CH. 16

The medication contained within a​ metered-dose inhaler is in which​ form? A. Viscous gel B. Aerosolized This is the correct answer. C. Compressed tablet D. Pressurized liquid

B. Aerosolized

You have been called to an industrial warehouse for a young adult male patient who was exposed to an unknown chemical gas. The patient was immediately removed from the environment and presents to you with a patent​ airway, burning to the throat with​ inspiration, and complaint of shortness of breath. His vital signs are​ pulse, 120;​ respirations, 28​ breaths/min; blood​ pressure, 164/60​ mmHg; and​ SpO2, 90%. In​ addition, you note bilateral wheezing to the lungs. What should be your first action in caring for this​ patient? A. Administer supplemental oxygen This is the correct answer. B. Administer a saline mist through a​ small-volume nebulizer C. Identify the chemical to which the patient was exposed D. Initiate manual spinal motion restriction

A. Administer supplemental oxygen

You are called to a motor vehicle collision. A​ 26-year-old female states that she was unrestrained and struck the steering column with her chest after the car she was driving hit another car from behind. She is somewhat​ confused, and complains of chest pain and difficult and painful breathing when she inhales. Her airway is patent and her breathing is adequate. Assessment of the radial pulse reveals it to be rapid and very irregular and weak. The patient has cyanosis in her nose and fingertips. Her breath sounds are clear and​ equal, and her skin is moist and pale. The patient informs you that she has asthma and has a​ metered-dose inhaler​ (MDI). What is your best initial action in treating this​ patient? A. Apply supplemental oxygen if indicated This is the correct answer. B. Assist the patient with her MDI C. Transport the patient in a supine position on a long spine board D. Apply CPAP and transport the patient expediently

A. Apply supplemental oxygen if indicated

The EMT is properly using a​ small-volume nebulizer when​ she: A. Attaches the nebulizer to oxygen at 8 to 10 lpm This is the correct answer. B. Shakes the medication canister for 30 seconds prior to administration C. Instructs the patient to breathe deeply through his nose D. Places a spacer on the nebulizer

A. Attaches the nebulizer to oxygen at 8 to 10 lpm

During your reassessment of the respiratory system and oxygenation status of a patient with a chronic pulmonary​ condition, which of these would most likely not be part of this reassessment​ process? A. Blood glucose level This is the correct answer. B. Mental status C. Breath sounds D. Vital signs

A. Blood glucose level

Auscultation of breath sounds in a patient complaining of shortness of breath reveals wheezing. Which condition is responsible for this​ finding? A. Bronchiole constriction This is the correct answer. B. Mucus in the lungs C. Swelling in the throat D. Significant hypoxia

A. Bronchiole constriction

The EMT is correctly accessing for accessory muscle use when he examines which part of the​ body? A. Chest This is the correct answer. B. Back C. Nares D. Inner mouth

A. Chest

You have been dispatched to a home for a​ 16-year-old female patient with shortness of breath. On​ scene, you find the patient in bed with her mother at her side. Her mother states that her daughter has a fever with a past medical history of cystic​ fibrosis; she would like to have her daughter transported to the hospital for evaluation of possible pneumonia. As a knowledgeable​ EMT, you know that the underlying pathophysiology of cystic fibrosis is​ a: A. Condition in which excessive and thick mucus often plugs the airways This is the correct answer. B. Disease in which lifelong antibiotic medications are needed for survival C. Hereditary disease in which the lungs are malformed and smaller than normal D. Contagious disease in which the lungs are damaged by bacteria and excessive coughing

A. Condition in which excessive and thick mucus often plugs the airways

During an asthma​ attack, three main pathological changes lead to hypoxia in the patient. Which of these changes is not one of these​ three? A. Decreased alveolar perfusion This is the correct answer. B. Increased edema to bronchiole walls C. Bronchospasm D. Heavy mucus secretion and airway plugging

A. Decreased alveolar perfusion

You have been called for a​ 2-year-old male patient who is sick and having a difficult time breathing. On​ scene, you find the patient in his​ mother's arms. He appears to have labored breathing and skin that is warm to the touch. Which of these additional assessment findings would you recognize as the most​ serious? A. Grunting noise heard as the child exhales This is the correct answer. B. Respiratory rate of 28​ breaths/min C. Slight abdominal movement with breathing D. Continual crying accompanied by a fever of 99.4degreesF

A. Grunting noise heard as the child exhales

A​ 6-year-old female patient is in acute respiratory distress and is still breathing adequately but will not keep the nonrebreather face mask on her face. In this​ situation, the EMT​ should: A. Have the mother hold the mask near her​ daughter's face This is the correct answer. B. Immediately transport the patient without oxygen therapy C. Start positive pressure ventilation D. Secure the mask with tape to the​ patient's face

A. Have the mother hold the mask near her​ daughter's face

You are having a hard time getting the past medical history of a patient who is short of breath. Which piece of information would lead the EMT to believe that the patient has a history of chronic lung​ disease, such as emphysema or chronic​ bronchitis? A. Her chest is barrel shaped This is the correct answer. B. Her respirations are tachypneic C. She takes a daily aspirin D. She continually coughs

A. Her chest is barrel shaped

You are starting to assess a​ patient's breath sounds and have just listened to the upper right back. You would next listen to​ the: A. Left upper back This is the correct answer. B. Left anterior chest C. Right lower back D. Left lateral chest

