Cardiology (Part 1) Flashcards
Which of the following sounds indicates an upper airway obstruction in a child who is in respiratory distress?
A) Wheezes
B) Stridor
C) Rales
D) Rhonchi
B) Stridor
An unresponsive 7-month-old female is lying limp in her father’s arms. He tells you that she was having an asthma attack but is better now. Her conjunctivae are pale and moist. You are only able to auscultate faint wheezes in her upper chest. Her vital signs are P 76 and R 18. You should first:
A) assess her oxygen saturation level.
B) assist with the administration of her nebulized albuterol.
C) assist her ventilation with a BVM.
D) administer oxygen by non-rebreather mask.
C) assist her ventilation with a BVM.
A 12-year-old male has difficulty breathing. He tells you he has had a cold all week. You auscultate rhonchi in his left lower chest. His vital signs are P 104, R 28, BP 104/74, and SpO2 is 89% on room air. You should suspect:
A) respiratory failure.
B) chronic asthma.
C) septic shock.
D) respiratory distress.
D) respiratory distress.
An 8-year-old female has had trouble breathing for two days. Her father called because she continues to have trouble breathing and he cannot wake her up. You do not hear any sounds when you auscultate her lower lungs and hear faint wheezes in her upper lungs. Her vital signs are P 60, R 26, BP 94/68, and SpO2 is 88% on room air. You should suspect:
A) respiratory distress.
B) respiratory failure.
C) eupneic respirations.
D) respiratory arrest.
B) respiratory failure.
An unresponsive 6-year-old male is taking shallow, irregular respirations once every 15 seconds. He has a weak carotid pulse. His mother tells you that he was playing alone in his room and was fine 30 minutes ago. You should suspect:
A) respiratory arrest.
B) Biot’s respirations.
C) Kussmaul’s respirations.
D) respiratory failure.
A) respiratory arrest.
A 10-year-old female complains of difficulty breathing after mixing bleach with another cleaner. Her skin and clothing are dry. You smell a strong odor, and your eyes begin to water. What route of exposure should you suspect is causing her dyspnea?
A) Inhalation
B) Absorption
C) Ingestion
D) Injection
A) Inhalation
An 11-year-old male who has a history of cystic fibrosis complains of difficulty breathing. He tells you he has been coughing up thick mucus. His vital signs are P 92, R 24, BP 118/76, and SpO2 is 91% on room air. You should:
A) administer a bronchodilator.
B) assist his ventilation.
C) administer humidified oxygen. D) apply CPAP.
C) administer humidified oxygen.
A 9-year-old male has partial-thickness burns around his mouth after inhaling steam. He has a history of asthma and has had a cold for three days. His mother tells you he has had chest congestion and she was trying to break up the phlegm. He is drooling and tells you he cannot swallow. You should first:
A) begin transport.
B) insert an oropharyngeal airway.
C) administer his metered-dose inhaler.
D) assess his vital signs.
A) begin transport.
You are preparing to ventilate an 11-month-old female with a BVM. Which of the following ensures that her airway is properly positioned?
A) Placing her in the sniffing position
B) Inserting a nasopharyngeal airway
C) Padding behind her shoulders
D) Using cricoid pressure while ventilating her
A) Placing her in the sniffing position
A 6-month-old female does not respond to you when you stimulate her. Her father tells you that she stopped breathing and turned blue. You observe supraclavicular and sternal retractions at a rate of 38. You should first:
A) administer oxygen by non-rebreather mask.
B) assess her blood glucose level.
C) assess her vital signs.
D) assist her ventilation.
D) assist her ventilation.
A 13-year-old male tells you that he has had a cough for two weeks. He has an episode of coughing, and you hear an inspiratory whoop after each cough. You auscultate rhonchi in his left lower lung. His vital signs are P 100, R 22, BP 118/76, and SpO2 is 93% on room air. You should:
A) assist his ventilation.
B) administer oxygen by nasal cannula.
C) assist with the administration of his beta2 agonist.
D) assist with the administration of his beta1 antagonist.
B) administer oxygen by nasal cannula.
An unresponsive 4-year-old female is apneic but has a carotid pulse of 52. You should first:
A) administer oxygen.
B) attach the AED.
C) begin chest compressions.
D) insert an oropharyngeal airway.
D) insert an oropharyngeal airway.
Which of the following may be a direct impact of positive pressure ventilation on perfusion when ventilating an infant?
A) Decreased preload
B) Decreased cardiac output
C) Increased systemic resistance
D) Increased V/Q mismatch
A) Decreased preload
Which of the following respiratory conditions in children over 2 years old has similar lung sounds to an infant who has bronchiolitis?
