Module 6 Exam Chapter 15
The _______ are pyramid-like structures that form the posterior attachment of the vocal cords A) arytenoid cartilages B) hypoepiglottic ligaments C) palatine tonsils D) piriform fossae
A page 777
Hypoventilation causes an _________ and leads to ______________. A) decreased minute volume, hypercapnia B) increased minute volume, hypercapnia C) increased minute volume, hypocapnia D) decreased minute volume, hypocapnia
A page 780
Biot respirations are characterized by: A) an irregular pattern of breathing with intermittent periods of apnea B) increased respiration's followed by apneic periods C) slow, shallow irregular respiration's or occasional gasping breaths D) deep, gasping respiration's that are often rapid but may be slow
A page 785
The average peak expiratory flow rate in a healthy adult is approximately: A) 550 mL B) 650 mL C) 450 mL D) 750 mL
A page 790
Typically, ETCO2 is approximately: A) 2 to 5 mm Hg lower than the arterial PaCO2 B) 5 to 10 mm hg lower than the arterial PaCO2 C) 2 to 5 mm Hg higher than the arterial Paco2 D) 5 to 10 mm Hg higher than arterial Paco2
A page 791
Capnography can serve as an indicator of: A) chest compression effectiveness B) cerebral perfusion pressure C) coronary perfusion pressure D) proper ventilatory depth
A page 791-794
Capnographic waveform, point ___ is the maximal ETCO 2 and is the best reflection of the alveolar CO 2 level. A) D B) B C) E D) C
A page 792
Which of the following would MOST likely caused a prolonged alveolar plateau? A) Heroin overdose B) Tachypnea C) Shock D) Diabetic Ketoacidosis
A page 792
Assessment of a patient in respiratory distress reveals capnograhic wave forms that resemble a shark fin. What should you suspect? A) bronchospasm B) heart failure C) hyperventilation D) pneumonia
A page 792-793
Which of the following capnography findings indicates that a patient is rebreathing previously exhaled carbon dioxide? A) increasing ETCO2 valuse and waveforms that never return to the baseline B) decreasing ETCO2 value and waveforms that fall well below the baseline C) Small capnographic waveforms with a complete loss of alveolar plateau D) intermittent loss of a capnograhic waveform, especially during inhalation
A page 792-793
An airway obstruction secondary to a severe allergic reaction: A) requires specific and aggressive treatment B) often responds well to humidified oxygen C) is treated effectively with abdominal thrusts D) is usually the result of pulmonary aspiration
A page 802
Poor lung compliance during your initial attempt to ventilate an unconscious, apneic adult should be treated by: A) reopening the airway and reattempting to ventilate B) administering 15 subdiaphragmatic thrusts at once C) sweeping the patient's mouth with your fingers D) performing 30 chest compression's and reassessing
A page 804
Supplemental oxygen is indicated for any patient with: A) respiratory distress B) ischemic stroke C) a syncopal episode D) cardiac chest pain
A page 806
A Bourdon-gauge oxygen flowmeter: A) reduces the high pressure in the oxygen cylinder to a safe pressure. B) allows you to administer oxygen to a patient under high pressures. C) is used for transferring oxygen from a larger tank to a smaller tank. D) must be placed in an upright position because it is affected by gravity.
