Chapt 16

Where does the lower airway​ begin?

At the level of the vocal cords

Which of the following is consistent with normal​ breathing?

Bilateral breath sounds

Which of the following is a sign of hyperventilation​ syndrome?

Carpopedal spasm

Which area of the brain is responsible for the gross rate and rhythm of the breathing​ pattern?

Medulla oblongata

While you are listening to breath​ sounds, the patient should be in what anatomic position whenever​ possible?

Sitting upright

A condition in which a lung collapses without any chest trauma is​ called:

spontaneous pneumothorax.

When treating a COPD patient who had a sudden onset of sharp chest pain and difficulty breathing while doing physical​ exercise, the EMT should be concerned about the possibility of a pulmonary embolus​ or:

spontaneous pneumothorax.

There are many problems that can cause chest pain. A symptom that usually signals pneumonia rather than another cause of chest pain​ is:

the presence of a fever.

A​ 25-year-old woman appears to be suffering from hyperventilation syndrome. You should

try to calm the patient.

The patient who has pneumonia usually has all of the​ following, EXCEPT:

vomiting blood.

Which receptors detect when the​ alveolar-capillary beds become engorged with​ blood?

​Juxta-capillary receptors

If you are going to assist in the administration of a beta​ 1-agonist inhaled​ stimulant, what are the breath sounds you are likely to hear upon auscultation that would warrant the drug and what causes​ them?

​Wheezing; narrowed bronchioles

A normal pulse oximeter reading is

94 percent.

As the lead EMT on a call for a dyspneic​ patient, you are reviewing the medications the patient takes. If the clinical criteria are met for assisting the patient with the administration of a​ bronchodilator, which of the following would the EMT be unable to​ use?

Advair

You are treating a​ 45-year-old woman who has been struggling in trying to breathe. She has a history of COPD from years of smoking more than two packs of cigarettes a day. Aside from administering the appropriate amount of​ oxygen, what else is an appropriate​ treatment?

Assist the patient with her bronchodilator according to your protocols.

Which of the following patients would be at risk for a primary spontaneous​ pneumothorax?

A​ tall, thin​ 18-year-old male athlete

You are assessing a​ 45-year-old woman who was in severe respiratory distress. She has not responded to two bronchodilator​ treatments, she has an altered mental​ status, and her head is bobbing. What should you do NEXT for this​ patient?

Begin assisting her ventilations.

A patient with which of the following signs indicates respiratory​ failure?

Central​ cyanosis, one- to​ two-word dyspnea, pulse oximeter reading of​ 84%

A​ 22-year-old woman tells you she is having a panic attack. Her vital signs are​ P110, R​ 36, BP​ 132/76, and her SPO2 is​ 99%. Which of the following is the appropriate treatment for this​ patient?

Coach her to slow her breathing.

Which assessment finding in a patient who is dyspneic is a clear indication of​ hypoxia?

Cyanosis

After administration of a​ bronchodilator, what would the EMT expect to hear during auscultation if the medication had its desired effect on the​ body?

Diminishment in wheezing

Which of the following is a sign of cardiogenic pulmonary​ edema?

Distended neck veins

You are treating a patient who has difficulty breathing. He is very thin and has a​ barrel-chest appearance. He is coughing but with little sputum and has a prolonged exhalation as if he is puffing. What type of disease does he MOST likely​ have?

Emphysema

After administering the​ 45-year-old female​ patient's bronchodilator, you notice that she continues to have considerable distress and her mental status is becoming altered. Aside from administering​ oxygen, what else should you be​ considering?

Getting out the​ bag-valve mask and preparing to assist ventilations

Which of the following is NOT a recommended part of the procedure for listening to breath​ sounds?

Have the patient breathe through the nose to avoid having the patient vocalize.

