NREMT Practice Questions: Airway and Breathing

The normal respiratory rate for an infant is how many breaths per minute? A. 25-50 B. 12-20 C. 10-18 D. 15-30

A. 25-50

You approach the scene of a fire where firefighters have just pulled a man from the burning house. You notice he is coughing and is cyanotic as you walk up to treat him. Cyanosis of the skin is due to? A. A decrease in the level of arterial oxygen B. An increase in the amount of circulating oxygen C. An increase in the level of venous oxygen D. An increase in perfusion

A. A decrease in the level of arterial oxygen

You have been dispatched to a restaurant for a possible choking. Your patient is an 18-month-old male who was eating chicken nuggets when he began to cough and appeared to experience respiratory distress. Your patient has a weak cry and cough, and you can hear inspiratory stridor from your patient when you walk in the door. What should your immediate action be? A. Abdominal thrusts B. Finger sweep C. Back blows and chest thrusts D. Let the patient continue to cough

A. Abdominal thrusts Answer Explanation: Abdominal thrusts are indicated for this patient since he is older than 1. Patient's less than 1 years of age should receive chest thrusts and back blows. Even though your patient is coughing, it has become weak (ineffective) and you can hear inspiratory stridor. If you do not act quickly, this partial airway obstruction could become a full airway obstruction.

What should your first action be when treating a conscious 40-year-old male with rapid respirations? A. Apply 100% oxygen B. Insert an airway adjunct C. Assess the regularity and quality of breathing D. Two slow breaths via BVM

A. Apply 100% oxygen

You are called to a conscious 28-year-old female lying supine on her front yard. She is restless and in obvious respiratory distress. After ensuring a patent airway, your next course of action is? A. Assess respiratory quality, effort, and rate B. Assess skin color and temperature C. Take a blood pressure D. Compare her carotid and radial pulses

A. Assess respiratory quality, effort, and rate

The proper hand placement and motion for abdominal thrusts is? A. Both hands slightly above the navel with an upward thrusting motion B. Both hands below the navel with an upward thrust C. Both hands slightly above the navel with thrust straight back D. Both hands directly over the navel with an upward thrust

A. Both hands slightly above the navel with an upward thrusting motion

A lower airway obstruction occurs in what anatomical structure(s)? A. Bronchioles B. Trachea C. Hypopharynx D. Oropharynx

A. Bronchioles

You are called to the home of a 2-year-old male. His mother states that he's had between a 100 and 101 degree fever the last few days, and woke with a 'bark-like' cough. On arrival, you find the boy sitting upright with inspiratory stridor. His condition is most likely caused by? A. Croup B. Epiglottitis C. Pneumonia D. Bronchitis

A. Croup

When a person hyperventilates, their minute volume? A. Decreases, due to decreased air volume reaching the alveoli B. Decreases, due to decreased air volume reaching the trachea and bronchi C. Increases, due to increased air volume reaching the alveoli D. Increases, due to increased air volume reaching the trachea and bronchi

A. Decreases, due to decreased air volume reaching the alveoli

Which of the following mechanisms causes emphysema? A. Destruction of the alveoli B. Bronchiole disintegration C. Congenital heart problems D. Accidental drowning

A. Destruction of the alveoli

You respond to a patient presenting with difficulty breathing, prolonged expiration, and they appear to have a barrel chest. Based on these findings, which respiratory condition would you expect this patient to have? A. Emphysema B. Cystic Fibrosis C. Chronic Bronchitis D. Asthma

A. Emphysema Answer Explanation: Emphysema causes alveolar damage and leads to "air trapping," enlarged lungs, which can give a person chest a barrel shaped appearance.

During artificial ventilation, it is possible for the stomach to become filled with air, which is known as? A. Gastric Distention B. Gastritis C. Gastric Bypass D. Colitis

A. Gastric Distention

When suctioning your adult patient's airway, you must not suction for longer than 15 seconds due to? A. Hypoxemia B. Esophageal disturbance C. Aspiration D. Pushing the obstruction further down the trachea

A. Hypoxemia

You arrive to find a 40-year-old female complaining of palpitations and dizziness. Your assessment reveals SpO2 reading of 86%, BP 102/78, pulse 128/irregular, and respirations of 26 per minute. The patient tells you she has no past medical problems. What do you suspect is happening based on the information? A. Hypoxemia B. Anxiety Attack C. Pending respiratory arrest D. Pneumonia

A. Hypoxemia

What occurs inside the body during exhalation? A. Intrathoracic pressure increases B. Intrathoracic volume increases C. External intercostal muscles contract D. The diaphragm contracts

