Question 1

Blood travels from the right ventricle to the:

Accepted Answer

The Right Ventricle pumps deoxygenated blood through the Pulmonary Artery to the lungs.

Question 2

The compression-to-ventilation ratio for adult CPR (1 or 2 rescuers) is:

Accepted Answer

For adults, the ratio is always 30:2 until an advanced airway is placed.

Question 3

The compression-to-ventilation ratio for 2-rescuer CPR on a CHILD or INFANT is:

Accepted Answer

For children/infants, 2 rescuers use 15:2 to provide more oxygen/ventilations (since pediatric arrest is often respiratory). 1 rescuer still uses 30:2.

Question 4

The proper depth of chest compressions for an infant is:

Accepted Answer

Infant compression depth is 1.5 inches (4 cm) or 1/3 the AP diameter of the chest. Adults are 2-2.4 inches.

Question 5

Where should AED pads be placed on an adult?

Accepted Answer

Standard placement is Upper Right (below clavicle) and Lower Left (side of ribs below nipple line) to direct current through the heart.

Question 6

What is the primary pacemaker of the heart under normal conditions?

Accepted Answer

The SA node, located in the right atrium, is the heart's natural pacemaker, firing at 60-100 beats per minute.

Question 7

The heart muscle receives its oxygen supply during:

Accepted Answer

Unlike other organs, the myocardium is perfused during diastole when the aortic valve closes and blood backflows into the coronary arteries.

Question 8

You are treating a 50-year-old male with chest pain. He has a history of angina and carries nitroglycerin. His BP is 90/60. You should:

Accepted Answer

Nitroglycerin is a vasodilator that lowers blood pressure. It is contraindicated if the systolic BP is below 100 mmHg (or 90 mmHg depending on local protocol, but 90 is generally the absolute floor).

Question 9

Which of the following cardiac rhythms is 'shockable' by an AED?

Accepted Answer

VF (chaotic quivering) and Pulseless VT (rapid regular rhythm) are shockable. Asystole (flatline) and PEA (organized rhythm without a pulse) are NOT shockable.

Question 10

When performing CPR on an adult, you should allow for full chest recoil to:

Accepted Answer

Full recoil creates negative pressure in the chest, pulling venous blood back into the heart (preload). Without recoil, cardiac output drops significantly.

Question 11

A 65-year-old female complains of weakness, nausea, and sweating. She denies chest pain. You suspect:

Accepted Answer

Women, elderly patients, and diabetics often present with 'atypical' MI symptoms (weakness, nausea, dyspnea) rather than classic crushing chest pain.

Question 12

The dosage for Aspirin in a patient with suspected Acute Coronary Syndrome (ACS) is:

Accepted Answer

Standard protocol is 162-324 mg (typically 4 chewable 81mg tablets). Aspirin prevents platelet aggregation (clot growth).

Question 13

Which vessel carries oxygenated blood from the lungs to the left atrium?

Accepted Answer

The Pulmonary Veins are the only veins in the body that carry oxygenated blood (returning from the lungs to the heart).

Question 14

You witness a 12-year-old collapse during a baseball game. He is pulseless and apneic. You should:

Accepted Answer

For a *witnessed* arrest in a child/adolescent (especially during sports), suspect sudden cardiac arrest (Commotio Cordis). Immediate defibrillation is the priority. For *unwitnessed* pediatric arrest, perform 2 mins of CPR first (hypoxia is more likely).

Question 15

The Cincinnati Prehospital Stroke Scale evaluates which three signs?

Accepted Answer

FAST: Facial droop (smile), Arm drift (hold arms out), Speech (repeat a sentence). If any 1 is abnormal, probability of stroke is 72%.

Question 16

A Transient Ischemic Attack (TIA) differs from a stroke in that:

Accepted Answer

A TIA ('mini-stroke') is a temporary blockage. Symptoms mimic a stroke but resolve on their own without permanent infarction. It is a major warning sign of impending stroke.

