Cardiology and Resuscitation (Paramedic) Study Center > Diagnostic Tests > Paramedic Diagnostic Tests > Cardiology and Resuscitation (Paramedic) Step 1 of 45 2% A 79 year old female has collapsed while at church. Bystanders prevented a complete fall and have been supporting her in a seated position. You note the patient is breathing 3-5 times per minute and is not responsive. You should next*administer high concentration oxygen.initiate rescue breathing.check for a pulse.transfer the patient to the ambulance. A 14 year old male was found submerged in the cold ocean water after falling from his family’s boat on a cold fall day. He is unconscious, apneic and pulseless and your thermometer is unable to register a body temperature. His skin is very cold, however. After the first round of compressions, you assess ventricular fibrillation on the monitor. You should next*defibrillate with half the normal energy.delay defibrillation until a body temperature of 86 F is confirmed.defibrillate at 200J.continue with a second round of compressions before defibrillation. A 70 year old female was found in cardiac arrest. CPR was initiated and she was defibrillated twice. At the second rhythm check, you note a sinus tachycardia. You should next*take a blood pressure.resume chest compressions.check for a pulse.defibrillate at 200 J. An 80 year old female woke from sleep with severe substernal chest pain. She is confused but complains also of difficulty breathing. Your assessment reveals pedal edema, JVD and rales over all lung fields. Her vital signs are P 110, R 40, BP 80/50. You should first*administer nitroglycerin.administer furosemide.administer norepinephrine.initiate CPAP. After cardioversion for atrial fibrillation, a rhythm converts to a regular narrow complex tachycardia exactly at 150 beats per minute. You note a single, peaked, P-wave like complex spaced equidistantly between each QRS complex. You should suspect*normal sinus rhythm.ventricular tachycardia.a second degree Type 2 AV block.2:1 atrial flutter. A 14 year old male was struck in the chest with a ball while playing lacrosse. He collapsed immediately and is now unconscious. He does not appear to be breathing. You should first*initiate positive pressure ventilation.assess for bilateral lung sounds.check for a pulse.take spinal precautions. A 78 year old male has been resuscitated from cardiac arrest. You have managed the airway and his blood pressure is stable. You note a wide complex sinus bradycardia on the monitor that has tall, peaked T-waves. The patient has a long history of chronic kidney disease and missed his last dialysis appointment. You should next administer*amiodarone.another dose of epinephrine.a 1 L bolus of normal saline.calcium chloride. A 30 year old male is in cardiac arrest after overdosing on an injected opioid. You confirm apnea and pulselessness and your partner confirms asystole on the monitor. You should next*initiate chest compressions.administer epinephrine.defibrillate at 200J.administer naloxone. A 54 year old male complains of sharp, stabbing chest pain that increases in intensity while lying flat. He notes he has been generally ill for roughly 3 days and notes the presence of a fever. His ECG shows a pattern of ST elevation in leads I, II, III and also through V1-6. You should suspect*a pulmonary embolism.an inferior AMI.pericarditis.an aortic aneurysm. A patient with severe right heart failure would commonly have a primary deficit in*automaticity.conduction.afterload.preload. A 66 year old male complains of acute onset chest pain and shortness of breath. His family notes that his mental status has diminished over the last ten minutes. The patient’s vital signs are P 182, R 30, BP 74/50. His ECG reveals a regular, wide complex tachycardia with no visible P-waves. You should first*administer adenosine.cardiovert at 100 J.administer diltiazem.administer amiodarone. A 71 year old female has had an acute onset of shortness of breath. She complains of nausea and tells you she “feels like she is going to die.” Your examination reveals rales over all lung fields as well as JVD and pedal edema. Her vital signs are P 108, R 30, BP 210/115. You should first administer*furosemide.albuterol.nitroglycerin.aspirin. Which of the following dysrhythmias would be characterized by a shortened PR interval?*A junctional rhythmVentricular tachycardiaA first degree AV blockAtrial flutter An 80 year old female was found outside on a park bench on a very cold morning. She is unresponsive and apneic. Her skin is very cold. A 10-second pulse check identifies no pulse. You should next*begin chest compressions.continue the pulse check for 45-120 seconds.attach a cardiac monitor to assess for a rhythm.declare the patient deceased. A 75 year old female complains of severe abdominal pain. You note a narrow complex, irregularly irregular tachycardia with no apparent P-waves on the ECG. Her vitals are P 190, R 40, BP 76/48. Which of the following would best describe the rhythm displayed?