Chapter 10 and 11
The normal respiratory rate for an adult ranges from: A) 10 to 12 breaths/min. B) 12 to 15 breaths/min. C) 12 to 20 breaths/min. D) 8 to 10 breaths/min.
12 to 20 breaths/min.
You are assessing the blood pressure of a 36-year-old male who was assaulted. A normal systolic blood pressure for a patient of this age should be approximately: A) 145 mm Hg. B) 140 mm Hg. C) 150 mm Hg. D) 120 mm Hg.
140 mm Hg.
Based solely on the mechanism of injury, which of the following adult patients is at greatest risk for serious injuries? A) 5' 2" patient who fell 12' B) 6' 8" patient who fell 13' C) 4' 5" patient who fell 14' D) 6' 1" patient who fell 14'
4' 5" patient who fell 14'
A portable oxygen cylinder should be taken out of service and refilled when the pressure inside it is at ________ psi or below: A) 500 B) 200 C) 1,000 D) 750
500
When high-flow oxygen is attached to the inlet valve of a pocket face mask, oxygen concentrations of up to ____ percent can be delivered to the patient. A) 55 B) 21 C) 70 D) 45
55
In adult females and adolescents, systolic blood pressure is considered critically low when it is less _____ mm Hg or less. A) 90 B) 80 C) 70 D) 60
80
You are the only AEMT in the back of the ambulance caring for an apneic patient. Which of the following ventilation devices would allow you to perform other patient care tasks while still ventilating the patient? A) Multilumen airway device B) Automatic transport ventilator C) Flow-restricted, oxygen-powered device D) Manually-triggered ventilation device
Automatic transport ventilator
Which of the following structures is NOT a part of the upper airway? A) Bronchioles B) Vallecular space C) Arytenoid cartilage D) Nasopharynx
Bronchioles
Which of the following methods of assessing circulation is LEAST reliable in adult patients? A) Condition of the skin B) Capillary refill time C) Temperature of the extremities
Capillary refill time
Which of the following injuries would the front seat passenger LEAST likely sustain when the front end of a car strikes a bridge pillar? A) Chest B) Pelvis C) Extremity D) Head
Chest
Which of the following is a sign that CPAP is improving your patient's clinical status? A) Decrease in respiratory rate B) Increase in respiratory rate C) The patient becomes combative D) Increase in heart rate
Decrease in respiratory rate
Which of the following questions would allow you to assess the "P" in the SAMPLE history? A) What were you doing when this episode began? B) Has this ever happened to you before? C) Are there any medications you cannot take? D) Do you take any prescription medications?
Has this ever happened to you before?
What are the pyriform fossae? A) Hollow pockets along the lateral borders of the larynx B) Solid structures located posterior to the vocal cords C) Anatomic spaces located at the base of the tongue D) Structures that support the vocal cords and larynx
Hollow pockets along the lateral borders of the larynx
Which of the following structures is NOT a part of the lower airway? A) Bronchi B) Trachea C) Larynx D) Alveoli
Larynx
Which of the following signs is MOST indicative of adequate breathing? A) An altered mental status B) Respirations of 20 breaths/min C) Shallow depth of breathing D) Avoidance of a supine position
Respirations of 20 breaths/min
A 43-year-old female is unconscious following an overdose of heroin. Her respirations are slow and shallow. Which of the following conditions will she initially develop if not treated? A) Respiratory alkalosis B) Metabolic acidosis C) Respiratory acidosis D) Metabolic alkalosis
Respiratory acidosis
Which of the following patients requires immediate transport following initial stabilization at the scene? A) Decreased movement of an extremity following trauma B) Large laceration to the arm with controlled bleeding C) Severe pain to the left lower quadrant of the abdomen D) Conscious patient involved in a low-speed MVC
Severe pain to the left lower quadrant of the abdomen
Which of the following statements regarding the King LT airway is correct? A) The King LT airway can be used in patients of any age and height B) Studies show that it is easier and quicker to insert than a Combitube C) The Combitube protects the airway more effectively than the King LT D) It features single lumen that is designed for tracheal insertion
Studies show that it is easier and quicker to insert than a Combitube
While assessing an unconscious 30-year-old female's airway, you note that her respirations are rapid, shallow, and gurgling. What is your initial course of action? A) Reposition her airway. B) Suction her oropharynx. C) Apply 100% oxygen. D) Begin assisted ventilations.
