NREMT Airway, Respiration, and Ventilation
A 70-year-old male has difficulty breathing. When assessing him, which of the following should influence your decision to assist his ventilation with a BVM? A. An increase in his respiratory rate B. A decrease in his mental status C. An SpO2 below 90% on room air D. A history of COPD
A decrease in his mental status
Why can inhalation exposure to carbon monoxide be toxic? A. It is a respiratory irritant. B. It displaces oxygen from hemoglobin. C. It suppresses the Hering-Breuer reflex. D. It prevents oxygen from participating in ATP production.
It displaces oxygen from hemoglobin.
Bystanders tell you that an unresponsive 22-year-old male fell 10 feet off a ladder and landed head first. You hear irregular, gasping respirations and palpate a carotid pulse. You should first: A. apply a cervical collar. B. perform a jaw-thrust maneuver. C. insert a nasopharyngeal airway. D. assess his vital signs.
perform a jaw-thrust maneuver.
What is the impact on intrathoracic pressure when you squeeze the BVM while ventilating a patient? A. It decreases airway pressure and increases intrathoracic pressure. B. It increases airway and intrathoracic pressures. C. It increases airway pressure and decreases intrathoracic pressure. D. It decreases airway and intrathoracic pressures.
It increases airway and intrathoracic pressures.
How does positive pressure ventilation impact cardiac output? A. It decreases intrathoracic pressure which increases preload. B. It decreases myocardial oxygen demand. C. It increases systemic vascular resistance. D. It increases intrathoracic pressure which decreases preload.
It increases intrathoracic pressure which decreases preload.
Which of the following describes how albuterol helps a patient who is having an asthma attack? A. It decreases pulmonary capillary pressure. B. It increases airway pressure in the alveoli. C. It relaxes the smooth muscles of the bronchioles. D. It reduces inflammation in the bronchus.
It relaxes the smooth muscles of the bronchioles.
You are ventilating an unresponsive 47-year-old male who is in respiratory arrest. How should you determine that you are delivering adequate tidal volume? A. Look for slight chest rise. B. Assess his pulse oximetry. C. Auscultate for bronchial breath sounds. D. Fully deflate the BVM.
Look for slight chest rise.
Why shouldn't you apply CPAP to a patient who is in respiratory arrest? A. CPAP doesn't ventilate the patient. B. CPAP doesn't keep the airways open. C. CPAP doesn't reduce preload. D. CPAP doesn't push fluid out of the alveoli.
CPAP doesn't ventilate the patient.
The serum concentration of which of the following gases increases during respiratory failure? A. Carbon monoxide B. Carbon dioxide C. Oxygen D. Nitrogen
Carbon dioxide
A 23-year-old female was rescued from a house fire. She is coughing up black phlegm and complains of difficulty breathing. You should suspect she inhaled which of the following gases that is difficult for the body to compensate for and can be toxic? A. Argon B. Nitrogen C. Cyanide D. Carbon dioxide
Cyanide
Which of the following may be a direct impact of positive pressure ventilation on perfusion when ventilating an infant? A. Decreased cardiac output B. Increased systemic resistance C. Increased V/Q mismatch D. Decreased preload
Decreased preload
You are assessing a 43-year-old female who complains of difficulty breathing. How should you determine if her minute ventilation is adequate? A. Evaluate if her current minute ventilation is 30 percent more than her resting volume. B. Determine if her dead space has increased in proportion to her respiratory rate. C. Evaluate her SpO2 and her respiratory rate and depth. D. Evaluate her mental status and tidal volume.
Evaluate her mental status and tidal volume.
A 10-year-old female complains of difficulty breathing after mixing bleach with another cleaner. Her skin and clothing are dry. You smell a strong odor, and your eyes begin to water. What route of exposure should you suspect is causing her dyspnea? A. Absorption B. Injection C. Ingestion D. Inhalation
Inhalation
A 39-year-old male has had difficulty breathing for two hours. What determines if he is in respiratory distress instead of respiratory failure? A. If his pulse oximetry is above 90 percent on room air B. If his skin is pale, but his capillary refill is less the two seconds C. If his body can compensate for its oxygen demands D. If he can speak in full sentences
If his body can compensate for its oxygen demands
Patients who have chronic bronchitis may have which of the following? A. Increased sensitivity of lower airways to irritants, bronchospasm, edema B. Destruction of alveolar walls, distention of alveolar sacs, reduced area for gas exchange C. Acute infectious disease, lung inflammation, pus-filled alveoli D. Persistent productive cough, thickening of walls of bronchioles, excessive mucus production
Persistent productive cough, thickening of walls of bronchioles, excessive mucus production
You are preparing to ventilate an 11-month-old female with a BVM. Which of the following ensures that her airway is properly positioned? A. Padding behind her shoulders B. Inserting a nasopharyngeal airway C. Using cricoid pressure while ventilating her D. Placing her in the sniffing position
Placing her in the sniffing position
A 60-year-old female is resting alongside the roadway during a marathon. She tells you that while she was running, she became short of breath, so she sat down. She has been resting for 10 minutes, and she is still short of breath. You should first: A. assess her pulse rate. B. move her to the aid station. C. assess her blood pressure. D. administer oxygen.
administer oxygen.