*AV nodal reentrant tachycardiaMultifocal atrial tachycardiaSinus tachycardiaAtrial fibrillation with a rapid ventricular response A 77 year old male presents with altered mental status and chest pain. His vitals are P 30, R 40, BP 68/40. His ECG shows a slow, wide complex rhythm with disassociation between P-waves and QRS complexes. You should suspect*a third degree block.a bundle branch block.a second degree AV block type II.ventricular tachycardia. A 61 year old electrician was burned on the hand after coming in contact with some live wiring. You find the patient unconscious and observe a small burn on his right hand. After assuring that the power has been disconnected, you should*check for a pulse.assess the patient for exit burns.cover the burn with a sterile dressing.place the patient on a cardiac monitor. A 41 year old female complains of palpitations and slight shortness of breath. Her vital signs are P 208, R 28, BP 108/70. Her ECG reveals a regular, narrow complex rhythm with no visible P waves. You should first*administer adenosine.administer metoprolol.cardiovert at 50J.initiate a vagal maneuver. The sympathetic nervous system causing increased automaticity in the SA node would most likely result in*decreased contractility.ectopic conduction.increased heart rate.hypertension. A 58 year old male complains of an acute onset of nausea and vomiting and states, “I can’t stop throwing up.” He notes he was fine 30 minutes ago but now feels awful. The patient has no past medical history and his vital signs are P 90, R 20, BP 160/90. You should first*administer ondansetron.complete a detailed physical examination.obtain a 12-lead ECG.complete a thorough patient history. A 44 year old female attempted suicide by ingesting an unknown quantity of beta blocker pills. She now presents lethargic and pale. Her vital signs are P 40, R 30, BP 88/50. You should first*administer atropine.initiate transcutaneous pacing.deliver a synchronized cardioversion.administer glucagon. A patient presents with chest pain and ST elevation in leads I, AVL, V5, and V6. You also note ST depression in leads II and III. You should suspect*a lateral wall myocardial infarction.a septal wall myocardial infarction.an inferior wall myocardial infarction.an anterior wall myocardial infarction. A 75 year old male is in cardiac arrest. You have defibrillated once and are now about to complete the 2-minute round of chest compressions. You pause briefly for a rhythm check and note ventricular fibrillation on the monitor. You should next*check for a pulse.defibrillate a second time.administer epinephrine.administer amiodarone. A 62 year old female has been found apneic and pulseless. After beginning chest compressions you identify ventricular tachycardia on the monitor. You should next*synchronize and cardiovert at 100 J.administer amiodarone.defibrillate the patient at 200 J.administer epinephrine. You are attempting to restrain a 40 year old male with agitated (excited) delirium. Using multiple responders you secure his arms and legs and then administer ketamine. The patient appears to stop breathing. You should next*initiate positive pressure ventilation.administer epinephrine.check for a pulse.secure the patient to the stretcher. A 44 year old male was found unconscious and unresponsive in the park. The weather is very cold and it is apparent that the patient has been on the ground for a long time. You find him pulseless, apneic and note that his chest is frozen and incompressible. You should next*initiate chest compressions.initiate positive pressure ventilation.attach a cardiac monitor.declare the patient deceased. You have just intubated an 80 year old apneic post-arrest patient. The tube has been confirmed and the patient remains unconscious. Her vital signs are P 98, R 12 (intubated), BP 110/72. You should next*take steps to prevent heat loss.hyperventilate the patient.obtain a 12-lead ECG.initiate a dopamine infusion. A 62 year old male was in ventricular tachycardia without a pulse. After one defibrillation, he converted to a sinus tachycardia with a pulse. The patient is now making purposeful movements and groaning. He is breathing on his own at a rate of 20. His pulse is 104 and his BP is 82/50. You should next*initiate a norepinephrine infusion.administer an amiodarone infusion.sedate the patient.administer a 500 mL bolus of normal saline. An 84 year old female complains of increased fatigue and exercise intolerance. She notes she had a heart attack six months prior and she has been feeling ill since. Your assessment finds she has JVD and swollen ankles. These findings most likely indicate*chronic kidney disease.right heart failure.left heart failure.severe