EMT: Chapter 15 [respiratory emergency]

A pleural effusion is MOST accurately defined as:

fluid accumulation outside the lung

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

Which of the following is MOST characteristic of adequate breathing?

24 breaths/min with bilaterally equal breath sounds and pink skin

When assisting an asthmatic patient with a small-volume nebulizer attached to oxygen, what is the appropriate flow rate for the oxygen?

6 L/min

Which of the following medications can be used for the treatment of an acute asthma attack?

Albuterol

Which of the following is a common MDI drug?

Alupent

CPAP is generally used for which condition

CPAP is a noninvasive means of providing ventilatory support for patients experiencing respiratory distress associated with obstructive pulmonary disease and acute pulmonary edema

Which of the following signs and symptoms will help distinguish COPD from congestive heart failure?

Dependent edema

In order for efficient pulmonary gas exchange to occur:

O2 and CO2 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 22 breaths/min with adequate depth. Which of the following treatments is MOST appropriate for this patient?

O2 via non-rebreathing mask and a focused secondary assessment

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.

Treatment with continuous positive airway pressure (CPAP) would MOST likely be contraindicated in which of the following situations?

SOB and a blood pressure of 76/56 mm Hg

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

abnormal breath sounds

Albuterol is a generic name for:

Ventolin; Proventil

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

a narcotic overdose

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

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

Crackles are caused by ________.

air passing through fluid

In what area of the lungs does respiration occur?

alveoli

Which of the following statements regarding anaphylaxis is correct?

anaphylaxis is characterized by airway swelling and hypotension

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. With all resources at your disposal, which of the following treatment plans will benefit the patient the MOST:

apply a 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. This finding is MOST consistent with which of the following conditions?

aspiration pneumonia

An allergic response to certain foods or some other allergen may produce an acute:

asthma attack

Which of the following statements is true regarding asthma?

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

What is atelectasis?

atelectasis is the collapse of the alveolar air spaces of the lungs

Respiratory alkalosis is a condition that occurs when

blood acidity is reduced by excessive breathing

His parents tell you that their son has had a chest infection for the past two days and when they took him to their family doctor, they were told it was likely due to the respiratory syncytial virus (RSV). They have kept him well hydrated, but the infection seems to have gotten worse. On auscultation, you hear decreased air entry bilaterally with fine expiratory wheezes and the occasional coarse wet crackle. Based on this information, your patient is most likely suffering from:

bronchiolitis

In addition to asthma, which of the following conditions is associated with wheezing?

bronchitis

The respiratory distress that accompanies emphysema is caused by:

chronic stretching of the alveolar walls

You arrive at a residence where you find a woman in her early 60s. She is anxious, tachycardic, and her fingertips and lips are blue. As you assess her, she coughs up frothy sputum, and you hear crackles and some wheezing as you check for breath sounds. What condition do these findings indicate?

congestive heart failure

Inflammation and swelling of the pharynx, larynx and trachea resulting in a "seal bark" is typically caused by:

croup

Which of the following is a genetic disorder that predisposes the patient to repeated lung infections?

cystic fibrosis

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 supplemental oxygen, you should:

determine if she has been prescribed a beta-agonist inhaler

You are attending to a 28-year-old female patient in severe respiratory distress. The patient has had a high fever all day, and the respiratory distress came on very quickly. Your patient is now sitting in a chair, leaning forward with her hands on her knees. She is making high-pitched sounds with each breath and does not seem to be moving very much air. Based on this information, your patient is likely suffering from

epiglottitis

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 the lung fields. His blood pressure is 90/50 mm Hg and his heart rate is 110 beats/min. In addition to giving him high-flow 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

Dyspnea is MOST accurately defined as:

shortness of breath or difficulty breathing

Pulmonary edema can develop quickly after a major:

heart attack

Contraindications for using CPAP include:

hypotension (increase in intrathoracic pressure caused by CPAP causes decrease in right ventricular preload and afterload)

Your patient has a chronic respiratory condition. His stimulus to breathe is triggered by low oxygen levels in the blood. This is known as the ___________.

hypoxic drive

Asthma is caused by a response of the:

immune system

What is the most appropriate method for oxygen delivery to an adult patient experiencing breathing difficulty?

in an adult patient with breathing difficulty, administer high-flow O2 through a non-rebreathing mask

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

increased CO2 levels

The two processes that occur during respiration are:

inspiration, 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

You are assessing a patient with respiratory distress and are unsure if the cause is congestive heart failure (CHF) or chronic obstructive pulmonary disease (COPD). Which of the following clinical signs would be the MOST helpful in determining whether the patient has CHF or COPD?

jugular vein distention

Which of the following must be assessed in every respiratory patient?

lung sounds

Your patient is complaining of fatigue. She is breathing at 18 breaths per minute, has equal chest rise and fall, and has clear lung sounds. She is presenting with signs of ___________.

normal breathing

You are attending to a 5-year-old male patient who has had a cold and fever for the last two days. His parents became concerned when he started having coughing spells that would last for over a minute, during which he would turn blue. After the coughing attack, his parents reported that he seemed to be sucking the air back in. Based on this information, your patient is most likely suffering from:

pertussis

An obstruction to the exchange of gases between the alveoli and the capillaries may result from:

pneumonia

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 O2 as needed

Your elderly patient recently had surgery. She now complains of a sudden onset of dyspnea and sharp chest pain. You should suspect ___________.

pulmonary embolus

If CO2 levels rise above normal, the patient breathes:

rapidly and deeply

When the level of arterial CO2 rises above normal:

respirations increase in rate and depth

"PASTE" is an alternate assessment tool for ___________.

respiratory patients

You are attending to a 6-year-old female patient. Her parents tell you that she has been sick for the last three days with the respiratory infection that has been going around her school. They became concerned when she stopped drinking fluids, and they could not get her to take in any liquids. The patient is showing signs of significant dehydration. Based on this information, your patient is most likely suffering from:

respiratory syncytial virus (RSV) infection

The hypoxic drive _______.

secondary respiratory drive

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

severe anxiety

If CO2 levels drop too low, the person automatically breathes:

slower and less deeply

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

In the mnemonic PASTE, what does the "S" stand for?

sputum

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

A prolonged asthma attack that is unrelieved by epinephrine may progress into a condition known as:

status asthmaticus

Harsh, high-pitched inspiratory sounds are characteristic of:

stridor

Common signs and symptoms of acute hyperventilation syndrome include:

tachypnea and tingling in the extremities

Of the following choices, the onset of acute pulmonary edema would MOST likely develop as the result of:

toxic chemical inhalation

During the primary assessment, you determine your patient has a life-threatening emergency. You should now:

transport rapidly

You are attending to a 54-year-old female patient in a homeless shelter. The patient tells you that she had the flu a couple of weeks ago, and she has not gotten over it. She has been tired and keeps waking up at night, sweating. She has been coughing up green sputum occasionally and has been experiencing episodes of chest pain that get worse when she breathes. Based on this information, your patient is most likely suffering from:

tuberculosis

Which of the following filters, warms, and humidifies air during inhalation?

upper airway

Always consider ___________________ in patients who were eating just before becoming SOB

upper airway obstruction

You are attending to a 3-year-old male patient who is presenting with severe shortness of breath. His parents report that he has had a cough and cold with a low grade fever for the past two days. They became worried today, as his level of distress has increased dramatically. On assessment, the patient is sitting upright and making high-pitched noises with each breath. Based on this information, the patient is most likely suffering from:

viral infection of the upper respiratory tract

Which type of breath sound are you more likely to hear in a person with congestive heart failure?

you are more likely to hear crackles in a patient with congestive heart failure