chapter 16 emt-Harrison Boyd

Respiratory distress caused by an infection is most likely from A. COPD B. CHF C. Pneumonia D. Anaphylaxis

pneumonia

Albuterol is a generic name for: A. singulair B. atrovent C. alupent D. ventolin

Ventolin

Treatment with continuous positive airway pressure (CPAP) would MOST likely be contraindicated in which of the following situations? A. Difficulty breathing, two word dyspnea and tachycardia B. shortness of breath and a blood pressure of 76/56 mm Hg C. Conscious and alert patient with an oxygen saturation of 85% D. Pulmonary edema, history of hypertension, and anxiety

-Shortness of breath and a blood pressure of 76/56 mm Hg.

Which of the following is MOST characteristic of adequate breathing? A.24 breaths/min with bilaterally equal breath sounds and pink skin B. 20 breaths/min with shallow movement of the chest wall and apallor C. 30 breaths/min with supraclavicular retractions clammy skin D. 22 breaths/min with an irregular pattern of breathing and cyanosis

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

An alert 44 year old female is complaining of shortness of breath. Vitals are BP 130/80, P 98, R 24 and shallow, Sp02 93%. What should you do? A. Assist ventilations with a BVM B. Initiate a rapid transport C. ADminister O2 via nonrebreather mask D. Administer O2 via nasal cannula

A. administer O2 via non-rebreather mask

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: A. provide reassurance and give oxygen as needed B. have her breathe into a paper or plastic bag C. position her on her left side and transport at once D. request a paramedic to give her a sedative

A. provide reassurance and give oxygen as needed.

Which of the following statements regarding anaphylaxis is correct? A. patients with asthma are at a lower risk of developing anaphylaxis B. Anaphylaxis is characterized by airway swelling and hypotension C. The signs of anaphylaxis are caused by widespread vasoconstriction D.most anaphylactic reactions occur within 60 minutes of exposure

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? A> aspiration pneumonia B. early pulmonary edema C. acute asthma attack D. widespread atelecstasis

Aspiration pneumonia

A 42-year-old female with wheezes is complaining of severe shortness of breath. She is tripoding and says she already used her metered-dose inhaler. What should you suspect? A. pulmonary embolism B. pneumothorax C. asthma D. pneumonia

Asthma

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: A. insert an oropharyngeal airway and perform oral suctioning B. insert a nasopharyngeal airway and begin assisted ventilation C. apply oxygen via a nonrebreathing mask and transport at once D. place her in the recovery position and monitor for vomiting

B. insert a nasopharyngeal airway and begin assisted ventilation.

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? A. rupture of the diaphragm B.acute pulmonary embolism C.spontaneous pneumothorax D. Exacerbation of his COPD

C. spontaneous pneumothorax

you are called to the home of a 3 year old male who has had fever,drooling, and difficulty breathing for the past 48 hours. on exam he is leaning forward and drooling, and he has audible inspiratory stridor. the mother informs you he is not vaccinated. what is the most likely cause of this patient's respiratory distress? A. epiglottis B. asthma C. bronchiolitis D. pneumonia

Epiglottitis

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? A. Altered mental status B. jugular vein distention C. rapid breathing D. cyanosis of the skin

Jugular vein distention

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? A. assisted ventilation with a bag valve mask and a head to toe exam B. Oxygen via nonrebreathing mask and focused secondary assessment C. oxygen via a nasal cannula, vital signs, and prompt transport tot he hospital D. positive pressure ventilations and immediate transport to the closest hospital

Oxygen via nonrebreathing mask and a focused secondary assessment

Which of the following statements regarding pulse oximetry is correct? A. pulse oximetry measures the percentage of hemoglobin that is saturated with oxygen but does not measure the actual hemoglobin content of the blood B. the pulse oximeter is a valuable assessment tool that measures the percentage of red blood cells that contain hemoglobin molecules C. most otherwise healthy patients can maintain adequate oxygenation and good skin color with oxygen saturation readings as low as 70% to 80% D.Caution must be exercised when using the pulse oximeter on a patient with carbon monoxide posioning because falsely low readings are common

Pulse oximetry measures the percentage of hemoglobin that is saturated with oxygen, but does not measure the actual hemoglobin content of the blood.