A. Left upper back

When assessing a​ 3-year-old male patient in respiratory​ distress, the EMT should recognize​ "see-saw" breathing when he​ observes: A. Movement of the chest and abdomen in opposite directions This is the correct answer. B. Alternate breathing through the nose and mouth C. ​Up-and-down motion of the head as the patient breathes D. Retraction of the muscles between the ribs

A. Movement of the chest and abdomen in opposite directions

The EMT is correctly assessing a patient for subcutaneous emphysema when​ he: A. Palpates the anterior and posterior chest This is the correct answer. B. Observes the chest for abnormalities C. Examines the neck veins for distention D. Listens posteriorly for breath sounds

A. Palpates the anterior and posterior chest

An acute infectious disease caused by bacterium or a virus that affects the lower respiratory tract and causes lung inflammation resulting in dyspnea​ is: A. Pneumonia This is the correct answer. B. Asthma C. Emphysema D. Chronic bronchitis

A. Pneumonia

You are treating a patient who states that he has been short of breath for the past month.​ Tonight, his breathing just​ "got too​ bad" and he decided to call 911. The​ 67-year-old male patient is alert and oriented and has a patent airway. He appears to have an adequate tidal volume. His pulse is strong and​ regular, and his skin is warm. Vital signs are​ pulse, 92;​ respirations, 22​ breaths/min; blood​ pressure, 128/66​ mmHg; and​ SpO2, 93% while on home oxygen at 2 lpm. Which instruction would you give to your partner regarding this​ patient's care? A. ​"Let's try 4 lpm through a nasal​ cannula." This is the correct answer. B. ​"Why don't we see how the patient tolerates a nasal​ airway?" C. ​"Let's go ahead and put the patient on 15 lpm of​ oxygen." D. ​"The patient seems pretty​ stable; we can refer him to his family​ doctor."

A. ​"Let's try 4 lpm through a nasal​ cannula."

The EMT understands adequate breathing when he​ states: A. ​"Normal and adequate breathing is specific to the patient and is determined by​ assessment." This is the correct answer. B. ​"If the respiratory rate is between 10 and 20​ breaths/min, with an intact airway and clear breath​ sounds, it is​ adequate." C. ​"If the respiratory rate is between 10 and 20​ breaths/min, the breathing is most likely​ adequate." D. ​"If the patient is breathing faster than 22​ breaths/min, it is​ inadequate."

A. ​"Normal and adequate breathing is specific to the patient and is determined by​ assessment."

Medical direction has ordered you to assist a patient in taking his​ metered-dose inhaler​ (MDI). After placing the​ patient's lips on the​ mouthpiece, which instruction would be most​ appropriate? A. ​"Please inhale slowly and I will administer the​ medication, then hold your​ breath." This is the correct answer. B. ​"Please inhale, then hold your​ breath, and I will give you the​ medication." C. ​"Please hold your breath and I will administer the​ medication." D. ​"Please exhale, hold your​ breath, and I will administer the​ medication."

A. ​"Please inhale slowly and I will administer the​ medication, then hold your​ breath."

You arrive on scene for a​ 9-year-old female patient with a severe cough. Her mother states that she has spoken to her​ pediatrician, who believes that the child may have whooping cough and should be taken to the hospital for evaluation. Her mother is unsure if her daughter has had all her immunizations. Which of these statements would be most appropriate in regard to the care of this​ patient? A. ​"She may be​ contagious, so​ let's put a surgical mask on​ her." This is the correct answer. B. ​"She is probably​ contagious, so we need to each put on a gown and goggles to protect​ ourselves." C. ​"Since this condition is caused by a​ virus, she is not contagious and we just need to transport​ her." D. ​"Let's get a full set of vital​ signs, since this disease can cause heart​ problems, especially in the​ young."

A. ​"She may be​ contagious, so​ let's put a surgical mask on​ her."

You are assisting a patient in taking her​ metered-dose inhaler for the first time. Which of these statements about the side effects of the medication would be most​ appropriate? A. ​"You may feel anxious and your heart rate may​ increase." This is the correct answer. B. ​"You will probably not even remember taking the​ medication." C. ​"The medication may cause you to become very tired and​ fatigued." D. ​"You may experience a runny nose and increase in​ saliva."

A. ​"You may feel anxious and your heart rate may​ increase."

A patient requires several doses of medication from her​ metered-dose inhaler. At a​ minimum, how long should the EMT wait between​ administrations? A. 10 minutes B. 2 minutes This is the correct answer. C. 5 minutes D. 30 seconds

B. 2 minutes

What is the typical resting respiratory rate for an elderly​ patient? A. 15​ breaths/min B. 20​ breaths/min This is the correct answer. C. 10​ breaths/min D. 30​ breaths/min

B. 20​ breaths/min

An alert and oriented​ 45-year-old female patient complains of shortness of breath. Although her respiratory volume and rate are​ satisfactory, you note cyanosis in her fingertips and you cannot get the pulse oximeter to show a reading. What should be your next​ action? A. Place a nasopharyngeal airway and assist respirations B. Administer supplemental oxygen This is the correct answer. C. Move the patient to the stretcher for immediate and rapid transport D. Assist respirations with the​ bag-valve mask

B. Administer supplemental oxygen

When assessing a patient who complains of shortness of breath but has an open​ airway, which action should the EMT perform​ next? A. Determine the cause of the shortness of breath B. Assess the adequacy of the​ patient's breathing This is the correct answer. C. Ascertain whether the patient has used an MDI D. Get the​ patient's SpO2 to​ 100%

