressure is 8,@,8. <ased on these findings" you would suspect that the patient% a. b. c. d. has an aortic dissection@aneurysm. is having a hypertensive emergency. is experiencing congestive heart failure. 5as pericardial tamponade.

$nswer% c &b'ective% 1()( +eference% *3( 1>. You have 'ust arrived with an $/0 at a scene where fellow &/# !echnicians are treating a patient in cardiac arrest. $2. has been contacted and is about 1 minute away. Which of the following actions would you take? a. b. c. d. 2et the &/# !echnicians continue #6+ and wait for $2.. $pply and use the $/0. +elieve the &/# !echnician doing chest compressions. Do outside to direct $2. when they arrive.

$nswer% b &b'ective% 1()1? +eference% *84

-?. Which of the following statements made by a patient would cause you to suspect an aortic abdominal aneurysm? a. b. c. d. I have really bad belly pain that I also feel in my back. 7y heart is beating so hard" you can feel it on my chest. !he pain is sharp and spreads to both arms. I seem to be vomiting up some blood.

$nswer% a &b'ective% 1()( +eference% *3( -1. You are assessing a ,8)year)old man who is complaining of severe abdominal pain that radiates to his back. 5e tells you that he has a history of an abdominal aortic aneurysm. <ased on this history and his complaints" on your physical exam you would look for% a. b. c. d. bruising on his abdomen. a pulsating mass in his abdomen. blood pressure that is higher in one arm than in the other. abdominal pain that is relieved when you place the patient on his side.

$nswer% b &b'ective% 1()3 +eference% *3( --. <lood in the right ventricle is pumped into the% a. b. c. d. left ventricle. pulmonary artery. left atrium. aorta.

$nswer% b &b'ective% 1()4 +eference% *(> -4. Which of the following statements concerning arteries is true? a. b. c. d. !hey carry blood away from the heart. !hey have a lower pressure than veins. !hey always carry oxygenated blood. !hey drain into the venae cavae.

$nswer% a &b'ective% 1()1 +eference% *,? -*. Which of the following statements concerning the cardiovascular system is true? a. It consists of four ma'or components% the heart" the lungs" the blood vessels" and blood.

b. !he heart is a muscular organ located behind and to the right of the sternum. c. $n electrical impulse that starts in the right atrium stimulates contraction of the heart muscle. d. !he subclavian arteries supply blood to the pelvis and legs. $nswer% c &b'ective% 1()1 +eference% *,? -(. !he largest artery in the body is the% a. b. c. d. carotid artery. femoral artery. aorta. 'ugular artery.

$nswer% c &b'ective% 1()1 +eference% *,? -,. !he walls of the capillaries are only one cell thick. !his allows the exchange of nutrients and oxygen and waste products. !he capillaries serve as the bridge between% a. b. c. d. arterioles and venules. the atrium right and the left atrium. the pulmonary vein and the pulmonary artery. arteries and veins.

$nswer% a &b'ective% 1()4 +eference% *,-3. Which of the following statements concerning the flow of blood to and through the right side of the heart is correct? a. <lood 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. b. 6oorly 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. c. &xygenated 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. d. 6oorly 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. $nswer% d &b'ective% 1()4 +eference% *(>

-8. Which of the following structures help direct blood flow forward and prevent the backflow of blood within the heart? a. b. c. d. .epta !he coronary arteries !he atrioventricular valves !he pulmonary vein and the pulmonary artery

$nswer% c &b'ective% 1()4 +eference% *(> ->. !he left side of the heart% a. b. c. d. 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.

$nswer% b &b'ective% 1()4 +eference% *(> 4?. $ thickening and loss of elasticity of the arterial walls is known as% a. b. c. d. arteriosclerosis. high blood pressure. angina pectoris. atherosclerosis.

$nswer% a &b'ective% 1()* +eference% *,( 41. $ patient tells you that he has been diagnosed with coronary artery disease. You recogniEe this diagnosis to mean that the patient has% a. b. c. d. 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.

$nswer% d &b'ective% 1()* +eference% *,* 4-. You are preparing to teach a class on hypertension. Which of the following statements provides incorrect information that you would not include in your presentation?

a. 5ypertension is defined as a blood pressure with a systolic reading greater than 1*? or a diastolic reading greater than >?. b. !here are no known treatable risk factors for hypertension. c. !he increased pressure in hypertension damages small arteries in many of the body9s organs. d. 5ypertension results from the restriction of blood flow when the internal diameter of small arterioles is reduced by atherosclerosis or other factors. $nswer% b &b'ective% 1()* +eference% *,( 44. Which of the following statements about cardiovascular disease B#A0C is false? a. b. c. d. #A0 involves a number of diseases that affect either the heart or blood vessels. #A0 is the leading cause of death worldwide. 7ost cases of #A0 are congenital and could be prevented with improved prenatal care. !he underlying cause of most cases of #A0 is coronary artery disease or atherosclerosis of the coronary arteries.