A page 807
Oxygen that is entirely devoid of moisture: A) will dry the patient's mucous membranes quickly B) is less combustible than humidified oxygen C) is optimum for patients requiring long-term oxygen D) should be given in conjunction with bronchodilators
A page 810
Which of the following statements regarding the automatic transport ventilator (ATV) is correct? A) the paramedic can control an apneic patient's minute volume with accuracy when using an ATV B) Most ATVs are large and cumbersome and are therefore impractical to use in the prehospital setting C) Inadvertent variations in the rate and duration of ventilation's often occur when the ATV is used. D) The ATV should not be used to ventilate a patient who is intuabted and in cardiac arrest
A page 816-817
When determining the correct-sized nasogastric tube for a patient, you should measure the tube: A) from the nose to the ear and to be xiphoid process B) from the nose, around the ear, and to the xiphoid process C) from the mouth to the chin and to the xiphoid process D) from the nose to the chin and to the epigastric region
A page 821
In order for a tracheostomy tube to be compatible with a mechanical ventilator or bag-mask device: A) it must be equipped with a 15/22 mm proximal adaptor B)the patient's head must be in a hyperextended position C) it should have an internal diameter of at least 6.0 mm D) it should have a stylet that can be removed easily
A page 825
The procedure in which the vocal cords are visulized for placement of an ET tube is called direct: A) laryngoscopy B) paryngoscopy C) tracheostomy D) bronchoscopy
A page 832
In contrast to a curved laryngoscope blade, a straight laryngoscope blade is designed to: A) extend beneath the epiglottis and lift it up B) fit into the vallecular space at the base of the tongue C) indirectly lift the epiglottis is expose the vocal cords D) move the patient's tongue to the left
A page 833
After properly positioning the patient's head for intubation, you should open his or her mouth and insert the laryngoscope blade: A: into the right side of the mouth and sweep the tongue to the left B) in the midline of the mouth and gently lift upward on the tongue C) in the midline of the mouth and gently sweep the tongue to the left D) into the left side of the mouth and move the blade to the midline
A page 836
Which of the following structures is the MOST critical to visualize during orotracheal intubatuion? A) Epiglottis B) Tongue C) Uvula D) Tonsils
A page 836
After your have intubated an apneic patient with chest trauma, your partner is asuscuting breath sounds and tells you that breath sounds are faint on the right side of the chest. you should: A) suspect that the patient has a pneumothorax on the right side of the chest B) increase the force of your ventilation's as your partner reascultates the lungs C) slightly withdraw the tube as your partner auscultates breath sounds D) immediately remove the ET tube and oxygenate the patient for 30 seconds
A page 839
Which of the following indicates that the lighted stylet has entered the trachea? A) Tightly circumscribed light below the thyroid cartilage B) Absent illumination at the midline of the patient's neck C) Dim, diffuse light at the anterior part of the neck D) Bulging of the soft tissue above the thyroid cartilage
A page 853
Reemergence phenomenon is characterized by: A) pleasant dreams or vivid nightmares B) a transient, but significant, drop in heart rate C) a drop in blood pressure as medication wears off D) incomplete recollection of previous events
A page 862
To prevent muscular fasciculations associated with use of succinylcholine, your should administer: A) 10% of the usual dose of a nondepolarizing paralytic B) an infusion of potassium chloride set at 5 mEq per hour C) 0.5 mg of atropine sulfate via rapid IV push D) 1 to 1.5 mg/kg of lidocaine over 10 to 15 minutes
A pages
Which of the following indicates that the lighted stylet has entered the trachea? A) Tightly circumscribed light below the thyroid cartilage B) Absent illumination at the midline of the patient's neck C) Dim, diffuse light at the anterior part of the neck D) Bulging of the soft tissue above the thyroid cartilage
A pages 852
Intrapulmonary shunting is defined as: A) A condition in which to much carbon dioxide is eliminated B) the return of unoxygenated blood to the left side of the heart C) a decrease in the surface of the alveoli caused by damage D) failure of blood to bypass an obstruction in a pulmonary artery
B page 781
Which of the following findings is MOST clinically significant in a 30-year-old woman with difficulty breathing and a history of asthma? A) Oral temperature of 97.9 B) Prior ICU admission for her asthma C) 3 mm Hg drop in systolic BP during inhalation D) Expiatory wheezing on exam