A) Asthma
B) Pulmonary edema
C) Pneumonia
D) Pertussis
A) Asthma
A 3-year-old male is in respiratory distress. His mother tells you that he has a fever of 102 degrees F. She tells you he cannot swallow and is drooling. He is sitting up, leaning forward and you hear inspiratory stridor. You should:
A) suction his airway.
B) administer oxygen.
C) insert an oropharyngeal airway. D) place him in the recovery position.
B) administer oxygen.
A 5-year-old female who has a history of asthma complains of trouble breathing. She is exhaling through pursed lips, and you auscultate wheezes. Her vital signs are P 110, R 32, BP 106/68, and SpO2 is 89% on room air. After administering oxygen, you should next:
A) assist her ventilation with a BVM.
B) reassess her vital signs.
C) assist with the administration of her metered dose inhaler.
D) titrate oxygen administration to 94%.
C) assist with the administration
A 7-year-old male who has had a cold for a week tells you that he can’t breathe. He has had a nonproductive cough for a day, and he is lying on his right side in the fetal position. His skin feels hot to the touch. He has a history of asthma, and you auscultate rhonchi in his right chest. His vital signs are P 118, R 24, BP 82/64, and SpO2 is 91% on room air. You should:
A) administer oxygen.
B) assist his ventilation.
C) place him in Fowler’s position. D) assist with the administration of his MDI.
A) administer oxygen.
An unresponsive 76-year-old female is lying in bed, and you hear snoring respirations. What should you suspect is partially occluding her airway?
A) Her tongue
B) Liquid
C) Food
D) Laryngotracheobronchitis
A) Her tongue
When assessing lung sounds in an adult who is sitting upright, where should you place your stethoscope to auscultate alveolar ventilation?
A) Third intercostal space, anterior axillary line
B) Sixth intercostal space, midscapular line
C) Fourth intercostal space, midaxillary line
D) Second intercostal space, midclavicular line
B) Sixth intercostal space, midscapular line
A 32-year-old male complains of difficulty breathing. He admits to smoking crack cocaine an hour before the problem started. You hear inspiratory stridor and observe drooling. His vital signs are P 108, R 18, BP 142/88, and SpO2 is 95% on room air. You should suspect:
A) epiglottitis.
B) agitated delirium.
C) laryngotracheobronchitis.
D) cocaine overdose.
A) epiglottitis.
A 39-year-old female is lying in bed. When you assess her, which of the following findings indicate an inadequate airway?
A) She is lying on her side.
B) She has an open pill bottle next to her bed.
C) She is unresponsive and snoring.
D) She has chest wall expansion with little abdominal wall movement.
C) She is unresponsive and snoring.
An unresponsive 45-year-old male was found lying on the ground outside. You do not see any obvious signs of trauma. He has snoring respirations and a carotid pulse. After opening his airway, you should next:
A) insert an oropharyngeal airway.
B) suction his airway.
C) assist his ventilation.
D) administer oxygen by non-rebreather mask.
A) insert an oropharyngeal airway.
An unresponsive 30-year-old female was the unrestrained driver involved in a car crash. Your partner stabilizes her head and tells you she is breathing and has a carotid pulse. As you examine her airway, you see blood, broken teeth, and hear gurgling sounds. You should first:
A) apply a cervical collar.
B) insert an oropharyngeal airway.
C) assist her ventilation.
D) suction her airway.
D) suction her airway.
Bystanders tell you that an unresponsive 22-year-old male fell 10 feet off a ladder and landed head first. You hear irregular, gasping respirations and palpate a carotid pulse. You should first:
A) assess his vital signs.
B) apply a cervical collar.
C) insert a nasopharyngeal airway. D) perform a jaw-thrust maneuver.
D) perform a jaw-thrust maneuver.
An unresponsive 24-year-old female is lying on a sofa with an empty vodka bottle nearby. You hear snoring respirations, and when you attempt to insert an oropharyngeal airway, she begins to gag. You should:
A) insert a nasopharyngeal airway.
B) insert the next size smaller oropharyngeal airway.
C) rotate the oropharyngeal airway into place and prepare to suction her airway.
D) rotate the oropharyngeal airway into place and place her in the recovery position.
A) insert a nasopharyngeal airway.
A 9-year-old male complains of pain in the middle of his chest. He tells you that the pain increases with deep inspiration. His mother tells you that he has had frequent coughing for the past week. She denies any other medical history and tells you he is up-to-date with his vaccinations. His lungs are clear to auscultation. His vital signs are P 110, R 18, BP 110/70, and SpO2 is 97% on room air. You should suspect:
A) chest pain of a non-cardiac origin.
B) laryngotracheobronchitis.
C) pertussis.
D) chest pain of a cardiac origin.
A) chest pain of a non-cardiac origin.
