EMT Ch 15 - Respiratory Emergencies

When auscultating the lungs of a patient with respiratory distress, you hear adventitious sounds. This means that the patient has:

abnormal breath sounds.

A pleural effusion is MOST accurately defined as:

fluid accumulation outside the lung.

bronchiolitis

inflammation of the bronchioles that usually occurs in children younger than 2 years of age

atelectasis

collapse of the alveolar air spaces of the lungs

Dyspnea is MOST accurately defined as:

shortness of breath or difficulty breathing.

Which of the following statements regarding anaphylaxis is correct?

Anaphylaxis is characterized by airway swelling and hypotension.

PASTE

Progression Associated chest pain Sputum Talking tiredness Exercise tolerance

Albuterol is a generic name for:

Proventil.

Which of the following statements regarding pulse oximetry is correct?

Pulse oximetry measures the percentage of hemoglobin that is saturated with oxygen, but does not measure the actual hemoglobin content of the blood.

Which of the following statements regarding severe acute respiratory syndrome (SARS) is correct?

SARS is a viral infection that often begins with flulike symptoms.

Which of the following statements regarding the hypoxic drive is MOST correct?

The hypoxic drive stimulates a person to breathe on the basis of low oxygen levels.

Hyperventilation could be associated with all of the following, EXCEPT:

a narcotic overdose.

adventitious breath sounds

abnormal breath sounds such as wheezes, ronchi, and rales

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:

acute pulmonary embolism

asthma

acute spasm of the smaller air passages, called bronchioles, associated with excessive mucus production and with swelling of the mucous lining of the respiratory passages

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:

adequate air exchange.

When administering supplemental oxygen to a hypoxemic patient with a chronic lung disease, you should:

adjust the flow rate accordingly until you see symptom improvement, but be prepared to assist his or her ventilations.

In what area of the lungs does respiration occur?

alveoli

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:

apply a continuous positive airway pressure (CPAP) device, monitor his blood pressure, and observe him for signs of improvement or deterioration.

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?

aspiration pneumonia

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:

assist her ventilations with a bag-mask device.

Alkalosis is a condition that occurs when:

blood acidity is reduced by excessive breathing.

Respiratory alkalosis is a condition that occurs when

blood acidity is reduced by excessive breathing.

acidosis

buildup of excess acid in the blood or body tissues that results form a primary illness

alkalosis

buildup of excess base in the body fluids

The respiratory distress that accompanies emphysema is caused by:

chronic stretching of the alveolar walls.

According to the chart on page 479 of the EMT-Basic textbook, paroxysmal nocturnal dyspnea (PND), rales, and dependent edema are clinical indicators of:

congestive heart failure.

Paroxysmal nocturnal dyspnea (PND), rales, and dependent edema are clinical indicators of:

congestive heart failure.

A young female is unconscious after intentionally ingesting a large amount of aspirin. You will MOST likely find her respirations:

deep and rapid.

Weakening of the airway in patients with chronic bronchitis is the result of:

destruction of protective mechanisms that remove foreign particles.

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:

determine if she has been prescribed a beta-agonist inhaler.

dup

dup

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:

epinephrine.

At the onset of an acute asthma attack, patients commonly experience difficulty breathing and:

expiratory wheezing.

anaphylaxis (anaphylactic shock)

extreme, life threatening, systematic allergic reaction that may include shock and respiratory failure

Asthma is caused by a response of the:

immune system

In a healthy individual, the brain stem stimulates breathing on the basis of:

increased carbon dioxide levels.

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:

insert a nasopharyngeal airway and begin assisted ventilation.

The two processes that occur during respiration are:

inspiration and expiration.

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:

instruct him to hold his breath for as long as he comfortably can.

bronchial breath sounds

normal breath sounds made by air moving through the bronchi

In order for efficient pulmonary gas exchange to occur:

oxygen and carbon dioxide must be able to freely diffuse across the alveolar-capillary membrane.

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?

oxygen via nonrebreathing mask and a focused secondary assessment

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:

provide reassurance and give oxygen as needed.

When the level of arterial carbon dioxide rises above normal:

respirations increase in rate and depth.

Which of the following conditions would LEAST likely result in hypoxia?

severe anxiety

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?

spontaneous pneumothorax

When assessing for fluid collection in the lungs during auscultation of lung sounds, you should:

start at the lower lung fields and determine at which level you start hearing clear breath sounds.

Harsh, high-pitched inspiratory sounds are characteristic of:

stridor.

allergen

substance that causes an allergic reaction

Common signs and symptoms of acute hyperventilation syndrome include

tachypnea and tingling in the extremities.

Acute pulmonary edema would MOST likely develop as the result of:

toxic chemical inhalation.