MY EMT- Chapter 11: Airway Management
Central chemoreceptors located in the medulla provide feedback to increase the rate and depth of breathing when they sense: Select one: A. slight increases in carbon dioxide or a decrease in the pH of the cerebrospinal fluid. B. decreased levels of oxygen in the blood and an increase in the pH of the cerebrospinal fluid. C. slight decreases in carbon dioxide and an increase in the pH of the cerebrospinal fluid. D. increased levels of oxygen in the blood and a decrease in the pH of the cerebrospinal fluid.
A
During insertion of an oropharyngeal airway into an unconscious patient, she begins to vomit. The first thing you should do is: A. turn the patient on her side. B. remove the airway at once. C. suction the patient's mouth. D. use a smaller-sized oral airway.
A
Gas exchange in the lungs is facilitated by: Select one: A. adequate amounts of surfactant. B. pulmonary capillary constriction. C. surfactant-destroying organisms. D. water or blood within the alveoli.
A
In which of the following patients would the head tilt-chin lift maneuver be the MOST appropriate method of opening the airway? Select one: A. A 37-year-old female who is found unconscious in her bed B. A 45-year-old male who is semiconscious after falling 20 feet C. A 24-year-old male who is found unconscious at the base of a tree D. A 50-year-old male who is unconscious following head trauma
A
Intrapulmonary shunting occurs when: Select one: A. blood coming from the right side of the heart bypasses nonfunctional alveoli and returns to the left side of the heart in an unoxygenated state. B. a decrease in respiratory rate and depth causes carbon dioxide accumulation in the alveoli and an overall decrease in blood oxygen levels. C. the presence of pulmonary surfactant causes a decrease in alveolar surface tension, thus impairing the exchange of gases in the lungs. D. any impairment in circulatory function causes a reduced ability for oxygen and carbon dioxide to diffuse across the alveolar-capillary membrane.
A
The EMT should assess a patient's tidal volume by: A. observing for adequate chest rise. B. assessing the facial area for cyanosis. C. counting the patient's respiratory rate. D. measuring the patient's oxygen saturation.
A
The MOST significant complication associated with oropharyngeal suctioning is: Select one: A. hypoxia due to prolonged suction attempts. B. clogging of the catheter with thick secretions. C. vomiting from stimulating the anterior airway. D. oral abrasions from vigorous suctioning.
A
The partial pressure of oxygen in the alveoli is _______ mm Hg; the partial pressure of carbon dioxide in the alveoli is _______ mm Hg. Select one: A. 104, 40 B. 88, 30 C. 90, 50 D. 70, 28
A
The process of exchanging oxygen and carbon dioxide between the alveoli and the blood of the capillaries is called: Select one: A. external respiration. B. alveolar ventilation. C. pulmonary ventilation. D. cellular metabolism.
A
What is the MOST common cause of airway obstruction in an unconscious patient? Select one: A. The tongue B. Vomitus C. Blood clots D. Aspirated fluid
A
What is the alveolar minute volume of a patient with a tidal volume of 500 mL, a dead space volume of 150 mL, and a respiratory rate of 16 breaths/min? Select one: A. 5,600 mL B. 8,000 mL C. 7,400 mL D. 6,000 mL
A
Which of the following patients should you place in the recovery position? Select one: A. A 31-year-old semiconscious male with low blood sugar and adequate breathing B. A 19-year-old conscious male with a closed head injury and normal respirations C. A 24-year-old unconscious female who overdosed and has a reduced tidal volume D. A 40-year-old conscious female with a possible neck injury and regular respirations
A
Which of the following structures is NOT found in the upper airway? Select one: A. Bronchus B. Larynx C. Oropharynx D. Pharynx
A
While providing CPAP to a patient in severe respiratory distress, you note that his heart rate has increased by 20 beats/min. He is conscious, but is no longer following verbal commands. You should: Select one: A. remove the CPAP device and ventilate him with a bag-mask device. B. decrease the amount of pressure that the CPAP device is delivering. C. remove the CPAP device and apply oxygen by nonrebreathing mask. D. increase the amount of pressure that the CPAP device is delivering.
A
With a good mask-to-face seal and an oxygen flow rate of 15 L/min, the nonrebreathing mask is capable of delivering up to ______% inspired oxygen. Select one: A. 90 B. 70 C. 80 D. 100
A
You are ventilating an apneic woman with a bag-mask device. She has dentures, which are tight fitting. Adequate chest rise is present with each ventilation, and the patient's oxygen saturation reads 96%. When you reassess the patency of her airway, you note that her dentures are now loose, although your ventilations are still producing adequate chest rise. You should: Select one: A. remove her dentures, resume ventilations, and assess for adequate chest rise. B. leave her dentures in place, but carefully monitor her for an airway obstruction. C. leave her dentures in place and increase the rate and volume of your ventilations. D. attempt to replace her dentures so that they fit tightly and resume ventilations.
A
You are performing bag-mask ventilations with oxygen connected and set at a flow rate of 15 L/min. What percentage of oxygen are you delivering? Select one: A. Nearly 100% B. 65% C. 55% D. 45%
A. Nearly 100%
A patient who is suspected of being hypoxic and is breathing adequately should be given supplemental oxygen with a: Select one: A. bag-mask device. B. nonrebreathing mask. C. nasal cannula. D. mouth-to-mask device.
