Airway management and emergencies test EMT
the partial pressure of oxygen in the alveoli is _____ mm Hg; the partial pressure of carbon dioxide in the alveoli is ____ mm Hg
104, 40
An adult at rest should have a respiratory rate that ranges between:
12 to 22 breaths/min
the pressure of gas in a full cylinder of oxygen is approximately
2000 pounds per square inch (PSI)
which of the following is MOST characteristic of adequate breathing
24 breaths/min with bilaterally equal breath sounds and pink skin
When testing a mechanical suctioning unit, you should turn on the device, clamp the tubing, and ensure that it generates a vacuum pressure of more than:
300 mm hg
At a flow rate of 6L/min, a nasal cannula can deliver.
44%
An oxygen cylinder should be taken out of service and refilled when the pressure inside it is less than:
500 psi
with a good mask-to face seal and an oxygen flow rate of 15L/min, the nonrebreathing mask is capable of delivering up to ____% inspired oxygen
90
what is the MOST common cause of airway obstruction in an unconscious patient
the tongue
The nasal cannula is MOST appropriately used in the prehospital setting
when the patient cannot tolerate a nonrebreathing mask
which of the following structures is NOT found in the upper airway
Bronchus
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
Oxygen via nonrebreathing mask and a focused secondary assessment
Alkalosis is a condition that occurs when:
blood acidity is reduced by excessive breathing.
intrapulmonary shunting occurs when
blood coming from the right side of the heart bypasses nonfunctional alveoli and returns to the left side of the heart in an unoxygenated state.
which of the following oxygen flow meters is NOT affected by gravity and can be used in any position when attached to an oxygen cylinder
bourdon-guage flowmeter
oxygen toxicity is a condition in which
cellular tissue damage occurs from excessive oxygen levels in the blood.
Without adequate oxygen, the body's cells:
incompletely convert glucose into energy, and lactic acid accumulates in the blood.
in a healthy individual, the brainstem stimulates breathing on the basis of
increased carbon dioxide levels
which of the following would cause an increase in the amount of an exhaled carbon dioxide
increased cardiac output
which of the following organs or tissues can survive the longest without oxygen
muscle
Hyperventilation could be associated with all of the following, EXCEPT
narcotic overdose
a patient who is suspected of being hypoxic and is breathing adequately should be given supplemental oxygen with a
nonrebreathing mask
Structures of the lower airway include all of the following, EXCEPT the:
the epiglottis
which of the following statements regarding the hypoxic drive is correct
the hypoxic drive stimulates a person to breathe on the basis of low oxygen levels
In which of the following patients would the head tilt- chin lift maneuver be the MOST appropriate method of opening the airway
A 37-year-old female who is found unconscious in her bed
which of the following patients would MOST likely require insertion of an oropharyngeal airway
A 40-year-old unconscious patient with slow shallow respirations
which of the following patients is breathing adequately`
A conscious male with respirations of 19 breaths/ min and pink skin
which of the following statements regarding anaphylaxis is correct
Anaphylaxis is characterized by airway swelling and hypotension
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
Irregular respirations characterized by an increasing rate and depth of breathing followed by periods of apnea are called:
Cheyne-strokes respirations
you are assessing a patient with respiratory distress and are unsure if the cause is CHF or COPD. which of the following clinical signs would be the MOST helpful in determining whether the patient has CHF or COPD
Jugular vein distension
Dyspnea is MOST accurately defined as
Shortness of breath or difficulty breathing.
Albuterol is a generic name for:
Ventolin
During your assessment of a patient with respiratory distress, you hear wheezing when listening to breath sounds. this indicated
a lower airway obstruction
When auscultating the lungs of a patient with respiratory distress, you hear adventitious sounds. This means that the patient has:
abnormal breath sounds
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. you asssessment reveals dried blood around her mouth, facial cyanosis, and an oxygen saturation of 88% you should suspect
acute pulmonary embolism
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
Gas exchange in the lungs is facilitated by:
adequate amounts of surfactant.
