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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

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the EMTs primary responsibility to the patient who has been poisoned is to

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recognize that a poisoning has occurred

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heroin is an example of an

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opioid

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hypotension,hypoventilation, and pinpoint pupils would be expected following an overdose of

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oxycodone(Percocet)

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signs and symptoms of a sympathomimetic drug overdose includes

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tachycardia

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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

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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

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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

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is aware of the substance that is involved

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which of the following statements regarding inhaled poisons is correct

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lung damage may progress after the patient is removed from the environment

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your priority in caring for a patient with a surface contact poisoning is to

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avoid contaminating yourself

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phosphorus or elemental sodium should be brushed off the skin instead of irrigated with water because

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these chemicals may ignite upon contact with water

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most poisonings occur via the ________ route

answer

ingestion

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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

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activated charcoal is given to patients who have ingested certain substance because because it

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binds to the substance and prevents absorption.

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in general, injected poisons are impossible to dilute or remove because they

answer

are usually absorbed quickly into the body.

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as you enter the residence of a patient who has possibly overdosed, you should

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be alert for personal hazards

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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

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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

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it is MOST important to determine a patients weight when asking questions pertaining to a toxic ingestion because

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activated charcoal is given based on a patients weight

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airborne substances are diluted with

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oxygen

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activated charcoal administration in contraindicated in patients who have ingested

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acids or alkalis

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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

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obtain approval form medical control

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the major side effect associated with ingestion of activated charcoal is:

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black stools

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after administering activated charcoal to a patient, it is MOST important to

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be alter for vomiting

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a person who routinely misuses a substance and requires increasing amounts to achieve the same effect is experiencing an

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tolernance

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the most commonly abused drug in the united states is

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alcohol

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a hypnotic drug is one that:

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induces sleep

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when caring for a know alcoholic patient with severe trauma to the chest and abdomen, you should be concerned that

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internal bleeding may be profuse because prolonged alcohol use may impair the bloods ability to colt

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DTs is a syndrome associated with withdraw from

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alcohol

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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

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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

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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

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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

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was given flunitrazepam (Rohypnol)

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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

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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

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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

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assisted ventilation with bag mask device

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atropine sulfate and pralidoxime chloride are antidotes for

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nerve gas agents

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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

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aspirin

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an overdose on acetaminophen, the active ingredient in Tylenol, will most likely cause

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liver failure

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which of the following statements regarding the salmonella bacterium is correct

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the salmonella bacterium itself causes food poisoning

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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

STUDY

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:

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ensure the airway is clear

question

Endotracheal intubation is MOST accurately defined as:

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inserting a tube into the trachea to maintain the airway and ventilate

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Endotracheal intubation is indicated for patients:

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who are unconscious and cannot protect their own airway

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If a patient is being adequately ventilated with a bag-mask device attached to high-flow oxygen:

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endotracheal intubation may not be necessary

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Visualized orotracheal intubation requires all of the following equipment, EXCEPT a:

answer

local anesthetic

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Prior to performing orotracheal intubation in a cardiac arrest patient, it is MOST important to:

answer

adequately preoxygenate with a bagmask device.

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Although you should carry a variety of endotracheal (ET) tube sizes, a _____ ET tube will adequately fit most adults.

answer

7.5mm

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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

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When determining the proper size ET tube to use in an infant or small child, you should:

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use a length-based resuscitation tape measure

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When an ET tube is placed in an adult patient, the tube-to-teeth mark is usually around:

answer

22 cm.

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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

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Prior to attempting endotracheal intubation, the EMT should:

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obtain authorization from medical control

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A single intubation attempt in the adult patient should not exceed:

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30 seconds.

