Emergency Care Chapter 10

What is NOT one of the basic parts of a bag-valve-mask system? A) 15/25 respiratory fitting B) Be nonrebreathing C) Non-jam valve D) Self-refilling shell

A) 15/25 respiratory fitting

Which of the following patients does NOT require the administration of supplemental oxygen? A) A 24-year-old woman who is breathing 28 times per minute after being in an argument with her husband B) A 31-year-old male who is unresponsive due to an overdose of narcotics C) A 6-year-old male with a history of asthma whose breath sounds are silent and who is drowsy D) A 60-year-old woman with a history of chronic obstructive pulmonary disease (COPD) who can speak two or three words at a time without a breath

A) A 24-year-old woman who is breathing 28 times per minute after being in an argument with her husband

What is the relatively rare condition that can cause respiratory depression? A) Chronic obstructive pulmonary disease (COPD) has changed the stimulus to breathe to the hypoxic drive and high concentration can depress breathing. B) Lungs can react unfavorably to oxygen when the concentration is too high for a long period of time and this can depress breathing. C) High concentration of oxygen can depress breathing when the patient has an allergic reaction from the oxygen. D) The eyes can develop scar tissue on the retina from a high concentration of oxygen

A) Chronic obstructive pulmonary disease (COPD) has changed the stimulus to breathe to the hypoxic drive and high concentration can depress breathing.

What are the signs of hypoxia? A) Commonly seen as blue or gray skin, deterioration of patient's mental status like confusion or restlessness B) Shock caused from the lack of blood flowing to the vital organs like the brain and heart that is irreversible C) Warm dry skin, with difficulty in breathing, and hypertension D) Disease process that robs the patient of adequate breathing and perfusion

A) Commonly seen as blue or gray skin, deterioration of patient's mental status like confusion or restlessness

Which of the following is necessary to deliver oxygen to patients at a safe pressure? A) Regulator B) Filter C) Flowmeter D) Float ball

A) Regulator

Which of the following describes why fast respiration may decrease minute volume? A) The lungs may not have the time to fill and exchange gas. B) It is due to the delay in the movement of the intercostal muscles and the pleural space. C) The rate causes turbulence in the trachea that increases the friction and decreases the amount of air movement. D) The rate does not decrease minute volume; it actually increases.

A) The lungs may not have the time to fill and exchange gas.

When does respiratory distress change to respiratory failure? A) When the respiratory challenge continues, the systems cannot keep up with the demand, and skin color and mental status change. B) When the respiratory challenge continues, the systems fail with the demand for oxygen, pupils dilate, and the skin becomes hot and dry. C) When the compensatory mechanism is no longer needed and the patient goes into arrest. D) When the patient who is short of breath, with noisy respiration, presents in the tripod position but then suddenly has the condition clear up and return to normal.

A) When the respiratory challenge continues, the systems cannot keep up with the demand, and skin color and mental status change.

Your patient is a 55-year-old man with a history of chronic bronchitis. You have been called to his home today because of an increase in his level of respiratory distress. The patient is on 2 liters per minute of oxygen by nasal cannula at home. Your assessment reveals difficulty speaking due to shortness of breath, leaning forward to breathe, a productive cough, and a respiratory rate of 32 per minute. Which of the following is true concerning the best course of action for this patient? A) You should increase the patient's oxygen flow rate to deliver adequate amounts of oxygen to his tissues. If his respiratory rate decreases, you can assist him with a bag-valve-mask device. B) You should increase the patient's oxygen flow rate until his respiratory rate decreases and then resume oxygen administration at 2 liters per minute. C) You should not increase the patient's oxygen flow rate because of his likely dependence on a hypoxic drive to stimulate breathing. D) Because increased blood levels of carbon dioxide are the primary stimulus to breathe, you should encourage the patient to rebreathe his exhaled air from a paper bag.

A) You should increase the patient's oxygen flow rate to deliver adequate amounts of oxygen to his tissues. If his respiratory rate decreases, you can assist him with a bag-valve-mask device.

Your patient is a 65-year-old male with a history of COPD. He is sitting up and complaining of a severe shortness of breath. You should: A) apply a nonrebreather mask giving 15 lpm of oxygen. B) administer 4 lpm of oxygen via nasal cannula. C) suction the airway with a rigid suction catheter. D) insert a nasal airway and ventilate

A) apply a nonrebreather mask giving 15 lpm of oxygen.

You are ventilating an adult patient with a bag-valve mask when you notice that his abdomen is getting bigger. You should: A) apply cricoid pressure. B) suction the airway. C) apply pressure to the abdomen. D) decrease the flow of oxygen.

A) apply cricoid pressure.

What is the percentage of oxygen provided by connecting a high flow of oxygen to the oxygen inlet found on a pocket mask? A) 21% B) 50% C) 100% D) 16%

B) 50%

Which of these patients would require a tracheostomy mask for supplemental oxygen administration? A) A patient with quadriplegia B) A patient with a stoma C) A patient with chronic bronchitis D) A patient with upper airway inflammation

B) A patient with a stoma

You have arrived at the scene of a call for a "man down." As you enter the residence you note that your patient is a male in his mid-60s who is awake but does not seem to acknowledge your presence. He is perspiring profusely, has cyanosis of his ears and lips, and has rapid, shallow respirations. Which of the following should you do first? A) Obtain the patient's medical history. B) Assist ventilations with a bag-valve mask and supplemental oxygen. C) Listen to his lung sounds. D) Check for a radial pulse.