A. Intrathoracic pressure increases

The breathing pattern characterized by hyperpnea and tachypnea is known as? A. Kussmaul breathing B. Obstructed breathing C. Biot's respirations D. Cheyne-Stokes respirations

A. Kussmaul breathing

While assessing the airway of a pediatric patient, you need to determine the patency of the airway. Which of the following is helpful in determining if an airway is patent or not? A. Look for movement of the chest and abdomen B. Determine level of consciousness C. Examine the pulse oximetry reading D. Assess the respiratory rate

A. Look for movement of the chest and abdomen Answer Explanation: Watching for chest and/or abdomen movement is an effective way to determine whether or not the patient's airway is patent. A pulse oximetry reading only tells you the oxygen saturation of the hemoglobin and the respiratory rate only indicates the rate of breathing.

In a patient suffering from COPD, their respiratory drive is dependent on? A. Oxygen B. Hemoglobin saturation C. PH level D. Carbon dioxide

A. Oxygen

You are called to a traffic accident of a motorcycle vs. car. You see the motorcyclist on the road, wearing a helmet, unconscious. He is responsive to pain, supine, and making gurgling sounds. His helmet will obstruct the ability to suction his airway. After checking that the scene is safe, you should first? A. Remove the helmet while trying to stabilize c-spine as much as possible. Suction the airway. B. Leave the helmet on so you can stabilize c-spine, and rotate him so that he is in the recovery position. C. Quickly perform a rapid trauma assessment to search for potential life threats. D. Leave the helmet on so you can stabilize c-spine, and reposition his head to open his airway.

A. Remove the helmet while trying to stabilize c-spine as much as possible. Suction the airway. Answer Explanation: The helmet should be removed because the airway is a higher priority than c-spine stabilization. A trauma assessment should be done only after the patient's airway has been made patent.

You are called to the scene of a single car MVA with one unconscious 32-year-old male patient. He has been placed on a backboard, but has profuse bleeding inside his mouth. What would be the best way to help this patient? A. Roll him on his side while backboarded and suction his airway B. Keep him supine to avoid further injury, suction mouth and then his nose C. Keep him supine to avoid further injury, suction no more than 20 seconds D. Unstrap the patient for easier access, roll him and suction

A. Roll him on his side while backboarded and suction his airway

You arrive on scene of a bar fight to find a 24-year-old male with an open head wound. As your partner maintains manual stabilization of his head, you perform an initial assessment. He is unconscious, has ineffective breathing, and bloody secretions in his mouth. You should next? A. Suction his oropharynx B. Assist ventilations with a BVM device C. Insert an oropharyngeal airway D. Assess the rate and quality of his pulse

A. Suction his oropharynx

In what situation would it be best to remove a motorcycle helmet after an accident? A. The airway is inaccessible, but the patient's breathing is stable B. The helmet is snugly fit around the patient's head allowing little to no movement C. Proper spinal immobilization can be performed with the helmet on D. Removal would cause further pain, but would not compromise spinal integrity

A. The airway is inaccessible, but the patient's breathing is stable Answer Explanation: Although the patient's breathing is stable at that time, unknown injuries that could obstruct the airway may be present or imminent, such as a tension pneumothorax. For this reason the patient's airway must be accessible at all times under your care.

The normal respiratory rate for an adult is how many breaths per minute? A. 15-30 B. 12-20 C. 25-50 D. 10-18

B. 12-20

During your assessment, you find that your pulse oximeter reads 100% when your patient is on 4 liters per minute oxygen via nasal cannula. You suspect your patient's hemoglobin is fully saturated. How many oxygen molecules can one hemoglobin hold when it is considered fully saturated? A. 6 B. 4 C. 2 D. 3

B. 4

What is the estimated total lung capacity in a healthy adult male? A. 12,000 mL B. 6,000 mL C. 9,000 mL D. 3,000 mL

B. 6,000 mL

Fill in the gap in the following sentence: The more ___________, the less air that flows into the chest. A. Cardiac output B. Airway resistance C. Air flow D. Bronchodilation effort

B. Airway resistance

You are assigned airway while treating a 33-year-old male with your crew. The patient is breathing at 6 breaths/min. Which oxygen delivery device will you use? A. Non-rebreather B. Bag-valve-mask C. Oropharyngeal airway D. Nasal cannula

B. Bag-valve-mask

When opening the airway of a child with a head-tilt chin-lift maneuver, you must? A. Never perform a head-tilt chin-lift on a child B. Be sure not to hyperextend the neck, because this will collapse the trachea C. Be sure to extend the neck fully, because their tongues are proportionally bigger than those of adults D. Perform the maneuver as you would on an adult