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Intubating a patient who is in cardiac arrest should occur after:

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the patient has been assessed to determine if defibrillation is indicated

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After successfully intubating a 56 year old man who is in cardiac arrest, you should:

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perform asynchronous CPR

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The appropriate method of inserting a laryngoscope blade into the patient's mouth to visualize the vocal cords is to:

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insert the blade in the right side of the mouth, sweep the tongue to the left, and lift

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During visualized orotracheal intubation, the straight blade:

answer

directly lifts the epiglottis and exposes the vocal cords.

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To avoid obscuring your view of the vocal cords during intubation, you should

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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

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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

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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

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Complications associated with endotracheal intubation include all of the following, EXCEPT:

answer

left main stem bronchus intubation

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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.

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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

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A major benefit when using a multilumen airway device is that:

answer

maintenance of a mask-to-face seal is not required.

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You should NOT attempt to insert a Combitube in a patient who:

answer

has ingested a caustic substance

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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.

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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.

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A disadvantage of the King LT airway is that it:

answer

does not completely protect the airway from aspiration.

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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

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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

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

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

STUDY

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

STUDY

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

STUDY

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

STUDY

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

answer

How many seconds do you start Chest compressions after recognition of cardiac arrest in victims of all ages.

question

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

STUDY

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

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

STUDY

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:

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pneumonia

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The chief component of connective tissue and bones that deteriorates as people age is called?

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collagen

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Motor nerve neuropathy is characterized by?

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loss of balance, muscle weakness, and spasms.

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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?

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Direct your partner to manually stabilize her head while you open her airway and ensure that her oropharynx is clear of secretions or blood.

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Many older victims of physical abuse may make false statements or lie about the origin of there injuries because?

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They fear retribution from the abuser.

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Which of the following statements regarding a decreased level of consciousness in the elderly patient is correct?

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A decreased level of consciousness is not a normal part of the aging process.

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When assessing a 78 yr old female who complains of shortness of breath the EMT should?

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Ask her how many pillows she uses when she sleeps.

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To minimize distraction and confusion when assessing an older patient you should?

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Have only one EMT speak to the patient at a time.

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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?

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The patient is experiencing delirious behavior, which suggests a new health problem.

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When assessing an older patient who has multiple bruises in various stages of healing the EMT should do all of the following except?

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Accuse the caregiver of physical abuse.

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Osteoporosis is most accurately defines as?

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A decrease in bone mass and density.

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abdominal aortic aneurysm (AAA)

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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.

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advance directive

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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.

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aneurysm

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A swelling or enlargement of part of a blood vessel, resulting from weakening of the vessel wall.

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ascites

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Fluid in the abdomen.

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decubitus ulcers

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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.

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deep venous thrombosis

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The formation of a blood clot within the larger veins of an extremity, typically following a period of prolonged immobilization.

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delirium

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A more or less sudden change in mental status marked by the inability to focus, think logically, and maintain attention.

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dementia

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The slow onset of progressive disorientation, shortened attention span, and loss of cognitive function.

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dyspnea

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Shortness of breath or difficulty breathing.

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elder abuse

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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.

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geriatrics

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The assessment and treatment of disease in someone who is 65 years or older.

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jugular vein distention

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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.

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kyphosis

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A forward curling of the back caused by an abnormal increase in the curvature of the spine.

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melena

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Black, foul-smelling, tarry stool containing digested blood.

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methicillin-resistant Staphylococcus aureus (MRSA)

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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.

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neuropathy

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A group of conditions in which the nerves leaving the spinal cord are damaged, resulting in distortion of signals to or from the brain.

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osteoporosis

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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.

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peptic ulcer disease

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An abrasion of the stomach or small intestine.

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pneumonia

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An inflammation/infection of the lung from a bacterial, viral, or fungal cause.

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polypharmacy

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The simultaneous use of multiple medications by a patient as typically seen in elderly people.

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presbycusis

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An age-related condition of the ear that produces progressive bilateral hearing loss that is most noted at higher frequencies.

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pulmonary embolism

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A blood clot that breaks off from a large vein and travels to the blood vessels of the lung, causing obstruction of blood flow.

