Bag Mask Device Flashcards, test questions and answers
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We've found 13 Bag Mask Device tests
Bag Mask Device
Chest And Abdomen
Emergency Medical Technology
Poison Control Center
EMT chapter 19 Toxicology – Flashcards 46 terms

Jamie Hutchinson
46 terms
Preview
EMT chapter 19 Toxicology – Flashcards
question
substance abuse is MOST accurately defined as
answer
knowingly misusing substances to produce a desired effect
question
the EMTs primary responsibility to the patient who has been poisoned is to
answer
recognize that a poisoning has occurred
question
heroin is an example of an
answer
opioid
question
hypotension,hypoventilation, and pinpoint pupils would be expected following an overdose of
answer
oxycodone(Percocet)
question
signs and symptoms of a sympathomimetic drug overdose includes
answer
tachycardia
question
which of the following drugs is NOT a sedative-hypnotic
answer
cocaine
question
your paramedic partner administers atropine to a 49 year old male with bradycardia which of the following side effects would you expect the patient to experience
answer
dry mucous membranes
question
which of the following questions would be LEAST pertinence during the initial questioning of a patient who ingested a substance
answer
why was the substance ingested
question
a poison that enters the body by ______ is the MOST difficult to treat.
answer
injection
question
the poison control center will be able to provide you with the most information regarding the appropriate treatment for a patient with a drug overdose if the center
answer
is aware of the substance that is involved
question
which of the following statements regarding inhaled poisons is correct
answer
lung damage may progress after the patient is removed from the environment
question
your priority in caring for a patient with a surface contact poisoning is to
answer
avoid contaminating yourself
question
phosphorus or elemental sodium should be brushed off the skin instead of irrigated with water because
answer
these chemicals may ignite upon contact with water
question
most poisonings occur via the ________ route
answer
ingestion
question
syrup of ipecac is no longer recommended to treat patients who have ingested a poisonous substance because it
answer
may result in aspiration of vomitus
question
activated charcoal is given to patients who have ingested certain substance because because it
answer
binds to the substance and prevents absorption.
question
in general, injected poisons are impossible to dilute or remove because they
answer
are usually absorbed quickly into the body.
question
as you enter the residence of a patient who has possibly overdosed, you should
answer
be alert for personal hazards
question
your unit is dispatched to the county jail for an intoxicated inmate. upon arrival, you find the patient, a 33 year old male. lying supine in a jail cell. he is responsive to painful stimuli only and has slow, shallow respirations. you should be MOST concerned that this patient
answer
may vomit and aspirate
question
you receive a call to a residence where a man found his wife unconscious on the couch. the patient is unresponsive, her respiratory rate is 8 breaths/min, her breathing is shallow, her heart rate is 40 beats per minutes, and her pulse is weak. the husband hands you an empty bottle of hydrocodone(vicodin) which was refilled the day before. you should:
answer
initiate ventilator assistance
question
it is MOST important to determine a patients weight when asking questions pertaining to a toxic ingestion because
answer
activated charcoal is given based on a patients weight
question
airborne substances are diluted with
answer
oxygen
question
activated charcoal administration in contraindicated in patients who have ingested
answer
acids or alkalis
question
common names for activated charcoal include all of the following except
answer
fructose
question
the usual dose for activated charcoal is up to ____ for a pediatric patient and up to ____ for an adult patient.
answer
12.5, 25g
question
a 4 year old male ingested an unknown quantity of acetaminophen (Tylenol). the child's mother states that the ingestion occurred approximately 20 minutes ago. the child is conscious and alert and in no apparent distress. after contacting medical control, you should
answer
administer up to 25 g of activated charcoal
question
before giving activated charcoal you should
answer
obtain approval form medical control
question
the major side effect associated with ingestion of activated charcoal is:
answer
black stools
question
after administering activated charcoal to a patient, it is MOST important to
answer
be alter for vomiting
question
a person who routinely misuses a substance and requires increasing amounts to achieve the same effect is experiencing an
answer
tolernance
question
the most commonly abused drug in the united states is
answer
alcohol
question
a hypnotic drug is one that:
answer
induces sleep
question
when caring for a know alcoholic patient with severe trauma to the chest and abdomen, you should be concerned that
answer
internal bleeding may be profuse because prolonged alcohol use may impair the bloods ability to colt
question
DTs is a syndrome associated with withdraw from
answer
alcohol
question
a 49 year old male presents with confusion, sweating, and visual hallucinations. the patients wife tells you that he is a heavy drinker and thinks he had a seizure shortly before your arrival. this patient is Most likely experiencing
answer
DT's
question
during your assessment of a 50 year old male who was found unconscious in an alley, you note that he has slow, shallow respirations, significant bradycardia, facial cyanosis, and pinpoint pupils. as your partner begins assisting the patients ventilations, he directs your attention to the patients arms, which have multiple needle tracks on them. this patients clinical presentation is MOST consistent with
answer
a heroin overdose
question
you and your paramedic partner are caring for a patient who ingested codeine, acetaminophen, and propoxyphene (daron). the patient is unresponsive , his breathing is slow and shallow, and his pulse is slow and weak. treatment for this patient with include
answer
assisted ventilation, naloxone (narcan), and rapid transport
question
you respond to a local motel for a young female who was sexually assaulted. the patient is conscious but confused, she tells you that the last thing she remembers was drinking beer at a club with her friends the night before, when she awoke, she was in the bed of the motel room. you should be most suspicious that this patient
answer
was given flunitrazepam (Rohypnol)
question
you respond to a college campus for a young male who is acting strangely. after law enforcement has secured the scene, you enter the patients dorm room and find him sitting on the edge of the bed, he appears agitated. as you approach him, you note that he has dried blood around both nostrils. he is breathing adequately, his pulse is rapid and irregular, and his blood pressure is 200/110. treatment for this patient includes
answer
attempting to calm him and giving him oxygen is tolerated
question
in an apparent suicide attempt, a 19 year old female ingested a full bottle of amitriptyline (Elavil) at present, she is conscious and alert and states that she swallowed the pills approximately 30 minutes earlier. her blood pressure is 90/50 her pulse is 140 and irregular , and her respirations are 22 breaths with adequate depth. when transporting this patient, you should be most alert for
answer
seizures and cardiac arrhythmias
question
you are dispatched to a local nursery for a 39 year old female who is sick. when you arrive, you find the patient lying on the floor. she is semiconscious, has copious amounts of saliva coming from her mouth, and is incontinent of urine. you quickly feel her pulse and note that it is very slow. initial management for this patient should include
answer
assisted ventilation with bag mask device
question
atropine sulfate and pralidoxime chloride are antidotes for
answer
nerve gas agents
question
a patient who presents with rapid breathing, nausea and vomiting, ringing in the ears, and a high fever should be suspected of ingesting a significant quantity of
answer
aspirin
question
an overdose on acetaminophen, the active ingredient in Tylenol, will most likely cause
answer
liver failure
question
which of the following statements regarding the salmonella bacterium is correct
answer
the salmonella bacterium itself causes food poisoning
question
a 3 year old female ingested several leaves from a plant in the living room. the childs mother is not sure what type of plant it is, stating that she bought it simply because it was pretty. after completing your initial assessment of the child, you should
answer
administer 25g of activated charcoal
Bag Mask Device
Emergency Medical Technology
Roles And Responsibilities
EMT Chapter 40 ALS Assist – Flashcards 93 terms

Kevin Stewart
93 terms
Preview
EMT Chapter 40 ALS Assist – Flashcards
question
Advanced airway management techniques should performed ONLY after:
answer
basic airway techniques have been completed
question
After opening a patient's airway, you should:
answer
ensure the airway is clear
question
Endotracheal intubation is MOST accurately defined as:
answer
inserting a tube into the trachea to maintain the airway and ventilate
question
Endotracheal intubation is indicated for patients:
answer
who are unconscious and cannot protect their own airway
question
If a patient is being adequately ventilated with a bag-mask device attached to high-flow oxygen:
answer
endotracheal intubation may not be necessary
question
Visualized orotracheal intubation requires all of the following equipment, EXCEPT a:
answer
local anesthetic
question
Prior to performing orotracheal intubation in a cardiac arrest patient, it is MOST important to:
answer
adequately preoxygenate with a bagmask device.
question
Although you should carry a variety of endotracheal (ET) tube sizes, a _____ ET tube will adequately fit most adults.
answer
7.5mm
question
Regardless of the size of the ET tube that you will use to intubate your patient, you should:
answer
have one tube smaller and one tube larger
question
When determining the proper size ET tube to use in an infant or small child, you should:
answer
use a length-based resuscitation tape measure
question
When an ET tube is placed in an adult patient, the tube-to-teeth mark is usually around:
answer
22 cm.
question
When inserting the stylet inside an ET tube, you should:
answer
avoid inserting the stylet past Murphy's eye
question
The distal cuff on an ET tube should be inflated with no more than ______ of air after it is placed into the trachea.
answer
10 mL
question
Prior to attempting endotracheal intubation, the EMT should:
answer
obtain authorization from medical control
question
A single intubation attempt in the adult patient should not exceed:
answer
30 seconds.
question
Intubating a patient who is in cardiac arrest should occur after:
answer
the patient has been assessed to determine if defibrillation is indicated
question
After successfully intubating a 56 year old man who is in cardiac arrest, you should:
answer
perform asynchronous CPR
question
The appropriate method of inserting a laryngoscope blade into the patient's mouth to visualize the vocal cords is to:
answer
insert the blade in the right side of the mouth, sweep the tongue to the left, and lift
question
During visualized orotracheal intubation, the straight blade:
answer
directly lifts the epiglottis and exposes the vocal cords.
question
To avoid obscuring your view of the vocal cords during intubation, you should
answer
not pass the ET tube down the center of the laryngoscope blade
question
You respond to a construction site where a steel girder collapsed on a 22-year-old male's chest. Coworkers removed the girder prior to your arrival. Your assessment reveals that he is unconscious and apneic, but has a pulse. You should:
answer
maintain stabilization of his head, open his airway with the jaw-thrust maneuver, ventilate with a bag-mask device, and prepare to intubate him.
question
Immediately after you place an ET tube in the trachea, you should remove the stylet and then:
answer
inflate the distal cuff and detach the syringe
question
Confirmation techniques and devices used to determine correct ET tube placement include all of the following, EXCEPT:
answer
rise and fall of the abdomen
question
Which of the following is the MOST reliable indicator of successful endotracheal intubation?
answer
visualization of the tube passing between the vocal cords
question
After intubating a 44-year-old unconscious, apneic male, you place him on the ambulance stretcher and prepare to load him into the ambulance. After he is placed into the ambulance, you should:
answer
reconfirm that the ET tube is still correctly positioned
question
Complications associated with endotracheal intubation include all of the following, EXCEPT:
answer
left main stem bronchus intubation
question
You have inserted an ET tube but are unable to hear breath sounds on the left side of the chest. You should:
answer
withdraw the tube approximately 1′′ and reassess breath sounds.
question
You have attempted to intubate a 66year-old male twice without success. Medical control is unable to be contacted. Your MOST appropriate action should be to:
answer
insert an oral airway, ventilate with a bag-mask device, and transport.
question
After performing endotracheal intubation on an elderly male in cardiac arrest, you think you hear breath sounds, but also hear gurgling over the epigastrium. You should:
answer
remove the ET tube at once, ventilate with a bag-mask device for 2 to 3 minutes, and reattempt intubation.
question
A 50-year-old female is found semiconscious by her son. Your assessment reveals that her respirations are slow and shallow and there is vomitus draining from her mouth. When you attempt to suction her oropharynx, she begins to gag. You should:
answer
ensure that her airway is clear, attempt to insert a nasopharyngeal airway, and assist her ventilations with a bag-mask device.
question
You are transporting an intubated 24year-old female when her level of consciousness improves and she becomes combative. You should anticipate that your paramedic partner will:
answer
give her a sedative drug per local protocol.
question
Which of the following statements regarding multilumen airway devices is correct?
answer
Ventilations can be provided whether the device is in the trachea or the esophagus
question
A major benefit when using a multilumen airway device is that:
answer
maintenance of a mask-to-face seal is not required.
question
You should NOT attempt to insert a Combitube in a patient who:
answer
has ingested a caustic substance
question
If it is necessary to remove a multilumen airway in the field, you should:
answer
turn the patient onto his or her side and have suction ready.
question
Which of the following statements regarding the King LT airway is correct?
answer
When the King LT is properly placed in the esophagus, one cuff is designed to seal the esophagus and the other cuff is designed to seal the oropharynx.
question
A disadvantage of the King LT airway is that it:
answer
does not completely protect the airway from aspiration.
question
The laryngeal mask airway (LMA) helps protect the airway and allows for adequate ventilation by:
answer
molding and sealing itself around the laryngeal opening by inflation of the mask.
question
In the prehospital setting, gastric tubes are used primarily to:
answer
decompress the stomach
question
Proper confirmation of correct gastric tube placement includes:
answer
injecting air into the tube and auscultating the stomach for gurgling
question
For which of the following patients would the use of a continuous positive airway pressure (CPAP) device be of MOST benefit?
answer
62-year-old man with severe respiratory distress, a history of congestive heart failure, and audible rhonchi in the lungs
question
The MOST important step in assembling intravenous (IV) equipment is to:
answer
strictly adhere to standard precautions
question
Common IV solutions used in the prehospital setting include all of the following, EXCEPT:
answer
5% albumin solution
question
D₅W is MOST commonly used for:
answer
mixing and administering medications
question
Once an IV solution is removed from its protective wrap, it must be used within:
answer
24 hours
question
Which of the following statements regarding the IV administration set is correct?
answer
It moves fluid from the IV bag into the patient's vascular system
question
A microdrip administration set delivers 1 mL of fluid after every ______ drops.
answer
60
question
You should routinely inspect a bag of IV fluid for all of the following, EXCEPT:
answer
the manufacturer
question
After sliding the piercing spike of the administration set into the IV bag port, you should next:
answer
prime the line and flush the air out of the tubing.
question
The purpose of a saline lock is to:
answer
maintain an active IV site without running fluids through the vein
question
ALS providers choose the type and size of the IV catheter based on all of the following factors, EXCEPT the:
answer
gender of the patient
question
Which of the following over-the-needle IV catheters has the largest diameter?
answer
14-gauge
question
Which of the following IV catheters would deliver fluid at the slowest rate?
answer
22-gauge
question
Intraosseous (IO) needles are used when:
answer
immediate IV access is difficult or impossible to obtain.
question
An IO needle is inserted into the:
answer
proximal tibia
question
Signs of an infiltrated IV include:
answer
edema at the catheter site
question
If an IV line is found to be infiltrated, you should:
answer
remove the catheter and apply direct pressure
question
Local reactions associated with IV therapy include all of the following, EXCEPT:
answer
catheter shear
question
Approximately 20 minutes after initiating an IV line of normal saline, your patient complains of generalized itching and develops a generalized rash. These are signs and symptoms of:
answer
an allergic reaction
question
A 50-year-old male develops acute respiratory distress and cyanosis shortly after an IV line has been established. You should administer high-flow oxygen and:
answer
place him on his left side with his head down.
question
Signs and symptoms of acute circulatory overload include all of the following, EXCEPT:
answer
a drop in blood pressure
question
Vasovagal reactions that occur in patients receiving IV therapy are MOST often the result of:
answer
a fear of needles or the sight of blood
question
An IV line is not running as fast as it should be. There are no signs of infiltration. You should:
answer
ensure that the tourniquet has been released
question
What is a Volutrol and when should it be used?
answer
Volutrol is a 100mL calibrated drip chamber that can be shut off from the IV bag. It should be used to prevent fluid overload in pediatric and geriatric patients.
question
Which of the following statements regarding vascular access in geriatric patients is correct?
answer
Elderly patients often have fragile skin that is easily damaged
question
The heart's primary pacemaker is the:
answer
sinoatrial (SA) node
question
The left and right bundle branches:
answer
travel through the interventricular septum and lead to the Purkinje fibers
question
Which of the following correctly describes the normal path of electricity through the cardiac conduction system?
answer
SA node, internodal pathways, AV node, bundle of His, left and right bundle branches, Purkinje system
question
The SA node normally paces at a rate of:
answer
60 to 100/min.
question
When an electrical impulse moves toward a positive electrode:
answer
the ECG records an upward wave
question
A single ECG complex consists of all of the following components, EXCEPT:
answer
an R-R interval.
question
When looking at ECG graph paper, one large box represents:
answer
0.20 seconds.
question
If each small box on the ECG graph paper represents 0.04 seconds, and there are 5 small boxes in one large box, how many large boxes represent 6 seconds?
answer
30
question
A normal sinus rhythm (NSR) is characterized by all of the following, EXCEPT:
answer
an irregular heart rate
question
A P wave is created when:
answer
electricity travels through the atria
question
The only route of communication between the atria and the ventricles is/are the:
answer
AV node
question
The QRS complex is an electrical representation of:
answer
ventricular contraction
question
Which of the following statements regarding sinus bradycardia is correct?
answer
It may be a normal variant in some individuals
question
Sinus tachycardia is differentiated from a normal sinus rhythm by the:
answer
irregular heart rate
question
When the heart rate becomes exceedingly high:
answer
ventricular filling time decreases
question
Any electrical impulse that originates in the ventricular conduction system has:
answer
wide, abnormally shaped QRS complexes.
question
Ventricular tachycardia is characterized by:
answer
wide QRS complexes and a heart rate greater than 100 beats/min.
question
A rapid, chaotic rhythm that is completely disorganized is called:
answer
ventricular fibrillation
question
The MOST effective treatment for ventricular fibrillation or pulseless ventricular tachycardia of short duration is:
answer
prompt, rapid defibrillation
question
Which of the following cardiac arrhythmias is characterized by a complete absence of myocardial electrical and mechanical activity?
answer
asystole
question
When applying the 4lead ECG electrodes to a patient, the white (negative) lead should be placed:
answer
on the right arm
question
It does not matter if you place the arm leads on the patient's shoulders or arms, as long as:
answer
they are at least 10 cm from the heart
question
Leads V₁ and V₂ in a 12-lead ECG should be positioned:
answer
on each side of the sternum at the fourth intercostal space
question
Obtaining an accurate ECG tracing can be difficult in patients experiencing a cardiac emergency because:
answer
the patient is often diaphoretic
question
A 12-lead ECG:
answer
may identify myocardial ischemia or injury
question
Which of the following leads views the lateral wall of the left ventricle?
answer
V₅ and V₆
question
Your paramedic partner has just acquired a 12lead ECG on a middle-aged man with chest discomfort. The patient is conscious, but anxious. His blood pressure is 140/84 mm Hg and his heart rate is 80 beats/min. He has a history of hypertension and type 2 diabetes. Your partner states that she believes the patient is experiencing a myocardial infarction of the anterior wall. Which of the following is the MOST likely basis for her statement?
answer
She has detected ST segment elevation in leads V₃ and V₄
question
The ultimate goal in treating a patient who is experiencing an ST-segment elevation myocardial infarction (STEMI) is to:
answer
rapidly restore perfusion to the injured heart
Bag Mask Device
Nursing
Pulmonology
Venous Return To The Heart
Airway exam review – Flashcards 37 terms

Charles Clay
37 terms
Preview
Airway exam review – Flashcards
question
When auscultating the lungs of a patient with early pulmonary edema, you will MOST likely hear:
answer
inspiratory rhonchi to the bilateral apices of the lungs.
question
The ____________ are pyramid-like structures that form the posterior attachment of the vocal cords.
answer
arytenoid cartilages
question
A patient who is coughing up purulent sputum is MOST likely experiencing:
answer
An infection
question
Intrapulmonary shunting is defined as:
answer
the return of unoxygenated blood to the left side of the heart.
question
The most obvious external landmark of the larynx is the:
answer
thyroid cartilage.
question
A sudden increase in end-tidal CO2 may be the earliest indicator of:
answer
return of spontaneous circulation.
question
Open cricothyrotomy is generally contraindicated in all of the following situations, EXCEPT:
answer
any patient who is younger than 16 years of age.
question
It would be appropriate to insert a nasopharyngeal airway in patients who:
answer
have an altered mental status with an intact gag reflex.
question
The BEST way to be certain that the ET tube has passed through the vocal cords is to:
answer
visualize the tube passing between the vocal cords.
question
Physiologic effects of CPAP include:
answer
opening of collapsed alveoli.
question
In contrast to negative-pressure ventilation, positive-pressure ventilation occurs when:
answer
air is forced into the lungs.
question
One of the hallmarks of a pulmonary embolism is:
answer
cyanosis that does not resolve with oxygen therapy.
question
When administering CPAP therapy to a patient, it is important to remember that:
answer
the increased intrathoracic pressure caused by CPAP can result in hypotension.
question
Wheezing is resolved with medications that:
answer
relax the smooth muscle of the bronchioles.
question
Patients with decompensated asthma or COPD who require positive-pressure ventilation:
answer
may develop a pneumothorax or experience a decrease in venous return to the heart if they are ventilated too rapidly.
question
Laryngospasm is defined as:
answer
spasmodic closure of the vocal cords.
question
Open cricothyrotomy is indicated when:
answer
you are unable to secure a patent airway with less invasive means.
question
The volume of air that is moved into or out of the respiratory tract in one breath is called:
answer
tidal volume
question
Hepatojugular reflux occurs when:
answer
mild pressure placed on the patient's liver further engorges the jugular veins.
question
The cricothyroid membrane:
answer
is relatively avascular and is covered by skin and minimal subcutaneous tissue.
question
The exchange of oxygen and carbon dioxide between the alveoli and the blood in the pulmonary capillaries is called:
answer
external respiration.
question
Apneustic breathing is characterized by
answer
short, brisk inhalations with a long pause before exhalation.
question
The trachea and mainstem bronchi:
answer
are lined with beta-2 receptors that result in bronchodilation when stimulated.
question
Hyperventilating an apneic patient:
answer
may decrease venous return to the heart.
question
Emphysema is caused by:
answer
chronic destruction of the alveolar walls.
question
Atelectasis occurs when:
answer
a deficiency of surfactant causes alveolar collapse.
question
Signs of clinical improvement during CPAP therapy include:
answer
increased ease of speaking
question
A patient with orthopnea:
answer
has dyspnea while lying flat.
question
The involuntary control of breathing originates in the?
answer
Pons and medulla
question
If chest compressions and repositioning of the airway are unsuccessful in removing a severe airway obstruction in an unconscious patient, you should?
answer
Perform laryngascopy and Magil forceps
question
The upper airway of an adult consists of all the structures above?
answer
The vocal cords
question
The___ is an anatomic space located between the base of the tongue and the epiglottis
answer
Vallecula
question
The volume of air that is moved into or out of the respiratory tract in one breath is called?
answer
Tidal volume
question
When ventilating an apneic adult with a pulse with a BVM, you should?
answer
Deliver each breath over 1 second at the rate of 10-12 breaths per minute
question
After inserting the et tube between the vocal cords, you should remove the stylet from the tube and then?
answer
Inflate the distal cuff with 5-10 cc of air
question
The most obvious risk associated with extubation is?
answer
Overestimating the patients ability to protect his or her own airway
question
In general, a multilumen airway should not be used in patients who are?
answer
Younger than 16 years old
Bag Mask Device
Emergency Medical Technology
Chapter 40: ALS Assist – Flashcards 35 terms

Carmen Dawson
35 terms
Preview
Chapter 40: ALS Assist – Flashcards
question
The distal cuff on an ET tube should be inflated with no more than ______ of air after it is placed into the trachea.
answer
10 mL
question
You are transporting an intubated 24-year-old female when her level of consciousness improves and she becomes combative. Without assisted ventilation, she appears to be breathing adequately. You should anticipate that your ALS partner will:
answer
Give her a sedative drug per local protocol.
