# Odd(?) Question: Where does an MI begin/



## TigerManMcCool9974 (Jan 21, 2014)

Two of us who have just passed the NREMT-B at the first of the month are trying to help a third classmate study to take hers. I got the 70 questions, done. The other got the full 120, and she said they asked the following:

In what part of the heart does an MI begin? The options were the 4 chambers, RA, RV, LA, LV.

My thinking: An MI is a coronary artery blockage, and it would depend on which of the arteries is blocked and what part that artery feeds. However, that's not one of the options. So, I consider: in a STEMI, the ST wave (per my understanding) indicates ventricular activity, the LV pumps oxygented blood, which would be what's blocked off in the artery to cause the MI. Ergo, I would have answered LV. As far as an NSTEMI, it seems like it would once again fall back onto which coronary artery is blocked, but I would still say the LV, because that's the chamber pumping the oxygenated blood into the arteries.

Seems like a paramedic level question, to me, but it is what it is. She said she answered RA, but I don't see it, and the test doesn't give the rights & wrongs. Could one of you kindly shine some light upon the subject?


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## FLdoc2011 (Jan 21, 2014)

That's a horrible question.


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## chaz90 (Jan 21, 2014)

Quite frankly, that question doesn't make a lot of sense.


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## epipusher (Jan 21, 2014)

I say 27. But my math could be off.


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## Handsome Robb (Jan 21, 2014)

Sounds like someone didn't read the question right.


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## Handsome Robb (Jan 21, 2014)

epipusher said:


> I say 27. But my math could be off.




Quoted because there's no like button and I spit beer everywhere. :rofl:


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## TigerManMcCool9974 (Jan 21, 2014)

Really, my first answer when they asked me was, "That's not going to be in the test. It doesn't make any sense." Then the one told me it was on her test. They were asking, because she just guessed at it.  I told 'em be one of the 20 she can miss and still pass. I just thought maybe someone out there might see where I'd miss something.


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## Handsome Robb (Jan 21, 2014)

Maybe they're asking which part of the heart is generally affected by an MI? That'd be your LV, in most cases.


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## STXmedic (Jan 21, 2014)

Robb said:


> Sounds like someone didn't read the question right.



I second this. I doubt that's exactly what the question said. It was most likely misread. If that is what it said, guess and cross your fingers, because it makes no sense.


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## mycrofft (Jan 21, 2014)

Robb said:


> Maybe they're asking which part of the heart is generally affected by an MI? That'd be your LV, in most cases.



This is the most likely solution.


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## Medic Tim (Jan 21, 2014)

TigerManMcCool9974 said:


> Really, my first answer when they asked me was, "That's not going to be in the test. It doesn't make any sense." Then the one told me it was on her test. They were asking, because she just guessed at it.  I told 'em be one of the 20 she can miss and still pass. I just thought maybe someone out there might see where I'd miss something.



where did you get the info on being able to get 20 questions wrong and still pass?


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## TigerManMcCool9974 (Jan 21, 2014)

Medic Tim said:


> where did you get the info on being able to get 20 questions wrong and still pass?



Basic math. My test was right at 70 questions. 70% of 70 is 49. So, I could miss roughly 20 questions and pass. The administrator said not to freak out if it cuts off around 70, because most everyone gets 70ish, unless they're the lucky 125th person that gets the whole test regardless. Guy in my class that took it same time as me got 73 questions, one earlier that morning 71, and the girl with this weirdo MI question got the whole 120. All passed.


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## teedubbyaw (Jan 21, 2014)

TigerManMcCool9974 said:


> Basic math. My test was right at 70 questions. 70% of 70 is 49. So, I could miss roughly 20 questions and pass. The administrator said not to freak out if it cuts off around 70, because most everyone gets 70ish, unless they're the lucky 125th person that gets the whole test regardless. Guy in my class that took it same time as me got 73 questions, one earlier that morning 71, and the girl with this weirdo MI question got the whole 120. All passed.





NREMT does not work on a grading scale like that. 

And there are multiple arteries that feed the heart, any of which can cause an MI to the area which they feed.


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## Medic Tim (Jan 22, 2014)

TigerManMcCool9974 said:


> Basic math. My test was right at 70 questions. 70% of 70 is 49. So, I could miss roughly 20 questions and pass. The administrator said not to freak out if it cuts off around 70, because most everyone gets 70ish, unless they're the lucky 125th person that gets the whole test regardless. Guy in my class that took it same time as me got 73 questions, one earlier that morning 71, and the girl with this weirdo MI question got the whole 120. All passed.



the nremt doesn't have a 70% or 80% pass like the tests you took in school. It is adaptive with different levels of questions...once it determines you meet minimum competency within 95% (I believe) it will cut you off. You can pass or fail anywhere between 70-150. some people get the full test as a control no matter how they are doing.


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## mycrofft (Jan 22, 2014)

*"There's your problem:"*

"...and she said they asked the following:…".:huh:


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## TigerManMcCool9974 (Jan 22, 2014)

All I know is we were told throughout the class we had to make 71 or higher to pass. I got in the car, did the math, calmed down b/c I knew I hadn't missed that many, & felt even better when I got a registry # 3 hrs later.


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## Medic Tim (Jan 22, 2014)

TigerManMcCool9974 said:


> All I know is we were told throughout the class we had to make 71 or higher to pass. I got in the car, did the math, calmed down b/c I knew I hadn't missed that many, & felt even better when I got a registry # 3 hrs later.



congrats on passing but the 70% pass thing is not true. 

the nremt website explains the test.

The old hand written test had a 70% to pass I believe.


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## TigerManMcCool9974 (Jan 22, 2014)

Medic Tim said:


> congrats on passing but the 70% pass thing is not true.
> 
> the nremt website explains the test.
> 
> The old hand written test had a 70% to pass I believe.



Thanks. That was the easy part. The big test is passing the job interview in the morning & getting started! I appreciate everyone's input.


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