B. Assess the adequacy of the​ patient's breathing

Pursed lip breathing is most commonly observed when a patient​ has: A. Pneumonia B. COPD This is the correct answer. C. Upper airway obstruction D. Croup

B. COPD

As compared to an​ adult, how would you describe the respiratory rate of an​ infant? A. Normally slower than an​ adult's rate, unless dyspnea is present B. Faster than an​ adult's rate This is the correct answer. C. Slower than an​ adult's rate D. Same as an​ adult's rate

B. Faster than an​ adult's rate

After you administer a medication through a​ metered-dose inhaler​ (MDI) and the patient has inhaled the​ medication, it is important that the​ patient: A. Exhale through pursed lips B. Hold her breath for several seconds This is the correct answer. C. Pant for 10 seconds D. Exhale as forcefully as possible

B. Hold her breath for several seconds

A​ 36-year-old patient has overdosed on an unknown drug and is unresponsive. His breathing is​ shallow, with a rate of 6​ breaths/min. He has cyanosis around his lips and to his fingertips. His skin is cool to the​ touch, and his radial pulse is rapid. His breath sounds are diminished but clear. The EMT should recognize which respiratory condition from this​ assessment? A. Tachypnea B. Hypoxia This is the correct answer. C. Bronchospasm D. Apnea

B. Hypoxia

A​ 48-year-old male patient is short of breath and confused. His airway is​ open, and his breathing is fast. A radial pulse is easily palpated. His skin is warm to cool and dry. Your partner reports the following vital​ signs: pulse,​ 124; respirations, 24​ breaths/min; blood​ pressure, 158/86​ mmHg; and​ SpO2, 89% on room air. The​ patient's lung sounds indicate slight wheezing. Based on this​ information, which of these conditions poses the most immediate threat to this​ patient's well-being? A. Elevated blood pressure B. Hypoxia This is the correct answer. C. Increased heart rate D. Possible infection

B. Hypoxia

You have arrived on scene to find a​ 32-year-old male patient who complains of rapid​ breathing, light-headedness,​ tachycardia, and numbness and tingling to his lips and hands. Family on scene report that he had just received bad advice from his attorney about a pending divorce when the symptoms started. The patient denies chest pain as well as any other past medical history. His pulse is​ 124, respirations are 52​ breaths/min, and his blood pressure is​ 158/68 mmHg. What is your first course of action in treating this​ patient? A. Have the patient breathe into a paper bag for approximately 5 minutes B. Instruct the patient to close his mouth and breathe through his nose This is the correct answer. C. Monitor for spasms of the hand muscles and administer nitroglycerin D. Apply a nonrebreather face mask with​ low-flow oxygen, allowing the patient to rebreathe his exhaled carbon dioxide

B. Instruct the patient to close his mouth and breathe through his nose

While you are obtaining a medical history for a patient with generalized weakness and​ fatigue, she hands you a list of all the medications she is currently taking. Which of these medications should the EMT recognize as a bronchodilator for which the EMT could assist in its​ administration? A. Metformin B. Metaproterenol This is the correct answer. C. Mucomyst D. Prednisone

B. Metaproterenol

You have been called to a residence for a patient with altered mental status and shortness of breath. On​ scene, an Emergency Medical Responder meets you and states that he believes the patient had a stroke and is unresponsive. As you enter the​ room, you see the patient lying in bed with snoring respirations. Oxygen at 15 liters per minute has been applied. Your immediate action when you reach the​ patient's side would be​ to: A. Place a nasal airway and suction B. Perform the​ head-tilt, chin-lift maneuver This is the correct answer. C. Start positive pressure ventilation D. Determine whether the patient has a pulse

B. Perform the​ head-tilt, chin-lift maneuver

A patient with an unknown medical problem is responsive to painful stimuli and breathing poorly at a rate of 8​ breaths/min. The airway is patent and the skin warm and moist. The​ patient's radial pulse is strong and irregular. Breath sounds are absent over the bases of the lungs. Vital signs are​ pulse, 84; blood​ pressure, 256/120​ mmHg; and​ SpO2, 81%. The best treatment for this​ patient's breathing difficulty would​ be: A. Continuous positive airway pressure​ (CPAP) B. Positive pressure ventilation This is the correct answer. C. 2 to 4 liters of oxygen through a nasal cannula D. ​High-concentration oxygen through a nonrebreather mask

B. Positive pressure ventilation

You have been called for a​ 3-year-old male patient who is​ "not breathing​ right." Aside from a notable expiratory​ wheeze, which of these findings would be a cause of great​ concern? A. Abdominal wall movement with inspiration B. Prolonged and forced expiration This is the correct answer. C. Respiratory rate of 24​ breaths/min D. Clinging to his mother and crying

B. Prolonged and forced expiration

A patient who is nonverbal from a previous stroke is in severe respiratory distress. A family member states that she has multiple medical​ problems, including high blood​ pressure, diabetes, and heart failure. When assessing this​ patient, which sign or symptom would raise your suspicion that the patient has heart​ failure? A. Diaphoresis B. Pulmonary crackles This is the correct answer. C. Edema to left foot D. Pursed lip breathing