question
A major benefit when using a multilumen airway device is that:
answer
Maintenance of a mask-to-face seal is not required.
question
In the prehospital setting, gastric tubes are used primarily to:
answer
Decompress the stomach.
question
For which of the following patients would the use of a continuous positive airway pressure (CPAP) device be of MOST benefit?
answer
62-year-old man with severe respiratory distress, a history of congestive heart failure, and audible rhonchi in the lungs
question
After sliding the piercing spike of the administration set into the IV bag port, you should next:
answer
Prime the line and flush the air out of the tubing.
question
If an IV line is found to be infiltrated, you should:
answer
Remove the catheter and apply direct pressure.
question
An IV line is not running as fast as it should be. There are no signs of infiltration. You should:
answer
Ensure that the tourniquet has been released.
question
The QRS complex is an electrical representation of:
answer
Ventricular contraction.
question
It does not matter if you place the arm leads on the patient's shoulders or arms, as long as:
answer
They are at least 10 cm from the heart.
question
A 12-lead ECG:
answer
may identify myocardial ischemia or injury.
question
A 50-year-old male develops acute respiratory distress and cyanosis shortly after an IV line has been established. You should administer high-flow oxygen and:
answer
place him on his left side with his head down.
question
After opening a patient's airway, you should:
answer
ensure the airway is clear.
question
Although you should carry a variety of endotracheal (ET) tube sizes, a _____ ET tube will adequately fit most adults.
answer
7.5-mm
question
Complications associated with endotracheal intubation include all of the following, EXCEPT:
answer
left main stem bronchus intubation.
question
D5W is MOST commonly used for:
answer
mixing and administering medications.
question
Endotracheal intubation is indicated for patients:
answer
who are unconscious and cannot protect their own airway.
question
Immediately after you place an ET tube in the trachea, you should remove the stylet and then:
answer
inflate the distal cuff and detach the syringe.
question
Leads V1 and V2 in a 12-lead ECG should be positioned:
answer
on each side of the sternum at the fourth intercostal space.
question
Proper confirmation of correct gastric tube placement includes:
answer
injecting air into the tube and auscultating the stomach for gurgling.
question
The heart's primary pacemaker is the:
answer
sinoatrial (SA) node.
question
The MOST effective treatment for ventricular fibrillation or pulseless ventricular tachycardia of short duration is:
answer
prompt, rapid defibrillation.
question
The MOST important step in assembling intravenous (IV) equipment is to:
answer
strictly adhere to standard precautions.
question
To avoid obscuring your view of the vocal cords during intubation, you should:
answer
not pass the ET tube down the center of the laryngoscope blade.
question
Vasovagal reactions that occur in patients receiving IV therapy are MOST often the result of:
answer
a fear of needles or the sight of blood.
question
Ventricular tachycardia is characterized by:
answer
wide QRS complexes and a heart rate greater than 100 beats/min.
question
Visualized orotracheal intubation requires all of the following equipment, EXCEPT a:
answer
local anesthetic.
question
What is a Volutrol and when should it be used?
answer
Volutrol is a 100-mL calibrated drip chamber that can be shut off from the IV bag. It should be used to prevent fluid overload in pediatric and geriatric patients.
question
When applying the 4-lead ECG electrodes to a patient, the white (negative) lead should be placed:
answer
on the right arm.
question
When determining the proper size ET tube to use in an infant or small child, you should:
answer
use a length-based resuscitation tape measure.
question
Which of the following correctly describes the normal path of electricity through the cardiac conduction system?
answer
SA node, internodal pathways, AV node, bundle of His, left and right bundle branches, Purkinje system
question
Which of the following is the MOST reliable indicator of successful endotracheal intubation?
answer
visualization of the tube passing between the vocal cords
question
Which of the following statements regarding the IV administration set is correct?
answer
It moves fluid from the IV bag into the patient's vascular system.
question
You have attempted to intubate a 66-year-old male twice without success. Medical control is unable to be contacted. Your MOST appropriate action should be to:
answer
insert an oral airway, ventilate with a bag-mask device, and transport.
question
You should routinely inspect a bag of IV fluid for all of the following, EXCEPT:
answer
the manufacturer
Bag Mask Device
Emergency Medical Technology
Gas Exchange In The Lungs
First Aid Scenario Checklist: Scenario 2: Choking – Flashcards 7 terms

Jaxon Craft
7 terms
Preview
First Aid Scenario Checklist: Scenario 2: Choking – Flashcards
question
What is the first step?
answer
View airway obstruction, state that you witness a case of obstruction
question
After observing a choking what do you do?
answer
Ask the victim if they are choking
question
What is proper form to remove an obstruction
answer
Form a fist, thumb on stomach, wrap arms tightly and upward thrusts
question
What happens after abdominal thrusts?
answer
Call 911
question
What do you state to 911?
answer
Your name, location, number, situation, number of victims, SITREP, verbalize that the operator told you its ok to hang up
question
Whats after 911?
answer
change gloves and assist with BLS
question
What are the summary steps?
answer
reassured and checked the status of the victims, remove gloves properly, put PPE's in biological waste bag, use hand sanitizer
Bag Mask Device
Emergency Medicine
Head Tilt Chin Lift
Skills USA First Aid/CPR – Flashcards 20 terms

Collin Foley
20 terms
Preview
Skills USA First Aid/CPR – Flashcards
question
When the victim is in a dangerous environment.
answer
When is it appropriate to move an adult victim who needs CPR?
question
10
answer
How many seconds do you start Chest compressions after recognition of cardiac arrest in victims of all ages.
question
10
answer
Interruptions in chest compressions should be limited to how many seconds?
question
There is a visible rise of the chest.
answer
How can you tell when a rescue breath for an infant is effective?
question
Head tilt-chin lift.
answer
What is the BEST method of opening the airway of an unresponsive victim when you do not suspect cervical spine injury?
question
Mouth-to-mouth technique.
answer
Which technique is not recommended for a single rescuer to bro ode breaths during CPR?
question
answer
What is likely to cause air to enter the victims stomach during bag mask ventilation?
question
Compress rate at a rate of at least 100 per minuet with two breaths every 5 to 10 seconds.
answer
What are the correct compression and ventilation rates for two rescuer CPR in the presence of an advanced airway in an adult victim.
question
30:2
answer
Compression ventilation ratio for two rescuer adult CPR
question
After 5 cycles
answer
To reduce fatigue during CPR how often should compressors switch roles?
question
100 per minute.
answer
Recommended compression rate for CPR
question
Nothing until the first rescuer needs relief.
answer
During two person CPR one rescuer will provide chest compressions. What is the role of the second rescuer?
question
They pump blood to the rest of the body.
answer
Why are chest compressions important?
question
Turn on the AED.
answer
What is the first step to prefer once the AED arrives on the scene?
question
After the AED advises a shock, charges. And states a "clear the victim" message and prompts me to press the shock button.
answer
When should you deliver a shock of the AED?
question
Preform abdominal thrusts
answer
What is the best way to relieve severe chocking in a responsive adult?
question
1.5 inch
answer
What is the correct depth of chest compressions for a child victim?
question
30:2
answer
What is the recommended compression- ventilation ratio for child CPR
question
Infant pads may be used if pediatric pads are not available
answer
What size AED pads should be used for a child less that 8 years of age?
question
30:2
answer
Compression-ventilation ratio for infant CPR
Bag Mask Device
Emergency Medical Technology
Gas Exchange In The Lungs
Partial Pressure Of Carbon Dioxide
EMT-B Chapter 10 – Airway Management – Flashcards 94 terms

Candace Young
94 terms
Preview
EMT-B Chapter 10 – Airway Management – Flashcards
question
On which of the following patients would it be MOST appropriate to use the flow-restricted, oxygen-powered ventilation device?
answer
a 21-year-old male with traumatic cardiac arrest
question
After ___________ minutes without oxygen, brain damage is very likely.
answer
6 to 10
question
Based on current guidelines, in which of the following situations should supplemental oxygen be administered? a) Exposure to carbon monoxide and an oxygen saturation of 95% b) Any elderly patient whose oxygen saturation is less than 95% c) Signs of myocardial infarction and an oxygen saturation of 97% d) Any diabetic patient whose oxygen saturation is less than 98%
answer
a) Exposure to carbon monoxide and an oxygen saturation of 95%
question
Your protocols state that during the first few minutes of working on a cardiac arrest patient, you should provide passive ventilation. This means that you will:
answer
allow recoil of the chest between compressions to draw air into the lungs
question
How does CPAP improve oxygenation and ventilation in patients with certain respiratory problems?
answer
It forces the alveoli open and pushes more oxygen across the alveolar membrane.
question
You come upon an unresponsive patient who is not injured and is breathing on her own with a normal rate and an adequate tidal volume. What would be the advantage of placing her in the recovery position?
answer
It helps to maintain a clear airway.
question
You and your partner are caring for a critically injured patient. Your partner is controlling severe bleeding from the patient's lower extremities as you attempt ventilations with a bag-mask device. After repositioning the mask several times, you are unable to effectively ventilate the patient. You should:
answer
begin ventilations using the mouth-to-mask technique
question
Which of the following oxygen flowmeters is NOT affected by gravity and can be used in any position when attached to an oxygen cylinder?
answer
Bourdon-gauge flowmeter
question
During your assessment of a patient with respiratory distress, you hear wheezing when listening to breath sounds. This indicates:
answer
a lower airway obstruction.
question
You are ventilating a patient with a stoma; however, air is escaping from the mouth and nose. To prevent this, you should:
answer
seal the mouth and nose.
question
Complications associated with using a manually triggered ventilation device include a) inadequate ventilation and hypercarbia. b) reduced tidal volume delivery and hypoxia. c) lung tissue injury and gastric distention. d) inadequate oxygenation and tracheal injury.
answer
c) lung tissue injury and gastric distention.
question
Which of the following is a late sign of hypoxia? a) Anxiety b) Restlessness c) Cyanosis d) Tachycardia
answer
c) Cyanosis
question
In which of the following patients would the head tilt-chin lift maneuver be the MOST appropriate method of opening the airway?
answer
a 37-year-old female who is found unconscious in her bed
question
Which of the following is the MOST reliable indicator of adequately performed bag-mask ventilations in an apneic adult with a pulse?
answer
adequate rise of the chest when squeezing the bag
question
The pressure of gas in a full cylinder of oxygen is approximately _______ pounds per square inch (psi).
answer
2,000
question
Which of the following patients is breathing adequately?
answer
a conscious male with respirations of 19 breaths/min and pink skin
question
While eating dinner, your partner suddenly grabs his throat and has a panicked look on his face. He has a weak cough, faint inspiratory stridor, and cyanosis around the lips. You should:
answer
stand behind him and administer abdominal thrusts.
question
The __________ cartilage is a firm ring that forms the inferior part of the larynx.
answer
cricoid
question
In the presence of oxygen, the mitochondria of the cells convert glucose into energy through a process called:
answer
aerobic metabolism.
question
What occurs when a patient is breathing very rapidly and shallowly?
answer
Air moves primarily in the anatomic dead space and does not participate in pulmonary gas exchange.
question
The MOST serious complication associated with using a nasopharyngeal airway in a patient with trauma to the head or face is:
answer
penetrating the cranium.
question
The process of exchanging oxygen and carbon dioxide between the alveoli and the blood of the capillaries is called:
answer
external respiration
question
Which of the following would cause an increase in the amount of exhaled carbon dioxide? a) Excessive ventilation b) Anaerobic metabolism c) Increased cardiac output d) Cardiopulmonary arrest
answer
Anaerobic metabolism
question
Which of the following statements regarding oxygen is correct?
answer
Oxygen supports the combustion process and may cause a fire.
question
An unconscious patient found in a prone position must be placed in a supine position in case he or she:
answer
requires cardiopulmonary resuscitation (CPR)
question
The hypoxic drive—the primary stimulus to breathe for patients with certain chronic respiratory diseases—is influenced by:
answer
low blood oxygen levels.
question
A patient who is suspected of being hypoxic and is breathing adequately should be given supplemental oxygen with a:
answer
nonrebreathing mask
question
Inhalation occurs when the:
answer
diaphragm and intercostal muscles contract and cause a decrease in intrathoracic pressure
question
The diaphragm is innervated by the _________ nerve, which allows it to contract.
answer
phrenic
question
The jaw-thrust maneuver is used to open the airway of patients with suspected:
answer
cervical spine injuries.
question
You are ventilating a 40-year-old uninjured man who is apneic but has a pulse. When your partner reassesses his blood pressure, he notes that it has decreased significantly from previous readings. You elevate the patient's legs, but this action has no effect. You should:
answer
reevaluate the rate and volume of your ventilations
question
Which of the following statements regarding positive-pressure ventilation is correct?
answer
With positive-pressure ventilation, more volume is required to have the same effects as normal breathing.
question
You have inserted an oral airway and are ventilating an apneic woman with a bag-mask device. She suddenly begins regurgitating large amounts of vomit. You should:
answer
roll her onto her side and remove the oral airway.
question
What is the minute volume of a patient with a tidal volume of 500 mL, a dead space volume of 150 mL, and a respiratory rate of 16 breaths/min?
answer
5,600 mL
question
Which of the following patients should you place in the recovery position?
answer
a 31-year-old semiconscious male with low blood sugar and adequate breathing
question
Which of the following structures is NOT found in the upper airway?
answer
bronchus
question
The primary waste product of aerobic metabolism is:
answer
carbon dioxide
question
A 51-year-old female presents with a sudden onset of difficulty breathing. She is conscious and alert and able to speak in complete sentences. Her respirations are 22 breaths/min and regular. You should:
answer
administer 100% oxygen via a nonrebreathing mask.
question
Tidal volume is defined as the volume of air that:
answer
moves into or out of the lungs in a single breath.
question
Intrapulmonary shunting occurs when:
answer
blood coming from the right side of the heart bypasses nonfunctional alveoli and returns to the left side of the heart in an unoxygenated state.
question
A ventilation/perfusion (V/Q ratio) mismatch occurs when:
answer
a disruption in blood flow inhibits the exchange of oxygen and carbon dioxide in the lungs, even though the alveoli are filled with fresh oxygen.
question
The MOST significant complication associated with oropharyngeal suctioning is:
answer
hypoxia due to prolonged suction attempts
question
Gas exchange in the lungs is facilitated by:
answer
adequate amounts of surfactant.
question
The partial pressure of oxygen in the alveoli is _______ mm Hg, while the partial pressure of carbon dioxide in the alveoli is _______ mm Hg.
answer
104, 40
question
Which of the following patients would MOST likely require insertion of an oropharyngeal airway?
answer
a 40-year-old unconscious patient with slow, shallow respirations
question
You and your partner are treating a 66-year-old man who experienced a sudden onset of respiratory distress. He is conscious but is unable to follow simple verbal commands. Further assessment reveals that his breathing is severely labored and his oxygen saturation is 80%. You should:
answer
assist his ventilations with a bag-mask device.
question
At a flow rate of 6 L/min, a nasal cannula can deliver an approximate oxygen concentration of up to:
answer
44%.
question
You are dispatched to a residence where a middle-aged man was found unconscious in his front yard. There are no witnesses who can tell you what happened. You find him in a prone position; his eyes are closed and he is not moving. Your FIRST action should be to:
answer
log roll him as a unit to a supine position.
question
Structures of the lower airway include all of the following, EXCEPT the:
answer
epiglottis
question
To select the proper size oropharyngeal airway, you should measure from the:
answer
corner of the mouth to the earlobe.
question
With a good mask-to-face seal and an oxygen flow rate of 15 L/min, the nonrebreathing mask is capable of delivering up to ______% inspired oxygen.
answer
90
question
A 19-year-old female is found unconscious by her roommate. Your primary assessment reveals that her breathing is inadequate. As you insert an oropharyngeal airway, she begins to gag violently. You should:
answer
remove the airway and be prepared to suction her oropharynx.
question
An oxygen cylinder should be taken out of service and refilled when the pressure inside it is less than:
answer
500 psi.
question
Which of the following organs or tissues can survive the longest without oxygen?
answer
muscle
question
The actual exchange of oxygen and carbon dioxide occurs in the:
answer
alveolar sacs.
question
A 71-year-old male is semiconscious following a sudden, severe headache. There is vomitus on his face and his respirations are slow and shallow. The EMT must immediately:
answer
perform oropharyngeal suctioning.
question
The diaphragm functions as an involuntary muscle when a person:
answer
sleeps.
question
Which of the following statements regarding oxygenation and ventilation is correct?
answer
In mines or confined places, where oxygen levels are low, ventilation may continue despite adequate oxygenation.
question
Which of the following statements regarding normal gas exchange in the lungs is correct?
answer
Oxygen and carbon dioxide diffuse across the alveolar walls and capillaries
question
Without adequate oxygen, the body's cells:
answer
incompletely convert glucose into energy, and lactic acid accumulates in the blood.
question
The main advantage of the Venturi mask is:
answer
the use of its fine adjustment capabilities in the long-term management of physiologically stable patients.
question
An adult at rest should have a respiratory rate that ranges between:
answer
12 and 20 breaths/min.
question
You are ventilating an apneic woman with a bag-mask device. She has dentures, which are tight-fitting. Adequate chest rise is present with each ventilation, and the patient's oxygen saturation reads 96%. When you reassess the patency of her airway, you note that her dentures are now loose, although your ventilations are still producing adequate chest rise. You should:
answer
remove her dentures, resume ventilations, and assess for adequate chest rise.
question
The nasopharyngeal airway is MOST beneficial because it:
answer
can maintain a patent airway in a semiconscious patient with a gag reflex.
question
Which of the following statements regarding the one-person bag-mask device technique is correct?
answer
Adequate tidal volume is often difficult to achieve when one EMT is operating the bag-valve mask.
question
Irregular respirations characterized by an increasing rate and depth of breathing followed by periods of apnea are called:
answer
Cheyne-Stokes respirations.
question
The physical act of moving air into and out of the lungs is called:
answer
ventilation.
question
When testing a mechanical suctioning unit, you should turn on the device, clamp the tubing, and ensure that it generates a vacuum pressure of more than:
answer
300 mm Hg
question
Central chemoreceptors located in the medulla provide feedback to increase the rate and depth of breathing when they sense:
answer
slight elevations in carbon dioxide or a decrease in the pH of the cerebrospinal fluid.
question
If ventilation is impaired, carbon dioxide levels in the bloodstream will increase. This condition is called:
answer
hypercarbia.
question
CPAP is indicated for patients who:
answer
have pulmonary edema and can follow verbal commands.
question
While providing CPAP to a patient in severe respiratory distress, you note that his heart rate has increased by 20 beats/min. He is conscious, but is no longer following verbal commands. You should:
answer
remove the CPAP device and ventilate him with a bag-valve mask.
question
As the single EMT managing an apneic patient's airway, the preferred initial method of providing ventilations is the:
answer
mouth-to-mask technique with a one-way valve.
question
Proper technique for suctioning the oropharynx of an adult patient includes:
answer
suctioning while withdrawing the catheter from the oropharynx.
question
Which of the following structures is contained within the mediastinum?
answer
esophagus
question
Which of the following is NOT a possible cause of airway obstruction?
answer
shallow breathing
question
You are performing mouth-to-mask ventilations with oxygen connected and set at a flow rate of 15 L/min. What percentage of oxygen is your patient receiving?
answer
55%
question
What is the MOST common cause of airway obstruction in an unconscious patient?
answer
the tongue
question
The nasal cannula is MOST appropriately used in the prehospital setting:
answer
when the patient cannot tolerate a nonrebreathing mask
question
All of the following will help minimize the risk of gastric distention when ventilating an apneic patient with a bag-mask device, EXCEPT:
answer
increasing the amount of delivered tidal volume.
question
While assisting with respirations, you note gastric distention. In order to prevent or alleviate the distention, you should: a) ensure that the patient's airway is appropriately positioned. b) ventilate the patient at the appropriate rate. c) ventilate the patient at the appropriate volume. d) All of these answers are correct.
answer
d) All of these answers are correct.
question
Which of the following statements regarding breathing adequacy is correct?
answer
Patients breathing shallowly may require assisted ventilation despite a normal respiratory rate.
question
A 37-year-old male has an apparent foreign body airway obstruction. He is conscious and alert and is coughing forcefully. His skin is pink, warm, and moist. The MOST appropriate treatment for this patient includes:
answer
encouraging him to cough and transporting.
question
The purpose of the pin-indexing system that has been established for compressed gas cylinders is to:
answer
ensure that the correct regulator is used for the cylinder.
question
Prior to applying a nonrebreathing mask on a patient, you must ensure that the:
answer
reservoir bag is fully inflated.
question
The leaf-shaped structure located superior to the larynx is called the:
answer
epiglottis.
question
A nasopharyngeal airway is inserted:
answer
with the bevel facing the septum if inserted into the right nare
question
Each cell of the body combines nutrients and oxygen and produces energy and waste products through a process called:
answer
metabolism.
question
Which of the following factors will cause a decreased minute volume in an adult?
answer
shallow breathing
question
Which of the following would NOT cause a decrease in tidal volume?
answer
deep respirations
question
How does positive-pressure ventilation affect cardiac output?
answer
It increases intrathoracic pressure, which decreases venous return to the heart and causes a decrease in cardiac output.
question
In contrast to inhalation, exhalation:
answer
is a passive process caused by increased intrathoracic pressure.
question
A 23-year-old male experienced severe head trauma after his motorcycle collided with an oncoming truck. He is unconscious, has rapid and shallow breathing, and has copious bloody secretions in his mouth. How should you manage his airway?
answer
Alternate 15 seconds of oral suctioning with 2 minutes of assisted ventilation.
question
You respond to a construction site and find a worker lying supine in the dirt. He has been hit by a heavy construction vehicle and flew more than 15 feet (4.6 m) before landing in his current position. There is discoloration and distention of his abdomen about the right upper quadrant. He is unconscious and his respirations are 10 breaths/min and shallow, with noisy gurgling sounds. What method will you use to keep his airway open?
answer
c) Oropharyngeal airway
Bag Mask Device
Central Venous Catheter
Emergency Medical Technology
Left Ventricle Of The Heart
Pen And Paper
Right Atrium Of The Heart
Right Sided Heart Failure
Chapter 33 and 34 – Flashcards 297 terms

Bernice Cooper
297 terms
Preview
Chapter 33 and 34 – Flashcards
question
General care for a patient with a tracheostomy tube includes all of the following, EXCEPT:
answer
removing the tube if the area around it appears to be infected.
question
Because hearing-impaired patients typically have more difficulty hearing high-frequency sounds, it is important for you to
answer
lower the pitch of your voice
question
A tube from the brain to the abdomen that drains excessive cerebrospinal fluid (CSF) is called a
answer
shunt
question
Because a tracheostomy tube bypasses the nose and mouth
answer
secretions can build up in and around the tube
question
A 13-year-old child is on a home ventilator. The parents called because the ventilator is malfunctioning. You should
answer
discontinue the ventilator and ventilate with a BVM device
question
Common causes of depression in the elderly include all of the following, EXCEPT:
answer
an acute onset of dementia.
question
A 73-year-old female experienced a syncopal episode while watching TV. She is now conscious, but is diaphoretic, tachycardic, and hypotensive. Your assessment reveals abdominal tenderness and a pulsating mass to the left of her umbilicus. You should be MOST suspicious for:
answer
an aortic aneurysm
question
A productive cough, fever, and chills in an 80-year-old patient with a compromised immune system should make you MOST suspicious for:
answer
pneumonia
question
An older patient with significant dehydration would MOST likely present with:
answer
dizziness or fainting upon standing.