Question 17

Right-sided Heart Failure (Cor Pulmonale) typically presents with:

Accepted Answer

When the right side fails, blood backs up into the body (systemic circulation), causing JVD and swelling in the legs/feet. Left-sided failure causes backup into the lungs (pulmonary edema).

Question 18

The primary cause of cardiac arrest in children is:

Accepted Answer

Unlike adults (cardiac cause), children usually arrest due to progressive respiratory failure/hypoxia or shock.

Question 19

You are performing CPR. You feel a 'pop' and suspect you have broken a rib. You should:

Accepted Answer

Rib fractures are a common complication of effective CPR. Do not stop. Re-verify hand placement (center of chest) and continue. The priority is perfusion.

Question 20

When using an AED on an infant (<1 year), you should prefer:

Accepted Answer

Use pediatric pads if available. If not, use adult pads (anterior-posterior placement) so they don't touch. Do not delay defibrillation.

Question 21

After a successful resuscitation (ROSC), the patient remains unconscious. You should:

Accepted Answer

Post-cardiac arrest care focuses on optimizing oxygenation (avoid hyperoxia) and maintaining blood pressure (systolic >90) to perfuse the brain.

Question 22

Which medication is contraindicated if the patient has taken medications for erectile dysfunction (e.g., Viagra/Cialis) within the last 24-48 hours?

Accepted Answer

Both Nitroglycerin and ED drugs (PDE-5 inhibitors) are vasodilators. Combining them causes a synergistic, profound, and potentially fatal drop in blood pressure.

Question 23

Cardiogenic shock is caused by:

Accepted Answer

Cardiogenic shock occurs when the heart muscle is so damaged (e.g., from a massive MI) that it cannot pump enough blood to meet the body's needs.

Question 24

You are treating a patient with a Left Ventricular Assist Device (LVAD). The patient is unresponsive and apneic. You assess for a pulse and:

Accepted Answer

LVADs are continuous flow pumps. Patients often do not have a palpable pulse or a measurable blood pressure, even when alive. Assess perfusion by skin color, mental status, and listen for the 'hum' of the pump.

Question 25

The most common symptom of a heart attack (MI) is:

Accepted Answer

While radiation to the arm/jaw is common, the most frequent complaint is crushing pressure or pain in the center of the chest (substernal).

Question 26

Which valve prevents blood from flowing back into the left ventricle?

Accepted Answer

The Aortic Valve separates the Left Ventricle from the Aorta.

Question 27

An Aortic Aneurysm (AAA) often presents with:

Accepted Answer

AAA is a weakening of the aortic wall. As it expands or dissects, patients describe 'tearing' pain radiating to the back. A pulsating abdominal mass may be felt (do not palpate vigorously!).

Question 28

The correct hand placement for chest compressions on an adult is:

Accepted Answer

Compressions must be centered on the lower half of the sternum to compress the ventricles efficiently. Avoid the xiphoid process to prevent liver injury.

Question 29

A patient in cardiac arrest has a pacemaker implanted in their upper right chest. You should place the AED pad:

Accepted Answer

Do not place pads directly over a device (pacemaker/ICD) as it blocks the current and can burn the skin. Place the pad at least 1 inch to the side.

Question 30

You respond to a 70-year-old male with slurred speech and right-sided weakness. The symptoms started 1 hour ago. This patient is a candidate for:

Accepted Answer

If the stroke is ischemic and within the time window (usually <3-4.5 hours), fibrinolytic drugs can dissolve the clot. Immediate transport to a Stroke Center is critical. Do NOT give aspirin (risk of hemorrhage).

Question 31

Which artery is palpated to check a pulse in an unresponsive infant?

Accepted Answer

In infants (<1 year), the brachial artery (upper arm) is easiest to feel. Carotids are hard to find due to short/fat necks.

