when obtaining a 12 - lead ECG, lead V1 should be placed:
A) upper right shoulder just above the clavicle
B) approximately 1 inch to the right of the angle of Louis
C) In the sec intercostal space just inferior to the sec rib.
D) in the fourth intercostal space just to the right of the ster...
a patient experiencing a right ventricular infarct
you are assessing a middle aged female who complai
in contrast to unstable angina stable angina occu
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Cardiology FISDAP practice question and answer
when obtaining a 12 - lead ECG, lead V1 should be placed:
A) upper right shoulder just above the clavicle
B) approximately 1 inch to the right of the angle of Louis
C) In the sec intercostal space just inferior to the sec rib.
D) in the fourth intercostal space just to the right of the sternum - correct answerD) in the fourth intercostal space just to the right of
the sternum
A patient experiencing a right ventricular infarction would be expected to present with:
A) hypertension and tachycardia
B) ST elevation in lead II, III and aVF.
C) greater than 2-mm ST depression in lead V1
D) sever pulmonary edema and hemoptysis - correct answerB) ST elevation in lead II, III and aVF.
You are assessing a middle-aged female who complains of chest discomfort. She is conscious, alert, and oriented. Her skin is
diaphoretic. Her blood pressure is 122/72 mm Hg, her pulse rate is 120 beats/min, and her respirations are 20 breaths/min. On the
basis of her chief complaint, which of your assessment findings is the MOST significant?
A) Diaphoresis
B) Mental status
C) Elevated Respiratory Rate
D) Pulse rate of 120 beats/min - correct answerD) pulse rate of 120 beats/min
In contrast to unstable angina, stable angina occurs when a patient:
A) complains of chest pain at the same time of the day for more than 2 weeks.
B) needs more than two nitroglycerin treatments to relieve his or her chest pain.
C) experiences chest discomfort after a certain, predictable amount of exertion.
D) presents with chest pain or discomfort during periods of low oxygen demand. - correct answerC) experiences chest discomfort
after a certain, predictable amount of exertion.
A 71-year-old male presents with chest pain and shortness of breath. He is conscious, but confused, and is profusely diaphoretic.
He has weakly palpable radial pulses, a BP of 70/40 mm Hg, and diffuse crackles in all lung fields. You administer high-flow oxygen
and apply the cardiac monitor, which reveals sinus tachycardia. The closest appropriate hospital is 40 miles away. Which of the
following is the MOST appropriate next action?
A) Obtain a 12-lead ECG tracing.
B) Begin an infusion of dopamine.
C) Perform a head-to-toe exam.
D) Give 20 mL/kg fluid boluses. - correct answerB) Begin an infusion of dopamine.
Which of the following is an absolute contraindication for fibrinolytic therapy?
A) Subdural hematoma 3 years ago
B) BP of 170/100 mm Hg on presentation
C) Current use of anticoagulant medication
D) Ischemic stroke within the last 12 months - correct answerA) Subdural hematoma 2 years ago
You are treating a 68-year-old woman with chest pressure and shortness of breath that started 2 days ago. Her BP is 76/52 mm Hg
and her pulse is 130 beats/min and weak. The cardiac monitor reveals sinus tachycardia with occasional PVCs and auscultation of
her lungs reveals diffuse coarse crackles. Which of the following treatment interventions is MOST appropriate for this patient?
A) Dopamine, 2 to 20 mcg/kg/min
B) Normal saline, 20 mL/kg rapid bolus
C) Amiodarone, 150 mg over 10 min
D) Nitroglycerin, 10 to 20 mcg/min - correct answerA) Dopamine, 2 to 20 mcg/kg/min
Which of the following findings would lead the paramedic to suspect pericarditis when assessing a 40-year-old male with chest pain
and no cardiac history?
A) The patient's age and absence of a cardiac history
B) The pain decreases when the patient sits forward
C) Widespread ST depression of greater than 2 mm
D) Greater than 3-mm ST elevation in leads V2 and V3 - correct answerB) The pain decreases when the patient sits forward
When assessing a patient with suspected cardiac-related chest pain, which of the following questions would be MOST appropriate
to ask?
A) Does the pain move to your arms?
B) Were you at rest when the pain began?
C) Is the pain crushing or dull in nature?
D) Can you describe the quality of the pain? - correct answerD) can you describe the quality of the pain?
, You are assessing a middle-aged female who complains of chest discomfort. She is conscious, alert, and oriented. Her skin is
diaphoretic. Her blood pressure is 122/72 mm Hg, her pulse rate is 120 beats/min, and her respirations are 20 breaths/min. On the
basis of her chief complaint, which of your assessment findings is the MOST significant?