$nswer% c &b'ective% 1()* +eference% *,( 4*. &ne complication of an acute myocardial infarction may be cardiogenic shock. <ased on your training" you would define cardiogenic shock as aBnC% a. condition whereby tissues of the body are oxygen deprived due to the heart9s inability to ade=uately pump blood. b. absolute or relative shortage of blood supply to a tissue due to a blood clot. c. abrupt cessation of the regular electrical activity of the heart. d. acute illness in which the cardiac muscle does not get enough oxygen. $nswer% a &b'ective% 1()( +eference% *,,F*,3 4(. 5ypotension" distended neck veins" and muffled or distant heart tones in which the heartbeat is difficult to auscultate are hallmark signs of% a. b. c. d. pericarditis. congestive heart failure. aortic aneurysm. pericardial tamponade.

$nswer% d &b'ective% 1()( +eference% *3(

4,. $ ,-)year)old man presents with a complaint of abdominal pain radiating to his groin. 5e also complains of diEEiness. &n examination" his abdomen is tender and you feel a large pulsatile mass. 5is signs and symptoms are suggestive of% a. b. c. d. acute embolism. an abdominal aortic aneurysm. a ruptured spleen. cardiogenic shock.

$nswer% b &b'ective% 1()( +eference% *3( 43. Your neighbor tells you that he is concerned about his 3?)year)old wife. .he is at home recovering from a heart attack that occurred about 4 weeks ago. 5e explains that over the last few days her ankles and lower legs have been gradually swelling and are painful to touch. !oday she seems to be a little short of breath. You recommend that your neighbor seek immediate medical attention because these findings are suggestive of% a. b. c. d. congestive heart failure. tension pneumothorax. an acute myocardial infarction. pericarditis.

$nswer% a &b'ective% 1()( +eference% *3( 48. You are out shopping when a middle)aged man suddenly falls to the ground. You =uickly run to assist him and note that he is not breathing and does not have a carotid pulse. You begin #6+ because you know that prompt intervention with an $/0 is needed. Which of the following statements is not a reason that prompt intervention with an $/0 is needed? a. .ince $/0 was first used by trained and lay rescuers" patient survival from sudden cardiac arrest has doubled. b. !wo common arrhythmias that are associated with sudden cardiac deathGventricular fibrillation and pulseless ventricular tachycardiaGcan respond to $/0 use. c. $systole" which can accompany an acute 7I" is often reversed by the use of an $/0. d. .tudies show that after 1? minutes of pulseless cardiac arrest due to A)fib or A)tach" the heart is less responsive to electrical stimulation. $nswer% c &b'ective% 1(), +eference% *,8 4>. When performing cardiac compressions on a 1-)year)old child" you would% a. administer cycles of 4? chest compressions followed by two breaths. b. compress the chest about 1 inch. c. recheck the pulse every four cycles.

d. place the heel of your hand on the upper section of the sternum. $nswer% a &b'ective% 1()1? +eference% *8? *?. Which of the following is not a reason to stop #6+? a. b. c. d. !he patient has the spontaneous return of a pulse and breathing. You are ready to use an $/0. It has been -( minutes" so brain damage has occurred. +escuers are too tired to continue administering #6+.

$nswer% c &b'ective% 1()1? +eference% *33 *1. In performing #6+ on an infant% a. place two fingers on the sternum 'ust beneath an imaginary line between the nipples" and make compressions that are approximately one)third the depth of the chest. b. stop to check for a pulse after administering about 1?? compressions. c. place the heel of one hand on the sternum 'ust above an imaginary line between the nipples" and make compressions that are about H inch deep. d. check the carotid artery for a pulse before beginning compressions. $nswer% a &b'ective% 1()1? +eference% *81 *-. !hree commonly used cardiac medications are% a. b. c. d. 6lavix" Iitroglycerine" and $lbuterol. Iitroglycerine" #oumadin" and 2asix. 2ipitor" 0ilantin" and !enormin. #oumadin" Jesteril" and an /pi)pen.

$nswer% b &b'ective% 1()> +eference% *83 *4. Which of the following actions is not an action you should take when using an $/0? a. /nsure that no one is touching the patient when analyEing the patient9s heart rhythm and when delivering a shock. b. /nsure that the chest is dry and wiped clean of any medications. c. $pply any set of electrodes as patient age is not relevant. d. Kse the electrode to rip away excess chest hair if the electrode is not sticking well to the chest.

$nswer% c &b'ective% 1()11 +eference% *84 **. You are assessing a 48)year)old woman who is complaining of the sudden onset of chest pain and dyspnea. .he describes the pain as sharp and states that it increases when she takes a deep breath. You note that she is tachypneic. 5er <6 is 14?@8- and her pulse is 1??. <ased on her presentation" you suspect that she may have% a. b. c. d. pulmonary embolism. pericardial effusion. unstable angina. an aortic dissection@aneurysm.

$nswer% a &b'ective% 1()( +eference% *3-" *3, *(. $fter 'ogging with your friend for about 4? 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. <ased on your understanding of the cardiovascular system" your best response would be which of the following statements? a. You9re out of shape. !hose things wouldn9t happen if you exercised more. b. /xercise makes your body need more nutrients and oxygen: your heart pumps harder and faster to deliver more blood containing those things to your muscles. c. When you exercise" your blood pressure increases" so your heart has to work harder to overcome the higher blood pressure. d. /xercise pushes more blood into your heart" so your heart has to work harder and faster to pump the blood out so you don9t go into heart failure. $nswer% b &b'ective% 1()+eference% *,*