B. Be sure not to hyperextend the neck, because this will collapse the trachea

You arrive on scene of a 24-year-old female who was involved in a head-on motor vehicle collision. While assessing your patient, you find contusions to the head, neck, and chest. You hear snoring respirations and palpate a weak and thready radial pulse. Your first course of action would be? A. Rapid extrication and transport B. C-spine immobilization and opening the airway with a modified jaw-thrust maneuver C. Endotracheal tube intubation D. Rapid trauma assessment

B. C-spine immobilization and opening the airway with a modified jaw-thrust maneuver

You arrive to a private residence and find a 34-year-old male in the tripod position, and you can hear stridorous respirations from the doorway. The patient is drooling and feels hot to the touch. What life-threatening condition do you suspect your patient has? A. COPD B. Epiglottitis C. Asthma D. ARDS

B. Epiglottitis Answer Explanation: Epiglottis is a life-threatening, upper respiratory illness. The epiglottis becomes inflamed and begins to obstruct airflow to the trachea. The fever, drooling, and respiratory distress are class presentation. Epiglottitis occurs in adults and children.

What is the proper way to open the airway of a patient with no suspected head or spine trauma? A. Modified jaw-thrust B. Head-tilt/chin-lift C. Head-tilt, jaw-thrust D. Head-tilt

B. Head-tilt/chin-lift

Which of the following is not a type of airway obstruction? A. Partial with poor air exchange B. Incomplete C. Complete D. Partial with good air exchange

B. Incomplete

Where should you position yourself in order to administer abdominal thrusts to a child? A. With both you and the patient on your knees B. Kneeling behind the patient C. In front of the patient D. Have the patient lay on the ground so you can give effective abdominal thrusts

B. Kneeling behind the patient

Labored breathing is indicative of respiratory distress. Signs of distress include? A. Audible chest breath sounds from both sides of the lungs B. Muscle retractions above the clavicle C. Movement of the abdomen D. Regular rise and fall of both sides of the chest

B. Muscle retractions above the clavicle Answer Explanation: When a patient is in respiratory distress, they will automatically recruit additional muscles to help with inspiration. Watch for recruitment of neck, abdomen, and rib muscles during inspiration as signs of respiratory distress.

Identify the correct order in which oxygen is carried through the respiratory system in order for respiration to occur. A. Pharynx-Trachea-Glottis-Bronchi-Lungs-Bronchioles-Alveoli B. Nasopharynx-Oropharynx-Larynx-Trachea-Bronchi-Lungs-Bronchioles-Alveoli C. Oropharynx-Glottis-Esophagus-Lungs-Bronchioles-Alveoli D. Nasopharynx-Glottis-Trachea-Bronchi-Bronchioles-Alveoli-Lungs

B. Nasopharynx-Oropharynx-Larynx-Trachea-Bronchi-Lungs-Bronchioles-Alveoli

Your patient is breathing at 12 breaths-per-minute with adequate tidal volume. During inspiration, pressure in the intrapulmonary space is? A. Greater than atmospheric pressure B. Negative compared to atmospheric pressure C. 500 mL D. Equal to atmospheric pressure

B. Negative compared to atmospheric pressure Answer Explanation: At sea level, atmospheric pressure is approximately 760 mmHg. During inspiration pressure in the intrapulmonary space is approximately 757 mmHg (negative compared to atmosphere) causing air to rush into the lungs.

You're called to a private residence for a 72-year-old male who has an altered mental status. Vital signs are BP: 102/58, HR: 104, RR: 6/min, SpO2: 88%. What should be your first intervention? A. Check the patient's temperature B. Place an appropriately sized NPA C. Place the patient in spinal precautions D. Ventilate the patient with a BVM

B. Place an appropriately sized NPA Answer Explanation: First things first. If you're going to ventilate the patient using a BVM you need to first place an appropriately sized OPA or NPA or both

A patient with a fever, cough, and inflammation of the lung due to bacterial or viral infection may have? A. Asthma B. Pneumonia C. Pneumothorax D. Emphysema

B. Pneumonia

You respond to a 54-year-old male with difficulty breathing and chest pain. The patient indicates that he broke both legs three weeks ago and has been confined to his bed since that time. Which of the following is most likely causing this patient's condition? A. Emphysema B. Pulmonary embolism C. Congestive heart failure D. Cardiac tamponade

B. Pulmonary embolism Answer Explanation: There is little information given in this question, so whatever you do, don't make stuff up that isn't there. All you know is that this patient is having chest pain, difficulty breathing, and has been confined to his bed for three weeks. When someone has little movement of the lower extremities, especially after a surgery, clots can form and then move to the lungs. If you answered differently, go look up each of the four conditions so that you can differentiate between them all.