A 39-year-old female is lying in bed. When you assess her, which of the following findings indicate an inadequate airway? A. She has chest wall expansion with little abdominal wall movement. B. She has an open pill bottle next to her bed. C. She is lying on her side. D. She is unresponsive and snoring.
She is unresponsive and snoring.
Which process allows gas exchange between the alveoli and capillaries? A. Oncotic pressure B. Osmosis C. Simple diffusion D. Active transport
Simple diffusion
Why would a 46-year-old male who inhaled steam from a malfunctioning boiler have stridor in his upper airway and wheezes in his lower airway? A. Steam can burn the upper airway causing edema and irritate the lower airway causing bronchoconstriction. B. Steam can irritate the upper airway causing bronchoconstriction and burn the lower airway causing edema. C. Steam can burn both upper and lower airways causing edema. D. Steam can irritate both upper and lower airways causing bronchoconstriction.
Steam can burn both upper and lower airways causing edema.
Why do you hear rales when you auscultate the lungs of a patient who has pulmonary edema? A. Mucus plugs and inflammation decrease the diameter of the bronchioles, causing turbulence. B. Inflammation and pus cause turbulence as air fills the alveoli. C. The terminal airways pop open with each inspiration. D. Air trapped by bronchoconstriction is escaping the alveoli.
The terminal airways pop open with each inspiration.
Why are chronic smokers predisposed to spontaneous pneumothorax? A. They are more prone to having blebs within the lung parenchyma. B. Their visceral pleura is stretched more within their chest cavity. C. Their parietal pleura is innervated by more intercostal nerves. D. They are more prone to direct trauma to the pleura because of reduced adipose tissue.
They are more prone to having blebs within the lung parenchyma.
Why should you assist the ventilation of a patient who is in respiratory failure? A. To improve alveolar ventilation B. To reduce intrathoracic pressure C. To reduce oncotic pressure D. To improve cardiac output
To improve alveolar ventilation
A 49-year-old male complains of a sore throat and has a muffled voice. He tells you the sore throat started a week ago and has gotten worse. He looks sick, and his skin is hot to the touch. He has a history of asthma. You auscultate a slight high-pitched sound occasionally in his upper airway. His vital signs are P 102, R 16, BP 132/84, and SpO2 is 93% on room air. You should: A. inspect his airway. B. assist with the administration of his MDI. C. place him supine. D. administer oxygen.
administer oxygen.
A 66-year-old male complains of difficulty breathing. He tells you that his asthma attack began 20 minutes ago, and his inhaler isn't helping. You auscultate wheezes in all lung fields and good chest rise with accessory muscle use. His vital signs are P 96, R 24, BP 146/88, and SpO2 is 93% on room air. You should suspect his minute ventilation is: A. adequate and administer CPAP. B. adequate and administer oxygen. C. inadequate and assist his ventilation. D. inadequate and administer oxygen.
adequate and administer oxygen.
An 11-year-old male who has a history of cystic fibrosis complains of difficulty breathing. He tells you he has been coughing up thick mucus. His vital signs are P 92, R 24, BP 118/76, and SpO2 is 91% on room air. You should: A. administer a bronchodilator. B. apply CPAP. C. administer humidified oxygen. D. assist his ventilation.
administer humidified oxygen.
A 7-year-old male who has had a cold for a week tells you that he can't breathe. He has had a nonproductive cough for a day, and he is lying on his right side in the fetal position. His skin feels hot to the touch. He has a history of asthma, and you auscultate rhonchi in his right chest. His vital signs are P 118, R 24, BP 82/64, and SpO2 is 91% on room air. You should: A. administer oxygen. B. assist his ventilation. C. assist with the administration of his MDI. D. place him in Fowler's position.
administer oxygen.
An unresponsive 7-month-old female is lying limp in her father's arms. He tells you that she was having an asthma attack but is better now. Her conjunctivae are pale and moist. You are only able to auscultate faint wheezes in her upper chest. Her vital signs are P 76 and R 18. You should first: A. administer oxygen by non-rebreather mask. B. assist her ventilation with a BVM. C. assess her oxygen saturation level. D. assist with the administration of her nebulized albuterol.
assist her ventilation with a BVM.