B
All of the following will help minimize the risk of gastric distention when ventilating an apneic patient with a bag-mask device, EXCEPT: Select one: A. delivering each breath over 1 second. B. increasing the amount of delivered tidal volume. C. ventilating the patient at the appropriate rate. D. ensuring the appropriate airway position.
B
An oxygen cylinder should be taken out of service and refilled when the pressure inside it is less than: Select one: A. 1,500 psi. B. 500 psi. C. 200 psi. D. 1,000 psi.
B
Breathing is controlled by an area in the: A. lungs. B. brainstem. C. spinal cord. D. diaphragm.
B
High-flow oxygen with a nasal cannula during the preoxygenation phase of endotracheal intubation is called: Select one: A. denitrogenation. B. apneic oxygenation. C. passive ventilation. D. active ventilation.
B
Which of the following oxygen flowmeters is NOT affected by gravity and can be used in any position when attached to an oxygen cylinder? Select one: A. Ball-and-float flowmeter B. Pressure-compensated flowmeter C. Vertical-position flowmeter D. Bourdon-gauge flowmeter
D
In contrast to inhalation, exhalation: Select one: A. requires muscular effort to effectively expel air from the lungs. B. is a passive process caused by increased intrathoracic pressure. C. is an active process caused by decreased intrathoracic pressure. D. occurs when the diaphragm lowers and expels air from the lungs.
B
Oxygen toxicity is a condition in which: Select one: A. decreased levels of oxygen in the blood result in free radical production. B. cellular tissue damage occurs from excessive oxygen levels in the blood. C. excessive blood oxygen levels cause the hypoxic patient to stop breathing. D. significantly low levels of oxygen in the blood damage the cellular tissue.
B
Signs of adequate breathing in the adult include all of the following, EXCEPT: A. pink, warm, dry skin. B. shallow chest rise. C. symmetrical chest movement. D. a respiratory rate of 16 breaths/min.
B
Structures of the lower airway include all of the following, EXCEPT: Select one: A. alveoli. B. the epiglottis. C. the trachea. D. bronchioles.
B
The __________ cartilage is a firm ring that forms the inferior part of the larynx. Select one: A. thyroid B. cricoid C. pyriform D. laryngeal
B
The pressure of gas in a full cylinder of oxygen is approximately _______ pounds per square inch (psi). Select one: A. 3,000 B. 2,000 C. 1,000 D. 500
B
The purpose of the pin-indexing system for compressed gas cylinders is to: Select one: A. help you determine what type of oxygen regulator to use. B. ensure that the correct regulator is used for the cylinder. C. prevent destroying or stripping the threads on the cylinder. D. reduce the cylinder pressure to a safe and more useful range.
B
To select the proper size oropharyngeal airway, you should measure from the: Select one: A. center of the mouth to the posterior ear. B. corner of the mouth to the earlobe. C. angle of the jaw to the center of the mouth. D. corner of the mouth to the superior ear.
B
When testing a mechanical suctioning unit, you should turn on the device, clamp the tubing, and ensure that it generates a vacuum pressure of more than: Select one: A. 100 mm Hg. B. 300 mm Hg. C. 400 mm Hg. D. 200 mm Hg.
B
Which of the following factors will cause a reduction in minute volume in an adult? Select one: A. Increased tidal volume B. Shallow breathing C. Respirations of 20 breaths/min D. Slight increase in respiratory rate
B
Which of the following organs or tissues can survive the longest without oxygen? Select one: A. Liver B. Muscle C. Heart D. Kidneys
B
Which of the following patients is breathing adequately? Select one: A. A conscious male with respirations of 18 breaths/min and reduced tidal volume B. A conscious male with respirations of 19 breaths/min and pink skin C. An unconscious 52-year-old female with snoring respirations and cool, pale skin D. A conscious female with facial cyanosis and rapid, shallow respirations
B
You and your partner are ventilating an apneic adult when you notice that his stomach is becoming distended. You should: A. suction his airway for up to 15 seconds. B. reposition his head. C. increase the rate and volume of your ventilations. D. decrease your ventilation rate but use more volume.
B
You are ventilating a patient with a stoma; however, air is escaping from the mouth and nose. To prevent this, you should: Select one: A. thrust the jaw forward. B. seal the mouth and nose. C. thoroughly suction the stoma. D. ventilate with less pressure.
B
An adult at rest should have a respiratory rate that ranges between: Select one: A. 8 and 15 breaths/min. B. 22 and 24 breaths/min. C. 12 and 20 breaths/min. D. 10 and 18 breaths/min.
C
For which of the following conditions would the EMT most likely administer humidified oxygen? Select one: A. Apnea B. Blood loss C. Croup D. Hypoxia
C
How does CPAP improve oxygenation and ventilation in patients with certain respiratory problems? Select one: A. It decreases intrathoracic pressure, which allows more room for lung expansion. B. It prevents alveolar collapse by pushing air into the lungs during inhalation. C. It forces the alveoli open and increases the concentration of oxygen in the alveoli. D. It pushes thick, infected pulmonary secretions into isolated areas of the lung.
