EMS Exam 3 -- Ch 10 (Quizzes & Handouts)

At a flow rate of 6 L/min, a nasal cannula can deliver an approximate oxygen concentration of up to: a. 52%. b. 24%. c. 44%. d. 35%.

c. 44%.

Based on current guidelines, in which of the following situations should supplemental oxygen be administered? a. Any diabetic patient whose oxygen saturation is less than 98% b. Any elderly patient whose oxygen saturation is less than 95% c. Exposure to carbon monoxide and an oxygen saturation of 95% d. Signs of myocardial infarction and an oxygen saturation of 97%

c. Exposure to carbon monoxide and an oxygen saturation of 95%

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When a nasal cannula is used, the flow rate should be no more than _____ liters per minute. A. 1 to 6 B. 6 to 10 C. 10 to 12 D. 12 to 14

A. 1 to 6

Methods of artificial ventilation, in order of preference, are 1. one-person bag-valve mask. 2. mouth-to-mask. 3. flow-restricted, oxygen-powered ventilation device. 4. two-person bag-valve mask. A. 2, 4, 3, 1 B. 2, 4, 1, 3 C. 1, 4, 3, 2 D. 4, 3, 1, 2

A. 2, 4, 3, 1

Which of the following is true regarding suctioning a patient's airway? A. Never suction the airway for longer than 15 seconds. B. Suction only as you insert the catheter into the mouth. C. BSI precautions are not important if there is no visible blood. D. You may hyperventilate a patient before and after suctioning.

A. Never suction the airway for longer than 15 seconds.

An insufficiency in the supply of oxygen to the body's tissues is called A. hypoxia. B. hyperventilation. C. respiratory compromise. D. bronchoconstriction.

A. hypoxia.

When a patient who has a full set of dentures needs ventilations A. leave the dentures in place if they are secure and then ventilate. B. remove the dentures in all circumstances before ventilating. C. an endotracheal intubation must be performed. D. an ATV should be used.

A. leave the dentures in place if they are secure and then ventilate.

The most difficult part of delivering BVM artificial ventilations for a single rescuer is A. obtaining an adequate mask seal. B. squeezing the bag completely. C. maintaining an open airway. D. preventing the patient from vomiting.

A. obtaining an adequate mask seal.

Stimulation of the back of a patient's throat when suctioning may cause A. convulsions. B. a slowed heart rate. C. unequal pupils. D. cyanosis.

B. a slowed heart rate.

Signs of inadequate artificial ventilation of an adult patient include A. a heart rate that returns to normal. B. failure of the patient's skin color to improve. C. the patient's chest rising and falling with each ventilation. D. a ventilation rate of 10-12 per minute.

B. failure of the patient's skin color to improve.

The use of which of the following methods is contraindicated with children? A. mouth-to-mask B. flow-restricted, oxygen-powered ventilation device C. two-person bag-valve mask D. one-person bag-valve mask

B. flow-restricted, oxygen-powered ventilation device

Oropharyngeal airways can be used on unconscious patients, except those who A. are in cardiac arrest. B. have a gag reflex. C. are younger than 8 years. D. have a contagious respiratory disease.

B. have a gag reflex.

One advantage of a "tonsil tip" catheter over a "French" catheter is that it A. is flexible and can be inserted deeper into the pharynx. B. is more effective for particulate matter. C. can suction the nose. D. can be inserted well beyond the base of the tongue.

B. is more effective for particulate matter.

A 24-year-old female patient has fallen from the roof of her house and is unconscious. The best method of opening her airway is the _____ maneuver. A. head-tilt, chin-lift B. jaw-thrust C. head-tilt, neck-lift D. tongue-jaw lift

B. jaw-thrust

The nasopharyngeal airway is often utilized because it A. comes in more sizes than the oropharyngeal airway. B. often does not stimulate the patient's gag reflex. C. can be used even if clear (CSF) fluid is seen in the nose or ears. D. is made of rigid, clear plastic, which is less likely to cause bleeding.