question
Causes of delirium in the older patient include all of the following, EXCEPT:
answer
Alzheimer disease.
question
Common causes of syncope in older patients include all of the following, EXCEPT:
answer
vasoconstriction
question
Fractures of the pelvis in older patients often occur as the result of a combination of:
answer
osteoporosis and low-energy trauma
question
In contrast to delirium, dementia:
answer
is usually considered irreversible
question
Poor maintenance of home, poor personal care, and dietary neglect are all possible indications of ____________ elder abuse.
answer
physical
question
The EMT should suspect left-sided heart failure in the geriatric patient who presents with:
answer
tachypnea and paroxysmal nocturnal dyspnea.
question
The stooped posture of some older people, which gives them a humpback appearance, is called:
answer
kyphosis
question
You are dispatched to a residence for an 80-year-old female who fell. When you arrive, you find the patient conscious, lying in a recumbent position on the floor in her living room. In addition to providing the appropriate treatment, you should ask the patient if:
answer
she became dizzy or fainted before falling
question
The purpose of the GEMS diamond is to:
answer
help EMS personnel remember what is different about elderly patients.
question
An older woman with osteoporosis presents with pain and deformity to her left hip after she shifted her weight onto her other foot. She has MOST likely experienced a
answer
pathologic fracture
question
In contrast to younger patients, older patients are more prone to a decrease in blood pressure upon standing because
answer
the baroreceptors have become less sensitive to blood pressure
question
A 10% to 20% reduction in brain weight and volume would MOST likely increase an older person's risk for:
answer
head trauma
question
Which of the following is the MOST common mechanism of injury in older patients?
answer
falls
question
Because of the complexity of the older patient and the vagueness of his or her complaint, you should:
answer
attempt to differentiate between chronic and acute problems
question
An abdominal aortic aneurysm:
answer
is often the result of hypertension and atherosclerosis.
question
When transporting a stable older patient to the hospital, the MOST effective way to reduce his or her anxiety is to:
answer
transport him or her to a hospital that he or she is familiar with
question
You are dispatched to a skilled nursing care facility for an 80-year-old female with abnormal behavior. The patient is clearly confused and asks you if you are her husband. As your partner administers oxygen to the patient, you should:
answer
determine the patient's baseline mental status
question
Clouding of the lenses of the eyes is called:
answer
cataracts
question
An elderly patient may understate or minimize the symptoms of his or her illness because:
answer
he or she fears hospitalization
question
Which of the following is NOT a reason why the exact extent and prevalence of elder abuse is unknown?
answer
Human resource agencies fail to investigate
question
Syncope in the older patient is
answer
question
caused by an interruption of blood flow to the brain
answer
question
During the natural process of aging, the number of functional cilia in the respiratory system decreases, resulting in
answer
question
a decreased ability to cough
answer
question
The leading cause of death in the geriatric patient is:
answer
question
heart disease
answer
question
In contrast to a living will, a "do not resuscitate" (DNR) order becomes valid when:
answer
question
the patient develops cardiac arrest
answer
question
When explaining the need for a particular procedure to an elderly patient, you should
answer
question
use plain language and simple terms
answer
question
When caring for an elderly patient who is hearing-impaired, you should:
answer
question
recall that elderly patients have difficulty hearing high-frequency sounds
answer
question
When faced with a situation in which an older patient with a terminal illness is in cardiac arrest, but written documentation regarding the patient's wishes cannot be located, the EMT should:
answer
question
attempt to resuscitate the patient.
answer
question
The slow onset of progressive disorientation, shortened attention span, and loss of cognitive function is known as:
answer
question
dementia
answer
question
When performing your secondary assessment on an older patient who has been injured, it is important to:
answer
question
recall that it will take a less severe mechanism of injury to cause significant injuries
answer
question
With age, the spine stiffens as a result of shrinkage of the intervertebral disc spaces, and the vertebrae become brittle. This increases the risk of:
answer
question
compression fractures
answer
question
A specific legal document that directs relatives and caregivers regarding the medical treatment that may be given to patients who cannot speak for themselves is called an
answer
question
advance directive
answer
question
Upon entering the residence of a geriatric patient with a medical or trauma complaint, the EMT should:
answer
question
observe for conditions that may make the residence unsafe.
answer
question
You receive a call for a sick person. When you arrive, you find the patient, a 75-year-old male, lying unresponsive in his bed. His respirations are slow and irregular and his pulse is slow and weak. His daughter tells you that he fell the day before, but refused to allow her to call 9-1-1. His past medical history is significant for hypothyroidism, deep vein thrombosis, heavy alcohol use, and liver cirrhosis. His medications include blood thinners and vitamins. You should be MOST suspicious that this patient is experiencing:
answer
question
a subdural hematoma
answer
question
Which of the following statements regarding communications with the elderly is correct?
answer
question
Older patients have difficulty understanding when they are stressed.
answer
question
Which of the following statements regarding the aging process is correct?
answer
question
Aging is a linear process; the rate at which a person loses functions does not increase with age.
answer
question
Which of the following statements regarding a decreased level of consciousness in the elderly patient is correct?
answer
question
a decrease level of consciousness is not a normal part of the aging process or Avpu scale is an in ineffective tool when assessing an elderly patient
answer
question
Findings during the social assessment of an older patient include all of the following, EXCEPT:
answer
question
outdated medications.
answer
question
When documenting a case of suspected elder abuse, it is MOST important for the EMT to:
answer
question
avoid documenting any unsupported opinions
answer
question
When caring for a geriatric patient with a traumatic injury, it is important to consider that:
answer
question
the injury may have been preceded by a medical condition.
answer
question
A "silent" heart attack occurs when:
answer
question
the usual chest pain is not present
answer
question
Which of the following statements regarding suicide in the older patient is correct?
answer
question
Older patients tend to use more lethal means than younger patients.
answer
question
Which of the following observations or statements represents the "E" in the GEMS diamond?
answer
question
The patient's residence is cold due to a malfunctioning heater.
answer
question
You are assessing a 70-year-old female who complains of intense thirst, frequent urination, and dizziness. She has a history of type 2 diabetes, heart disease, rheumatoid arthritis, and gout. Her blood glucose level is 450 mg/dL. She is conscious, but confused. Her blood pressure is 92/52 mm Hg, her pulse rate is 130 beats/min and weak, and her respirations are 22 breaths/min and shallow. This patient's clinical presentation is MOST consistent with:
answer
question
hyperosmolar hyperglycemic nonketotic coma (HHNC).
answer
question
When an elderly patient presents you with multiple over-the-counter medications that he or she is taking, it is MOST important to:
answer
question
recall that the patient is at risk for negative medication interactions.
answer
question
When assessing a geriatric patient who has possibly experienced an acute ischemic stroke, it is MOST important to:
answer
question
determine the onset of the patient's symptoms
answer
question
Which of the following patients is at a higher risk for pulmonary embolism
answer
question
71 yr old male wth recent surgery of the lower extremity.
answer
question
Sedentary behavior while healing from a hip fracture would most like predispose the old patient to:
answer
question
pneumonia
answer
question
The chief component of connective tissue and bones that deteriorates as people age is called?
answer
question
collagen
answer
question
Motor nerve neuropathy is characterized by?
answer
question
loss of balance, muscle weakness, and spasms.
answer
question
Upon arriving at the residence of an elderly female who apparently fainted, you find her lying supine on her living room floor. she is not moving and her eyes are closed. a neighbor tells you that she found the patient this way. but did not move her. when you talk to the patient she does not respond you should?
answer
question
Direct your partner to manually stabilize her head while you open her airway and ensure that her oropharynx is clear of secretions or blood.
answer
question
Many older victims of physical abuse may make false statements or lie about the origin of there injuries because?
answer
question
They fear retribution from the abuser.
answer
question
Which of the following statements regarding a decreased level of consciousness in the elderly patient is correct?
answer
question
A decreased level of consciousness is not a normal part of the aging process.
answer
question
When assessing a 78 yr old female who complains of shortness of breath the EMT should?
answer
question
Ask her how many pillows she uses when she sleeps.
answer
question
To minimize distraction and confusion when assessing an older patient you should?
answer
question
Have only one EMT speak to the patient at a time.
answer
question
A 77 yr old female presents with an acute onset of altered mental status. her son is present and advises that she has a history of type 2 diabetes and glaucoma. he further advises that she takes numerous medications and that she is normally alert. when you assess this patient it is important to note that?
answer
question
The patient is experiencing delirious behavior, which suggests a new health problem.
answer
question
When assessing an older patient who has multiple bruises in various stages of healing the EMT should do all of the following except?
answer
question
Accuse the caregiver of physical abuse.
answer
question
Osteoporosis is most accurately defines as?
answer
question
A decrease in bone mass and density.
answer
question
abdominal aortic aneurysm (AAA)
answer
question
A condition in which the walls of the aorta in the abdomen weaken and blood leaks into the layers of the vessel, causing it to bulge.
answer
question
advance directive
answer
question
Written documentation that specifies medical treatment for a competent patient should the patient become unable to make decisions; also called a living will or health care directive.
answer
question
aneurysm
answer
question
A swelling or enlargement of part of a blood vessel, resulting from weakening of the vessel wall.
answer
question
ascites
answer
question
Fluid in the abdomen.
answer
question
decubitus ulcers
answer
question
Also known as bedsores, they are caused by the pressure of skin against a surface for long periods. These sores can range from a pink discoloration of the skin to a deep wound that may invade into bone or organs.
answer
question
deep venous thrombosis
answer
question
The formation of a blood clot within the larger veins of an extremity, typically following a period of prolonged immobilization.
answer
question
delirium
answer
question
A more or less sudden change in mental status marked by the inability to focus, think logically, and maintain attention.
answer
question
dementia
answer
question
The slow onset of progressive disorientation, shortened attention span, and loss of cognitive function.
answer
question
dyspnea
answer
question
Shortness of breath or difficulty breathing.
answer
question
elder abuse
answer
question
Any action on the part of an older person's family member, caregiver, or other associated person that takes advantage of the older person, his or her property, or emotional state; also called granny beating and parent battering.
answer
question
geriatrics
answer
question
The assessment and treatment of disease in someone who is 65 years or older.
answer
question
jugular vein distention
answer
question
A visual bulging of the jugular veins in the neck that can be caused by fluid overload, pressure in the chest, cardiac tamponade, or tension pneumothorax.
answer
question
kyphosis
answer
question
A forward curling of the back caused by an abnormal increase in the curvature of the spine.
answer
question
melena
answer
question
Black, foul-smelling, tarry stool containing digested blood.
answer
question
methicillin-resistant Staphylococcus aureus (MRSA)
answer
question
A bacterium that causes infections in different parts of the body and is often resistant to commonly used antibiotics; can be found on the skin, in surgical wounds, in the bloodstream, lungs, and urinary tract.
answer
question
neuropathy
answer
question
A group of conditions in which the nerves leaving the spinal cord are damaged, resulting in distortion of signals to or from the brain.
answer
question
osteoporosis
answer
question
A generalized bone disease, commonly associated with postmenopausal women, in which there is a reduction in the amount of bone mass leading to fractures after minimal trauma in either sex.
answer
question
peptic ulcer disease
answer
question
An abrasion of the stomach or small intestine.
answer
question
pneumonia
answer
question
An inflammation/infection of the lung from a bacterial, viral, or fungal cause.
answer
question
polypharmacy
answer
question
The simultaneous use of multiple medications by a patient as typically seen in elderly people.
answer
question
presbycusis
answer
question
An age-related condition of the ear that produces progressive bilateral hearing loss that is most noted at higher frequencies.
answer
question
pulmonary embolism
answer
question
A blood clot that breaks off from a large vein and travels to the blood vessels of the lung, causing obstruction of blood flow.
answer
question
respiratory syncytial virus
answer
question
A highly contagious virus that causes an infection of the upper and lower respiratory system.
answer
question
syncope
answer
question
A fainting spell or transient loss of consciousness, often caused by an interruption of blood flow to the brain.
answer
question
unilateral pedal edema
answer
question
Pedal edema is a swelling of the foot and ankle caused by fluid overload; unilateral would present in only one extremity.
answer
question
urinary tract infection (UTI)
answer
question
Infections, usually of the lower urinary tract (urethra and bladder), which occur when normal flora bacteria enter the urethra and grow.
answer
question
A significant number of patients with cerebral palsy also have:
answer
question
a seizure disorder,
answer
question
EMS personnel would MOST likely be called to the residence of a patient receiving home health care when the home care provider:
answer
question
has recognized a change in the patient's health status.
answer
question
A tube from the brain to the abdomen that drains excessive cerebrospinal fluid is called a:
answer
question
shunt
answer
question
In contrast to conductive hearing loss, sensorineural hearing loss is caused by
answer
question
nerve damage
answer
question
Patients with autism
answer
question
have extreme difficulty with complex tasks that require many steps
answer
question
Characteristic anatomic features of Down syndrome include:
answer
question
a round head with a flat occiput
answer
question
When caring for a morbidly obese patient, you should:
answer
question
establish his or her chief complaint and then communicate your plan to help
answer
question
Which of the following statements regarding cerebral palsy is correct?
answer
question
Conditions such as brain injury at birth, postpartum infections, and fetal hypoxia can cause cerebral palsy
answer
question
When interacting with a developmentally disabled patient, the best approach is to:
answer
question
ask your team members to wait until you can establish a rapport with the patient
answer
question
You are assessing a 440-lb man who complains of shortness of breath and lower back pain. The patient is conscious and alert, his blood pressure is 148/98 mm Hg, and his heart rate is 120 beats/min. Your MOST immediate action should be to:
answer
question
avoid placing him in a supine position if possible and administer oxygen.
answer
question
General care for a patient with a tracheotomy tube includes all of the following, EXCEPT:
answer
question
removing the tube if the area around it appears to be infected
answer
question
Which of the following statements regarding interaction with the caregiver of a child or adult with special health care needs is correct?
answer
question
Communication with the patient's caregiver or family members is important because they are the most familiar with the patient's condition
answer
question
Common complications associated with central venous catheters include all of the following, EXCEPT:
answer
question
rupture of a central vein.
answer
question
An important aspect in the assessment of a patient who experienced a previous brain injury involves
answer
question
speaking with the patient and family to establish what is considered normal for the patient.
answer
question
Which of the following would be the MOST practical method of communicating with a hearing-impaired patient until his or her hearing aids can be located?
answer
question
using a piece of paper and writing utensil to ask questions
answer
question
According to the "E" in the DOPE mnemonic, which of the following actions should you perform to troubleshoot inadequate ventilation in a patient with a tracheostomy tube?
answer
question
Check the mechanical ventilator for malfunction
answer
question
When enlisting the help of an interpreter who signs, it is important for you to ask the interpreter to:
answer
question
report exactly what the patient signs and not to add any commentary
answer
question
Airway management can be challenging in patients with Down syndrome because their
answer
question
teeth are misaligned and they have a large tongue
answer
question
When caring for patients with cerebral palsy, it is important to remember that:
answer
question
their limbs are often underdeveloped and are prone to injury.
answer
question
If suctioning of the tracheostomy tube is necessary, the EMT should:
answer
question
attempt to use the patient's suction device first because it is probably already sized correctly.
answer
question
Spina bifida is MOST accurately defined as:
answer
question
a birth defect caused by incomplete closure of the spinal column.
answer
question
When assessing or providing care to a patient with a developmental disability, you should:
answer
question
be observant for signs of fear or reluctance from the patient
answer
question
Autism is MOST accurately defined as a:
answer
question
pervasive developmental disorder characterized by impairment of social interaction.
answer
question
Because a tracheostomy tube bypasses the nose and mouth
answer
question
secretions can build up in and around the tube.
answer
question
Cerebral palsy is characterized by poorly controlled ________ movement.
answer
question
body
answer
question
Under what circumstances is a left ventricular assist device used?
answer
question
as a bridge to heart transplantation while a donor heart is being located
answer
question
Down syndrome is a genetic defect that occurs as the result of:
answer
question
a triplication of chromosome 21
answer
question
You respond to a residence for a 9-year-old female with Down syndrome who is sick. When you arrive at the scene and assess the patient, you determine that she is unresponsive and has gurgling respirations. You should:
answer
question
open her airway with a manual maneuver, suction her oropharynx, and insert a simple airway adjunct.
answer
question
Vagal nerve stimulators may be an alternative treatment to medication for patients with:
answer
question
chronic seizure disorders
answer
question
According to the Emergency Medical Treatment and Active Labor Act (EMTALA):
answer
question
all health care facilities must provide a medical assessment and required treatment, regardless of the patient's ability to pay.
answer
question
Which of the following statements regarding interaction with the caregiver of a child or adult with special health care needs is correct?
answer
question
Communication with the patient's caregiver or family members is important because they are the most familiar with the patient's condition
answer
question
Which of the following statements regarding gastrostomy (gastric) tubes is correct?
answer
question
Patients with a gastrostomy tube may still be at risk for aspiration
answer
question
For which of the following conditions would you MOST likely encounter a ventricular peritoneum shunt?
answer
question
hydrocephalus
answer
question
A service dog is easily identified by its
answer
question
harness
answer
question
Which of the following statements regarding autism is correct?
answer
question
Most cases of autism are diagnosed by 3 years of age.
answer
question
When interacting with a developmentally disabled patient, the best approach is to:
answer
question
ask your team members to wait until you can establish a rapport with the patient.
answer
question
The purpose of a ventricular peritoneum shunt is to:
answer
question
prevent excess CSF from accumulating in the brain
answer
question
A 70-year-old male complains of shortness of breath. During your assessment, you note that he has bilateral hearing aids. When you ask him questions related to his chief complaint, he does not answer you. You can hear a whistling sound coming from his hearing aids. You should:
answer
question
try repositioning the hearing aid or remove it and turn down the volume.
answer
question
When caring for a patient who is visually impaired, it is important to:
answer
question
tell him or her what is happening, identify noises, and describe the situation and surroundings.
answer
question
Which of the following statements regarding hearing aids is correct?
answer
question
Hearing aids cannot restore hearing to normal levels.
answer
question
Which of the following statements regarding patients with developmental disabilities is correct?
answer
question
Patients with developmental disabilities are susceptible to the same disease processes as other patients.
answer
question
You receive a call to a residence for an apneic 2-month-old male. When you arrive at the scene, the infant's mother tells you that her son was born prematurely and that his apnea monitor has alarmed 4 times in the past 30 minutes. Your assessment of the infant reveals that he is conscious and active. His skin is pink and dry, and he is breathing at an adequate rate and with adequate tidal depth. His oxygen saturation reads 98% on room air. You should:
answer
question
transport the infant to the hospital and bring the apnea monitor with you.
answer
question
A 13-year-old child is on a home ventilator. The parents called because the ventilator is malfunctioning and the child has increasing respiratory distress. You should:
answer
question
disconnect the ventilator and use a bag-mask device
answer
question
BY PLACING ON HAND ON TOP OF YOUR HEAD AND THE OTHER HAND OVER YOUR ABDOMEN, YOU ARE ASKING A HEARING-IMPAIRED PATIENT IF HE/SHE IS:
answer
question
sick
answer
question
CEREBRAL PALSY IS A CONDITION THAT RESULTS FROM DAMAGE OR INJURY TO THE:
answer
question
brain
answer
question
You are dispatched to the residence of an Asian family for a child with a high fever. When you assess the child, you note that he has numerous red marks on his back. The child's parents explain that these represent coining--a traditional Asian healing practice in which hot coins are rubbed on the back. You should:
answer
question
Document this on the patient care report and advise the emergency department staff of what the child's parents told you.
answer
question
Blood loss in a child exceeding ____ of his or her total blood volume significantly increases the risk of shock.
answer
question
25%
answer
question
The pulse rate of a child from ages 6 to 12 years is approximately:
answer
question
70 to 120 beats/min
answer
question
The tip of a central venous catheter rests in the:
answer
question
Vena Cava
answer
question
Which of the following conditions would most likely cause a patient to slur words, speak very slowly or speak in a monotone?
answer
question
parkinsons disease
answer
question
General techniques for communicating with hearing-impaired patients include?
answer
question
Positioning yourself approximately 18" directly in front of the patient.
answer
question
Two thirds of children born with Down Syndrome have
answer
question
Positioning yourself approximately 18" directly in front of the patient.
answer
question
Two thirds of children born with Down Syndrome have
answer
question
Congenital heart disease.
answer
question
A per son is said to be obese when he or she is ________ over his of her ideal weight?
answer
question
by 20% to 30%
answer
question
Common associated conditions in patients with Spina Bifida include all of the following EXCEPT
answer
question
Spastic limb movement.
answer
question
Characteristic anatomic features of Down Syndrome include
answer
question
A round head with a flat occiput
answer
question
A surgical procedure that creates an opening between the intestine and the surface of the body that allows for elimination of waste products is called?
answer
question
colostomy
answer
question
TEAM stands for...
answer
question
Trust, Every, Available, Member
answer
question
developmental disability
answer
question
A disability caused by insufficient cognitive development of the brain, which results in a person's inability to learn and socially adapt at a normal developmental rate.
answer
question
autism
answer
question
A pervasive developmental disorder characterized by impairment of social interaction. The spectrum of this disability is wide. About 1 in 150 children are diagnosed with it.
answer
question
Sensorineural deafness
answer
question
Occurs from a lesion or damage to the inner ear.
answer
question
Conductive hearing loss
answer
question
This is caused by a faulty transmission of sound waves, which can occur when a person has an accumulation of wax within the ear canal or a perforated eardrum.
answer
question
cerebral palsy
answer
question
A term for a group of disorders characterized by poorly controlled body movement.
answer
question
spina bifida
answer
question
A birth defect caused by the incomplete closure of the spinal column that results in an exposed spinal cord and undeveloped vertebrae.
answer
question
obesity
answer
question
A condition in which a person has an excessive amount of body fat and is the result of an imbalance between food eaten and calories used.
answer
question
tracheostomy tube
answer
question
A plastic tube placed in a surgical opening from the anterior part of the neck into the trachea.
answer
question
DOPE
answer
question
Displacement, dislodged, or damaged tube, obstruction of the tube, pneumothorax, pulmonary problems, equipment failure
answer
question
Shunts
answer
question
Tubes that extend from the brain to the abdomen to drain excess cerebrospinal fluid that may accumulate near the brain.
answer
question
Gastric tubes
answer
question
Tubes that are placed directly into the stomach for feeding patients who cannot ingest fluids, food, or medication by mouth.
answer
question
colostomy (or) ileostomy
answer
question
Surgical procedure that creates an opening between the small or large intestine and the surface of the body that allows for elimination of waste products. (there are 2 terms for this procedure)
answer
question
Stoma
answer
question
The special opening between the small or large intestine and the surface of the body
answer
Bag Mask Device
Emergency Medical Technology
High Blood Glucose Levels
Pulmonology
Right Sided Heart Failure
EMT Chapter 13 Review – Flashcards 40 terms

Judith Simpson
40 terms
Preview
EMT Chapter 13 Review – Flashcards
question
Dyspnea is MOST accurately defined as: A. shortness of breath or difficulty breathing. B. a complete cessation of respiratory effort. C. a marked increase in the exhalation phase. D.labored breathing with reduced tidal volume.
answer
A. shortness of breath or difficulty breathing.
question
In what area of the lungs does respiration occur? A. alveoli B. trachea C. bronchi D. capillaries
answer
A. alveoli
question
The two processes that occur during respiration are: A. ventilation and diffusion. B. inspiration and expiration. C. diffusion and oxygenation. D. oxygenation and ventilation.