A 3-year-old female complains of pain in her chest. Her father tells you that she has mitral valve prolapse. Her skin is cyanotic. Her lungs are clear on auscultation. Her vital signs are P 136 and irregular, R 30, BP 94/64, and SpO2 is 93% on room air. You should administer:
A) oxygen by nasal cannula.
B) aspirin.
C) oxygen by non-rebreather mask.
D) nitroglycerin.
A) oxygen by nasal cannula.
An 11-year-old male passed out while playing soccer. When you arrive, he is conscious and tells you he had dizziness and sharp chest pain before he passed out. He points to his mid-sternum when you ask him the location of the pain. He denies any pain currently. His vital signs are P 66, R 18, BP 114/72, and SpO2 is 95% on room air. You should:
A) administer oxygen by non-rebreather mask.
B) administer oxygen by nasal cannula.
C) transport him fully immobilized to a long backboard.
D) transport him in a position of comfort.
D) transport him in a position of comfort.
A 6-month-old female is non-responsive to stimuli and has central cyanosis. Her father tells you she has had a cold. Her vital signs are P 80, R 24 and shallow, and her capillary refill is three seconds. What should you suspect is causing her bradycardia?
A) Atherosclerosis
B) Hypoxia
C) Sick sinus syndrome
D) Myocardial ischemia
B) Hypoxia
A 7-year-old male passed out while playing soccer. He has a history of asthma. He is alert now and tells you he feels like his heart is beating out of his chest. He is dyspneic, and you auscultate clear lung sounds. His pulse is too fast to count, and the rest of his vital signs are R 32, BP 88/58, and SpO2 is 92% on room air. You should:
A) assist with the administration of albuterol.
B) administer oxygen.
C) administer aspirin.
D) assist with the administration of nitroglycerin.
B) administer oxygen.
An unresponsive 10-month-old female is lying in her crib. You observe cyanosis in her lips and tongue. Her vital signs are P 76, R 18 and shallow, and her capillary refill is four seconds. You should first:
A) assess her pulse oximetry.
B) assess her blood pressure.
C) assist her ventilation.
D) begin chest compressions.
C) assist her ventilation.
An unresponsive 2-year-old male is lying in his bed. His mother tells you that he has been sick for four days. You should next:
A) assess his breathing and pulse.
B) attach the AED and analyze his rhythm.
C) ventilate him.
D) begin chest compressions.
A) assess his breathing and pulse
An unresponsive 3-month-old female is in cardiac arrest. While you and your partner are resuscitating her, you should compress her chest:
A) using a two-finger technique.
B) using a two thumb — encircling hands technique.
C) over the upper third of her sternum.
D) approximately one half of the anterior-posterior diameter of the chest.
B) using a two thumb — encircling hands technique.
You are resuscitating a 6-year-old male who is in cardiac arrest. After you analyze his rhythm, the AED announces, “No shock advised.” You should immediately:
A) ventilate him twice.
B) resume chest compressions.
C) assess his breathing.
D) assess his pulse.
B) resume chest compressions.
An unresponsive 14-year-old female was rescued from the bottom of a pool. Bystanders are
performing high-quality CPR and tell you they do not know how long she was submerged. You
should first:
A) apply a cervical collar.
B) attach the AED.
C) determine if the pool is saltwater or chlorinated.
D) perform abdominal thrusts.
B) attach the AED.
An unresponsive 1-year-old male is lying on the floor with full-thickness burns to his left hand and right knee. He is apneic and pulseless. You should have your partner first:
A) apply sterile dressings to his wounds.
B) ventilate him.
C) begin chest compressions.
D) apply the AED and analyze his rhythm.
C) begin chest compressions.
An unresponsive 8-year-old female was found outside on a cold night. She is apneic, pulseless, and her skin is cold. You begin chest compressions, attach the AED, and analyze her rhythm. The AED announces, “Shock advised.” You should:
A) shock her and reanalyze her rhythm.
B) shock her and resume compressions.
C) disregard the AED and begin transport.
D) disregard the AED and begin to rewarm her actively.
B) shock her and resume compressions.
An unresponsive 10-month-old male is apneic and pulseless. While you are performing chest compressions, you observe that he appears to be breathing. You should next:
A) assess for a pulse.
B) auscultate his lung sounds.
C) analyze his rhythm with the AED.
D) continue compressions.
A) assess for a pulse.
While resuscitating a 1-month-old female, you achieve ROSC. She is unresponsive and has a rapid brachial pulse. You should next:
A) assess her breathing.
B) analyze her rhythm with the AED.
C) continue compressions.
D) begin to cool her.
A) assess her breathing.
