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S1 > 15 Airway Management, Respiration, and Artificial Ventilation > Flashcards

15 Airway Management, Respiration, and Artificial Ventilation Flashcards

1
Q 
The phrenic nerve originates from which spinal nerves?
A.
C1 - C2 - C3
C.
C5 - C6 - C7
B.
C3 - C4 - C5
D.
C6 - C7 - T1
A

B

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2
Q 
What is an aspect of expiration?
A.
Always active to counter the active inspiratory center
B.
Inactive during quiet respiration
C.
Controlled by the fifth cranial nerve
D.
Necessary for normal respiration
A

B

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3
Q 
What structure contains the chemoreceptors?
A.
Cerebrum
C.
Spinal cord
B.
Blood vessels in the extremities
D.
Arch of the aorta
A

D

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4
Q 
When stretch receptors are stimulated by expansion of the lungs, information is conveyed to the medulla by which nerve?
A.
Intercostal
C.
Phrenic
B.
Vagus
D.
Diaphragmatic
A

B

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5
Q 
What structure contains the pneumotaxic center?
A.
Pons
C.
Cerebellum
B.
Hypothalamus
D.
Medulla oblongata
A

A

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6
Q 
What is the major difference from the left mainstem bronchus and the right mainstem bronchus?
A.
Shorter
C.
More angled from the trachea
B.
Narrower
D.
Made of thicker membrane
A

A

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7
Q 
What is the transfer of oxygen and carbon dioxide between the capillary red blood cells and the tissue cells called?
A.
Pulmonary ventilation
C.
External respiration
B.
Internal respiration
D.
Internal ventilation
A

B

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8
Q

The intrathoracic pressure is normally _____.
A.
Much higher than the atmospheric pressure
B.
Less than atmospheric pressure
C.
Equal to the atmospheric pressure
D.
Slightly higher than atmospheric pressure

A

B

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9
Q

Air normally moves into the lungs from the _____.
A.
Pressure gradient created when the lungs expand
B.
Higher pressure within the lungs during inspiration
C.
Positive pressure forcing air into the lungs
D.
Increased intrathoracic pressure during inspiration

A

A

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10
Q

What is diffusion?
A.
The active transport of gas with energy expended
B.
A gaseous substance dissolving in a liquid substance
C.
The movement of a gas from a lower pressure to a higher pressure across a semipermeable membrane
D.
The movement of a gas from a higher pressure to a lower pressure across a semipermeable membrane

A

D

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11
Q 
The normal movement of the diaphragm during inspiration \_\_\_\_\_.
A.
Causes the diaphragm to move up
B.
Increases the side-to-side dimensions of the chest
C.
Flattens the diaphragm
D.
Causes passive inhalation
A

C

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12
Q 
The ease with which the lungs expand during inspiration is known as what aspect?
A.
Pulmonary pressure
C.
Inspiratory pressure gradient
B.
Compliance
D.
Atmospheric diffusion
A

B

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13
Q

What is the function of pulmonary surfactant?
A.
Increases airway pressures within the lungs
B.
Lowers the surface tension, preventing alveolar collapse
C.
Increases the attractive forces between the water molecules in the lungs
D.
Lowers the recoil in the elastic fibers in the alveolar walls

A

B

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14
Q

Scalene and sternocleidomastoid muscles are normally used during what occurrence?
A.
During normal quiet breathing
B.
During mouth breathing
C.
As voluntary muscles if a patient chooses to take a deep breath
D.
As accessory muscles during labored breathing

A

D

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15
Q

What is physiologic dead space?
A.
Normally 10 times the volume of anatomic dead space
B.
Created by the upper respiratory tract and nonrespiratory bronchioles
C.
Increased in patients with respiratory diseases such as emphysema
D.
Composed of the nonfunctional alveoli

A

C

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16
Q

Tidal volume is the amount of air _____.
A.
Inhaled or exhaled during a normal breath
B.
Left in the lungs after a forceful exhalation
C.
One can inhale after a maximal inhalation
D.
Always present in the alveoli

A

A

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17
Q

Minute volume is the amount of air _____.
A.
That can be inhaled after a maximal inhalation
B.
In the tidal volume multiplied by the respiratory rate
C.
In the dead space moved in and out of the respiratory tract each minute
D.
Available for gas exchange in every minute

