Chapter 17 Quiz ~ Study Plan – Flashcards
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The primary function of the heart is to:
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Circulate blood.
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When treating a patient with chest pain, the primary goal of the EMT is to:
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Recognize the possibility of cardiac compromise and provide proper care.
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Which of the following descriptors of pain is common in a patient suffering from chest pain secondary to a heart attack?
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Heavy.
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Prior to administering nitroglycerin to a patient with chest pain, the EMT must ensure that the:
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Nitroglycerin is prescribed for the patient.
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If it is required in your state that every ambulance must be staffed at a minimum with one EMT and one Paramedic, this requirement was established to meet which of the Technical Assistance Program Assessment Standards?
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Regulation and policy.
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Who is most likely to suffer a silent MI?
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55-year-old female with diabetes.
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You have just arrived by the side of a 68-year-old male complaining of chest pain. After determining his airway is patent and breathing adequate, it is imperative that you perform which action next?
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Check his radial pulse.
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Which of the following contributes to cardiac arrest more so in geriatric patients than pediatric patients?
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History of trauma.
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The term "depolarization" refers to:
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The contraction of the heart muscle.
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Based on your protocol, which one of the screening procedures may you be specifically asked to perform on certain patients with a suspected myocardial infarction?
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Fibrinolytic checklist.
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You are treating a patient complaining of altered mental status, shortness of breath, and chest pain. A paramedic has just administered a medication that causes the sympathetic nervous system to increase its influence in the body. Which one of the following actions should you anticipate?
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Increased heart rate.
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You are treating a patient who was dizzy and fell, sustaining a laceration to the forehead. He does not appear to be having a hypertensive crisis. Aside from determining the cause of the dizziness, how should you deal with the bleeding?
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Direct pressure and a bandage.
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The National Highway Traffic Safety Administration provides a set of recommended standards for EMS systems called the "Technical Assistance Program Assessment Standards." These ten standards include which one of the following?
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Medical direction.
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Your patient has chest pain, and you have just assisted him in taking his nitroglycerin tablet. Which of the following patient statements is the cause for greatest concern?
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"The chest pain does not feel any different."
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When administering aspirin to a patient with chest pain that is suggestive of a heart attack, the EMT recognizes that this medication will benefit the patient by:
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Decreasing the ability of the platelets in the blood to form clots.
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If there are NOT electrical events occurring in the heart, then:
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There will be no mechanical events occurring in the heart either.
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Which of the following scene size-up observations would make you suspicious that a patient complaining of shortness of breath is suffering from congestive heart failure?
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Multiple pillows stacked at the head of his bed.
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This disease process happens when the coronary arteries are narrowed or occluded.
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Acute Coronary Syndrome.
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Which of the following blood vessels directly interface with cells throughout the body?
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Capillaries.
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Which of the following blood vessels primarily carry deoxygenated blood?
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Veins.
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The delivery of oxygen and nutrients, and the removal of waste products from the cells is called?
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Perfusion.
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Which statement accurately differentiates angina and myocardial infarction?
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The pain of angina usually goes away on its own.
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Two conditions related to cardiac compromise are angina pectoris and myocardial infarction. In comparing the two, remember:
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Nitroglycerin may give incomplete or no relief of myocardial infarction pain.
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When asking about the quality of the chest pain a patient with angina is experiencing, you are asking:
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If the pain is sharp, dull, burning, or squeezing.
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The majority of out-of-hospital deaths attributed to coronary artery disease are due to what sudden event?
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Lethal cardiac rhythm disturbance.
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Trace the pathway the blood takes through the heart and lungs.
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Vena cava, right atrium, right ventricle, lungs, left atrium, left ventricle, and aorta.
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Which of the following is TRUE regarding the heart and blood vessels?
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The pulmonary arteries are the only arteries that carry oxygen-depleted blood.
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The capillaries are a network of tiny blood vessels:
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That connect arterioles to venules.
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Cardiac muscle cells have one property that MOST skeletal and smooth muscle cells do NOT have. This property is known as:
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Automaticity.
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When the electrical impulse leaves the SA node and starts to travel down the conduction pathway, what happens mechanically?
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Atrial contraction.
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What pacemaker site in the heart serves as the primary pacemaker?
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Sinoatrial node.
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What is the terminal portion of the heart's conduction system?
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Purkinje fibers.
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The site in the heart's conduction system where the electrical impulse is temporarily slowed down to allow the ventricles to fill with blood is the:
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AV node.
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The cardiac conduction system allows the heart to generate electrical impulses. Trace an electrical impulse through the structures of the heart, in order.
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SA node, AV node, bundle of His, and Purkinje fibers.
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Of the three main portions of the ECG tracing, the portion that corresponds with the depolarization of the ventricles is the:
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QRS complex.
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During cardiac arrest, instead of coordinated contractions, the heart may show uncoordinated twitching known as:
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Ventricular fibrillation.
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Abnormal contractions of the ventricles in response to conduction system irritability from a lack of oxygen are called?
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PVCs.
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A lethal heart rhythm that can occur as a response to conduction system injury or death, and results in an absence of cardiac output, is called:
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Ventricular fibrillation.
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With the hypoxia and damage to the heart muscle that comes with ischemia or infarction, what can happen to the conduction cells of the myocardium?
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They may become damaged and fail.
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Which one of the following statements is TRUE regarding blood pressure?
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The smaller the artery the greater the resistance and the higher the diastolic pressure.
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If blood is NOT circulated adequately through the body's capillaries, cells become starved for oxygen and nutrients and overloaded with carbon dioxide and waste products. This condition is known as:
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Hypoperfusion.