answer
B. inspiration and expiration.
question
In order for efficient pulmonary gas exchange to occur: A. the percentage of inhaled carbon dioxide must exceed the percentage of inhaled oxygen. B. there must be low quantities of pulmonary surfactant to allow for full alveolar expansion. C. the pulmonary capillaries must be completely constricted and the alveoli must be collapsed. D. oxygen and carbon dioxide must be able to freely diffuse across the alveolar-capillary membrane.
answer
D. oxygen and carbon dioxide must be able to freely diffuse across the alveolar-capillary membrane.
question
In a healthy individual, the brain stem stimulates breathing on the basis of: A. increased oxygen levels. B. decreased oxygen levels. In a healthy individual, the brain stem stimulates breathing on the basis of: A. increased oxygen levels. B. decreased oxygen levels. C. increased carbon dioxide levels. D. decreased carbon dioxide levels.
answer
C. increased carbon dioxide levels.
question
When the level of arterial carbon dioxide rises above normal: A. the brain stem inhibits respirations. B. respirations increase in rate and depth. C. exhalation lasts longer than inhalation. D. respirations decrease in rate and depth.
answer
B. respirations increase in rate and depth.
question
Which of the following is MOST characteristic of adequate breathing? A. 22 breaths/min with an irregular pattern of breathing and cyanosis B. 20 breaths/min with shallow movement of the chest wall and pallor C. 24 breaths/min with bilaterally equal breath sounds and pink skin D. 30 breaths/min with supraclavicular retractions and clammy skin
answer
C. 24 breaths/min with bilaterally equal breath sounds and pink skin
question
An alert patient presents with a regular pattern of inhalation and exhalation and breath sounds that are clear and equal on both sides of the chest. These findings are consistent with: A. an obstructed airway. B. adequate air exchange. C. respiratory difficulty. D. respiratory insufficiency.
answer
B. adequate air exchange.
question
Which of the following statements regarding the hypoxic drive is MOST correct? A. The hypoxic drive stimulates a person to breathe on the basis of low oxygen levels. B. Chronic carbon dioxide elimination often results in activation of the hypoxic drive. C. The hypoxic drive serves as the primary stimulus for breathing in healthy individuals. D. 100% supplemental oxygen will always cause apnea in patients with a hypoxic drive.
answer
A. The hypoxic drive stimulates a person to breathe on the basis of low oxygen levels.
question
When administering supplemental oxygen to a hypoxemic patient with a chronic lung disease, you should: A. recall that most patients with chronic lung diseases are stimulated to breathe by increased carbon dioxide levels. B. adjust the flow rate accordingly until you see symptom improvement, but be prepared to assist his or her ventilations. C. begin with a low oxygen flow rate, even if the patient is unresponsive, because high-flow oxygen may depress his or her breathing. D. avoid positive-pressure ventilation because the majority of patients with chronic lung disease are at increased risk for lung trauma.
answer
B. adjust the flow rate accordingly until you see symptom improvement, but be prepared to assist his or her ventilations.
question
Paroxysmal nocturnal dyspnea (PND), rales, and dependent edema are clinical indicators of: A. emphysema. B. severe pneumonia. C. bronchitis or asthma. D. congestive heart failure.
answer
D. congestive heart failure.
question
Which of the following conditions would LEAST likely result in hypoxia? A. pleural effusion B. severe anxiety C. pulmonary edema D. prolonged seizures
answer
B. severe anxiety
question
Which of the following statements regarding severe acute respiratory syndrome (SARS) is correct? A.Multiple bacteria have been identified as being the cause of SARS. B. SARS is most commonly transmitted by direct contact with blood. C. The onset of SARS is typically marked by acute, severe pneumonia. D. SARS is a viral infection that often begins with flulike symptoms.
answer
D. SARS is a viral infection that often begins with flulike symptoms.
question
Acute pulmonary edema would MOST likely develop as the result of: A.right-sided heart failure. B. severe hyperventilation. C. toxic chemical inhalation. D. an upper airway infection.
answer
C. toxic chemical inhalation.
question
Weakening of the airway in patients with chronic bronchitis is the result of: A. destruction of protective mechanisms that remove foreign particles. B. loss of the lubricating substance that facilitates alveolar expansion. C. airway irritation caused by a marked decrease in mucus production. D. acute constriction of the bronchioles caused by an external irritant.
answer
A. destruction of protective mechanisms that remove foreign particles.
question
The respiratory distress that accompanies emphysema is caused by: A. repeated exposure to cigarette smoke. B. chronic stretching of the alveolar walls. C. massive constriction of the bronchioles. D. acute fluid accumulation in the alveoli.
answer
B. chronic stretching of the alveolar walls.
question
Asthma is caused by a response of the: A. immune system. B. endocrine system. C. respiratory system. D. cardiovascular system.
answer
A. immune system.
question
At the onset of an acute asthma attack, patients commonly experience difficulty breathing and: A. audible stridor. B. rales and rhonchi. C. profound cyanosis. D. expiratory wheezing.
answer
D. expiratory wheezing.
question
Which of the following statements regarding anaphylaxis is correct? A. Patients with asthma are at lower risk of developing anaphylaxis. B. Anaphylaxis is characterized by airway swelling and hypotension. C. Most anaphylactic reactions occur within 60 minutes after exposure. D. The signs of anaphylaxis are caused by widespread vasoconstriction.
answer
B. Anaphylaxis is characterized by airway swelling and hypotension.
question
A 30-year-old male presents with acute shortness of breath, widespread hives, and facial swelling. He denies any past medical history and takes no medications. During your assessment, you hear wheezing over all lung fields. His blood pressure is 90/50 mm Hg and his heart rate is 110 beats/min. In addition to giving him 100% oxygen, the MOST important treatment for this patient is: A. albuterol. B. epinephrine. C. an antihistamine. D. a beta-antagonist.
answer
B. epinephrine.
question
A 59-year-old male with a history of emphysema complains of an acute worsening of his dyspnea and pleuritic chest pain following a forceful cough. Your assessment reveals that he has a barrel-shaped chest, unilaterally diminished breath sounds, and tachycardia. What is the MOST likely cause of this patient's condition? A. rupture of the diaphragm B. exacerbation of his COPD C. acute pulmonary embolism D. spontaneous pneumothorax
answer
D. spontaneous pneumothorax
question
A pleural effusion is MOST accurately defined as: A. a unilaterally collapsed lung. B. diffuse collapsing of the alveoli. C. fluid accumulation outside the lung. D. a bacterial infection of the lung tissue.
answer
C. fluid accumulation outside the lung.
question
You are dispatched to a residence for a 67-year-old female who was awakened by shortness of breath and sharp chest pain. Her husband tells you that she was recently discharged from the hospital after having hip surgery. Your assessment reveals dried blood around her mouth, facial cyanosis, and an oxygen saturation of 88%. This patient's presentation is MOST consistent with: A. acute pulmonary edema. B. right-sided heart failure. C. acute pulmonary embolism. D. spontaneous pneumothorax.
answer
C. acute pulmonary embolism.
question
Hyperventilation could be associated with all of the following, EXCEPT: A. a narcotic overdose. B. a respiratory infection. C. an overdose of aspirin. D. high blood glucose levels.
answer
A. a narcotic overdose.
question
A young female is unconscious after intentionally ingesting a large amount of aspirin. You will MOST likely find her respirations: A. slow and deep. B. deep and rapid. C. slow and shallow. D. rapid and shallow.
answer
B. deep and rapid.
question
Alkalosis is a condition that occurs when: A. blood acidity is reduced by excessive breathing. B. dangerous acids accumulate in the bloodstream. C. the level of carbon dioxide in the blood increases. D. slow, shallow breathing eliminates too much carbon dioxide.
answer
A. blood acidity is reduced by excessive breathing.
question
Common signs and symptoms of acute hyperventilation syndrome include: A. altered mental status and bradycardia. B. unilateral paralysis and slurred speech. C. anxiety, dizziness, and severe bradypnea. D. tachypnea and tingling in the extremities.
answer
D. tachypnea and tingling in the extremities.
question
A 60-year-old male presents with acute respiratory distress. He is conscious and alert, has pink and dry skin, and has respirations of 24 breaths/min with adequate depth. Which of the following treatment modalities is MOST appropriate for this patient? A. assisted ventilation with a bag-mask device and a head-to-toe exam B. oxygen via nonrebreathing mask and a focused secondary assessment C. positive-pressure ventilations and immediate transport to the closest hospital D. oxygen via a nasal cannula, vital signs, and prompt transport to the hospital
answer
B. oxygen via nonrebreathing mask and a focused secondary assessment
question
You receive a call for a 70-year-old female with respiratory distress. Her husband tells you that she has congestive heart failure; however, he does not think that she has been taking her medications as prescribed. The patient is laboring to breathe, appears tired, and has cyanosis around her lips. You should: A. assist her ventilations with a bag-mask device. B. apply a pulse oximeter and obtain vital signs. C. administer oxygen via a nonrebreathing mask. D. obtain a complete list of all of her medications.
answer
A. assist her ventilations with a bag-mask device.
question
When auscultating the lungs of a patient with respiratory distress, you hear adventitious sounds. This means that the patient has: A. normal breath sounds. B. abnormal breath sounds. C. diminished breath sounds. D. an absence of breath sounds.
answer
B. abnormal breath sounds.
question
When assessing for fluid collection in the lungs during auscultation of lung sounds, you should: A. note the presence of a high-pitched whistling sound, which is an indicator of fluid in the lungs. B. pay special attention to the exhalation phase since this is when you will likely hear rales or rhonchi. C. auscultate the posterior chest first and compare the apex of one lung to the base of the opposite lung. D. start at the lower lung fields and determine at which level you start hearing clear breath sounds.
answer
D. start at the lower lung fields and determine at which level you start hearing clear breath sounds.
question
While auscultating an elderly woman's breath sounds, you hear low-pitched "rattling" sounds at the bases of both of her lungs. With which of the following conditions is this finding MOST consistent? A. acute asthma attack B.widespread atelectasis C. aspiration pneumonia D. early pulmonary edema
answer
C. aspiration pneumonia
question
Harsh, high-pitched inspiratory sounds are characteristic of: A. rales. B. stridor. C. rhonchi. D. wheezing.
answer
B. stridor.
question
A conscious and alert 29-year-old female with a history of asthma complains of difficulty breathing that began after her morning jog. The temperature outside is 40°F (5°C). On exam, you hear bilateral expiratory wheezing. After providing 100% oxygen, you should: A. place her in a recumbent position to facilitate breathing. B. contact medical control and administer an antihistamine. C. call medical control and ask how to proceed with treatment. D. determine if she has been prescribed a beta-agonist inhaler.
answer
D. determine if she has been prescribed a beta-agonist inhaler.
question
Which of the following statements regarding pulse oximetry is correct? A. The pulse oximeter is a valuable assessment tool that measures the percentage of red blood cells that contain hemoglobin molecules. B. Caution must be exercised when using the pulse oximeter on a patient with carbon monoxide poisoning because falsely low readings are common. C. Pulse oximetry measures the percentage of hemoglobin that is saturated with oxygen, but does not measure the actual hemoglobin content of the blood. D. Most otherwise healthy patients can maintain adequate oxygenation and good skin color with oxygen saturation readings as low as 70% to 80%.
answer
C. Pulse oximetry measures the percentage of hemoglobin that is saturated with oxygen, but does not measure the actual hemoglobin content of the blood.
question
You are dispatched to an apartment complex where a 21-year-old female has apparently overdosed on several narcotic medications. She is semiconscious and has slow, shallow respirations. You should: A. insert an oropharyngeal airway and perform oral suctioning. B. apply oxygen via a nonrebreathing mask and transport at once. C. insert a nasopharyngeal airway and begin assisted ventilation. D. place her in the recovery position and monitor for vomiting.
answer
D. place her in the recovery position and monitor for vomiting.
question
Albuterol is a generic name for: A. Alupent. B. Atrovent. C. Proventil. D. Singulair.
answer
C. Proventil.
question
You are assisting an asthma patient with his prescribed metered-dose inhaler. After the patient takes a deep breath and depresses the inhaler, you should: A. instruct him to hold his breath for as long as he comfortably can. B. immediately reapply the oxygen mask and reassess his condition. C. advise him to exhale forcefully to ensure medication absorption. D. allow him to breathe room air and assess his oxygen saturation.
answer
A. instruct him to hold his breath for as long as he comfortably can.
question
A 22-year-old female patient is complaining of dyspnea and numbness and tingling in her hands and feet after an argument with her fiancé. Her respirations are 40 breaths/min. You should: A. have her breathe into a paper or plastic bag. B. provide reassurance and give oxygen as needed. C. request a paramedic to give her a sedative drug. D. position her on her left side and transport at once.
answer
B. provide reassurance and give oxygen as needed.
question
A 62-year-old man with a history of congestive heart failure presents with severe respiratory distress and an oxygen saturation of 82%. When you auscultate his lungs, you hear widespread rales. He is conscious and alert, is able to follow simple commands, and can only speak in two- to three-word sentences at a time. You should: A. place him in a position of comfort, deliver oxygen via nasal cannula, and closely monitor his breathing. B. apply a continuous positive airway pressure (CPAP) device, monitor his blood pressure, and observe him for signs of improvement or deterioration. C. force fluid from his alveoli by hyperventilating him with a bag-mask device at a rate of at least 20 breaths/min. D. place him in a supine position and assist his ventilations with a bag-mask device and high-flow oxygen.
answer
B. apply a continuous positive airway pressure (CPAP) device, monitor his blood pressure, and observe him for signs of improvement or deterioration.
Bag Mask Device
Nursing
Pulmonology
Venous Return To The Heart
5.3 – Flashcards 20 terms

Michael Seabolt
20 terms
Preview
5.3 – Flashcards
question
Common clinical findings in patients with obstructive lung disease include all of the following, EXCEPT: A. pursed-lip breathing. B. chronic air trapping in the lungs. C. a decreased expiratory phase. D. abdominal muscle use.
answer
C. a decreased expiratory phase.
question
Pneumonitis is especially common in older patients with: A. a history of a stroke. B. frequent infections. C. chronic food aspiration. D. immunocompromise.
answer
C. chronic food aspiration.
question
Which of the following statements regarding epiglottitis is correct? A. Epiglottitis has become relatively rare in children due to vaccinations against the Haemophilus influenzae type b bacterium. B. Most cases of epiglottitis are progressive in their onset and result in severe swelling of the larynx, trachea, and bronchi. C. Unlike croup, epiglottitis most commonly occurs in the middle of the night, when the outside temperature is cool. D. Characteristic signs of epiglottitis include a low-grade fever, a seal-like barking cough, and varying degrees of respiratory distress.
answer
A. Epiglottitis has become relatively rare in children due to vaccinations against the Haemophilus influenzae type b bacterium.
question
Why are children more prone to croup when they acquire a viral infection than adults infected with the same virus? A. A child's airway is narrower than an adult's, and even minor swelling can result in obstruction. B. The virus that causes croup replicates far more aggressively in children than it does in adults. C. Children's immune systems are not as developed as adults', so they are more prone to infection. D. Adults were vaccinated against the virus that causes croup, whereas most children were not.
answer
A. A child's airway is narrower than an adult's, and even minor swelling can result in obstruction.
question
COPD is characterized by: A. small airway spasms during the inhalation phase, resulting in progressive hypoxia. B. widespread alveolar collapse due to increased pressure during the exhalation phase. C. narrowing of the smaller airways that is often reversible with prompt treatment. D. changes in pulmonary structure and function that are progressive and irreversible.
answer
D. changes in pulmonary structure and function that are progressive and irreversible.
question
A patient with a history of asthma is at GREATEST risk for respiratory arrest if he or she: A. was recently evaluated in an emergency department. B. takes a bronchodilator and a corticosteroid. C. was previously intubated for his or her condition. D. has used his or her inhaler twice in the previous week.
answer
C. was previously intubated for his or her condition.
question
A critical step when using a CPAP unit to treat a patient with severe respiratory distress is: A. setting the oxygen flow rate to at least 6 L/min. B. starting with CPAP levels above 10 to 15 cm of water. C. holding the mask to the noncompliant patient's face. D. ensuring an adequate mask seal with minimal leakage.
answer
D. ensuring an adequate mask seal with minimal leakage.
question
A morbidly obese man called 9-1-1 because of difficulty breathing. When you arrive, you find the 39-year-old patient lying supine in his bed. He is in marked respiratory distress and is only able to speak in two-word sentences. He has a history of hypertension, but denies any respiratory conditions. What should you do FIRST? A. Administer a beta-2 agonist drug. B. Begin assisting his ventilations. C. Sit him up or place him on his side. D. Assess his oxygen saturation level.
answer
C. Sit him up or place him on his side.
question
Reactive airway disease is characterized by: A. excessive mucus production and a chronic cough. B. chronic bronchoconstriction of varying severity. C. bronchospasm, edema, and mucus production. D. acute, reversible swelling of the laryngeal muscles.
answer
C. bronchospasm, edema, and mucus production
question
A 76-year-old woman with emphysema presents with respiratory distress that has worsened progressively over the past 2 days. She is breathing through pursed lips and has a prolonged expiratory phase and an oxygen saturation of 76%. She is on home oxygen at 2 L/min. Your initial action should be to: A. administer a beta-2 agonist via nebulizer. B. auscultate her lungs for adventitious breath sounds. C. increase her oxygen flow rate to 6 L/min. D. place her in a position that facilitates breathing.
answer
D. place her in a position that facilitates breathing.
question
The primary treatment of bronchospasm is: A. humidified oxygen. B. corticosteroid therapy. C. assisted ventilation. D. bronchodilator therapy.
answer
D. bronchodilator therapy.
question
Intubation of a patient with severe asthma: A. is clearly indicated if the patient's condition does not resolve following field corticosteroid therapy. B. should only be performed after hyperventilating the patient with a bag-mask device for 2 to 3 minutes. C. is often a last resort because asthmatics are difficult to ventilate and are prone to pneumothoraces. D. is generally contraindicated because weaning the patient off of a ventilator can take several days.
answer
C. is often a last resort because asthmatics are difficult to ventilate and are prone to pneumothoraces.
question
You are transporting a middle-aged man on a CPAP unit for severe pulmonary edema. An IV line of normal saline is in place. Prior to applying the CPAP device, the patient was tachypneic and had an oxygen saturation of 90%. When you reassess him, you note that his respirations have increased and his oxygen saturation has dropped to 84%. You should: A. suspect that he has developed a pneumothorax and prepare to perform a needle chest decompression. B. decrease the amount of positive-end expiratory pressure that you are delivering and reassess. C. remove the CPAP unit, assist his ventilations with a bag-mask device, and prepare to intubate him. D. continue the CPAP treatment and administer a diuretic to remove fluids from his lungs quickly.
answer
C. remove the CPAP unit, assist his ventilations with a bag-mask device, and prepare to intubate him.
question
A known heroin abuser is found unconscious on a park bench. Your assessment reveals that his respirations are slow and shallow, and his pulse is slow and weak. You should: A. preoxygenate him with a bag-mask device for 2 to 3 minutes and then intubate his trachea. B. apply oxygen via nonrebreathing mask, administer naloxone, and be prepared to assist ventilations. C. suction his oropharynx, perform intubation, and then administer naloxone via slow IV push. D. assist ventilations with a bag-mask device, administer naloxone, and reassess his ventilatory status.
answer
D. assist ventilations with a bag-mask device, administer naloxone, and reassess his ventilatory status.
question
Unlike bronchodilator therapy, corticosteroid therapy: A. is administered exclusively in a hospital setting. B. is the primary treatment for acute bronchospasm. C. takes a few hours to reduce bronchial edema. D. causes immediate improvement in breathing.
answer
C. takes a few hours to reduce bronchial edema.
question
CPAP in the emergency setting is used to treat patients with certain obstructive airway diseases by: A. increasing the rate and depth of ventilation, thus improving minute volume and mitigating hypoxia. B. maintaining stability of the posterior pharynx, thereby preventing upper airway obstruction. C. improving patency of the lower airway through the use of positive-end expiratory pressure. D. delivering one pressure during the inspiratory phase and a different pressure during the expiratory phase.
answer
C. improving patency of the lower airway through the use of positive-end expiratory pressure.
question
A patient with orthopnea: A. is awakened from sleep with severe dyspnea. B. seeks a sitting position when short of breath. C. prefers to lie flat in order to facilitate breathing. D. has no position of comfort
answer
B. seeks a sitting position when short of breath.
question
Use of an automated transport ventilator is NOT appropriate for patients who are: A. in cardiac arrest. B. apneic with a pulse. C. chemically paralyzed. D. breathing spontaneously.
answer
D. breathing spontaneously.
question
Patients with obvious respiratory failure require immediate: A. passive oxygenation. B. intubation. C. bronchodilator therapy. D. ventilation support.
answer
D. ventilation support.
question
A 36-year-old man with a history of asthma presents with severe respiratory distress. You attempt to administer a nebulized beta-2 agonist, but his poor respiratory effort is inhibiting effective drug delivery via the nebulizer and his mental status is deteriorating. You should: A. start an IV of normal saline and administer a steroid. B. assist him with a metered-dose inhaler bronchodilator. C. apply high-flow oxygen via a nonrebreathing mask. D. assist his ventilations and establish vascular access.
answer
D. assist his ventilations and establish vascular access.
Bag Mask Device
6.5 – Flashcards 46 terms

Brenda Gannon
46 terms
Preview
6.5 – Flashcards
question
The proper compression-to-ventilation ratio for two-rescuer adult CPR when an oropharyngeal airway is in place is: A. 30:2. B. 5:1. C. asynchronous. D. 15:2.
answer
A. 30:2.
question
When managing cardiac arrest, the appropriate dosing regimen for epinephrine is: A. 1 mg of a 1:10,000 solution every 3 to 5 minutes. B. 10 mL of a 1:1,000 solution every 3 to 5 minutes. C. 0.1 mg/kg of a 1:10,000 solution every 3 minutes. D. 1 mL of a 1:10,000 solution every 3 to 5 minutes.
answer
A. 1 mg of a 1:10,000 solution every 3 to 5 minutes.
question
You respond to the scene of an assault, where a 20-year-old man was struck in the chest with a steel pipe. Your assessment reveals that the patient is unresponsive, apneic, and pulseless. The MOST appropriate next intervention is to: A. look for evidence of a pericardial tamponade. B. immediately assess the patient's cardiac rhythm. C. perform 5 cycles of well-coordinated CPR. D. give 2 minutes of 15 compressions and 2 breaths.
answer
C. perform 5 cycles of well-coordinated CPR.
question
The preferred antiarrhythmic medication and initial dose for a patient with refractory ventricular fibrillation or pulseless ventricular tachycardia is: A. procainamide, 20 mg/min. B. lidocaine, 0.75 mg/kg. C. amiodarone, 300 mg. D. lidocaine, 1.5 mg/kg.
answer
C. amiodarone, 300 mg.
question
Atherosclerosis is a process in which: A. plaque ruptures from a distant location and lodges in one of the coronary arteries. B. plaque infiltrates the arterial wall, decreasing its elasticity and narrowing its lumen. C. the outer wall of a coronary artery becomes lined with masses of fatty tissue. D. calcium precipitates into the arterial walls, greatly reducing the artery's elasticity.
answer
B. plaque infiltrates the arterial wall, decreasing its elasticity and narrowing its lumen.
question
After delivering a shock to a patient in pulseless ventricular tachycardia, you should: A. deliver two effective ventilations. B. check for a pulse. C. reassess the cardiac rhythm. D. resume CPR
answer
D. resume CPR
question
The MOST important initial pieces of equipment to bring to the side of an unresponsive patient are the: A. defibrillator and airway management equipment. B. intubation kit and equipment for vascular access. C. drug kit and stretcher with a long backboard. D. pocket face mask and equipment for intubation.