B page 784
Is the ET tube is placed in the trachea properly, the colorimetric paper inside the CO2 detector should: A) turn yellow during inhalation B) turn yellow during exhalation C) remain purple during ventilation D) not cange colors
B page 790
While ventilating an intubated patient, you note a complete loss of capongroahic waveform and numeric value, yet the patient's chest rises with ventilation's and you are able to hear bilateral breath sounds. What should you do? A) Decrease the rate ventilation B) Replace the ETCO2 inline adaptor C) Increase the rate of ventilation D) Extubate and ventilate with a bag-mask
B page 792
Which of the following conditions would MOST likely cause laryngeal spasm and edema? A) Mild asthma attack B) inhalation injury C) croup D) viral pharyngitis
B page 802-803
When two paramedics are ventilating an apneic patient with a bag-mask device, the paramedic not squeezing the bag should: A) manually position the patient's head B) maintain an adequate mask-to-face seal C) continually ausulatate breath sounds D) apply posterior criocoid pressure
B page 815
When administering CPAP therapy to a patient, it is important to remember that: A) acute symptomatic bradycardia has been directly linked to CPAP therapy B) the increased intathoracic pressure caused by CPAP can result in hypotension C) the head straps must be secured immediately in order to achieve an adequate seal D) SpO2 of 100% must be achieved within the first 5 minutes of CPAP application
B page 818-820
If a patient has a stoma and no trachestomy tube in place: A) you should not seal the nose and mouth when ventilating B) ventilations can be performed by placing a mask over the stoma C) you must perform a head tilit-chin kift maneuver before ventilating D) suctioning of the stoma must be performed before ventilating
B page 824
When suctioning a patient's stoma, you should: A) asking the patient to inhale as your are suctioning B) insert the catheter until resistance is felt C) provide suction for no longer than 20 seconds D) insert the catheter no more than 15 cm
B page 825
Whether your are providing ventilation to a patient with a using a resuscitation mask or bag-mask device, you must FIRST: A) adequately cleanse the stoma site with iodine B) place the patient's head in a neutral position C) suction the stoma for no longer than 10 seconds D) perform a head tilt-chin lift maneuver
B page 826-827
A young woman experienced massive facial trauma after being ejected from her car when it struck a tree. She is semiconscious, has blood draining from her mouth, and has poor respiratory effort. The MOST appropriate initial airway management for this patient involves: A) providing positive pressure ventilatory support with a bag-mask device and making preparations to perform an open cricothyrotomy B) suctioning her away until its clear of blood and other secretions, administering a sedative and paralytic, and performing endotracheal intubation C) vigorously suctioning her oropharynx for no longer than 30 to 45 seconds and then inserting a multilumen airway device D) suctioning her oropharynx and performing direct laryngoscopy to assess the amount of upper airway damage or swelling that is present
B page 828
With regard to intubation difficulty, neck mobility problems are MOST commonly associated with: A) small children B) elderly patients C) female patients D) tall, thim patients
B page 830
The opening on the distal side of an ET tube allows ventilation to occur: A) if the tube is inserted into the right mainstem bronchus B) even if the tip of the tube is occluded by blood or mucus C) weather the tube is in the trachea or in the esophagus D) even if the ET tube does not enter the patient's trachea fully
B page 831-832
You should insert the ET tube between the vocal cords until the: A) distal end of the cuff is 1 to 2 cm past the vocal cords B) proximal end of the cuff is 1 to 2 cm past the vocal cords C) tube meets resistance as it makes contact with the carina D) centimeter marking reads 15 cm at the patient's teeth
B page 838
If the ET tube has been positioned properly in the trachea: A) breath sounds should be somewhat louder on the right side and the epigastrium should be silent B) the bag-mask device should be easy to compress and you should see corresponding chest expansion C) breath sounds should be loud at the apices of the lungs but somewhat diminished at the bases D) you should not see vapor mist in the ET tube during exhalation when ventilating with a bag-mask device
B page 839