A

B

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18
Q 
A patient with a tidal volume of 500 mL, a dead space of 100 mL, and a respiratory rate of 10 breaths per minute has a minute alveolar ventilation of \_\_\_\_\_ L per minute.
A.
6
C.
4
B.
5
D.
3
A

C

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19
Q 
A hiccup results from the stimulation of which structure?
A.
Lungs
C.
Diaphragm
B.
Nasal passages
D.
Intercostal muscles
A

C

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20
Q 
What gas is most prevalent in the atmosphere?
A.
Oxygen
C.
Water vapor
B.
Carbon dioxide
D.
Nitrogen
A

D

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21
Q 
Blood in the pulmonary veins is \_\_\_\_\_.
A.
Transported to the right and left lungs
C.
High in carbon dioxide
B.
Transported to the right atrium
D.
High in oxygen
A

D

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22
Q 
Which reading is a normal PO2?
A.
80 mm Hg
C.
120 mm Hg
B.
100 mm Hg
D.
140 mm Hg
A

A

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23
Q 
Which reading is a normal PCO2?
A.
25 mm Hg
C.
45 mm Hg
B.
35 mm Hg
D.
55 mm Hg
A

B

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24
Q 
Most of the oxygen in blood is carried \_\_\_\_\_.
A.
Dissolved in plasma
C.
As carboxyhemoglobin
B.
Attached to hemoglobin
D.
Attached to leukocytes
A

B

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25
Q 
Fully saturated hemoglobin can carry how many molecules of oxygen?
A.
1
C.
3
B.
2
D.
4
A

D

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26
Q

What is the most important factor in determining the extent to which oxygen combines with hemoglobin?
A.
Partial pressure of oxygen in the blood plasma
B.
Relative number of red blood cells in the plasma
C.
Number of oxygen receptor sites on the hemoglobin
D.
Partial pressure of oxygen in the lungs

A

A

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27
Q 
Which is likely to decrease carbon dioxide production?
A.
Resting quietly
C.
Ketoacidosis
B.
Anaerobic metabolism
D.
Exercise
A

A

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28
Q 
The majority of carbon dioxide in the blood is carried \_\_\_\_\_.
A.
Dissolved in plasma
C.
As bicarbonate ions
B.
Attached to hemoglobin
D.
Inside red blood cells
A

C

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29
Q 
What occurs as a result of hyperventilation?
A.
Dilated cerebral vessels
C.
Improved cerebral perfusion
B.
Hypercarbia
D.
Low carbon dioxide levels
A

D

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30
Q 
What is the major determinant(s) in controlling respiration?
A.
Oxygen content in the blood
C.
Partial pressure of carbon dioxide
B.
Impulses generated within the lungs
D.
pH of capillary blood
A

C

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31
Q 
A patient with chronic bronchitis is likely to rely on what mechanism to stimulate respiratory drive?
A.
Hypoxia
C.
Changes in pH
B.
Elevated carbon dioxide levels
D.
Increased bicarbonate ions
A

A

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32
Q 
Which respiratory pattern is characterized by an irregular pattern, rate, and volume, with intermittent periods of apnea?
A.
Cheyne-Stokes
C.
Central neurogenic hyperventilation
B.
Biot’s
D.
Agonal
A

B

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33
Q 
Which respiratory pattern is characterized by deep, rapid respirations?
A.
Cheyne-Stokes
C.
Central neurogenic hyperventilation
B.
Biot’s
D.
Agonal
A

C

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34
Q 
A 45-year-old man chokes on a piece of steak during dinner; he is coughing forcefully. How should the paramedic continue?
A.
Perform back blows
C.
Monitor the patient
B.
Attempt a finger sweep
D.
Give abdominal thrusts
A

C

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35
Q 
What is the primary cause of airway obstruction in unconscious patients?
A.
The tongue
C.
Toys or other small objects
B.
Loose-fitting dentures
D.
Incompletely chewed food
A

A

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36
Q 
What is the component of the oxygen delivery system in which 50 psi oxygen is reduced to 30 psi oxygen for safe patient delivery?
A.
Therapy regulator
C.
Flowmeter
B.
PIN index safety system
D.
Oxygen tank head
A