B. Pulmonary crackles

A​ 4-year-old female patient is having great difficulty breathing. She is responsive to verbal stimuli and has an open airway. Her respiratory rate is 40​ breaths/min, and she has an SpO2 reading of​ 88%, which has dropped from​ 90% despite​ high-concentration oxygen through a pediatric nonrebreather mask. Her pulse is​ rapid, and her skin cool to the touch. As a knowledgeable​ EMT, you would recognize these findings as associated with which​ condition? A. Respiratory arrest B. Respiratory failure This is the correct answer. C. Respiratory distress D. Cardiopulmonary arrest

B. Respiratory failure

You have been called for a patient who complains of shortness of breath. On​ scene, you find the​ 41-year-old woman sitting upright in bed with nasal flaring and wheezing. A​ metered-dose inhaler​ (MDI) is lying on the nightstand next to her. To assist her with the​ MDI, which criteria must be​ met? A. ​High-concentration oxygen must be administered first for 5 minutes B. The MDI must be prescribed for the patient This is the correct answer. C. The patient must display altered mental status D. The pulse oximeter reading must be less than​ 90%

B. The MDI must be prescribed for the patient

You realize the EMT is properly ventilating an unresponsive adult male patient​ when: A. He allows 2 seconds between each ventilation B. You observe the pulse oximeter trending upward This is the correct answer. C. He flexes the​ patient's head as ventilations are administered D. He ventilates smoothly at a rate of 24​ breaths/min

B. You observe the pulse oximeter trending upward

You have been called for a​ 6-year-old male patient with shortness of breath. On​ scene, you find the patient with a runny nose and mucus coming from the right nare. Breath sounds are clear and his SpO2 is​ 99% on room air. When​ asked, the patient states that his throat is very sore. His vital signs are​ pulse, 124;​ respirations, 20​ breaths/min; and​ temperature, 98.9°F. There is no medical​ history, according to the mother. Which statement or instruction would be most appropriate for this​ situation? A. ​"I am very concerned he may have​ epiglottitis, so we are going to take him to the hospital with lights and​ siren." B. ​"He is​ stable, but we will take him to the hospital. The danger lies in the infection spreading to the​ lungs." This is the correct answer. C. ​"Let's give him some oxygen since the heart rate is most likely elevated because his oxygen is​ low." D. ​"Why don't we give him an aspirin for his fever and then you can follow up at your​ pediatrician's office."

B. ​"He is​ stable, but we will take him to the hospital. The danger lies in the infection spreading to the​ lungs."

The EMT indicates that he is properly assessing the​ patient's breath sounds when he gives which of these instructions to the​ patient? A. ​"Please take a deep breath and gently cough as I listen to your​ lungs." B. ​"Please breathe deeply through your mouth as I listen to your​ lungs." This is the correct answer. C. ​"I need to listen to your right lung first and then compare it to your​ left." D. ​"Please sit upright and take a deep breath through your nose as I listen to your​ lungs."

B. ​"Please breathe deeply through your mouth as I listen to your​ lungs."

Following a call in which you treated a pediatric patient with​ croup, a new EMT who is in orientation asks you how you can differentiate croup from epiglottitis. Which of these responses would be most​ appropriate? A. ​"Croup is typically associated with​ wheezing; epiglottitis is typically associated with crackles in the​ lungs." B. ​"The child with epiglottitis is typically​ drooling; the child with croup​ rarely, if​ ever, drools." This is the correct answer. C. ​"The swelling associated with epiglottitis typically decreases with exposure to cool​ air; the swelling with croup does​ not." D. ​"Epiglottitis is accompanied by a​ cough; croup is not associated with a​ cough."

B. ​"The child with epiglottitis is typically​ drooling; the child with croup​ rarely, if​ ever, drools."

Within minutes of administering Proventil​ (albuterol) to a patient through her​ metered-dose inhaler​ (MDI), the patient is breathing easier and states that she feels much better. An Emergency Medical Responder on scene asks you how the medication in the MDI helped the patient. Which of these responses would be most​ appropriate? A. ​"The medication in the MDI relaxes the​ throat, allowing more oxygen to​ enter." B. ​"The medication in the inhaler relaxes and opens up the small airways in the​ lungs." This is the correct answer. C. ​"The medication travels to the brain and forces the respiratory rate to​ increase." D. ​"The medication is an​ anti-inflammatory and decreases swelling in the lung​ tissue."

B. ​"The medication in the inhaler relaxes and opens up the small airways in the​ lungs."

When auscultating breath​ sounds, the EMT should recognize rhonchi when he hears which type of​ sound? A. ​High-pitched whistling-like noises heard more on expiration B. ​Rattling-like noises that change when the patient coughs This is the correct answer. C. ​Crowing-like sounds that are accompanied by a​ high-pitched cough D. ​Crackling-like noises heard in the upper portion of the lung

B. ​Rattling-like noises that change when the patient coughs

A patient has a medical problem characterized by an increase of interstitial fluid in and around his alveoli. This condition would disrupt normal oxygen and carbon dioxide exchange by creating which type of​ disturbance? A. A perfusion disturbance B. A neurological disturbance C. A gas exchange disturbance This is the correct answer. D. A ventilation disturbance

C. A gas exchange disturbance

When auscultating the lungs of an elderly​ patient, you note​ rhonchi-like noises in the upper regions of both lungs. As a knowledgeable​ EMT, you would recognize that this finding is caused​ by: A. Fluid accumulation in the alveoli B. Narrowing of the larger airways C. Accumulation of mucus in the bronchi This is the correct answer. D. Edema to the bronchioles