A confused 60-year-old female is having an asthma attack. She is unable to sit upright and keeps leaning to the side. Her chest is silent on auscultation. She is tachypneic and tachycardic. You should: A. assist her ventilation. B. administer her albuterol inhaler. C. administer oxygen by non-rebreather mask. D. assess her vital signs.
assist her ventilation.
An unresponsive 55-year-old female who has a history of amyotrophic lateral sclerosis is lying in bed. Her husband tells you she has progressively been having more difficulty breathing and now he cannot wake her. She is tachypneic with shallow respirations. You should first: A. administer oxygen by non-rebreather mask. B. determine her SpO2. C. assist her ventilation. D. assess her vital signs.
assist her ventilation.
A 9-year-old male has partial-thickness burns around his mouth after inhaling steam. He has a history of asthma and has had a cold for three days. His mother tells you he has had chest congestion and she was trying to break up the phlegm. He is drooling and tells you he cannot swallow. You should first: A. administer his metered-dose inhaler. B. insert an oropharyngeal airway. C. begin transport. D. assess his vital signs.
begin transport.
An 88-year-old male tells you he is having trouble breathing. He tells you he has a cold that is getting worse. He has a chronic productive cough and a 60 pack-year smoking history. You auscultate rhonchi at the bases of his lungs. His vital signs are P 96, R 20, BP 162/98, and SpO2 is 91% on room air. You should suspect: A. cystic fibrosis. B. tuberculosis. C. asthma. D. chronic bronchitis.
chronic bronchitis.
You are assisting the ventilation of a 57-year-old female who is in respiratory failure. Her initial vital signs were P 102, R32, BP 142/84, and SpO2 was 88% on room air. After five minutes of assisted ventilation, her vital signs are P 96, R 18 assisted with slight chest rise, BP 108/80, and SpO2 is 95% on oxygen 15 L/minute by BVM. You should: A. decrease your ventilation rate. B. decrease the tidal volume of your ventilation. C. increase the tidal volume of your ventilation. D. increase the oxygen flow rate.
decrease your ventilation rate.
A 63-year-old male complains of shortness of breath. His skin is cyanotic, and you auscultate wheezes in all lung fields. His vital signs are P 72, R 26, BP 142/88, and SpO2 is 92% on room air. You should suspect: A. increased cell membrane permeability. B. decreased alveolar ventilation. C. increased capillary shunting. D. decreased cardiac output.
decreased alveolar ventilation.
An afebrile 78-year-old male tells you he woke up unable to catch his breath. He is sitting on the edge of his bed with his legs dependent. You auscultate bilateral wheezes. His vital signs are P 96, R 22, BP 158/80, and SpO2 is 92% on room air. You should suspect: A. emphysema. B. pleural effusion. C. pneumonia. D. congestive heart failure.
emphysema.
A 32-year-old male complains of difficulty breathing. He admits to smoking crack cocaine an hour before the problem started. You hear inspiratory stridor and observe drooling. His vital signs are P 108, R 18, BP 142/88, and SpO2 is 95% on room air. You should suspect: A. epiglottitis. B. agitated delirium. C. cocaine overdose. D. laryngotracheobronchitis.
epiglottitis.
A 34-year-old female complains of difficulty swallowing. Her voice is muffled as she tells you that she has had a cold for a week. She is sitting leaning forward, and you hear audible stridor. You should suspect: A. croup. B. epiglottitis. C. influenza. D. pneumonia.
epiglottitis.
Coworkers call 9-1-1 for a 22-year-old male who was having an asthma attack. The patient tells you that he took his albuterol inhaler prior to your arrival and feels better. You auscultate clear lung sounds. His vital signs are P 92, R 18, BP 130/82, and SpO2 is 93% on room air. You should administer: A. oxygen by non-rebreather mask. B. albuterol by his inhaler. C. oxygen by nasal cannula. D. albuterol by nebulizer.
oxygen by nasal cannula.
A 52-year-old male complains of difficulty breathing. He tells you he has a history of asthma. He used his albuterol inhaler twice without relief. You auscultate wheezes in all fields. His vital signs are P 72, R 20, BP 142/78, and SpO2 is 90 % on room air. You should administer oxygen and: A. have him use his inhaler. B.place him supine. C. assist his ventilation. D. transport.
have him use his inhaler.
