Cardiology FISDAP practice question and answer

Cardiology FISDAP practice quiz When obtaining a 12 - lead ECG, lead V1 should be placed: A) Upper right shoulder just above the clavicle B) Approximately 1 inch to the right of the angle of Louis C) In the sec intercostal space just inferior to the sec rib. D) In the fourth intercostal space just to the right of the sternum Correct Answer: D) in the fourth intercostal space just to the right of the sternum A patient experiencing a right ventricular infarction would be expected to present with: A) hypertension and tachycardia B) ST elevation in lead II, III and aVF. C) greater than 2-mm ST depression in lead V1 D) sever pulmonary edema and hemoptysis Correct Answer: B) ST elevation in lead II, III and aVF. You are assessing a middle-aged female who complains of chest discomfort. She is conscious, alert, and oriented. Her skin is diaphoretic. Her blood pressure is 122/72 mm Hg, her pulse rate is 120 beats/min, and her respirations are 20 breaths/min. On the basis of her chief complaint, which of your assessment findings is the MOST significant? A) Diaphoresis B) Mental status C) Elevated Respiratory Rate D) Pulse rate of 120 beats/min Correct Answer: D) pulse rate of 120 beats/min In contrast to unstable angina, stable angina occurs when a patient: A) complains of chest pain at the same time of the day for more than 2 weeks. B) needs more than two nitroglycerin treatments to relieve his or her chest pain. C) experiences chest discomfort after a certain, predictable amount of exertion. D) presents with chest pain or discomfort during periods of low oxygen demand. Correct Answer: C) experiences chest discomfort after a certain, predictable amount of exertion. A 71-year-old male presents with chest pain and shortness of breath. He is conscious, but confused, and is profusely diaphoretic. He has weakly palpable radial pulses, a BP of 70/40 mm Hg, and diffuse crackles in all lung fields. You administer high-flow oxygen and apply the cardiac monitor, which reveals sinus tachycardia. The closest appropriate hospital is 40 miles away. Which of the following is the MOST appropriate next action? A) Obtain a 12-lead ECG tracing. B) Begin an infusion of dopamine. C) Perform a head-to-toe exam. D) Give 20 mL/kg fluid boluses. Correct Answer: B) Begin an infusion of dopamine. Which of the following is an absolute contraindication for fibrinolytic therapy? A) Subdural hematoma 3 years ago B) BP of 170/100 mm Hg on presentation C) Current use of anticoagulant medication D) Ischemic stroke within the last 12 months Correct Answer: A) Subdural hematoma 2 years ago You are treating a 68-year-old woman with chest pressure and shortness of breath that started 2 days ago. Her BP is 76/52 mm Hg and her pulse is 130 beats/min and weak. The cardiac monitor reveals sinus tachycardia with occasional PVCs and auscultation of her lungs reveals diffuse coarse crackles. Which of the following treatment interventions is MOST appropriate for this patient? A) Dopamine, 2 to 20 mcg/kg/min B) Normal saline, 20 mL/kg rapid bolus C) Amiodarone, 150 mg over 10 min D) Nitroglycerin, 10 to 20 mcg/min Correct Answer: A) Dopamine, 2 to 20 mcg/kg/min Which of the following findings would lead the paramedic to suspect pericarditis when assessing a 40-year-old male with chest pain and no cardiac history? A) The patient's age and absence of a cardiac history B) The pain decreases when the patient sits forward C) Widespread ST depression of greater than 2 mm D) Greater than 3-mm ST elevation in leads V2 and V3 Correct Answer: B) The pain decreases when the patient sits forward When assessing a patient with suspected cardiac-related chest pain, which of the following questions would be MOST appropriate to ask? A) Does the pain move to your arms? B) Were you at rest when the pain began? C) Is the pain crushing or dull in nature? D) Can you describe the quality of the pain? Correct Answer: D) can you describe the quality of the pain? You are assessing a middle-aged female who complains of chest discomfort. She is conscious, alert, and oriented. Her skin is diaphoretic. Her blood pressure is 122/72 mm Hg, her pulse rate is 120 beats/min, and her respirations are 20 breaths/min. On the basis of her chief complaint, which of your assessment findings is the MOST significant? A) Diaphoresis B) Mental status C) Elevated respiratory rate D) Pulse rate of 120 beats/min Correct Answer: D) Pulse rate of 120 beats/min A 27-year-old female complains of palpitations. The cardiac monitor reveals a narrow-complex tachycardia at 180/min. She denies any other symptoms, and states that this has happened to her before, but it typically resolves on its own. Her blood pressure is 126/66 mm Hg, pulse is 180 beats/min, and respirations are 16 breaths/min. After attempting vagal maneuvers and giving two doses of adenosine, her cardiac rhythm and vital signs remain unchanged. You should: A) Administer 5 mg of midazolam and perform synchronized cardioversion starting with 50 joules. B) Administer 0.35 mg/kg of diltiazem over 2 minutes and then reassess her hemodynamic status. C) Transport at once, reassesses her frequently, and performs synchronized cardioversion if necessary. D) Infuse 150 mg of amiodarone over 10 minutes, reassess her, and repeat the amiodarone if needed. Correct Answer: C) transport at once, reassess her frequently, and perform synchronized cardioversion if necessary. You are assessing a 75-year-old male who experienced a sudden onset of slurred speech, a right-sided facial droop, and left-sided hemiparesis approximately 45 minutes ago. His blood pressure is 170/94 mm Hg, pulse rate is 68 beats/min and irregular, and respirations are 14 breaths/min and unlabored. His oxygen saturation is 92% on room air. The MOST appropriate treatment for this patient includes: A) oxygen via nonrebreathing mask, an IV of normal saline, cardiac monitoring, 5 mg of labetalol to lower his BP, blood glucose assessment, and rapid transport. B) 160 to 325 mg of aspirin, supplemental oxygen via nasal cannula, cardiac monitoring, blood glucose assessment, an IV of an isotonic crystalloid, and transport. C) assisted ventilation with a bag-valve-mask device, cardiac monitoring, an IV of normal saline, IV dextrose if his blood glucose level is less than 80 mg/dL, and transport. D) supplemental oxygen via nasal cannula, cardiac monitoring, blood glucose assessment, an IV of normal saline set to keep the vein open, and prompt transport. Correct Answer: D) supplemental oxygen via nasal cannula, cardiac monitoring, blood glucose assessment, an IV of normal saline set to keep the vein open, and prompt transport. You are assessing a 67-year-old female with chest discomfort when she becomes unresponsive, apneic, and pulseless. The cardiac monitor reveals coarse ventricular fibrillation. You achieve return of spontaneous circulation after 4 minutes and the cardiac monitor now reveals a narrow complex rhythm. The patient is still unresponsive, has occasional respirations, a blood pressure of 70/40 mm Hg, and a weak pulse of 70 beats/min. The MOST appropriate postresuscitation care for this patient includes: A) insertion of an airway adjunct, assisted ventilation with a bag-valve-mask device, vascular access, a 500- to 1,000-mL crystalloid fluid bolus, and an amiodarone infusion at 1 mg/min. B) preoxygenation with a bag-valve-mask device and high-flow oxygen, endotracheal intubation, vascular access, 300 mg of amiodarone, and a dopamine infusion. C) insertion of a supraglottic airway device, ventilatory assistance, vascular access, 150 mg of amiodarone over 10 minutes, and 0.5 mg of atropine sulfate. D) oxygen via nonrebreathing mask, vascular access, a lidocaine infusion, and an adequate volume of normal saline solution to increase her blood pressure. Correct Answer: A) insertion of an airway