Airway Test Prep Flashcards
1
Q
You have attempted orotracheal intubation on a patient in cardiac arrest, but were unsucessful after three attempts. When you resume bag-mask ventilations, you are unable to maintain an adequate mask-to-fast seal. What should you do?
A
Inserta supraglottic airway device
2
Q
In which of the following conditions would you most likley detect a drop in systolic blood pressure during inhalation?
A
Severe asthma
3
Q
A patient with a reactive lower airway disease would be expected to present with
A
expiratory wheezing
4
Q
How should you ventilate an adult patient with a stoma and no tracheostomy tube?
A
Use an infant- or child-size mask attached to an adult-size bag-mask device
5
Q
You are ventilating a severely dehydrated, apneic 70-year-old male with a history of end-stage emphysema. In order to minimize the risk of lowering his cardiac output and blood pressure, you should
A
adjust the ventilation rate to allow complete exhalation
6
Q
During an intubation attempt, you are having difficulty viewing the patient’s vocal cords. Which of the following actions would most likley help?
A
Ask your partner to manipulate the external larynx
7
Q
Which of the following techniques or devices will provide the highest tidal volume to a patient?
A
Pocket face mask with oxygen attached
8
Q
Assessment of a patient with respiratory distress reveals that his expiratory phase is four times longer than his inspiratory phase. Which of the following conditions would cause this?
A
Bronchospasm
9
Q
A selective beta-2 adrenergic agonist will produce which of the following effects?
A
Bronchodilation
10
Q
When passing an endotracheal tube inbetween the vocal cords, the paramedic should recall that
A
the trachea descends into the chest cavity just beyond the vocal cords
11
Q
The normal partial pressure of oxygen in arterial blood is
A
80 to 100 mm Hg.
12
Q
A patient with emphysema and respiratory distress is responsive to pain only. He has cyanosis to the face, neck, and chest; a decreased level of consciousness; and a heart rate of 170 beats/min. What should you do?
A
Assist his ventilations with a bag-mask device
13
Q
After inserting a King LT supraglottic airway device into a patient and inflating the cuff with 40 ml of air, you meet resistance when ventilating and cannot see the patient’s chest rise. What should you do?
A
Slowly pull back on the King airway while observing for chest rise
14
Q
Which of the following respiratory patterns is consistent with apneustic breathing?
A
Prolonged, gasping inhalation, followed by extremely short, ineffective exhalation.
15
Q
The paramedic is ventilating an unresponsive intubated patient and can clearly see her chest rise with each ventilation. His partner reports that the patient’s blood pressure has decreased from 130/80 mm Hg to 90/60 mm Hg. Which of the following would BEST explain this?
A
Ventilations are being delivered too quickly or with to much volume
16
Q
What is the approximate minute alveolar volume of a patient who is breathing at a rate of 26 breaths/min with an estimated tidal volume of 450 mL?
A
8,200 mL
17
Q
Assessment of a patient with acute respiratory distress reveals that he is conscious and alert, but wheezing on exhalation. Which of the following treatments is appropriate for this patient?
A
Inhaled beta-2 agnoist medication nebulized
18
Q
Which of the following findings is consistent with inadequate breathing in an adult?
A
14 breaths/min with reduced tidal volume
19
Q
Which of the following intervention sequences is correct when treating an unresponsive adult with a severe foreign body airway obstruction?
A
Chest compression, larynoscopy and use of magill forcepts, cricothyrotomy
20
Q
A hypoxemic patient
A
has decreased oxygen level in the arterial blood
21
Q
Which of the following occurs when a patient is hypoventilating?
A
Increased PaCO2, decreased Pa02, decreased PH
22
Q
Which of the following best describes vesicular breath sounds?
A
Inspiratory sounds are longer than expiratory sounds, and both are faint.
23
Q
A 60-year-old woman presents with difficulty breathing. She is conscious and alert, but anxious, and tells you that she was suddenly awakened with the feeling that she was suffocating. She has dried blood on her lips and cyanosis around her mouth. Her heart rate is 120 beats/min and her oxygen saturation is 80%. What should you do?