A

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37
Q 
What is the safe residual amount of oxygen a cylinder can contain when considered empty?
A.
200 psi
C.
1000 psi
B.
500 psi
D.
2000 psi
A

A

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38
Q

What is an advantage of liquid oxygen (LOX) over gaseous oxygen?
A.
The oxygen content in LOX is much higher
B.
A larger volume of LOX can be stored in a smaller space
C.
LOX is much cheaper than gaseous oxygen
D.
There are no special requirements for LOX storage and cylinder transfer

A

B

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39
Q 
The maximum acceptable flow rate for a nasal cannula is \_\_\_\_\_ L/min.
A.
4
C.
8
B.
6
D.
10
A

B

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40
Q 
A nasal cannula delivers \_\_\_\_\_% oxygen at a flow rate of 6 L/min in optimal conditions.
A.
35
C.
58
B.
44
D.
66
A

B

41
Q 
The minimum oxygen flow rate for any face mask is \_\_\_\_\_ L/min.
A.
2
C.
6
B.
4
D.
8
A

C

42
Q 
Oxygen concentrations of \_\_\_\_\_ can be delivered using a simple face mask at a flow rate of 10 L/min.
A.
20%-40%
C.
80%-90%
B.
40%-60 %
D.
100%
A

B

43
Q

What is an advantage of a Venturi mask?
A.
High concentrations of oxygen can be delivered.
B.
It uses less oxygen but delivers a higher concentration.
C.
It can be used to deliver a precise concentration of oxygen.
D.
It is color coded for easy recognition in dimly lit environments.

A

C

44
Q 
What is the most reliable indication that adequate tidal volumes are being delivered during artificial ventilation?
A.
The oxygen saturation improves.
C.
Adequate chest rise is observed.
B.
The patient’s color improves.
D.
The stomach inflates slightly.
A

C

45
Q

When delivering mouth-to-mask ventilations with supplemental oxygen, what should occur?
A.
It is not for the patient’s chest rise to be visible.
B.
Deliver each breath over 10 seconds.
C.
Slow the ventilatory rate to 1 breath every 8 seconds.
D.
Provide a minimum flow rate of 10 to 12 L/min.

A

D

46
Q 
The greatest difficulty in using a bag-mask device for mouth-to-mask ventilation is maintaining which aspect?
A.
Proper oxygen flow
C.
Consistent bag inflation
B.
Adequate mask seal
D.
Adequate ventilation rate
A

B

47
Q 
What concentration of oxygen does a bag-mask device with a reservoir and an adequate oxygen source (at least 15 L/min) deliver?
A.
21%
C.
80%
B.
40%-60%
D.
100%
A

D

48
Q

A bag-mask device for neonates, infants, and children should include which aspect?
A.
Be equipped with a fish-mouth-operated outlet valve
B.
Have a pop-off valve to prevent overinflation of the lungs
C.
Have a minimum volume of 450 mL
D.
Be used with an oxygen flow rate of 6 to 8 L/min

A

C

49
Q 
Before a second attempt at intubation, a patient should be well ventilated with 100% oxygen for \_\_\_\_\_ to \_\_\_\_\_ seconds.
A.
5, 10
C.
1, 2
B.
15, 30
D.
3, 5
A

B

50
Q 
Which position is the head and neck placed when using the sniffing position?
A.
Flex the neck and extend the head.
B.
Flex the neck so the chin is close to the chest.
C.
Flex the head and neck forward.
D.
Flex the head and extend the neck.
A

A

51
Q 
What is the maximum depth that a catheter should be inserted when suctioning a tracheotomy or stoma?
A.
3 to 5 cm
C.
5 to 10 cm
B.
3 to 5 inches
D.
5 to 10 inches
A

B

52
Q 
To apply cricoid pressure, place firm pressure against which structure?
A.
Hyoid bone
C.
Cricoid cartilage
B.
Thyroid cartilage
D.
Cricothyroid membrane
A

C

53
Q 
Automatic transport ventilators are typically contraindicated in which type of patients?
A.
Unresponsive
C.
Under 12 years of age
B.
Breathing spontaneously
D.
Awake
A