Suction her oropharynx.
Which of the following statements regarding a patient with traumatic cardiac arrest is correct? A) The patient's cardiac rhythm must be assessed, as soon as possible, with a manual cardiac monitor/defibrillator. B) IV fluid replacement has priority over defibrillation for patients with traumatic cardiac arrest. C) You should initiate CPR, apply an AED as soon as possible, and begin rapid IV fluid replacement. D) Cardiac monitoring is not necessary since most traumatic cardiac arrest victims do not require defibrillation.
The patient's cardiac rhythm must be assessed, as soon as possible, with a manual cardiac monitor/defibrillator.
The concept of standard precautions assumes that: A) certain body fluids, such as blood and vaginal secretions, are infectious until proven otherwise. B) body fluids, such as sputum, urine, and sweat are potentially infectious only if they contain visible blood. C) gloves, a face shield, and a gown will virtually eliminate the risk of you being exposed to an infectious disease. D) all blood, body fluids, nonintact skin, and mucous membranes may pose a substantial risk of infection.
all blood, body fluids, nonintact skin, and mucous membranes may pose a substantial risk of infection.
Tidal volume minus dead space volume is called: A) residual volume. B) alveolar ventilation. C) minute volume. D) vital capacity.
alveolar ventilation
A patient with congenital anisocoria would be expected to have pupils that: A) do not respond to light. B) are constricted and nonreactive. C) dilate when exposed to light. D) are unequal in size.
are unequal in size
The hypoxic drive stimulates breathing when the: A) venous levels of carbon dioxide decrease. B) arterial oxygen level falls. C) arterial carbon dioxide levels increase. D) pH of the CSF increases.
arterial oxygen level falls
An oxygen humidifier is MOST beneficial when a patient is: A) being given oxygen during a lengthy transport to the hospital. B) receiving oxygen via nonrebreathing mask during a short transport. C) not breathing and is being ventilated with a bag-mask device. D) receiving ventilations through a multilumen airway device.
being given oxygen during a lengthy transport to the hospital
When ventilation is compromised but perfusion continues: A) the alveoli are filled with fresh oxygen, but it cannot diffuse into the blood. B) blood passes over some alveolar membranes without gas exchange taking place. C) more CO2 diffuses across the pulmonary-capillary membrane and is eliminated. D) air movement into and out of the lungs is adequate, but diffusion is impaired.
blood passes over some alveolar membranes without gas exchange taking place.
The primary waste product(s) of cellular respiration is/are: A) oxygen. B) carbon dioxide and water. C) nitrogen. D) lactic and pyruvic acid.
carbon dioxide and water.
Slow, shallow, irregular respirations or occasional gasps are MOST indicative of: A) narcotic drug overdose. B) brainstem injury. C) cerebral anoxia. D) intracranial pressure.
cerebral anoxia.
When attempting to ventilate an unconscious patient, you note decreased lung compliance. This indicates: A) decreased airway resistance. B) decreased pulmonary resistance. C) increased alveolar expansion. D) decreased alveolar expansion.
decreased alveolar expansion.
A 30-year-old male presents with signs of shock. He is conscious but anxious, and is in no obvious respiratory distress. After applying oxygen, you attach a pulse oximeter, which reads 78%. This low oxygen saturation reading is MOST likely the result of: A) volume depletion. B) severe hypocarbia. C) a decreased PCO2. D) decreased perfusion.
decreased perfusion
A young male is found to be unconscious. When assessing his pupils, you note that they dilate when exposed to bright light. This clinical finding is MOST suggestive of: A) depressed brain function. B) a barbiturate overdose. C) a hemorrhagic stroke. D) congenital anisocoria.
depressed brain function.