answer
A. defibrillator and airway management equipment.
question
Once an advanced airway device has been inserted into a cardiac arrest patient: A. you should deliver one breath every 5 to 6 seconds. B. the compressor should pause so ventilations can be given. C. chest compressions should be increased to 120 per minute. D. ventilations are delivered at a rate of 8 to 10 breaths/min.
answer
D. ventilations are delivered at a rate of 8 to 10 breaths/min.
question
When performing CPR on an adult patient in cardiac arrest, it is important to: A. limit interruptions in chest compressions to 20 seconds. B. allow the chest to fully recoil between compressions. C. deliver at least 80 to 90 compressions per minute. D. deliver forceful ventilations between compressions.
answer
B. allow the chest to fully recoil between compressions.
question
You are called to a local gym for a patient with nausea. Your patient, a 29-year-old man, tells you that he thinks he has a "stomach bug." He is conscious and alert, denies chest pain or shortness of breath, and tells you that he has been nauseated for the last 4 hours but has not vomited. His blood pressure is 124/66 mm Hg, pulse is 46 beats/min and strong, respirations are 20 breaths/min and regular, and room air oxygen saturation is 99%. The cardiac monitor reveals a sinus bradycardia. You should: A. give 100% oxygen, start two large-bore IV lines, administer 20 mL/kg normal saline boluses, and transport. B. advise him that he can probably drive himself to the emergency department or schedule an appointment with his physician. C. apply high-flow oxygen via nonrebreathing mask, start an IV line, administer 0.5 mg of atropine, and transport to the closest facility. D. administer oxygen via nasal cannula, start an IV of normal saline, consider administering an antiemetic, and transport.
answer
D. administer oxygen via nasal cannula, start an IV of normal saline, consider administering an antiemetic, and transport.
question
If you are using a biphasic defibrillator, but are unsure of the appropriate starting energy setting, you should set the defibrillator to: A. 120 J. B. 200 J. C. 150 J. D. 360 J.
answer
B. 200 J.
question
Treatment for a patient with bradycardia and significantly compromised cardiac output includes: A. transcutaneous cardiac pacing. B. a dopamine infusion at 20 mg/min. C. 1 mg of atropine via IV push. D. 1 mg of epinephrine 1:10,000.
answer
A. transcutaneous cardiac pacing.
question
You and your partner arrive at the scene of an unresponsive male patient. Your assessment reveals that he is pulseless and apneic. The patient's wife tells you that he collapsed about 10 minutes ago. You should: A. ask the patient's wife if her husband has a living will. B. initiate CPR as your partner applies the defibrillator pads. C. apply the defibrillator pads and assess his cardiac rhythm. D. begin CPR with a compression to ventilation ratio of 15:2.
answer
B. initiate CPR as your partner applies the defibrillator pads.
question
You have applied the cardiac monitor to your 66-year-old male cardiac arrest patient and see what appears to be asystole. You should: A. check for a pulse for a maximum of 10 seconds. B. resume CPR and place an advanced airway device. C. continue CPR and reassess the rhythm in 2 minutes. D. assess another lead or increase the gain sensitivity.
answer
D. assess another lead or increase the gain sensitivity.
question
The recommended first-line treatment for third-degree heart block associated with bradycardia and hemodynamic compromise is: A. a dopamine infusion. B. atropine sulfate. C. transcutaneous pacing. D. an epinephrine infusion.
answer
C. transcutaneous pacing.
question
Common causes of cardiac arrest include all of the following, EXCEPT: A. hyperglycemia. B. cardiac tamponade. C. pulmonary embolism. D. hypovolemia.
answer
A. hyperglycemia.
question
A 56-year-old man presents with an acute onset of chest pressure and diaphoresis. He has a history of hypertension and type 2 diabetes. His airway is patent and his breathing is adequate. You should: A. obtain baseline vital signs. B. administer supplemental oxygen. C. acquire a 12-lead ECG tracing. D. establish vascular access.
answer
B. administer supplemental oxygen.
question
A patient is considered a potential candidate for fibrinolytic therapy if he or she has experienced chest discomfort for: A. more than 5 minutes. B. less than 15 minutes C. more than 24 hours. D. less than 12 hours.
answer
D. less than 12 hours.
question
You receive a call to a skilled nursing facility for an elderly man with generalized weakness. The patient's nurse tells you that he has not eaten anything in the past 18 hours. She presents you with his chart, which states that he has a history of atrial fibrillation, congestive heart failure, and hypertension. His medications include Vasotec, digoxin, and warfarin. As you apply the cardiac monitor, your partner takes the patient's vital signs, which reveal a blood pressure of 136/76 mm Hg, a rapid and irregular pulse, and respirations of 22 breaths/min. The ECG reveals atrial fibrillation with a variable rate between 110 and 130 beats/min, and a 12-lead ECG tracing reveals the same. After applying supplemental oxygen, you should: A. establish IV access, give a beta blocker to slow his heart rate, and transport. B. place him in a position of comfort and transport with continuous monitoring. C. start an IV line set to keep the vein open, administer diltiazem, and transport. D. establish an IV, administer Versed, and perform synchronized cardioversion.
answer
C. start an IV line set to keep the vein open, administer diltiazem, and transport.
question
Regardless of the patient's presenting cardiac arrest rhythm, the first IV or IO drug that should be given is: A. calcium chloride. B. an inotrope. C. a vasopressor. D. an antidysrhythmic.
answer
C. a vasopressor.
question
Which of the following actions should NOT occur while CPR is in progress? A. Advanced airway placement B. Establishment of vascular access C. Assessment for a palpable pulse D. Cardiac rhythm assessment
answer
D. Cardiac rhythm assessment
question
A 70-year-old woman remains in asystole following 10 minutes of well-coordinated CPR, successful intubation, IV therapy, and three doses of epinephrine. There are no obvious underlying causes that would explain her cardiac arrest. At this point, it would be appropriate to: A. defibrillate one time in case she is in V-Fib. B. seriously consider ceasing resuscitative efforts. C. attempt transcutaneous cardiac pacing. D. transport at once with CPR continuing en route.
answer
B. seriously consider ceasing resuscitative efforts.
question
After administering 40 units of vasopressin to an elderly woman in bradycardic pulseless electrical activity, you should: A. pause CPR for no longer than 10 seconds and assess for a pulse. B. administer 1 mg of epinephrine 1:10,000 while CPR is ongoing. C. give naloxone to rule out opiate overdose as the cause of her arrest. D. continue CPR and flush the IV line with 20 mL of normal saline.
answer
D. continue CPR and flush the IV line with 20 mL of normal saline.
question
Which of the following factors would present the GREATEST difficulty when distinguishing supraventricular tachycardia from ventricular tachycardia? A. Absence of P waves B. Aberrant conduction C. Retrograde conduction D. The rate of the rhythm
answer
B. Aberrant conduction
question
Myocardial ischemia occurs when the heart muscle: A. undergoes necrosis because of prolonged oxygen deprivation. B. suffers oxygen deprivation secondary to coronary vasodilation. C. is deprived of oxygen because of a blocked coronary artery. D. experiences a decreased oxygen demand and an increased supply. Incorrect
answer
C. is deprived of oxygen because of a blocked coronary artery.
question
The preferred antiarrhythmic medication and initial dose for a patient with refractory ventricular fibrillation or pulseless ventricular tachycardia is: A. amiodarone, 300 mg. B. lidocaine, 0.75 mg/kg. C. procainamide, 20 mg/min. D. lidocaine, 1.5 mg/kg.
answer
A. amiodarone, 300 mg.
question
You and an EMT are performing CPR on an elderly woman in cardiac arrest as your paramedic partner prepares to intubate her. After the patient has been intubated and proper ET tube placement has been confirmed, you should: A. direct your partner to deliver one breath every 3 to 5 seconds as the EMT-B continues chest compressions. B. administer 2.5 mg of epinephrine via the ET tube and hyperventilate the patient to ensure drug dispersal. C. instruct the EMT-B to pause after 30 compressions so your partner can deliver two ventilations. D. perform asynchronous CPR while ventilating the patient at a rate of 8 to 10 breaths/min.
answer
D. perform asynchronous CPR while ventilating the patient at a rate of 8 to 10 breaths/min.
question
A 33-year-old woman presents with an acute onset of "fluttering" in her chest. She is conscious and alert but is somewhat anxious. She denies any significant medical problems but states that she has been under a lot of stress at work. You apply the cardiac monitor, which reveals a narrow QRS complex tachycardia at a rate of 170 beats/min. The patient's blood pressure is 140/90 mm Hg, and she is breathing without difficulty. The MOST appropriate treatment for this patient involves: A. oxygen, emotional support, and 2.5 mg of midazolam IM. B. oxygen, vagal maneuvers, and emotional support. C. vagal maneuvers, IV access, and 0.25 mg/kg of diltiazem. D. oxygen, IV access, vagal maneuvers, and 6 mg of adenosine.
answer
D. oxygen, IV access, vagal maneuvers, and 6 mg of adenosine.
question
Common causes of cardiac arrest include all of the following, EXCEPT: A. cardiac tamponade. B. hypovolemia. C. hyperglycemia. D. pulmonary embolism.
answer
C. hyperglycemia.
question
Which of the following pulseless rhythms is NOT treated as pulseless electrical activity? A. Ventricular tachycardia B. Idioventricular rhythm C. Junctional escape rhythm D. Sinus bradycardia
answer
A. Ventricular tachycardia
question
You have just performed synchronized cardioversion on a patient with unstable ventricular tachycardia. Upon reassessment, you note that the patient is unresponsive, apneic, and pulseless. You should: A. increase the energy setting on the defibrillator and repeat the cardioversion. B. desynchronize the defibrillator, defibrillate one time, and check for a pulse. C. perform five cycles of CPR, reassess the cardiac rhythm, and defibrillate if needed. D. ensure that the synchronizer is off, defibrillate, and immediately begin CPR.
answer
D. ensure that the synchronizer is off, defibrillate, and immediately begin CPR.
question
When assessing an anxious patient who presents with tachycardia, you must: A. prepare for cardioversion if the rate is less than 150 beats/min. B. administer diazepam or midazolam to facilitate your assessment. C. obtain a 12-lead ECG tracing before initiating any treatment. D. determine if the tachycardia is causing hemodynamic instability.
answer
D. determine if the tachycardia is causing hemodynamic instability.
question
You are performing CPR on an 80-year-old woman whose cardiac arrest was witnessed by her husband. Several intubation attempts have been unsuccessful, but ventilations with a bag-mask device are producing adequate chest rise. IV access has been obtained and 1 mg of epinephrine has been administered. The cardiac monitor displays a narrow QRS complex rhythm at a rate of 70 beats/min. According to the patient's husband, she has had numerous episodes of diarrhea over the past 24 hours and has not had much of an appetite. The MOST appropriate next action should be to: A. assess the rhythm and pulse after 3 minutes of CPR. B. administer 1 mg of atropine while CPR is ongoing. C. continue CPR and administer crystalloid fluid boluses. D. administer 50% dextrose for presumed hypoglycemia.
answer
C. continue CPR and administer crystalloid fluid boluses.
question
You have restored spontaneous circulation in a 54-year-old man who was in ventricular fibrillation. During the arrest interval, you delivered 2 shocks, 1 mg of epinephrine, and 300 mg of amiodarone. The patient's blood pressure is 96/60 mm Hg, and the cardiac monitor displays a sinus rhythm at a rate of 70 beats/min with frequent premature ventricular complexes. Appropriate post-resuscitation care for this patient includes: A. 0.5 mg of atropine sulfate. B. a low-dose dopamine infusion. C. a 20-mL/kg crystalloid bolus. D. an infusion of amiodarone
answer
D. an infusion of amiodarone
question
Following 2 minutes of CPR, you reassess an unresponsive man's pulse and cardiac rhythm. He remains pulseless and the monitor displays coarse ventricular fibrillation. You should: A. resume CPR as the defibrillator is charging. B. perform 2 minutes of CPR and then reassess. C. continue CPR and intubate his trachea. D. continue CPR and establish IV or IO access.
answer
A. resume CPR as the defibrillator is charging.
question
A 39-year-old man in asystole has been unresponsive to high-quality CPR and two doses of epinephrine. The patient is intubated and an IO catheter is in place. You should focus on: A. providing mild hyperventilation. B. searching for reversible causes. C. establishing a peripheral IV line D. transcutaneous cardiac pacing
answer
B. searching for reversible causes.
question
In which of the following situations would you likely NOT be able to palpate a pulse despite effective chest compressions? A. Profound hypoxia B. Severe acidosis C. Tension pneumothorax D. Hyperkalemia
answer
C. Tension pneumothorax
question
When assessing an anxious patient who presents with tachycardia, you must: A. administer diazepam or midazolam to facilitate your assessment. B. prepare for cardioversion if the rate is less than 150 beats/min. C. determine if the tachycardia is causing hemodynamic instability. D. obtain a 12-lead ECG tracing before initiating any treatment.
answer
C. determine if the tachycardia is causing hemodynamic instability.
question
A middle-aged man in ventricular fibrillation has been refractory to several biphasic defibrillations, well-coordinated CPR, adequately performed ventilations, and two doses of epinephrine. What should you do next? A. Administer 300 mg of amiodarone via rapid IV push B. Give amiodarone followed by 1.5 mg/kg of lidocaine C. Rapidly infuse 2 liters of normal saline solution D. Give 40 units of vasopressin followed by defibrillation
answer
A. Administer 300 mg of amiodarone via rapid IV push
question
Fibrinolysis may be contraindicated in all of the following, EXCEPT: A. major trauma or surgery within the past 4 weeks. B. a history of anaphylactic shock caused by salicylates. C. significant closed head trauma within the past 3 weeks. D. a history of structural central nervous system disease.
answer
B. a history of anaphylactic shock caused by salicylates.
question
You have applied the defibrillator pads to a pulseless and apneic 60-year-old woman and observe a slow, wide QRS complex rhythm. Your next action should be to: A. attempt cardiac pacing. B. resume CPR at once. C. check the carotid pulse. D. assess breathing effort.
answer
B. resume CPR at once.
question
A 68-year-old woman presents with an acute onset of confusion, shortness of breath, and diaphoresis. Her blood pressure is 72/50 mm Hg, her heart rate is slow and weak, and her respirations are increased and shallow. The ECG reveals a third-degree heart block at a rate of 38 beats/min. After placing the patient on high-flow oxygen, you should: A. obtain a 12-lead ECG to detect an acute myocardial infarction. B. obtain vascular access and give a fluid bolus. C. immediately attempt transcutaneous pacing. D. start an IV and administer 0.5 mg atropine.
answer
C. immediately attempt transcutaneous pacing.
question
A 41-year-old man complains of chest heaviness and mild shortness of breath that began about 2 hours ago. He is conscious and alert. As you are assessing him, he tells you that he has high blood pressure for which he takes Clonidine. His blood pressure is 160/90 mm Hg, heart rate is 140 beats/min and regular, and respirations are 22 breaths/min and somewhat labored. The cardiac monitor displays a narrow complex tachycardia in lead II. Which of the following interventions is NOT indicated for this patient? A. IV access B. Aspirin C. 12-Lead ECG D. Adenosine
answer
D. Adenosine
question
What is the approximate maximum dose of lidocaine for a 200-pound patient? A. 300 mg B. 275 mg C. 325 mg D. 350 mg
answer
B. 275 mg
question
If a patient remains comatose following return of spontaneous circulation, you should: A. immediately obtain a 12-lead. B. begin an infusion of dopamine. C. begin hypothermia treatment. D. provide mild hyperventilation.
answer
D. provide mild hyperventilation.
question
If a patient remains comatose following return of spontaneous circulation, you should: A. immediately obtain a 12-lead. B. provide mild hyperventilation. C. begin an infusion of dopamine. D. begin hypothermia treatment.
answer
D. begin hypothermia treatment.
Bag Mask Device
Peak Expiratory Flow Rate
Airway Management Practice Test – Flashcards 250 terms

Alden Wolfe
250 terms
Preview
Airway Management Practice Test – Flashcards
question
1. Which of the following is your primary goal during airway management? a. Ensure clear, unobstructed breathing. b. Ensure that CPR is effective. c. Provide a means of drug administration. d. Provide optimal patient ventilation.
answer
d
question
2. You are on scene managing a 14-year-old asthmatic male. He is breathing 28 breaths/min and has retractions. Which of the following is your primary focus? a. Ensure adequate perfusion. b. Ensure optimal ventilation. c. Get ready for CPR. d. Perform a secondary survey.
answer
b
question
3. A 57-year-old obese male patient has been found unresponsive. Ventilating the patient's lungs with a bag-mask device has improved the pulse oximetry up to 88%. Which of the following might continue to improve the pulse oximetry? a. Adequate inflation of the endotracheal tube cuff b. Assessing end-tidal CO2 when performing CPR c. Ensuring a good mask seal when using a bag-mask device d. Failure to ventilate between intubation attempts
answer
c
question
4. A 27-year-old male patient has been found apneic behind a nightclub. Bystanders suggest that the patient has overdosed on heroin. You are attempting to initially ventilate the patient's lungs using a bag-mask device, but the patient's color fails to improve and there is difficulty squeezing the bag. A common reason for this includes: a. Failure to properly tilt the head and lift the chin b. Forcing the tongue into the throat with high-pressure breathing c. Overly squeezing the bag and forcing too much air into the patient d. Pressing too tightly with the bag-mask device on the patient's face
answer
a
question
5. Which of the following is a structure of the upper airway? a. Alveoli b. Bronchioles c. Carina d. Pharynx
answer
d
question
6. A 15-year-old is complaining of pain and pressure in his right ear and the right frontal sinus. He states he just arrived on a flight returning from vacation and, as the aircraft descended, the pain and pressure started. He also states that his hearing is diminished in his right ear. A likely cause for the teenager's problem is: a. Basilar skull fracture b. Blocked eustachian tube c. Inner ear infection d. Right frontal sinus infection
answer
b
question
7. Although the palatine tonsils are part of the lymphatic system, they affect the airway because: a. They cause asthma to develop in children. b. They cause the trachea to close when we swallow. c. They secrete saliva coating the cilia. d. When inflamed, they can impair breathing causing respiratory distress.
answer
d
question
8. The narrowest part of the adult upper airway is known as the: a. Epiglottis b. Glottic opening c. Nasopharynx d. Vallecula
answer
b
question
9. As you and your partner are assisting ventilations with a bag-mask device, you notice significant distention of the stomach. Which of the following maneuvers will help prevent further dilation? a. Gentle compression of the lateral neck b. Gentle pressure below the thyroid cartilage c. Gentle pressure over nares d. Gentle pressure superior to the thyroid cartilage
answer
b
question
10. Compared to the left mainstem bronchus, the right mainstem bronchus is: a. At a more gradual angle b. Made of thicker membrane c. More angled from the trachea d. More narrow
answer
a
question
11. Which of the following is the function of the cilia? a. Cool exhaled air b. Filter inhaled air c. Help O2/CO2 exchange d. Warm inhaled air
answer
b
question
12. Which of the following respiratory structures is the location of oxygen and carbon dioxide exchange? a. Alveoli b. Carina c. Hilum d. Vallecula
answer
a
question
13. A 15-year-old male patient is eating chips while laughing. He begins to cough forcefully. Which of the following reflexes is preventing aspiration of the chips into the lungs? a. Gag reflex b. Korsacoff's reflex c. Retch reflex d. Vagus nerve reflex
answer
a
question
14. You are attempting to intubate an apneic patient. As you pass the tube through the vocal cords, the patient begins to cough. Which of the following changes in the vital signs would be expected with this symptom? a. Bradycardia, hypertension, and increased ventilation b. Bradycardia, hypotension, and decreased ventilation c. Tachycardia, hypotension, and decreased ventilation d. Tachycardia, hypotension, and increased ventilation
answer
b
question
15. A patient has overdosed on narcotic medications. Upon your arrival, the patient has no obvious gag reflex. Which of the following conditions may this patient develop because of his lack of gag reflex? a. Alkalosis b. Aspiration pneumonia c. Hypertension d. Hypocarbia
answer
b
question
16. A chemical substance inside the alveoli that acts to lubricate the alveoli, decrease surface tension inside the alveoli, and facilitate expansion of the alveoli is known as: a. Atelectasis enzyme b. Hilum expansion chemical c. Surface enzyme d. Surfactant
answer
d
question
17. Pulmonary surfactant: a. Increases airway pressures within the lungs b. Increases the attractive forces between the water molecules in the lungs c. Lowers the recoil in the elastic fibers in the alveolar walls d. Lowers the surface tension, preventing alveolar collapse
answer
d
question
18. A 4-year-old girl is in respiratory arrest. After opening the airway and ventilating the lungs using a bag-mask device, you notice that there is no chest rise and fall with the bag-mask ventilation. A head tilt/chin lift maneuver is repeated. Which of the following is the next most important step? a. Assess for foreign body obstruction. b. Assume pneumothorax and perform a needle decompression. c. Assume that there is an infectious process and continue to ventilate using the bag-mask device. d. Assume that the bag-mask device is defective and should be discarded.
answer
a
question
19. Placing an infant or young child in a supine position may cause flexion and occlusion of the airway. Which of the following may be the cause for this occlusion? a. The anterior location of the larynx and pharynx b. The extreme flexibility of the infant's airway c. The larger size of the child's head relative to his body d. The larger size of the child's tongue relative to his body
answer
c
question
20. You are preparing to intubate a 4-year-old male patient. Upon removing the endotracheal tube from its package, you notice there is no inflatable cuff on the tube. Which of the following explains why this tube does not have a cuff? a. The pediatric airway collapses and is too small for a cuff. b. The pediatric airway creates a natural seal around the tube. c. The pediatric airway is fragile and a cuff may rupture it. d. The pediatric airway is too rigid to accommodate a cuff.
answer
b
question
21. A 4-year-old boy requires transport to the hospital for evaluation of his autism; his parents tell you he is acting much worse today than normal. He is restless and somewhat combative. You place the child on the gurney and secure several straps across his chest and abdomen to keep him still. Shortly thereafter, the child develops respiratory distress. Which of the following could be contributing to the child's respiratory distress? a. A supine position may compress the airway because of the size of the head. b. One or more straps could be interfering with the child's diaphragm. c. The combative child's struggling is compromising his airway. d. The child's accessory muscle of breathing are impaired by the straps
answer
b
question
22. The normal movement of the diaphragm during inspiration: a. Causes passive inhalation b. Causes the diaphragm to move up c. Flattens the diaphragm d. Increases the side-to-side dimensions of the chest
answer
c
question
23. Which of the following is an anatomic difference in a child's airway as compared to that of an adult? a. A child's tongue is small in relationship to the size of the mouth. b. The distance from the vocal cords to the carina gets smaller with age. c. The epiglottis is U-shaped in a child. d. The vocal cords slope from front to back in infants.