D

54
Q 
A catheter that is flexible and designed to suction smaller portions of the airway or through an endotracheal tube is known as a \_\_\_\_\_ catheter.
A.
Whistle-tip
C.
Tonsil-tip
B.
Yankauer
D.
Pharyngeal
A

A

55
Q 
In ideal circumstances, suctioning of an adult patient should not exceed \_\_\_\_\_ seconds.
A.
2
C.
15
B.
5
D.
20
A

C

56
Q 
Suctioning (application of negative pressure) should be activated upon:
A.
Insertion of the suction catheter
B.
Extraction of the suction catheter
C.
Both insertion and extraction
D.
Either insertion or extraction (it makes no difference)
A

B

57
Q

Nasogastric or orogastric tube placement can be confirmed by which assessment aspect?
A.
Lack of resistance noted upon insertion
B.
Auscultating over the epigastrium while injecting 30 to 50 mL of air
C.
Palpating the epigastrium during insertion
D.
Noting resistance to aspiration

A

B

58
Q

The nasopharyngeal airway should be measured from which point?
A.
The corner of the mouth to the earlobe
B.
The tip of the nose to the tragus of the ear
C.
The tip of the nose to the corner of the mouth
D.
The tip of the nose to the chin

A

B

59
Q 
While inserting the nasal airway, the beveled tip should be directed toward which point?
A.
Top of the nose
C.
Floor of the nose
B.
Septum of the nose
D.
Lateral cartilage of the nose
A

B

60
Q

Oropharyngeal airways are designed to perform which maneuver?
A.
Push the tongue into the oropharynx.
B.
Prevent the tongue from obstructing the glottis.
C.
Allow for better visualization during endotracheal intubation.
D.
Provide a guide for suction catheters.

A

B

61
Q

Which is an advantage of the oral airway?
A.
A good head position is no longer needed during ventilation.
B.
Adequate mask seal is no longer necessary during ventilation.
C.
The tongue will not obstruct the glottis during ventilation.
D.
The lower airway is protected from aspiration during ventilation.

A

C

62
Q 
The endotracheal (ET) tube size refers to the \_\_\_\_\_ in millimeters.
A.
External diameter
B.
Internal diameter
C.
Length
D.
Length of tube that will pass beyond the vocal cords
A

B

63
Q 
Cuffed ET tubes may be appropriate for children with which respiratory condition?
A.
Pneumonia
C.
Bronchitis
B.
ARDS
D.
Croup
A

B

64
Q 
When using a straight blade to intubate an adult patient, the tip of the blade should be placed in which location?
A.
Directly on the epiglottis
C.
In the vallecula
B.
Under the epiglottis
D.
Past the epiglottis at the vocal cords
A

A

65
Q 
Advocates of the curved blade claim which statement?
A.
Provides more exposure of the glottis
B.
Reduces the need for a stylet
C.
Is recommended for use on infants
D.
Provides more room for passage of the ET tube
A

D

66
Q

When intubating an adult patient with a curved blade, the tip of the blade should be placed in which spot?
A.
Under the epiglottis
B.
In the vallecula, at the base of the tongue
C.
In the vallecula, at the opening of the vocal cords
D.
To the right of the epiglottis

A

B

67
Q 
Which intubation technique may be performed without the use of specialized equipment?
A.
Orotracheal
C.
Retrograde
B.
Transluminal
D.
Digital
A

D

68
Q 
The distal cuff of the ET tube should hold \_\_\_\_\_ mL of air.
A.
5 to 10
C.
15 to 25
B.
10 to 20
D.
20 to 30
A

A

69
Q 
Nasotracheal intubation would be the airway procedure of choice for which patient condition?
A.
Cardiac arrest
C.
COPD
B.
Nasal trauma
D.
Basilar skull fracture
A

C

70
Q 
Phenylephrine spray is used during nasotracheal intubation to achieve which goal?
A.
Sedate the patient before the procedure
C.
Anesthetize the nasal passages
B.
Lubricate the nasal passages
D.
Constrict the blood vessels
A

D

71
Q

Which is true of nasotracheal intubation?
A.
Use an uncuffed endotracheal tube.
B.
Use a tube 1 to 2 sizes smaller than that used for orotracheal intubation.
C.
Use a longer endotracheal tube with a stylet.
D.
Use a tube that is slightly shorter than that used for orotracheal intubation.