.Which of the following represents the MOST correct technique for preforming transillumination-guided intubation? A) place the patient's head in a neutral position, displace the tongue with a tongue blade, and insert the tube-stylet combination in the midline of the mouth B) Grasp the lower jaw with your thumb and forefinger, displace it forward, and insert the tube-stylet combination in the midline of the patient's mouth C) Place the patient head in a hyperflexed position and insert the tube-stylet combination into the left side of the mouth D) hyperextend the patient's head, pull the jaw down, and insert the tube-stylet combination into the right side of the patient's mouth
B page 852-853
An intuabted 33 year old man is becoming agitated and begins moving his head around. Your estimated time of arrival at the hospital is 15 minutes. you should: A) suction his airway and carefully extubate B) administer a sedative medication C) chemically paralyze him with vecurnium D) physically restrain his head to the stretcher
B page 859
The MOST obvious risk associated with extubation is: A) a moderate airway swelling as the ET tube is removed B) overestimating the patient's ability to protect his or her own airway C) bradycardia from stimulation of the parasympathetic nervous system D) patient retching and gagging as your remove the ET tube
B page 859
Appropriate insertion of a soft-tip (whistle-tip) suction catheter down the ET tube involves: A) inserting the catheter no farther than 6 to 8 in. B) gently inserting the catheter until resistance is felt C) applying suction while gently inserting the catheter D) inserting the catheter until secretions are observed
B page 8599869
When performing an open cricothyrotomy, you should FIRST: A) maintain aseptic technique as you cleanse the area with iodine B) palpate for the V notch of the thyroid cartilage and stabilize the larynx C) hyperextend the patient's neck and then palpate the crioid cartilage D) slide your index finger between the thyroid and cricoid cartilages
B page 880
After inserting the needle into through the cricothyroid membrane, you should next: A) aspirate with the syringe and then insert the needle about 2 cm farther B) insert the needle about 1 cm farther and then aspirate with the syringe C) advance the catheter over the needle until the hub is flush with the skin D) change your angle to 90 degree and advance the catheter over the needle
B page 883
Which of the following patients is LEAST likely in need of positive pressure ventilation? A) Semiconscious 39-year-old man with shallow chest wall movement, cyanosis, and bradypnea B) Conscious 36-year-old man with difficulty breathing, symmetrical chest rise and fall, and flushed skin C) confused 46 year old women with labored respiration's, adventitious breath sounds, and pallor D) conscious 41 year old women with two world dyspnea, perioral cyanosis , and tachycardia
B pages 783-784
All of the following are complications associated with orotracheal intubation, EXCEPT: A) barotrauma from forceful ventilation B) necrosis of the nasal mucosa C) Laryngeal swelling D) damage to the vocal cords
B pages 831
Neuromuscular blocking agents: A) are most commonly used as the sole agent to facilitate placement of an ET tube B) convert a breathing patient with a marginal airway into an apneic patient with no airway C) induce total body paralysis within 10 to 15 minutes following administration via IV push D) have a negative effect on both cardiac and smooth muscle and commonly cause dyshythmias
B pages 862
You are transporting an intubated patient and note that his ETCO2 reading has fallen below 30 mm Hg. you should: A) promptly extubate the patient and ventilate with a bag-mask device B) take immediate measures to comfirm proper placement of the ET tube C) slow your ventilation rate to see if the ETCO2 reading decreases D) hyperventilate the patient to see if the ETCO2 reading increases
C
Capography is a reliable method for confirming proper ET tube placement because: A) capnographers measure the amount of exhaled oxygen B) capnographers measure the amount of carbon dioxide in inhaled air C) carbon dioxide is not present in the esophagus D) it is a reliable indicator of the patient's PaO2 level
C page 792
The use of capnography in patients with prolonged cardiac arrest may be limited because: A) metabolic alkalosis damages the colorimetric paper B) of an excess buildup of nitrogen in the blood C) of acidosis and minimal carbon dioxide elimination D) the paramedic often ventilates the patient to slowly
C page 792
After inserting oropharyngeal airway in an unresposive women, the patient begins to gag. you should: A) suction her oropharynx for up to 15 seconds B) spray an anesthetic medication into her mouth C) remove the airway and have suction ready D) turn the patient on her side in case she vomits
C page 800