A 23-year-old female called EMS because of a sudden onset of abdominal pain. During your assessment, you ask her to point to the area of her abdomen that is painful. She encircles a large area of her left lower quadrant with her finger. You would describe this patient's pain as being: A) focal. B) radiating. C) diffuse. D) referred.
diffuse.
During your reassessment of a patient with an illness or injury, it is important to: A) document any changes in his or her condition. B) repeat the secondary assessment every 5 minutes. C) reassess vital signs only if a change is noted. D) perform a head-to-toe assessment every 15 minutes.
document any changes in his or her condition.
You arrive at the scene of a motor-vehicle crash where a small car has struck a tree head-on. You see one patient sitting in the driver's seat with the door open. Prior to exiting the ambulance, you should: A) request a rescue team for vehicle extrication. B) don the appropriate protective equipment. C) observe the patient's mental status. D) document your observations on the run form.
don the appropriate protective equipment.
Cellular function deteriorates and death occurs when the pH: A) drops below 7.1 or rises above 7.6. B) drops below 6.9 or rises above 7.8. C) fluctuates between 7.35 and 7.45. D) drops below 7.0 or rises above 7.5.
drops below 6.9 or rises above 7.8.
Clues about the potential seriousness of your patient's injury or injuries are MOST reliably obtained by: A) questioning witnesses about the incident. B) forming a general impression. C) evaluating the mechanism of injury. D) determining the age of the patient.
evaluating the mechanism of injury.
The formulation of an appropriate treatment plan is ultimately based on the: A) findings in the primary assessment. B) field impression of the patient. C) AEMT's differential diagnosis. D) patient's vital signs and medical history.
field impression of the patient.
The exchange of oxygen and carbon dioxide occurs by a process of diffusion, in which: A) gases in the cells remain in equal concentration until arterial oxygen levels fall. B) carbon dioxide is not allowed to move across the pulmonary capillary membrane. C) gas moves from an area of lower concentration to an area of higher concentration. D) gas moves from an area of higher concentration to an area of lower concentration.
gas moves from an area of higher concentration to an area of lower concentration.
All of the following conditions would require immediate transport after the primary assessment and treatment phase, EXCEPT: A) abdominal pain and cool, clammy skin. B) headache without mental status change. C) responsiveness but inability to follow commands. D) inability to move the extremities following trauma.
headache without mental status change
A responsive 40-year-old male complains of chest pain. He is able to speak to you in complete sentences and has no obvious respiratory difficulty. From this information, you can conclude that: A) he is in immediate need of high-flow oxygen. B) low-flow oxygen is all that is necessary for him. C) he is likely having an acute myocardial infarction. D) his airway is patent and his breathing is adequate.
his airway is patent and his breathing is adequate.
The lower portion of the pharynx that opens into the larynx anteriorly and the esophagus posteriorly is the: A) nasopharynx. B) larynx. C) hypopharynx. D) oropharynx.
hypopharynx
Trending a critically-injured patient's vital signs will allow you to determine: A) the underlying injuries that are making the patient unstable. B) whether or not transport to a trauma center is necessary. C) whether or not a rapid head-to-toe assessment is indicated. D) if the patient's condition is stabilizing or deteriorating.
if the patient's condition is stabilizing or deteriorating
The turbinates, which extend into the nasal passageway, function by: A) facilitating drying of the nasal mucosa and maintaining vascular dilation. B) improving filtration, warming, and humidification of inhaled air. C) protecting the nasal septum from injury and preventing it from deviating. D) decreasing the surface area of the anterior nasopharynx.
improving filtration, warming, and humidification of inhaled air.
A 50-year-old male has fallen from a significant height. He is conscious and alert, but is unable to feel or move both of his lower extremities. This is MOST likely the result of: A) traumatic brain injury. B) local nerve injury. C) injury to the spinal cord. D) a response to severe pain.
injury to the spinal cord.