C. Accumulation of mucus in the bronchi

You are administering a medication through a​ metered-dose inhaler​ (MDI) using a spacer. Which of these actions would be most​ appropriate? A. Instruct the patient to inhale slowly just prior to the medication being placed in the spacer B. Administer the medication into the spacer and then have the patient exhale C. Administer the medication into the spacer and then have the patient inhale This is the correct answer. D. Instruct the patient to exhale slowly as you place the medication into the spacer

C. Administer the medication into the spacer and then have the patient inhale

The mother of a​ 5-year-old female patient states that her daughter has been​ "sick" with a sore throat and fever for several days. The mother became concerned tonight and called 911 because the child was​ "making funny​ noises" and could not breathe well. Your assessment reveals a​ lethargic, well-developed child sitting upright and with​ high-pitched tracheal noises when she breathes in. What should be the priority action for the​ EMT? A. Performing abdominal thrusts B. Placing an oropharyngeal airway C. Administering supplemental oxygen if indicated This is the correct answer. D. Inspecting the airway with a tongue depressor

C. Administering supplemental oxygen if indicated

A​ 4-year-old boy in respiratory distress is sitting upright in bed and drooling. His mother states that he complained of a sore throat throughout the​ day, and tonight became severely short of breath and started drooling. He is alert with adequate breathing. His skin is very warm to the touch. Vital signs are​ pulse, 132;​ respirations, 28​ breaths/min; and​ SpO2, 90% on room air. Which is your first action in caring for this​ child? A. Insert an oral airway and start ventilations B. Suction the airway of secretions C. Apply supplemental oxygen This is the correct answer. D. Use a tongue depressor to inspect for a foreign body obstruction

C. Apply supplemental oxygen

As you enter the living room of an adult patient who called 911 for shortness of​ breath, you observe the patient sitting upright in a chair with a panicked look on her​ face, struggling to​ breathe, with obvious suprasternal retractions. Her breathing rate appears to be fast and her tidal volume poor. You can hear rhonchi from her lungs without the aid of a stethoscope. Once at her​ side, your initial care should be​ to: A. Apply oxygen immediately B. Establish her rate of breathing C. Assess her airway This is the correct answer. D. Auscultate lung sounds

C. Assess her airway

A​ 26-year-old male patient has summoned EMS after lifting a heavy box and suddenly experiencing shortness of breath and sharp pain to the left side of his chest that worsens with deep inspiration. Given this​ description, you immediately become suspicious of a pneumothorax. Which action should you perform next to help confirm this​ suspicion? A. Inquire about past lung problems B. Obtain an SpO2 reading C. Auscultate breath sounds This is the correct answer. D. Palpate the chest for subcutaneous emphysema

C. Auscultate breath sounds

When assessing an adult patient with difficulty​ breathing, which of these signs or symptoms would be of most immediate​ concern? A. Rate between 20 and 24​ breaths/min B. Cyanosis to the fingernails C. Blue coloration to the lips This is the correct answer. D. Temperature of 101.3degreesF

C. Blue coloration to the lips

An alert and distressed​ 72-year-old male patient with a history of pulmonary edema from heart failure is in severe respiratory​ distress, breathing 28 to 32 times per minute. His airway is​ patent, respirations are​ labored, crackles are heard in the bases of the​ lungs, and skin is found to be diaphoretic with a rapid radial pulse. Other vital signs are​ pulse, 136; blood​ pressure, 202/110​ mmHg; and​ SpO2, 83%. Cyanosis is evident in the fingertips. The best treatment for this​ patient's breathing difficulty would​ be: A. Albuterol MDI B. Supplemental oxygen via nasal cannula C. CPAP This is the correct answer. D. Nasal airway with​ high-concentration O2

C. CPAP

A​ 67-year-old male patient complains of shortness of breath. The patient cannot remember how many times he used his inhaler prior to your​ arrival, but he knows it has been multiple times. He is tachypneic and tachycardic. After administering​ oxygen, what should be your next​ action? A. Transport the patient to the hospital B. Auscultate the​ patient's lung sounds and administer the inhaler if you hear wheezing C. Call medical direction for advice This is the correct answer. D. Assist the patient in the​ self-administration of his inhaler

C. Call medical direction for advice

When administering albuterol to a patient with shortness of​ breath, the EMT realizes that the therapeutic effect of this medication is achieved​ by: A. Decreasing inflammation B. Decreasing mucus production C. Dilating the small airways This is the correct answer. D. Opening the large airways

C. Dilating the small airways

You suspect a patient of being infected with pertussis. While performing the primary​ assessment, you note a deep cough with clear breath sounds. Her vital signs are​ pulse, 108;​ respirations, 16​ breaths/min; and​ SpO2, 96% on room air. Given this​ scenario, which action by the EMT would be most​ appropriate? A. Administer oxygen via nasal cannula B. Monitor the patient and transport This is the correct answer. C. Encourage the patient not to cough D. Assist with use of a​ metered-dose inhaler

C. Encourage the patient not to cough

You are at an extended care facility for the elderly to assess and transport a patient suspected of having pneumonia to the hospital for evaluation. During your pulmonary​ assessment, which breath sound would you expect to hear that would be most specific to pneumonia versus other pulmonary​ conditions? A. Inspiratory stridor B. Bilateral rhonchi C. Localized wheezing to one side of the chest This is the correct answer. D. Inspiratory and expiratory crackles to the tops of both lungs