Hyperventilating an apneic patient: A) is appropriate if the patient is an adult B) reduces the incidence of gastric distention C) may decrease venous return to the heart D) is beneficial if the pulse rate is too slow
C page 811-812
A 66-year-old women is found to be unresponsive and apneic. Her carotid pulse is weak and rapid. When ventilating this patient, you should deliver: A) each breath over 2 seconds at a rate of 10 breaths/min B) one breath over 1 second every 3 to 5 seconds C) each breath over 2 seconds every 5 to 6 seconds
C page 814
Which of the following is an indicator of inadequate artificial ventilation when ventilating an apneic, tachycardic adult with a bag-mask device? A) One breath is given every 10 to 12 sseconds B) The patient's heart rate slows down C) about 20 breaths per minute are being delivered D) Each ventilation is delivered over 1 second
C page 816
CPAP is NOT appropriate for patients with: A) evidence of congestive heart failure B) acute or chronic bronchospasm C) slow, shallow respiratory effort D) an oxygen saturation less than 9-%
C page 818
You have been providing bag-mask ventilation's to an unresponsive, apneic patient with facial trauma for approximately 10 minutes. After intubating the patient, you should: A) ventilate the patient at a rate of 12 to 20 breaths/min B) insert a nasopgastric tube to decompress the stomach C) insert an orogastric tube to relieve gastric distention D) hyperventilate the patient with 100% oxygen
C page 820
you are dispatched to the residence of a 19 year old man who has tracheostomy tube and is on a mechanical ventilator. According to the patient's mother, he began experiencing difficulty breathing about 30 minutes ago. Auscultation of his lungs receals bilaterally diminished breath sounds, and his oxygen saturation is 80%. You disconnect the patient from the mechanical ventilator and begin bag-mask ventilations; however, you meet significant resistance. you should: A) remove his tracheotomy tube and replace it with a new one B) suspect that he has bilateral pneumothoraces C) remove the bag-mask device and suction his tracheostomy tube D) ventilate with a demand valve and transport at once
C page 824
A mouth-opening width of less than ___ cm indicates a potentially difficult airway. A) 3 B) 4 C) 2 D) 5
C page 829
A Cormack-Lehane Class 3 airway is characterized by: A) a full view of the glottic opening B) an inability to see the epiglottis or glottis C) visualization of the epiglottis only D) a partial view of the arytenoid cartilage
C page 831
When inserting a stylet into an ET tube, you must ensure that: A) the stylet is rigid and does not allow the ET tube to bend B) you use a petroleum-based gel to facilitate easy removal C) the stylet rests at least 1/2 inch back from the end of the tube D) the tube is bent in the form of a U to facilitate placement
C page 832
You will know that you have achieved the proper laryngoscopic view of the vocal cords when you see: A) the tip of the straight blade touching the posterior wall of the pharynx B) the epiglottis lift when the tip of the curved blade is resting underneath it C) two white fibrous bands that lie vertically within the glottic opening D) the thyroid cartilage bulge anteriorly as your lift up o the larynogoscope
C page 837
The BEST way to be certain that the ET tube has passed through the vocal cords is to: A) note the appropriate color change of the capographer B) feel the ridges of the tracheal wall with the ET tube C) visualize the tube passing between the vocal cords D) ensure the presence of bilaterally equal breath sounds
C page 838
which of the following statement regarding field extubation is correct? A) The risk of laryngospasm following extubation is relatively low B) Extubation should be performed with the patient in a supine position C) it is generally better to sedate the patient rather than extubate D) the patient should be extubated if spontaneous breathing occurs
C page 859
Fentanyl (Sublimaze) is a: A) sedative-hypnotic drug B) benzodiazepine sedative C) narcotic analgesic D) butrophenone sedative
C page 863
Nondepolarizing neuromusclar blocking agents include all of the following, EXCEPT: A) vecuronium bromide B) rocuronum bromide C) succinycholine chloride D) pancuronium bromide
C page 863
Paralytic medications exert their effect by: A) blocking the function of the autonomic nervous system and impeding the action of acetylcholinesterase B) blocking the release of epinephrine and norepinephrine from the sympathetic nervous system C) functioning at the neuromuscular junction and relaxing the muscle by impeding the action of acetycholine D) competitively binding the motor neurons in the brain, thus blocking their ability to send messages
C page 863
