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24 Respiratory Flashcards

1
Q 
Foreign body airway obstruction is defined as a problem with what?
A.
Ventilation
C.
Perfusion
B.
Diffusion
D.
Oxygenation
A

A

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2
Q 
What is the process of air moving into and out of the lungs?
A.
Ventilation
C.
Respiration
B.
Diffusion
D.
Oxygenation
A

A

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3
Q 
CNS depression will lead to what problem?
A.
Ventilation
C.
Perfusion
B.
Diffusion
D.
Oxygenation
A

A

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4
Q 
Pulmonary edema will lead to what problem?
A.
Ventilation
C.
Perfusion
B.
Diffusion
D.
Oxygenation
A

B

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5
Q

While gathering the history of an asthma patient, the patient states, “They had to intubate me last time this happened.” What does this information mean?
A.
An accurate indicator of severe pulmonary disease
B.
Not related to future ventilation needs
C.
Pertinent to this event; you should intubate this patient immediately.
D.
Important to the hospital staff but not important in the prehospital environment

A

A

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6
Q

What will bradycardia with a pulmonary complaint represent?
A.
A sign that the patient is handling the event well
B.
Less serious than tachycardia
C.
An ominous sign of severe hypoxemia
D.
A cardiac event and is not related to the pulmonary complaint

A

C

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7
Q 
Paramedics are treating a patient who reports that she has COPD. If she has emphysema, what finding would paramedics expect?
A.
A productive cough
C.
Chronic cyanosis
B.
Mild, chronic dyspnea
D.
A thick, barrel-chested appearance
A

D

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8
Q 
What might excessive positive intrathoracic pressure during an asthma attack lead to?
A.
Excessively increased preload
C.
Hypocapnia
B.
Hypertension
D.
Pulsus paradoxus
A

D

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9
Q 
Which adventitious lung sounds are most commonly associated with asthma?
A.
Stridor
C.
Rhonchi
B.
Rales (crackles)
D.
Wheezes
A

D

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10
Q 
What is the name of the test that measures the amount of expired air in a patient with respiratory problems?
A.
Capnography (ETCO2)
B.
PEEP (positive end-expiratory pressure)
C.
PEFR (peak expiratory flow rate)
D.
CPAP (continuous positive airway pressure)
A

C

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11
Q 
After measuring peak expiratory flow, paramedics note that this reading varies by 30% from previous readings. What does this indicate in regards to the exacerbation?
A.
Resolved
C.
Moderate
B.
Mild
D.
Severe
A

D

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12
Q 
What is the most common site for thrombus formation leading to pulmonary embolism?
A.
Upper arm
C.
Bone marrow
B.
Abdominal fat
D.
Legs
A

D

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13
Q 
Which is associated with patients with COPD?
A.
Pursed-lip breathing
C.
Clubbing of the fingertips
B.
Accessory muscle use
D.
All of the above
A

D

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14
Q 
Which patient would be predisposed to spontaneous pneumothorax?
A.
A female between ages 60 and 70
B.
A male between ages 60 and 70
C.
A patient who is thin and tall and has a narrow chest
D.
A patient who is short and obese
A

C

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15
Q 
What is a common finding on auscultation of lung sounds in a patient with a pulmonary embolism?
A.
Rales
C.
Wheezes
B.
Rhonchi
D.
Clear
A

D

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16
Q 
One factor that may help differentiate pneumonia from COPD is the presence of what finding?
A.
Rales
C.
Productive cough
B.
Rhonchi
D.
Fever
A

D

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17
Q 
The resultant respiratory alkalosis associated with hyperventilation syndrome is due to an excessive loss of what element?
A.
O2
C.
CO2
B.
Na
D.
N
A

C

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18
Q 
A patient states that he has been coughing up thick, green sputum. Of what is this indicative?
A.
Allergies
C.
Pulmonary edema
B.
Inflammatory disease
D.
Pneumonia
A

D

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19
Q 
What does clubbing of the fingers indicate?
A.
Excess deoxygenated hemoglobin in the blood
B.
Long-standing chronic hypoxemia
C.
Hypocapnia
D.
Hypercapnia
A