You are providing ventilations by BVM to a 92-year-old male. You feel resistance when you attempt to deliver a breath and do not see adequate chest rise. How should you proceed? A. Remove the OPA B. Reposition the airway C. Have another rescuer hold cricoid pressure D. Remove the OPA and insert an NPA

B. Reposition the airway

While ventilating your unresponsive patient, you suddenly notice that the ventilations are becoming difficult to administer. What is the most appropriate action? A. Perform CPR B. Reposition the head and reattempt ventilation C. Perform a finger sweep to clear any obstruction, suction if needed D. Squeeze the bag harder

B. Reposition the head and reattempt ventilation

You have been requested by police for a medical evaluation and to remove Taser barbs from a detained suspect. The scene is safe and the patient is handcuffed, lying prone on the sidewalk. You note he is breathing irregularly and police indicate he was acting erratically before being detained. What should you do next? A. Medically release the patient because if they are calm and cooperative B. Roll the patient supine C. Remove the Taser barbs D. Leave the patient in a prone position, prepare for transport

B. Roll the patient supine

You are dispatched emergent to a fall injury. Upon arrival, your pt is a 16-year-old male who fell 15 feet off a roof. The pt has been unresponsive since the incident. He is cyanotic around the lips with gurgling respirations and a rate of 8/min. He has a weak radial pulse. After you instruct your partner to hold c-spine, you should? A. Expose the patient B. Suction C. Activate the trauma system D. Completely immobilize the patient

B. Suction

A semiconscious 23-year-old male has shallow, gurgling respirations at a rate of 10 breaths per minute. Initial management includes? A. Initiating positive pressure ventilations B. Suctioning the oropharynx C. Applying 100% oxygen via NRB D. Inserting an NPA

B. Suctioning the oropharynx

You arrive on scene to find a unconscious male patient supine on his living room floor. The patient is a known diabetic. At the time of assessment, he presents with snoring respirations. What is the most likely cause? A. Loose or broken teeth, since the patient possibly had an unwitnessed fall B. The patient's tongue, consider an airway adjunct C. Oral secretions, suction is indicated, consider intubation D. Food or foreign body, visualization of the airway is critical

B. The patient's tongue, consider an airway adjunct

Which of the following is not an anatomically correct difference between adult and pediatric patients? A. Pediatric structures are smaller and more easily obstructed B. The trachea is more flexible in adults C. The primary cause of cardiac arrest in children is uncorrected respiratory issues D. Infant's tongues take up proportionally greater space in the mouth than adults

B. The trachea is more flexible in adults

You arrive on scene of a 4-year-old male in respiratory distress. Initial evaluation of the patient reveals the following: cyanosis around the lips, audible gasping, and a weak brachial pulse. Vitals: BP 52/24, P 78, R 8. What is going to be your immediate intervention? A. Begin chest compressions at a ratio of 15:2 (compressions to breath ratio) B. Ventilate with a BVM @ 15 L/min, one breath every 3-5 seconds C. Nasal cannula @ 6 L/min D. NRB @ 15 L/min

B. Ventilate with a BVM @ 15 L/min, one breath every 3-5 seconds

You are called to a nursing home to assist a 92-year-old male patient with emphysema. When listening for abnormal breath sounds in this patient, you will most likely hear? A. Pleural friction rubbing B. Wheezing C. Crowing D. Stridor

B. Wheezing Answer Explanation: Emphysema is a disease characterized by decreased alveolar surface tension. It is a lower airway disorder and patients will most often exhibit wheezing during periods of breathing difficulty. Stridor and crowing describe a high pitched sound that is characteristic of an upper airway blockage. Pleural friction rubbing sounds like grating or squeaking and occurs when the pleural layers are inflamed. Pleural friction rubbing is often a sign of pneumonia.

In which of the following situations should the jaw-thrust maneuver be used? A. A pediatric patient needing constant suctioning B. When you are unclear of the mechanism of injury C. A geriatric patient who is in cardiac arrest D. An apneic homeless woman with no signs of trauma

B. When you are unclear of the mechanism of injury

What is the suggested flow rate for administration of an albuterol neb set? A. 10 - 12 liters per minute B. 2 - 4 liters per minute C. 6 - 8 liters per minute D. 12 - 15 liters per minute

C. 6 - 8 liters per minute

You have been dispatched to a home where a family member leads you to a 74-year-old man who is supine in bed. He is not responding to verbal or painful stimuli. His airway is patent and his respirations are rapid and shallow. Your initial action should be to? A. Obtain his blood pressure B. Apply a pulse oximeter C. Assist ventilations D. Transport immediately

C. Assist ventilations Answer Explanation: A patient that has a patent airway, but rapid and shallow respirations will need to have assisted ventilations to ensure adequate oxygenation and ventilation. You may recognize this as a priority patient and want to transport immediately, but interventions must be taken to prevent further deterioration of his condition.