The laryngeal mask airway (LMA) is indicated when: A) intubation is not possible and mask ventilation is the only option. B) superior protection from aspiration of gastric contents is needed. C) patients require positive-pressure ventilation with high pressures. D) an unconscious patient is apneic and has an intact gag reflex
intubation is not possible and mask ventilation is the only option
Carbonic acid is an ideal buffer because it: A) fully dissociates and maintains a high level of alkalinity. B) binds with water to form bicarbonate. C) is a strong acid and destroys only hydrogen ions. D) is a weak acid and can accept or donate hydrogen ions.
is a weak acid and can accept or donate hydrogen ions.
An electronic blood pressure cuff that measures readings using stepped deflation: A) provides a more accurate measurement than auscultating a patient's blood pressure using a manual blood pressure cuff. B) may be more accurate in patients who are moving because the pressure in the cuff is released in intervals at variable lengths, allowing the system to better detect oscillations. C) is less accurate in hypotensive patients than the device that uses linear deflation because linear deflation allows a uniform decline in pressure during deflation. D) is ineffective in taking accurate measurements if the patient's blood pressure is greater than 200/100 mm Hg or if it detects any kind of patient movement.
may be more accurate in patients who are moving because the pressure in the cuff is released in intervals at variable lengths, allowing the system to better detect oscillations.
A patient who coughs up thick yellow or green sputum: A) most likely has an advanced respiratory infection. B) should not be given oxygen via the nasal route. C) should be treated for congestive heart failure. D) has a closed chest injury until proven otherwise.
most likely has an advanced respiratory infection.
Intrapulmonary shunting occurs when: A) blood returning to the left side of the heart is low in carbon dioxide. B) nonfunctional alveoli inhibit the diffusion of oxygen and carbon dioxide. C) a blockage in the pulmonary artery prevents blood from reaching the lungs. D) blood entering the lungs from the right side of the heart is hyperoxygenated.
nonfunctional alveoli inhibit the diffusion of oxygen and carbon dioxide.
The preferred device to use when administering supplemental oxygen in the prehospital setting is the: A) partial rebreathing mask. B) simple face mask. C) nasal cannula. D) nonrebreathing mask.
nonrebreathing mask
The focused assessment of a patient is based primarily on the: A) initial set of vital signs. B) patient's chief complaint. C) presence of obvious injuries. D) nature of the patient's illness.
patient's chief complaint.
Ventilation is defined as the: A) physical act of moving air into and out of the lungs. B) removal of carbon dioxide during the exhalation phase. C) exchange of gases between the body and its environment. D) delivery of oxygen to the alveoli during the inhalation phase.
physical act of moving air into and out of the lungs.
In contrast to the dorsal respiratory group, the ventral respiratory group is: A) responsible for initiating inspiration based on the information received from the chemoreceptors. B) primarily responsible for motor control of the inspiratory and expiratory muscles. C) anatomically located within the pons and functions by terminating the inspiratory phase. D) controlled by the phrenic nerve, which innervates the diaphragm muscle and allows it to contract.
primarily responsible for motor control of the inspiratory and expiratory muscles.
You are ventilating a trauma patient with a bag-mask device, but are having difficulty maintaining an effective mask seal. Prior to inserting the King LT airway, you should: A) protect the patient's spine as you position his head. B) logroll the patient and suction his airway for 15 seconds. C) flex the patient's head to facilitate insertion of the device. D) measure the device from the corner of the mouth to the ear
protect the patient's spine as you position his head
When performing the rapid body scan on an unresponsive patient, you should follow the same approach as the: A) general impression. B) secondary assessment. C) primary assessment. D) rapid trauma assessment.
rapid trauma assessment
You note little movement of an apneic patient's chest when you and your partner are ventilating with the two-person bag-mask device technique. You should: A) use a flow-restricted, oxygen-powered ventilation device. B) reassess the position of the patient's airway and readjust if needed. C) insert a multilumen airway device and continue bag-mask ventilations. D) continue ventilating the patient and reassess him or her in two minutes.
reassess the position of the patient's airway and readjust if needed.
The MOST dangerous complication associated with the use of the LMA is: A) regurgitation and aspiration. B) swelling of the upper airway structures. C) occlusion of the opening to the esophagus. D) inadvertent tracheal placement.
regurgitation and aspiration.