A
Apply supplemental oxygen
24
Q
A 56-year-old woman presents with severe respiratory distress. She is confused, appears tired, and has an oxygen saturation of 73%. What should you do?
A
Ventilate with a bag-mask device
25
A patient's arterial blood gas reveals a pH of 7.49, PCO2 of of 12 mm Hg, PaO2 of 123 mm Hg, and bicarbonate of 24 mEq/L. What do these values indicate?
Respiratory alkalosis
26
Which of the following conditions can cause deep, rapid breathing and an end-tidal CO2 of less than 35 mm Hg?
Aspirin overdose
27
Which of the following conditions would have a direct negative impact on ventilation?
Muscular dystrophy
28
During your assessment of a patient with labored breathing, you note asymmetric chest wall movement. This indicates that
airflow into one lung is reduced
29
Which of the following statements regarding physiologic dead space is correct?
Diffuse alveolar collapse increases the size of the physiologic dead space
30
Common signs of a laryngeal fracture include all of the following, EXPECT
hematemsis
31
A 40-year-old patient has a blood glucose level of 800 mg/dl and is breathing deeply at a rate of 34 breaths/min. Which of the following should the paramedic expect to observe?
Small capnographic waveforms; low end-tidal CO2 reading
32
You are ventilating an intubated patient who has been in cardiac arrest for approximately 20 minutes. Despite the presence of bilaterally equal breath sounds, quantitative capnography persistently reads less than 10 mm Hg. What should you suspect?
The patient is not producing carbon dioxide
33
Which of the following statements regarding the concentration of gases is correct?
Nitrogen accounts for approximately 79% of atmopsheric air.
34
A patient with anaphylaxis is unresponsive. He has severe edema to the face and neck. Breath sounds ar difficult to hear, and loud inspiratory stridor is noted. What should you do?
Perform intubation
35
Which of the following is an appropriate drug combination to administer prior to intubation of a semiconscious patient with respiratory failure?
Etomidate and rocuronium
36
A 66-year-old male presents with labored breathing. He is conscious and alert; however, he is tachypneic, tachycardic, and is experiencing difficulty speaking. He has a history of hypertension and heart failure. Auscultation of his lungs reveals diffuse coarse crackles and his oxygen saturation is 86%. Which of the following interventions will be of MOST benefit to this patient?
Continuous positive airway pressure
37
A 40-year-old man was shot in the face with a shotgun. He is conscious, sitting upright in a chair. There is massive soft-tissue damage to his face; his mandible is gone and his upper airway structures are exposed. His oxygen saturation is 95% and his respiratory rate is 22 breaths/min. What should you do?
keep him sitting up, suction his airway, and transport
38
A 60-year-old female presents with acute respiratory distress. The patient has a tracheostomy tube in place, but is able to breath spontaneously. She is conscious, but restless. Her heart rate is 120 beats/min and her oxygen saturation is 82%. What should you do?
Assess for secretions in the tracheostomy tube and suction the tube if needed
39
In an otherwise healthy individual, breathing is primarily stimulated by:
an increase in arterial CO2
40
Which of the following MOST accurately describes the process of gas exchange in the lungs?
The gases exchanged in the lungs move from an area of greater concentration to an area of lesser concentration
41
Which of the following signs is unique to a severe foreign body upper airway obstruction?
Perioral cyanosis
42
A firefighter was exposed to smoke during a structure fire. He is conscious, alert, and oriented, but is experiencing respiratory distress. His oxygen saturation is 91% on room air and his heart rate is rapid and strong. Which of the following is the MOST appropriate initial means of oxygenating this patient?
Nonrebreathing mask set at 12 to 15 L/min
43
While intubating a 44-year-old man in respiratory arrest, you note that his pulse rate increases during the procedure. What should you do?
Recognize this as a normal response during intubation and monitor the pulse rate
44
Immediate treatment for an unresponsive patient with sonorous breathing involves
Manual head positioning
45
When attempting visualization of the vocal cords with a curved laryngoscope blade, you should
place the tip of the blade in the vallecula, and lift the jaw, tongue, and blade gently at a 45 angle.