hypertension. A 29 year old male has been working in the hot sun all day and had a syncopal episode. He is slightly confused and wet with sweat. His vital signs are P 130, R 30, BP 128/80. His ECG shows a narrow complex tachycardia with P-waves for every QRS complex and a normal PR interval. You should first*initiate a vagal maneuver.administer a fluid bolus.administer adenosine.administer metoprolol. A 72 year old male developed substernal chest pain while shoveling snow. He became short of breath and diaphoretic as well. He notes that after the symptoms began he went inside, sat down and ten minutes later he was symptom free. This history most likely indicates*myocardial infarction.a pulmonary embolism.flash pulmonary edema.angina pectoris. A patient ruptures a papillary muscle due to thrombosis and subsequent ischemia. This would most likely lead to*calf pain and tenderness.a large vessel stroke.a failed heart valve.a pulmonary embolism. A patient’s ECG presents with a slow bradycardia that has evident dropped QRS complexes. Upon further examination, you note that a pattern of two consecutively conducted beats with equal PR intervals precedes every dropped QRS. This pattern most likely indicates a*second-degree type two AV block.first-degree block.second-degree type one AV block.third-degree block. An 80 year old male has end-stage kidney disease. The family called EMS today because of a decline in mental status over the last 3 days. The patient is extremely lethargic and very confused. His vital signs are P 40, R 28, BP 94/60. His ECG presents with wide QRS complexes and peaked T-waves. You should suspect*high ammonia levels.low calcium levels.low sodium levels.high potassium levels. A 65 year old end stage COPD patient presents with a narrow complex irregularly irregular rhythm with 3 different yet clear morphologies of P-waves. Her vitals are P 110, R 36, BP 94/60. Which of the following rhythms would this patient most likely be in?*Wandering atrial pacemakerMultifocal atrial tachycardiaSinus arrhythmiaAtrial fibrillation Which of the following findings is most commonly associated with hyperkalemia?*A tall, peaked T waveNarrowing of the QRS segmentAn inverted T wavePR elevation Which of the following would be a characteristic ECG finding associated with a bundle branch block?*A missing P-waveA widened QRS complexA prolonged PR intervalA high amplitude QRS complex A 90 year old female presents with symptomatic bradycardia and an ECG rhythm whose PR interval consecutively widens before dropping a QRS complex. She is alert and her vital signs are P 46, R 28, BP 88/60. You should*administer atropine.administer adenosine.administer an epinephrine infusion.go immediately to transcutaneous pacing. Which of the following disorders is commonly associated with an accessory pathway that allows conduction in the heart to bypass the AV junction?*Sick sinus syndromeBundle branch blockAtrial fibrillationWolff-Parkinson-White syndrome An 85 year old woman complains of burning abdominal pain in her upper left quadrant. She is slightly agitated and sweating. Your assessment notes a significantly different blood pressure in her right arm compared to that in her left arm. You should suspect*a hiatal hernia.acute myocardial infarction.an abdominal aneurysm.a perforated ulcer. A 24 year old female complains of slight vertigo after a long run. She is alert and oriented, denies further symptoms and notes that her vertigo occurs from time to time after exercise. Her vital signs are P 84, R 16, BP 110/80. Her blood glucose is 76 mg/dL. You should*administer 25 g dextrose 50%.administer high concentration oxygen.obtain a 12-lead ECG.administer 250 mL of a dextrose 10% solution. A 65 year old female notes she had an episode of substernal chest pain that came on while walking up the stairs. The pain has since subsided. She notes she has been short of breath while climbing stairs for the last two days. Her vital signs are P 68, R 20, BP 190/90. You should next*administer an albuterol treatment.obtain a 12-lead ECG.administer nitroglycerin.administer low concentration oxygen. The three methods of diagnosing an acute myocardial infarction include history, blood enzymes and*ECG.vital signs.level of pain.physical exam. Which of the following structures is most commonly perfused by the right coronary artery?*The interventricular septumThe bundle branchesThe left ventricleThe AV junction A 66 year old female complains of an acute onset of shortness of breath combined with palpitations. You note that she looks fatigued and see that she is diaphoretic. She describes a history of episodic atrial fibrillation. Her vital signs are P 150, R 32, BP 110/80. Her ECG shows an atrial fibrillation with a rapid ventricular response. You should first*administer metoprolol.initiate a vagal maneuver.administer adenosine.cardiovert at 50J.