EMT Cardiology Sample Test 1 — Questions and Answers

Question 1: Your patient is a 52-year old male complaining of dull, achy chest pains. He is alert & oriented but upon assessment, you notice his skin is pale, cool and clammy. What is your next step?

Obtain SAMPLE History
Apply an AED
Administer Supplemental Oxygen (Correct answer)
Assist the patient with his wife’s nitroglycerin.

Correct answer: Administer Supplemental Oxygen

In any patient presenting with signs of cardiac compromise, especially with pale, cool, and clammy skin indicating poor perfusion, administering supplemental oxygen is a critical initial step. This addresses potential hypoxia and helps improve oxygen delivery to the heart muscle and other vital organs. Following the ABCs (Airway, Breathing, Circulation) is paramount before proceeding with other assessments or interventions.

Question 2: Cardiac Compromise is:

Angina
A heart attack
A period of time when the heart stops
Any type of heart problem (Correct answer)

Correct answer: Any type of heart problem

Cardiac compromise is a broad term that encompasses any condition or problem affecting the heart's ability to function properly. This can include a wide range of issues such as angina, myocardial infarction (heart attack), congestive heart failure, arrhythmias, or other structural or functional abnormalities. It signifies that the heart is not working as it should, leading to various symptoms and potential life threats.

Question 3: An AED is used to treat patients in:

Ventricular Fibrillation (Correct answer)
Asystole
Pulseless Electrical Activity
Acute Myocardial Infarction

Correct answer: Ventricular Fibrillation

An Automated External Defibrillator (AED) is designed to deliver an electrical shock to interrupt chaotic electrical activity in the heart. Ventricular Fibrillation (VFib) is a life-threatening arrhythmia where the heart's ventricles quiver ineffectively, preventing blood circulation. The AED's shock aims to reset the heart's electrical system, allowing a normal rhythm to resume.

Question 4: The normal heart rate for a newborn (0-3 months) is:

120 – 140
140 – 160 (Correct answer)
100 – 120
80 – 100

Correct answer: 140 – 160

Newborns (0-3 months) have a significantly higher metabolic rate and smaller cardiac output compared to adults, requiring a faster heart rate to circulate blood effectively. A normal heart rate range of 140-160 beats per minute is typical for this age group. This elevated rate ensures adequate oxygen and nutrient delivery to their rapidly developing bodies.

Question 5: The two-flap valve located on the left side of the heart is the:

Bivalve
Aortic valve
Bicuspid valve (Correct answer)
Pulmonary Valve

Correct answer: Bicuspid valve

The bicuspid valve, also known as the mitral valve, is situated between the left atrium and the left ventricle of the heart. It is characterized by having two leaflets or cusps. Its function is to prevent the backflow of oxygenated blood from the left ventricle into the left atrium during ventricular contraction.

Question 6: The cardiovascular system or the circulatory system is made up of three major components; which of the following is not a component of the cardiovascular system?

Heart
Blood vessels
Myoglobin (Correct answer)
Blood

Correct answer: Myoglobin

The cardiovascular system, or circulatory system, is comprised of the heart, which pumps blood, the blood vessels (arteries, veins, capillaries) that transport it, and the blood itself. Myoglobin is an oxygen-binding protein found within muscle cells, particularly in the heart and skeletal muscles, but it is not a structural component of the circulatory system's main transport network.

Question 7: Name the layers of the heart from the outside in.

Pericardium, endocardium, epicardium
Myocardium, epicardium, endocardium
Epicardium, myocardium, endocardium (Correct answer)
Endocardium, myocardium, epicardium

Correct answer: Epicardium, myocardium, endocardium

The heart wall consists of three distinct layers, starting from the outside and moving inward. The outermost layer is the epicardium, which is also the visceral layer of the serous pericardium. Beneath it lies the myocardium, the thick muscular layer responsible for the heart's pumping action. The innermost layer, lining the heart chambers and valves, is the endocardium.

Question 8: Which of the following complaints is often used to describe chest pain resulting from a cardiac event?

Sharp stabbing pain which can be located with one finger
A ton of bricks on my chest (Correct answer)
A tickling feeling
Dull tooth ache, nagging discomfort

Correct answer: A ton of bricks on my chest

Chest pain resulting from a cardiac event, such as a myocardial infarction, is frequently described as a heavy, crushing, or squeezing sensation. Patients often use phrases like 'a ton of bricks on my chest' or 'an elephant sitting on my chest' to convey the intense pressure and discomfort. This diffuse, oppressive pain is a classic symptom of cardiac ischemia.

Question 9: What artery carries deoxygenated blood and which vein caries oxygenated blood?

Pulmonary, Aorta
Pulmonary, inferior vena cava
Pulmonary, Pulmonary (Correct answer)
Aorta, Superior vena cava

Correct answer: Pulmonary, Pulmonary

The pulmonary artery is unique among arteries because it carries deoxygenated blood from the right ventricle to the lungs for oxygenation. Conversely, the pulmonary veins are unique among veins as they carry oxygenated blood from the lungs back to the left atrium. This specialized circuit is essential for gas exchange.

Question 10: Which are not blood components that are responsible for clot formation?

