EMT/NREMT Practice Test (Cardiology) — Questions and Answers

Question 1: Your patient is a 52-year-old man who is experiencing dull, aching chest symptoms. He seems attentive and focused, but his skin is pale, cool, and clammy upon assessment. What's the next step?

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

Correct answer: Administer Supplemental Oxygen

The patient's symptoms (chest pain, pale, cool, clammy skin) are highly suggestive of a cardiac event, which can lead to hypoxia. Administering supplemental oxygen is a critical initial step to improve oxygenation to the heart and tissues. This addresses a primary physiological need immediately, before other interventions like obtaining a SAMPLE history or considering medications.

Question 2: For a newborn (0-3 months), the normal heart rate is:

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

Correct answer: 140 – 160

Newborns and infants have significantly higher resting heart rates compared to older children and adults due to their rapid metabolism and smaller heart size. A normal heart rate for a newborn (0-3 months) typically falls within the range of 140 to 160 beats per minute. This elevated rate is a physiological norm for their age group.

Question 3: On the left side of the heart is a two-flap valve called the:

Aortic valve
Pulmonary Valve
Bivalve
Bicuspid valve (Correct answer)

Correct answer: Bicuspid valve

The bicuspid valve, also known as the mitral valve, is located on the left side of the heart, specifically between the left atrium and the left ventricle. It is characterized by having two cusps or flaps, which regulate blood flow from the atrium to the ventricle. The other options are either incorrect names or located elsewhere in the heart.

Question 4: The cardiovascular system, often known as the circulatory system, is made up of three basic components; which of the following is not one of these components?

Blood vessels
Blood
Heart
Myoglobin (Correct answer)

Correct answer: Myoglobin

The three primary components of the cardiovascular (circulatory) system are the heart (the pump), blood vessels (the conduits), and blood (the transport medium). Myoglobin is an oxygen-binding protein found within muscle tissue, particularly cardiac and skeletal muscle, but it is not considered a basic structural component of the cardiovascular system itself.

Question 5: From the outside in, identify the layers of the heart.

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

Correct answer: Epicardium, myocardium, endocardium

The heart wall consists of three distinct layers, listed from the outermost to the innermost. The epicardium is the outermost layer, also known as the visceral layer of the serous pericardium. The myocardium is the thick middle layer composed of cardiac muscle, responsible for pumping blood, and the endocardium is the innermost layer, lining the heart chambers and valves.

Question 6: Which of the following is a common complaint for chest pain caused by a cardiac event?

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

Correct answer: A ton of bricks on my chest

Chest pain associated with a cardiac event, such as a myocardial infarction, is often described as a heavy, crushing, or squeezing sensation. Patients frequently use phrases like "a ton of bricks on my chest" or "an elephant sitting on my chest" to convey this intense pressure. Sharp, localized, or tickling pains are less typical for cardiac-related chest pain.

Question 7: Which vein carries oxygenated blood and which artery carries deoxygenated blood?

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

Correct answer: Pulmonary, Pulmonary

The pulmonary circulation is unique in that the pulmonary veins carry oxygenated blood from the lungs back to the left atrium of the heart. Conversely, the pulmonary arteries carry deoxygenated blood from the right ventricle to the lungs. This is an exception to the general rule that arteries carry oxygenated blood and veins carry deoxygenated blood in systemic circulation.

Question 8: The leading causes of death in the United States are:

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

Correct answer: Coronary heart disease.

According to the Centers for Disease Control and Prevention (CDC) and other health organizations, heart disease, particularly coronary heart disease, remains the leading cause of death for both men and women in the United States. While cancer is also a major cause, heart disease consistently ranks highest in mortality statistics.

Question 9: A child's normal heart rate between the ages of one to six is:

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

Correct answer: 100 – 120

As children grow older, their normal resting heart rates gradually decrease from the higher rates seen in newborns and infants. For a child between the ages of one to six years, a normal heart rate typically falls within the range of 100 to 120 beats per minute. This is still higher than adult rates but lower than infant rates.

Question 10: What is the correct blood flow through the heart and lungs?