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If a patient has hypoperfusion from a massive heart attack, what etiology of shock would this be considered?
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Cardiogenic.
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You are treating a patient with a very irregular pulse. Which of the following would be avoided in your treatment plan?
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Administration of epinephrine utilizing the patient's self injector.
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The EMT's treatment of a cardiac emergency while still on scene should include administering oxygen, assisting the patient into a position of comfort, administering aspirin, and:
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Expediting transport.
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Which of the following is a critical element in the EMT's field treatment of all myocardial infarction patients?
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Early recognition.
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Which of the following patients would likely have the highest risk for developing a heart attack?
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Elderly male who smokes, is obese, and lives a sedentary lifestyle.
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The disease process that results in a buildup of fatty deposits on the inner walls of the arteries is called:
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Atherosclerosis.
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You are treating a patient with severely swollen feet and a distended, spongy abdomen. You should suspect that the patient is suffering from:
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Congestive heart failure.
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If the patient you are treating has a BP of 90/60 mmHg and crushing chest pain, what would be the MOST appropriate treatment?
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Administer oxygen.
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When might an aspirin administered by the EMT be considered contraindicated?
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If the patient is known to be allergic to aspirin.
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A late sign of congestive heart failure would include:
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Jugular vein distension.
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A clot that develops in a blood vessel to the point that it occludes it, is called a:
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Thrombus.
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A condition in which the artery walls become hard and stiff due to calcium deposits is called:
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Arteriosclerosis.
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Heart failure is defined as:
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The heart's inability to pump a sufficient amount of blood from the ventricles.
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In events that compromise cardiac function, time becomes a crucial element for patient survival. Which of the following is TRUE regarding cardiac compromise?
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Any adult with chest pain should be treated as a cardiac emergency until proven otherwise.
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You are assessing a 58-year-old male who is short of breath and has very little energy. He normally leads a very sedentary lifestyle. You note that he has two past heart attacks and edema to his lower extremities. What is his MOST likely problem?
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Congestive heart failure.
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A clot or other matter that has traveled from another area of the body is called a/an:
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Embolus.
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What is the leading cause of death in adult females?
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Coronary heart disease.
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Besides females, what high-risk demographic is likely to present with atypical findings when experiencing ACS or a myocardial infarction?
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Diabetics.
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The symptoms of myocardial infarction in females are:
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Usually more subtle, or slightly different than those in males.
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Which of the choices is an atypical finding of a heart attack in females?
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Neck ache.
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A female patient is complaining of feeling tired over the past two days, associated with swelling of the ankles, epigastric pain, and nausea. This patient may be suffering from:
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A coronary event.
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You must reassess your patient within two minutes after administering nitroglycerin, as one of the side effects is:
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A decrease in blood pressure.
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You just administered nitro to a patient who has chest pain which was a 9/10. He suddenly gets very weak and feels dizzy. What should you do?
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Check his vitals and lay him down.
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You are assessing a 58-year-old male patient with a chief complaint of chest pain and difficulty breathing. He states that he has had crushing substernal pain for the past hour. He has his nitro with him, but just forgot to take it. Should you administer his nitro to him?
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Yes, if his BP is above 90 mmHg systolic.
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Patients with known cardiac problems often will have been prescribed nitroglycerin for their chest pain. Nitroglycerin eases chest pain by:
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Increasing the diameter of blood vessels and decreasing the workload of the heart.
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If you are treating an elderly male in his 80s, and has a very slow pulse, but is still alert, what would be your FIRST priority?
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Inquire about his history and monitor his vital signs.
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What is the typical reason a pediatric patient goes into cardiac arrest?
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Airway and ventilatory problems
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When a patient tells you that he has chest pain and feels dizzy, the dizziness is referred to as a/n:
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Associated sign or symptom.
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You are assessing a patient complaining of chest pain which started about 45 minutes ago. He is pale, clammy, and has very little energy. His vitals are respirations of 24, pulse of 110, and BP of 94/60. What priority would you give this patient?
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High, due to the low blood pressure reading.
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The EMT is assisting a patient with chest pain to take his own nitroglycerin. If the patient continues to experience NO relief after one dose, the EMT should:
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Obtain medical control permission to administer a second dose.
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You are transporting a patient with a clinical presentation consistent with an acute coronary event. Assuming that all of the following receiving facilities are roughly the same distance from your location, which receiving facility would you transport to?
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The hospital with PCI capability.
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Which of the following is an absolute contraindication for receiving fibrinolytic therapy?
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History of an intracranial bleed.
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If a patient with an acute coronary syndrome presents to EMS, and the providers are able to resolve all pain through the use of nitrates and oxygen, why should this patient still be taken to a hospital capable of percutaneous coronary interventions?
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So that the cause of the MI can be more permanently resolved within a very narrow and time-sensitive window of opportunity.
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Which is an absolute contraindication for the use of fibrinolytic drugs in a patient experiencing a myocardial infarction?
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Active bleeding.
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You are evaluating a 72-year-old male who states he has pain from his belly into his back. On palpation, he seems to have a pulsatile mass in his abdomen. His vitals are respirations of 22, pulse of 110, and BP of 146/100 mmHg. What do you suspect his problem is?
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Aortic aneurysm.
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You are assessing a 58-year-old female who called EMS due to a nosebleed, bounding pulse, and ringing in her ears. Of the following what is the likely cause of these symptoms happening together today?
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Hypertensive emergency.
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The biggest concern when confronted with a patient who has had a nosebleed for the past few days is the potential for significant blood loss and:
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A hypertensive crisis.