CPC Cardiovascular Risk Reduction and Monitoring 2

Question 1

A community paramedic performs a 12-lead ECG on a patient with chest pain and identifies ST-segment elevation in leads II, III, and aVF. This finding MOST likely indicates:

Accepted Answer

Inferior STEMI

Answer

ST elevation in leads II, III, and aVF represents the inferior ECG territory, supplied by the right coronary artery (RCA) in most patients. This pattern indicates an inferior STEMI requiring immediate 911 activation.

Question 2

A community paramedic visits a patient with a history of heart failure who has a cardiac resynchronization therapy defibrillator (CRT-D). The patient reports the device 'fired' twice in the last 24 hours. The MOST appropriate action is:

Accepted Answer

Immediately escalate to emergency services and notify the patient's electrophysiologist

Answer

Two ICD shocks in 24 hours indicates recurrent ventricular arrhythmia or inappropriate shocks — both require urgent evaluation. This is an electrical storm scenario until proven otherwise, requiring immediate escalation to EMS and the electrophysiologist.

Question 3

Which dietary intervention is MOST strongly associated with reduction in LDL cholesterol?

Accepted Answer

Replacing saturated fats with unsaturated fats and increasing dietary soluble fiber

Answer

Replacing saturated fat (raises LDL) with unsaturated fat (lowers LDL) and adding soluble fiber (binds bile acids, reduces LDL reabsorption) are the two most evidence-based dietary strategies for LDL cholesterol reduction.

Question 4

Which of the following is an indication for aspirin therapy in PRIMARY cardiovascular prevention according to current USPSTF guidelines?

Accepted Answer

Adults aged 40–59 with a ≥10% 10-year CVD risk where the clinician determines benefits outweigh harms

Answer

Per 2022 USPSTF guidelines, aspirin for primary prevention is recommended (Grade B) for adults aged 40–59 with ≥10% 10-year CVD risk. Adults ≥60 years should NOT initiate aspirin for primary prevention due to increased bleeding risk.

Question 5

A community paramedic visits a patient 5 days post-discharge following an acute MI. The patient is prescribed metoprolol succinate, lisinopril, atorvastatin, and aspirin. The patient reports not taking the lisinopril due to a persistent dry cough. The BEST community paramedic action is:

Accepted Answer

Document the side effect, educate the patient that cough is a known ACEi side effect, and contact the care team for a possible ARB switch

Answer

Dry cough is a well-known class effect of ACE inhibitors due to bradykinin accumulation. The solution is not to discontinue post-MI neurohormonal therapy but to contact the care team for substitution with an ARB (which blocks the same pathway without bradykinin accumulation).

(CPC) Community Paramedic Certification Practice Test

(CPC) Community Paramedic Certification Practice Test

CPC Cardiovascular Risk Reduction and Monitoring 2