When a patient is given a paralytic without sedation: A) placement of an ET tube is less traumatic B) you should only give one-tenth of the standard dose C) he or she is fully aware and can hear and feel D) paralysis is not achieved and intubation is not possible
C page 863
If the patient's oxygen saturation drops at any point during rapid-sequence intubation, you should: A) apply posterior criocoid pressure and continue the intubation attempt B) continue the intubation attempt and monitor the cardiac rhythm closely C) abort the intubation attempt and ventilate wit a bag-mask device D) stop and hyperventilate the patient at a rate of 24 breath/min
C page 865
The process of delayed sequence intubation involes: A) administering a paralytic only, followed by intubation in 2 to 3 minutes B) avoiding the need to intubate a patient through the use of CPAP or BPAP C) administering a sedative in order to facilitate oxygenation of the patient D)administering a sedative only, followed by intubation 3 to 5 minutes
C page 865
The concept of apneic oxygenation is based on the fact that: A) supplemental oxygen after chemical paralysis will not reduce a hypoxic event B) in the apneic patient, approximately 200 mL/min of carbon dioxide moves in the alveoli C) oxygen uptake by the alveoli will continue, even when the diaphragm is not moving D) the average healthy adult patient will not desaturate for 15 to 20 minutes
C page 866
The main disadvantage of the LMA is that it: A) is associated with significant upper airway swelling B) spontaneously dislodges in the majority of patients C) does not provide protection against aspiration D) is technically more difficult to perform than intubation
C page 869-870
A size 3 or 4 LMA: A) is less likely to become dislodged than smaller sizes B) is most suitable for use in morbidly obese patients C) will accommodate the passage of a 6.0-mm ET tube D) is appropriate to use in children younger than 6 years of age
C page 870
Proper insertion of LMA involes: A) flexing the patient's neck, depressing the tongue with a tongue blade, and blindly inserting the LMA B) inserting the LMA into the patient's mouth by following the curvature of the patient's tongue C) inserting the LMA along the roof of the mouth and using your finger to push the airway against the heard palate D)Lifting the patient's jaw upward and blindly inserting the LMA until you meet resistance
C page 871-872
Incising the cricothyroid membrane vertically will: A) minimize the risk of damaging the thyroid gland. B) facilitate insertion of an 8.0- to 9.0-mm ET tube. C) completely eliminate the risk of any external bleeding. D) increase the risk of damaging the external jugular veins
C page 879
Which of the following statement regarding translaryngeal catheter ventilation is correct? A) it provides a more definitive airway than an open cricothyrotomy B) the technique uses the tracheal wall as an entry point to the airway C) Ventilation is achieved by the use of a high-pressure jet ventilator D) it is more difficult to perform than an open cricothyrotomy
C page 880
A patient with a suppressed cough mechanism: A) often requires ventilation support B) should have continuous airway suctioning C) is at serious risk for aspiration D) should be intubated at once
C pages 785
When obtaining a peak expiatory flow rate for a patient with acute bronchospasm, you should: A) ensure that the patient is in a supine position to obtain an accurate reading B) administer one bronchodilator treatment before obtaining the first reading C) perform the test three times and take the best rate of the three readings D) ask the patient to fully exhale before blowing into the mouth piece
C pages 790
Refardless of the internal diameter, all ET tubes have: A) black millimeter markings on the side B) a 15/22 mm proximal adaptor C) an inflatable cuff at the dital tip D) a pilot ballon on the proximal end
B pages 831-832
After obtaining a peak expiatory flow reading of 200 mL, you administered one bronchodilator treatment to a 21 - year-old woman with an acute episode of expiatory wheezing. The next peak flow reading is 400 mL. You should: A) assist ventilation's and be prepared to intubate her B) give another bronchodilator treatment and reassess C) try another treatment modality to treat her wheezing D) recognize that the patient's condition has improved
D page 789
Assessment of a spontaneously perfusing patient's ETCO2 reveals small capnographic waveforms and reading of 22 mm Hg. Which of the following does this indicate? A) Bradypnea B) Respiratory acidosis C) Metabolic alkalosis D) Hyperventilation
D page 792
When administering oxygen via a nonrebreathing mask, you must ensure that the: A) flow rate is set to at least 6 L/min B) one-way valves are disabled C) reservoir is half-filled first D) patient has adequate tidal volume
D page 808
