- Of the following situations, which would serve most to diminish the cardiac output?
Your answer:
increase in heart rate while stroke volume remains the same
decrease in heart rate with an increase in stroke volume
decrease in stroke volume with an increase in heart rate
increased afterflow with a decrease in preload
- A patient suffering an acute MI presents with systemic hypotension and lung sounds that are clear of any adventitious noises. Which of the following should be suspected by the health care professional?
Your answer:
a left ventricular MI with right ventricular involvement
an acute MI with no ventricular involvement
possible right ventricular failure
possible left ventricular failure
- In which of the following situations will the myocardial oxygen demand be decreased the most?
Your answer:
increase in afterflow
decrease in afterload
increase in contractility
increase in preload
- You are administering oxygen to a patient with an acute MI. Which of the following is most likely to occur as a result?
Your answer:
improvement of function to ischemic tissue
increase in myocardial workload
increase of activity in the infarct region
restoration of function to all injured cells
- Of the following patients, which could be said to be suffering the greatest infarct in terms of size?
Your answer:
patient with blockage of the left subclavian artery
patient with blockage in the left circumflex artery
patient with occlusion in the left coronary artery
patient with occlusion in the left descending coronary artery
- In the acute MI, which of the following pathophysiological processes is responsible for the majority of deaths?
Your answer:
electrical instability in the infarcted tissue
aberrant conduction through ischemic and injured tissue
the formation of aneurysms on the left ventricle
myocardial wall rupture
- When assessing a patient with a possible acute myocardial infarction, which of the following would most support the evaluation that an acute MI is occurring?
Your answer:
a blood pressure of 90/66
ST elevation in leads V2 and V5
the presence of chest pain
ST elevation in leads V4 and V5
- A 53-year-old female patient has the chief complaint of shortness of breath. Upon questioning, she denies the presence of chest pain. On the cardiac monitor, you note a sinus rhythm of 88 beats per minute with ST elevation in leads V3 and V4. You would suspect.
Your answer:
no infarction is occurring because of the absence of chest pain
the pateint has an occulsion of the right coronary artery
a posible anterior-wall infarction is occurring
the patient has COPD
- Of the following choices, which DEFINITIVELY indicates an acute myocardial infarction?
Your answer:
patient with serum enzyme changes and pathologic Q waves
patient with shortness of breath and chest pain
patient with symmetrically inverted T waves in leads V5 and V6
patient with ST elevation in leads V3 and V5
- A 67-year-old male presents with crushing chest pain and is diaphoretic. Upon inspection, you note sinus bradycardia with ST elevation in lead V4R, blood pressure of 94/70, and engorgement of the neck veins. Which of the following represents the BEST course of treatment for this patient?
Your answer:
oxygen with a bolus of normal saline
oxygen
oxygen with nitroglycerin and morphine
oxygen with nitroglycerin and beta blockers
- A physician orders a bolus of heparin to a patient after thrombolytic therapy has been completed. The rational for such a move is to
Your answer:
prevent action bleeding elsewhere in the body
lower the returning preload
keep opened artery patent
decrease myocardial workload
- Which of the following choices represents the MOST prudent order of treatment for a hemodynamically stable MI patient presenting with 10 multifocal PVCs per minute?
Your answer:
oxygen, lidocaine, nitroglycerin
lidocaine, oxygen, beta blockers
lidocaine, oxygen, morphine
oxygen, nitroglycerin, lidocaine if needed
- A COPD patient is incurring a left ventricular infarction. The patient is confused, diaphoretic, and displays a pulse oximeter reading of 87%. Which of the following treatments would be most beneficial for the patient?
Your answer:
high flow oxygen delivered by a nonrebreather
low flow oxygen delivered through a nasal cannula
withhold oxygen so as not to depress respiratory drive
oxygen at 4 liters per minute delivered through a simple face mask
- After administering nitroglycerin to a chest pain patient, the patient's blood pressure drops drastically, and she goes into pulseless electrical activity (PEA). Your best course of action would be to
Your answer:
give large amounts of fluid while administering CPR
place the patient supine with legs elevated and defrillate
administer dopamine at 10 mg/kg/min
- Of the following patients, which would be MOST eligible for thromgolytic therapy?
Your answer:
female with left ventricular infarction and pregnant
male involved in car crash with right ventricular infarct and head injury
male with transmural infarct and BP 150/120
female with transmural infarct and CVA 11 months ago
- Which of the following electrical disturbances represents the greatest life threat to occur within the first hour post infarct?
Your answer:
ventricular tachycardia
asystole
ventricular fibrillation
PEA
- You are treating a serverly lethargic patient in cardiogenic shock from a massive left ventricular MI. Which of the following regiments best describes the appropriate treatment of this patient?
Your answer:
oxyten, IV, cardiac monitor, nitroglycerin
intubation, oxygen, nitroglycerin, dopamine
intubation, oxygen, dopamine, nonrepineshrine
oxygen, dopamine, norepinephine
- Of the following cardiac drugs, which is the most important in the management of the acute mycardial infarction?
Your answer:
morphine sulfate
oxygen
beta blockers
nitroglycerin
- You are treating a patient who complains of chest pain and exhibits respiratory distress with adventitiouslung sounds heard on auscultation. As you examine the patient, you note a pink froth beginning to appear at the corners of her mouth. You note a systolic blood pressure of 140 mmHg. Which of the following represents the BEST choice for the initial treatment of this patient?
Your answer:
furosemide
IV nitrogylcerin
oxygen at 15 lpm
nitrogylcerin given by mouth
- Insertion of the endotracheal tube in the glottic opening should be stopped when
Your answer:
resistance is met and the tip of the tube is suspected to be at the level of the carina
the 2 cm on the tube is at the level of the front teeth
the proximal end of the cuff has passed 1 to 2.5 cm beyond the level of the vocal cords
the distal end fo the cuff is at the level of the vocal cords
- Which of the following should be initially performed with the first ventilation following intubation to confirm endotracheal tube placement?
Your answer:
inspect for condensation in the endotracheal tube
auscultate bilateral breath sounds
inspect the centimeter maker at the level of the teeth
assess chest rise and auscultate for epigastric sounds
- The cricothyroid membrane is located
Your answer:
inferiorto the cricoid and superior to the supraternal notch
superior to the thyroid cartilage and inferior to the hyoid bone
inferior to the thyroid cartilgae and superior to the cricoid cartilage
inferior to the cricoid cartilage and superior to the thyroid cartilage
- The tidal volume that should be delivered to an adult patient when performing positive pressure ventilation is
Your answer:
15 to 20 ml/kg
20 to 25 ml/kg
5 to 10 ml/kg
10 to 15 ml/kg
- The most serious complication associated with tracheobronchial suctioning is
Your answer:
hypoxemia secondary to a decrease in functional residual volume
stimulations of the sympathetic nervous system with resultant tachycardia
mucosal damage and subsequenent infection
stimulations of the cough and gag reflex
- Which of the following is true regarding the simple face mask?
Your answer:
the mask is well tolerated by pediatric patients
the liter flow should not be set at less than 6 lpm
An FiO2 of 100% is possible with the mask
oxygen is collected in a reservior bag prior to inhalation