A 29-year-old female complains of difficulty breathing and numbness in her lips. She tells you that she has a lot of stress and cannot take it anymore. Her vital signs are P 104, R 28 and deep, BP 118/88, and SpO2 100% on room air. You should suspect: A. metabolic alkalosis. B. thyroid storm. C. decreased systemic vascular resistance. D. increased alveolar ventilation.
increased alveolar ventilation.
A 76-year-old male complains of a severe headache that feels like a band around his head. He tells you he has been cooking with his grill in the garage because it is raining. His vital signs are P 88, R 14, BP 142/68, and SpO2 is 99% on room air. You should administer: A. ibuprofen. B. oxygen by nasal cannula. C. oxygen by non-rebreather mask. D. aspirin.
oxygen by non-rebreather mask.
A 16-year-old female complains of a runny nose and a low-grade fever. She has a burst of rapid coughing with an inspiratory whooping sound. While she is coughing her skin becomes cyanotic. After she stops coughing her skin color returns to normal. You should suspect: A. tuberculosis. B. pertussis. C. pneumonia. D. rubella.
pertussis.
A 47-year-old male complains of a sore throat and drooling. He tells you that it is too painful to swallow. He has a history of cancer and is receiving chemotherapy. You auscultate stridor in his upper airway. When transporting him to the hospital, you should: A. place him in his position of comfort. B. suction his airway. C. insert a nasopharyngeal airway. D. visualize his upper airway.
place him in his position of comfort.
A febrile 37-year-old female who has a history of HIV complains of difficulty breathing. She tells you she has been coughing up yellow phlegm for two days. Her skin is pale and sweaty. You auscultate crackles in her right lower lung. You should suspect: A. tuberculosis. B. neoplasm. C. influenza. D. pneumonia.
pneumonia.
A febrile 69-year-old male complains of body aches and decreased appetite. He tells you he has had the flu for a week. His skin is cyanotic and diaphoretic. You auscultate rhonchi and decreased lung sounds over his left lower lung. His vital signs are P 102, R 26, BP 116/90, and SpO2 is 91% on room air. You should suspect: A. septic shock. B. pneumonia. C. influenza. D. pleurisy.
pneumonia.
A 59-year-old female complains of difficulty breathing. She is hiking at high altitude and tells you that she has no past medical problems. When you auscultate her lungs, you hear rales in her lower lungs. Her vital signs are P 78, R 18, BP 138/76, and SpO2 is 94% on room air. You should suspect: A. pleurisy. B. neoplasm. C. pulmonary edema. D. aspiration pneumonitis.
pulmonary edema.
An unresponsive 22-year-old male is lying on the ground outside a bar. You do not see any chest rise but palpate a carotid pulse. You should suspect: A. respiratory arrest. B. alcohol intoxication. C. hypoglycemia. D. head injury.
respiratory arrest.
A 55-year-old female is in respiratory arrest. When ventilating her, you should squeeze the bag once every: A. five seconds, enough to cause her chest to rise two inches. B. twelve seconds, enough to cause barely visible chest rise. C. six seconds, enough to cause barely visible chest rise. D. ten seconds, enough to cause her chest to rise two inches.
six seconds, enough to cause barely visible chest rise.
A 34-year-old female was rescued from a house fire. She complains of difficulty breathing. You do not observe any burns to her face or singed hair, but she is coughing up black tinged phlegm. You should suspect: A. smoke inhalation. B. lower airway burns. C. a low SpO2 reading. D. upper airway burns.
smoke inhalation.
A 49-year-old male complains of sudden onset of shortness of breath. He has a 66 pack-year smoking history. He tells you he was sitting in a chair resting when it began. His skin is diaphoretic, and you auscultate diminished breath sounds in his right upper chest. His vital signs are P 96, R 24, BP 148/94, and SpO2 is 93% on room air. You should suspect: A. spontaneous pneumothorax. B. pertussis. C. lung cancer. D. COPD.
spontaneous pneumothorax.
An unresponsive 30-year-old female was the unrestrained driver involved in a car crash. Your partner stabilizes her head and tells you she is breathing and has a carotid pulse. As you examine her airway, you see blood, broken teeth, and hear gurgling sounds. You should first: A. insert an oropharyngeal airway. B. apply a cervical collar. C. suction her airway. D. assist her ventilation.
suction her airway.
An 86-year-old female who has a history of emphysema complains of chest pain. Her initial SpO2 was 92% on home oxygen by nasal cannula, 3 L/minute. You administered oxygen by non-rebreather, 12 L/minute. Her SpO2 is now 100%, and her chest pain is resolved after aspirin and nitroglycerin administration. You should next: A. decrease the flow rate to 6 L/minute. B. switch to a simple face mask. C. discontinue oxygen administration. D. transport her.
switch to a simple face mask.