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respiratory syncytial virus

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A highly contagious virus that causes an infection of the upper and lower respiratory system.

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syncope

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A fainting spell or transient loss of consciousness, often caused by an interruption of blood flow to the brain.

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unilateral pedal edema

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Pedal edema is a swelling of the foot and ankle caused by fluid overload; unilateral would present in only one extremity.

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urinary tract infection (UTI)

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Infections, usually of the lower urinary tract (urethra and bladder), which occur when normal flora bacteria enter the urethra and grow.

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A significant number of patients with cerebral palsy also have:

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a seizure disorder,

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EMS personnel would MOST likely be called to the residence of a patient receiving home health care when the home care provider:

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has recognized a change in the patient's health status.

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A tube from the brain to the abdomen that drains excessive cerebrospinal fluid is called a:

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shunt

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In contrast to conductive hearing loss, sensorineural hearing loss is caused by

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nerve damage

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Patients with autism

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have extreme difficulty with complex tasks that require many steps

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Characteristic anatomic features of Down syndrome include:

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a round head with a flat occiput

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When caring for a morbidly obese patient, you should:

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establish his or her chief complaint and then communicate your plan to help

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Which of the following statements regarding cerebral palsy is correct?

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Conditions such as brain injury at birth, postpartum infections, and fetal hypoxia can cause cerebral palsy

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When interacting with a developmentally disabled patient, the best approach is to:

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ask your team members to wait until you can establish a rapport with the patient

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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:

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avoid placing him in a supine position if possible and administer oxygen.

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General care for a patient with a tracheotomy tube includes all of the following, EXCEPT:

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removing the tube if the area around it appears to be infected

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Which of the following statements regarding interaction with the caregiver of a child or adult with special health care needs is correct?

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Communication with the patient's caregiver or family members is important because they are the most familiar with the patient's condition

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Common complications associated with central venous catheters include all of the following, EXCEPT:

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rupture of a central vein.

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An important aspect in the assessment of a patient who experienced a previous brain injury involves

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speaking with the patient and family to establish what is considered normal for the patient.

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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?

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using a piece of paper and writing utensil to ask questions

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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?

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Check the mechanical ventilator for malfunction

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When enlisting the help of an interpreter who signs, it is important for you to ask the interpreter to:

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report exactly what the patient signs and not to add any commentary

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Airway management can be challenging in patients with Down syndrome because their

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question

teeth are misaligned and they have a large tongue

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When caring for patients with cerebral palsy, it is important to remember that:

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their limbs are often underdeveloped and are prone to injury.

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If suctioning of the tracheostomy tube is necessary, the EMT should:

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attempt to use the patient's suction device first because it is probably already sized correctly.

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Spina bifida is MOST accurately defined as:

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a birth defect caused by incomplete closure of the spinal column.

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When assessing or providing care to a patient with a developmental disability, you should:

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be observant for signs of fear or reluctance from the patient

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Autism is MOST accurately defined as a:

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pervasive developmental disorder characterized by impairment of social interaction.

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Because a tracheostomy tube bypasses the nose and mouth

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secretions can build up in and around the tube.

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Cerebral palsy is characterized by poorly controlled ________ movement.

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question

body

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Under what circumstances is a left ventricular assist device used?

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as a bridge to heart transplantation while a donor heart is being located

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Down syndrome is a genetic defect that occurs as the result of:

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a triplication of chromosome 21

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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

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open her airway with a manual maneuver, suction her oropharynx, and insert a simple airway adjunct.

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Vagal nerve stimulators may be an alternative treatment to medication for patients with:

answer

question

chronic seizure disorders

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According to the Emergency Medical Treatment and Active Labor Act (EMTALA):

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question

all health care facilities must provide a medical assessment and required treatment, regardless of the patient's ability to pay.

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question

Which of the following statements regarding interaction with the caregiver of a child or adult with special health care needs is correct?