A

B

72
Q 
The laryngeal mask airway \_\_\_\_\_.
A.
Is ideal for conscious patients
B.
Provides absolute protection against aspiration
C.
Generally protects against aspiration
D.
Is well tolerated by a patient with an intact gag reflex
A

C

73
Q

What is a disadvantage of the laryngeal mask airway (LMA)?
A.
Not all patients can be adequately ventilated with an LMA.
B.
The spine must be manipulated for insertion of an LMA.
C.
Patients commonly aspirate with this airway technique.
D.
The LMA must be removed before intubation.

A

A

74
Q 
To correctly position a patient’s head for Combitube insertion, the paramedic should implement which action?
A.
Place the patient in the sniffing position.
B.
Extend the head.
C.
Flex the neck.
D.
Place the head in the neutral position.
A

D

75
Q

Paramedics elect to place a Combitube in a patient suffering from cardiac arrest. After ventilating through the #1 port, and breath sounds are heard, what is the next most appropriate action?
A.
Remove the tube and ventilate the patient.
B.
Secure the tube and ventilate through the #1 port.
C.
Secure the tube and ventilate through the #2 port.
D.
Pull the tube back approximately 1 to 2 cm.

A

B

76
Q 
What does capnography measure?
A.
Oxygen levels in the blood
C.
Carbon dioxide levels in exhaled air
B.
Oxygen levels in the lungs
D.
Carbon dioxide levels in tissues
A

C

77
Q 
The end tidal CO2 detector of an intubated patient in cardiac arrest does not change color. After visually confirming the tube passing through the vocal cords, what should the paramedic suspect?
A.
The tube is definitely misplaced.
C.
There may be low cardiac output.
B.
The tube is in the esophagus.
D.
The CO2 detector is defective.
A

C

78
Q 
If an endotracheal tube has been correctly placed, an esophageal detector device will \_\_\_\_\_.
A.
Color change
C.
Reinflate more easily
B.
Give a normal CO2 readout
D.
Remain collapsed
A

C

79
Q 
What does pulse oximetry measure?
A.
Amount of oxygen saturation in blood
B.
Ratio of oxygen to carbon dioxide saturation in blood
C.
Amount of hemoglobin saturated with oxygen
D.
Partial pressure of oxygen
A

A

80
Q 
What location is necessary to use for a needle cricothyrotomy?
A.
Cricoid ring
C.
Cricothyroid membrane
B.
Thyroid cartilage
D.
Second laryngeal ring
A

C

81
Q 
What is the endotracheal tube size range used for cricothyrotomy?
A.
3.0 to 4.0
C.
6.0 to 7.0
B.
5.0 to 6.0
D.
7.0 to 8.0
A

C

82
Q

Which is an anatomical difference in a child’s airway as compared to that of an adult?
A.
A child’s tongue is small in relationship to the size of the mouth.
B.
The epiglottis is omega-shaped in a child.
C.
The vocal cords slope from front to back in infants.
D.
The distance from the vocal cords to the carina gets smaller with age.

A

B

83
Q 
The approximation of the correct depth of insertion in centimeters for a 10-year-old child is \_\_\_\_\_ cm.
A.
10
C.
17
B.
12
D.
22
A

C

84
Q

Lung sounds are heard after intubation only over the right lung of an adult patient. The endotracheal tube is at 27 cm at the teeth.

	What is the most likely explanation for the findings in the intubation scenario?
A.
Right mainstem intubation
C.
Left-sided pneumothorax
B.
Occlusion of the endotracheal tube
D.
Right-sided hypertympany
A

A

85
Q

Lung sounds are heard after intubation only over the right lung of an adult patient. The endotracheal tube is at 27 cm at the teeth.

What is the next appropriate action to take in the intubation scenario?
A.
Continue to ventilate the patient.
B.
Deflate the cuff and withdraw the tube 1 to 2 cm.
C.
Inflate the cuff with an additional 3 to 5 mL of air.
D.
Remove the tube.