B

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20
Q

What does the term, obstructive airway disease, refer to?
A.
Pneumonia, asthma, and emphysema
B.
Chronic bronchitis, pneumonia, and asthma
C.
Inflammatory diseases, asthma, and pneumonia
D.
Chronic bronchitis, asthma, and emphysema

A

D

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21
Q

How can chronic bronchitis be defined?
A.
Inflammatory changes and excessive mucus production in the bronchial tree
B.
Chronic enlargement of the alveoli, with loss of elasticity
C.
Recurrent reactive bronchospasm
D.
A chronic fungal infection leading to pus-filled epithelial tissue and bronchoconstriction

A

A

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22
Q

How can the clinical diagnosis of chronic bronchitis be made?
A.
A chronic cough for at least 1 year
B.
A cough with sputum production occurring for at least 3 months of the year for at least 2 consecutive years
C.
Cough and sputum production occurring seasonally each year for 5 years
D.
Recurrent upper respiratory bacterial infections refractory to penicillin-based antibiotics

A

B

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23
Q 
The term, blue bloater, is used to describe which condition?
A.
Emphysema
C.
Asthma
B.
Chronic bronchitis
D.
Pneumonia
A

B

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24
Q 
What is chronic bronchitis most commonly associated with exposure to?
A.
Allergens
C.
Chemical fertilizers
B.
Hydrofluoric acid
D.
Cigarette smoke
A

D

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25
Q 
What is emphysema described as?
A.
Reactive airway disease
B.
Constriction of the bronchial passage
C.
Permanent abnormal enlargement of the air spaces and destruction of alveoli
D.
Long-term bacterial infection in the lungs
A

C

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26
Q 
What is an elevated hematocrit level secondary to chronic hypoxia known as?
A.
Hemoglobinemia
C.
Polycythemia
B.
Hematocritis
D.
Hemopoiesis
A

C

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27
Q 
The term, pink puffer, generally refers to which pulmonary disease?
A.
Chronic bronchitis
C.
Asthma
B.
Emphysema
D.
Pneumonia
A

B

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28
Q 
When do patients with emphysema have increased airway resistance?
A.
Inspiration
C.
Inspiration and expiration
B.
Expiration
D.
Inspiration during an exacerbation
A

B

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29
Q 
How do drugs like albuterol help asthma patients?
A.
Dilating the bronchi
C.
Preventing atelectasis
B.
Increasing mucus production
D.
Increasing surfactant production
A

A

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30
Q

While treating a patient with COPD, she advises not to administer oxygen because she breathes on the basis of her “hypoxic drive.” Her pulse oximetry reading is 85%. How should paramedics proceed?
A.
Administer high-flow oxygen and be prepared to ventilate if necessary
B.
Administer oxygen via a simple mask at 4 to 6 L per minute
C.
Administer oxygen via a nasal cannula at 2 L per minute
D.
Withhold oxygen therapy

A

A

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31
Q 
What is a reactive airway disease that is stimulated by both intrinsic and extrinsic factors known as?
A.
Emphysema
C.
Cystic fibrosis
B.
Chronic bronchitis
D.
Asthma
A

D

32
Q 
What does asthma exacerbations result in?
A.
Bronchial smooth muscle contraction
B.
Drying of respiratory mucus
C.
Loss of elasticity in the bronchial walls
D.
Carbon dioxide offloading
A

A

33
Q 
What is the current cornerstone of asthma treatment in the United States?
A.
Steroids
C.
Racemic epinephrine
B.
Albuterol
D.
Aminophylline
A

B

34
Q

Paramedics have just intubated a patient who is suspected to have an asthma exacerbation. Immediately after intubation, the patient is easy to ventilate. What should paramedics suspect?
A.
Paramedics have bypassed the constricted airways.
B.
Albuterol administered previously has just taken effect.
C.
The patient might have an upper airway obstruction and not asthma.
D.
Paramedics should continue to administer IV albuterol.

A

C

35
Q

A 3-year-old boy’s parents report that he can’t stop wheezing. He has a history of asthma and recently began to have a runny nose and sniffles. The parents have administered three doses of albuterol from the child’s inhaler.