You are called to a 60-year-old female in respiratory distress. When you arrive, she is only able to speak in 3-4 word sentences and is very anxious. Her pulse is 110, respirations 24 and labored, skin is pink, warm, and diaphoretic. Oxygen should be administered? A. At 2-6 L/min via nasal canula B. Oxygen should not be administered until the patient is asked if she has COPD C. At 12-15 L/min via Non-rebreather mask D. At 12-15 L/min via BVM

C. At 12-15 L/min via Non-rebreather mask

You're managing a patient whose breathing pattern gets progressively deeper and faster, followed by a gradual decrease until it stops for a short period. The pattern repeats itself throughout your transport. This pattern of breathing is known as? A. Kussmaul respirations B. Apnea C. Cheyne-Stokes respirations D. Tachypnea

C. Cheyne-Stokes respirations Answer Explanation: Apnea is the absence of breathing. Tachypnea is an abnormally rapid breathing rate, but does not slow down to a stop. Kussmaul respirations are deep, labored, continuous breaths. Cheyne-Stokes respirations present as deep, rapid breaths that slow down to a period of apnea, and then repeat again.

Your unit is dispatched to a 4-year-old child with a fever. The mother meets you at the door telling you that he was fine last night and when he woke up this morning, complained of a sore throat and trouble breathing. You assessment reveal the patient has a seal-like bark when he coughs. You suspect the patient to be suffering from? A. Epiglottitis B. Flu C. Croup D. Bronchiolitis

C. Croup

When placing an NPA, the correct landmarks you use to measure it are which of the following? A. Ear to ear B. Ear to mouth C. Ear to nose D. Ear to eye

C. Ear to nose

The leaf-shaped structure that is designed to prevent food and liquids from entering the trachea during swallowing is called? A. Uvula B. Pharynx C. Epiglottis D. Stoma

C. Epiglottis

Pediatric patients with respiratory complaints can deteriorate rapidly. It is important to understand the anatomy and physiology of the respiratory system so you can intervene quickly when needed. What is the main function of the respiratory system? A. Oxygenation of arterial blood B. Perfusion C. Gas exchange D. Ventilation

C. Gas exchange

You are called to a local park where a 19-year-old male is experiencing respiratory distress. When you arrive, he is sitting on a bench in the tripod position. He was playing soccer during the onset of his symptoms and has no history of respiratory problems or known allergies. His pulse is 100, respirations 30 and shallow with wheezing, and he is pale, cool, and dry. His vitals are steadily trending downwards. Your first priority is? A. Give 100% oxygen and administer an inhaler immediately B. Withhold oxygen temporarily to avoid carbonic driven respiration, and transport immediately C. Give 100% oxygen and transport immediately D. Give 100% oxygen and call medical direction for permission to administer an inhaler

C. Give 100% oxygen and transport immediately Answer Explanation: An inhaler cannot be administered, because the patient is not prescribed one (he had no history of asthma). Oxygen should never be withheld.

You find a 32-year-old male who is pale and diaphoretic, with snoring respirations. Your patient's vital signs read blood pressure 96/62, respirations 8 per minute, heart rate 58 beats per minute, pupils are constricted and non-reactive. Bystanders report that the patient was injecting something into his arm. Your initial intervention should be? A. Fully immobilizing the patient B. Administer Naloxone 0.4 mg IM C. Head tilt, chin lift D. Preparing to insert an advanced airway

C. Head tilt, chin lift Answer Explanation: Your first intervention should be to open the patient's airway and stop the snoring respirations. The other answers are important, but secondary to airway.

You arrive on scene and find an unconscious patient, with a pulse. You suspect that the patient's tongue is occluding the airway. After using the head-tilt-chin-lift technique, what would be your next course of action? A. Ventilate using a bag-valve-mask B. Apply a non-rebreather mask C. Insert an OPA D. Attempt rescue breaths

C. Insert an OPA

The main advantage of an NPA (nasopharyngeal adjunct) over an OPA (oropharyngeal adjunct) is that? A. It can be used on conscious patients as well as unconscious patients B. It does not compromise c-spine when it is inserted C. It is less likely to be rejected if the patient has a gag reflex D. It can be put in faster, because it does not need to be lubricated

C. It is less likely to be rejected if the patient has a gag reflex

After a patient has received successful thrusts during a choking emergency, the patient should? A. Call 911 back and tell them you no longer need assistance B. Avoid food for approximately an hour C. Make sure to still be seen by a healthcare professional D. Drink a large amount of water to make sure the windpipe is clear