B. often does not stimulate the patient's gag reflex.

When high-flow, high-concentration oxygen is attached to a bag-valve mask, the concentration of oxygen delivered to the patient is approximately A. 16 percent. B. 24 percent. C. 100 percent. D. 90 percent.

C. 100 percent.

Oxygen cylinder sizes vary, but all are considered "full" when pressure is equal to _____ psi. A. 1,000 B. 1,500 C. 2,000 D. 2,500

C. 2,000

A suction device, whether portable or mounted, must generate a vacuum of _____ mmHg. A. 100 B. 200 C. 300 D. 400

C. 300

Because the oropharyngeal airway is likely to stimulate the patient's gag reflex, the rescuer should A. use only nasal airways. B. use the next smaller size. C. be prepared to suction. D. not use one.

C. be prepared to suction.

Before suctioning, a patient who is artificially ventilated should be A. placed in a position of comfort. B. hypoventilated. C. hyperventilated. D. fully immobilized.

C. hyperventilated.

Administer oxygen to any patient who needs supplemental oxygen unless A. the patient is an infant. B. the patient has COPD. C. medical direction instructs otherwise. D. the patient has TB.

C. medical direction instructs otherwise.

The first step of emergency care in the patient with inadequate breathing is A. checking for the patient's pulse. B. manually stabilizing the cervical spine. C. opening and maintaining the patient's airway. D. looking for and controlling severe bleeding.

C. opening and maintaining the patient's airway.

A nasal cannula should be used to deliver oxygen to a patient who A. has a chronic lung disease. B. requires a high flow and high concentration of oxygen. C. will not tolerate a nonrebreather mask. D. uses a cannula with a home oxygen system.

C. will not tolerate a nonrebreather mask.

in class review

CH 10 REVIEW -Increased Cardiac output increases exhaled CO2 -CPAP patient gets worse, take off CPAP and bag them -max resp. rate for: adults 12-20 toddlers = max 40 Infants = max 60 -shallow respirations = reduced tidal volume -inhale = contracting = active = decreasing pressure inside thoracic cavity -exhale = relaxing = passive = increasing pressure inside thoracic cavity -decreased minute volume = shallow breathing -hypoxia = cyanosis *late sign* , tachycardia, sweating, increased HR -exchange gas = external respiration -surfactant = soapy material, lines airways & Alveoli = so tissues don't stick together GAS EXCHANGE REQUIRES SURFACTANT -NPA bevel goes towards septum -cheynne-stokes = deep long breaths, then no breathing -CPAP - forces alveoli open, forces air through the membrane -wheezing = constriction of bronchioles, tissue obstruction (mucus buildup) -O2 tank under 500psi needs to be refilled -nonrebreather = O2 delivered at 90% -hyperventilating patient decreases BP, slow down ventilations

To ease insertion, nasopharyngeal airways must be lubricated with A. lubricant with petroleum jelly. B. any petroleum-based lubricant, such as WD-40. C. any silicone-based lubricant. D. any water-soluble lubricant.

D. any water-soluble lubricant.

Inadequate breathing or inadequate blood circulation can cause A. kyphosis. B. hyperglycemia. C. lordosis. D. hypoxia.

D. hypoxia.

Signs of inadequate breathing include all of the following except A. retractions above the clavicles, between ribs, and below the rib cage. B. cyanosis of the lips, ear lobes, or nail beds. C. bradypnea. D. pink skin and respiratory rate between 10 and 24 per minute.

D. pink skin and respiratory rate between 10 and 24 per minute.

All of the following are important features of bag-valve-mask systems except a A. non-jam valve system. B. 15/22 mm respiratory fitting. C. nonrebreathing valve. D. pop-off valve.