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question

Communication with the patient's caregiver or family members is important because they are the most familiar with the patient's condition

answer

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Which of the following statements regarding gastrostomy (gastric) tubes is correct?

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question

Patients with a gastrostomy tube may still be at risk for aspiration

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For which of the following conditions would you MOST likely encounter a ventricular peritoneum shunt?

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hydrocephalus

answer

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A service dog is easily identified by its

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question

harness

answer

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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

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The purpose of a ventricular peritoneum shunt is to:

answer

question

prevent excess CSF from accumulating in the brain

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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

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When caring for a patient who is visually impaired, it is important to:

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tell him or her what is happening, identify noises, and describe the situation and surroundings.

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Which of the following statements regarding hearing aids is correct?

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question

Hearing aids cannot restore hearing to normal levels.

answer

question

Which of the following statements regarding patients with developmental disabilities is correct?

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question

Patients with developmental disabilities are susceptible to the same disease processes as other patients.

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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

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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

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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

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CEREBRAL PALSY IS A CONDITION THAT RESULTS FROM DAMAGE OR INJURY TO THE:

answer

question

brain

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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:

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question

Document this on the patient care report and advise the emergency department staff of what the child's parents told you.

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Blood loss in a child exceeding ____ of his or her total blood volume significantly increases the risk of shock.

answer

question

25%

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The pulse rate of a child from ages 6 to 12 years is approximately:

answer

question

70 to 120 beats/min

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question

The tip of a central venous catheter rests in the:

answer

question

Vena Cava

answer

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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

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General techniques for communicating with hearing-impaired patients include?

answer

question

Positioning yourself approximately 18" directly in front of the patient.

answer

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Two thirds of children born with Down Syndrome have

answer

question

Positioning yourself approximately 18" directly in front of the patient.

answer

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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

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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

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TEAM stands for...

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question

Trust, Every, Available, Member

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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

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question

Occurs from a lesion or damage to the inner ear.

answer

question

Conductive hearing loss

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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.

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question

cerebral palsy

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question

A term for a group of disorders characterized by poorly controlled body movement.

answer

question

spina bifida

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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

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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

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tracheostomy tube

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question

A plastic tube placed in a surgical opening from the anterior part of the neck into the trachea.

answer

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DOPE

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Displacement, dislodged, or damaged tube, obstruction of the tube, pneumothorax, pulmonary problems, equipment failure

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Shunts

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Tubes that extend from the brain to the abdomen to drain excess cerebrospinal fluid that may accumulate near the brain.

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Gastric tubes

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Tubes that are placed directly into the stomach for feeding patients who cannot ingest fluids, food, or medication by mouth.

answer

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colostomy (or) ileostomy

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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)

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Stoma

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The special opening between the small or large intestine and the surface of the body

answer

STUDY

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.

STUDY

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.

STUDY

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.

STUDY

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

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.

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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

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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

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5. Which of the following is a structure of the upper airway? a. Alveoli b. Bronchioles c. Carina d. Pharynx

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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

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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.

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8. The narrowest part of the adult upper airway is known as the: a. Epiglottis b. Glottic opening c. Nasopharynx d. Vallecula

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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

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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

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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

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12. Which of the following respiratory structures is the location of oxygen and carbon dioxide exchange? a. Alveoli b. Carina c. Hilum d. Vallecula

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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

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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

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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

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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

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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

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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.

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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

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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.

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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

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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

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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.

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24. Which of the following terms best describes the process of breathing? a. Diffusion b. Insufflation c. Respiration d. Ventilation

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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

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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

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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

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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

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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

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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

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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

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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

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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

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34. One of the most prevalent atmospheric gasses is: a. Helium b. Nitric oxide c. Nitrogen d. Water vapor

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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

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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.

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37. A normal pulse oximetry reading is at or above: a. 90% b. 93% c. 95% d. 98%

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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.