C. Localized wheezing to one side of the chest

Which of these is considered an early sign of inadequate breathing in​ children? A. Crying B. ​Blue-gray skin C. Nasal flaring This is the correct answer. D. Barrel chest

C. Nasal flaring

What is the most common cause of cardiac arrest in infants and​ children? A. Heart birth defect B. Abuse and neglect C. Respiratory compromise This is the correct answer. D. Accidental overdose

C. Respiratory compromise

On​ scene, you suspect that a young female patient is suffering from hyperventilation syndrome. Which additional finding would best assist you in confirming this​ suspicion? A. Heart rate of 64​ beats/min B. Urinary incontinence C. Spasm of the hands This is the correct answer. D. Breathing through the mouth

C. Spasm of the hands

A son has called 911 for his​ father, who is having difficulty breathing. On​ scene, the​ 81-year-old patient is lying on a couch in the living​ room, lethargic, and in obvious respiratory distress. He is​ confused, but has an open airway. His respirations are 38​ breaths/min and​ shallow, and his skin is extremely diaphoretic with cyanosis in the fingertips. At this​ time, the EMT​ should: A. Suction the airway of secretions B. Assess the​ patient's breath sounds C. Start positive pressure ventilation This is the correct answer. D. Determine the​ patient's past medical history

C. Start positive pressure ventilation

A​ 4-year-old female patient with a decreased level of consciousness is in respiratory distress. Her airway is patent and respirations are 12 per minute. Breath sounds are diminished​ bilaterally, and there is noted accessory muscle use with inspiration and expiration. Her pulse is 84 and SpO2​ 88%. What should be your immediate​ action? A. Recheck the SpO2 on another finger B. Initiate immediate transport to the hospital C. Start positive pressure ventilation This is the correct answer. D. Apply CPAP

C. Start positive pressure ventilation

On​ scene, you find a​ 2-year-old male patient in significant respiratory distress. He is responsive to painful stimuli and exhibits noisy respirations through an open airway. His breathing is shallow at a rate of 44​ breaths/min. His pulse is rapid. Assessment of the skin shows it to be cool and​ diaphoretic, with cyanosis to the extremities and around the mouth. What is the immediate priority for this​ patient? A. Apply oxygen through a pediatric nonrebreather mask B. Insert an oropharyngeal airway C. Start positive pressure ventilation This is the correct answer. D. Move the patient to the ambulance for immediate transport

C. Start positive pressure ventilation

Which audible respiratory sounds would make you suspicious of an upper airway​ problem? A. Wheezing B. Crackles C. Stridor This is the correct answer. D. Rhonchi

C. Stridor

You have been dispatched for a young child with difficulty breathing. As you enter the​ apartment, which scene​ size-up clue would best indicate that the patient is experiencing a problem in her upper​ airway? A. Grunting with exhalation B. ​Low-pitched sobbing and crying C. Stridorous noises with inspiration This is the correct answer. D. Audible wheezing on expiration

C. Stridorous noises with inspiration

You are by the side of a​ 77-year-old male patient with a complaint of shortness of breath. Auscultation of his lungs indicates crackles in the bases. In​ addition, both of his feet are swollen. His SpO2 on room air is​ 82%. The remainder of his vital signs are​ pulse, 144;​ respirations, 26​ breaths/min; and blood pressure​ 168/90, mmHg. The patient reports lower back pain with a history of a​ "pinched nerve" in that area. He states that he always has this pain. He has difficulty finishing his sentences without gasping for air. What is the most appropriate care for this patient after initiating​ oxygen? A. Initiate a bronchodilator through a​ small-volume nebulizer B. Apply the AED in case he arrests en route to the hospital C. Transport him in a sitting position This is the correct answer. D. Provide spinal motion precautions and secure him to a long spine board for back pain

C. Transport him in a sitting position

You are administering positive pressure ventilation to an elderly male patient with a history of chronic obstructive pulmonary disease​ (COPD). Which point must you keep in mind as you care for this​ patient? A. High concentrations of oxygen will damage the lungs and must be avoided B. ​High-concentration oxygen is contraindicated for this patient C. Use of a CPAP may rupture the lung tissue and cause a pneumothorax This is the correct answer. D. Ventilations must be given with greater force to overcome natural stiffening of the rib cage

C. Use of a CPAP may rupture the lung tissue and cause a pneumothorax

After administering a bronchodilator to a patient through a​ small-volume nebulizer, which of these statements made by the patient should be of most concern to an​ EMT? A. ​"I feel​ shaky." B. ​"I suddenly feel​ nervous." C. ​"My chest feels​ heavy." This is the correct answer. D. ​"My mouth is really​ dry."

C. ​"My chest feels​ heavy."

You are delivering positive pressure ventilations to a patient who is breathing poorly and has absent breath sounds in the right lung. Which of these instructions would you provide to those responders who are ventilating the​ patient? A. ​"Make sure to really get those ventilations into his good lung. He needs the​ oxygen." B. ​"If his SpO2 is​ 85% or​ greater, let's stop the ventilations and put him on​ high-concentration oxygen with a face​ mask." C. ​"Use the minimal tidal volume​ possible, just enough to make the chest rise and​ fall." This is the correct answer. D. ​"Let's use just room air for the ventilations. We​ don't want to cause a tension pneumothorax by giving pure​ oxygen."