Inferior/superior vena cavae, right atrium, right ventricle, aorta, lungs, left atrium, left ventricle
Inferior/superior vena cavae, right atrium, right ventricle, lungs, left atrium, left ventricle, aorta (Correct answer)
Right atrium, right ventricle, Inferior/superior vena cavae, lungs, aorta, left ventricle, left atrium
Aorta, left atrium, left ventricle, lungs, right atrium, right ventricle, Inferior/superior vena cavae

Correct answer: Inferior/superior vena cavae, right atrium, right ventricle, lungs, left atrium, left ventricle, aorta

Deoxygenated blood enters the right atrium from the body via the superior and inferior vena cavae. It then flows to the right ventricle, which pumps it to the lungs for oxygenation. Oxygenated blood returns from the lungs to the left atrium, then to the left ventricle, which pumps it out to the body via the aorta.

Question 11: Your patient is an 80-year-old man who has been experiencing shortness of breath. Which of the following conditions could your patient be experiencing?

Cardiac compromise
All of the above (Correct answer)
A myocardial infarction
Congestive heart failure

Correct answer: All of the above

Shortness of breath (dyspnea) in an 80-year-old patient is a non-specific symptom that can indicate several serious cardiac conditions. Cardiac compromise is a general term encompassing various heart issues, including a myocardial infarction (heart attack) and congestive heart failure. All these conditions can present with shortness of breath, making "All of the above" the most comprehensive and correct answer.

Question 12: On the right side of the heart, there is a three-flap valve called:

Mitral valve
Triluminar valve
Tri-valve
Tricuspid valve (Correct answer)

Correct answer: Tricuspid valve

The tricuspid valve is located on the right side of the heart, specifically between the right atrium and the right ventricle. It is named for its three cusps or flaps, which open and close to regulate the flow of deoxygenated blood from the right atrium into the right ventricle. This prevents backflow during ventricular contraction.

Question 13: What is the function of the Mitral valve?

Prevents blood from flowing between the right and left ventricles
Prevents blood from back-flowing into the lungs
Prevents blood from back-flowing into the left ventricle
Prevents blood from back-flowing into the left Atrium (Correct answer)

Correct answer: Prevents blood from back-flowing into the left Atrium

The mitral valve, also known as the bicuspid valve, is located between the left atrium and the left ventricle. Its primary function is to ensure unidirectional blood flow by preventing oxygenated blood from flowing backward into the left atrium when the left ventricle contracts. This ensures efficient pumping of blood into the aorta.

Question 14: The patient, a 45-year-old man, is having chest pains. After you've put him in a comfortable position, what should you do next?

Administer oxygen by nonrebreather mask at 15 liters per minute. (Correct answer)
Administer oxygen by the nasal cannula at 6 liters per minute.
Ventilate the patient with the bag-valve mask at 15 liters per minute.
Ventilate the patient with a nonrebreather mask at 15 liters per minute.

Correct answer: Administer oxygen by nonrebreather mask at 15 liters per minute.

For a patient experiencing chest pain suggestive of a cardiac event, administering high-flow supplemental oxygen is a crucial initial intervention. A nonrebreather mask at 15 liters per minute delivers the highest concentration of oxygen to a spontaneously breathing patient, helping to improve myocardial oxygenation and reduce ischemia. This is prioritized after positioning for comfort.

Question 15: Which of the following cardiac rhythms frequently leads to ventricular fibrillation?

Ventricular tachycardia (Correct answer)
Atrial tachycardia
Asystole
Atrial fibrillation

Correct answer: Ventricular tachycardia

Ventricular tachycardia (VT) is a rapid heart rhythm originating in the ventricles. If left untreated, VT can often degenerate into ventricular fibrillation (VF), a chaotic and ineffective electrical activity in the ventricles that results in no cardiac output. VF is a life-threatening arrhythmia requiring immediate defibrillation.

Question 16: Which of the following is a common way for patients to describe heart attack pain?

Less severe than indigestion
Intermittent (comes and goes)
Crushing or squeezing (Correct answer)
Like “pins and needles”

Correct answer: Crushing or squeezing

Patients experiencing a heart attack (myocardial infarction) frequently describe the chest pain as a severe, oppressive sensation. Common descriptors include "crushing," "squeezing," "pressure," or "tightness," often radiating to the arm, jaw, or back. This type of pain is typically persistent, not intermittent, and much more severe than indigestion.

EMT/NREMT Practice Test (Cardiology)

Your patient is a 52-year-old man who is experiencing dull,
aching chest symptoms.
He seems attentive and focused,
but his skin is pale, cool, and clammy upon assessment.
What's the next step?