answer
c
question
24. Which of the following terms best describes the process of breathing? a. Diffusion b. Insufflation c. Respiration d. Ventilation
answer
d
question
25. A patient takes in a deep breath. The oxygen and carbon dioxide molecules transfer across the capillary in the alveoli. Which of the following terms best describes this type of respiration? a. External respiration b. External ventilation c. Internal respiration d. Pulmonary diffusion
answer
a
question
26. A 52-year-old male patient states that he is short of breath and weak. He continues to tell you that blood has been passing in his stools. He has no history of respiratory complaints. He has a respiratory rate of 24 breaths/min and a heart rate of 118 beats/min. Which of the following may be the cause of this patient's weakness and dyspnea? a. Decreased carbon dioxide b. Decreased hemoglobin c. Decreased ventilation d. Increased hematocrit
answer
b
question
27. Air normally moves into the lungs from the: a. Higher pressure within the lungs during inspiration b. Increased intrathoracic pressure during inspiration c. Positive pressure forcing air into the lungs d. Pressure gradient created when the lungs expand
answer
d
question
28. Diffusion is: a. A gaseous substance dissolving in a liquid substance b. The active transport of gas with energy expended c. The movement of a gas from a higher pressure to a lower pressure across a semipermeable membrane d. The movement of a gas from a lower pressure to a higher pressure across a semipermeable membrane
answer
c
question
29. Which of the following is a normal PaO2? a. 70 mm Hg b. 90 mm Hg c. 110 mm Hg d. 140 mm Hg
answer
b
question
30. The term partial pressure of gases refers to: a. The concentration of a gas in a mixture of other gases b. The concentration of a single gas unmixed with other gases c. The pressure a gas exerts in a mixture of other gases d. The pressure of a single gas unmixed with other gases
answer
c
question
31. At sea level, the pressure of all gases is 760 mm Hg, or 760 Torr. If the concentration of oxygen in the atmosphere at sea level is 21%, the partial pressure of oxygen at sea level is approximately: a. 150 mm Hg b. 160 mm Hg c. 180 mm Hg d. 210 mm Hg
answer
b
question
32. The normal partial pressure of oxygen in arterial blood is: a. 80 to 100 Torr b. 150 to 160 Torr c. 180 to 200 Torr d. 210 to 220 Torr
answer
a
question
33. A 28-year-old male patient arrives in Denver (elevation 5200 feet) and immediately begins to hike up into the Rocky Mountains. He notes that he quickly became short of breath and has begun breathing rapidly. Which of the following may be a cause of his dyspnea? a. Decreased partial pressure of carbon monoxide b. Decreased partial pressure of oxygen c. Increased partial pressure of nitrogen d. Increased partial pressure of oxygen
answer
b
question
34. One of the most prevalent atmospheric gasses is: a. Helium b. Nitric oxide c. Nitrogen d. Water vapor
answer
c
question
35. Measuring the oxygen levels in a patient's blood can give the paramedic valuable information. A pulse oximeter is an external device that measures: a. The partial pressure of carbon dioxide in the patient's arterial blood b. The partial pressure of oxygen in the patient's arterial blood c. The percentage of free oxygen in the patient's arterial blood d. The percentage of oxygen bound to hemoglobin in the patient's blood
answer
d
question
36. A patient has a pulse oximetry reading of 72%. You notice the patient has some cyanosis of his fingers and toes. He is breathing 24 breaths/min. Which of the following would be the most important action? a. Assess for external bleeding. b. Obtain a 12 lead ECG. c. Place the patient on the cardiac monitor. d. Provide supplemental oxygen.
answer
d
question
37. A normal pulse oximetry reading is at or above: a. 90% b. 93% c. 95% d. 98%
answer
d
question
38. You are caring for a patient in the early stages of shock for which the body is compensating adequately. Which of the following comments regarding pulse oximetry readings is appropriate? a. The reading is completely accurate and reflects oxygen saturation. b. The reading is inaccurate because of the poor perfusion to the periphery. c. The reading is low and calls for aggressive airway management. d. The reading suggests adequate breathing and oxygenation.
answer
b
question
39. Most of the oxygen in blood is carried: a. As carboxyhemoglobin b. Attached to hemoglobin c. Attached to leukocytes d. Dissolved in plasma
answer
b
question
40. The most important factor in determining the extent to which oxygen combines with hemoglobin is the: a. Number of oxygen receptor sites on the hemoglobin b. Partial pressure of oxygen in the blood plasma c. Partial pressure of oxygen in the lungs d. Relative number of red blood cells in the plasma
answer
b
question
41. Which of the following is a normal PaCO2? a. 20 mm Hg b. 40 mm Hg c. 50 mm Hg d. 60 mm Hg
answer
b
question
42. Carbon dioxide is transported to the lungs in blood in the form of: a. Bicarbonate ions b. Carbonic acid c. CO2 active pump d. CO2 gas bubble
answer
a
question
43. A 78-year-old male with a history of severe emphysema has a pulse oximetry of 96%. However, he is breathing 26 breaths/min and is confused and combative. Which of the following would you expect to see from a blood gas reading? a. Elevated PaCO b. Elevated PaCO2 c. Elevated PaN d. Elevated PaO2
answer
b
question
44. The transfer of oxygen and carbon dioxide between the capillary red blood cells and the tissue cells is called: a. External respiration b. Internal respiration c. Internal ventilation d. Pulmonary ventilation
answer
b
question
45. On a cross-country flight, a patient begins complaining of shortness of breath. The flight attendant provides supplemental oxygen while the pilot prepares for an emergency landing. While breathing the supplemental oxygen, the patient states that breathing difficulties have subsided. Further, as the aircraft reaches the airport, the patient states that the distress had ended. Which of the following may be causing the respiratory distress? a. Elevated hemoglobin levels in the patient's blood b. Low partial pressure of oxygen in the airplane c. Low serum potassium levels causing hypoventilation d. Pulmonary embolism caused by deep vein thrombosis
answer
b
question
46. The patient is a 38-year-old woman who fell and broke her left femur. The woman is complaining of severe pain. Her vital signs are blood pressure, 116/70 mm Hg; pulse, 90 beats/min; and respirations, 18 breaths/min. After caring for the woman's injury, you and your team place the woman on the stretcher and in the ambulance. You decide to monitor the patient's pulse oximetry. Although the woman's vital signs remain nearly unchanged, her SpO2 drops from 98 to 92 and her skin becomes slightly pale. Which of the following is the most likely cause for the drop in SpO2? a. Development of shock lung b. Loss of blood because of the fracture c. Malfunctioning pulse oximeter d. Severe pain interrupting breathing
answer
b
question
47. Hypercarbia is best described as: a. Decreased carbon dioxide levels b. Decreased oxygen levels c. Increased carbon dioxide levels d. Increased oxygen levels
answer
c
question
48. A 44-year-old male with a long history of type 1 diabetes calls 9-1-1 and complains of shortness of breath. You find the patient sitting upright in a kitchen chair. An assessment reveals a normal blood pressure, elevated pulse, and respirations of 32 breaths/min. There is a sweet odor to the patient's breath. The patient states, "I can't slow my breathing down." Which of the following best explains the reason for the rapid breathing? a. Anxiety resulting in a hyperventilation syndrome b. Elevated fever increasing CO2 production c. Metabolic acidosis (diabetic ketoacidosis) d. Respiratory depression associated with drug abuse
answer
c
question
49. A patient has been found unresponsive by a friend who states that the patient has a problem with heroin abuse. Upon his arrival at the hospital, the patient's blood gas demonstrates a PaCO2 of 90. Which of the following would be a possible cause of this hypercarbia? a. Hyperventilation b. Hypoventilation c. Hypoxia d. Metabolic acidosis
answer
b
question
50. A patient has been complaining of pain and swelling in his right lower leg. He had a sudden onset of shortness of breath. He is tachypneic and dyspneic. Based on your clinical interpretation of his condition, which of the following conditions would you expect? a. Hypercarbia b. Hypocarbia c. Hypoventilation d. Normal PaO2
answer
b
question
51. Which of the following is likely to decrease carbon dioxide production? a. Anaerobic metabolism b. Exercise c. Ketoacidosis d. Resting quietly
answer
d
question
52. Hyperventilation leads to: a. Dilated cerebral vessels b. Hypercarbia c. Improved cerebral perfusion d. Low carbon dioxide levels
answer
d
question
53. The greatest rate of airflow that can be achieved during forced expiration beginning with the lungs fully inflated best describes: a. Peak expiratory flow b. Peak expiratory reserve c. Peak inspiratory volume d. Peak residual volume
answer
a
question
54. For which of the following conditions is peak expiratory flow decreased? a. Asthma b. Emphysema c. Profound hypovolemia d. Pulmonary embolism
answer
a
question
55. A patient is being evaluated, and the pulmonologist states that the minute volume is decreased. Which of the following would also be decreased? a. Alveolar air volume b. FiO2 c. Peak expiratory flow d. Tidal volume
answer
d
question
56. You are caring for a 58-year-old male patient who has been on a ventilator at home. One of the ventilator settings shows FiO2 = 0.40. What does this indicate? a. The minimum peak expiratory flow rate is 4 liters per minute. b. The percentage of carbon dioxide arterial blood is 40. c. The inspired oxygen is set at 40%. d. The rate of breathing is set at 40 times per minute.
answer
c
question
57. A patient has significant respiratory distress. Upon auscultation, you note increased rales and wheezes. The patient begins to have decreased mental status and respiratory failure. After intubating the patient, what FiO2 setting should be used? a. 40% b. 50% c. 75% d. 100%
answer
d
question
58. Which of the following best describes respiration? a. Involuntary with some voluntary control b. Totally involuntary c. Totally voluntary d. Voluntary with some automatic control
answer
a
question
59. A patient suffered severe head trauma and is not spontaneously breathing. Which location in the brain has sustained injury and is responsible for respiration? a. Brain stem b. Cerebral cortex c. Diaphragm d. Hippocampus
answer
a
question
60. While you are deep suctioning a patient's airway, he begins to cough forcefully. You notice the patient's heart rate has dropped. Which of the following best describes this drop in heart rate? a. Irritation of the medulla oblongata b. Release of histamines in the airways c. Stimulation of the beta-receptors of the lungs d. Stimulation of the vagus nerve
answer
d
question
61. A patient has suffered a cervical spine fracture. He is not breathing spontaneously. Which of the following nerves is experiencing the damage from the cord injury? a. Apneustic nerves b. Diaphragmatic nerves c. Phrenic nerves d. Pneumotaxic nerves
answer
c
question
62. Scalene and sternocleidomastoid muscles are used: a. As accessory muscles during labored breathing b. As voluntary muscles if a patient chooses to take a deep breath c. During mouth breathing d. During normal quiet breathing
answer
a
question
63. Physiologic dead space is: a. Composed of the nonfunctional alveoli b. Created by the upper respiratory tract and nonrespiratory bronchioles c. Increased in patients with respiratory diseases such as emphysema d. Normally 10 times the volume of anatomic dead space
answer
c
question
64. Tidal volume is the amount of air: a. Always present in the alveoli b. Inhaled or exhaled during a normal breath c. Left in the lungs after a forceful exhalation d. That oOne can inhale after a maximal inhalation
answer
b
question
65. Minute volume is the amount of air: a. Available for gas exchange in every minute b. In the dead space moved in and out of the respiratory tract each minute c. In the tidal volume multiplied by the respiratory rate d. That can be inhaled after a maximal inhalation
answer
c
question
66. A patient with a tidal volume of 500 mL, a dead space of 100 mL, and a respiratory rate of 10 breaths/min has a minute alveolar ventilation of: a. 3 L/min b. 4 L/min c. 5 L/min d. 6 L/min
answer
b
question
67. The pneumotaxic center is located in the: a. Cerebellum b. Hypothalamus c. Medulla oblongata d. Pons
answer
d
question
68. The major determinant(s) in controlling respiration is (are) the: a. Impulses generated within the lungs b. Oxygen content in the blood c. Partial pressure of carbon dioxide d. pH of capillary blood
answer
c
question
69. Chemoreceptors are located in the: a. Arch of the aorta b. Blood vessels in the extremities c. Cerebrum d. Spinal cord
answer
a
question
70. A 77-year-old male patient has developed a severe cough and fever. He is breathing rapidly. Which of the following is a factor that is responsible for his increased respiratory rate? a. Increased carbon dioxide b. Increased carbon monoxide c. Increased oxygen d. Increased partial pressure of nitrogen
answer
a
question
71. An Olympic athlete is exercising at maximum capacity. Which of the following best explains the body's response mechanism that causes increased breathing for this athlete? a. Baroreceptors in the aortic arch detect decreased oxygen. b. Chemoreceptors in the carotid arteries detect increased carbon dioxide. c. The medulla detects decreased oxygen. d. The pneumotaxic center decreased inhalation.
answer
b
question
72. A patient with chronic bronchitis is likely to rely on what mechanism to stimulate respiratory drive? a. Changes in pH b. Elevated carbon dioxide levels c. Hypoxia d. Increased bicarbonate ions
answer
c
question
73. An 88-year-old female patient suffers from COPD. A blood gas reveals that her PaCO2 level is 85. She is mildly dyspneic, but not in acute distress. What would best explain these findings in this patient? a. The PaCO2 level is normal. b. The patient is hyponatremic. c. The patient's body is working on hypoxic drive. d. The situation is acute, and the patient's body has not responded yet.
answer
c
question
74. Hypoxemia is defined as a. Inadequate blood oxygen levels b. Inadequate hemoglobin levels c. Inadequate tissue oxygen levels d. Inadequate tissue perfusion
answer
a
question
75. Hypoxia is defined as: a. Inadequate blood oxygen levels b. Inadequate hemoglobin levels c. Inadequate tissue oxygen levels d. Inadequate tissue perfusion
answer
c
question
76. A 12-year-old child fell at school. The school nurse called EMS to assess the child and, if needed, transport the child to the hospital. You find minor injuries and vitals signs of BP—112/68 breaths/min; P—90; and R—24 breaths/min. Although the blood pressure and pulse are normal, you consider the rate of breathing to be: a. Indicative of hyperventilation b. Suggestive of head injury c. Too slow for the child's age d. Within normal limits
answer
d
question
77. Which of the following is the most concerning? a. A 4-month-old female patient with a respiratory rate of 18 breaths/min b. A 6-year-old male patient with a respiratory rate of 30 breaths/min c. A 16-year-old female patient with asthma who has a respiratory rate of 24 breaths/min after a 4-mile run d. A 75-year-old male patient with a history of COPD and a respiratory rate of 28 breaths/min
answer
a
question
78. A patient in respiratory distress may sit upright, leaning slightly forward. The head may be tilted back with the neck extended, chin projected forward, and mouth open. Which of the following might cause a patient to present in this position? a. Lower airway obstruction b. Malfunction of the medulla c. Malfunction of the pons d. Upper airway obstruction
answer
a
question
79. A 77-year-old male has difficulty in breathing and cannot lie flat. He states that it is much easier for him to breath when he sits upright. During your examination, he is breathing 24 breaths/min and has rales and rhonchi heard on auscultation. Which of the following causes should you suspect? a. Asthma b. Left ventricular failure c. Pneumonia d. Pulmonary embolus
answer
b
question
80. A patient states he is having difficulty in breathing. Which of the following terms best describes this condition? a. Apnea b. Dyspnea c. Hypercarbia d. Hypoxia
answer
b
question
81. A patient has an altered level of consciousness after a head injury. The patient has a breathing pattern in which he speeds up his breathing and then it slows down and almost stops. Which of the following describes this type of breathing? a. Bradypnea b. Cheyne-Stokes respirations c. Hyperpnea d. Kussmaul respirations
answer
b
question
82. The patient is a 60-year-old woman with a history of congestive heart failure. She called 9-1-1 because of increased trouble breathing. In describing her recent history, she states that she cannot catch her breath unless she is sitting up. Her difficulty breathing is best described as: a. Arthopnea b. Dyspepsia c. Orthopnea d. Tachypnea
answer
c
question
83. In assessing a patient complaining of trouble breathing, you notice that the patient's anterior-posterior chest diameter seems larger than normal. This condition is more commonly known as: a. Barrel chest b. Chronic bronchitis c. Emphysema d. Pulmonary hypertrophy
answer
a
question
84. The ease with which the lungs expand during inspiration is known as: a. Atmospheric diffusion b. Compliance c. Inspiratory pressure gradient d. Pulmonary pressure
answer
b
question
85. A hiccup results from stimulation of the: a. Diaphragm b. Intercostal muscles c. Lungs d. Nasal passages
answer
a
question
86. A respiratory pattern characterized by an irregular pattern, rate, and volume, with intermittent periods of apnea is: a. Agonal b. Biot's c. Central neurogenic hyperventilation d. Cheyne-Stokes
answer
b
question
87. A respiratory pattern characterized by deep, rapid respirations is: a. Agonal b. Biot's c. Central neurogenic hyperventilation d. Cheyne-Stokes
answer
c
question
88. Your patient is 32-year-old construction worker who fell from a ladder. In assessing the patient, you notice totally irregular breathing that varies in rate and depth. Occasionally, you notice periods of apnea. Based on the patient's recent history and the current breathing pattern, what do you suspect? a. Acute asthma b. Diabetic ketoacidosis c. Emphysema d. Severe head injury
answer
d
question
89. Which of the following is used as a portable cylinder for the on-scene administration of oxygen? a. E cylinder b. K cylinder c. L cylinder d. M cylinder
answer
a
question
90. You are caring for a patient in his apartment on the 10th floor. The patient is complaining of chest pain, and you have been administering oxygen via a nonrebreather mask at 15 L/min. You are preparing to move the patient to the ambulance and notice that your E cylinder gauge reads 650 psi. It will take you approximately 10 minutes to move the patient from your current position and load him into the back of the ambulance. You are concerned about the amount of oxygen remaining in the cylinder. What should you do? a. Change the oxygen delivery device to a nasal cannula at 6 L/min. b. Promptly transport the patient but do not worry about the remaining oxygen. c. Reduce the liter flow to 10 L/min to conserve the remaining oxygen. d. Take time to change the oxygen cylinder before moving the patient.
answer
d
question
91. An advantage of liquid oxygen (LOX) over gaseous oxygen is that: a. A larger volume of LOX can be stored in a smaller space b. LOX is much cheaper than gaseous oxygen c. The oxygen content in LOX is much higher d. There are no special requirements for LOX storage and cylinder transfer
answer
a
question
92. The purpose of a regulator attached to the oxygen cylinder is to: a. Decrease the escape pressure from the tank. b. Increase the escape pressure from the tank. c. Mix room air to dilute the oxygen. d. Provide a set flow rate of oxygen to the patient.
answer
a
question
93. You are caring for a patient complaining of trouble breathing, and you are providing the patient high-flow oxygen with a nonrebreather mask. The patient's spouse enters the room with a lit cigarette. Which of the following is the most appropriate action? a. Ask the spouse to leave the room and extinguish the cigarette. b. Discontinue the use of oxygen until the spouse leaves the room. c. Grab the cigarette from the spouse and quickly extinguish it. d. Use a fire extinguisher to snuff the cigarette and prevent a fire.
answer
a
question
94. You are providing supplemental oxygen to a patient. A bystander notices the oxygen cylinder lying next to the patient's bed and stands the tank upright, explaining that it provides better oxygen flow from the tank through the regulator. Which of the following is your next most important action? a. Agree with and thank the bystander. b. Return the cylinder to a flat position for safety. c. Shake the tank to stir the oxygen to increase flow rate. d. Use rope or chain to secure the tank to the furniture.
answer
b
question
95. A patient with COPD is having difficulty breathing. He has an O2 saturation of 92%. You have a prolonged transport time. Which of the following would be the most appropriate for this patient? a. Nonrebreather mask b. Partial rebreather mask c. Simple face mask d. Venturi mask
answer
d
question
96. The online medical director suggests up to 90% oxygen to a patient in moderate respiratory distress. Which of the following devices and flow rates would be used to deliver the suggested oxygen percentage? a. Nasal cannula at 10 L/minute b. Nonrebreather at 6 L/minute c. Nonrebreather at 15 L/minute d. Partial rebreather at 25 L/minute
answer
c
question
97. The maximum acceptable flow rate for a nasal cannula is _____ L/min. a. 4 b. 6 c. 8 d. 10
answer
b
question
98. A nasal cannula delivers _____ % oxygen at a flow rate of 6 L/min in optimal conditions. a. 35 b. 44 c. 58 d. 66
answer
b
question
99. Oxygen concentrations of _____ can be delivered using a simple face mask at a flow rate of 10 L/min. a. 20% to 40% b. 40% to 60 % c. 80% to 90% d. 100%
answer
b
question
100. An advantage of a Venturi mask is that: a. It can be used to deliver a precise concentration of oxygen b. High concentrations of oxygen can be delivered c. It is color coded for easy recognition in dimly lit environments d. It uses less oxygen but delivers a higher concentration
answer
a
question
101. Which of the following best defines the purpose of humidified oxygen? a. Bubble oxygen to add moisture to the gas b. Dry moist oxygen to prevent airway irritation c. Inject moisture into the oxygen cylinder d. Moisten oxygen the inside the face mask
answer
a
question
102. A child has a barking cough and coarse respiratory sounds. She has oxygen saturations of 99%. Which of the following treatments would be appropriate for this patient? a. Intubate the patient. b. Provide humidified oxygen. c. Provide morphine sulfate. d. Supply oxygen with a nonrereather.
answer
b
question
103. A 48-year-old woman sustained a partial airway obstruction while eating a piece of steak. Her airway is only partially blocked by the meat. Which of the following may develop? a. Allergic reaction to the foreign body and airway swelling b. Drooling and saliva accumulation in the throat c. Intact gag reflexes and monitoring for bradycardia d. Poor oxygen-carbon dioxide exchange and hypoxia
answer
d
question
104. A 34-year-old male patient was eating at a restaurant when, according to bystanders, he began to gasp and was unable to cough. The patient then collapsed and began turning blue. Upon arrival, which of the following is your first course of action? a. Begin CPR. b. Open the airway. c. Perform a finger sweep of the oropharynx. d. Provide supplemental oxygen.
answer
b
question
105. A 45-year-old man chokes on a piece of steak during dinner and is coughing forcefully. What should you do? a. Attempt a finger sweep. b. Give abdominal thrusts. c. Monitor the patient. d. Perform back blows.
answer
c
question
106. Your patient was choking on a piece of meat. He attempted to cough the meat out, then became silent and turned blue. You and your partner attempted the Heimlich maneuver without any success. The patient is now unresponsive. Which of the following would be an appropriate next action? a. Attempt to remove the meat with Magill forceps. b. Begin CPR. c. Place an oropharyngeal airway. d. Provide supplemental oxygen.
answer
a
question
107. You are on scene with a 42-year-old male patient who had been choking and is now unresponsive. You have attempted the Heimlich maneuver without success and could not visualize the foreign object with direct laryngoscopy. Which of the following would be the next appropriate action? a. Attempt to intubate and push food down into the right mainstem bronchus. b. Check for a pulse. c. Place a nasal airway. d. Provide supplemental oxygen.
answer
a
question
108. You arrive on scene to a patient who is unresponsive and not breathing spontaneously. In this patient, which of the following is the most common cause of airway obstruction? a. Airway bleeding b. Foreign bodies c. Laryngeal edema d. The tongue
answer
d
question
109. A 30-year-old male was having dinner at a restaurant with friends while you and your partner were attempting to order food between calls. Suddenly, the man stands up and starts clutching his neck. His friends ask if he is okay, but all he can do is shake his head. Being a responsible paramedic, you volunteer assistance. You suspect that the primary cause of this man's complaint is: a. An allergic reaction to the shrimp he was eating b. Aspiration of the alcoholic beverage he was drinking c. Attempting to swallow a small fish bone d. Complete airway obstruction by a foreign body
answer
d
question
110. A 44-year-old woman has a partially obstructed airway from a piece of chicken. She is found awake, alert, and oriented, leaning over the dinner table, as the position affords her the most comfort. Although the woman has adequate air exchange, the airway could become totally obstructed. If the airway becomes obstructed, you can remove the bolus of food by: a. Administering the Heimlich maneuver until the airway clears b. Giving back blows until the woman coughs up the obstruction c. Performing a cricothyroidotomy with a knife or "cric" kit d. Visualizing the airway and removing the object with Magill forceps
answer
a
question
111. For a complete airway obstruction in a conscious adult, which of the following is the first appropriate action? a. Contact the medical director for permission to perform a cricothyroidotomy. b. Immediately prepare to use a high-power suction device to clear the airway. c. Intubate the patient in order to push the obstruction out of the way. d. Perform abdominal thrusts to help the patient clear the obstruction.