C. ​"Use the minimal tidal volume​ possible, just enough to make the chest rise and​ fall."

A confused and cyanotic patient is breathing 8 times per minute with poor chest rise and fall. Which instruction would you give your partner about the respiratory care of this​ patient? A. ​"Deliver a ventilation with the​ bag-valve mask only when he​ breathes." B. ​"Since he is​ breathing, let's go ahead and put him on a nonrebreather mask with 15 lpm of​ oxygen." C. ​"Ventilate him at 10 times per​ minute." This is the correct answer. D. ​"Ventilate him with the​ bag-valve mask in between each of his​ breaths."

C. ​"Ventilate him at 10 times per​ minute."

Your medical​ director's written protocol instructs you to obtain​ on-line medical direction prior to assisting a patient with a​ metered-dose inhaler​ (MDI). Given this​ protocol, you must​ contact: A. No​ one; physician direction is not required when assisting with the MDI B. The medical director after assisting with the MDI C. The​ patient's family doctor before assisting with the MDI D. An emergency physician before assisting with the MDI

D. An emergency physician before assisting with the MDI

A​ confused, lethargic, and nonverbal​ 50-year-old female patient has altered mental status. You are told she has a history of chronic obstructive pulmonary disease​ (COPD). The primary assessment reveals a respiration rate of 6​ breaths/min and​ cool, clammy skin with cyanosis around the lips. What should be your priority​ management? A. Administer oxygen by nasal cannula at 15 lpm B. Administer oxygen by nonrebreather mask at 15 lpm C. Sit the patient​ up, assess lung​ sounds, and obtain a blood pressure D. Assist respirations with positive pressure ventilation This is the correct answer.

D. Assist respirations with positive pressure ventilation

You have been called to a home for an​ 18-year-old male​ patient, who informs you that he experienced a sudden onset of shortness of breath and back pain while watching television. He has a history of spontaneous​ pneumothorax, and the current symptoms he is experiencing are identical to those he felt with a previous pneumothorax. Assessment reveals the patient to be slightly dyspneic with breath sounds clear and intact bilaterally. During​ transport, what is most critical to continually monitor on this​ patient? A. Mental status B. Spasms to the hands C. Blood pressure D. Breath sounds

D. Breath sounds

A patient with a history of COPD is breathing 32 times a minute. Her vital signs are​ pulse, 140; blood​ pressure, 168/102​ mmHg; and​ SpO2, 98% on room air. You would classify this​ patient's condition​ as: A. Bradypnea B. Hypoxia C. Apnea D. Dyspnea

D. Dyspnea

A 911 call was placed for a​ 3-year-old child with difficulty breathing. On​ scene, you note that the child is upright with slight stridor upon inspiration. He is alert and breathing at a rate of 30​ breaths/min. His skin is warm and​ dry, and his radial pulse strong and regular. His breath sounds are clear and equal. His mother states that he was fine all day until 15 minutes​ ago, when he was playing with friends in the playroom and suddenly started having difficulty breathing. As an​ EMT, you should suspect which​ condition? A. Bronchial asthma B. Croup C. Epiglottitis D. Foreign body airway obstruction

D. Foreign body airway obstruction

You have been called to a residence for an​ 18-year-old female patient with shortness of breath and a history of cystic fibrosis. On​ scene, you find the patient to be very thin and sick looking. Her airway is patent and breathing​ adequate, although slightly labored. Her radial pulse is​ strong, and she has a constant​ cough, which occasionally produces​ green- and​ yellow-colored mucus. Auscultation of the lungs reveals rhonchi to the upper portion of both lungs. Vital signs are​ pulse, 108;​ respirations, 20​ breaths/min; blood​ pressure, 98/56​ mmHg; and​ SpO2, 92%. Based on these​ findings, appropriate care should​ include: A. Gentle abdominal thrusts to help the patient expectorate the mucus B. Suctioning of the lower airway to remove mucus C. A bronchodilator administered via​ small-volume nebulizer D. Humidified oxygen via nasal cannula starting at 2 liters per minute

D. Humidified oxygen via nasal cannula starting at 2 liters per minute

When a child starts to become​ hypoxic, the pulse will​ initially: A. Not change B. Become irregular C. Decrease D. Increase

D. Increase

Which of these statements regarding ventilation in a healthy patient is​ true? A. Both inspiration and expiration require the same amount of energy B. Inspiration and expiration require no energy in a healthy person C. Inspiration requires little​ energy; expiration requires much energy D. Inspiration is an active process that requires​ energy; expiration requires little to no energy

D. Inspiration is an active process that requires​ energy; expiration requires little to no energy

A patient in respiratory distress is exhibiting pursed lip breathing. You realize that he is doing this​ to: A. Exhale increased amounts of CO2 B. Prevent the loss of vapor with exhalation C. Inhale additional amounts of oxygen D. Keep the small airways open

D. Keep the small airways open

Which of these pieces of information would heighten the​ EMT's suspicion that a child with a persistent cough may have whooping​ cough? A. Chest pain while coughing B. Cough for the past six months C. Cough worse during the day D. Never had childhood immunizations

D. Never had childhood immunizations

When arrive on​ scene, a family member directs you to a bedroom where a​ 62-year-old male patient is in respiratory distress. During the scene​ size-up, which finding would most strongly suggest that the patient suffers from a chronic respiratory​ disease? A. Furnace turned on high with the humidifier running B. Bottles of aspirin and nitroglycerin on the nightstand C. Smell of cigarettes in house and the patient is obese D. Patient in a chair in tripod position and has a​ barrel-shaped chest