You are caring for a patient with a history of emphysema who has a primary complaint of shortness of breath and the following​ findings: pulse oximeter reading of 93​ percent, heart rate​ 110, blood pressure​ 180/86, and respiratory rate​ 26/minute. You find the​ patient's skin to be diaphoretic with ashen fingers and toes. There are bilaterally diminished breath sounds with a slight expiratory​ wheeze, but alveolar sounds are still present. Given these​ findings, how would you characterize this​ patient's current ventilation​ adequacy?

He displays respiratory​ distress, and he is at risk for deterioration.

Which of the following conditions can initially present with lethargy and​ confusion?

Hypercarbia

What is the MOST severe consequence of reduced airflow from​ COPD?

Hypoxia

Which of the following is consistent with adequate​ breathing?

Intact airway

Which of the following is true about hyperventilation​ syndrome?

It is commonly associated with emotions.

Which of the following is an easily recognizable prescribed medication for a patient for a respiratory​ disease?

Levalbuterol

The EMT will encounter many patients with respiratory distress. Which of the following will be the most common​ cause?

Obstructive lung disease

What is the pathophysiology of cystic​ fibrosis?

Overabundant production of mucus in the lower airways

Which of the following conditions stimulates receptors in the​ lungs?

Pneumonia

Your​ 68-year-old male patient complains of shortness of breath that has been getting worse over the past few days. He denies any history of COPD and has not experienced any penetrating trauma. He does have a​ low-grade fever. He says that he feels weak and has some chest pain. What is MOST likely to be his​ problem?

Pneumonia

Your patient woke up in the middle of the night with extreme shortness of breath. He says that he has a​ "cardiac history" and always sleeps with three pillows. He denies any chest pain. What is his MOST likely​ condition?

Pulmonary edema

A patient who just completed an international flight complains of a sudden onset of shortness of breath. The patient has no previous medical history. Which of the following is the likely cause of the​ distress?

Pulmonary embolism

Which of the following medications is the EMT NOT allowed to use for the acute management of a patient with​ bronchoconstriction, wheezing, and a history of​ asthma?

Salmeterol xinafoate

You are reassessing a patient to whom you have administered oxygen and an MDI for respiratory distress. During your​ reassessment, you find that there is only slight expiratory​ wheezing, the pulse oximeter reading is 97​ percent, the patient is speaking in full​ sentences, and the​ patient's color is good. Given​ this, which of the following characterizes the​ patient?

She is displaying mild respiratory distress.

You are standing by at a local 5K race when you are asked to take a look at a runner who did not complete the race. He is a​ 29-year-old skinny man who describes a sudden onset of sharp chest pain on the right side with shortness of breath. What is the MOST likely​ problem?

Spontaneous pneumothorax

You are managing a patient who you believe is severely​ hypoxic, and the pulse oximeter is not functioning properly. Given this​ information, what is the BEST thing you could do for the​ patient?

Start​ high-flow oxygen.

Which of the following is NOT a contraindication to administering a bronchodilator by MDI to a patient with​ asthma?

The patient is in severe respiratory distress.

Besides the symptom of respiratory​ distress, how would an EMT know that a patient may have a viral infection affecting the respiratory​ system?

The presence of a fever

During your reassessment of a patient with respiratory​ distress, which of the following would be a clinical indication that you need to initiate positive pressure ventilation with supplemental​ oxygen?

There are no alveolar breath sounds.

Which of the following is true in relation to a pulmonary​ embolism?

There is decreased blood flow to the alveoli.

Drugs that are commonly prescribed for patients to assist in the​ long-term control of a pulmonary pathology but are NOT used during acute deterioration by the EMT have what​ property?

They contain a steroidal compound.

Which of the following includes the proper way to assess for breath​ sounds?

Use the diaphragm end of the​ stethoscope, listen over bare​ skin, and instruct the patient to cough first.

Pulmonary edema can be caused by all of the following​ EXCEPT:

a stroke.