C. Make sure to still be seen by a healthcare professional

You are called to a 3-year-old male with difficulty breathing. The patient's mom tells you that he was playing when he suddenly started wheezing. The child is very anxious and can not answer questions, but you note air movement during auscultation. What is your primary suspicion? A. Pneumonia B. Complete airway obstruction C. Partial airway obstruction D. Seizure

C. Partial airway obstruction

Diffusion is the process by which gases move between the alveoli and which of the following? A. Bronchi B. Pericardium C. Pulmonary capillaries D. Pulmonary branch

C. Pulmonary capillaries

You are en route to a private residence for an "unknown medical." Police have requested your assistance after performing a routine welfare check and finding a patient unconscious in the kitchen. Upon your arrival, the patient is rolling around on the ground, not responding appropriately. As you approach the patient, you can hear gurgling sounds upon inspiration. What should your immediate action be? A. Check the patient's blood glucose level B. Begin ventilation of the patient with a BVM attached to high-flow oxygen C. Reposition the patient's airway and suction as needed D. Insert an oropharyngeal airway

C. Reposition the patient's airway and suction as needed

You have been called to the playground and find a small girl sitting on the curb leaning forward with her arms outstretched to either side of her. Her jaw is open and her chin is thrust forward. Her position is indicative of? A. Exhaustion B. Hyperthermia C. Respiratory distress D. Trauma

C. Respiratory distress Answer Explanation: The girl is in the tripod position. A person in respiratory distress may present like this due to the position's ability to open their airway and help them breath.

A 19-year-old male fell from the second story balcony of his college residence. He is lying supine, unconscious, breathing is slow and irregular, and is missing several teeth that appear to be in his mouth. Your partner stabilizes the head and performs a jaw thrust. What should you do next? A. Apply oxygen via a nasal cannula B. Apply positive pressure ventilations C. Suction his mouth to remove the missing teeth D. Initiate CPR

C. Suction his mouth to remove the missing teeth

What is the primary cause of your respiratory rate increasing during exercise, as compared to your respiratory rate at rest? A. The pH is higher B. Involuntary response of the diaphragm C. The level of carbon dioxide in the blood is increased D. Decreased oxygen available to the cells

C. The level of carbon dioxide in the blood is increased

The formula used to calculate the minute respiratory volume is which of the following? A. Total lung capacity x breaths per minute B. Dead air space x breaths per minute C. Tidal volume x respiratory rate D. Inspiratory reserve volume x breaths per minute

C. Tidal volume x respiratory rate

What is the most common cause of airway obstruction in an unconscious patient? A. Teeth B. Misplaced OPA C. Tongue D. Vomit

C. Tongue Answer Explanation: The loss of muscle tone when unconscious can allow the tongue to fall back and partially obstruct a patient's airway. Although vomit could certainly be an obstruction, the tongue is a better answer because it applies to more patients.

You are called to the scene of a rock climbing accident. At the base of the cliff, you find a patient unresponsive and lying on her back. Bystanders tell you she fell on her head from about 35 feet. To assess the patient's airway you should? A. Tilt the patient's head and lift her chin B. Tilt the patient's head back C. Use both hands thrust the patient's jaw forward D. Using both hands thrust the patient's jaw forward and tilt her head back

C. Use both hands thrust the patient's jaw forward

Which of the following would hinder the delivery of high-quality CPR the most? A. When the victim is pregnant B. When the victim is obese C. When performed on a bed or a couch D. When you as a rescuer are by yourself

C. When performed on a bed or a couch

If a victim experiencing a choking emergency is pregnant or too large for you to reach your hands around their abdomen, does this change the care you're going to provide? A. Yes, reposition thrusts lower than normal. B. Yes, position yourself in front of the victim and give thrusts. C. Yes, reposition your hand placement to higher around the chest. D. No, nothing changes. Choking is treated the same.

C. Yes, reposition your hand placement to higher around the chest.

You have a patient with an SpO2 reading of 92% and you apply supplemental oxygen via nasal cannula. Protocol states that the flow rate should be set between 1-6 liters per minute. What is the oxygen concentration in this range? A. 100% B. 10 - 30% C. 35 - 60% D. 24 - 44%

D. 24 - 44% Answer Explanation: The concentration for a nasal cannula is 24-44%. A non-rebreather at 6-15 lpm is 60-90%. The concentration for a bag valve mask is 100%.

A patient breathing room air is considering hypoxemic if their SpO2 is less than? A. 95% B. 97% C. 96% D. 94%

D. 94% Answer Explanation: A SpO2 of less than 94% indicates that a patient is hypoxemic. Hypoxemia and hypoxia are often used interchangeably even though they are different concepts. Hypoxia is inadequate tissue oxygenation (oxygen demand is greater than oxygen delivery in the tissues). Hypoxemia is low oxygen saturation in arterial blood and is a sign of poor oxygenation.