A febrile 52-year-old female complains of coughing up blood. She tells you that she has had recent unexplained weight loss. You auscultate rhonchi over the right upper lung. Her vital signs are P 86, R 16, BP 138/84, and SpO2 is 95% on room air. You should suspect: A. congestive heart failure. B. emphysema. C. chronic bronchitis. D. tuberculosis.
tuberculosis.
A febrile 72-year-old male who lives in an assisted care facility has hemoptysis. He tells you that he has had night sweats and recent weight loss. You should suspect: A. bronchiolitis. B. rhinovirus. C. tuberculosis. D. emphysema.
tuberculosis.
An unresponsive 94-year-old female was found by her husband in bed. He tells you that she has a history of diabetes. You do not observe chest rise or air movement, but she has a pulse. You should first: A. ventilate her with a BVM. B. assess her blood glucose level. C. assess her vital signs. D. administer oxygen by non-rebreather mask.
ventilate her with a BVM.
Which of the following respiratory conditions in children over 2 years old has similar lung sounds to an infant who has bronchiolitis? A. Pulmonary edema B. Asthma C. Pertussis D. Pneumonia
Asthma
Which of the following patients should you suspect needs administration of supplemental oxygen? A. A 91-year-old female who complains of chest pain; her vital signs are P 72, R 16, BP 142/86, and SpO2 is 96% on room air B. A 63-year-old male who had a left-sided stroke; his vital signs are P 68, R 14, BP 172/104, and SpO2 is 95% on room air C. A 43-year-old female who fractured her left arm; her vital signs are P 100, R 18, BP 130/86, and SpO2 is 97% on room air D. A 27-year-old male who complains of difficulty breathing; his vital signs are P 92, R 20, BP 126/74, and SpO2 is 94% on room air
A 27-year-old male who complains of difficulty breathing; his vital signs are P 92, R 20, BP 126/74, and SpO2 is 94% on room air
A 64-year-old male is having an asthma attack. Which class of medication can help improve his alveolar ventilation? A. Beta2 antagonist B. Beta1 antagonist C. Beta2 agonist D. Beta1 agonist
Beta2 agonist
How is most of the oxygen transported from the lungs to the cells in a normoxic patient? A. Attached to platelets B. Dissolved in plasma C. Attached to monocytes D. Bound to hemoglobin
Bound to hemoglobin
What causes the prolonged expiratory phase of the respiratory cycle in a patient who is having an asthma attack? A. Bronchiole constriction B. Pulmonary venous hypertension C. Thick, sticky mucus production D. Ruptured blebs
Bronchiole constriction
Which of the following prevents the over-inflation of the lungs during normal respiration? A. Cushing reflex B. Baroreceptor reflex C. Stretch receptors D. Chemoreceptors
Stretch receptors
An unresponsive 45-year-old male was found lying on the ground outside. You do not see any obvious signs of trauma. He has snoring respirations and a carotid pulse. After opening his airway, you should next: A. suction his airway. B. administer oxygen by non-rebreather mask. C. insert an oropharyngeal airway. D. assist his ventilation.
insert an oropharyngeal airway.
You are assisting the ventilation of a 17-year-old male who had a severe asthma attack. When your partner reassesses the patient's vital signs, there is a significant reduction in his blood pressure. Which of the following is the likely cause? A. Increased intrathoracic pressure B. Increased preload C. Decreased hypoxia D. Decreased V/Q mismatch
Increased intrathoracic pressure
Which of the following are characteristics of asthma? A. Increased sensitivity of lower airways to irritants, bronchospasm, edema B. Acute infectious disease, lung inflammation, pus-filled alveoli C. Persistent productive cough, thickening of walls of bronchioles, excessive mucus production D. Destruction of alveolar walls, distention of alveolar sacs, reduced area for gas exchange
Increased sensitivity of lower airways to irritants, bronchospasm, edema
Why can pulmonary embolisms cause a V/Q mismatch? A. They block bronchial airflow. B. They block bronchiole airflow. C. They block pulmonary venous blood flow. D. They block pulmonary arterial blood flow.
They block pulmonary arterial blood flow.
A 73-year-old female complains about night sweats and a recent unexplained weight loss. She denies any past medical problems, other than recently coughing up a little blood. Her vitals are P 92, R 18, BP 140/68, and SpO2 is 93% on room air. After donning the proper PPE, you should: A. administer oxygen by nasal cannula and place a surgical mask over her mouth and nose. B. administer oxygen by nasal cannula and place a respirator over her mouth and nose. C. administer oxygen by nasal cannula. D. place a non-rebreather mask without supplemental oxygen over her mouth and nose.
administer oxygen by nasal cannula and place a surgical mask over her mouth and nose.