B) Assist ventilations with a bag-valve mask and supplemental oxygen.

Which of the following oxygen cylinders would normally run out after 50 minutes when flowing at 10 liters per minute? A) G tank B) E tank C) D tank D) M tank

B) E tank

What signs and symptoms would indicate inadequate breathing in a patient? A) Decreased depth of respiration, decreased rate of breathing, hot clammy skin, normal mental status B) Increased effort to breathe, cyanosis, cool clammy skin, altered mental status C) Rapid breathing, pale skin, and a normal mental status D) Increased effort to breathe, increased depth of respiration, pink dry skin, normal mental status

B) Increased effort to breathe, cyanosis, cool clammy skin, altered mental status

In assessing a patient's breathing, what is your first question? A) Is he big sick or little sick? B) Is he breathing? C) Is he alive or dead? D) Is his breathing adequate or inadequate?

B) Is he breathing?

What device is used to perform mouth-to-mask ventilation? A) Stoma B) Pocket face mask C) Bag-valve mask D) Automatic transport ventilator

B) Pocket face mask

Of the three types of oxygen flowmeters, which one can only be used upright? A) Bourdon gauge flowmeter B) Pressure-compensated flowmeter C) Constant flow selector valve D) Hudson gauge flowmeter

B) Pressure-compensated flowmeter

Which of the following BEST describes inadequate breathing? A) The minute volume is greater than normal. B) The minute volume is less than normal. C) The respiratory rate is slower than normal. D) The respiratory rate is faster than normal.

B) The minute volume is less than normal.

A 16-year-old patient presents with labored breathing and increased respiratory rate, increased heart rate, and leaning forward with his hands on his knees. His skin is pink and his accurate pulse oximetry is 96. This patient is suffering from respiratory: A) failure. B) distress. C) hypoxia. D) arrest.

B) distress.

For life to be maintained, a balance of oxygen and carbon dioxide is needed. The condition when oxygen levels are low is called: A) hyperventilation. B) hypoxia. C) hypercarbia. D) hypotension.

B) hypoxia.

Venturi masks are designed to mix oxygen with: A) nitrogen. B) inhaled air. C) carbon monoxide. D) humidified air.

B) inhaled air.

The movement of oxygen and carbon dioxide between the alveoli and circulating blood is called: A) internal respiration. B) pulmonary (external) respiration. C) osmosis. D) cellular respiration.

B) pulmonary (external) respiration.

You are attempting to replace the oxygen cylinder in your truck. After removing the regulator from the old cylinder, removing the old cylinder, and placing the new cylinder in the oxygen compartment, you attempt to connect the regulator. The new cylinder has a yellow stripe around it instead of a green one but was stored with the green cylinders. You are unable to get the regulator to seat properly and it will not turn. You should: A) replace the oxygen regulator with a new one. B) remove the cylinder and get a green cylinder. C) put the old cylinder back on the truck. D) attempt to force the regulator onto the cylinder.

B) remove the cylinder and get a green cylinder.

The oxygen flow rate for a nasal cannula should not exceed ________ liters per minute. A) 4 B) 8 C) 6 D) 2

C) 6

Which of the following statements BEST describes the exchange of gas in the alveoli? A) Air moves into the airway, blood arrives via the pulmonary veins, and osmosis occurs. B) Blood moves by way of the pulmonary capillaries, air arrives at the alveoli, and osmosis occurs. C) Air moves into the alveoli, blood is transported by the pulmonary capillaries, and diffusion occurs. D) Blood moves from the left heart to the lungs, air arrives in the alveoli sacks, and diffusion occurs.

C) Air moves into the alveoli, blood is transported by the pulmonary capillaries, and diffusion occurs.

Which of the following is acceptable for maintaining a seal between an oxygen cylinder and regulator? A) Medical grade adhesive tape B) Pop-off valve C) Gasket D) Grease plug

C) Gasket

Which of the following colors identifies an oxygen cylinder? A) Black and tan B) Orange and red C) Green and white D) Blue and yellow

C) Green and white

The normal stimulus to breathe is stimulated by the chemoreceptors that measure the change of what two gases? A) Low hydrogen and high carbon monoxide B) High carbon monoxide and low oxygen C) High carbon dioxide and low oxygen D) High hydrogen and low carbon dioxide

C) High carbon dioxide and low oxygen

Before applying a nonrebreather mask, the EMT should take what action? A) Connect the mask to a humidified oxygen source and wait for the patient's heart rate to slow. B) Make sure the oxygen supply has greater than 2,000 psi in the tank. C) Inflate the reservoir bag and make sure the bag does not deflate during inspiration. D) Insert a properly sized oropharyngeal airway.

C) Inflate the reservoir bag and make sure the bag does not deflate during inspiration.