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39. Most of the oxygen in blood is carried: a. As carboxyhemoglobin b. Attached to hemoglobin c. Attached to leukocytes d. Dissolved in plasma

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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

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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

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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

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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

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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

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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

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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

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47. Hypercarbia is best described as: a. Decreased carbon dioxide levels b. Decreased oxygen levels c. Increased carbon dioxide levels d. Increased oxygen levels

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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

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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

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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

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51. Which of the following is likely to decrease carbon dioxide production? a. Anaerobic metabolism b. Exercise c. Ketoacidosis d. Resting quietly

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52. Hyperventilation leads to: a. Dilated cerebral vessels b. Hypercarbia c. Improved cerebral perfusion d. Low carbon dioxide levels

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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

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54. For which of the following conditions is peak expiratory flow decreased? a. Asthma b. Emphysema c. Profound hypovolemia d. Pulmonary embolism

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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

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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.

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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%

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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

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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

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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

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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

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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

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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

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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

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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

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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

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67. The pneumotaxic center is located in the: a. Cerebellum b. Hypothalamus c. Medulla oblongata d. Pons

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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

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69. Chemoreceptors are located in the: a. Arch of the aorta b. Blood vessels in the extremities c. Cerebrum d. Spinal cord

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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

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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.

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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

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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.

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74. Hypoxemia is defined as a. Inadequate blood oxygen levels b. Inadequate hemoglobin levels c. Inadequate tissue oxygen levels d. Inadequate tissue perfusion

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75. Hypoxia is defined as: a. Inadequate blood oxygen levels b. Inadequate hemoglobin levels c. Inadequate tissue oxygen levels d. Inadequate tissue perfusion

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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

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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

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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

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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

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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

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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

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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

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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

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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

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85. A hiccup results from stimulation of the: a. Diaphragm b. Intercostal muscles c. Lungs d. Nasal passages

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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

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87. A respiratory pattern characterized by deep, rapid respirations is: a. Agonal b. Biot's c. Central neurogenic hyperventilation d. Cheyne-Stokes

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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

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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

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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.

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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

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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.

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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.

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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.

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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

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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

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97. The maximum acceptable flow rate for a nasal cannula is _____ L/min. a. 4 b. 6 c. 8 d. 10

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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

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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%

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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

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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

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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.

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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

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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.

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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.

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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.

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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.

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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

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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

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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

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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.

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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

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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

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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.

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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.

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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

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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

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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.

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119. In ideal circumstances, suctioning of an adult patient should not exceed _____ seconds. a. 2 b. 5 c. 15 d. 20

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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

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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

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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

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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.

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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.

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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

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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

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127. Which of the following is a complication of suctioning? a. Hypertension b. Hypoglycemia c. Hypoxia d. Tachycardia

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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.

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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.

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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.

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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

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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.

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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.

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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

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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.

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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

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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.

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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

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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

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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

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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.

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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

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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

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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

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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.

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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

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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%

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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

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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.

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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.

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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

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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

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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

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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.

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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

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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%

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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.

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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.

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159. To apply cricoid pressure, place firm pressure against the: a. Cricoid cartilage b. Cricothyroid membrane c. Hyoid bone d. Thyroid cartilage

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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

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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.

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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

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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.

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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

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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

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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.

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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

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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.

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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.

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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.

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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.

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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

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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

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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.

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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

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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

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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

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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.

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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

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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

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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

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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.

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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

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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.

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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.

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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

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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.

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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.

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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.

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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

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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.

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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.

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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

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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

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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

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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.

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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.

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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

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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

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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

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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

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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.

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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

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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

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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

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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.

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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

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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

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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

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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

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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

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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

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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

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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

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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.

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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

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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

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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

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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

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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.

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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

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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.

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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

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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.

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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

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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.

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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

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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.

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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

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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

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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.