Which of the following statements regarding the hypoxic drive is correct? A. 100% supplemental oxygen will always cause apnea in patients with a hypoxic drive B. the hypoxic drive serves as the primary stimulus for breathing in healthy individuals C. the hypoxic drive stimulates a person to breathe on the basis of low oxygen levels D. chronic carbon dioxide elimination often results in activation of the hypoxic drive

The hypoxic drive stimulates a person to breathe on the basis of low oxygen levels.

Hyperventilation could be associated with all of the following, EXCEPT: A. A respiratory infection B. High blood glucose levels C. a narcotic overdose D. an overdose of aspirin

a narcotic overdose.

When auscultating the lungs of a patient with respiratory distress, you hear adventitious sounds. This means that the patient has: A.normal breath sounds B. diminished breath sounds C. abnormal breath sounds D. an absence of breath sounds

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. Your assessment reveals dried blood around her mouth, facial cyanosis, and an oxygen saturation of 88%. You should suspect: A. spontaneous pneumothorax B. acute pulmonary edema C. acute pulmonary embolism D. right-sided heart failure

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: A. respiratory difficulty B. an obstructed airway C. adequate air exchange D. respiratory insufficiency

adequate air exchange

When administering supplemental oxygen to a hypoxemic patient with a chronic lung disease, you should: A. recall that most patients with chronic lung diseases are stimulated to breathe by increased carbon dioxide levels B. avoid positive-pressure ventilation because the majority of patients with chronic lung disease are at increased risk for lung trauma C. begin with a low oxygen flow rate, even if the patient is unresponsive, because high flow oxygen may depress his or her breathing D. adjust the flow rate accordingly until you see symptom improvement, but be prepared to assist hiso r her ventilations

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

In what area of the lungs does respiration occur? A. capillaries B. alveoli C. Trachea D. bronchi

alveoli

A 62-year-old man with a history of congestive heart failure presents with severe respiratory distress and with 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. You should: A. Apply a CPAP device, monitor his blood pressure, and observe him for signs of improvement or deterioration B. Force fluid from his alveoli by hyperventilating him with a bag valve mask at a rate of at least 20 breaths/min C. place him in a position of comfort, deliver oxygen via nasal cannula, and closely monitor his breathing D. Place him in a supine position and assist his ventilations with a bag-valve mask and high-flow oxygen

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 congestive heart failure; 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: A. apply a pulse oximeter and assess her vital signs B. administer oxygen via a nonrebreathing mask C. assist her ventilations with a bag mask device D. obtain a complete list of all of her medications

assist her ventilations with a bag-valve mask.

At the onset of an acute asthma attack, patients commonly experience difficulty breathing and: A. rales and rhonci B. audible stridor C. expiratory wheezing D. profound cyanosis

audible stridor

Alkalosis is a condition that occurs when: A. the level of carbon dioxide in the blood increases B. slow, shallow breathing eliminates too much carbon dioxide C. blood acidity is reduced by excessive breathing D. dangerous acids accumulate in the bloodstream

blood acidity is reduced by excessive breathing.

The respiratory distress that accompanies emphysema is caused by: A. chronic stretching of the alveolar walls B. massive constriction of the bronchioles C. repeated exposure to cigarette smoke D. acute fluid accumulation in the alveoli

chronic stretching of the alveolar walls.

A pleural effusion is MOST accurately defined as: A. Unilaterally collapsed lung B. a bacterial infection of hte lung tissue C. diffuse collapsing of the alveoli D. fluid accumulation outside the lung

fluid accumulation outside the lung.

Your patient has a history of congestive heart failure and is complaining of shortness of breath. What type of breath sounds would you anticipate hearing in this patient? A. Stridor B. decreased or absent breath sounds C. Crackles D. Rhonci

crackles

A young female is unconscious after intentionally ingesting a large amount of aspirin. You will MOST likely find her respirations: A. rapid and shallow B. slow and depp C. deep and rapid D. slow and shallow

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: A. determine if she has been prescribed a beta-agonist inhaler B. place her in a recumbent position to facilitate breathing C. contact medical control and administer an antihistamine D. call medical control and ask how to proceed with the treatment

determine if she has been prescribed a beta-agonist inhaler.