A 3-year-old male was in cardiac arrest. You successfully resuscitated him, but he remains unresponsive. His vital signs are P 124, R 22, BP 94/70, and SpO2 is 100% on oxygen by non-rebreather mask. You should:
A) switch to a nasal cannula.
B) assist his ventilation.
C) resume chest compressions.
D) begin to cool him.
A) switch to a nasal cannula.
A 14-year-old female passed out while running. She is now awake and tells you she feels light-headed and like her heart is pounding out of her chest. Her lungs are clear to auscultation. Her vital signs are P 186, R 20, BP 80/58, and SpO2 is unattainable. What should you suspect caused her to pass out?
A) Increased ventricular filling pressure
B) Reduced intrathoracic pressure
C) Increased intrathoracic pressure
D) Reduced atrial filling pressure
D) Reduced atrial filling pressure
A 1-year-old male is irritable, and his skin is diaphoretic. His mother tells you that he has coarctation of his aorta. His lungs are clear to auscultation with good chest rise. His vital signs are P 138, R 28, BP 116/68, and SpO2 is 93% on room air. You should:
A) assist his ventilation.
B) administer aspirin.
C) assist with the administration of his nitroglycerin.
D) administer oxygen.
D) administer oxygen
A 61-year-old female complains of pain to the right side of her chest. She tells you that it started while she was mowing her lawn. She rates the pain 7 of 10 and tells you it does not change with movement. She has a history of cardiac and lung disease. Her skin is diaphoretic. You auscultate coarse crackles in bases of her lungs. Her vital signs are P 96, R 16, BP 168/110, and SpO2 is 95% on room air. You should suspect:
A) acute coronary syndrome.
B) hypertensive crisis.
C) costochondritis.
D) congestive heart failure.
A) acute coronary syndrome.
An 84-year-old male complains of pain in the left side of his chest that woke him up. He has a history of hypertension and hyperlipidemia. He rates the pain 6 of 10. There is no change in the pain with deep inspiration. You auscultate fine crackles in his lower lung fields. His vital signs are P 88, R 16, BP 148/78, and SpO2 is 95% on room air. You should suspect:
A) respiratory distress.
B) acute coronary syndrome.
C) costochondritis.
D) emphysema.
B) acute coronary syndrome.
A 32-year-old female complains of pain in her chest. She tells you that it started 15 minutes ago while she was exercising, but it is gone now. Her lungs are clear to auscultation. Her vital signs are P 92, R 16, BP 116/76, and SpO2 is 97% on room air. You should suspect:
A) acute myocardial infarction.
B) angina.
C) pulmonary embolism.
D) pulmonary edema.
B) angina.
A 49-year-old male complains of left-sided chest pain. He tells you it started an hour ago and it has been constantly 4 of 10. He denies any past medical history. He has a 38 pack-year smoking history. You auscultate fine crackles in his lower lungs. His vital signs are P 96, R 16, BP 154/96, and SpO2 is 96% on room air. You should suspect:
A) acute myocardial infarction.
B) lung cancer.
C) emphysema.
D) Prinzmetal’s angina.
A) acute myocardial infarction.
A 93-year-old female complains of a sudden onset of sweating and fatigue. She denies chest pain or difficulty breathing but tells you she feels like she is going to die. Her vital signs are P 78, R 16, BP 142/86, and SpO2 is 94% on room air. You should suspect:
A) sepsis.
B) gastroenteritis.
C) influenza.
D) acute coronary syndrome.
D) acute coronary syndrome.
An 84-year-old male complains of pain in his chest that started while he was watching TV. He describes the pain as squeezing and rates it 5 of 10. He tells you he has a history of heart disease. His lungs are clear to auscultation. His vital signs are P 102, R 16, BP 118/80, and SpO2 is 95% on room air. You should:
A) administer aspirin.
B) assist with the administration of his nitroglycerin.
C) administer oxygen by nasal cannula.
D) administer oxygen by non-rebreather mask.
A) administer aspirin.
A 68-year-old female who has a history of angina tells you she has chest pain. She describes the pain as sharp and rates it 6 of 10. She tells you she took one aspirin prior to your arrival. Her lungs are clear to auscultation. Her vital signs are P 104, R 18, BP 156/90, and SpO2 is 95% on room air. You should next:
A) administer oxygen by nasal cannula.
B) assist with the administration of her nitroglycerin.
C) determine the aspirin dosage and route of administration.
D) administer oxygen by non-rebreather mask.
C) determine the aspirin dosage
An 81-year-old male complains of chest pain that he describes as a heaviness. He denies any allergies to medication or active bleeding. He denies taking any medication prior to your arrival. You should first:
A) assess his vital signs.
B) auscultate his lung sounds.
C) administer aspirin.
D) determine his pulse oximetry.
C) administer aspirin.
