unit 15 tmc questions

The first priority in the management of a patient who has a tension pneumothorax is which of the following? Select one: A.obtain an arterial blood gas analysis B.obtain a STAT chest x-ray C.administer CPAP D.release air from the pleural space

A tension pneumothorax is a life-threatening event. Unless the pressure (tension) is relieved, the lungs will not be able to expand and heart function will be compromised. Therefore, the first priority is to release the pressure from the pleural space. The correct answer is: release air from the pleural space

You find an adult patient unresponsive with no pulse or respirations. After calling a code and asking for a defibrillator, your next action should be to: Select one: A.open the patinet's airway B.check for pupillary reactivity C.administer two breaths D.begin chest compressions

After verifying pulselessness, calling a code, and asking for a defibrillator you should apply 30 chest compressions, followed by 2 breaths, then continue that cycle until help and the defribrillator arrive (C-A-B sequence). The correct answer is: begin chest compressions

Inhalation of which of the following biological agents can result in the need for ventilatory support? Select one: A.phosgene B.botulism toxin C.sarin D.chlorine

Biological agents that can cause respiratory failure and require ventilatory support include inhaled anthrax and botulism toxin. Phosgene, chlorine and sarin are chemical agents that can cause severe airway inflammation and/or pulmonary edema resulting in the need for ventilatory support. The correct answer is: botulism toxin

An intubated patient in asystole is undergoing resuscitation. The resident in charge cannot establish either an IV or intraoseous drug route. Which of the following drugs would you recommend FIRST be instilled via the endotracheal tube? Select one: A.isoproterenol B.atropine C.epinephrine D.lidocaine

Lidocaine, epinephrine, atropine and naloxone (L-E-A-N) can all be administered via direct instillation into an endotracheal tube. For asystole, epinephrine is always given first. The correct answer is: epinephrine

You are trying to apply mouth-to-mouth ventilation to an unconscious adult patient, but are unable to maintain a tight seal at the lips. At this point you should: Select one: A.place a handkerchief over the victim's mouth and continue B.use the jaw thrust maneuver instead of the head tilt/chin lift C.apply mouth-to-nose ventilation instead of mouth-to-mouth D.immediately apply a series of strong back blows to the victim

Mouth-to-nose ventilation is recommended if ventilation through the victim's mouth is impossible (eg, the mouth is seriously injured), the mouth cannot be opened, the victim is in water, or a mouth-to-mouth seal is difficult to achieve. The correct answer is: apply mouth-to-nose ventilation instead of mouth-to-mouth

During transport of an orally intubated patient to the radiology department, you note a drop in SpO2 to 85%, gurgling sounds coming out of the patient's mouth, and mild respiratory distress. Which of the following actions would be appropriate at this time? Immediately stopthe transportCall theattending doctorAuscultate forbreath soundsA.YesYesNoB.YesYesYesC.NoYesYesD.YesNoYes Select one: A.A B.B C.C D.D

Respiratory compromise and gurgling sounds are signs of a potential endotracheal tube cuff leak or dislodgment. The transport should be immediately stopped and the patient assessed for proper tube position via auscultation of breath and epigastric sounds. The tube cuff should be re-inflated if needed. In the case of unplanned extubation, the patient should immediately be ventilated with a bag-valve-mask. Calling the attending doctor does not resolve the immediate problem and wastes precious time. The correct answer is: D

Sodium bicarbonate administration during resuscitation would be most helpful in which of the following situations? Select one: A.in patients with hypoxic lactic acidosis B.in patients suffering drug overdose C.in patients with known hyperkalemia D.in patients suffering protracted arrest

Sodium bicarbonate (50 mEq over 5 minutes) is helpful during resuscitation only in patients with known hyperkalemia. Note that bicarbonate alone is less effective in reducing serum K+ than glucose plus insulin or nebulized albuterol (10 to 20 mg over 15 minutes). For this reason it is best used in conjunction with these medications. The correct answer is: in patients with known hyperkalemia

During two-person CPR applied to an adult, the proper ratio of compressions to ventilation is: Select one: A.5 compressions for every 1 breaths B.5 compressions for every 2 breaths C.15 compressions for every 1 breaths D.30 compressions for every 2 breaths

When two people provide CPR, two breaths should be interposed after every 30 compressions, with the compression rate is maintained at approximately 100/min. The correct answer is: 30 compressions for every 2 breaths

After a patient is intubated in the ER, your partner begins manual ventilation with 100% O2. During auscultation, you note decreased breath sounds on the left, while also observing reduced chest wall movement on the same side. Which of the following has most likely occurred? Select one: A.the right mainstem bronchus has been intubated B.there is a right-sided tension pneumothorax C.the left mainstem bronchus has been intubated D.the patient's esophagus has been intubated

While a patient is being manually ventilated after intubation, one should listen for equality of breath sounds and observe the chest wall for adequate and equal chest expansion. In combination, a decrease in left-sided breath sounds and decreased left chest movement indicate intubation of the right mainstem bronchus. This can be corrected by slowly withdrawing the tube, while listening for restoration of breath sounds on the right. The correct answer is: the right mainstem bronchus has been intubated

After inspecting the rhythm strip of a patient under your care in ICU, you note the occurrence of 8-10 premature atrial contractions (PACs) per minute. What action would you recommend at this time? Select one: A.administration of an antiarrhythmic drug like lidocaine B.administration of an adrenergic agent like isoproterenol C.administration of an anticholinergic agent like atropine D.cardioversion with a direct current discharge of 100 joules

he primary cause of PACs is an increased excitability of the atrial myocardium. Although strong sympathetic stimulation is a common cause, a variety of chemical or humoral agents may also provoke PACs. Generally, less than six PACs/min requires no treatment; higher rates (above 6/min) are treated with antiarrhythmic drugs like lidocaine. The correct answer is: administration of an antiarrhythmic drug like lidocaine