Question 32

Sudden Cardiac Arrest (SCA) differs from a Heart Attack (MI) in that:

Accepted Answer

MI is a blockage of blood flow causing tissue death. SCA is a malfunction of the electrical system causing the heart to stop beating unexpectedly.

Question 33

What is the maximum time you should interrupt chest compressions (e.g., for breaths or rhythm check)?

Accepted Answer

Interruptions destroy perfusion pressure. Keep pauses <10 seconds.

Question 34

Angina Pectoris occurs when:

Accepted Answer

Angina is chest pain caused by reversible ischemia. It typically happens during exertion and resolves with rest or nitroglycerin. MI pain does not resolve.

Question 35

Hypertensive Crisis is defined as a blood pressure usually exceeding:

Accepted Answer

Systolic >180 or Diastolic >120 is considered a crisis, posing immediate risk of stroke or organ damage.

Question 36

You are treating a patient with a suspected MI. Aspirin is given to:

Accepted Answer

Aspirin is an antiplatelet agent. It stops the clot from growing. It is NOT a painkiller (at this dose) or a thrombolytic (clot buster).

Question 37

Which cardiac rhythm looks like a chaotic, wavy line with no QRS complexes?

Accepted Answer

Ventricular Fibrillation (VF) is disorganized electrical activity. The ventricles quiver and do not pump.

Question 38

Syncope (fainting) is typically caused by:

Accepted Answer

Syncope is a transient loss of consciousness due to global cerebral hypoperfusion (low blood flow). Patients usually recover quickly once flat.

Question 39

While attempting to ventilate a patient in cardiac arrest, you meet resistance and the chest does not rise. You should:

Accepted Answer

Airway obstruction or improper positioning is the most common cause. Reposition first. If that fails, assume Foreign Body Airway Obstruction and check mouth/perform chest compressions.

Question 40

A patient complains of a 'tearing' pain in his back between his shoulder blades. His blood pressures are significantly different in each arm. You suspect:

Accepted Answer

Aortic Dissection involves a tear in the inner layer of the aorta. Unequal pulses/BP and tearing back pain are hallmark signs.

Question 41

The electrical impulse of the heart normally begins at the:

Accepted Answer

The SA node is the primary pacemaker, initiating the electrical impulse that spreads through the atria to the AV node.

Question 42

You are treating a patient with chest pain. He has taken 3 doses of nitroglycerin prior to your arrival. His blood pressure is 100/60. You should:

Accepted Answer

Most protocols limit nitroglycerin to 3 doses max. Additionally, a systolic BP of 100 is borderline; giving more risks severe hypotension.

Question 43

Beck's Triad, indicating Cardiac Tamponade, consists of:

Accepted Answer

Cardiac Tamponade (fluid in the pericardial sac compressing the heart) restricts filling, causing low BP (Hypotension), backup of blood (JVD), and fluid insulation (Muffled sounds).

Question 44

The proper rate of chest compressions for a cardiac arrest patient of ANY age is:

Accepted Answer

Current guidelines recommend 100-120 compressions/minute to maximize coronary perfusion pressure.

Question 45

While using an AED, the device prompts 'Check Electrodes'. You should:

Accepted Answer

Poor contact due to sweat or hair is the most common cause. Press pads down firmly. If that fails, shave hair or replace pads.

Question 46

A 55-year-old male is in cardiac arrest. Bystanders have been performing CPR for 5 minutes. You arrive and set up the AED. It analyzes and advises 'No Shock'. You should:

Accepted Answer

Do not delay compressions to check a pulse after a 'No Shock' advisory. The patient likely has Asystole or PEA, which requires high-quality CPR to perfuse the heart.

Question 47

Which of the following side effects is common after administering Nitroglycerin?

Accepted Answer

Nitroglycerin causes systemic vasodilation. Dilation of cerebral vessels often causes a throbbing headache.

Question 48

In the context of CPR, 'Recoil' refers to:

Accepted Answer

Full recoil is critical to allow the heart chambers to refill with blood before the next compression pushes it out.