You suspect that a​ 66-year-old female patient has pneumonia. Vital signs are​ P110, R20, BP​ 110/84 and her SpO2 is​ 92% on room air. You should first

administer oxygen at 2 lpm via nasal cannula.

When a patient who was in respiratory failure stops​ breathing, this is​ called:

apnea

The complete cessation of breathing effort is known as​ respiratory:

arrest

Emergency medical care for a child who is experiencing significant difficulty breathing may​ include:

beginning positive pressure ventilations if breathing becomes inadequate.

Most patients you encounter as an emergency medical technician​ (EMT):

breathe normally.

In treating the patient with a history of​ asthma, it is helpful to assist the patient​ with:

bronchodilator medication.

When a patient who has COPD develops a viral respiratory​ infection, he will often​ need:

bronchodilator treatments.

If the patient has an SPO2 below 90​ percent, it is likely that his color will​ be:

cyanotic.

En route to the​ hospital, it is important to perform an ongoing assessment of the patient with breathing difficulty. While you are reevaluating your​ patient, remember​ that:

decreased wheezing always indicates improvement.

When a blood clot ends up in the​ lungs, the patient may have sudden development​ of:

dyspnea

A permanent disease process that is characterized by destruction of the alveolar walls and distention of the alveolar sacs is a type of COPD​ called:

emphysema

A condition that can cause obstruction of an​ infant's upper airway is swelling of the epiglottis from an infection. This condition is known​ as:

epiglottitis

Each of the following may indicate that apnea is​ imminent, EXCEPT:

hypertension

If the cells of the body are not getting an adequate supply of​ oxygen, they begin to die. This state of inadequate oxygen supply is​ called:

hypoxia

While assessing a patient with breathing​ difficulty, you see that the patient is​ restless, anxious, and somewhat confused as to​ what's going on. These signs are often caused​ by:

hypoxia affecting the brain.

If you are treating a patient with respiratory complaints and the patient is​ cyanotic, it could indicate that the patient​ is:

in respiratory failure.

If you are assessing a patient who is having breathing difficulty as well as stridor and​ drooling, you should be careful NOT​ to:

inspect the airway.

Your​ 26-year-old female patient has breathing difficulty and has been prescribed an MDI bronchodilator. If all the requirements to administer the medication have been​ met, the steps​ include:

instructing the patient to hold her breath for as long as is comfortable after inhaling the medication.

Signs of respiratory failure in an infant or child​ include:

loss of muscle tone.

In the asthma​ patient, all of the following contribute to the increasing resistance to airflow and difficulty​ breathing, EXCEPT:

malaise and decreasing appetite.

Your patient is exhibiting minimal use of accessory muscles while breathing. This is a sign of

normal breathing.

A​ 65-year-old man complains of shortness of breath. He is speaking in​ two-word sentences. You hear crackles when you auscultate lung sounds. Vital signs are P​ 98, R​ 26, BP​ 210/114, and his SPO2 is​ 86%. You should​ administer:

positive pressure ventilations via a​ bag-valve-mask (BVM) device.

If your patient is breathing adequately but with difficulty and the pulse oximeter reads 84​ percent, you​ should:

provide oxygen by a nonrebreather mask at 15 lpm.

All of the following are considered chronic obstructive pulmonary​ diseases, EXCEPT:

pulmonary embolism.

You respond to a call from the regional airport to remove an elderly patient experiencing respiratory distress from a plane that just landed after a long flight. A respiratory condition that may be caused by a deep vein thrombosis that develops when a person has been sitting for a long time​ is:

pulmonary embolism.

While you are obtaining your​ patient's blood​ pressure, you notice that the needle drops more than 10​ mm/Hg each time the patient inhales. This is​ called:

pulsus paradoxus.

When a patient has​ dyspnea, the​ EMT's primary focus is to manage the condition before the development​ of:

respiratory failure.

Early signs of breathing difficulty in the infant or child​ include:

retractions during inspiration.