Download Name: Date: ______ 1. All of the following are strategies for

MORRIS EMS System Continuing Education Quiz – January 2016
Name: __________________________ Date: _____________
1. All of the following are strategies for decreasing the risk for cardiovascular disease,
EXCEPT:
A) smoking cessation.
B) lipid management.
C) anaerobic exercise.
D) behavior modification.
2. The heart's anatomic location is MOST accurately described as being:
A) retrosternal.
B) hemithoracic.
C) submediastinal.
D) supradiaphragmatic.
3. Which of the following statements regarding the SA node is correct?
A) The SA node is the dominant cardiac pacemaker in healthy patients.
B) SA nodal ischemia occurs when the left coronary artery is occluded.
C) The SA node is located in the superior aspect of the right ventricle.
D) Impulses generated by the SA node travel through the right atrium only.
4. The AV junction:
A) includes the AV node but not the bundle of His.
B) is the dominant and fastest pacemaker in the heart
C) receives its blood supply from the circumflex artery.
D) is composed of the AV node and surrounding tissue.
5. The SA node:
A) cannot depolarize faster than 100 times/min.
B) will outpace any slower conduction tissue.
C) functions as the heart's secondary pacemaker.
D) has an intrinsic firing rate of 40 to 60 times per minute.
6. If the heart's secondary pacemaker becomes ischemic and fails to initiate an electrical
impulse:
A) the AV junction will begin pacing at 40 to 60 times/min.
B) you will see a brief period of bradycardia followed by asystole.
C) the P wave and PR interval will have an abnormal appearance.
D) you should expect to see a heart rate slower than 40 beats/min.
Page 1
7. The P wave represents:
A) SA nodal discharge.
B) atrial depolarization.
C) a delay at the AV node.
D) contraction of the atria.
8. The brief pause between the P wave and QRS complex represents:
A) depolarization of the inferior part of the atria.
B) the period of time when the atria are repolarizing.
C) full dispersal of electricity throughout both atria.
D) a momentary conduction delay at the AV junction.
9. Which of the following ECG waveforms represents ventricular depolarization?
A) T wave
B) ST segment
C) QRS complex
D) U wave
10. If you are unsure whether a conscious cardiac patient requires immediate transport
versus continued assessment at the scene, you should:
A) continue with the secondary assessment to obtain more information.
B) take the patient's vital signs and then make your transport decision.
C) begin immediate transport and perform a focused assessment en route.
D) contact medical control and inform him or her of the patient's condition.
11. Common complaints in patients experiencing an acute coronary syndrome include all of
the following, EXCEPT:
A) fatigue.
B) headache.
C) chest pain.
D) palpitations.
Page 2
12. Which of the following statements regarding oxygen administration for a patient
experiencing an acute myocardial infarction is correct?
A) Evidence has shown that high (greater than 90%) concentrations of oxygen reduce
mortality.
B) In order to prevent hypoxic injury, do not give any patient with an acute
myocardial infarction more than 2 L/min of oxygen.
C) Treatment with oxygen should be individualized and titrated to maintain the SpO2
level above 94%.
D) Any patient experiencing an acute myocardial infarction should receive high-flow
oxygen.
13. Which of the following interventions should be performed en route to the hospital
during a lengthy transport of a patient with a suspected myocardial infarction?
A) Supplemental oxygen
B) Aspirin administration
C) IV therapy and analgesia
D) 12-lead electrocardiography
14. If a patient's ECG rhythm shows any artifact, you should:
A) ensure the electrodes are applied firmly to the skin.
B) reverse the limb leads to obtain a clearer ECG tracing.
C) place the ground lead in a different anatomic location.
D) remove the negative lead and reassess the cardiac rhythm.
15. When analyzing a cardiac rhythm strip in lead II, you should routinely evaluate all of
the following components, EXCEPT the:
A) QRS width.
B) PR interval.
C) ST segment.
D) R-R interval.
16. Supraventricular tachycardia is MOST accurately defined as:
A) any tachycardic rhythm with a heart rate greater than 130 beats/min and absent P
waves.
B) a tachycardic rhythm originating from a pacemaker site above the level of the
ventricles.
C) an irregular tachycardic rhythm that originates just below the AV junction.
D) a regular tachycardic rhythm between 150 and 180 beats/min with P waves buried
in the QRS complexes.
Page 3
17. Patients with a heart rate greater than 150 beats/min usually become unstable because
of:
A) reduced ventricular filling.
B) an increase in the atrial kick.
C) increased right atrial preload.
D) a significantly reduced afterload.
18. A 17-year-old man complains of palpitations and lightheadedness that began suddenly
about 20 minutes ago. His blood pressure is 118/74 mm Hg, heart rate is rapid and
regular, and respirations are 18 breaths/min. The cardiac monitor reveals a narrow QRS
complex tachycardia at 180 beats/min. As you are applying supplemental oxygen, the
cardiac rhythm spontaneously converts to a sinus rhythm. Closer evaluation of his
rhythm reveals a rapid upslope to the R wave immediately after the end of the P wave.
Which of the following statements regarding this scenario is correct?
A) This patient likely has Wolff-Parkinson-White syndrome.
B) The patient's ECG abnormality is called an Osborn wave.
C) The ECG abnormality is caused by failure of the AV node.
D) In this patient, there is a delay in ventricular depolarization.
19. A 33-year-old woman presents with an acute onset of “fluttering” in her chest. She is
conscious and alert but is somewhat anxious. She denies any significant medical
problems but states that she has been under a lot of stress at work. You apply the cardiac
monitor, which reveals a narrow QRS complex tachycardia at a rate of 170 beats/min.
The patient's blood pressure is 140/90 mm Hg, and she is breathing without difficulty.
The MOST appropriate treatment for this patient involves:
A) oxygen, vagal maneuvers, and emotional support.
B) vagal maneuvers, IV access, and 0.25 mg/kg of diltiazem.
C) oxygen, emotional support, and 2.5 mg of midazolam IM.
D) oxygen, IV access, vagal maneuvers, and 6 mg of adenosine.
20. A 56-year-old man complains of chest tightness, shortness of breath, and nausea. During
your assessment, you note that he appears confused. He is profusely diaphoretic and has
a blood pressure of 98/68 mm Hg and a rapid radial pulse. The cardiac monitor reveals a
wide QRS complex tachycardia at a rate of 200 beats/min. After administering
high-flow oxygen, you should:
A) attempt to slow his heart rate with vagal maneuvers and then start an IV line.
B) establish IV access, consider sedation, and perform synchronized cardioversion.
C) establish vascular access and administer 150 mg of amiodarone over 10 minutes.
D) obtain a 12-lead ECG tracing to determine the origin of his tachycardic rhythm.
Page 4
Answer Key
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
C
A
A
D
B
D
B
D
C
A
B
C
C
A
C
B
A
A
D
B
Page 5