A) Diaphoresis
B) Mental status
C) Elevated respiratory rate
D) Pulse rate of 120 beats/min - correct answerD) Pulse rate of 120 beats/min
A 27-year-old female complains of palpitations. The cardiac monitor reveals a narrow-complex tachycardia at 180/min. She denies
any other symptoms, and states that this has happened to her before, but it typically resolves on its own. Her blood pressure is
126/66 mm Hg, pulse is 180 beats/min, and respirations are 16 breaths/min. After attempting vagal maneuvers and giving two doses
of adenosine, her cardiac rhythm and vital signs remain unchanged. You should:
A) administer 5 mg of midazolam and perform synchronized cardioversion starting with 50 joules.
B) administer 0.35 mg/kg of diltiazem over 2 minutes and then reassess her hemodynamic status.
C) transport at once, reassess her frequently, and perform synchronized cardioversion if necessary.
D) infuse 150 mg of amiodarone over 10 minutes, reassess her, and repeat the amiodarone if needed. - correct answerC) transport
at once, reassess her frequently, and perform synchronized cardioversion if necessary.
You are assessing a 75-year-old male who experienced a sudden onset of slurred speech, a right-sided facial droop, and left-sided
hemiparesis approximately 45 minutes ago. His blood pressure is 170/94 mm Hg, pulse rate is 68 beats/min and irregular, and
respirations are 14 breaths/min and unlabored. His oxygen saturation is 92% on room air. The MOST appropriate treatment for this
patient includes:
A) oxygen via nonrebreathing mask, an IV of normal saline, cardiac monitoring, 5 mg of labetalol to lower his BP, blood glucose
assessment, and rapid transport.
B) 160 to 325 mg of aspirin, supplemental oxygen via nasal cannula, cardiac monitoring, blood glucose assessment, an IV of an
isotonic crystalloid, and transport.
C) assisted ventilation with a bag-valve-mask device, cardiac monitoring, an IV of normal saline, IV dextrose if his blood glucose
level is less than 80 mg/dL, and transport.
D) supplemental oxygen via na - correct answerD) supplemental oxygen via nasal cannula, cardiac monitoring, blood glucose
assessment, an IV of normal saline set to keep the vein open, and prompt transport.
You are assessing a 67-year-old female with chest discomfort when she becomes unresponsive, apneic, and pulseless. The cardiac
monitor reveals coarse ventricular fibrillation. You achieve return of spontaneous circulation after 4 minutes and the cardiac monitor
now reveals a narrow complex rhythm. The patient is still unresponsive, has occasional respirations, a blood pressure of 70/40 mm
Hg, and a weak pulse of 70 beats/min. The MOST appropriate postresuscitation care for this patient includes:
A) insertion of an airway adjunct, assisted ventilation with a bag-valve-mask device, vascular access, a 500- to 1,000-mL crystalloid
fluid bolus, and an amiodarone infusion at 1 mg/min.
B) preoxygenation with a bag-valve-mask device and high-flow oxygen, endotracheal intubation, vascular access, 300 mg of
amiodarone, and a dopamine infusion.
C) insertion of a supraglottic airway device, ventilatory assistance, vascular acce - correct answerA) insertion of an airway adjunct,
assisted ventilation with a bag-valve-mask device, vascular access, a 500- to 1,000-mL crystalloid fluid bolus, and an amiodarone
infusion at 1 mg/min.
At the end of ventricular relaxation, the left ventricle contains 110 mL of blood. This is referred to as the:
A) Preload
B) Afterload
C) Stroke volume
D) Cardiac output - correct answerA) Preload
You are assessing a man with a acute chest pain. As you are inquiring about the quality of his pain, he clenches his fist. This is
called __________ sign and nonverbally conveys a feeling of:
A) Levine's, pressure.
B) Cullen's, dullness.
C) Beck's, impending doom.
D) Grey-Turner's, fluttering. - correct answerA) Levine's, pressure.
After determining that an elderly man is pulseless and apneic, you and your team begin CPR and briefly pause to assess his cardiac
rhythm, which is shown below. After resuming CPR, you should:
A) prepare to cardiovert the patient at 50 to 100 joules.
B) establish vascular access and give 1 mg of epinephrine.
C) give 1 mEq of sodium bicarbonate to rule out acidosis.
D) insert an advanced airway as CPR is briefly paused. - correct answerB) establish vascular access and give 1 mg of epinephrine.
Occlusion of the right coronary artery would MOST likely result in:
A) sudden cardiac arrest.
B) sinoatrial node failure.
C) an increase in atrial kick.
D) ectopic ventricular complexes. - correct answerB) sinoatrial node failure.
In which of the following situations is transcutaneous cardiac pacing (TCP) clearly indicated?
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