A

B

86
Q

Lung sounds are heard after intubation only over the right lung of an adult patient. The endotracheal tube is at 27 cm at the teeth.

The endotracheal tube in this scenario is most likely placed in which structure?
A.
Trachea
C.
Left mainstem
B.
Right mainstem
D.
Esophagus
A

B

87
Q

Lung sounds are heard after intubation only over the right lung of an adult patient. The endotracheal tube is at 27 cm at the teeth.

What is the next action the paramedic should perform in this scenario?
A.
Continue ventilations and secure the tube.
B.
Pull the tube back 1 to 2 cm.
C.
Insert another endotracheal tube around the first one.
D.
Remove the endotracheal tube and oxygenate the patient.

A

B

88
Q 
When intubating using a lighted stylet, you see a dim, indistinct light in the throat. The paramedic has most likely intubated which structure?
A.
Right mainstem bronchus
C.
Esophagus
B.
Left mainstem bronchus
D.
Trachea
A

C

89
Q

You are called to the home of a 5-year-old male who has a tracheotomy and is on a ventilator. The patient’s mother called because she could not suction the tracheotomy adequately and the patient’s oxygen saturation is dropping. The mother states that the patient has been ill for the past 2 days with a fever, congested lungs, and copious amounts of thick, green-tinged mucus. You attempt to suction the tracheotomy with no results. What is the next action for the paramedic to perform?
A.
Remove the tracheotomy tube and replace it with a new one.
B.
Perform a translaryngeal cannulation.
C.
Ventilate the patient with a bag-mask device.
D.
Rapidly transport the patient.

A

A

90
Q

The paramedic notes the following: BP 170/100 mm Hg, P 50; ventilation assisted at one breath every 5 seconds; SaO2 not obtainable; etCO2 4 mm Hg after performing endotracheal intubation for a patient with COPD. What action should the paramedic take?
A.
Continue ventilation and reassess the patient in 5 minutes.
B.
Decrease the rate of ventilation to one breath every 6 seconds.
C.
Ensure that the cuff is inflated to the proper volume.
D.
Extubate the patient, ventilate, and reintubate.

A

D

91
Q

How do the drugs used in neuromuscular blockade cause paralysis?
A.
Acting on the calcium pumps in muscle cells
B.
Blocking the neuromuscular junction
C.
Blocking the sodium and potassium pumps in the muscle cells
D.
Blocking the muscular contraction at the sarcomere

A

B

92
Q

What is the definition of depolarizing agents?
A.
Substitute themselves for acetylcholine at the neuromuscular junction
B.
Substitute themselves for norepinephrine at the neuromuscular junction
C.
Block the uptake of acetylcholine at the neuromuscular junction
D.
Block the uptake of norepinephrine at the neuromuscular junction

A

A

93
Q

What is the definition of nondepolarizing agents?
A.
Substitute themselves for acetylcholine at the neuromuscular junction
B.
Substitute themselves for norepinephrine at the neuromuscular junction
C.
Block the uptake of acetylcholine at the neuromuscular junction
D.
Block the uptake of norepinephrine at the neuromuscular junction

A

C

94
Q 
Depolarizing agents have a \_\_\_\_\_ as compared to polarizing agents.
A.
Quicker onset and shorter duration
C.
Longer onset and shorter duration
B.
Quicker onset and longer duration
D.
Longer onset and longer duration
A

A

95
Q 
An example of a depolarizing neuromuscular blocking drug is which drug?
A.
Succinylcholine
C.
Fentanyl
B.
Vecuronium
D.
Etomidate
A

A

96
Q 
To blunt any potential rise in intracranial pressure during an intubation attempt, consider the administration of which drug?
A.
Atropine
C.
Vecuronium
B.
Lidocaine
D.
Fentanyl
A

B

97
Q 
After the administration of succinylcholine, a patient is usually relaxed enough for intubation after \_\_\_\_\_.
A.
10 seconds
C.
2 minutes
B.
45 seconds
D.
5 minutes
A

C

98
Q 
A drop in systolic blood pressure of 10 mm Hg or more during inspiration is known as which occurrence?
A.
Pericardial tamponade
C.
Orthostatic change
B.
Pulsus paradoxus
D.
Pulse pressure
A

B

S1 (21 decks)

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