You and your EMT partner are preparing to ventilate an elderly non-trauma patient who has a stoma. Your partner performs the head-tilt, chin-lift maneuver and you ask him to return the patient's head to a neutral position. "Why? This is not a pediatric patient!" your partner protests. What would you say? A) Elderly patients should never have their heads tilted back because spinal curvatures are common and can prevent airway positioning. B) Stoma breathers should only have their airways positioned after placement of the ventilation device. C) It is not necessary to position the airway of a stoma breather when providing ventilations. D) Using the head-tilt, chin-lift prior to clearing any mucus plugs from the stoma can cause airway occlusion.

C) It is not necessary to position the airway of a stoma breather when providing ventilations.

Why is inhalation described as an active process? A) It requires the diaphragm to relax and use energy to move, creating a positive pressure. B) It uses oxygen to assist chest muscles to contract, creating a negative pressure. C) It requires chest muscles to contract and use energy to move, creating a negative pressure. D) It requires chest muscles to relax and use energy to move, creating a positive pressure.

C) It requires chest muscles to contract and use energy to move, creating a negative pressure.

Which of the following is the best device to deliver high-concentration oxygen to a breathing patient? A) Simple face mask B) Nasal cannula C) Nonrebreather mask D) Oropharyngeal airway

C) Nonrebreather mask

To calculate the minute volume, you need to multiply what two measurements? A) Respiratory rate and bronchial dilation B) Tidal volume and dead space air C) Tidal volume and respiratory rate D) Alveolar ventilation and respiratory rate

C) Tidal volume and respiratory rate

A ________ is NOT typically used in the prehospital setting for oxygen administration. A) regulator B) nasal cannula C) partial rebreather mask D) tracheostomy mask

C) partial rebreather mask

You are aggressively ventilating an adult patient with a bag-valve mask when you notice that his previously strong pulse is getting weaker. You should: A) reduce the concentration of oxygen. B) begin chest compressions. C) reduce the volume of the ventilations. D) increase the concentration of oxygen.

C) reduce the volume of the ventilations.

The process of air moving in and out of the chest is called: A) tidal volume. B) respiration. C) ventilation. D) inhalation.

C) ventilation.

The safe residual for an oxygen cylinder is ________ psi. A) 500 B) 300 C) 1,000 D) 200

D) 200

A nonrebreather mask at 12 to 15 liters per minute will generally provide the patient what percentage of oxygen? A) 16-21 B) 24-44 C) 90-100 D) 80-100

D) 80-100

Why does a patient involved in an auto crash who has major internal abdominal bleeding require oxygen to maintain internal respiration? A) The red blood cells have a reduction of hemoglobin that reduces the amount of oxygen that can be transported. B) The swelling of the abdominal space causes the diaphragm to be restricted, which will reduce the thorax space. C) A lack of oxygen in the air decreases the oxygen diffused into the bloodstream, which creates an increase of carbon dioxide. D) A lack of circulating volume decreases the oxygen and carbon dioxide transport capability.

D) A lack of circulating volume decreases the oxygen and carbon dioxide transport capability.

) Concerning the use of humidified oxygen, which of the following is true? A) It should only be used when assisting ventilations with a bag-valve-mask device. B) The water in the reservoir should be treated with chlorine tablets to prevent the growth of bacteria. C) The water reservoir should be changed on a weekly basis. D) It is not of great benefit during short transports but can make the patient more comfortable.

D) It is not of great benefit during short transports but can make the patient more comfortable.

Your patient is a motorcyclist who was ejected after striking a guard rail. The patient is unresponsive to painful stimuli and is breathing shallowly six to eight times per minute. Which of the following should you do first? A) Perform a rapid trauma assessment. B) Apply a nonrebreather mask with an oxygen flow rate of 15 lpm. C) Apply a cervical collar. D) Use a bag-valve mask with supplemental oxygen.

D) Use a bag-valve mask with supplemental oxygen.

You are transporting a 44-year-old female with chest pain and sudden respiratory distress. She is agitated, anxious, and refuses to have a nonrebreather mask applied. Which of the following is the best option? A) Consult with medical control about restraining the patient. B) Do not make further attempts to administer oxygen as it will only agitate the patient further. C) Have her breathe into a paper bag to control her hyperventilation. D) Use a nasal cannula instead.

D) Use a nasal cannula instead.

A 21-year-old patient presents with labored breathing and audible wheezes, heart rate of 124, respiration 36; he has significantly altered mentation. What is the treatment for this patient? A) Supplement the breaths with high-concentration oxygen through a nonrebreather mask. B) Give mouth-to-mouth breathing with a nasal cannula, providing the patient with an increase of oxygen. C) Use a pocket mask, which will provide adequate oxygen to improve the patient's condition. D) Ventilate with a bag-valve mask with high oxygen or FROPVD.

D) Ventilate with a bag-valve mask with high oxygen or FROPVD.

The movement of oxygen and carbon dioxide across the cell membranes from the capillaries is called: A) dehydration. B) external respiration. C) oxygenation. D) internal respiration

D) internal respiration