answer
d
question
112. A 30-year-old male patient is found unresponsive in his apartment after a night of partying. The man is exhibiting loud, sonorous respirations suggesting a partial airway obstruction. There is no suggestion of accidental trauma and nothing to indicate a possible neck injury. The best way to manually open the man's airway is to: a. Use the head tilt/chin life maneuver b. Use the jaw-thrust maneuver c. Open the mouth by tugging on the mandible d. Open the mouth through the oropharyngeal airway
answer
a
question
113. A 16-year-old male was standing on the top of a car when the car suddenly moved. The teen fell from the car and struck his head rendering him unresponsive. The best method for manually opening the teenager's airway is the: a. Head tilt/chin life maneuver b. Head tilt/neck lift maneuver c. Jaw-thrust maneuver d. Oropharyngeal airway
answer
c
question
114. A patient has suffered a direct blow to the nose and mouth by a baseball. You open the airway, and there is blood in the oropharynx. Which of the following is the most appropriate method to clear the airway? a. Use the left lateral recumbent position. b. Place a nasal airway. c. Suction the upper airway. d. Use a bag-mask device to oxygenate the patient.
answer
c
question
115. A 24-year-old male patient has overdosed on narcotics and is unresponsive. It appears that he may have vomited and has some remaining stomach contents in his mouth. Which of the following would be an appropriate action? a. Create an open airway without positioning the head or chin. b. Perform a needle decompression. c. Remove large obstructions such as a bolus of meat. d. Suction the stomach contents from the mouth.
answer
d
question
116. Your partner asks for a Yankauer suction tip to help clear the patient's upper airway. Which of the following should you provide? a. A hard but flexible catheter with a whistle tip b. A hard plastic device angled to suction the upper airway c. A large straw attached to the suction device d. A soft, flexible catheter without a whistle tip
answer
b
question
117. A patient has a tracheostomy tube in place. You are transporting this patient from an extended care facility to the emergency department. It appears that the tracheostomy may be partially obstructed. Which of the following devices or techniques would be the best to remove an obstruction from the tracheostomy tube? a. Finger sweep b. French catheter attached to suction c. Remove the tracheostomy tube and flush with fluid d Yankauer suction tip
answer
b
question
118. A 44-year-old male patient has shot himself in the mouth. He is still conscious and awake; however, there are copious amounts of blood in his airway. Which of the following would be the next appropriate action? a. Leave the airway intact. b. Remove the blood and tissue with gauze. c. Remove the blood with a suction device. d. Provide supplemental oxygen with a bag-mask device.
answer
c
question
119. In ideal circumstances, suctioning of an adult patient should not exceed _____ seconds. a. 2 b. 5 c. 15 d. 20
answer
c
question
120. Suctioning (application of negative pressure) should be activated upon: a. Both insertion and extraction b. Either insertion or extraction (it makes no difference) c. Extraction of the suction catheter d. Insertion of the suction catheter
answer
c
question
121. A patient has copious secretions in the nares. Which is the best device to use in this situation? a. A hard, rigid catheter b. A soft catheter with a stylet c. A soft, flexible catheter d. A Yankauer suction tip
answer
c
question
122. Which of the following best describes the purpose of the whistle tip catheter? a. Allows gastric lavage while suctioning the airway b. Allows positive pressure ventilation while suctioning c. Allows suctioning of the lower airway d. Permits endotracheal intubation during suctioning
answer
c
question
123. You are about to suction a patient's airway because of copious secretions. Which of the following should be completed before suctioning? a. Provide supplemental oxygen before suctioning. b. Provide supplemental oxygen with a bag-mask device before suctioning. c. Remove secretions with gauze before suctioning. d. Suction with hard catheter first.
answer
a
question
124. A patient requires suctioning because of emesis in the oropharynx. Which of the following best describes the correct method of suctioning? a. Apply suction when inserting and removing the catheter. b. Keep the catheter in place until all secretions are cleared. c. Suction the airway for no more than 30 seconds. d. Suction the airway only while removing the catheter.
answer
d
question
125. A catheter that is flexible and designed to suction smaller portions of the airway or through an endotracheal tube is known as a _____ catheter. a. Pharyngeal b. Tonsil-tip c. Whistle-tip d. Yankauer
answer
c
question
126. You have just delivered a newborn male and need to suction secretions from the airway. Which of the following best describes the amount of time that suctioning should be done on a newborn? a. 3 to 5 seconds b. 10 seconds or less c. Under 15 seconds d. 30 seconds or less
answer
a
question
127. Which of the following is a complication of suctioning? a. Hypertension b. Hypoglycemia c. Hypoxia d. Tachycardia
answer
C
question
128. You are on scene with a patient who has a tracheostomy tube. The patient has coarse rhonchi with each ventilated breath. There are no apparent wheezes or rales. Which of the following is the next appropriate treatment? a. Increase the tidal volume on the ventilator. b. Inject 10 mL of fluid into the tracheostomy and then suction. c. Use a large Yankauer catheter to suction the trach. d. Use a sterile suction catheter to remove secretions and prevent infection of the airway.
answer
D
question
129. During the transfer of an intubated patient, you notice that coarse breath sounds are developing. You attempt to suction the trachea for secretions. The suction catheter becomes obstructed. Which of the following best describes the next appropriate action? a. Change the catheter tip. b. Flush the catheter with sterile saline to clear obstruction. c. Perform a finger sweep. d. Stop suctioning, and continue to ventilate.
answer
B
question
130. While suctioning copious secretions from an intubated patient, you notice that the patient's ECG is showing multiple premature ventricular contractions. The secretions are particularly thick, requiring extensive suctioning to clear the airway and ensure adequate gas exchange. Which of the following is the next appropriate action? a. Continue suctioning until the airway is clear, then hyperoxygenate. b. Discontinue suctioning until you reach the emergency department. c. Ignore the irregular heart rhythm, and continue suctioning the patient. d. Stop suctioning, oxygenate the patient, then resume suctioning.
answer
D
question
131. A 28-year-old female patient is unresponsive from an unknown medical cause. Verbal and physical stimulation have failed to awaken her. You notice that the patient's airway is partially obstructed by her tongue. After properly positioning the woman's head and chin, you decide to insert an oropharyngeal airway. To determine the proper size airway, you measure from the: a. Center of the mouth to the larynx b. Corner of the mouth to the ear lobe c. Middle of the ear to the larynx d. Tip of the nose to the ear lobe
answer
b
question
132. The purpose of the oropharyngeal airway is to: a. Keep the tongue from blocking the airway. b. Lift the palate to further open the airway. c. Open the nasopharynx to allow airflow. d. Push the epiglottis away from the larynx.
answer
a
question
133. A patient has sustained a closed head injury with significant nasal bleeding. A jaw thrust maneuver has been performed to open the airway. The patient has an intact gag reflex. Which of the following is the next most appropriate action? a. Insert a nasopharyngeal airway. b. Insert a size 0 oropharyngeal airway. c. Suction secretions/blood from airway. d. Supply supplemental oxygen by a bag-mask device.
answer
c
question
134. The nasopharyngeal airway has also been called the nasal trumpet because of its flared end. When properly sized and positioned, the trumpet: a. Is located next to the outer edge of the nostril b. Is visible in the back of the mouth c. Rests against the uvula in the nasopharynx d. Vibrates gently in the upper airway
answer
a
question
135. After inserting an oropharyngeal airway, you notice that the patient is not ventilating as easily. Which of the following may be the cause of this finding? a. The bag-mask device is malfunctioning. b. The oropharyngeal airway is too small and is causing the tongue to obstruct the airway. c. The patient has an intact gag reflex. d. The posterior airway was traumatized, and edema has formed.
answer
b
question
136. A patient who is conscious has a severe nosebleed. You are having difficulty maintaining the airway. Which of the following might help keep the airway patent? a. Nasal airway b. Nose plug c. Oral airway d. Suctioning
answer
d
question
137. You are inserting a nasopharyngeal airway and are meeting resistance during the insertion. Which of the following should be your next step? a. Increase the insertion pressure until the airway is seated. b. Remove the airway, and use an oropharyngeal airway. c. Remove the airway, relubricate it, and insert the airway in the other nostril. d. Tape the airway in place, and insert a second airway into the other nostril.
answer
c
question
138. The nasopharyngeal airway should be measured: a. From the corner of the mouth to the earlobe b. From the tip of the nose to the chin c. From the tip of the nose to the corner of the mouth d. From the tip of the nose to the tragus of the ear
answer
d
question
139. While inserting a nasal airway, the beveled tip should be directed toward the: a. Floor of the nose b. Lateral cartilage of the nose c. Septum of the nose d. Top of the nose
answer
c
question
140. Oropharyngeal airways are designed to: a. Allow for better visualization during endotracheal intubation b. Prevent the tongue from obstructing the airway c. Provide a guide for suction catheters d. Push the tongue into the oropharynx
answer
b
question
141. Which of the following is an advantage of the oral airway? a. A good head position is no longer needed during ventilation. b. Adequate mask seal is no longer necessary during ventilation. c. The lower airway is protected from aspiration during ventilation. d. The tongue will not obstruct the airway during ventilation.
answer
d
question
142. After ensuring that the patient's airway is open and inserting an oropharyngeal airway, you use a bag-mask device to ventilate the patient. You notice that with each breath, the patient's chest rises minimally, but the abdomen is getting larger. Which action will help to prevent this problem in the future? a. Performing cricoid pressure b. Providing pressure to the midabdominal region c. Providing slower ventilations with the bag-mask device d. Providing ventilations with a larger volume
answer
a
question
143. After ventilating a patient's lungs by using a bag-mask device, you notice that the patient's abdomen has enlarged because the patient's stomach has filled with air. Which of the following complications should you anticipate? a. Belching noxious gases b. Decreasing blood pressure c. Increasing heart rate d. Vomiting and aspiration
answer
d
question
144. When using a bag-mask device or mask to provide mouth-to-mask ventilation, the mask should be made of transparent material to permit: a. Easy access to remove secretions or other airway obstructions b. Escape of excess air during positive pressure breathing c. Quick recognition of secretions or discoloration of the lips d. Release of gastric distention in the event of hyperventilation
answer
c
question
145. During ventilation of a patient with a bag-mask device, you notice a large air leak near the nose. Which of the following may be the cause of the problem? a. The mask might be too small for the patient's face. b. The oxygen might be too high. c. The patient might be breathing spontaneously. d. There might be secretions present in the airway.
answer
a
question
146. Which of the following is a complication of mouth-to-mouth ventilation? a. Exposure to a communicable disease carried by the patient b. Gastric collapse because of the inadequate pressure c. Hypoventilation of the paramedic performing the procedure d. Oversaturating the patient with excessive oxygen
answer
a
question
147. When using a bag-mask device on room air, the paramedic will provide the patient with an oxygen concentration of approximately 21%. By adding a reservoir and supplemental oxygen to the bag-mask device at a flow rate of 15 L/min, the paramedic can deliver an oxygen concentration of: a. 60% to 80% b. 75% to 100% c. 80% to 90% d. 90% to 100%
answer
d
question
148. While ventilating the lungs of a nonbreathing, medical patient with a bag-mask device, you notice that the patient's chest is not rising adequately, and there is a low pulse oximetry, suggesting that the patient is not oxygenating adequately. What do you suspect? a. Airway obstruction caused by the patient's tongue b. An inadequate tidal volume with each breath c. Tension pneumothorax with increased dead space d. The mask size is too small for the patient
answer
b
question
149. When delivering mouth-to-mask ventilations with supplemental oxygen: a. Deliver each breath for longer than 10 seconds. b. It is not necessary for the patient's chest rise to be visible. c. Provide a minimum flow rate of 10 to 12 L/min. d. Slow the ventilatory rate to 1 breath every 8 seconds.
answer
c
question
150. You are using a bag-mask device to ventilate the lungs of a 4 year old. You are using an adult bag on this child. Which of the following must be done to prevent injury? a. Squeeze the bag-mask device forcefully for each ventilation. b. Use a lower oxygen level. c. Use a simple mask instead of a bag-mask device. d. Use smaller tidal volumes to prevent gastric distension.
answer
d
question
151. You are ventilating the lungs of an adult patient. Which of the following is an appropriate indicator of adequate ventilation? a. A gentle chest rise b. A rapid chest rise c. No chest rise d. Stomach distention
answer
a
question
152. The most reliable indication that adequate tidal volumes are being delivered during artificial ventilation is: a. Adequate chest rise is observed b. The oxygen saturation improves c. The patient's color improves d. The stomach inflates slightly
answer
a
question
153. Automatic transport ventilators are typically contraindicated in patients who: a. Are breathing spontaneously b. Are under 12 years of age c. Are unresponsive d. Have an airway obstruction
answer
d
question
154. You arrive on scene and begin to ventilate an unresponsive 44-year-old female patient. Your partner is starting an IV. A medical first responder (MFR) arrives. Which of the following tasks will you assign the MFR for optimal patient care? a. The MFR should flag additional units to this location. b. The MFR should hang crystalloid fluids. c. The MFR should open the drug box. d. The MFR should use his two hands to apply gentle pressure to the bag-mask device.
answer
d
question
155. The greatest difficulty in using a bag-mask device to deliver ventilations is: a. Adequate mask seal b. Adequate ventilation rate c. Consistent bag inflation d. Proper oxygen flow
answer
a
question
156. A bag-mask device with a reservoir and an adequate oxygen source (at least 15 L/min) delivers an oxygen concentration of: a. 21% b. 40% to 60% c. 80% d. 90% to 100%
answer
d
question
157. You are on scene with an adult who requires bag-mask ventilation. Which of the following should be done to prevent excessive air from entering the stomach? a. Place the palm of the hand over the epigastrium and press firmly. b. Push the cricoid cartilage upward and backward in the airway. c. Use the palm of the hand over the cricoid membrane to press downward. d. Use the thumb and index fingers to depress the cricoid cartilage downward.
answer
d
question
158. You are ventilating the lungs of an adult patient, and your partner is applying cricoid pressure. The patient makes a retching sound as though he might vomit. Which of the following should be done to avoid injury? a. Increase the downward pressure to prevent aspiration of gastric contents. b. Move the cartilage laterally in the neck to reduce the tendency to vomit. c. Release the pressure on the cricoid cartilage to prevent gastric rupture. d. Suction the airway while maintaining pressure on the cricoid cartilage.
answer
c
question
159. To apply cricoid pressure, place firm pressure against the: a. Cricoid cartilage b. Cricothyroid membrane c. Hyoid bone d. Thyroid cartilage
answer
a
question
160. Which of the following would be an indication for the use of an automatic transport ventilator? a. A nonbreathing patient being transported for an extended time b. A nonbreathing patient being transported over a very short distance c. A patient who is hyperventilating and in need of ventilatory control d. An unresponsive breathing patient being transported to a close facility
answer
a
question
161. What is a major advantage in using an automatic transport ventilator? a. Automatic adjustments reduce the need to monitor the device. b. CPR is more effective when using the ventilator. c. Paramedics are able to attend to other essential tasks. d. Only one paramedic is required to ventilate the patient's lungs.
answer
c
question
162. A 24-year-old male patient is in respiratory failure as a result of asthma. You have attempted multiple medical routes to manage his distress, and you determine that he requires intubation. Which of the following is the most appropriate device to ventilate this patient for the transport? a. Automatic transport ventilator b. Bag-mask device c. Nasal cannula d. Simple mask
answer
b
question
163. A 46-year-old male patient sustained multiple chest injuries in a blast accident at a manufacturing plant. He is not breathing and needs assisted ventilation over a prolonged transport to a trauma center. Which of the following is an accurate statement? a. Alternate between an automatic transport ventilator and bag-mask device. b. An automatic transport ventilator should be used. c. Intubate the patient, then ventilate the patient with a bag-mask device. d. Use an automatic transport ventilator with low-flow oxygen.
answer
c
question
164. Which of the following best defines tracheostomy? a. A needle opening into the cricoid cartilage b. A surgical opening between the tracheal rings c. A surgical opening into the carina d. A surgical opening through the vocal cords
answer
b
question
165. A stoma is best described as: a. A surgical opening into the trachea that bypasses the upper airway b. A temporary opening in the neck to overcome a blocked airway c. A valve on the suction catheter to permit or prevent suctioning d. An opening into the right lung to decompress the chest
answer
a
question
166. A patient has a tracheostomy. You attempt to ventilate the patient's lungs through the tracheostomy tube. Air appears to leak from the nose and mouth. Which of the following is an appropriate action? a. Change the tidal volume. b. Close and seal the nose and mouth. c. Inflate the balloon with more air. d. Remove the tracheostomy.
answer
b
question
167. A 68-year-old male with a history of throat cancer had his larynx removed. To breathe, the patient has a permanent tracheostomy tube. The procedure of removing the larynx is known as: a. Cricothyreotomy b. Cricothyrotomy c. Laryngectomy d. Laryngoscopy
answer
c
question
168. A patient has a tracheostomy tube. The patient continually coughs, and there appears to be an obstruction of the tracheostomy tube. Which of the following rationales best explains why this occurs? a. The air bypasses the nose and mouth. b. The air has a shorter transport to the lungs. c. The material of the tracheostomy tube absorbs the humidity. d. There is too much humidified air in the trachea.
answer
a
question
169. The patient is a 62-year-old woman involved in a motor vehicle crash. You note that the woman is in obvious respiratory distress. In assessing the patient, you also note that the patient has a stoma because of a laryngectomy several years earlier. What should you do to assist the woman's breathing? a. Insert an endotracheal tube into the stoma and ventilate. b. Perform nasotracheal intubation and ventilate thought the tube. c. Use an adult bag-mask device over the patient's mouth and nose. d. Use an adult-sized mask and ventilate through the stoma.
answer
a
question
170. You are called to care for a 77-year-old female patient in respiratory distress. During the patient assessment, you note that the patient has a tracheostomy tube inserted into a permanent tracheostomy. The tube has become dislodged. Which of the following should be your next action? a. Attempt to replace the tracheostomy tube or intubate if necessary. b. Immediately perform nasotracheal intubation to secure an open airway. c. Insert a nasogastric tube to reduce swelling and make breathing easier. d. Reinsert the tracheostomy tube.
answer
a
question
171. You are called to the home of a 5-year-old boy who has a tracheotomy tube and is on a ventilator. The patient's mother called because she could not suction the tracheotomy tube adequately and the patient's oxygen saturation is dropping. The mother states that the patient has been ill for the past 2 days with a fever, congested lungs, and copious amounts of thick, green-tinged mucus. You attempt to suction the tracheotomy tube with no results. What is your best course of action at this point? a. Perform a translaryngeal cannulation. b. Rapidly transport the patient. c. Remove the tracheotomy tube, and replace it with a new one. d. Ventilate the patient with a bag-mask device.
answer
c
question
172. A patient is intubated and the lungs are being manually ventilated by a bag-mask device. The tidal volume is too high. Which of the following would you expect to occur? a. Atelectatic pneumonia and ventilatory compromise b. Hyperventilation syndrome and hypercarbia c. Pressure on the diaphragm and resistance to ventilation d. Stimulation of the vagus nerve and risk of bradycardia
answer
c
question
173. A patient has been intubated, and the lungs are being ventilated. The abdomen is very firm and distended. Which of the following would the most appropriate treatment for this patient? a. Esophageal intubation and suctioning b. Fine needle aspiration of the stomach c. Nasotracheal intubation and suctioning d. Orogastric or nasogastric suctioning
answer
d
question
174. Which of the following best describes the advantage of a nasogastric tube over a orogastric tube? a. Nasogastric tubes are better tolerated by the patient. b. Nasogastric tubes are useful in patients with facial trauma. c. Nasogastric tubes are cause less gastric irritation. d. Nasogastric tubes are require no lubrication to insert.
answer
a
question
175. A patient was eating dinner at a restaurant. He began having a severe asthma attack and went into respiratory distress. Following intubation, which of the following would be the most appropriate intervention for this patient? a. Nasotracheal suctioning b. Needle decompression of the stomach c. Orogastric tube d. Oropharyngeal airway
answer
c
question
176. Nasogastric or orogastric tube placement can be confirmed by: a. Auscultating over the epigastrium while injecting 30 to 50 mL of air b. Lack of resistance noted upon insertion c. Noting resistance to aspiration d. Palpating the epigastrium during insertion
answer
a
question
177. You have placed a nasogastric tube in a patient with obvious gastric distention. The patient has no facial injuries or other trauma. After inserting the nasogastric tube, there is no appreciable reduction in gastric distention, even though air flows freely through the tube. A likely reason for the problem is: a. Excessive depth of tube placement b. Kinking of the nasogastric tube c. The tube has an open whistle tip d. The tube has been misplaced in the trachea
answer
d
question
178. While assessing the nonbreathing patient, you note significant gastric distention and determines that a nasogastric tube is appropriate. In preparing the equipment for the procedure, you are told that the patient has a history of alcoholism and suffers from esophageal varices. What should you do? a. Defer nasogastric tube insertion until you arrive at the emergency department. b. Ignore the patient's past medical history, and insert the nasogastric tube. c. Insert the nasogastric tube, and prepare to vigorously suction the upper airways. d. Prepare to insert an orogastric tube rather than a nasogastric tube.
answer
a
question
179. A patient has sustained significant facial trauma and is bleeding. While preparing to intubate this patient, which of the following should be worn for personal protection equipment? a. Gloves and shoe coverings b. Gloves, eye shield, and a gown if available c. Gloves, gown, and shoe coverings d. Gloves only
answer
b
question
180. A patient with significant facial trauma has copious vomiting. The patient is intubated. Which of the following is the most appropriate? a. A nasogastric tube b. A suction catheter c. A Yankauer suction tip d. An orogastric tube
answer
d
question
181. A 21-year-old male patient has been struck in the neck several times with a metal baseball bat during a gang-related fight. As you assess the patient, you hear stridor with each breath. Appropriate management for this patient includes: a. Early Combitube or LMA placement to protect the airway b. Early intubation to protect the airway c. Supplement oxygen with a nasal cannula d. Supplemental oxygen with a simple face mask
answer
b
question
182. On scene with a pediatric patient that requires assisted ventilations, which of the following is correct? a. An adult-sized bag-mask is preferable for a small child. b. Because of airway diameters, proper positing of the head is critical. c. Children have a more pronounced nasal bridge, making a mask seal easier. d. One person can effectively create a mask seal when ventilating a child.
answer
b
question
183. Which of the following is an effective technique for obtaining an effective mask seal? a. Applying petroleum jelly around the mouth and nose b. Covering the child's eyes with the face mask c. Inserting a nasogastric airway before ventilating d. Using a two-person bag-mask technique
answer
d
question
184. You are caring for a newly born infant who is not breathing adequately. Although the newborn is positioned properly, the neonatal-sized bag-mask device is not providing adequate tidal volume to provide effective ventilation. Which of the following is the next most appropriate step? a. Change to a larger sized bag-mask device, and monitor ventilation. b. Continue attempts to ventilate the newborn using the neonatal equipment. c. Insert a neonatal gastric tube, and continue ventilation attempts. d. Pad the bridge of the nose to ensure an adequate or better mask seal.
answer
a
question
185. Following the emergency delivery of a term infant, assisted ventilations are required. Which of the following best describes how this should be accomplished? a. Use a neonatal bag-mask device. b. Use a nonrebreather. c. Use a pediatric bag-mask device. d. Use an adult bag-mask device.
