EMT Ch 13 - Respiratory Emergencies
When auscultating the lungs of a patient with respiratory distress, you hear adventitious sounds. This means that the patient has:
abnormal breath sounds.
A pleural effusion is MOST accurately defined as: a) a bacterial infection of the lung tissue. b) fluid accumulation outside the lung c) diffuse collapsing of the alveoli. d) a unilaterally collapsed lung.
fluid accumulation outside the lung
A pleural effusion is MOST accurately defined as:
fluid accumulation outside the lung.
In a healthy individual, the brain stem stimulates breathing on the basis of: a) increased oxygen levels. b) decreased carbon dioxide levels. c) decreased oxygen levels. d) increased carbon dioxide levels.
increased carbon dioxide levels.
bronchiolitis
inflammation of the bronchioles that usually occurs in children younger than 2 years of age
Albuterol is a generic name for:
Proventil.
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%. This patient's presentation is MOST consistent with:
A)acute pulmonary edema. B)right-sided heart failure. CORRECT C)acute pulmonary embolism. D)spontaneous pneumothorax.
Which of the following statements regarding anaphylaxis is correct?
Anaphylaxis is characterized by airway swelling and hypotension.
Which of the following statements regarding anaphylaxis is correct? a) Most anaphylactic reactions occur within 60 minutes after exposure. b) Patients with asthma are at lower risk of developing anaphylaxis. c) Anaphylaxis is characterized by airway swelling and hypotension. d) The signs of anaphylaxis are caused by widespread vasoconstriction.
Anaphylaxis is characterized by airway swelling and hypotension.
Dyspnea is MOST accurately defined as:
CORRECT A) shortness of breath or difficulty breathing. B) a complete cessation of respiratory effort. C) a marked increase in the exhalation phase. D) labored breathing with reduced tidal volume.
Hyperventilation could be associated with all of the following, EXCEPT:
CORRECT A)a narcotic overdose. B)a respiratory infection. C)an overdose of aspirin. D)high blood glucose levels.
PASTE
Progression Associated chest pain Sputum Talking tiredness Exercise tolerance
Albuterol is a generic name for: a) Alupent. b) Singulair. c) Proventil. d) Atrovent.
Proventil.
Which of the following statements regarding pulse oximetry is correct?
Pulse oximetry measures the percentage of hemoglobin that is saturated with oxygen, but does not measure the actual hemoglobin content of the blood.
Which of the following statements regarding pulse oximetry is correct? a) The pulse oximeter is a valuable assessment tool that measures the percentage of red blood cells that contain hemoglobin molecules. b) Pulse oximetry measures the percentage of hemoglobin that is saturated with oxygen, but does not measure the actual hemoglobin content of the blood. 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 poisoning 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 severe acute respiratory syndrome (SARS) is correct?
SARS is a viral infection that often begins with flulike symptoms.
Which of the following statements regarding severe acute respiratory syndrome (SARS) is correct? a) The onset of SARS is typically marked by acute, severe pneumonia. b) SARS is a viral infection that often begins with flulike symptoms. c) SARS is most commonly transmitted by direct contact with blood. d) Multiple bacteria have been identified as being the cause of SARS.
SARS is a viral infection that often begins with flulike symptoms.
Harsh, high-pitched inspiratory sounds are characteristic of:
Stridor
Which of the following statements regarding the hypoxic drive is MOST correct?
The hypoxic drive stimulates a person to breathe on the basis of low oxygen levels.
Which of the following statements regarding the hypoxic drive is MOST correct? a) Chronic carbon dioxide elimination often results in activation of the hypoxic drive. b) The hypoxic drive stimulates a person to breathe on the basis of low oxygen levels. c) 100% supplemental oxygen will always cause apnea in patients with a hypoxic drive. d) The hypoxic drive serves as the primary stimulus for breathing in healthy individuals.
The hypoxic drive stimulates a person to breathe on the basis of low oxygen levels.
adventitious breath sounds
abnormal breath sounds such as wheezes, ronchi, and rales
Hyperventilation could be associated with all of the following, EXCEPT:
a narcotic overdose.
