2207 exam 2 Flashcards
You are managing a 29-year-old male patient who was shot in the head. There is a gurgling noise in the airway.
The patient is breathing spontaneously at 42 breaths per minute and has a heart rate of 110 and a systolic and diastolic pressure of 102/82.
In which of the following situations would you expect end tidal carbon dioxide levels to be very low, despite a patient airway?
-Room air PPV
- Hyperthermia
- Hypoventilation
- Cardiac arrest
Cardiac arrest
When performing tracheobronchial suctioning, what should be the maximum amount of suction time?
15 seconds
20 seconds
10 seconds
5 seconds
20 seconds
A musical, squeaking, or whistling sound that may be heard on inspiration or expiration while auscultating lung fields is known as:
Crackles
Stridor
Rhonchi
Wheezing
Wheezing
Which of the following is a disadvantage of pulse oximetry?
Tissue hypoxia may be present even with a normal SaO2 reading.
Pulse oximetry cannot differentiate between hemoglobin bound to oxygen and hemoglobin bound to carbon monoxide.
Pulse oximetry gives no information about the amount of carbon dioxide in the blood.
All of the above are disadvantages.
All of the above are disadvantages
A portable suction device should generate a flow rate of ________ liters per minute when the tube is open.
20
30
40
5
30
The respiratory rate may be greater than normal because?
Alcoholic beverage ingestion
The use of medications such as diazepam or morphine
Being asleep or nearly asleep
Metabolic acidosis
l because of:
Metabolic acidosis
Physiologically, the term respiration refers to the:
Exchange of gases at the alveolar-capillary interface
Mechanical process that moves air into and out of the lungs
Exchange of all gases, nutrients, and wastes at the cellular level
Exchange of gases at the cellular level
unknown
An attempt at endotracheal intubation must not interrupt ventilations for more than ________ seconds.
10
15
20
30
unknown
The maximum flow rate to be used with a nasal cannula is ________ liters per minute.
10
6
8
4
6
Which of the following is an objective technique to verify proper endotracheal tube placement?
Direct visualization
Esophageal detector device
Tube misting
Auscultation
unknown
Insertion of an endotracheal tube too far is likely to result in ventilation of:
The right lung only
The left lung only
Only the lower lobes of both lungs
Neither lung
The right lung only
At the end of exhalation, the intrathoracic pressure is:
Significantly less than atmospheric pressure
Slightly less than atmospheric pressure
Greater than atmospheric pressure
Equal to atmospheric pressure
Equal to atmospheric pressure
The tip of a curved laryngoscope blade is placed correctly:
At the junction of the hard and soft palates
At the glottic opening
Under the epiglottis
In the vallecula
In the vallecula
Which of the following is the most common cause of airway obstruction?
Foreign bodies
Food
Upper airway edema
The tongue
The tongue
The MOST common indication for a surgical cricothyrotomy is:
Massive facial or neck trauma
Failed rapid sequence intubation
Status seizures with trismus
Foreign body airway obstruction
Massive facial or neck trauma
When you are suctioning an adult patient, the onset of bradycardia is most likely due to:
Hypercarbia
Hypoxia
Stimulation of the vagus nerve
Increased intracranial pressure
Stimulation of the vagus nerve
As the thoracic cavity begins to expand, the intrathoracic pressure:
Does not change
Is greater than atmospheric pressure
Is the same as atmospheric pressure
Is less than atmospheric pressure
Is the same as atmospheric pressure
What airway intervention should be performed first on this patient?
Head-tilt/chin-lift maneuver
Suctioning the airway
Insertion of an oropharyngeal airway
Endotracheal intubation
unknown
Which of the following is the correct order of events after an endotracheal tube has been properly inserted?
Inflate the cuff with 5 to 10 cc of air, secure the tube, listen for equal breath sounds bilaterally, and listen for breath sounds over the epigastrium.
Inflate the cuff with 5 to 10 cc of air, auscultate the epigastrium and then the lungs, and secure the tube.
Secure the tube, listen for breath sounds over the epigastrium, listen for equal breath sounds bilaterally, and inflate the cuff with 5 to 10 cc of air.
Inflate the cuff with 5 to 10 cc of air, listen for breath sounds over the epigastrium, listen for equal breath sounds bilaterally, and secure the tube.
unknown
Which of the following serves as an important visual landmark when performing endotracheal intubation under direct intubation?
Cricothyroid membrane
Cricoid cartilage
Thyroid cartilage
Posterior cartilages
unknown
In which of the following conditions is insertion of a nasogastric tube contraindicated?
Patient having a gag reflex
Patient with facial fractures
Patient awake and alert
All of the above
unknown
The correct rate of assisted ventilation for this patient is ________ breaths per minute.
6
12
14
18
12
When a bag-valve ventilation device is used with supplemental oxygen, it delivers an oxygen concentration of ________ percent.
40
90
60
21
unknown
Which of the following mechanisms is responsible for hypoxemia in the patient with a pulmonary embolism?
Pulmonary shunting
Pulsus paradoxus
Lower airway obstruction
Atelectasis
Pulmonary shunting
When a portion of the lung is unavailable for gas exchange, yet pulmonary circulation continues in that area of the lung, a condition known as ________ results.