What is the lung sound referred to as "crackles" indicative of? A. Foreign body obstruction of the upper airway B. Air moving through airways narrowed by constriction or swelling of lower airways C. Swelling of the upper airway D. Air being forced through airways that are narrowed by fluid, mucus, or pus

D. Air being forced through airways that are narrowed by fluid, mucus, or pus Answer Explanation: Crackles are caused by fluid in the small airways. They are popping sounds that are heard when air is forced through the small airways that are being narrowed by the accumulation of fluid, mucus, or pus.

What occurs when the diaphragm contracts? A. The lungs become hyperventilated B. Air moves out of the lungs C. The lungs cannot properly inflate D. Air moves into the lungs

D. Air moves into the lungs

You are dispatched to a report of gunshots having been fired at a night club. After confirming the scene is safe, you enter to find a 23-year-old male lying supine on the floor and bleeding profusely from his abdominal region. He appears to be CAOx4 and is very anxious. During your assessment, you find what appears to be a gunshot wound to the left upper quadrant of his abdomen. After controlling his bleeding, his vital signs are: BP 150/98, HR 108, and RR 40 with equal and bilateral chest rise. What would be the most appropriate next step in treating this patient? A. Attempt to remove the bullet with sterile tweezers to prevent further bleeding B. Apply high-flow oxygen via non-rebreather mask at 15 lpm C. Request administration of at least 0.4 mg of nitroglycerin to lower the patient's blood pressure and prevent further blood loss D. Apply high-flow oxygen via bag valve mask at 15 lpm

D. Apply high-flow oxygen via bag valve mask at 15 lpm Answer Explanation: Due to the patient's respiratory rate of 40, it's necessary to start him on a BVM to assist with his already labored breathing. A NRB may help, but would not be as effective as a BVM in this case. Finally, there is no indication to administer NTG.

You respond to a 57-year-old male having trouble breathing. You arrive to find a long line of oxygen tubing running into the back bedroom and your patient who is seated in a chair in obvious respiratory distress. You find that he has a strong rapid pulse, respirations at 24 per minute, and his lungs sounds reveal wheezing in all fields. What diagnosis would you develop for this patient? A. CHF (Congestive Heart Failure) B. AMI (Acute Myocardial Infraction) C. Asthma D. COPD (Chronic Obstructive Pulmonary Disease)

D. COPD (Chronic Obstructive Pulmonary Disease) Answer Explanation: COPD is a chronic disease where the alveoli narrow over time and become less elastic, making them unable to retain oxygen and successfully complete gas exchange. Your first clue that this patient has COPD is the oxygen tubing. Many COPD patients require continuous oxygen administration in order to function normally. These patients will almost always have an increased heart rate and will be wheezing due to the narrowing of the airway and mucus in the airway.

Your patient has an oxygen saturation of 98%, measured continually during assessment, yet he dies of hypoxia. Which of the following would explain this? A. Traumatic injury to the chest B. Uncontrolled hypertension C. Hypovolemia D. Carbon monoxide poisoning

D. Carbon monoxide poisoning Answer Explanation: Pulse oximeters measure oxygen saturation of hemoglobin. Though hemoglobin in this case is saturated at 98%, it is not saturated with oxygen, but rather saturated with carbon monoxide. Carbon monoxide has a greater affinity for the hemoglobin molecule than oxygen does, so it replaces it. Because of this, the pulse oximeter reading will be high but the patient will still be hypoxic.

You are working with an ALS partner. You hear him state that he the CPAP machine seems to be giving the patient relief of the shortness of breath they were experiencing. You know CPAP to stand for? A. Constant pressure of airway palpation B. Compressions performed by advanced personnel C. Circulation positive airway pressure D. Continuous positive airway pressure

D. Continuous positive airway pressure

Your patient is a 9-year-old female who is unusually quiet according to her mother. She looks distant and is responding to verbal commands. When you take her vitals, you notice a slowed pulse. You suspect she is experiencing? A. Stroke B. Hypoglycemia C. Hypotension D. Hypoxia

D. Hypoxia

The diaphragm contracts during? A. Expiration B. Exhalation C. Ventilation D. Inspiration

D. Inspiration

Which of the following statements regarding the head-tilt-chin lift maneuver is most accurate? A. It should be used on all unresponsive patients B. It is the best choice for patients with spinal injuries C. It can only be used in conjunction with an OPA D. It can only be used temporarily and must be replaced by an airway adjunct

D. It can only be used temporarily and must be replaced by an airway adjunct

An elderly man is found lying unresponsive next to his bed. His wife is unsure what happened or why he is lying unconscious. Once you establish that the patient has a strong carotid pulse, what is your next priority? A. Assess respirations B. Apply 100% supplemental oxygen C. Activate a modified-trauma D. Jaw-thrust maneuver

D. Jaw-thrust maneuver Answer Explanation: The jaw-thrust maneuver should be used to open the airway because it is unknown if the patient experienced trauma. Just as you should, this question is following the C-A-B assessment.