Minute volume would increase if: A) respiratory rate was increased. B) tidal volume was reduced. C) the amount of dead space air increased. D) a patient's breathing was shallow.
respiratory rate was increased.
You are called to a grocery store where a clerk has found an unresponsive female in one of the aisles. There were no witnesses to the event. You should immediately: A) assist ventilations with a bag-mask device attached to 100% oxygen. B) open her airway with a head-tilt chin lift maneuver and apply oxygen. C) assess the rate and regularity of the patient's respiratory effort. D) stabilize her head and open her airway with the jaw-thrust maneuver.
stabilize her head and open her airway with the jaw-thrust maneuver.
A 72-year-old male with a tracheal stoma requires ventilatory assistance. However, when you attempt to ventilate, you meet resistance. You should: A) suction the stoma and mouth. B) immediately insert a multilumen airway. C) ventilate through the patient's mouth. D) ventilate with higher tidal volume.
suction the stoma and mouth.
A 40-year-old male is unconscious, has inadequate breathing, and is producing copious, continuous secretions from his mouth. This situation is MOST effectively managed by: A) ventilating for 30 seconds and suctioning for 2 minutes. B) continuous ventilation until the patient can be intubated. C) continuously suctioning until the secretions are cleared. D) suctioning for 15 seconds and ventilating for 2 minutes.
suctioning for 15 seconds and ventilating for 2 minutes.
The nature of a patient's illness is MOST often determined by: A) asking a family member. B) repeated calls to the patient's home. C) the patient's chief complaint. D) your general impression of the patient.
the patient's chief complaint.
You are attempting to obtain medical history information from a 20-year-old female. However, she does not answer your questions, despite the fact that she is conscious and alert and speaks English. You should: A) use close-ended questions and reassess the manner in which you are questioning her. B) advise her that if she does not answer your questions, there is no way you can help. C) decrease the amount of time in between each of the questions that you ask her. D) provide any necessary treatment and defer her medical history to the hospital staff.
use close-ended questions and reassess the manner in which you are questioning her.
The finer and somewhat fainter breath sounds noted in the lateral wall of the chest are known as: A) vesicular sounds. B) bronchovesicular sounds. C) bronchial sounds. D) pleural sounds.
vesicular sounds.
The Cobra perilaryngeal airway (CobraPLA) is contraindicated in patients: A) with a possible fracture of the c-spine. B) who are younger than 16 years of age. C) with massive trauma to the oral cavity. D) with known esophageal disease.
with massive trauma to the oral cavity.
After inserting a King LT airway, you attach the bag-mask device and begin to ventilate the patient. However, you meet resistance with your initial ventilation attempts. You should: A) ventilate with greater force until resistance is not felt. B) remove the device and resume bag-mask ventilations. C) deflate the cuffs and advance the device 2 cm further. D) withdraw the device slightly until ventilations are easy
withdraw the device slightly until ventilations are easy
During your secondary assessment of a 70-year-old male with congestive heart failure, you note the presence of 4+ pitting edema to his lower extremities. This means that: A) the edema extends from the ankle to the area just below the knee. B) it takes greater than 4 minutes for the skin to recoil after depressing it. C) the edema is so significant that it is impairing distal circulation. D) you are able to make an indentation in the skin of greater than 1".
you are able to make an indentation in the skin of greater than 1".
When using CPAP on a patient with respiratory distress, it is important to remember that: A) most patient's being treated with CPAP experience hypotension at some point. B) it often takes at least 10 to 15 minutes before clinical improvement is noted. C) the patient's condition is such that he or she will likely need to be intubated. D) you are not treating the underlying cause of the patient's respiratory distress.
you are not treating the underlying cause of the patient's respiratory distress.
When obtaining medical history information on a patient who has been serious injured, it is important to remember that: A) transport has a higher priority, so medical history gathering should be deferred. B) patient care tasks will likely prevent you from gathering any medical history. C) you should gather as much information as possible without delaying transport. D) bystanders or family members are more reliable historians than the patient.
you should gather as much information as possible without delaying transport