answer
a
question
186. A bag-mask device for infants and children should: a. Be equipped with a fish-mouth-operated outlet valve b. Be used with an oxygen flow rate of 6 to 8 L/min c. Have a minimum volume of 450 mL d. Have a pop-off valve to prevent overinflation of the lungs
answer
c
question
187. Choose the correct statement pertaining to a major difference between endotracheal intubation and the use of other advanced airways such as the Combitube, LMA, or King airway. a. Endotracheal intubation does not permit suctioning of the lower airways. b. Endotracheal intubation does not require visualization of the vocal cords. c. The other airways can be used on all and any patient group. d. The other airways do not require visualization of the vocal cords for insertion.
answer
d
question
188. A patient is in respiratory failure. Using the laryngoscope, you attempt to visualize the vocal cords with no success. Your partner attempts with no success. Which of the following would be an appropriate action at this time? a. Insert the endotracheal tube blindly. b. Perform a head tilt/chin lift maneuver. c. Perform a tracheostomy. d. Utilize a dual lumen airway.
answer
d
question
189. The patient is a 37-year-old male who is not breathing. In maintaining the man's airway, you note a strong gag reflex when an oropharyngeal airway is introduced. What should you do in this situation? a. Insert a Combitube to maintain the airway and assist ventilation. b. Insert an orogastric tube, and then use any appropriate airway device. c. Use a head/tilt chin lift maneuver to maintain the airway and assist breathing. d. Use an LMA to maintain the airway and assist ventilation.
answer
c
question
190. A patient has ingested hydrochloric acid. You would like to secure the airway. Which of the following is the most appropriate method? a. Bag-mask device with supplemental oxygen b. Combitube c. Endotracheal tube d. Laryngeal mask airway
answer
c
question
191. You have finished inserting a Combitube into an unresponsive, nonbreathing adult female. When attempting to inflate the cuff, you notice that the cuff fails to remain inflated. What should you do next? a. Continue to inflate the cuff. b. Increase the tidal volume of each ventilation. c. Remove device and inspect cuff. d. Ventilate the patient's lungs.
answer
c
question
192. You are considering using the LMA to manage the patient's airway. After inserting the airway, the patient begins to gag. What should you do next? a. Continue ventilating the patient, as the LMA is a secure airway. b. Provide suction through the LMA. c. Remove the LMA, and ventilate the patient with a bag-mask device. d. Reposition the LMA.
answer
c
question
193. The laryngeal mask airway: a. Is easier to insert than an endotracheal tube b. Is ideal for conscious patients c. Is well tolerated by a patient with an intact gag reflex d. Provides absolute protection against aspiration
answer
a
question
194. A disadvantage of the laryngeal mask airway is that: a. It can be used on any sized mouth b. Not all patients can be adequately ventilated with an LMA c. The LMA must be removed before intubation d. The spine must be manipulated for insertion of an LMA
answer
b
question
195. To correctly position a patient's head for Combitube insertion, you should: a. Extend the head b. Flex the neck c. Place the head in the neutral position d. Place the patient in the sniffing position
answer
c
question
196. You place a Combitube on a 27-year-old male patient in cardiac arrest. After ventilating through the number 1 port, you hear breath sounds. What should you do? a. Pull the tube back approximately 1 to 2 cm. b. Remove the tube and ventilate the patient. c. Secure the tube and ventilate through the number 1 port. d. Secure the tube and ventilate through the number 2 port.
answer
c
question
197. A 44-year-old female patient is in respiratory distress after being struck in the face with a baseball bat. The patient has an oxygen saturation of 72%. Which of the following airway maneuvers is the most appropriate? a. Insert a dual lumen airway. b. Insert an endotracheal tube. c. Insert an oropharyneal airway. d. Use a nasopharyngeal airway.
answer
b
question
198. A 48-year-old female patient presents in respiratory failure following an exposure to toxic fumes. She is breathing four times per minute and she appears to be gasping for each breath. Which of the following devices should be used? a. Bag-mask device ventilation b. Endotracheal intubation c. Inserting the LMA d. Using the Combitube
answer
b
question
199. Which of the following is an advantage of endotracheal intubation as compared to other airway devices? a. Avoids delivering high-flow oxygen to the patient b. Avoids problems with air filtration in the upper airway c. Permits deep tracheal suctioning to remove secretions d. Permits gastric lavage through the endotracheal tube
answer
c
question
200. The endotracheal tube size refers to the _____ in millimeters. a. External diameter b. Internal diameter c. Length d. Length of tube that will pass beyond the vocal cords
answer
b
question
201. The distal cuff of the ET tube should hold _____ mL of air. a. 6 to 10 b. 10 to 20 c. 15 to 25 d. 20 to 30
answer
a
question
202. Which of the following best describes the risk of infection to the paramedic when performing endotracheal intubation? a. In spite of personal protective equipment, exposure is highly likely. b. The paramedic is at a lower risk of infection because of isolating the airway. c. The risk of infection is similar to all other risks during patient contact. d. There is a higher risk of infection because of close proximity with the airway.
answer
d
question
203. A 78-year-old female patient with an altered mental status and copious secretions has begun coughing and experiencing respiratory distress, which quickly leads to apnea. Which of the following personal protection equipment is appropriate for this scenario? a. Gloves and face shield only b. Gloves, face shield, shoe covers c. Gloves, goggles, and face shield d. Gloves, goggles, and shoe covers
answer
c
question
204. A 46-year-old male patient is seated at the table and leaning over his dinner plate in a family restaurant. As you approach, the man's wife states, "He took a large bite of steak then started coughing. He's breathing, but we think something's stuck." The man is sitting motionless, but he is breathing, conscious, and able to answer questions. He acknowledges that a piece of meat is stuck in his throat. Which of the following is the most appropriate intervention at this time? a. Abdominal thrust maneuver to clear the food b. Direct laryngoscopy to remove the food c. Monitor patient and supply supplemental oxygen d. Orotracheal intubation for airway control
answer
c
question
205. A 15-year-old male patient is unresponsive after choking at the dinner table. Abdominal thrusts have not cleared the airway. What equipment is appropriate to use next? a. Laryngoscope and large diameter endotracheal tube b. Laryngoscope and Magill forceps c. Laryngoscope and suction catheter d. Scalpel and large surgical cricothyrotomy needle
answer
b
question
206. A 79-year-old male patient is unresponsive and apneic on his dining room floor. You attempt to ventilate the patient's lungs with a bag-mask device. There is no chest rise. Following the head/tilt chin lift for the second time, there is still no chest rise. What is your next step? a. Perform chest compressions. b. Perform surgical cricothyroidotomy. c. Place a dual lumen airway. d. Use Magill forceps to remove the foreign body.
answer
a
question
207. Direct laryngoscopy is associated with complications including: a. Main stem bronchus intubation b. Oral trauma and breaking of teeth c. Perforation of the maxillary sinus d. Rupture of the tonsillar membrane
answer
b
question
208. You are performing direct laryngoscopy on a still-breathing 70-year-old female patient in respiratory failure caused by COPD. As you introduce the laryngoscope into the patient's mouth, she begins to gag and nearly vomits. Because maintaining the airway and ventilation is critical in this patient, you should: a. Ignore the vomiting and continue b. Perform nasotracheal intubation c. Resort to bag-mask-device ventilation d. Suction the oropharynx and continue
answer
b
question
209. When using a straight blade to intubate an adult patient, the tip of the blade should be placed: a. Above the epiglottis b. Directly on the epiglottis c. In the vallecula d. Past the epiglottis at the vocal cords
answer
b
question
210. When intubating an adult patient with a curved blade, the tip of the blade should be placed: a. In the vallecula, at the base of the tongue b. In the vallecula, at the opening of the vocal cords c. To the right of the epiglottis d. Under the epiglottis
answer
a
question
211. The laryngoscope should be held in the _____ hand and inserted on the _____ side of the mouth. a. Left, left b. Left, right c. Right, left d. Right, right
answer
b
question
212. The acronym BURP describes how to: a. Confirm tube placement following intubation visualization during intubation b. Correct a right mainstem intubation c. Maneuver the larynx for vocal cord visualization d. Prepare equipment for intubation
answer
c
question
213. Which of the following is the most appropriate location for a Miller blade to be placed during intubation with direct laryngoscopy? a. Into the carina b. Into the vallecula c. Through the vocal cords d. Under the epiglottis
answer
d
question
214. You have a patient that requires intubation. The epiglottis is soft and floppy. Which of the following would be the most appropriate airway maneuver? a. Dual lumen airway b. The Macintosh blade in the vallecula c. The Macintosh blade over the epiglottis d. The miller blade to lift the epiglottis
answer
d
question
215. You are using an esophageal detection device to verify endotracheal tube placement. After squeezing the bulb, attaching it to the endotracheal tube, and releasing the bulb, you note that the bulb does not reinflate. Which of the following should you assume? a. The endotracheal tube is in the esophagus. b. The endotracheal tube is in the mainstem bronchus. c. The endotracheal tube is in the trachea. d. The endotracheal tube is positioned in the carina.
answer
a
question
216. Lung sounds are heard after intubation only over the right lung of an adult patient. The 7.0id ET tube is at 27 cm at the teeth. The most likely explanation for the findings in the intubation scenario is: a. Left-sided pneumothorax b. Occlusion of the endotracheal tube c. Right mainstem intubation d. Right-sided hypertympany
answer
c
question
217. After intubation you determine a right mainstem intubation. The next appropriate action to take is to: a. Continue to ventilate the patient b. Deflate the cuff and withdraw the tube 1 to 2 cm c. Inflate the cuff with an additional 3 to 5 mL of air d. Remove the tube
answer
b
question
218. After placing an endotracheal tube, you cannot hear any lung sounds but you hear gurgling over the epigastrium. The endotracheal tube is most likely placed in the: a. Esophagus b. Left mainstem c. Right mainstem d. Trachea
answer
a
question
219. If an endotracheal tube has been correctly placed, an esophageal detector device will: a. Change color b. Give a normal CO2 readout c. Reinflate easily d. Remain collapsed
answer
c
question
220. Once the endotracheal tube position has been confirmed, which of the following is the next most appropriate step? a. Assess capnography and arterial blood gases every 5 minutes. b. Insert the tube further into the airway as a precaution. c. Manually hold the tube in place during ventilation. d. Secure the tube with tape or a commercial tube holder.
answer
d
question
221. A 44-year-old male patient has been intubated following experiencing respiratory failure caused by asthma. Which of the following is an appropriate step for packaging this patient? a. Elevating the patient's head to facilitate ventilation b. Placing the patient in a left lateral recumbent position c. Using a cervical collar to reduce head movement d. Using a KED or spine board to immobilize the spine
answer
c
question
222. A child is in severe respiratory distress. Which of the following needs to be accomplished before intubation? a. Avoid intubation if at all possible. b. Place the child's head in slight flexion. c. Place the child in Trendelenburg. d. Provide sufficient preoxygenation.
answer
d
question
223. A 5-year-old patient is in respiratory failure from RSV. Which of the following best describes the choice of blade for this patient? a. A curved blade can better retract the epiglottis b. The laryngoscope should not be used in children c. The optimum blade size should be at least a 3 d. The optimum blade to use is the straight blade
answer
d
question
224. Which of the following statements is correct regarding the endotracheal tube used in pediatric patients under the age of 8 years? a. The endotracheal tube cuff should be inflated fully with 10 mL of air. b. The cuff of the tube should be inflated with 5 mL of air. c. The endotracheal tube should not need an inflatable cuff. d. Use a small, cuffed tube, but do not inflate the cuff.
answer
c
question
225. You are treating a 9-year-old child in need of intubation. Which of the following best describes the appropriate tube size? a. 5.0 to 5.5 mm internal diameter b. 6.0 to 6.5 mm internal diameter c. 7.0 to 7.5 mm internal diameter d. 8.0 to 8.5 mm internal diameter
answer
b
question
226. A 10-year-old in respiratory failure from asthma has been intubated with the tube placed at a depth of 30 cm. What is the next most appropriate action? a. Begin ventilating the patient; this is the appropriate depth. b. Pull the tube back to 17 cm and begin ventilating. c. Push the tube in 2 cm farther. d. Remove tube and reintubate.
answer
b
question
227. The approximation of the correct depth of insertion in centimeters for a 10-year-old child when placing an endotracheal tube is: a. 10 cm b. 12 cm c. 17 cm d. 22 cm
answer
c
question
228. Which of the following is an advantage of nasotracheal intubation over orotracheal intubation? a. It is better in patients with long, thin necks and no abnormalities. b. It is more appropriate in patients with severe nasal injuries. c. It can be used effectively in breathing patients who require intubation. d. It can be used in trauma patients with a Glasgow Coma Scale score of 10.
answer
c
question
229. A patient is apneic and requires a method for securing the airway. Which of the following is the most appropriate equipment for this patient on the first attempt? a. Bag-mask device and oropharyngeal airway b. Dual lumen airway c. Endotracheal tube with laryngoscope d. Nasaltracheal tube
answer
c
question
230. Phenylephrine spray is used during nasotracheal intubation to: a. Anesthetize the nasal passages b. Constrict the blood vessels c. Lubricate the nasal passages d. Sedate the patient before the procedure
answer
b
question
231. You are caring for an unresponsive 45-year-old female patient who is in respiratory arrest and is trapped in a narrow, confined space. Extrication from the confined space is expected to take some time. You determine that the patient's airway is best managed by intubation. Direct visualization of the airway is difficult if not impossible. Which of the following techniques would be an appropriate first choice? a. Continue with a bag-mask device. b. Create a surgical airway. c. Perform blind digital intubation. d. Perform nasotracheal intubation.
answer
c
question
232. During a digital intubation attempt, which of the following needs to be done before digit insertion? a. A bite block should be placed to avoid injury to the rescuer b. Intravenous access should be established c. Nasotracheal intubation d. Placement of an endotracheal tube
answer
a
question
233. Which position should the endotracheal tube be in for digital intubation? a. Curved in a more exaggerated J shape b. In a straight position to facilitate insertion c. Larger than the tube ordinarily used d. Well lubricated with a numbing solution
answer
a
question
234. A 22-year-old male patient is in status epilepticus. The usual means to terminate the seizure have failed, and the patient is rapidly becoming hypoxic. Intubation is appropriate; however, the seizure activity has clenched the patient's jaw. Which of the following is the next best method for securing the airway? a. Digital intubation with transillumination technique b. Nasotracheal intubation with transillumination c. Opening the airway with a cricothyrotomy d. Rapid sequence intubation to secure the airway
answer
d
question
235. Which of the following is a complication of rapid sequence intubation? a. Death from anoxia b. Hypertension c. Hypokalemia d. Tachycardia
answer
a
question
236. A patient has suffered a significant head injury and is highly combative. While preparing to intubate this patient, which of the following medications should be administered first? a. A paralytic b. A sedative c. Atropine d. Lidocaine
answer
d
question
237. Which of the following best describes the role of atropine in rapid sequence intubation? a. Decreases the heart rate b. Dilates the pupils c. Dries airway secretions d. Increases the blood pressure
answer
c
question
238. A patient is being intubated using rapid sequence intubation. Which of the following medications will paralyze the patient? a. Etomidate b. Ketamine c. Succinylcholine d. Thiopental
answer
c
question
239. Depolarizing agents: a. Block the uptake of acetylcholine at the neuromuscular junction b. Block the uptake of norepinephrine at the neuromuscular junction c. Substitute themselves for acetylcholine at the neuromuscular junction d. Substitute themselves for norepinephrine at the neuromuscular junction
answer
c
question
240. To blunt any potential rise in intracranial pressure during an intubation attempt, consider administration of: a. Atropine b. Fentanyl c. Lidocaine d. Vecuronium
answer
c
question
241. The patient has been sedated and paralyzed in preparation for rapid sequence intubation. After the procedure, you notice that the sedative has worn off. What should you do next? a. Administer additional paralytic. b. Administer additional sedative. c. Calm and reassure the patient. d. Continue with airway control.
answer
b
question
242. After administering a sedative and paralytic, you attempt to pass the endotracheal tube. Unfortunately, it is not possible to insert the tube. After 45 to 60 seconds, what should you do? a. Continue the attempts, as the patient needs the airway. b. Invite your assistant to attempt endotracheal intubation. c. Remove the airway, reoxygenate, and attempt intubation again. d. Suction the airway as the attempt to intubate continues.
answer
c
question
243. You are preparing to intubate a patient with rapid sequence intubation. Which of the following would be the first medication? a. Diphenhydramine b. Midazolam c. Pancuronium d. Vecuronium
answer
b
question
244. You are about to electively intubate a 35-year-old female patient experiencing a severe asthma attack. This may be a difficult airway. Which of the following would be the most appropriate for this patient? a. Fentanyl b. Pancuronium c. Thiopental d. Vecuronium
answer
a
question
245. You have just performed a needle cricothyrotomy. What is the next step? a. Attach the needle to a special bag-mask device. b. Connect a very small endotracheal tube. c. Use a bag-mask device adapter. d. Use a jet ventilator device.
answer
d
question
246. A patient is being ventilated with a needle in the cricothyroid space. Which of the following should be monitored? a. The cardiac monitor for hypocarbia b. The catheter for evidence of shear c. The chest rise for signs of hyperventilation d. The neck for hematoma formation
answer
d
question
247. A 22-year-old female unrestrained driver has sustained significant face and neck injuries after her car collides head on into a tree. Her neck is swollen and distended because of bleeding into the soft tissues. Endotracheal intubation is nearly impossible. Choose the correct statement about creating an airway with a surgical cricothyrotomy. a. It is a viable option, because endotracheal intubation is not possible. b. It is contraindicated in patients with underlying trauma to the neck. c. It is indicated only after a needle cricothyrotomy has been done. d. It is permissible only after nasotracheal intubation has failed.
answer
b
question
248. After performing a surgical cricothyrotomy, you notice swelling of the soft tissues in the neck accompanied by what appears to be a large hematoma along with subcutaneous emphysemas. What should you do next? a. Anticipate that this is a normal effect of the procedure, and continue care. b. Check the position of the cricothyrotomy tube, and replace if needed. c. Insert the cricothyrotomy tube deeper into the patient's airway. d. Perform endotracheal or nasotracheal intubation as soon as possible.
answer
b
question
249. A 22-year-old male patient has fallen 35 feet from an open window and has a GCS score of 2, 2, 2 for a total of 6. You have determined that intubation is necessary; however, his airway is very difficult to navigate because of fractures and bleeding. To consider a surgical airway, what equipment is needed? a. Endotracheal tube, 9 mm b. Jet insufflation device c. Scalpel, no. 10 or 15 d. Sterile nylon sutures
answer
c
question
250. You have created an airway using a surgical cricothyrotomy. What should follow the insertion of the endotracheal or tracheostomy tube and verifying tube placement? a. Secure the tube, and frequently assess ETCO2, adequate ventilation, and ECG. b. Secure the tube, and inflate the cuff with at least 10 mL of air . c. Secure the tube, and make sure that the EMT adequately ventilates the patient. d. Secure the tube with sutures, and continue to monitor for ventilation.
answer
a
Bag Mask Device
Emergency Medical Technology
High Frequency Sounds
EMT Chapter 36: Patients With Special Challenges – Flashcards 32 terms

Ben Stevenson
32 terms
Preview
EMT Chapter 36: Patients With Special Challenges – Flashcards
question
Which of the following statements regarding patients with developmental disabilities is correct?
answer
Patients with developmental disabilities are susceptible to the same disease processes as other patients.
question
Autism is MOST accurately defined as a:
answer
pervasive developmental disorder characterized by impairment of social interaction.
question
Patients with autism:
answer
have extreme difficulty with complex tasks that require many steps.
question
Which of the following statements regarding autism is correct?
answer
Most cases of autism are diagnosed by 3 years of age.
question
Characteristic anatomic features of Down syndrome include:
answer
a round head with a flat occiput.
question
2/3 of children born with Down Syndrome have
answer
congenital heart disease
question
airway management can be challenging in patients with down syndrome because their
answer
teeth are misaligned and they have a large tongue
question
You respond to a residence for a 9 year old female with Down syndrome who is sick. When you arrive at the scene and assess the patient, you determine that she is unresponsive and has gurgling respirations. You should:
answer
open her airway with a manual maneuver, suction her oropharynx, and insert a simple airway adjunct.
question
An important aspect in the assessment of a patient who experienced a previous brain injury involves:
answer
speaking with the patient and family to establish what is considered normal for the patient.
question
Which of the following conditions would MOST likely cause a patient to slur words, speak very slowly, or speak in a monotone?
answer
Parkinsons
question
Which of the following would be the MOST practical method of communicating with a hearing-impaired patient until his or her hearing aids can be located?
answer
using a piece of paper and writing utensil to ask questions
question
General techniques for communicating with hearing-impaired patients include:
answer
positioning yourself approximately 18? directly in front of the patient.
question
Because hearing-impaired patients typically have more difficulty hearing high-frequency sounds, it is important for you to:
answer
lower the pitch of your voice.
question
When enlisting the help of an interpreter who signs, it is important for you to ask the interpreter to:
answer
report exactly what the patient signs and not to add any commentary.
question
By placing one hand on top of your head and the other hand over your abdomen, you are asking a hearing-impaired patient if he or she:
answer
is sick
question
Cerebral palsy is characterized by poorly controlled ________ movement.
answer
body
question
Cerebral palsy is a condition that results from damage or injury to the
answer
brain
question
Which of the following statements regarding cerebral palsy is correct?
answer
Conditions such as brain injury at birth, postpartum infections, and fetal hypoxia can cause cerebral palsy.
question
A significant number of pt with cerebral palsy also have
answer
Seizure disorders
question
Common associated conditions in patients with spina bifida include all of the following, EXCEPT:
answer
spastic limb movement
question
According to the "E" in the DOPE mnemonic, which of the following actions should you perform to troubleshoot inadequate ventilation in a patient with a tracheostomy tube?
answer
Check the mechanical ventilator for malfunction.
question
General care for a patient with a tracheostomy tube includes all of the following, EXCEPT:
answer
removing the tube if the area around it appears to be infected.
question
If suctioning of the tracheostomy tube is necessary, the EMT should:
answer
attempt to use the patient's suction device first because it is probably already sized correctly.
question
A 13-year-old child is on a home ventilator. The parents called because the ventilator is malfunctioning and the child has increasing respiratory distress. You should:
answer
disconnect the ventilator and use a bag-mask device.
question
You receive a call to a residence for an apneic 2-month-old male. When you arrive at the scene, the infant's mother tells you that her son was born prematurely and that his apnea monitor has alarmed 4 times in the past 30 minutes. Your assessment of the infant reveals that he is conscious and active. His skin is pink and dry, and he is breathing at an adequate rate and with adequate tidal depth. His oxygen saturation reads 98% on room air. You should:
answer
transport the infant to the hospital and bring the apnea monitor with you.
question
In contrast to an automated implanted cardioverter/defibrillator, an internal cardiac pacemaker:
answer
regulates the patient's heart rate if it falls below a preset value.
question
Common complications associated with central venous catheters include all of the following, EXCEPT:
answer
rupture of a central vein
question
Which of the following statements regarding gastronomy tubes is correct?
answer
Pt with a gastronomy tube may still be at risk for aspiration
question
For which of the following conditions would you MOST likely encounter a ventricular peritoneum shunt?
answer
hydrocephalus
question
The purpose of a ventricular peritoneum shunt is to:
answer
prevent excess cerebrospinal fluid from accumulating in the brain.
question
Vagal nerve stimulators may be an alternative treatment to medication for patients with:
answer
chronic seizure disorders
question
According to the Emergency Medical Treatment and Active Labor Act (EMTALA):
answer
all health care facilities must provide a medical assessment and required treatment, regardless of the patient's ability to pay.