CH10 Respiration and Artificial Ventilation

A​ 16-year-old patient presents with labored breathing and increased respiratory​ rate, increased heart​ rate, and leaning forward with his hands on his knees. His skin is pink and his accurate pulse oximetry is 96. This patient is suffering from​ respiratory: A. distress. B. arrest. C. failure. D. hypoxia.

A

Before applying a nonrebreather​ mask, the EMT should take what​ action? A. Inflate the reservoir bag and make sure the bag does not deflate during inspiration. B. Make sure the oxygen supply has greater than​ 2,000 psi in the tank. C. Insert a properly sized oropharyngeal airway. D. Connect the mask to a humidified oxygen source and wait for the​ patient's heart rate to slow.

A

In assessing a​ patient's breathing, what is your first​ question? A. Is he​ breathing? B. Is he big sick or little​ sick? C. Is his breathing adequate or​ inadequate? D. Is he alive or​ dead?

A

Which of the following BEST describes inadequate​ breathing? A. The minute volume is less than normal. B. The respiratory rate is faster than normal. C. The respiratory rate is slower than normal. D. The minute volume is greater than normal.

A

Which of the following is acceptable for maintaining a seal between an oxygen cylinder and​ regulator? A. Gasket B. Medical grade adhesive tape C. Grease plug D. ​Pop-off valve

A

Which of these patients would require a tracheostomy mask for supplemental oxygen​ administration? A. A patient with a stoma B. A patient with quadriplegia C. A patient with chronic bronchitis D. A patient with upper airway inflammation

A

Why is inhalation described as an active​ process? A. It requires chest muscles to contract and use energy to​ move, creating a negative pressure. B. It uses oxygen to assist chest muscles to​ contract, creating a negative pressure. C. It requires the diaphragm to relax and use energy to​ move, creating a positive pressure. D. It requires chest muscles to relax and use energy to​ move, creating a positive pressure.

A

You are attempting to replace the oxygen cylinder in your truck. After removing the regulator from the old​ cylinder, removing the old​ cylinder, and placing the new cylinder in the oxygen​ compartment, you attempt to connect the regulator. The new cylinder has a yellow stripe around it instead of a green one but was stored with the green cylinders. You are unable to get the regulator to seat properly and it will not turn. You​ should: A. remove the cylinder and get a green cylinder. B. replace the oxygen regulator with a new one. C. attempt to force the regulator onto the cylinder. D. put the old cylinder back on the truck.

A

You have arrived at the scene of a call for a​ "man down." As you enter the residence you note that your patient is a male in his​ mid-60s who is awake but does not seem to acknowledge your presence. He is perspiring​ profusely, has cyanosis of his ears and​ lips, and has​ rapid, shallow respirations. Which of the following should you do​ first? A. Assist ventilations with a​ bag-valve mask and supplemental oxygen. B. Obtain the​ patient's medical history. C. Listen to his lung sounds. D. Check for a radial pulse.

A

A​ 21-year-old patient presents with labored breathing and audible​ wheezes, heart rate of​ 124, respiration​ 36; he has significantly altered mentation. What is the best treatment for this​ patient? A. Give​ mouth-to-mouth breathing with a nasal​ cannula, providing the patient with an increase of oxygen. B. Ventilate with a​ bag-valve mask with high oxygen or FROPVD. C. Supplement the breaths with​ high-concentration oxygen through a nonrebreather mask. D. Use a pocket​ mask, which will provide adequate oxygen to improve the​ patient's condition.

B

Concerning the use of humidified​ oxygen, which of the following is​ true? A. The water reservoir should be changed on a weekly basis. B. It is not of great benefit during short transports but can make the patient more comfortable. C. The water in the reservoir should be treated with chlorine tablets to prevent the growth of bacteria. D. It should only be used when assisting ventilations with a​ bag-valve-mask device.

B

Of the three types of oxygen​ flowmeters, which one can only be used​ upright? A. Constant flow selector valve B. ​Pressure-compensated flowmeter C. Hudson gauge flowmeter D. Bourdon gauge flowmeter

B

The oxygen flow rate for a nasal cannula should not exceed​ ________ liters per minute. A. 2 B. 6 C. 8 D. 4

B

What are the signs of​ hypoxia? A. Warm dry​ skin, with difficulty in​ breathing, and hypertension B. Commonly seen as blue or gray​ skin, deterioration of​ patient's mental status like confusion or restlessness C. Shock caused from the lack of blood flowing to the vital organs like the brain and heart that is irreversible D. Disease process that robs the patient of adequate breathing and perfusion