Hyperventilation could be associated with all of the following, EXCEPT: a) a narcotic overdose. b) a respiratory infection. c) an overdose of aspirin. d) high blood glucose levels.
a narcotic overdose.
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%. This patient's presentation is MOST consistent with: a) acute pulmonary edema. b) right-sided heart failure. c) acute pulmonary embolism. d) spontaneous pneumothorax.
acute pulmonary embolism
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%. This patient's presentation is MOST consistent with:
acute pulmonary embolism.
asthma
acute spasm of the smaller air passages, called bronchioles, associated with excessive mucus production and with swelling of the mucous lining of the respiratory passages
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.
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) adequate air exchange. c) an obstructed airway. d) respiratory insufficiency.
adequate air exchange.
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 or her ventilations.
When administering supplemental oxygen to a hypoxemic patient with a chronic lung disease, you should: a) begin with a low oxygen flow rate, even if the patient is unresponsive, because high-flow oxygen may depress his or her breathing. b) recall that most patients with chronic lung diseases are stimulated to breathe by increased carbon dioxide levels. c) avoid positive-pressure ventilation because the majority of patients with chronic lung disease are at increased risk for lung trauma. d) adjust the flow rate accordingly until you see symptom improvement, but be prepared to assist his or 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?
alveoli
In what area of the lungs does respiration occur? a) bronchi b) alveoli c) capillaries d) trachea
alveoli
A 62-year-old man with a history of congestive heart failure presents with severe respiratory distress and an oxygen saturation of 82%. When you auscultate his lungs, you hear widespread rales. He is conscious and alert, is able to follow simple commands, and can only speak in two- to three-word sentences at a time. With all resources at your disposal, which of the following treatment plans will benifit the patient the MOST:
apply a continuous positive airway pressure (CPAP) device, monitor his blood pressure, and observe him for signs of improvement or deterioration.
A 62-year-old man with a history of congestive heart failure presents with severe respiratory distress and an oxygen saturation of 82%. When you auscultate his lungs, you hear widespread rales. He is conscious and alert, is able to follow simple commands, and can only speak in two- to three-word sentences at a time. You should:
apply a continuous positive airway pressure (CPAP) device, monitor his blood pressure, and observe him for signs of improvement or deterioration.
A 62-year-old man with a history of congestive heart failure presents with severe respiratory distress and an oxygen saturation of 82%. When you auscultate his lungs, you hear widespread rales. He is conscious and alert, is able to follow simple commands, and can only speak in two- to three-word sentences at a time. You should: a) force fluid from his alveoli by hyperventilating him with a bag-mask device at a rate of at least 20 breaths/min. b) place him in a supine position and assist his ventilations with a bag-mask device and high-flow oxygen. c) apply a continuous positive airway pressure (CPAP) device, monitor his blood pressure, and observe him for signs of improvement or deterioration. d) place him in a position of comfort, deliver oxygen via nasal cannula, and closely monitor his breathing.
apply a continuous positive airway pressure (CPAP) device, monitor his blood pressure, and observe him for signs of improvement or deterioration.
While auscultating an elderly woman's breath sounds, you hear low-pitched "rattling" sounds at the bases of both of her lungs. With which of the following conditions is this finding MOST consistent?
aspiration pneumonia
While auscultating an elderly woman's breath sounds, you hear low-pitched "rattling" sounds at the bases of both of her lungs. With which of the following conditions is this finding MOST consistent?
aspiration pneumonia
While auscultating an elderly woman's breath sounds, you hear low-pitched "rattling" sounds at the bases of both of her lungs. With which of the following conditions is this finding MOST consistent? a) aspiration pneumonia b) widespread atelectasis c) acute asthma attack d) early pulmonary edema
aspiration pneumonia
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) assist her ventilations with a bag-mask device. b) apply a pulse oximeter and obtain vital signs. c) administer oxygen via a nonrebreathing mask. d) obtain a complete list of all of her medications.
assist her ventilations with a bag-mask device.
Alkalosis is a condition that occurs when: a) dangerous acids accumulate in the bloodstream. b) the level of carbon dioxide in the blood increases. c) slow, shallow breathing eliminates too much carbon dioxide. d) blood acidity is reduced by excessive breathing.
blood acidity is reduced by excessive breathing.