D. Patient in a chair in tripod position and has a​ barrel-shaped chest

As you enter a room for an unknown medical​ emergency, you find an unresponsive male with snoring respirations lying supine in bed. Which action should you take​ immediately? A. Start positive pressure ventilation B. Suction the airway of fluids C. Take manual spinal motion restriction precautions D. Perform a​ head-tilt, chin-lift maneuver

D. Perform a​ head-tilt, chin-lift maneuver

The best way to gauge the effectiveness of oxygen therapy is to monitor​ the: A. Respiratory rate B. Mental status C. Heart rate D. Pulse oximetry

D. Pulse oximetry

You are transporting a​ 4-year-old female patient whom you found sitting in a chair with labored​ respirations, inspiratory​ stridor, and drooling. Which sign or symptom would warrant immediate​ reassessment? A. The SpO2 drops from​ 96% to​ 95% B. The drooling continues. C. The patient remains dyspneic D. The stridor ceases

D. The stridor ceases

Why would a patient with COPD have a higher percentage of red blood cells than a healthy person without​ COPD? A. To help prevent spontaneous bleeding in the lungs B. To better fight lung infections C. To make the blood​ "thinner" D. To carry additional oxygen to the cells

D. To carry additional oxygen to the cells

A new employee of your EMS system is about to take a protocol test in front of the EMS supervisor. As he is reviewing the protocol from​ memory, he gets confused about which amount of oxygen to administer to a patient with a suspected pulmonary embolism. How would you respond if he asks you for​ help? A. ​"Since a pulmonary embolism is a vascular problem rather than lung​ problem, administer oxygen to maintain a pulse oximeter reading of greater than​ 95%." B. ​"A patient with a pulmonary embolism has a perfusion​ deficit, not a ventilation​ deficit, so oxygen will not change things. Simply start ventilations and transport the​ patient." C. ​"Administer 2 liters per minute by nasal cannula to all patients with suspected pulmonary​ embolism." D. ​"Administer supplemental oxygen to the patient of sufficient amount to maintain the pulse oximeter reading at or greater than​ 94%." This is the correct answer.

D. ​"Administer supplemental oxygen to the patient of sufficient amount to maintain the pulse oximeter reading at or greater than​ 94%."

Assessment of a​ 67-year-old male patient reveals absent lung sounds to the right​ lung, accompanied by sharp chest pain to the same side. When obtaining a​ history, which of these statements made by the​ patient's wife would the EMT recognize as most​ important? A. ​"He had a fever last​ night." B. ​"He did not take his medications​ today." C. ​"He has been in bed for 12​ hours." D. ​"He has​ emphysema."

D. ​"He has​ emphysema."

A​ 71-year-old female patient complains of the sudden onset of shortness of breath and rapid breathing. She also states that she is experiencing some chest pain that seems to worsen when she takes a deep breath. The primary assessment shows her to be alert and oriented with a patent airway and rapid breathing that is adequate. Her pulse rate is 92 and her blood pressure is​ 116/68 mmHg. When obtaining a​ history, which of these statements made by the patient should raise your suspicion that the patient may be experiencing a pulmonary​ embolism? A. ​"I had a headache earlier and took an​ aspirin." B. ​"I just started a new blood pressure medication​ today." C. ​"I think that I may also have a​ fever." D. ​"I had leg surgery five days​ ago."

D. ​"I had leg surgery five days​ ago."

At a health​ fair, a patient informs you that she has just been prescribed a​ metered-dose inhaler​ (MDI) for her asthma. She is confused about how to take the medication when needed. Which of these statements about the MDI would be most appropriate for you to​ make? A. ​"Make sure to store the​ metered-dose inhaler in your​ refrigerator." B. ​"Take it every 4 hours around the​ clock, even if you feel​ fine." C. ​"You should take the medication only after calling your​ doctor." D. ​"It is important to shake the inhaler vigorously before taking the​ medication."

D. ​"It is important to shake the inhaler vigorously before taking the​ medication.

When instructing a patient on how to use a​ small-volume nebulizer, which of these statements would be​ correct? A. ​"Take nice slow and deep​ breaths, and try not to cough the medicine​ out." B. ​"Breathe about​ 20-30 times per minute so the medication gets into your​ lungs." C. ​"As I depress the trigger on the​ canister, take in a deep​ breath." D. ​"It is really important to occasionally cough during the​ treatment."

D. ​"It is really important to occasionally cough during the​ treatment."

While talking to your partner one day in between emergency​ calls, he tells you he has recently read a CE article on pulmonary embolisms. Which of these statements indicates that your partner understands the underlying pathophysiology of how a pulmonary emboli can cause​ hypoxia? A. ​"The primary cause of a pulmonary emboli is a blood clot from the legs that lodges in the pulmonary veins and prevents blood exiting the alveolar capillary beds from reaching the​ heart." B. ​"A pulmonary emboli occurs when a small bronchiole of a lung becomes plugged by mucus or a clot in the​ bloodstream, blocking the movement of air into the​ alveoli, which results in​ hypoxia." C. ​"During an embolic​ process, the alveoli become inflamed and the walls of the alveoli thicken and prevent oxygen​ transfer, resulting in​ hypoxia." D. ​"When the pulmonary vasculature becomes blocked by an​ emboli, then blood cannot reach the alveoli for gas​ exchange, and hypoxia can​ result."

D. ​"When the pulmonary vasculature becomes blocked by an​ emboli, then blood cannot reach the alveoli for gas​ exchange, and hypoxia can​ result."