Platelets
Plaque (Correct answer)
Thrombin
Fibrin

Correct answer: Plaque

Blood components responsible for clot formation include platelets, which initiate the clotting process, and proteins like thrombin and fibrin, which form the structural mesh of the clot. Plaque, however, is a buildup of fatty deposits, cholesterol, and other substances on arterial walls, contributing to atherosclerosis and narrowing of vessels, but it is not a direct blood component involved in the clotting cascade.

Question 11: You are dispatched to a residence of a 46-year-old female patient ... You are dispatched to a residence of a 46-year-old female patient complaining of nausea, vomiting, diarrhea, and abdominal cramping. She states that the onset occurred shortly after eating some cheesecake. Her only medical history is lactose intolerance. Her blood pressure is 136/88 mm Hg. Her radial pulse is 94 beats per minute and her respiratory rate is 18 breaths per minute. She vomited two times prior to your arrival. From what condition is this patient most likely suffering?

Gastrointestinal reflux disease
Diverticulitis
Peptic ulcer disease
Acute gastroenteritis (Correct answer)

Correct answer: Acute gastroenteritis

The patient's symptoms of nausea, vomiting, diarrhea, and abdominal cramping, especially with an acute onset after eating, are classic indicators of acute gastroenteritis. This condition, often referred to as a stomach flu, involves inflammation of the gastrointestinal tract. While lactose intolerance can cause GI upset, the combination of all symptoms points more strongly to an acute infectious or inflammatory process.

Question 12: Your patient is a 32-year-old male who was complaining of ...Your patient is a 32-year-old male who was complaining of a severe, crushing feeling in the center of his chest and shortness of breath that began while he was mowing his lawn 45 minutes prior to your arrival. He is now only responding to painful stimuli. Presently, his minute ventilation is still adequate, his pulse oximeter reads 95% on room air, and you find his skin to be pale, cool, and diaphoretic. What would be your initial action?

12- 15 liters oxygen by nonrebreather. (Correct answer)
325 mg aspirin.
4-6 liters oxygen by nasal cannula.
Sublingual nitroglycerin.

Correct answer: 12- 15 liters oxygen by nonrebreather.

This patient presents with severe crushing chest pain, shortness of breath, and signs of poor perfusion (pale, cool, diaphoretic skin), strongly suggesting an acute coronary syndrome and potential hypoxia. Administering high-flow oxygen via a nonrebreather mask is the initial priority to improve oxygenation and reduce myocardial workload. Optimizing oxygen delivery is critical before other interventions like aspirin or nitroglycerin.

Question 13: You are called to a nursing home for a patient with swelling to her legs... You are called to a nursing home for a patient with swelling to her legs. Upon arrival, you find a 76-year-old patient sitting in a wheelchair. Assessment confirms pitting edema to both lower legs. You are able to palpate a dorsalis pedal pulse bilaterally. Her skin is warm, pink, and dry. Her lungs are clear bilaterally. Which of the following conditions do you suspect?

Deep vein thrombosis.
Bilateral acute arterial occlusion.
Atherosclerosis.
Chronic CHF. (Correct answer)

Correct answer: Chronic CHF.

Pitting edema in both lower legs, particularly in an elderly patient, is a hallmark sign of chronic congestive heart failure (CHF). In CHF, the heart's pumping efficiency is reduced, leading to fluid retention and increased pressure in the capillaries, causing fluid to leak into the interstitial spaces. The clear lungs and palpable pulses suggest the edema is primarily due to systemic fluid overload rather than an acute vascular issue.

Question 14: You are treating a 49-year-old patient... You are treating a 49-year-old patient who complains of an intense pain between his shoulder blades radiating to his lower back. Pain began 10 minutes prior to your arrival while he was eating and has been constant. He rates the pain as a 10 out of 10. Pain is described as a sharp, tearing pain. He has no significant past medical history. Blood pressure is 130/76 mm Hg in the right arm and 78/48 mm Hg in the left arm. Radial pulse in his right arm is 98 beats per minute and regular, and respiratory rate is 20 per minute and non-labored. What condition would you most likely suspect?

Myocardial infarction
Angina pectoris
Aortic dissection (Correct answer)
Congestive heart failure

Correct answer: Aortic dissection

The patient's sudden, intense, tearing pain radiating to the back, combined with a significant difference in blood pressure between the right and left arms, is highly indicative of an aortic dissection. This life-threatening condition involves a tear in the inner lining of the aorta, allowing blood to separate the layers of the aortic wall. The differential blood pressure is a classic sign due to compromised blood flow to one extremity.

Question 15: The single largest cause of death for Americans is/are:

Coronary heart disease. (Correct answer)
Chronic obstructive airway disease.
Cancer.
Traumatic injuries.

Correct answer: Coronary heart disease.

Coronary heart disease (CHD) is the leading cause of death for both men and women in the United States. It involves the narrowing or blockage of the coronary arteries, which supply blood to the heart, often due to atherosclerosis. This can lead to myocardial infarctions (heart attacks), angina, and other serious cardiac events, making it the most significant cause of mortality.

EMT Cardiology Sample Test 1

Your patient is a 52-year old male complaining of dull, achy chest pains.
He is alert & oriented but upon assessment, you notice his skin is pale, cool and clammy.
What is your next step?