Respiratory alkalosis is a condition that occurs when
blood acidity is reduced by excessive breathing.
acidosis
buildup of excess acid in the blood or body tissues that results form a primary illness
alkalosis
buildup of excess base in the body fluids
The respiratory distress that accompanies emphysema is caused by:
chronic stretching of the alveolar walls.
The respiratory distress that accompanies emphysema is caused by: a) repeated exposure to cigarette smoke. b) chronic stretching of the alveolar walls. c) acute fluid accumulation in the alveoli. d) massive constriction of the bronchioles.
chronic stretching of the alveolar walls.
atelectasis
collapse of the alveolar air spaces of the lungs
According to the chart on page 479 of the EMT-Basic textbook, paroxysmal nocturnal dyspnea (PND), rales, and dependent edema are clinical indicators of:
congestive heart failure.
Paroxysmal nocturnal dyspnea (PND), rales, and dependent edema are clinical indicators of:
congestive heart failure.
A young female is unconscious after intentionally ingesting a large amount of aspirin. You will MOST likely find her respirations:
deep and rapid.
A young female is unconscious after intentionally ingesting a large amount of aspirin. You will MOST likely find her respirations: a) slow and shallow. b) slow and deep. c) rapid and shallow. d) deep and rapid.
deep and rapid.
Weakening of the airway in patients with chronic bronchitis is the result of:
destruction of protective mechanisms that remove foreign particles.
Weakening of the airway in patients with chronic bronchitis is the result of: a) loss of the lubricating substance that facilitates alveolar expansion. b) destruction of protective mechanisms that remove foreign particles. c) airway irritation caused by a marked decrease in mucus production. d) acute constriction of the bronchioles caused by an external irritant.
destruction of protective mechanisms that remove foreign particles.
A conscious and alert 29-year-old female with a history of asthma complains of difficulty breathing that began after her morning jog. The temperature outside is 40°F (5°C). On exam, you hear bilateral expiratory wheezing. After providing 100% oxygen, you should:
determine if she has been prescribed a beta-agonist inhaler.
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 100% oxygen, you should: Question 6 options: a) place her in a recumbent position to facilitate breathing b) determine if she has been prescribed a beta-agonist inhaler. c) call medical control and ask how to proceed with treatment. d) contact medical control and administer an antihistamine.
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 lung fields. His blood pressure is 90/50 mm Hg and his heart rate is 110 beats/min. In addition to giving him 100% oxygen, the MOST important treatment for this patient is:
epinephrine.
A 30-year-old male presents with acute shortness of breath, widespread hives, facial swelling, and a red rash on his neck and chest. He denies any past medical history and takes no medications. During your assessment, you hear wheezing over all lung fields. His blood pressure is 90/50 mm Hg and his heart rate is 110 beats/min. According to the NM EMT-Basic Scope of Practice and in addition to giving him 100% oxygen, the MOST important medication for this patient is:
epinephrine.
At the onset of an acute asthma attack, patients commonly experience difficulty breathing and:
expiratory wheezing.
At the onset of an acute asthma attack, patients commonly experience difficulty breathing and: a) expiratory wheezing. b) rales and rhonchi. c) audible stridor. d) profound cyanosis.
expiratory wheezing.
anaphylaxis (anaphylactic shock)
extreme, life threatening, systematic allergic reaction that may include shock and respiratory failure
Asthma is caused by a response of the:
immune system
Asthma is caused by a response of the: a) respiratory system. b) endocrine system. c) immune system. d) cardiovascular system.
immune system.
In a healthy individual, the brain stem stimulates breathing on the basis of:
increased carbon dioxide levels.
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.
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 a nasopharyngeal airway and begin assisted ventilation. b) insert an oropharyngeal airway and perform oral suctioning. c) place her in the recovery position and monitor for vomiting. d) apply oxygen via a nonrebreathing mask and transport at once.
insert a nasopharyngeal airway and begin assisted ventilation.
The two processes that occur during respiration are:
inspiration and expiration.
The two processes that occur during respiration are: a) diffusion and oxygenation. b) oxygenation and ventilation. c) ventilation and diffusion. d) inspiration and expiration.
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.