A 67-year-old male tells you he has had an upper respiratory infection for two weeks. Today he started to have an episode of uncontrolled coughing. While he is speaking with you, he has a coughing burst of 15-20 episodes with an inspiratory whooping sound. His SpO2 while coughing is 92% on room air. After he stops coughing his vital signs are P 92, R 18, BP 142/90, and SpO2 is 94% on room air. After donning an N-95 mask, you should: A. administer oxygen by nasal cannula. B. place an N-95 respirator over his mouth and nose and administer supplemental oxygen. C. transport him to the hospital for further evaluation. D. administer oxygen by nasal cannula and place a surgical mask over his mouth and nose.
administer oxygen by nasal cannula and place a surgical mask over his mouth and nose.
An 18-year-old male complains of abdominal pain and diarrhea. He tells you he has a history of cystic fibrosis. You auscultate rhonchi in his lower lungs. His vital signs are P 88, R 22, BP 126/78, and SpO2 is 93% on room air. You should: A. administer oxygen by non-rebreather mask. B. assist with the administration of an OTC antidiarrheal. C. assist with the administration of an OTC antiemetic. D. administer oxygen by nasal cannula.
administer oxygen by nasal cannula.
An unresponsive 6-year-old male is taking shallow, irregular respirations once every 15 seconds. He has a weak carotid pulse. His mother tells you that he was playing alone in his room and was fine 30 minutes ago. You should suspect: A. respiratory arrest. B. respiratory failure. C. Biot's respirations. D. Kussmaul's respirations.
respiratory arrest.
A 13-year-old male tells you that he has had a cough for two weeks. He has an episode of coughing, and you hear an inspiratory whoop after each cough. You auscultate rhonchi in his left lower lung. His vital signs are P 100, R 22, BP 118/76, and SpO2 is 93% on room air. You should: A. assist his ventilation. B. assist with the administration of his beta1 antagonist. C. assist with the administration of his beta2 agonist. D. administer oxygen by nasal cannula.
administer oxygen by nasal cannula.
A 93-year-old female complains of a sudden onset of difficulty breathing. She tells you that she has a history of breast cancer. She tells you it is easier for her to breathe when she is sitting up. She has decreased lung sounds when you auscultate her left mid-axillary line, sixth intercostal space. Her vital signs are P 86, R 18, BP 144/92, and SpO2 is 95% on room air. You should: A. administer oxygen by nasal cannula. B. administer oxygen by non-rebreather mask. C. administer aspirin. D. assist with the administration of her nitroglycerin.
administer oxygen by nasal cannula.
A 39-year-old male starts to have difficulty breathing while hiking at 9000 feet above sea level. He is coughing, and you observe pink, frothy sputum. His skin is pale and moist. You auscultate rales in all fields. His vital signs are P 96, R 22, BP 118/68, and SpO2 is 89% on room air. You should: A. administer nitroglycerin and wait for aeromedical evacuation. B. administer oxygen by non-rebreather mask while moving him to a lower elevation. C. administer oxygen by nasal cannula and wait for aeromedical evacuation. D. administer nitroglycerin while moving him to a lower elevation.
administer oxygen by non-rebreather mask while moving him to a lower elevation.
A 25-year-old female complains of difficulty breathing. She tells you she took her inhaler without relief. Her mucous membranes are pale. You auscultate decreased lung sounds in the bases and wheezes in her upper lungs. Her vital signs are P 86, R 24, BP 130/72, and SpO2 is 89% on room air. You should: A. withhold further use of her inhaler. B. administer oxygen by non-rebreather mask. C. administer oxygen by nasal cannula. D. assist her ventilation.
administer oxygen by non-rebreather mask.
A 67-year-old female has a history of emphysema. She tells you that she suddenly started to have sharp right shoulder pain and increased difficulty breathing after placing items on a high shelf. Her skin is pale and diaphoretic. You auscultate slight wheezes in both bases and absent lung sound in the apex of her right lung. Her vital signs are P 88, R 22, BP 138/84, and SpO2 is 87% on home oxygen 3 L/minute by nasal cannula. You should: A. administer oxygen by non-rebreather mask. B. position her in the right lateral recumbent position. C. assist her ventilations with a BVM. D. apply CPAP.
administer oxygen by non-rebreather mask.
A 77-year-old female complains of difficulty breathing. She tells you she has had a productive cough for several years. You auscultate coarse rhonchi in the bases of her lungs. You observe her mucous membranes are cyanotic. Her vital signs are P 96, R 26 and labored, BP 148/92, and SpO2 is 88% on home oxygen 3 L/minute by nasal cannula. You should: A. assist her ventilation with a BVM. B. rapidly transport her to the hospital. C. increase the oxygen flow rate to 4 L/minute. D. administer oxygen by non-rebreather mask.
administer oxygen by non-rebreather mask.