46
After intubating a cardiac arrest patient, you observe a capnography reading that is steadily decreasing. During each ventilation, you see obvious bilateral chest rise and ventilatory compliance is good. What should do?
Reevaluate the effectiveness of your CPR
47
Which of the following would occur as the result of central neurogenic hyperventilation?
Hypocarbia and respiratory alkalosis
48
Which of the following statements regarding Cheyne-Stokes respirations is correct?
They are not considered ominous unless grossly exaggerated or in the context of a traumatic brain injury.
49
An 16-year-old presents with acute respiratory distress. His mother tells you that he recently lost his job. He is conscious and alert, but obviously anxious. He has a respiratory rate of 40 breaths/min and an oxygen saturation of 98% on room air. Further assessment reveals carpopedal spams to his hands. What should you do?
Provide coaching to slow the patient's breathing
50
You are ventilating an apneic, intubated patient and note that his ETCO2 reading, per waveform capnography, is 56 mm Hg. What should you do?
Increase the rate of ventilations
51
You are en route to the hospital with a patient in respiratory failure. You have administered a sedative and a paralytic drug to the patient, but have been unable to succesfully intubate him after two attempts. Your EMT partner tells you that the patient's oxygen saturation is 98% and that his heart rate is 80 beats/min. Your estimated time of arrival at the hospital is 7 minutes. What should you do?
Resume bag-mask ventilations at 10 breaths/min and insert a supraglottic airway device
52
Which of the following patients would benefit the most from continous positive airway pressure (CPAP) therapy?
61-year-old male with severe respiratory distress and diffuse crackles
53
Which of the following inspiratory/expiratory (I/E) ratios is consistent with a patient who has obstructive lung disease?
1:4
54
Which of the following end-tidal CO2 patterns would you expect to observe in a patient with diabetic ketoacidosis who is compensating via the respiratory buffer system?
Less than 35 mm Hg; short capnographic waveforms
55
Assessment of a patient with respiratory distress reveals capnographic waveforms that look like a shark fin. What does this indicate?
Uneven alveolar emptying
56
You would likely encounter bradypnea in a patient who
has metabolic alkalosis
57
An unresponsive man is brought to the emergency department by his wife. Initial arterial blood gas analysis reveals a pH of 7.1, a PaO2 of 81 mm Hg, and a PaCO2 of 60 mm Hg. These findings are consistent with:
respiratory acidosis
58
You are transporting a woman with a history of COPD, who called EMS when her difficulty breathing suddenly worsened. She is receiving oxygen at 4 L/min via nasal cannula, is on a cardiac monitor, and has an IV line in place. During your reassessment, you note that she is responsive to pain only, is increasingly tachycardic, and is developing cyanosis around her mouth. What should you do?
Ventilate her with a bag-mask device
59
Which of the following is an example of a discontinuos adventitious breath sound?
Crackles
60
A 30-year-old man overdosed on codeine and has respirations of 6 breaths/min and shallow. Which of the following conditions will he develop initially?
Respiratory acidosis
61
A 40-year-old male presents with acute respiratory distress while eating a meal. He is conscious and alert; is able to speak, but with difficulty; and has pink, moist skin. Which of the following statements BEST describes this patient's condition?
Mild airway obstruction with adequate air exchange
62
An unresponsive trauma patient has sonorous respirations and blood draining from the corner of his mouth. What should you do?
Perform a jaw-thrust maneuver
63
A 24-year-old female, who is a known heroin abuser, is unresponsive. Her respirations are 6 breaths/min and shallow and her pulse rate is 40 beats/min and weak. What should you do?
Ensure that her airway is clear and begin assisting her ventilations
64
The exchange of oxygen and carbon dioxide between inspired air and the pulmonary capillaries is called:
External respiration
65
An older woman presents with a respiratory distress. She is conscious and alert and is able to answer your questions with slight difficulty. Her respirations are 22 breaths/min and labored and her oxygen saturation is 89%. What should you do?
Give oxygen by nasal cannula and assess her breath sounds
66
A man is unresponsive and has shallow, gurgling respirations. After manually opening his airway, you should:
Suction the oropharynx
67
Treatment for a patient with an acute asthma attack should focus on which of the following goals?
