AEMT Cardiology & Resuscitation practice questions

Correct answer: D. A supraventricular tachycardia

A supraventricular tachycardia is identified by a regular narrow-complex rhythm at 195 in which P waves cannot be distinguished. Working through rate, regularity, P wave presence, PR interval, and QRS width in the same order every time is what makes interpretation reliable under pressure.

• A. A sinus rhythm with bigeminy instead shows a rhythm in which every second beat is an early wide bizarre complex.
• B. An idioventricular rhythm instead shows a regular rhythm at 32 with wide bizarre QRS complexes and no visible P waves.
• C. First-degree atrioventricular block instead shows a regular rhythm in which every P wave is followed by a QRS but the PR interval is consistently 0.28 seconds.
• D. These features define a supraventricular tachycardia.

Correct answer: C. Pumps deoxygenated blood to the lungs

The right ventricle pumps deoxygenated blood to the lungs. Anatomy underpins assessment: knowing what sits where is what turns a location of pain into a working hypothesis.

• A. That describes the carotid artery rather than this structure.
• B. That describes the sinoatrial node rather than this structure.
• C. This correctly describes the right ventricle.
• D. That describes the medulla oblongata rather than this structure.

Correct answer: A. A paced rhythm

A paced rhythm is identified by a regular rhythm in which a sharp vertical spike precedes each wide QRS complex. Working through rate, regularity, P wave presence, PR interval, and QRS width in the same order every time is what makes interpretation reliable under pressure.

• A. These features define a paced rhythm.
• B. Sinus tachycardia instead shows a regular rhythm at 118 with an upright P wave before every QRS and a normal PR interval.
• C. Sinus arrhythmia instead shows an irregular rhythm with an upright P wave before every QRS in which the rate varies with respiration.
• D. Atrial flutter instead shows a regular ventricular response with sawtooth-shaped atrial waves between the QRS complexes.

Correct answer: D. Nitrate vasodilator

Nitroglycerin is a nitrate vasodilator. Knowing a drug's class lets you predict its effects and its likely adverse effects even when the specific agent is unfamiliar.

• A. That class describes oral glucose, which is given for symptomatic hypoglycemia in a patient who can protect their airway.
• B. That class describes oxygen, which is given for hypoxia or suspected inadequate tissue oxygenation.
• C. That class describes normal saline, which is given for intravascular volume replacement.
• D. Nitroglycerin is a nitrate vasodilator, which is why it is used for ischemic chest pain with an adequate blood pressure.

Correct answer: D. repeat the 12-lead and treat the presentation, not the tracing

One normal tracing doesn't rule out an infarction, especially early, and changes can show up over the next few minutes. The patient in front of you with ongoing pain is the finding. The tracing is one test that hasn't caught up yet.

• A. A normal tracing doesn't exclude an infarction that's still evolving.
• B. Holding treatment until a tracing turns abnormal ignores the clinical picture.
• C. Ongoing chest pain gets transported, whatever the first tracing shows.
• D. Serial tracings catch changes that one early tracing misses.

Correct answer: D. exertional collapse with a family history of sudden death

Fainting during exertion is how the cardiomyopathies that kill young athletes show up. A first-degree relative dying suddenly young is the strongest clue in the history. Looking well now doesn't make either one reassuring.

• A. A normal blood pressure doesn't rule out structural heart disease.
• B. Being well conditioned doesn't explain fainting during exertion.
• C. A normal rate after the episode doesn't lower the concern.
• D. Exertional syncope with a family history of sudden death is the classic warning pattern.

Correct answer: D. consider aortic dissection and avoid treatments that assume a coronary cause

A big difference between the arms suggests a dissection flap involving the origin of one subclavian artery. Why does that matter so much? Anticoagulants and antiplatelets help in infarction but can be catastrophic in dissection.

• A. Writing off a reproducible difference as error misses a lethal diagnosis.
• B. Picking one reading throws away the difference, and the difference is the finding.
• C. Carrying on unchanged risks giving anticoagulation to a dissecting aorta.
• D. An interarm difference suggests dissection, where standard coronary treatment can do harm.

Correct answer: B. inferior wall of the left ventricle

Leads II, III and aVF look at the heart from below, so they're your inferior leads. Know the groups and you can name the territory and expect the complications that come with an inferior infarct.

• A. The posterior wall isn't viewed directly. You infer it from reciprocal changes.
• B. II, III and aVF look at the heart from below. They're the inferior group.
• C. You see the anterior wall in the precordial leads V3 and V4.
• D. You see the lateral wall in I, aVL, V5 and V6.