A 19-year-old female complains of difficulty breathing. She tells you she has a history of cystic fibrosis. Her skin is pale and diaphoretic. You auscultate scattered rhonchi in all fields. Her vital signs are P 78, R 20, BP 118/72, and SpO2 is 92% on room air. You should: A. assist with the administration of her bronchodilator inhaler. B. administer oxygen. C. assist her ventilation. D. suction her airway.
administer oxygen.
A 20-year-old male is coughing after inhaling chlorine gas. He was moved outside to fresh air by coworkers. His only complaints are that his throat is burning, and it is hard to catch his breath because of the coughing. You should first: A. administer oxygen. B. collect a sample of his phlegm. C. decontaminate the affected area. D. allow him to drink water.
administer oxygen.
A 34-year-old female who is in her third trimester, complains of a sudden onset of feeling light-headed and short of breath. She tells you she has had pain in her left leg for two days. You observe it is swollen and tender to palpation. She tells you she has been on bed rest for the last month for a high-risk pregnancy. Her lungs are clear to auscultation. Her vital signs are P 96, R 20, BP 116/74, and SpO2 is 96% on room air. You should: A. place a compression wrap on her leg. B. administer oxygen. C. place a hot pack on her leg. D. elevate her legs.
administer oxygen.
A 47-year-old male complains of difficulty breathing, and he cannot stop coughing. His conjunctivae are pale and moist. He has a 40 pack-year smoking history. You should first: A. determine his past medical history. B. collect a sample of his phlegm. C. administer oxygen. D. assess his vital signs.
administer oxygen.
A 57-year-old male complains of difficulty breathing after a non-stop flight from Asia. He has a history of asthma. He tells you that he started to cough up bloody sputum after his flight landed. His skin is pale and diaphoretic. You auscultate rales on the left side of his chest. His vital signs are P 108, R 26, BP 112/60, and SpO2 is 90% on room air. You should: A. assist his ventilation. B. assist with the administration of his inhaler. C. administer oxygen. D. suction his airway.
administer oxygen.
A 6-month-old female does not respond to you when you stimulate her. Her father tells you that she stopped breathing and turned blue. You observe supraclavicular and sternal retractions at a rate of 38. You should first: A. assess her vital signs. B. assist her ventilation. C. administer oxygen by non-rebreather mask. D. assess her blood glucose level.
assist her ventilation.
A confused 57-year-old male has difficulty breathing. His wife tells you he has been coughing up rust-colored sputum and recently lost weight. His lung sounds are diminished in the bases, and you auscultate fine and coarse crackles over his left upper chest. His vital signs are P 86, R 24 and shallow, BP 136/72, and SpO2 is 88% on room air. You should: A. apply CPAP. B. administer oxygen by venturi mask. C. administer oxygen by non-rebreather mask. D. assist his ventilation.
assist his ventilation.
An unresponsive 46-year-old male has severe respiratory distress. His wife tells you he was resuscitated after drowning several hours ago but refused to go to the hospital. You auscultate rales and decreased lung sounds in all fields. You should: A. assist his ventilation. B. apply CPAP. C. assess his vital signs. D. administer oxygen by non-rebreather mask.
assist his ventilation.
An unresponsive 88-year-old male was found by nursing home staff having difficulty breathing. His skin is pale and febrile. You auscultate diminished lung sounds throughout his chest and faint rhonchi in his upper chest. His vital signs are P 104, R 26 and shallow, BP 112/86, and SpO2 is 89 % on room air. You should: A. apply CPAP. B. administer oxygen by venturi mask. C. assist his ventilation. D. administer oxygen by non-rebreather mask.
assist his ventilation.
A 65-year-old male who has a history of congestive heart failure is slumped in a chair not responding to you. His wife tells you that his difficulty breathing started an hour ago and has been getting worse. He is tachypneic, and you auscultate rales in all fields. You should first: A. apply CPAP. B. assess his vital signs. C. administer oxygen by non-rebreather mask. D. assist his ventilation.
assist his ventilation.
A 67-year-old female who has a history of emphysema has difficulty breathing. She is sitting leaning forward and exhaling with her lips pursed. You auscultate wheezes and rhonchi in all fields. Her vital signs are P 102, R 22, BP 134/86, and SpO2 is 95 % on home oxygen 3 L/minute by nasal cannula. You should: A. assist with the administration of her albuterol. B. administer oxygen by venturi mask. C. administer oxygen by non-rebreather mask. D. assist her ventilation.
assist with the administration of her albuterol.