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/her ventilations
Your protocols state that during the first few minutes of working on a cardiac arrest patient, you should provide passive ventilation. This means that you will:
allow recoil of the chest between compressions to draw air into the lungs
the actual exchange of oxygen and carbon dioxide occurs in
alveolar sacs
in what area of the lungs does respiration occur
alveoli
high flow oxygen with a nasal cannula during the preoxygenation phase of endotracheal intubation is called
apneic oxygenation
A 62-year-old man with a history of CHF presents with severe respiraory distress and with an oxygen saturation of 82% when you auscultate his lungs, you hear a widespread rales. he is conscious and alert, is able to follow simple commands, and can only speak in two-to three words sentences at a time. you should:
apply a CPAP device, monitor his blood pressure, and observe him for signs of improvement or deterioration
you receive a call for a 70-year-old female with respiratory distress. her husband tells you that she has CHF; 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
you and your partner are treating a 66-year-old man who experienced a sudden onset of respiratory distress. He is conscious but is unable to follow simple commands. further assessment reveals that his breathing is severely labored and his oxygen saturation is 80%. you should
assist his ventilations with a bag mask device
At the onset of an acute asthma attack, patients commonly experience difficulty breathing and:
audible stridor
the primary waste product of aerobic metabolism is
carbon dioxide
a man was found unresponsive in his bed at home. there is no evidence of injury, and the patient's medical history is not known. the patient's face is cherry red, yet the pulse oximeter reads 98% which of the following would most likely explain this
carbon monoxide poisoning
the respiratory distress that accompanies emphysema is caused by:
chronic stretching of the alveolar walls
to select the proper size oropharyngeal airway, you should measure from the
corner of the mouth to the earlobe
for which of the following conditions would the EMT most likely administer humidified oxygen
croup
which of the following is late sign of hypoxia
cyanosis
A young female is unconscious after intentionally ingesting a large amount of aspirin. you will MOST likely find her respirations:
deep and rapid
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
A 37-year-old male has an apparent foreign body airway obstruction. he is conscious and alert and is coughing forcefully. what should you do
encouraging him to cough and transport
The purpose of the pin-indexing system for compressed gas cylinders is to
ensure that the correct regulator is used for the cylinder
the structure located superior to the larynx is called
epiglottis
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 all over lung fields. his blood pressure is 90/50 mm Hg, and his heart rate is 110 bpm. In addition to giving him high flow oxygen, the most important treatment for this patient is
epinephrine
a pleural effusion is MOST accurately defined as
fluid accumulation outside the lung.
The presence of elevated carbon dioxide levels in the blood is called
hypercarbia
asthma is caused by a response of the
immune system
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
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
In contrast to inhalation, exhalation:
is a passive process caused by increased intrathoracic pressure.
How does positive-pressure ventilation affect cardiac output?
it increases intrathoracic pressure, which decreases venous return to the heart and causes decrease in cardiac output
The hypoxic drive is influenced by
low blood oxygen levels
As the single EMT managing an apneic patient's airway, the preferred initial method of providing ventilations is the:
mouth to mask technique with a one way valve
In order for efficient pulmonary gas exchange to occur:
oxygen and carbon dioxide must be able to freely diffuse across the alveolar- capillary membrane
the MOST serious complication associated with using a nasopharyngeal airway in a patient with trauma to the head or face is
penetrating the cranium
the diaphragm is innervated by the ___ nerve, which allows it to contract
phrenic
A 22-year-old patient is complaining of dyspnea and numbness and tingling in her hands and feet after an argument with her fiancé. Her respirations are 40 breathes/ min. you should
provide reassurance and give oxygen as needed
which of the following statements regarding pulse oximetry is correct
pulse oximetry measures the percentage of the hemoglobin that is saturated with oxygen but does not measure the actual hemoglobin content of the blood
You are ventilating a 40-year-old uninjured man who is apneic but has a pulse. When your partner reassesses his blood pressure, he notes that it has decreased significantly from previous readings. You elevate the patient's legs, but this action has no effect. You should:
reduce the rate of volume ventilations you are delivering
You are ventilating an apneic woman with a bag-mask device. She has dentures, which are tight-fitting. Adequate chest rise is present with each ventilation, and the patient's oxygen saturation reads 96%. When you reassess the patency of her airway, you note that her dentures are now loose, although your ventilations are still producing adequate chest rise. You should:
remove her dentures, resume ventilations, and assess for adequate chest rise and fall
a 19-year-old female is found unconscious by her roomate. your primary assessment reveals that her breathing is inadequate. as you insert an oropharyngeal airway, she begins to gag violently. you should
remove the airway and be prepared to suction her oropharynx
When the level of arterial carbon dioxide rises above normal:
respirations increase in rate and depth
which of the following conditions would be LEAST likely to result in hypoxia
severe anxiety
which of the following factors will cause a reduction in minute volume in an adult
shallow breathing
Treatment with continuous positive airway pressure (CPAP) would MOST likely be contraindicated in which of the following situations?
shortness of breath and a blood pressure of 76/56 mm hg
Central chemoreceptors located in the medulla provide feedback to increase the rate and depth of breathing when they sense:
slight increases in carbon dioxide or a decrease in the PH of the cerebrospinal fluid
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 patients 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 should start hearing clear breath sounds
Harsh, high-pitched inspiratory sounds are characteristic of:
stridor
Proper technique for suctioning the oropharynx of an adult patient includes:
suctioning while withdrawing the catheter from the oropharynx
common signs and symptoms of acute hyperventilation syndrome :
tachypnea and tingling in the extremities
Acute pulmonary edema would MOST likely develop as the result of:
toxic chemical inhalation