EMT Cardiology Practice Test 1 — Questions and Answers

Question 1: Your patient is a 52-year old male complaining of dull, achy chest pains. He is alert & oriented but upon assessment, you notice his skin is pale, cool and clammy. What is your next step?

Obtain SAMPLE History
Apply an AED
Administer Supplemental Oxygen (Correct answer)
Assist the patient with his wife’s nitroglycerin.

Correct answer: Administer Supplemental Oxygen

The patient's symptoms (dull, achy chest pain; pale, cool, clammy skin) are highly suggestive of cardiac compromise. Administering supplemental oxygen is the immediate priority in such cases to improve oxygen delivery to the heart muscle and other vital organs. This critical intervention should be performed before obtaining a detailed history or administering medications.

Question 2: Cardiac Compromise is:

Angina
A heart attack
A period of time when the heart stops
Any type of heart problem (Correct answer)

Correct answer: Any type of heart problem

Cardiac compromise is a broad medical term used to describe any condition that impairs the heart's ability to function normally. This encompasses a wide range of heart problems, including angina, myocardial infarction (heart attack), heart failure, and arrhythmias. It indicates that the heart is not working as it should, potentially leading to various symptoms.

Question 3: An AED is used to treat patients in:

Ventricular Fibrillation (Correct answer)
Asystole
Pulseless Electrical Activity
Acute Myocardial Infarction

Correct answer: Ventricular Fibrillation

An Automated External Defibrillator (AED) is specifically designed to deliver an electrical shock to correct life-threatening heart rhythms. Its primary use is to treat ventricular fibrillation (VF), a chaotic and ineffective electrical activity in the heart that prevents it from pumping blood. The shock aims to 'reset' the heart's electrical system, allowing a normal rhythm to resume.

Question 4: The normal heart rate for a newborn (0-3 months) is:

140 – 160 (Correct answer)
120 – 140
100 – 120
80 – 100

Correct answer: 140 – 160

Newborns (0-3 months) have a significantly faster resting heart rate compared to older children and adults due to their higher metabolic rate and smaller heart size. A normal heart rate range for this age group is typically between 100-160 beats per minute, with 140-160 bpm being a common and healthy average.

Question 5: The two-flap valve located on the left side of the heart is the:

Bivalve
Aortic valve
Bicuspid valve (Correct answer)
Pulmonary Valve

Correct answer: Bicuspid valve

The bicuspid valve, also known as the mitral valve, is located on the left side of the heart, specifically between the left atrium and the left ventricle. It is characterized by having two cusps or flaps. This valve ensures that oxygenated blood flows in one direction, from the left atrium into the left ventricle, and prevents backflow during ventricular contraction.

Question 6: The cardiovascular system or the circulatory system is made up of three major components; which of the following is not a component of the cardiovascular system?

Heart
Blood vessels
Myoglobin (Correct answer)
Blood

Correct answer: Myoglobin

The cardiovascular system consists of the heart (the pump), blood vessels (the network of tubes), and blood (the fluid transported). Myoglobin is a protein found in muscle tissue that binds oxygen, but it is not a structural component of the cardiovascular system itself. Platelets, thrombin, and fibrin are all crucial components involved in the process of blood clot formation.

Question 7: Name the layers of the heart from the outside in.

Pericardium, endocardium, epicardium
Myocardium, epicardium, endocardium
Epicardium, myocardium, endocardium (Correct answer)
Endocardium, myocardium, epicardium

Correct answer: Epicardium, myocardium, endocardium

The heart wall is composed of three distinct layers. From the outermost layer to the innermost layer, they are the epicardium (the outer protective layer), the myocardium (the thick muscular middle layer responsible for pumping blood), and the endocardium (the smooth inner lining of the heart chambers and valves).

Question 8: Which of the following complaints is often used to describe chest pain resulting from a cardiac event?

Sharp stabbing pain which can be located with one finger
A ton of bricks on my chest (Correct answer)
A tickling feeling
Dull tooth ache, nagging discomfort

Correct answer: A ton of bricks on my chest

Patients experiencing chest pain from a cardiac event, such as a heart attack or severe angina, often describe the sensation as a heavy, crushing, or squeezing pressure. The phrase 'a ton of bricks on my chest' is a classic description that conveys this characteristic feeling, distinguishing it from sharp, localized, or superficial pains.

Question 9: What artery carries deoxygenated blood and which vein caries oxygenated blood?

Pulmonary, Aorta
Pulmonary, inferior vena cava
Pulmonary, Pulmonary (Correct answer)
Aorta, Superior vena cava

Correct answer: Pulmonary, Pulmonary

The pulmonary artery is unique because it carries deoxygenated blood from the right ventricle to the lungs for oxygenation. Conversely, the pulmonary veins are unique among veins as they carry oxygenated blood from the lungs back to the left atrium of the heart. This is an exception to the general rule that arteries carry oxygenated blood and veins carry deoxygenated blood.