Abnormal respiratory sounds often indicate that a patient is in respiratory distress. When these abnormal respiratory sounds are found with retractions, what may your patient be experiencing? A. Nasal flaring B. Flail chest C. Croup D. Obstruction

D. Obstruction Answer Explanation: When retractions are present along with abnormal respiratory sounds, you should be able to differentiate between respiratory problems. Each abnormal respiratory sound (with retractions present) is indicative of a specific type of respiratory problem. For example, retractions present with stridor may imply that your patient is experiencing an upper airway obstruction.

You are assigned to the airway during the treatment of an unconscious male. As you insert an OPA, he gags. How do you proceed? A. Remove and use a smaller size B. Remove, turn the OPA 90 degrees and reinsert C. Maintain the OPA in place D. Remove and insert an NPA

D. Remove and insert an NPA

The respiratory system has two main functions: the first is to deliver oxygen to the body. Which of the following is the second? A. Deliver carbon dioxide to the body B. Remove carbon monoxide from the body C. Deliver carbon monoxide to the body D. Remove carbon dioxide from the body

D. Remove carbon dioxide from the bod

You have been dispatched to a patient with chest pain. Upon arrival, you find the patient is not breathing, has no pulse, and you immediately begin CPR. The patient has a stoma and air is leaking from the nose and mouth. The most appropriate action would be? A. Ventilate with less pressure B. Thoroughly suction the stoma C. Use the jaw thrust maneuver D. Seal the nose and mouth

D. Seal the nose and mouth Answer Explanation: If a patient needing CPR has a stoma, you must ventilate that patient through their stoma. If your positive pressure ventilations are leaking through the nose and mouth, sealing them will provide for more effective CPR.

You have just finished giving 5 abdominal thrusts to a choking victim when he becomes unresponsive, falling to the ground. You are able to control the fall, but the victim is unresponsive and not breathing. What would the correct care for this victim be? A. Continue abdominal thrusts B. Start CPR at a ratio of 15:2 C. Give rescue breaths to clear the airway D. Start CPR

D. Start CPR

Which of the following is not a sign that a patient is experiencing respiratory distress? A. Nasal flaring B. Tripod position C. Agitation D. Symmetrical chest rise and fall

D. Symmetrical chest rise and fall Answer Explanation: Symmetrical chest rise and fall is a normal finding in any patient that is breathing. Symmetrical means same. Agitation, nasal flaring, and tripod positioning are all possible signs that a patient is in respiratory distress.

You are assessing a 23-year-old male with difficulty breathing after a motor vehicle collision. He indicates that it's getting harder and harder to breathe, and appears to be increasingly anxious. Vitals: BP - 90/62, P 124, R 20, SpO2 93%, CBG 72, Lungs - absent on the left side. What do you suspect is occurring with this patient? A. Pneumothorax B. Flail chest C. Cardiac tamponade D. Tension pneumothorax

D. Tension pneumothorax

Which of the following is the greatest advantage of two-person BVM ventilations? A. The timing of ventilations is more effective and consistent B. The tidal volume can be increased C. The amount of air going into the stomach is decreased D. The ability to maintain a seal and deliver more effective breaths is increased

D. The ability to maintain a seal and deliver more effective breaths is increased

The external hole that is surgically placed in a patient's trachea is called? A. Trachoma B. OPA C. Gastronomy D. Tracheostomy

D. Tracheostomy

What is the preferred method for initially providing ventilations to an apneic patient when no pocket mask is available? A. One-person BVM with 100% oxygen B. NRB mask with 100% oxygen C. Mouth to mask D. Two-person BVM with 100% oxygen

D. Two-person BVM with 100% oxygen

A reduced tidal volume would most likely occur from? A. Nostril flaring B. Accessory muscle use C. Increased minute volume D. Unequal chest expansion

D. Unequal chest expansion

When ventilating an apneic adult patient with a BVM, you must ensure that? A. You are positioned alongside the patient B. The pop-off valve on the BVM remains open C. You ventilate at a rate of 20-breaths per minute D. You've inserted an airway adjunct

D. You've inserted an airway adjunct