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) immediately reapply the oxygen mask and reassess his condition. c) allow him to breathe room air and assess his oxygen saturation. d) advise him to exhale forcefully to ensure medication absorption.
instruct him to hold his breath for as long as he comfortably can.
bronchial breath sounds
normal breath sounds made by air moving through the bronchi
Dyspnea is MOST accurately defined as:
shortness of breath or difficulty breathing.
In order for efficient pulmonary gas exchange to occur:
oxygen and carbon dioxide must be able to freely diffuse across the alveolar-capillary membrane.
A 60-year-old male presents with acute respiratory distress. He is conscious and alert, has pink and dry skin, and has respirations of 24 breaths/min with adequate depth. Which of the following treatment modalities is MOST appropriate for this patient?
oxygen via nonrebreathing mask and a focused secondary assessment
A 60-year-old male presents with acute respiratory distress. He is conscious and alert, has pink and dry skin, and has respirations of 24 breaths/min with adequate depth. Which of the following treatment modalities is MOST appropriate for this patient? a) oxygen via nonrebreathing mask and a focused secondary assessment b) positive-pressure ventilations and immediate transport to the closest hospital c) assisted ventilation with a bag-mask device and a head-to-toe exam d) oxygen via a nasal cannula, vital signs, and prompt transport to the hospital
oxygen via nonrebreathing mask and a focused secondary assessment
A 22-year-old female patient is complaining of dyspnea and numbness and tingling in her hands and feet after an argument with her fiancé. Her respirations are 40 breaths/min. You should:
provide reassurance and give oxygen as needed.
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) request a paramedic to give her a sedative drug. b) provide reassurance and give oxygen as needed. c) position her on her left side and transport at once. d) have her breathe into a paper or plastic bag.
provide reassurance and give oxygen as needed.
When the level of arterial carbon dioxide rises above normal: a) exhalation lasts longer than inhalation. b) respirations increase in rate and depth. c) the brain stem inhibits respirations. d) respirations decrease in rate and depth.
respirations increase in rate and depth
When the level of arterial carbon dioxide rises above normal:
respirations increase in rate and depth.
Which of the following conditions would LEAST likely result in hypoxia (low oxygen levlel in the blood)?
severe anxiety
Which of the following conditions would LEAST likely result in hypoxia? a) pleural effusion b) severe anxiety c) prolonged seizures d) pulmonary edema
severe anxiety
Dyspnea is MOST accurately defined as: a) labored breathing with reduced tidal volume. b) a marked increase in the exhalation phase. c) shortness of breath or difficulty breathing. d) a complete cessation of respiratory effort.
shortness of breath or difficulty breathing.
A 59-year-old male with a history of emphysema complains of an acute worsening of his dyspnea and pleuritic chest pain following a forceful cough. Your assessment reveals that he has a barrel-shaped chest, unilaterally diminished breath sounds, and tachycardia. What is the MOST likely cause of this patient's condition?
spontaneous pneumothorax
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) spontaneous pneumothorax c) acute pulmonary embolism d) exacerbation of his COPD
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 start hearing clear breath sounds.
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) note the presence of a high-pitched whistling sound, which is an indicator of fluid in the lungs. d) pay special attention to the exhalation phase since this is when you will likely hear rales or rhonchi.
start at the lower lung fields and determine at which level you start hearing clear breath sounds.
Harsh, high-pitched inspiratory sounds are characteristic of:
stridor.
Harsh, high-pitched inspiratory sounds are characteristic of: a) rales. b) rhonchi. c) wheezing. d) stridor.
stridor.
allergen
substance that causes an allergic reaction
Common signs and symptoms of acute hyperventilation syndrome include
tachypnea and tingling in the extremities.
Common signs and symptoms of acute hyperventilation syndrome include:
tachypnea and tingling in the extremities.
Acute pulmonary edema would MOST likely develop as the result of:
toxic chemical inhalation.
Acute pulmonary edema would MOST likely develop as the result of: a) right-sided heart failure. b) severe hyperventilation. c) an upper airway infection. d) toxic chemical inhalation.
toxic chemical inhalation.
Of the following choices, the onset of acute pulmonary edema would MOST likely develop as the result of:
toxic chemical inhalation.