Relief of the bronchospasm and improved ventilation
68
A patient who is intubated and on a mechanical transport ventilator is being transferred from one hospital to another. During transport, the high-pressure alarm sounds on the ventilator. Which of the following could cause this?
The ET tube is in the right mainstem bronchus
69
Common clinical signs of respiratory distress include all of the following, except:
a flushed appearance
70
What is the approximate minute alveolar volume of a patient who breathes in 550 mL of air at a rate of 14 times per minute?
5.4 L
71
Which of the following medications is used to sedate a patient prior to performing orotracheal intubation?
Amidate
72
Which of the following respiratory diseases is associated with decreased alveolar elasticity, air trapping in the lungs, and an increase in residual lung volume?
Emphysema
73
While transporting a man with severe respiratory distress, he pulls the oxygen mask from his face and frantically attempts to get off of the stretcher. What should you do?
Apply a nasal cannula and try to calm the patient
74
When assessing a responsive patient with a suspected pulmonary embolism (PE), it is important to remember that:
Ventilation continues, but oxygenation is inadequate
75
Which of the following is associated with insufficient carbon dioxide elimination?
Bradypnea and hypopnea
76
Which of the following would likley occur if an adult patient is breathing at a rate of 36 breaths/min and shallow?
Minute alveolar ventilation would decrease
77
After placing an endotracheal tube in a patient who experienced cardiac arrest, large amounts of vomitus immediately begin flowing out of the tube. What should you do?
Leave the ET tube in place, fold it to the side so the vomitus can drain, and resume bag-mask ventilations
78
An unresponsive patient is taking irregular breaths that vary in volume and rate with periods of apnea. This breathing pattern is consistent with:
Biot respirations
79
Hemoglobin from which oxygen has been released to the cells is called:
reduced hemoglobin
80
You are attempting to ventilate a patient with a bag-mask device and do not see the chest visibly rise. What should you do?
Reposition the patient's head
81
After determining that your unresponsive patient has a severe (complete) upper airway obstruction caused by a foreign body, you should:
perform chest compressions
82
Which of the following clinical presentations is consistent with a severe upper airway obstruction?
Weak cough and cyanosis
83
Which of the following end-tidal CO2 (ETCO2) findings indicates return of spontaneous circulation?
Abrupt and sustained increase in ETCO2
84
A 49-year-old man presents with acute shortness of breath. He is conscious, but confused, and is gasping for air. The pulse oximeter reads 79% on room air. What should you do?
Ventilate with a bag-mask device.
85
A young male presents with sharp pain just below his armpit that is worse when he breathes. When you ausculate his breath sounds. you hear a friction rub over that area. What does this indicate?
Inflammation has caused the visceral and parietal pleurae to make contact.
86
Which of the following would MOST likley cause laryngeal spasm?
Extubation of a semiconscious patient
87
Which of the following clinical presentations is MOST indicative of a patent airway?
Diaphoresis; tachycardia; gagging
88
When arterial oxygen levels in the body fall, chemoreceptors in the brain send messages to the diaphragm via the:
phrenic nerve
89
You have been ventilating an unresponsive apneic man with a bag-mask device for approximately 12 minutes. After securing his airway with an endotracheal tube and confirming proper ET tube placement, you should:
insert an orogastric or nasogastric tube
90
You are ventilating an unresponsive, apneic 50-year-old man. He has a pulse, but it is rapid and weak. When ventilating this patient, you should:
ventilate until the chest visibly rises
91
A 30-year-old male with type 1 diabetes presents with a decreased level of consciousness, deep respirations at 30 breaths/min, and a blood glucose reading of 450 mg/dl. His oxygen saturation is 92%. What should you do?
Insert a nasopharyngeal airway and administer oxygen
92
Which of the following is most consistent with a patient who is hypoventilating
PCO2 of 52 mm Hg
93
During transport of an intubated patient receiving bag-mask ventilation, you note decreased ventilation compliance and asymmetrical chest rise. The patient's BP is 88/56 mm Hg and end-tidal CO2 is 28 mm Hg. What should you suspect?
