Quiz 1.8

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Ritameeker
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216333
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Quiz 1.8
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2013-04-28 14:16:47
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Cardiology
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Quiz 1.8 - Cardiology
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  1. The presence of an inverted T wave on an ECG indicates:

    A. myocardial infarction
    B. myocardial ischemia
    C. myocardial injury
    D. myocardial necrosis
    B. myocardial ischemia
    (this multiple choice question has been scrambled)
  2. Which of the following would eliminate a patient from consideration for fibrinolytic therapy?

    A. hemorrhagic stroke six months ago
    B. age less than 40 years
    C. hypertension controlled with a calcium channel blocker
    D. history of type II diabetes
    A. hemorrhagic stroke six months ago
    (this multiple choice question has been scrambled)
  3. Which of the following is LEAST likely to be associated with the pain of acute myocardial infarction?

    A. pain reproducible with palpation
    B. radiation to arms and neck
    C. pain described as sharp
    D. a sensation described as pressure
    A. pain reproducible with palpation
    (this multiple choice question has been scrambled)
  4. A 48 year-old male is complaining of CP the he describes as dull, located substernally, but radiating to his neck.  He rates the pain a 6 on a scale of 1 to 10 and complains of nausea and lightheadedness.  His skin is cool and diaphoretic.  HR=96, BP=124/82, RR=14, SaO2=97%.  The 12 lead ECG is nondiagnostic.  In addition to oxygen, an IV of normal saline at a keep open rate, and transport to the emergency department, which of the following would be most appropriate?

    A. Nitroglycerin, morphine, and furosemide
    B. Reassurance that likely his condition is not cardiac in nature
    C. Nitroglycerin
    D. Aspirin, nitroglycerin, and morphine
    D. Aspirin, nitroglycerin, and morphine
    (this multiple choice question has been scrambled)
  5. Which of the following ECG findings is LEAST anticipated in a patient experiencing an acute myocardial infarction?

    A. ST depression
    B. Osborn wave
    C. ST elevation
    D. QRS greater than 0.12 seconds
    B. Osborn wave
    (this multiple choice question has been scrambled)
  6. Your Pt is a 32 yo female, 30 wks pregnant, complaining of SOB and palpitations.  She is alert & oriented, though anxious; her skin is cool and moist, and her radial pulse is weak and rapid, but regular.  HR=180, BP=100/72, RR=24.  The monitor shows supraventricular tachycardia.  After applying oxygen by nonrebreather and starting an IV of normal saline, which of the following is most appropriate?

    A. Transport without further intervention
    B. 2 mg of Versed and cardioversion beginning at 50 joules
    C. 150 mg of Amiodarone
    D. 6 mg of Adenosine
    D. 6 mg of Adenosine
    (this multiple choice question has been scrambled)
  7. Your Pt is a 58 yo female who is confused and dyspneic.  Her daughter called EMS bc the Pt complained of a fluttering sensation in her chest, followed a few minutes later by CP and an acute onset of confusion.  She is pale and diaphoretic without a palpable radial pulse.  The monitor shows a narrow complex rhythm at a rate of 180.  Which of the following is most appropriate?

    A. Immediate synchronized cardioversion
    B. Valsalva maneuver
    C. IV Adenosine
    D. IV Diltiazem
    A. Immediate synchronized cardioversion
    (this multiple choice question has been scrambled)
  8. Which of the following will occur with an increase in peripheral vascular resistance?

    A. decreased afterload
    B. increased preload
    C. decreased stroke volume
    D. increased ejection fraction
    C. decreased stroke volume
    (this multiple choice question has been scrambled)
  9. Myocardial ischemia may result in:

    A. ST segment depression
    B. J waves
    C. inverted P waves
    D. QRS duration greater than 0.12 seconds
    A. ST segment depression
    (this multiple choice question has been scrambled)
  10. An increase in afterload results in a(n) _____ workload of the heart, especially in the _____ ventricle.

    A. decreased, left
    B. increased, left
    C. decreased, right
    D. increased, right
    B. increased, left
    (this multiple choice question has been scrambled)
  11. The most common cause of death resulting from myocardial infarction is:

    A. dysrhythmia
    B. inadequate tissue perfusion
    C. end-organ failure
    D. heart failure
    B. inadequate tissue perfusion
    (this multiple choice question has been scrambled)
  12. Which of the following most accurately describes a Valsalva maneuver?

    A. Asking the patient to bear down as if to move his bowels with his nose and mouth closed
    B. Firmly pressing the carotid artery against the transverse process of the vertebra
    C. Digital rectal stimulation
    D. Immersing the face in cold water
    A. Asking the patient to bear down as if to move his bowels with his nose and mouth closed
    (this multiple choice question has been scrambled)
  13. A 64 yo female is alert and oriented, in moderate respiratory distress, and complaining of CP.  She describes an acute onset of right-sided CP that radiates across her chest.  Physical examination reveals cold, diaphoretic skin; lung sounds with rales bilaterally; JVD; and peripheral edema.  Medical history includes hypertension, prior myocardial infarction, and heart failure.  HR=128, BP=86/56, RR=26, SaO2=92%.  Which of the following is appropriate in the prehospital treatment of this Pt?