Pulsus paradoxus
Ventilation-perfusion mismatch
Atelectasis
Eupnea
Ventilation-perfusion mismatch
Which of the following increases the risk of foreign body airway obstruction
Age
Alcohol consumption
Dentures
All of the above
All of the above
During a respiratory assessment, the absence of breath sounds may indicate:
A pneumothorax
A pulmonary embolism
Flail chest
Bronchitis
A pneumothorax
When correctly placed, the tip of a straight laryngoscope blade should be:
Under the epiglottis
At the uvula
At the soft palate
In the vallecula
Under the epiglottis
A high-pitched inspiratory noise caused by a partial upper airway obstruction is called:
Stridor
Dysphonia
Rhonchi
Wheezing
Stridor
When you are intubating a stoma site, how far beyond the distal cuff (in cm) should you insert the endotracheal tube?
1 to 2
3 to 4
2 to 3
4 to 5
1 to 2
The reading obtained by the use of a pulse oximeter reflects the:
Amount of saturated hemoglobin per deciliter of blood
Amount of oxygen dissolved in the blood
Ratio of unsaturated hemoglobin to saturated hemoglobin
Partial pressure of oxygen in capillary blood
Ratio of unsaturated hemoglobin to saturated hemoglobin
Which of the following best suggests an esophageal intubation?
Color change from purple to yellow with a colorimetric ETCO2 detector
Free return of air when aspirating with an esophageal detector device
Gurgling sounds over the epigastrum with each ventilation delivered
Maintaining a pulse oximetry reading of 80 to 85 percent
Color change from purple to yellow with a colorimetric ETCO2 detector
Which of the following interferes with ventilation in the presence of a flail segment?
The ability to generate positive intrathoracic pressure is impaired.
Intrathoracic pressure increases on the affected side.
Intrathoracic pressure decreases on the affected side.
The ability to generate negative intrathoracic pressure is impaired.
The ability to generate negative intrathoracic pressure is impaired.
What is the normal partial pressure of oxygen in the arterial blood?
35 to 45
50 to 75
80 to 100
100 to 150
80 to 100
Which of the following basic airway adjuncts prevents the tongue from falling back to occlude the airway?
Yankauer catheter
Laryngeal mask airway
Nasal cannula
Oropharyngeal airway
Oropharyngeal airway
All of the following are indications for endotracheal intubation, EXCEPT:
A heart rate over 100
Respiratory arrest
Cardiac arrest
Airway swelling.
Airway swelling.
The tip of the endotracheal tube for the pediatric patient should be inserted no more than ________ cm below the vocal cords.
1 to 2
3 to 4
2 to 3
4 to 5
2 to 3
Which of the following may complicate airway management procedures in the pediatric patient?
The trachea narrows at the cricoid cartilage.
The tongue occupies a greater proportion of space.
The epiglottis is larger and floppier than in an adult.
All of the above are possible complications.
All of the above are possible complications.
Of the normal tidal volume for the average 70-kg adult, what amount of air (in ml) is NOT available for gas exchange?
50
100
150
250
150
Without adequate airway maintenance and ventilation, the patient can succumb to brain injury or death in how many minutes?
4
10
6
12
unknown
Which of the following manual airway maneuvers should be used when you are caring for a patient with a suspected cervical spine injury?
Sellick’s
Modified jaw-thrust
Jaw/tongue lift
Head-tilt/chin-lift
Modified jaw-thrust
Progressively deeper, faster breathing alternating gradually with shallow, slower breathing is called:
Cheyne-Stokes respirations
Kussmaul’s respirations
Biot’s respirations
Agonal respirations
Cheyne-Stokes respirations
The hypoxic drive is stimulated by:
High PaCO2
Low PaO2
High PaO2
Low PaCO2
Low PaO2
A(n) ________ may be used to facilitate nasotracheal intubation.
Uncuffed endotracheal tube
Malleable stylette
Lighted stylette
Endotrol tube
unknown
A fine, bubbling sound heard on inspiration and associated with fluid in the alveoli and terminal bronchioles is called?
Bronchovesicular sounds
Rales (crackles)
Rhonchi
Pleural frictionhioles is called:
Rales
During spontaneous breathing, which of the following reflexes prevents overinflation of the lungs?
Cheyne-Stokes
Hering-Breuer
Apneustic
Cushing’s
Hering-Breuer
A drop in blood pressure of greater than 10 torr during inspiration is called:
Pulsus paradoxus
Pulsus obliterans
Pulsus tardus
Pulsus alternans
Pulsus paradoxus
The automatic transport ventilator is contraindicated for all of the following intubated patients, EXCEPT:
A 17-year-old gunshot victim
A 4-year-old near-drowning victim
A 56-year-old in pulmonary edema
A 34-year-old with adult respiratory distress syndrome
A 17-year-old gunshot victim
The movement of oxygen from the alveoli to the blood in the pulmonary capillaries depends on:
Facilitated transport by way of the hemoglobin molecule
Active transport of oxygen from an area of lower concentration to an area of higher concentration
Diffusion of oxygen from an area of higher concentration to an area of lower concentration
Osmosis of the H2O molecule across the respiratory membrane, where oxygen dissociates from hydrogen
Diffusion of oxygen from an area of higher concentration to an area of lower concentration
Which of the following statements about manual airway maneuvers is TRUE?
They require specialized equipment.
They are often neglected by EMTs and paramedics.
They are contraindicated in trauma patients.
They are difficult to learn.
They are often neglected by EMTs and paramedics.