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 A. an antihistamine B. albuterol C. a beta-antagonist D. epinephrine-[

epinephrine

All of the following are signs of inadequate breathing except A. accessory muscle use B. shallow respirations C. cyanotic skin signs D. equal breath sounds

equal breath sounds

Asthma is caused by a response of the: A. respiratory system B. cardiovascular system C.endocrine system D. immune system

immune system

In a healthy individual, the brain stem stimulates breathing on the basis of: A> decreased oxygen levels B. decreased carbon dioxide levels C. increased oxygen levels D. increased carbon dioxide levels

increased carbon dioxide levels.

The two processes that occur during respiration are: A. ventilation and diffusion B. inspiration and expiration C. diffusion and oxygenation D. oxygenation and ventilation

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: A. instruct him to hold his breath for as long as he comfortably can B. allow him to breathe room air and assess his oxygen saturation C. immediately reapply the oxygen mask and reassess his condition D. advise him to exhale forcefully to ensure medication absorption

instruct him to hold his breath for as long as he comfortably can.

you respond to a homeless shelter for a 48- year- old male who is unconscious in respiratory distress. on arrival, the shelter tells you that the man had been complaining of fever, trouble breathing, sweating at night, and a persistent cough for the past week. he also noticed that the man has lost a significant amount of weight in the past month. which of the following pieces of personal protective equipment is the most important to don before making contact with this patient? A.Gown B.Shoe covers C. Surgical Mask D. N-95 Respirator

n-95 respirator

In order for efficient pulmonary gas exchange to occur: A. there must be low quantities of pulmonary surfactant to allow for full alveolar expansion B. the percentage of inhaled carbon dioxide must exceed the percentage of inhaled oxygen C. oxygen and carbon dioxide must be able to freely diffuse across the alveolarr-capillary membrane D. the pulmonary capillaries must be completely constricted and the alveoli must be collapsed

oxygen and carbon dioxide must be able to freely diffuse across the alveolar-capillary membrane.

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: A. provide reassurance and give oxygen as needed B. have her breathe into a paper or plastic bag C. position her on her left side and transport at once D. request a paramedic to give her a sedative

provide reassurance and give oxygen as needed.

A 19 year old female with audible wheezes complains of shortness of breath. She states that a friend gave her someone else's Ventolin inhaler to help, but she hasn't used it yet. Vital signs are BP 120/64, P 110, R 24, Sp02 90%. What should you do? A. initiate transport immediately B. obtain a sample history C. provide supplemental oxygen D. assist her with the inhaler

provide supplemental oxygen

a blood clot in the pulmonary is referred to as a A. Pulmonary embolism B. pulmonary edema C. pulmonary aneurysm D. pulmonary effusion

pulmonary embolism

When the level of arterial carbon dioxide rises above normal: A. respirations increase in rate and depth B. the brain stems inhibits respirations C. exhalation lasts longer than the inhalation D. respirations decrease in rate and depth

respirations increase in rate and depth.

Which of the following conditions would LEAST likely result in hypoxia? A. pulmonary edema B. severe anxiety C. narcotic overdose D. pleural effusion

severe anxiety

Dyspnea is MOST accurately defined as: A. a marked increase in the exhalation phase B. a complete cessation of respiratory effort C. shortness of breath or difficulty breathing D. labored breathing with reduced tidal volume

shortness of breath or difficulty breathing.

When assessing for fluid collection in the lungs during auscultation of lung sounds, you should: A. auscultate the posterior chest first and compare the apex of one lung to the base of the opposite lung B. start at the lower lung fields and determine at which level you start hearing clear breath sounds C. pay special attention to the exhalation phase because this is when you will likely hear rales or rhonci D. note the presence of a high-pitched whistling sound, which is an indicator of fluid in the lungs

start at the lower lung fields and determine at which level you start hearing clear breath sounds.

A choking patient presents with a severe upper airway obstruction. What type of lung sounds would you anticipate hearing? A. stridor B. wheezing C. snoring D. gurgling

stridor

Harsh, high-pitched inspiratory sounds are characteristic of: A. stridor B. wheezing C. rhonci D. rales

stridor

Common signs and symptoms of acute hyperventilation syndrome include: A. tachypnea and tingling in the extremities B. unilateral paralysis and slurred speech C. altered mental status and brady cardia D. anxiety, dizziness, and severe bradypnea

tachypnea and tingling in the extremities.

Acute pulmonary edema would MOST likely develop as the result of: A. severe hyperventilation B. Right-sided heart failure C. an upper airway infection D. Toxic chemical inhalation

toxic chemical inhalation.