What is asthma that doesn’t resolve with repeated doses of bronchodilators called?
A.
Refractory asthma
C.
Status asthmaticus
B.
Severe asthma
D.
Type II asthma
A

C

36
Q

A 3-year-old boy’s parents report that he can’t stop wheezing. He has a history of asthma and recently began to have a runny nose and sniffles. The parents have administered three doses of albuterol from the child’s inhaler.

What is this type of asthma exacerbation commonly triggered by?
A.
Stress
C.
Physical exertion
B.
Hormone imbalance
D.
Viral respiratory infection
A

D

37
Q

A 3-year-old boy’s parents report that he can’t stop wheezing. He has a history of asthma and recently began to have a runny nose and sniffles. The parents have administered three doses of albuterol from the child’s inhaler.

In addition to repeated doses of albuterol, what should paramedics do?
A.
Begin positive pressure ventilations.
C.
Initiate IV rehydration.
B.
Try to have the child lie flat.
D.
Administer epinephrine.
A

C

38
Q 
A 74-year-old woman who has a high fever and a productive cough has had “shaking chills” for the past 3 hours. What should paramedics suspect?
A.
COPD
C.
Emphysema
B.
Bronchitis
D.
Pneumonia
A

D

39
Q 
A local preschool has closed because of an epidemic of pneumonia among the children. What is the most common cause of children’s pneumonia?
A.
Fungus growing in the preschool
C.
Environmental exposure to allergens
B.
Influenza A
D.
Streptococcal pneumonia
A

B

40
Q

What statement is most accurate in regards to vaccinations against pneumonia?
A.
80% to 90% effective against bacterial pneumonia
B.
Not available in the United States
C.
Effective primarily against viral pneumonia
D.
Live virus vaccines that are dangerous to infants and to the elderly

A

A

41
Q 
Days after a seizure and a period of unconsciousness, a patient develops pneumonia. What is this patient at high risk for?
A.
Viral pneumonia
C.
Bacterial pneumonia
B.
Aspiration pneumonia
D.
Mycoplasmal pneumonia
A

B

42
Q 
A patient with pneumonia reports coughing up blood-tinged sputum. What should paramedics suspect?
A.
Viral pneumonia
C.
Bacterial pneumonia
B.
Aspiration pneumonia
D.
Pneumococcal pneumonia
A

D

43
Q 
A patient with pneumonia may have a condition in which an area of the lung fills with fluid and cellular debris. What is this condition known as?
A.
Consolidation
C.
Pulmonary effusion
B.
Pulmonary edema
D.
Atelectasis
A

A

44
Q 
What is the name of the condition that exists when the capillaries in the lung have greater permeability, which leads to rales and stiff alveoli?
A.
ARDS
C.
Pulmonary embolism
B.
COPD
D.
Asthma
A

A

45
Q 
What will all disorders that result in ARDS cause?
A.
Pulmonary edema
C.
Infection
B.
Wheezing
D.
Consolidation
A

A

46
Q 
What is PEEP used to do?
A.
Open constricted bronchi
C.
Keep alveoli open
B.
Overcome upper airway obstructions
D.
Ventilate patients with pneumothorax
A

C

47
Q

What is an advantage of BiPAP over CPAP?
A.
BiPAP can be applied with a face mask and doesn’t require intubation.
B.
BiPAP reduces the pressure applied when the patient exhales.
C.
BiPAP transmits positive pressure throughout the respiratory cycle.
D.
BiPAP can be used in spontaneously breathing patients.

A

B

48
Q

A 35-year-old woman developed sudden-onset chest pain and dyspnea. She is hypotensive and has no previous history of cardiac problems or infectious illnesses. Her lungs are clear, and she has no edema in her legs.

What should paramedics suspect?
A.
Pneumonia
C.
Congestive heart failure
B.
Pulmonary embolism
D.
Asthma
A

B

49
Q

A 35-year-old woman developed sudden-onset chest pain and dyspnea. She is hypotensive and has no previous history of cardiac problems or infectious illnesses. Her lungs are clear, and she has no edema in her legs.