An 8-year-old child in cardiac arrest has been intubated. When ventilating the child, the paramedic should: A) allow partial exhalation between breaths B) deliver on breath every 15 seconds C) observe for full chest expansion D) deliver 10 breaths per minute
D page 814
Which of the following is NOT proper procedure when inserting a nasogastric tube in a responsive patient? A) injecting 25 mL of air into the tube while auscultating over the epigastrium B) encouraging the patient to swallow or drink to facilitate passage of the tube C) administering a topical alpha agonist to constrict the nasal vasculature D) keeping the patient's head in an extended position while inserting the tube
D page 820-822
Patients with a partial laryngectomy: A) are easy to differentiate from patients who have had a total laryngectomy, especially when they are apneic B) cannot be ventilated with the mouth-to-mask technique because there is no connection between the pharynx and lower airway C) have had their entire larynx removed and breathe through an opening in the neck called a stoma D) are called partial neck breathers because they breathe through both a stoma and the nose and mouth
D page 823-824
Patients with laryngectomies MOST commonly debelop muscous plugs in their stoma because: A) the diameter of the stoma is small B) their swalloing mechanism is suppressed C) they are at higher risk for pneumonia D) they do not possess an efficient cough
D page 824
When looking inside a patient's mouth, you cannot see the posterior pharynx and only the base of the uvula is exposed. This is indicative of a Mallampati Class: A) IV B) II C) I D) III
D page 830
Which of the following is NOT a step that is performed during nasotracheal intubation? A) Advancing the ET tube as the patient inhales B) preoxygenating with a bag-mask device as necessary C) Placing the patient's head in a neutral position D) Ensuring that the patient's head is hyper-flexed
D page 848-850
Which of the following medications is a dissociative anesthetic that produces anesthesia through hallucinogenic, amnesic, analgesic, and sedative effects? A) Fentanyl B) Diazepam C) Versed D) Ketamine
D page 861-862
Drugs such as vecuronium bromide (Norcuron) and pancuronium bromide (Pavulon) are MOST appropriate to administer when: A) you have a transport time of less than 15 minutes B) longer-acting paralytics are containdicated C) intubation of the patient is anticipated to be difficult D) extended periods od paralysis are needded
D page 864
How does the i-gel differ from the LMA? A) The i-gel mask holds more air than the LMA B) the lumen of the i-gel is smaller than the LMA C) the i-gel comes in only two sizes D) the i-gel has a noniflatable mask
D page 871
When correctly placed, the distal tip of the Cobra perilaryngeal airway (CobraPLA): A) enters the esophagus and provides complete obturation B) rests against the arytenoid cartilage and enters the glottis C) is in almost perfect alignment with the esophageal opening D) is proximal to the esophagus and seals the hypoharynx
D page 873
You should be MOST suspicious of the tube misplacement following an open cricothyrotomy if: A) there is minimal rise of the chest during ventilations B) progressive redness is noted around the insertion site C) bleeding from the subcutaneous tissue is observed D) a crackling sensation is noted when palpating the neck
D page 879
If return of spontaneous circulation (ROSC) occurs, which of the following ETCO2 findings would expext to encounter? A) A progressive decrease in the ETCO2 reading B) Complete loss of a capnorahic waveform C) Capnograhic waveforms that get smaller D) An abrupt and sustained increase in ETCO2
D pages 791, 794
You are caring for a 69-year-old man with congestive heart failure. His breathing is profoundly labored, his oxygen saturation reads 79% on oxygen via nonrebrathing mask, and he is showing signs of physical exhaustion. Considering that your protocols do not allow you to perform rapid sequence intubation, you should. A) insert an oral airway, assist ventilations with a bag-mask device, and transport at once B) give him Valium for sedation, perform orotracheal intubation, and transport to the hospital at once C) insert a nasopharyngeal airway and ensure that the nonrebreathing mask is tightly secured to his face D) proxygenate him with a bag-mask device and then perform blind nasotracheal intuation
D pages 846-847
A patient with orthopnea: A) awakens at night with dyspnea B) has blood-tinged sputum C) is breathing through pursed lips D) has dyspnea while lying flat
D page 783
If the distance between the hyoid bone and the thyroid notch is at least ____ fingerbreadths wide, the difficulty of intubation should be low. A) four B) one C) two D) three
C page 829-830