Pneumothorax
94
When assessing an unresponsive patient, you note that he is not breathing. Which of the following airway devices or interventions is contraindicated?
Nasotracheal intubation
95
Which of the following processes occurs during inhalation?
The diaphragm contracts and descends, intrathoracic pressure decreases, and air enters the lungs via negative pressure.
96
An adult patient without respiratory distress, who is breathing at a rate of 14 times per minute and has adequate tidal volume, will most likley:
eliminate adequate carbon dioxide from the body
97
What is the fraction of inspired oxygen delivered to an apneic patient who is receiving bag-mask ventilation without supplemental oxygen attached?
0.21
98
A 60-year-old man presents with dyspnea. While ascultating his chest, you hear fine, moist, thin sounds in all lung fields. What should you suspect?
Fluid in the small lower airways
99
During mechanical ventilation, what range of tidal volume that should be provided to a woman who weighs 215 pounds and is 5 feet 5 inches tall?
342 to 456 mL
100
A 60-year-old man with acute pulmonary edema is receiving CPAP therapy at 7.5 cm/H2O. He remains conscious and alert, yet his oxygen saturation is 78% and his work of breathing has not decreased. What should you do?
Increase the PEEP to 10 cm/H2O
101
A responsive 20-year-old male with a supsected foreign body airway obstruction is anxious, coughing forcefully, and able to speak with difficulty. What should you do?
Closely monitor the patient's condition and encourage him to keep coughing
102
Which of the following corresponds with phase 3 (C-D) on a normal capnographic waveform?
Alveolar gas is passing by the CO2 sensor
103
Which of the following clinical signs is indicative of adequate breathing?
Pink oral mucous membranes
104
A 60-year-old man was injured when his tractor rolled over on him. The tractor has been stabilized by resuce personnel. When you assess the man, you note that he is responsive to pain only. What should you do?
Open his airway with the jaw-thrust maneuver
105
A patient presents with an acute onset of dyspnea. Which of the following conditions would be the LEAST likley underlying cause?
Pneumonia
106
A 56-year-old male preents with respiratory distress. He appears tired and is slow to answer your questions. He is taking a series of quick breaths, followed by pronlonged exhalation. What should you do?
Begin ventilating with a bag-mask device
107
You have inserted an oral airway in an apneic patient and are ventilating him with a bag-mask device when he suddenly vomits. What should you do first?
Turn him on his side
108
In contrast to the pneumotaxic center of the medulla, the apneustic center:
influences the respiratory rate by increasing the number of inspirations per minute.
109
Which of the following airway devices is most appropriate to use in a deeply unresponsive intoxicated patient?
Endotracheal tube
110
Normal breathing in a resting adult male
should be marked by only subtle changes in rate or regularity
111
You are assisting the ventilations of an adult with a bag-mask device. The patient is responsive to pain only and has a heart rate of 140 beats/min. Which of the following signs would indicate that your assisted ventilations are inadequate?
A marked increase in heart rate
112
A 40-year-old obese woman reports a sudden onset of difficulty breathing and sharp chest pain. Her oxygen saturation remains below 80% despite high-flow oxygen, and her heart rate is 130 beats/min. What should you suspect?
Acute pulmonary embolism
113
When providing positive-pressure ventilation PPV to a patient, the paramedic should recall that:
PPV can impair venous return and cause hypotension
114
Which of the following values is consistent with metabolic alkalosis?
PaCO2, 60 mm Hg
115
A 50-year-old man with a self-inflicted gunshot wound to the face is apneic. He has multiple fractures of the mandible, massive soft-tissue damage, and severe oropharyngeal bleeding. What should you do?
Perform surgical cricothyrotomy
116
You are ventilating an intubated patient and note decreased compliance with each delivered ventilation. Which of the following conditions would be the LEAST likely cause of this?
Beta-2 receptor stimulation
117
A 70-year-old man complains of dyspnea that began 2 days ago. Which of the following assessments would give the paramedic the MOST information regarding the possible cause of his dyspnea?
Lung sounds
118
Which of the following patients is the BEST candidate for nasotracheal intubation?
Semiconscious, pulmonary edema, tachypnea