A 5-year-old female who has a history of asthma complains of trouble breathing. She is exhaling through pursed lips, and you auscultate wheezes. Her vital signs are P 110, R 32, BP 106/68, and SpO2 is 89% on room air. After administering oxygen, you should next: A. reassess her vital signs. B. assist her ventilation with a BVM. C. assist with the administration of her metered dose inhaler. D. titrate oxygen administration to 94%.
assist with the administration of her metered dose inhaler.
An 83-year-old female complains of difficulty breathing. She tells you that it started after carrying in her groceries. You observe pursed lips breathing. She is tachypneic, and you auscultate diffuse wheezes. You should suspect: A. congestive heart failure. B. pleurisy. C. pneumonia. D. asthma.
asthma.
A 26-year-old male complains of difficulty breathing after playing basketball. His skin is pale and diaphoretic. You auscultate wheezes in all fields. His vital signs are P 98, R 22, BP 132/72, and SpO2 is 91% on room air. You should suspect: A. pleural effusion. B. tension pneumothorax. C. spontaneous pneumothorax. D. asthma.
asthma.
A 69-year-old male has severe difficulty breathing. He states, "Help, I...can't breathe!" He is sitting upright, and you see accessory muscle use. You auscultate wheezes in his upper chest, and no sounds in his lower chest. He denies a cough and indicates that this episode just started 30 minutes ago. You should suspect: A. chronic bronchitis. B. acute respiratory distress syndrome. C. congestive heart failure. D. asthma.
asthma.
An unresponsive 4-year-old female is apneic but has a carotid pulse of 52. You should first: A. administer oxygen. B. attach the AED. C. begin chest compressions. D. insert an oropharyngeal airway.
insert an oropharyngeal airway.
A 70-year-old male who has a history of emphysema complains of difficulty breathing. He has four-word dyspnea, and you auscultate a slight wheeze in his lower lung fields. His vital signs are P 102, R 22, and BP 152/88. His SpO2 is 92% on home oxygen 2 L/minute by nasal cannula attached to 100 feet of extension tubing. You should: A. administer oxygen by non-rebreather mask. B. administer oxygen by simple face mask. C. administer oxygen 8 L/minute by your nasal cannula. D. increase his home oxygen flow rate to 4 L/minute.
increase his home oxygen flow rate to 4 L/minute.
A 40-year-old female was exposed to fumes from a chemical at work when she opened a container that is now closed. She complains of difficulty breathing. After ensuring the scene is safe, you should: A. read the Material Safety Data Sheet. B. activate a Hazmat response. C. decontaminate her. D. flush her with water.
read the Material Safety Data Sheet.
An 86-year-old female has difficulty breathing. She tells you she has lung cancer and she is receiving chemotherapy. Her skin is pale, and you auscultate clear lung sounds. Her vital signs are P 68, R 18, BP 126/86, and SpO2 is 92% on room air. Based on your findings, you should suspect: A. reduction in the size of her tumor. B. respiratory failure. C. remission of her cancer. D. respiratory distress.
respiratory distress.
A 12-year-old male has difficulty breathing. He tells you he has had a cold all week. You auscultate rhonchi in his left lower chest. His vital signs are P 104, R 28, BP 104/74, and SpO2 is 89% on room air. You should suspect: A. respiratory failure. B. septic shock. C. respiratory distress. D. chronic asthma.
respiratory distress.
A 24-year-old male complains of difficulty breathing. He is sitting in a chair leaning forward. He tells you that he was exercising when it started. His lung sounds are clear but diminished in the bases bilaterally. His vital signs are P 92, R 22, BP 132/90, and SpO2 is 93% on room air. You should suspect: A. respiratory failure. B. tension pneumothorax. C. spontaneous pneumothorax. D. respiratory distress.
respiratory distress.
An 8-year-old female has had trouble breathing for two days. Her father called because she continues to have trouble breathing and he cannot wake her up. You do not hear any sounds when you auscultate her lower lungs and hear faint wheezes in her upper lungs. Her vital signs are P 60, R 26, BP 94/68, and SpO2 is 88% on room air. You should suspect: A. eupneic respirations. B. respiratory arrest. C. respiratory failure. D. respiratory distress.
respiratory failure.
A 59-year-old female was working on a boiler when it vented super-heated air into her face. You see partial thickness burns to her face, and she tells you her throat is swelling up. You auscultate stridor in her upper airway. You should immediately: A. transport her. B. assess her vital signs. C. apply a cold pack to her face. D. administer oxygen.
transport her.