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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

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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

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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

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235. Which of the following is a complication of rapid sequence intubation? a. Death from anoxia b. Hypertension c. Hypokalemia d. Tachycardia

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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

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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

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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

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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

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240. To blunt any potential rise in intracranial pressure during an intubation attempt, consider administration of: a. Atropine b. Fentanyl c. Lidocaine d. Vecuronium

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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.

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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.

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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

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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

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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.

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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

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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.

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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.

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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

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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.

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Bag Mask Device Emergency Medical Technology High Frequency Sounds

EMT Chapter 36: Patients With Special Challenges – Flashcards 32 terms

Ben Stevenson

32 terms

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EMT Chapter 36: Patients With Special Challenges – Flashcards

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Which of the following statements regarding patients with developmental disabilities is correct?

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Patients with developmental disabilities are susceptible to the same disease processes as other patients.

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Autism is MOST accurately defined as a:

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pervasive developmental disorder characterized by impairment of social interaction.

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Patients with autism:

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have extreme difficulty with complex tasks that require many steps.

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Which of the following statements regarding autism is correct?

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Most cases of autism are diagnosed by 3 years of age.

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Characteristic anatomic features of Down syndrome include:

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a round head with a flat occiput.

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2/3 of children born with Down Syndrome have

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congenital heart disease

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airway management can be challenging in patients with down syndrome because their

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teeth are misaligned and they have a large tongue

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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:

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open her airway with a manual maneuver, suction her oropharynx, and insert a simple airway adjunct.

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An important aspect in the assessment of a patient who experienced a previous brain injury involves:

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speaking with the patient and family to establish what is considered normal for the patient.

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Which of the following conditions would MOST likely cause a patient to slur words, speak very slowly, or speak in a monotone?

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Parkinsons

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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?

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using a piece of paper and writing utensil to ask questions

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General techniques for communicating with hearing-impaired patients include:

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positioning yourself approximately 18? directly in front of the patient.

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Because hearing-impaired patients typically have more difficulty hearing high-frequency sounds, it is important for you to:

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lower the pitch of your voice.

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When enlisting the help of an interpreter who signs, it is important for you to ask the interpreter to:

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report exactly what the patient signs and not to add any commentary.

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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:

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is sick

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Cerebral palsy is characterized by poorly controlled ________ movement.

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body

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Cerebral palsy is a condition that results from damage or injury to the

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brain

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Which of the following statements regarding cerebral palsy is correct?

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Conditions such as brain injury at birth, postpartum infections, and fetal hypoxia can cause cerebral palsy.

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A significant number of pt with cerebral palsy also have

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Seizure disorders

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Common associated conditions in patients with spina bifida include all of the following, EXCEPT:

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spastic limb movement

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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?

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Check the mechanical ventilator for malfunction.

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General care for a patient with a tracheostomy tube includes all of the following, EXCEPT:

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removing the tube if the area around it appears to be infected.

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If suctioning of the tracheostomy tube is necessary, the EMT should:

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attempt to use the patient's suction device first because it is probably already sized correctly.

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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:

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disconnect the ventilator and use a bag-mask device.

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transport the infant to the hospital and bring the apnea monitor with you.

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In contrast to an automated implanted cardioverter/defibrillator, an internal cardiac pacemaker:

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regulates the patient's heart rate if it falls below a preset value.

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Common complications associated with central venous catheters include all of the following, EXCEPT:

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rupture of a central vein

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Which of the following statements regarding gastronomy tubes is correct?

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Pt with a gastronomy tube may still be at risk for aspiration

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For which of the following conditions would you MOST likely encounter a ventricular peritoneum shunt?

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hydrocephalus

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The purpose of a ventricular peritoneum shunt is to:

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prevent excess cerebrospinal fluid from accumulating in the brain.

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Vagal nerve stimulators may be an alternative treatment to medication for patients with:

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chronic seizure disorders

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According to the Emergency Medical Treatment and Active Labor Act (EMTALA):

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all health care facilities must provide a medical assessment and required treatment, regardless of the patient's ability to pay.

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