D. pop-off valve.

The pressure of gas in a full cylinder of oxygen is approximately _______________ pounds per square inch (psi). a. 2,000 b. 3,000 c. 500 d. 1,000

a. 2,000

Which of the following statements regarding positive-pressure ventilation is correct? a. With positive-pressure ventilation, more volume is required to have the same effects as normal breathing. b. Unlike negative-pressure ventilation, positive-pressure ventilation does not affect the esophageal opening pressure. c. Positive-pressure ventilation allows blood to naturally be pulled back to the heart from the body. d. To prevent hypotension, the EMT should increase the rate and force of positive-pressure ventilation.

a. With positive-pressure ventilation, more volume is required to have the same effects as normal breathing.

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: a. allow recoil of the chest between compressions to draw air into the lungs. b. ventilate with a bag-valve mask that is not attached to oxygen. c. time your positive-pressure ventilations to occur during chest recoil. d. deliver positive-pressure ventilation at rate of only 5 or 6 breaths/min.

a. allow recoil of the chest between compressions to draw air into the lungs.

The leaf-shaped structure located superior to the larynx is called the: a. epiglottis. b. thyroid cartilage. c. vallecula. d. cricoid ring.

a. epiglottis.

The MOST significant complication associated with oropharyngeal suctioning is: a. hypoxia due to prolonged suction attempts. b. oral abrasions from vigorous suctioning. c. vomiting from stimulating the anterior airway. d. clogging of the catheter with thick secretions.

a. hypoxia due to prolonged suction attempts.

The hypoxic drive is influenced by: a. low blood oxygen levels. b. high blood carbon dioxide levels. c. high blood oxygen levels. d. low blood carbon dioxide levels.

a. low blood oxygen levels.

Which of the following statements regarding the one-person bag-valve mask technique is correct? a. The C-clamp method of holding the mask to the face is not effective when ventilating a patient with a bag-valve mask. b. Adequate tidal volume is often difficult to achieve when one EMT is operating the bag-valve mask. c. Bag-valve mask ventilations should be delivered every 2 seconds when the device is being operated by one person. d. The bag-valve mask delivers more tidal volume and a higher oxygen concentration than the mouth-to-mask technique.

b. Adequate tidal volume is often difficult to achieve when one EMT is operating the bag-valve mask.

A 23-year-old male experienced severe head trauma after his motorcycle collided with an oncoming truck. He is unconscious, has rapid and shallow breathing, and has copious bloody secretions in his mouth. How should you manage his airway? a. Suction his oropharynx with a rigid catheter until all secretions are removed. b. Alternate 15 seconds of oral suctioning with 2 minutes of assisted ventilation. c. Insert a nasopharyngeal airway and provide suction and assisted ventilations. d. Provide continuous ventilations with a bag-valve mask to minimize hypoxia.

b. Alternate 15 seconds of oral suctioning with 2 minutes of assisted ventilation.

Which of the following organs or tissues can survive the longest without oxygen? a. Liver b. Muscle c. Kidneys d. Heart

b. Muscle

Which of the following factors will cause a decreased minute volume in an adult? a. Respirations of 20 breaths/min b. Shallow breathing c. Increased tidal volume d. Slight decrease in respiratory rate

b. Shallow breathing

To select the proper size oropharyngeal airway, you should measure from the: a. corner of the mouth to the superior ear. b. center of the mouth to the posterior ear. c. corner of the mouth to the earlobe. d. angle of the jaw to the center of the mouth.

c. corner of the mouth to the earlobe.

Without adequate oxygen, the body's cells: a. begin to metabolize fat, resulting in the production and accumulation of ketoacids. b. cease metabolism altogether, resulting in carbon dioxide accumulation in the blood. c. incompletely convert glucose into energy, and lactic acid accumulates in the blood. d. rely solely on glucose, which is completely converted into adenosine triphosphate.

c. incompletely convert glucose into energy, and lactic acid accumulates in the blood.

Complications associated with using a manually triggered ventilation device include: a. reduced tidal volume delivery and hypoxia. b. inadequate oxygenation and tracheal injury. c. lung tissue injury and gastric distention. d. inadequate ventilation and hypercarbia.

c. lung tissue injury and gastric distention.