What does definitive treatment for this condition include?
A.
Nitroglycerin
C.
Morphine
B.
Albuterol
D.
Heparin
A

D

50
Q 
What is a bleb?
A.
Weakened area of the lung
C.
Loss of lung elasticity
B.
Type of cancer cell
D.
Type of cell that produces mucus
A

A

51
Q 
What is air entering the pleural space that is not related to trauma known as?
A.
Simple pneumothorax
C.
Spontaneous pneumothorax
B.
Medical pneumothorax
D.
Tension pneumothorax
A

C

52
Q 
What is rapid deep breathing characterized by resulting respiratory alkalosis known as?
A.
Kaposi syndrome
C.
Hysteria-induced alkalosis
B.
Hyperventilation syndrome
D.
Tachypnea
A

B

53
Q 
A 40-year-old man is experiencing dyspnea, chest pain, and tingling and spasm in his hands and feet. He states that just after he was told that he’d been fired, he began to breathe very quickly and then developed chest pain. His blood pressure is 130/90, heart rate is 100, and his respiratory rate is 30. He has no past medical history and takes no meds. How should the paramedic initially treat the patient?
A.
Calming and reassuring him
C.
Applying CPAP
B.
Administering albuterol
D.
Intubating him
A

A

54
Q

A 34-year-old patient states, “I can’t catch my breath.” The patient appears upset and anxious and states, “I have just missed the most important business meeting of my life.” The patient is tachypneic. Lung sounds are clear. The patient is also complaining that his lips and fingers are numb and tingling. The patient has no previous medical history.

	What is the patient most likely suffering from?
A.
Pulmonary embolism
C.
Asthma
B.
Spontaneous pneumothorax
D.
Hyperventilation syndrome
A

D

55
Q

A 34-year-old patient states, “I can’t catch my breath.” The patient appears upset and anxious and states, “I have just missed the most important business meeting of my life.” The patient is tachypneic. Lung sounds are clear. The patient is also complaining that his lips and fingers are numb and tingling. The patient has no previous medical history.

What is the tingling in the hands that may progress to spasm and tetany known as?
A.
Carpopedal spasm
C.
Alkalotic neuromuscular blockade
B.
Tarsophalangeal spasm
D.
Digital tetany
A

A

56
Q

A 34-year-old patient states, “I can’t catch my breath.” The patient appears upset and anxious and states, “I have just missed the most important business meeting of my life.” The patient is tachypneic. Lung sounds are clear. The patient is also complaining that his lips and fingers are numb and tingling. The patient has no previous medical history.

What does the most appropriate treatment for this patient include?
A.
High-flow oxygen
B.
Calming the patient and supplying oxygen as necessary
C.
Instructing the patient to breathe into a paper bag
D.
Encouraging the patient to hold his breath for as long as possible

A

B

57
Q

A 34-year-old patient states, “I can’t catch my breath.” The patient appears upset and anxious and states, “I have just missed the most important business meeting of my life.” The patient is tachypneic. Lung sounds are clear. The patient is also complaining that his lips and fingers are numb and tingling. The patient has no previous medical history.

If arterial blood gases were drawn on this patient, what would they most likely reveal?
A.
Respiratory acidosis
C.
Metabolic acidosis
B.
Respiratory alkalosis
D.
Metabolic alkalosis
A

B

58
Q

How can chronic bronchitis be defined?
A.
Inflammatory changes and excessive mucus production in the bronchial tree
B.
Chronic enlargement of the alveoli with loss of elasticity
C.
Recurrent reactive bronchospasm
D.
A chronic fungal infection leading to pus-filled epithelial tissue and bronchoconstriction

A

A

59
Q

What is a characteristic of pulmonary hypertension?
A.
An increase in the pressure of the pulmonary artery because of vasoconstriction of the pulmonary capillaries
B.
An increase in the pressure of the pulmonary artery because of the increased pumping action of the heart
C.
An increase in the pressure of the pulmonary artery because of right-sided heart failure
D.
Easily treated with antihypertensive medications

A

A

60
Q 
What can pulmonary hypertension lead to?
A.
Left-sided heart failure
C.
Cerebral emboli
B.
Right-sided heart failure
D.
Eupnea
A

B

61
Q 
What is right-heart failure and hypertrophy that result from increased pressures in the pulmonary artery known as?
A.
Cor ventriculostenosis
C.
Cor pulmonale
B.
Congestive heart failure
D.
Cardiopulmonary resistance
A