Question 10: Which are not blood components that are responsible for clot formation?

Platelets
Plaque (Correct answer)
Thrombin
Fibrin

Correct answer: Plaque

Blood clot formation involves platelets, which initiate the clotting process, and the proteins thrombin and fibrin, which form the structural meshwork of the clot. Plaque, however, is an accumulation of fatty deposits and other substances on the inner walls of arteries, contributing to atherosclerosis, but it is not a direct component of the blood clotting cascade itself.

Question 11: You are dispatched to a residence of a 46-year-old female patient complaining of nausea, vomiting, diarrhea, and abdominal cramping. She states that the onset occurred shortly after eating some cheesecake. Her only medical history is lactose intolerance. Her blood pressure is 136/88 mm Hg. Her radial pulse is 94 beats per minute and her respiratory rate is 18 breaths per minute. She vomited two times prior to your arrival. From what condition is this patient most likely suffering?

Gastrointestinal reflux disease
Diverticulitis
Peptic ulcer disease
Acute gastroenteritis (Correct answer)

Correct answer: Acute gastroenteritis

The patient's symptoms of nausea, vomiting, diarrhea, and abdominal cramping, with an acute onset after eating, are highly characteristic of acute gastroenteritis. This condition, often caused by viral or bacterial infection or food poisoning, involves inflammation of the stomach and intestines. While lactose intolerance might contribute, the overall presentation strongly points to gastroenteritis.

Question 12: Your patient is a 32-year-old male who was complaining of a severe, crushing feeling in the center of his chest and shortness of breath that began while he was mowing his lawn 45 minutes prior to your arrival. He is now only responding to painful stimuli. Presently, his minute ventilation is still adequate, his pulse oximeter reads 95% on room air, and you find his skin to be pale, cool, and diaphoretic. What would be your initial action?

12- 15 liters oxygen by nonrebreather. (Correct answer)
325 mg aspirin.
4-6 liters oxygen by nasal cannula.
Sublingual nitroglycerin.

Correct answer: 12- 15 liters oxygen by nonrebreather.

The patient's severe, crushing chest pain, shortness of breath, altered mental status, and pale, cool, diaphoretic skin indicate a serious cardiac event and potential shock. Despite a 95% SpO2, high-flow oxygen via a nonrebreather mask (12-15 L/min) is the initial critical intervention to maximize oxygen delivery to ischemic tissues and prevent further deterioration before administering medications.

Question 13: You are called to a nursing home for a patient with swelling to her legs. Upon arrival, you find a 76-year-old patient sitting in a wheelchair. Assessment confirms pitting edema to both lower legs. You are able to palpate a dorsalis pedal pulse bilaterally. Her skin is warm, pink, and dry. Her lungs are clear bilaterally. Which of the following conditions do you suspect?

Deep vein thrombosis.
Deep vein thrombosis.
Atherosclerosis.
Chronic CHF. (Correct answer)

Correct answer: Chronic CHF.

Bilateral pitting edema in the lower legs of an elderly patient, especially with clear lung sounds, is a classic sign of chronic congestive heart failure (CHF). In CHF, the heart's pumping efficiency is reduced, leading to fluid retention and accumulation in dependent areas like the legs. The clear lungs suggest the fluid has not yet backed up into the pulmonary system.

Question 14: You are treating a 49-year-old patient who complains of an intense pain between his shoulder blades radiating to his lower back. Pain began 10 minutes prior to your arrival while he was eating and has been constant. He rates the pain as a 10 out of 10. Pain is described as a sharp, tearing pain. He has no significant past medical history. Blood pressure is 130/76 mm Hg in the right arm and 78/48 mm Hg in the left arm. Radial pulse in his right arm is 98 beats per minute and regular, and respiratory rate is 20 per minute and non-labored. What condition would you most likely suspect?

Myocardial infarction
Angina pectoris
Aortic dissection (Correct answer)
Congestive heart failure

Correct answer: Aortic dissection

The patient's sudden, intense, sharp, tearing pain radiating to the back, combined with a significant difference in blood pressure between the two arms, is highly indicative of an aortic dissection. This life-threatening condition involves a tear in the inner lining of the aorta, allowing blood to dissect between the arterial layers, causing the characteristic pain and often leading to unequal blood pressures in the limbs.

Question 15: The single largest cause of death for Americans is/are:

Coronary heart disease. (Correct answer)
Chronic obstructive airway disease.
Cancer.
Traumatic injuries.

Correct answer: Coronary heart disease.

Coronary heart disease (CHD), which encompasses conditions like heart attacks and angina, remains the single largest cause of death for Americans. It is responsible for a greater number of fatalities annually than cancer, chronic obstructive airway disease, or traumatic injuries, highlighting its significant public health impact.

EMT Cardiology Practice Test 1

Your patient is a 52-year old male complaining of dull, achy chest pains.
He is alert & oriented but upon assessment, you notice his skin is pale, cool and clammy.
What is your next step?