Airway, Respiration, Ventilation

Question 1

Signs of respiratory distress in an infant

Answer 1

Anxiety/restlessness,

grunting,

nasal flaring,

retractions,

pallor or mottled,

abdominal breathing

inspiratory stridor.

Question 2

Symptomatic Bradycardia, 1st step

Answer 2

administer atropine 1 mg IV/IO.

Can be repeated every 3-5 minutes with a max of 3 mg.

Question 3

Symptomatic Bradycardia, atropine ineffective

Answer 3

Transcutaneous pacing (TCP) is indicated

TCP begins at 60-80 bpm at 30 mA.

Question 4

An 82-year-old male is having difficulty breathing and repeated nonproductive coughing episodes. His wife states her husband’s breathing has worsened in the past hour despite using his home oxygen. As you auscultate lung sounds, you note rhonchi in the bilateral lower lobes, and the patient has a barrel chest. Vital signs are BP 128/72, P 88, R 24, and SpO2 86% ORA.

What should you do first?

a. Place the patient on the cardiac monitor and initiate rapid transport

b. Administer oxygen at 15 Ipm via a non-rebreather

c. Administer nebulized albuterol and initiate transport

d. Start an IV and administer a 250 mL fluid bolus

Answer 4

b. Administer oxygen at 15 lpm via non-rebreather.

Question 5

A patient diagnosed with atelectasis is at high risk of developing:

Lung cancer

Pneumonia

Chronic bronchitis

Spontaneous pneumothorax

Answer 5

Correct answer: Pneumonia

Atelectasis is the collapse of the alveoli. It greatly increases the chances of the patient developing pneumonia.

Spontaneous pneumothorax, lung cancer, and chronic bronchitis are not caused by atelectasis.

Question 6

A pleural effusion is commonly caused by infection or trauma. If a patient has a large pleural effusion, it may need to be drained by a physician. What is this medical procedure called?

Fasciotomy

Excision

Thoracentesis

Pericardiocentesis

Answer 6

Correct answer: Thoracentesis

A thoracentesis is a medical procedure performed to drain a large pleural effusion.

This procedure will provide immediate relief of symptoms for the patient.

Question 7

Fasciotomy

Answer 7

Fasciotomy is a surgical procedure used in the treatment of compartment syndrome. The fascia is cut to relieve pressure within the muscle compartment.

Question 8

Pericardiocentesis

Answer 8

Pericardiocentesis is a procedure used to relieve a cardiac tamponade.

Question 9

Excision

Answer 9

Excision is a debridement procedure used in the treatment of burns.

Question 10

What is the leading cause of lower respiratory tract infections in infants and immunocompromised individuals?

Croup

Respiratory syncytial virus

Bronchiolitis

Epiglottitis

Answer 10

Correct answer: Respiratory syncytial virus

Respiratory Syncytial Virus (RSV) is a common and very contagious virus that is responsible for causing pneumonia in both children and immunocompromised individuals and also bronchiolitis in children.

Transmission of RSV occurs by direct and indirect contact.

Signs and symptoms of RSV mirror those of an upper respiratory tract infection.

Question 11

Croup

Answer 11

Croup is an upper airway infection commonly caused by the parainfluenza virus.

Question 12

Bronchiolitis

Answer 12

Bronchiolitis is a lower respiratory tract infection.

Inflammation of the bronchioles due to a viral infection.

Question 13

Epiglottitis

Answer 13

Epiglottitis is an infection of the epiglottitis.

This is a life-threatening condition.

Question 15

A 58-year-old male presents with sudden-onset shortness of breath and chest pain after exertion. The patient has a history of smoking two packs a day for 30 years. He is coughing up brown sputum and states his chest pain is worst on inhalation. You note diminished lung sounds on one side. Vital signs are BP 101/72, P 118, R 22, and SpO2 92%. What should you suspect?

Lung cancer

Pneumonia

Pleural effusion

Spontaneous pneumothorax

Answer 15

Correct answer: Spontaneous pneumothorax

A patient with an extensive history of smoking two packs a day has a high probability of developing blebs on the lung.

Blebs are weak spots occurring between the lung and the visceral pleura.

Exertion in the presence of blebs makes the patient susceptible to a spontaneous pneumothorax.

A pleural effusion is caused by trauma, pulmonary embolism, or cancer.
It causes dyspnea but not a productive cough.

Lung cancer does not present with sudden-onset shortness of breath and chest pain, as it is not an acute disease.

Pneumonia symptoms develop over time and are not sudden.