Question 49

Which vessel supplies the heart muscle itself with blood?

Accepted Answer

The coronary arteries branch off the base of the aorta and supply oxygenated blood to the myocardium. Blockage here causes an MI.

Question 50

You are treating a patient with severe chest pain. BP is 110/70. HR is 90. SpO2 is 93%. You should administer oxygen via:

Accepted Answer

For ACS (Acute Coronary Syndrome), oxygen is titrated to maintain SpO2 >94%. High-flow oxygen can cause vasoconstriction and worsen injury if the patient isn't hypoxic. A cannula is appropriate to bring 93% up to 94%.

Question 51

Pulsus Paradoxus (a drop in BP during inhalation) is a sign of:

Accepted Answer

In tamponade, the heart is compressed. Inhalation increases thoracic pressure, further compressing the heart and dropping systolic BP by >10 mmHg.

Question 52

You are transporting a patient with chest pain. He suddenly becomes unconscious. You check for a pulse and find none. The monitor shows Sinus Rhythm. This condition is called:

Accepted Answer

PEA is the presence of organized electrical activity on the monitor without a palpable pulse (mechanical capture). Treat with CPR (not shockable).

Question 53

Atherosclerosis is best defined as:

Accepted Answer

Atherosclerosis is the buildup of cholesterol/calcium plaques inside arteries, restricting flow and leading to CAD/MI/Stroke.

Question 54

Which patient is the highest priority for transport?

Accepted Answer

The 60-year-old female presents with atypical MI symptoms (indigestion/sweating) and relative hypotension. This is a potential active MI. The 55-year-old likely has stable angina (relieved by rest).

Question 55

Nitroglycerin is administered via which route?

Accepted Answer

SL administration allows rapid absorption into the bloodstream via the mucous membranes, bypassing digestion.

Question 56

You are performing CPR on a child. An AED arrives with only adult pads. You should:

Accepted Answer

If pediatric pads/attenuator are unavailable, use adult pads. Place them anterior-posterior (front/back) so they do not touch or overlap. Shock is better than no shock.

Question 57

Which chamber of the heart has the thickest muscular wall?

Accepted Answer

The Left Ventricle pumps blood against high pressure to the entire body (systemic circulation), requiring the most muscle mass.

Question 58

A Commotio Cordis event occurs when:

Accepted Answer

Often seen in sports (baseball/hockey), a blow to the chest during the repolarization phase (T-wave) can disrupt the rhythm and cause sudden cardiac arrest (VF). Immediate AED is curative.

Question 59

To prevent fatigue and maintain compression quality, rescuers should switch roles:

Accepted Answer

Compressor fatigue sets in quickly, reducing depth and rate. Switch every 2 minutes (or 5 cycles of 30:2) to maintain quality.

Question 60

Which of the following patients is NOT a candidate for Aspirin?

Accepted Answer

Active GI bleeding is a major contraindication. While blood thinners are a precaution, active bleeding is the hard stop. Asthma is generally not a contraindication unless there is a specific aspirin allergy.

Question 61

The tricuspid valve is located between the:

Accepted Answer

The Tricuspid valve (Right side) separates the RA and RV. The Mitral/Bicuspid valve (Left side) separates the LA and LV.

Question 62

Ischemia is defined as:

Accepted Answer

Ischemia is reversible hypoxic injury (like Angina). Infarction is irreversible tissue death (like MI).

Question 63

A patient is unresponsive with a suspected stroke. You find him slumped in a chair, snoring. Your FIRST action is:

Accepted Answer

ABC priority. Snoring indicates airway obstruction by the tongue. You must open the airway (head-tilt chin-lift) before assessing sugar or stroke scale.

Question 64

Which of the following findings is most consistent with Left-Sided Heart Failure?

Accepted Answer

Left heart failure backs up into the lungs (Pulmonary Edema = Crackles). Right heart failure backs up into the body (JVD, Pedal Edema).

Cardiology Practice Questions

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