The diaphragm is innervated by the _______________ nerve, which allows it to contract. a. hypoglossal b. vestibulocochlear c. phrenic d. vagus

c. phrenic

While eating dinner, your partner suddenly grabs his throat and has a panicked look on his face. He has a weak cough, faint inspiratory stridor, and cyanosis around the lips. You should: a. deliver up to five back blows and reassess him. b. place him in a supine position and open his airway. c. stand behind him and administer abdominal thrusts. d. encourage him to cough as forcefully as he can.

c. stand behind him and administer abdominal thrusts.

With a good mask-to-face seal and an oxygen flow rate of 15 L/min, the nonrebreathing mask is capable of delivering up to _______________ % inspired oxygen. a. 70 b. 90 c. 100 d. 80

d. 80

Which of the following oxygen flowmeters is NOT affected by gravity and can be used in any position when attached to an oxygen cylinder? a. Ball-and-float flowmeter b. Pressure-compensated flowmeter c. Vertical-position flowmeter d. Bourdon-gauge flowmeter

d. Bourdon-gauge flowmeter

The primary waste product of aerobic metabolism is: a. lactic acid. b. adenosine triphosphate. c. pyruvic acid. d. carbon dioxide.

d. carbon dioxide.

Inhalation occurs when the: a. diaphragm and intercostal muscles relax and cause an increase in intrathoracic pressure. b. diaphragm ascends and the intercostal muscles contract, causing a decrease in intrathoracic pressure. c. diaphragm and intercostal muscles ascend and cause an increase in intrathoracic pressure. d. diaphragm and intercostal muscles contract and cause a decrease in intrathoracic pressure.

d. diaphragm and intercostal muscles contract and cause a decrease in intrathoracic pressure.

The process of exchanging oxygen and carbon dioxide between the alveoli and the blood of the capillaries is called: a. cellular metabolism. b. pulmonary ventilation. c. alveolar ventilation. d. external respiration.

d. external respiration.

In contrast to inhalation, exhalation: a. is an active process caused by decreased intrathoracic pressure. b. occurs when the diaphragm lowers and expels air from the lungs. c. requires muscular effort to effectively expel air from the lungs. d. is a passive process caused by increased intrathoracic pressure.

d. is a passive process caused by increased intrathoracic pressure.

As the single EMT managing an apneic patient's airway, the preferred initial method of providing ventilations is the: a. one-person bag-valve mask. b. manually triggered ventilation device. c. mouth-to-mouth technique. d. mouth-to-mask technique with a one-way valve.

d. mouth-to-mask technique with a one-way valve.

An unconscious patient found in a prone position must be placed in a supine position in case he or she: a. regains consciousness. b. begins to vomit. c. has increased tidal volume. d. requires CPR.

d. requires CPR.

Prior to applying a nonrebreathing mask to a patient, you must ensure that the: a. flow rate is set at 6 L/min. b. patient has reduced tidal volume. c. one-way valve is sealed. d. reservoir bag is fully inflated.

d. reservoir bag is fully inflated.

Central chemoreceptors located in the medulla provide feedback to increase the rate and depth of breathing when they sense: a. decreased levels of oxygen in the blood and an increase in the pH of the cerebrospinal fluid. b. slight decreases in carbon dioxide and an increase in the pH of the cerebrospinal fluid. c. increased levels of oxygen in the blood and a decrease in the pH of the cerebrospinal fluid. d. slight increases in carbon dioxide or a decrease in the pH of the cerebrospinal fluid.

d. slight increases in carbon dioxide or a decrease in the pH of the cerebrospinal fluid.

Proper technique for suctioning the oropharynx of an adult patient includes: a. continuously suctioning patients with copious oral secretions. b. suctioning for up to 1 minute if the patient is well oxygenated. c. removing large, solid objects with a tonsil-tip suction catheter. d. suctioning while withdrawing the catheter from the oropharynx.

d. suctioning while withdrawing the catheter from the oropharynx.