B

What signs and symptoms would indicate inadequate breathing in a​ patient? A. Decreased depth of​ respiration, decreased rate of​ breathing, hot clammy​ skin, normal mental status B. Increased effort to​ breathe, cyanosis, cool clammy​ skin, altered mental status C. Increased effort to​ breathe, increased depth of​ respiration, pink dry​ skin, normal mental status D. Rapid​ breathing, pale​ skin, and a normal mental status

B

Which of the following colors identifies an oxygen​ cylinder? A. Blue and yellow B. Green and white C. Orange and red D. Black and tan

B

Which of the following is necessary to deliver oxygen to patients at a safe​ pressure? A. Flowmeter B. Regulator C. Float ball D. Filter

B

Which of the following is the best device to deliver​ high-concentration oxygen to a breathing​ patient? A. Simple face mask B. Nonrebreather mask C. Oropharyngeal airway D. Nasal cannula

B

Which of the following oxygen cylinders would normally run out after 50 minutes when flowing at 10 liters per​ minute? A. D tank B. E tank C. M tank D. G tank

B

Which of the following patients does NOT require the administration of supplemental​ oxygen? A. A​ 31-year-old male who is unresponsive due to an overdose of narcotics B. A​ 24-year-old woman who is breathing 28 times per minute after being in an argument with her husband C. A​ 60-year-old woman with a history of chronic obstructive pulmonary disease​ (COPD) who can speak two or three words at a time without a breath D. A​ 6-year-old male with a history of asthma whose breath sounds are silent and who is drowsy

B

Which of the following statements BEST describes the exchange of gas in the​ alveoli? A. Air moves into the​ airway, blood arrives via the pulmonary​ veins, and osmosis occurs. B. Air moves into the​ alveoli, blood is transported by the pulmonary​ capillaries, and diffusion occurs. C. Blood moves by way of the pulmonary​ capillaries, air arrives at the​ alveoli, and osmosis occurs. D. Blood moves from the left heart to the​ lungs, air arrives in the alveoli​ sacks, and diffusion occurs.

B

You and your EMT partner are preparing to ventilate an elderly​ non-trauma patient who has a stoma. Your partner performs the​ head-tilt, chin-lift maneuver and you ask him to return the​ patient's head to a neutral position.​ "Why? This is not a pediatric​ patient!" your partner protests. What would you​ say? A. Stoma breathers should only have their airways positioned after placement of the ventilation device. B. It is not necessary to position the airway of a stoma breather when providing ventilations. C. Using the​ head-tilt, chin-lift prior to clearing any mucus plugs from the stoma can cause airway occlusion. D. Elderly patients should never have their heads tilted back because spinal curvatures are common and can prevent airway positioning.

B

You are transporting a​ 44-year-old female with chest pain and sudden respiratory distress. She is​ agitated, anxious, and refuses to have a nonrebreather mask applied. Which of the following is the best​ option? A. Consult with medical control about restraining the patient. B. Use a nasal cannula instead. C. Have her breathe into a paper bag to control her hyperventilation. D. Do not make further attempts to administer oxygen as it will only agitate the patient further.

B

You are ventilating an adult patient with a​ bag-valve mask when you notice that his abdomen is getting bigger. You​ should: A. decrease the flow of oxygen. B. reduce the force and volume of ventilations. C. apply pressure to the abdomen. D. suction the airway.

B

Your patient is a​ 55-year-old man with a history of chronic bronchitis. You have been called to his home today because of an increase in his level of respiratory distress. The patient is on 2 liters per minute of oxygen by nasal cannula at home. Your assessment reveals difficulty speaking due to shortness of​ breath, leaning forward to​ breathe, a productive​ cough, and a respiratory rate of 32 per minute. Which of the following is true concerning the best course of action for this​ patient? A. You should increase the​ patient's oxygen flow rate until his respiratory rate decreases and then resume oxygen administration at 2 liters per minute. B. You should increase the​ patient's oxygen flow rate to deliver adequate amounts of oxygen to his tissues. If his respiratory rate​ decreases, you can assist him with a​ bag-valve-mask device. C. Because increased blood levels of carbon dioxide are the primary stimulus to​ breathe, you should encourage the patient to rebreathe his exhaled air from a paper bag. D. You should not increase the​ patient's oxygen flow rate because of his likely dependence on a hypoxic drive to stimulate breathing.

B

Your patient is a​ 65-year-old male with a history of COPD. He is sitting up and complaining of a severe shortness of breath. You​ should: A. administer 4 lpm of oxygen via nasal cannula. B. apply a nonrebreather mask giving 15 lpm of oxygen. C. insert a nasal airway and ventilate. D. suction the airway with a rigid suction catheter.