C
Hypoxia is MOST accurately defined as: Select one: A. an increase in carbon dioxide in the blood. B. a decrease in arterial oxygen levels. C. inadequate oxygen to the tissues and cells. D. high oxygen levels in the tissues and cells.
C
In an otherwise healthy individual, the primary stimulus to breathe is a(n): A. increased level of oxygen in the blood. B. decreased level of oxygen in the blood. C. increased level of carbon dioxide in the blood. D. decreased level of carbon dioxide in the blood.
C
In the presence of oxygen, the cells convert glucose into energy through a process called: Select one: A. anaerobic metabolism. B. perfusion. C. aerobic metabolism. D. respiration.
C
In which of the following patients would a nasopharyngeal airway be contraindicated? A. A semiconscious patient with a gag reflex B. An unconscious patient with an intact gag reflex C. A patient who fell 20 feet and landed on his or her head D. An unconscious patient who gags when you insert an oral airway
C
Prior to applying a nonrebreathing mask to a patient, you must ensure that the: Select one: A. flow rate is set at 6 L/min. B. patient has reduced tidal volume. C. reservoir bag is fully inflated. D. one-way valve is sealed.
C
The hypoxic drive is influenced by: Select one: A. high blood oxygen levels. B. high blood carbon dioxide levels. C. low blood oxygen levels. D. low blood carbon dioxide levels.
C
The nasal cannula is MOST appropriately used in the prehospital setting: Select one: A. if long-term supplemental oxygen administration is required. B. when the patient breathes primarily through his or her mouth. C. when the patient cannot tolerate a nonrebreathing mask. D. if the patient's nasopharynx is obstructed by secretions.
C
Which of the following statements regarding positive-pressure ventilation is correct? Select one: A. Unlike negative-pressure ventilation, positive-pressure ventilation does not affect the esophageal opening pressure. B. To prevent hypotension, the EMT should increase the rate and force of positive-pressure ventilation. C. With positive-pressure ventilation, more volume is required to have the same effects as normal breathing. D. Positive-pressure ventilation allows blood to naturally be pulled back to the heart from the body.
C
You are delivering oxygen to a patient with a nasal cannula at 4 L/min when he begins to complain of a burning sensation in his nose. You should: A. remove the nasal cannula. B. apply a nonrebreathing mask. C. attach an oxygen humidifier. D. increase the flow rate to 6 L/min.
C
A 51-year-old female presents with a sudden onset of difficulty breathing. She is conscious and alert and able to speak in complete sentences. Her respirations are 22 breaths/min and regular. You should: Select one: A. insert a nasal airway in case her mental status decreases. B. assist her ventilations with a bag-mask device. C. perform a secondary assessment and then begin treatment. D. administer oxygen via a nonrebreathing mask.
D
A patient is found unconscious after falling from a third-floor window. His respirations are slow and irregular. You should: A. place him in the recovery position. B. apply oxygen via a nonrebreathing mask. C. suction his airway for up to 15 seconds. D. assist his breathing with a bag-mask device.
D
At a flow rate of 6 L/min, a nasal cannula can deliver an approximate oxygen concentration of up to: Select one: A. 24%. B. 35%. C. 52%. D. 44%.
D
Irregular respirations characterized by an increasing rate and depth of breathing followed by periods of apnea are called: Select one: A. eupneic respirations. B. ataxic respirations. C. agonal respirations. D. Cheyne-Stokes respirations.
D
The actual exchange of oxygen and carbon dioxide occurs in the: Select one: A. pulmonary capillaries. B. apex of the lung. C. bronchioles. D. alveolar sacs.
D
The diaphragm is innervated by the _________ nerve, which allows it to contract. Select one: A. vagus B. vestibulocochlear C. hypoglossal D. phrenic
D
The presence of elevated carbon dioxide levels in the blood is called: Select one: A. hypoxia. B. acidosis. C. hypoxemia. D. hypercarbia.
D
When ventilating an apneic adult with a bag-mask device, you should squeeze the bag: A. until it is empty. B. over a period of 2 seconds. C. at a rate of 20 breaths/min. D. until visible chest rise is noted.
D
Which of the following is a late sign of hypoxia? Select one: A. Anxiety B. Restlessness C. Tachycardia D. Cyanosis
D
Which of the following patients would MOST likely require insertion of an oropharyngeal airway? Select one: A. A 51-year-old confused patient with severely labored respirations B. A 64-year-old conscious patient with rapid and deep respirations C. A 33-year-old semiconscious patient with reduced tidal volume D. A 40-year-old unconscious patient with slow, shallow respirations
D
Which of the following statements regarding breathing adequacy is correct? Select one: A. A patient with slow respirations and adequate depth will experience an increase in minute volume. B. Patients with a grossly irregular breathing pattern usually do not require assisted ventilation. C. The single most reliable sign of breathing adequacy in the adult is his or her respiratory rate. D. Patients breathing shallowly may require assisted ventilation despite a normal respiratory rate.
D