C

62
Q 
What term would best describe the respiratory disorder characterized by enlargement of and loss of elasticity of the alveoli?
A.
Chronic bronchitis
C.
Asthma
B.
Emphysema
D.
Cor pulmonale
A

B

63
Q 
What is an increased red blood cell production secondary to chronic hypoxia known as?
A.
Hemoglobinemia
C.
Polycythemia
B.
Hematocritis
D.
Hemopoiesis
A

C

64
Q 
In the normally healthy person, the primary drive to breathe is based on levels of what element?
A.
O2
C.
N
B.
CO2
D.
CO
A

B

65
Q 
What is a prolonged asthma attack that does not respond to bronchodilators known as?
A.
Intrinsic asthma
C.
Status asthmaticus
B.
Extrinsic asthma
D.
Status epilepticus
A

C

66
Q 
What is pneumonia caused by?
A.
Bacteria
C.
Fungi
B.
Viruses
D.
All of the above
A

D

67
Q 
What would first-line treatment for reactive airway disease include?
A.
Albuterol
C.
IV fluid therapy
B.
Epinephrine
D.
Steroids
A

A

68
Q 
What does the application of PEEP serve to do?
A.
Generate a greater tidal volume
B.
Create a pressure to keep the alveoli open
C.
Increase the respiratory rate
D.
Provide for more rapid exhalation
A

B

69
Q 
What is a respiration/ventilation device that is leak tolerant?
A.
BiPAP
C.
PEEP
B.
CPAP
D.
ARPS
A

A

70
Q 
What is a blockage of a pulmonary artery by a clot known as?
A.
Pulmonary edema
C.
ARDS
B.
Pulmonary embolism
D.
Atelectasis
A

B

71
Q 
Late-stage asthma usually responds best to what pharmacological agent?
A.
Albuterol
C.
Diphenhydramine
B.
Epinephrine
D.
Corticosteroids
A

D

72
Q 
What is the major side effect of administering bronchodilators to a patient with an acute exacerbation of asthma?
A.
Increased drying effect on the mucus
B.
Increased myocardial oxygen demands
C.
Vasoconstriction with hypertension
D.
Hypotension secondary to bronchodilation
A

B

73
Q 
How does metaproterenol work in managing asthma?
A.
Vasoconstriction
C.
Increasing cardiac contractility
B.
Stopping histamine release
D.
Bronchodilation
A

D

74
Q 
Which would not be considered a cause of respiratory distress that results from a perfusion problem?
A.
Muscular dystrophy
C.
Pulmonary embolus
B.
Anemia
D.
Trauma
A

A

75
Q 
Which pharmacological classes can cause respiratory depression?
A.
Diuretics
C.
Sympatholytics
B.
Benzodiazepines
D.
Sympathomimetics
A

B

76
Q

A 38-year-old female has just returned from China. She complains of a sudden onset of difficulty in breathing and chest pain. She is very anxious and has the following vital signs: BP 90/70, P 128 bpm, R 28/min, and SaO2 88%. Her lungs are clear to auscultation. She is allergic to sulfa drugs and her only daily medications are birth control pills. Her ECG shows sinus tachycardia with no ischemic changes. You apply oxygen and start an IV en route to the hospital. Which additional intervention would be appropriate for her care?
A.
Administer nitroglycerin 0.4 mg SL
B.
Begin bag-mask ventilation and prepare to intubate
C.
Deliver albuterol 2.5 mg/3 mL NS updraft
D.
Screen for fibrinolytic inclusion/exclusion criteria

A

D

77
Q 
An 82-year-old man complains of difficulty in breathing. He has a cough that began 3 days before. His skin is hot and moist and he appears to be in moderate distress. Auscultation of his lungs reveals slight crackles and wheezing in the right upper chest. Vital signs are: BP 102/68, P 124 bpm, R 24/min, and SaO2 90%. He has a history of esophageal reflux. After oxygen therapy is initiated, which intervention would be most appropriate?
A.
Albuterol 2.5 mg/3 mL NS updraft
C.
Morphine 2-4 mg IV
B.
Furosemide 40 mg IV
D.
Nitroglycerin 0.4 mg SL
A

A

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