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Fisdap Cardiology Review (Paramedic) questions with correct answers
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Fisdap Cardiology Review (Paramedic) questions withcorrect answers
The MOST appropriate initial action for a 54-year-old man who presents
with the following cardiac rhythm should consist of: Correct Answer-
Assessing the patient's clinical status.
When assessing the cardiac rhythm of any patient, you must interpret it
in the context of his or her clinical status. Before you reach for atropine
or a pacemaker, determine if the bradycardia is causing hemodynamic
compromise (ie, hypotension, altered mental status, chest pressure or
discomfort, pulmonary edema). If the patient is hemodynamically
unstable, treat according to established ACLS guidelines (ie, atropine,
pacing, etc.). However, if the patient is hemodynamically stable, simply
monitor his or her clinical status and transport to the hospital.
You should interpret the following cardiac rhythm as: Correct Answer-
Atrial flutter with a fixed block.
Because of the typical "sawtooth" flutter (F) waves, this rhythm is
interpreted as atrial flutter (A-Flutter). The block is fixed in that the ratio
of F waves to QRS complexes is consistent (2:1). A-Flutter with a
variable block occurs when the ratio of F waves to QRS complexes is
different. Atrial fibrillation (A-Fib) is characterized by an irregularly
irregular rhythm with no identifiable P waves. A type II second-degree
AV block is characterized by a rhythm in which some P waves are
blocked (eg, they are not followed by QRS complexes).
,You should interpret the following cardiac rhythm as: Correct Answer-
Third-degree AV block.
The rhythm is regular, with a ventricular rate of approximately 40 to 50
beats/min. It has wide (greater than 120 ms [0.12 sec]) QRS complexes
and more P waves than QRS complexes. Because there is no relationship
between any one P wave to a given QRS complex, this is a third-degree
AV block, also called complete heart block. First-degree AV block is
characterized by P-R intervals that exceed 200 ms (0.20 seconds [5
small boxes]), although there is a consistent 1:1 P-to-QRS ratio; unless
ectopic compexes are present, it is usually a regular rhythm. Second-
degree AV block type I is characterized by P-R intervals that
progressively lengthen until a P wave is blocked (not followed by a QRS
complex); it is an irregular rhythm. Second-degree AV block type II,
which may be regular or irregular, is characterized by more P waves
than QRS complexes; however, the P-R intervals of the conducted
complexes are the same.
A 44-year-old man presents with the rhythm shown below. He
complains of nausea, but denies vomiting. He is conscious and alert with
a BP of 122/62 mm Hg, a pulse rate of 98 beats/min, and respirations of
16 breaths/min and unlabored. Treatment for this patient would MOST
likely include: Correct Answer-Ondansetron, 4 mg.
Unless associated with a fast rate (> 100 beats/min) and hemodynamic
compromise (eg, hypotension, altered mental status, pulmonary edema),
treatment for atrial flutter is usually not necessary in the prehospital
setting. Administer supplemental oxygen if indicated, transport, and
monitor the patient's hemodynamic status en route. For this patient, you
,should treat his nausea with an antiemetic, such as ondansetron (Zofran),
4 mg; or promethazine (Phenergan), 12.5 to 25 mg.
A patient's medication regimen includes fluoxetine, Toprol, Proscar,
lansoprazole, and Klonopin. Which of these medications is used to treat
cardiovascular disorders? Correct Answer-Toprol.
Toprol (metaprolol) is a commonly prescribed beta-blocker used to treat
various cardiovascular conditions, including hypertension and
tachydysrhythmias. Proscar (finasteride) is used to treat benign prostatic
hyperplasia (BPH). Fluoxetine (Prozac) is a selective serotonin reuptake
inhibitor (SSRI) antidepressant. It is used to treat conditions such as
depression, generalized anxiety disorder, and obsessive-compulsive
disorder (OCD). Lansoprazole (Prevacid)—a proton pump inhibitor—is
used to treat conditions such as heartburn, acid reflux disease, and
ulcers. Clonazepam (Klonopin) is a benzodiazepine sedative-hypnotic; it
is used to treat anxiety.
A 65-year-old man with difficulty breathing and palpitations presents
with the cardiac rhythm shown below, which you should interpret as:
Correct Answer-Supraventricular tachycardia.
Since this rhythm has narrow (less than 0.12 seconds) QRS complexes
and a rate greater than 150 beats/min, it should be interpreted as
supraventricular tachycardia (SVT), which means that its site of origin is
above (supra) the level of the ventricles. SVT can be either atrial or
junctional in origin. Atrial fibrillation is characterized by an irregularly
irregular rhythm and no discernable P waves. Atrial flutter is
characterized by flutter (F) waves that resemble a saw tooth. Ventricular
, tachycardia (V-Tach), in contrast to SVT, is characterized by wide
(greater than 0.12 seconds) QRS complexes and no visible P waves.
You are transporting a 44-year-old man with shortness of breath. He is
conscious alert and is receiving supplemental oxygen. A patent IV line
has been established. Suddenly, he develops the rhythm shown below.
He is now responsive to pain only; is profusely diaphoretic; and has
weak radial pulses. You should: Correct Answer-Perform synchronized
cardioversion with 100 joules.
The patient is in monomorphic ventricular tachycardia with a pulse. He
is clinically unstable, as evidenced by his decreased level of
consciousness, profuse diaphoresis, and weak radial pulses. Assessing
his BP will yield little additional information; therefore, you should
perform synchronized cardioversion with 100 joules. Consider sedating
the patient, but do not delay cardioversion. Amiodarone, 150 mg IV over
10 minutes, would be an appropriate intervention if the patient was
clinically stable. Adenosine is used for clinically stable patients with
narrow-complex tachycardias and can be considered for clinically stable
patients with wide-complex monomorphic tachycardias.
An elderly man is apneic and pulseless. The ECG shows the following
rhythm, which you should interpret as: Correct Answer-Sinus
tachycardia.
The rhythm shown is sinus tachycardia at a rate of approximately 100 to
110 beats/min. First-degree AV block is characterized by a PR interval
that is greater than 0.20 seconds, the normal being 0.12 to 0.20 seconds
(120 to 200 milliseconds). The fact that the patient does not have a pulse
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