    A. Dopamine
    B. Amiodarone
    C. Nitroglycerine
    D. Morphine
    A. Dopamine
    (this multiple choice question has been scrambled)
  14. Which of the following rhythms requires transcutaneous pacing?

    A. symptomatic third-degree AV block
    B. sinus bradycardia
    C. supraventricular tachycardia
    D. junctional tachycardia
    A. symptomatic third-degree AV block
    (this multiple choice question has been scrambled)
  15. Which of the following is NOT considered a modifiable risk factor for coronary heart disease?

    A. diet
    B. gender
    C. obesity
    D. stress
    B. gender
    (this multiple choice question has been scrambled)
  16. Which of the following most accurately describes the etiology of Wolff-Parkinson-White syndrome?

    A. shifting supraventricular pacemaker sites
    B. idiopathic
    C. increased automaticity
    D. presence of an accessory conduction pathway
    D. presence of an accessory conduction pathway
    (this multiple choice question has been scrambled)
  17. A 35 yo male is complaining of a HA, blurred vision, nausea, and vomiting.  He has a hx of HTN but is noncompliant with his medications.  His pupils are equal and reactive, his skin is warm and dry, and his breath sounds are clear and equal bilaterally.  HR=72, BP=192/138, RR=12, SaO2=99%.  In addition to monitoring his cardiac rhythm, administering oxygen, and starting an IV at a KVO rate, which of the following is most appropriate?

    A. Nitroglycerin, SL
    B. Morphine, IV
    C. Labetalol, IV
    D. Diazepam, IV
    C. Labetalol, IV
    (this multiple choice question has been scrambled)
  18. Which of the following most accurately differentiates cardioversion from defibrillation?

    A. the electrical stimulation of cardioversion travels at a slower rate through the myocardium
    B. cardioversion cannot e used in patients who have a pulse
    C. cardioversion requires fewer than 100 joules
    D. cardioversion is times to be synchronous with the patient's R wave
    D. cardioversion is timed to be synchronous with the patient's R wave
    (this multiple choice question has been scrambled)
  19. PSVT is LEAST likely to occur secondary to:

    A. Wolff-Parkinson-White syndrome
    B. ingestion of caffeine
    C. stress
    D. myocardial infarction
    D. myocardial infarction
    (this multiple choice question has been scrambled)
  20. A 67 yo male is unconscious, is sitting in a chair, and has agonal respirations.  His wife states that he was up all night with difficulty breathing and chest discomfort but would not go to the hospital.  Physical examination reveals pink, frothy sputum in the airway; cold, diaphoretic skin; and rales audible without a stethoscope.  HR=108, BP=74 mmHg by palpation, RR=4, SaO2=82%.  The monitor shows sinus tachycardia.  Which of the following is the highest priority when treating this patient?

    A. Dopamine infusion
    B. immediate transport
    C. intubation
    D. determining whether the patient has a DNR
    C. intubation
    (this multiple choice question has been scrambled)
  21. Which of the following the the MOST likely result of increased pulmonary artery pressure?

    A. decreased right atrial workload and right ventricular hypertrophy
    B. increased right ventricular workload and cor pulmonale
    C. increased left ventricular workload and CHF
    D. increased left ventricular workload and cor pulmonale
    B. increased right ventricular workload and cor pulmonale
    (this multiple choice question has been scrambled)
  22. If the stroke volume decreased, which of the following would occur to maintain the blood pressure at its current value?

    A. increased HR and increased peripheral vascular resistance
    B. decreased HR and increased peripheral vascular resistance
    C. increased HR and decreased peripheral vascular resistance
    D. decreased HR and decreased peripheral vascular resistance
    A. increased HR and increased peripheral vascular resistance
    (this multiple choice question has been scrambled)
  23. A 48 yo male is sitting upright in bed in respiratory distress. He describes an acute onset of difficulty breathing and CP during the night that has been worsening for the past 3 hours.  He also complains of nausea.  Pain is described as a substernal pressure radiating to his left shoulder.  Physical examination reveals cool, diaphoretic skin and rales on auscultation bilaterally.  Medical hx includes two prior MIs.  Medications include Zestril and Metoprolol.  HR=132, BP=140/100, RR=25, SaO2=92%.  Which of the following is NOT indicated?

    A. Nitroglycerin
    B. Morphine
    C. Adenosine
    D. Enalapril
    C. Adenosine
    (this multiple choice question has been scrambled)
  24. Which of the following is most characteristic of right heart failure?

    A. Ascites, peripheral edema, and cyanosis
    B. Rales, cough productive of blood-tinged sputum
    C. JVD, peripheral edema, and pulmonary edema
    D. JVD, peripheral edema, and hepatic engorgement
    D. JVD, peripheral edema, and hepatic enjorgement
    (this multiple choice question has been scrambled)
  25. Which of the following is appropriate for a patient with an implanted cardioverter-defibrillator who is in ventricular fibrillation?

    A. Use anterior-posterior pad or paddle placement, and do not exceed 100 joules
    B. Perform CPR, administer antidysrhythmics, and do not perform external defibrillation
    C. Avoid placing the pads or paddles directly over the device, and defibrillate as usual
    D. Reverse the pads or paddles so that the sternum pad is at the apex and the apex pad is at the sternum
    C. avoid placing the pads or paddles directly over the device, and defibrillate as usual
    (this multiple choice question has been scrambled)

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