B

The movement of oxygen and carbon dioxide between the alveoli and circulating blood is​ called: A. osmosis. B. internal respiration. C. pulmonary​ (external) respiration. D. cellular respiration.

C

The normal stimulus to breathe is stimulated by the chemoreceptors that measure the change of what two​ gases? A. Low hydrogen and high carbon monoxide B. High hydrogen and low carbon dioxide C. High carbon dioxide and low oxygen D. High carbon monoxide and low oxygen

C

The process of air moving in and out of the chest is​ called: A. tidal volume. B. inhalation. C. ventilation. D. respiration.

C

The safe residual for an oxygen cylinder is​ ________ psi. A. ​1,000 B. 300 C. 200 D. 500

C

Venturi masks are designed to mix oxygen​ with: A. nitrogen. B. humidified air. C. inhaled air. D. carbon monoxide.

C

What device is used to perform​ mouth-to-mask ventilation? A. ​Bag-valve mask B. Automatic transport ventilator C. Pocket face mask D. Stoma

C

What is NOT one of the basic parts of a​ bag-valve-mask system? A. Be nonrebreathing B. ​Non-jam valve C. ​15/25 respiratory fitting D. ​Self-refilling shell

C

Which of the following describes why fast respiration may decrease minute​ volume? A. The rate causes turbulence in the trachea that increases the friction and decreases the amount of air movement. B. It is due to the delay in the movement of the intercostal muscles and the pleural space. C. The lungs may not have the time to fill and exchange gas. D. The rate does not decrease minute​ volume; it actually increases.

C

Your patient is a motorcyclist who was ejected after striking a guard rail. The patient is unresponsive to painful stimuli and is breathing shallowly six to eight times per minute. Which of the following should you do​ first? A. Apply a nonrebreather mask with an oxygen flow rate of 15 lpm. B. Perform a rapid trauma assessment. C. Use a​ bag-valve mask with supplemental oxygen. D. Apply a cervical collar.

C

A nonrebreather mask at 12 to 15 liters per minute will generally provide the patient what percentage of​ oxygen? A. ​16-21 B. ​90-100 C. ​24-44 D. ​80-100

D

A​ ________ is not typically used in the prehospital setting for oxygen administration. A. tracheostomy mask B. nasal cannula C. regulator D. partial rebreather mask

D

The movement of oxygen and carbon dioxide across the cell membranes from the capillaries is​ called: A. oxygenation. B. external respiration. C. dehydration. D. internal respiration.

D

To calculate the minute​ volume, you need to multiply what two​ measurements? A. Tidal volume and dead space air B. Alveolar ventilation and respiratory rate C. Respiratory rate and bronchial dilation D. Tidal volume and respiratory rate

D

What is the percentage of oxygen provided by connecting a high flow of oxygen to the oxygen inlet found on a pocket​ mask? A. ​21% B. ​16% C. ​100% D. ​50%

D

What is the relatively rare condition that can cause respiratory​ depression? A. Lungs can react unfavorably to oxygen when the concentration is too high for a long period of time and this can depress breathing. B. High concentration of oxygen can depress breathing when the patient has an allergic reaction from the oxygen. C. The eyes can develop scar tissue on the retina from a high concentration of oxygen. D. Chronic obstructive pulmonary disease​ (COPD) has changed the stimulus to breathe to the hypoxic drive and high concentration can depress breathing.

D

When does respiratory distress change to respiratory​ failure? A. When the compensatory mechanism is no longer needed and the patient goes into arrest. B. When the respiratory challenge​ continues, the systems fail with the demand for​ oxygen, pupils​ dilate, and the skin becomes hot and dry. C. When the patient who is short of​ breath, with noisy​ respiration, presents in the tripod position but then suddenly has the condition clear up and return to normal. D. When the respiratory challenge​ continues, the systems cannot keep up with the​ demand, and skin color and mental status change.

D

Why does a patient involved in an auto crash who has major internal abdominal bleeding require oxygen to maintain internal​ respiration? A. The red blood cells have a reduction of hemoglobin that reduces the amount of oxygen that can be transported. B. A lack of oxygen in the air decreases the oxygen diffused into the​ bloodstream, which creates an increase of carbon dioxide. C. The swelling of the abdominal space causes the diaphragm to be​ restricted, which will reduce the thorax space. D. A lack of circulating volume decreases the oxygen and carbon dioxide transport capability.`

D

You are aggressively ventilating an adult patient with a​ bag-valve mask when you notice that his previously strong pulse is getting weaker. You​ should: A. reduce the concentration of oxygen. B. begin chest compressions. C. increase the concentration of oxygen. D. reduce the volume of the ventilations.

D