Cardiology and Resuscitation (Paramedic) Study Center > Diagnostic Tests > Paramedic Diagnostic Tests > Cardiology and Resuscitation (Paramedic) Step 1 of 45 2% 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*third-degree block.second-degree type one AV block.second-degree type two AV block.first-degree block. 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*administer amiodarone.defibrillate the patient at 200 J.synchronize and cardiovert at 100 J.administer epinephrine. 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 The sympathetic nervous system causing increased automaticity in the SA node would most likely result in*ectopic conduction.decreased contractility.increased heart rate.hypertension. 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.check for a pulse.assess for bilateral lung sounds.take spinal precautions. 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*an inferior AMI.pericarditis.a pulmonary embolism.an aortic aneurysm. 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.transfer the patient to the ambulance.check for a pulse.initiate rescue breathing. Which of the following would be a characteristic ECG finding associated with a bundle branch block?*A missing P-waveA prolonged PR intervalA high amplitude QRS complexA widened QRS complex 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*defibrillate at 200J.initiate chest compressions.administer naloxone.administer epinephrine. 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*initiate a vagal maneuver.cardiovert at 50J.administer adenosine.administer metoprolol. 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*declare the patient deceased.begin chest compressions.attach a cardiac monitor to assess for a rhythm.continue the pulse check for 45-120 seconds. 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*ventricular tachycardia.a second degree Type 2 AV block.normal sinus rhythm.2:1 atrial flutter. 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*administer a fluid bolus.initiate a vagal maneuver.administer adenosine.administer metoprolol. 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 nitroglycerin.administer an albuterol treatment.administer low concentration oxygen.obtain a 12-lead ECG. Which of the following structures is most commonly perfused by the right coronary artery?*The bundle branchesThe interventricular septumThe AV junctionThe left ventricle 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*cardiovert at 50J.administer adenosine.initiate a vagal maneuver.administer metoprolol. Which of the following disorders is commonly associated with an accessory pathway that allows conduction in the heart to bypass the AV junction?*Bundle branch blockWolff-Parkinson-White syndromeSick sinus syndromeAtrial fibrillation The three methods of diagnosing an acute myocardial infarction include history, blood enzymes and*vital signs.ECG.level of pain.physical exam. 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*administer an amiodarone infusion.sedate the patient.initiate a norepinephrine infusion.administer a 500 mL bolus of normal saline. 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.aspirin.nitroglycerin.albuterol. 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 an epinephrine infusion.administer atropine.go immediately to transcutaneous pacing.administer adenosine. Which of the following findings is most commonly associated with hyperkalemia?*An inverted T waveA tall, peaked T waveNarrowing of the QRS segmentPR elevation 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*initiate CPAP.administer norepinephrine.administer furosemide.administer nitroglycerin. 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 diltiazem.cardiovert at 100 J.administer amiodarone.administer adenosine. 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 second degree AV block type II.ventricular tachycardia.a bundle branch block. 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*hyperventilate the patient.obtain a 12-lead ECG.initiate a dopamine infusion.take steps to prevent heat loss. 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.administer amiodarone.administer epinephrine.defibrillate a second time. A patient with severe right heart failure would commonly have a primary deficit in*automaticity.afterload.preload.conduction. 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. 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. 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 potassium levels.low sodium levels.low calcium levels.high ammonia levels. 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.an abdominal aneurysm.acute myocardial infarction.a perforated ulcer. 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 at 200J.defibrillate with half the normal energy.delay defibrillation until a body temperature of 86 F is confirmed.continue with a second round of compressions before defibrillation. 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.place the patient on a cardiac monitor.cover the burn with a sterile dressing.assess the patient for exit burns. 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*defibrillate at 200 J.check for a pulse.take a blood pressure.resume chest compressions. 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*complete a detailed physical examination.obtain a 12-lead ECG.administer ondansetron.complete a thorough patient history. 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*declare the patient deceased.initiate chest compressions.attach a cardiac monitor.initiate positive pressure ventilation. 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*left heart failure.chronic kidney disease.severe hypertension.right heart failure. 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?*Multifocal atrial tachycardiaSinus arrhythmiaWandering atrial pacemakerAtrial fibrillation 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.administer glucagon.deliver a synchronized cardioversion.initiate transcutaneous pacing. 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*another dose of epinephrine.amiodarone.a 1 L bolus of normal saline.calcium chloride. 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 septal wall myocardial infarction.an anterior wall myocardial infarction.a lateral wall myocardial infarction.an inferior wall myocardial infarction. 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*obtain a 12-lead ECG.administer 250 mL of a dextrose 10% solution.administer high concentration oxygen.administer 25 g dextrose 50%. Which of the following dysrhythmias would be characterized by a shortened PR interval?*A junctional rhythmVentricular tachycardiaAtrial flutterA first degree AV block A patient ruptures a papillary muscle due to thrombosis and subsequent ischemia. This would most likely lead to*a large vessel stroke.calf pain and tenderness.a pulmonary embolism.a failed heart valve.