Chapter 13 - Respiratory Emergencies

Question 1

A 30-year-old man presents with acute shortness of breath, widespread hives, and facial swelling. He denies any past medical history and takes no medications. During your assessment, you hear wheezing over all lung fields. His blood pressure is 90/50 mm Hg and his heart rate is 110 beats/min. In addition to giving him 100% oxygen, the MOST important treatment for this patient is:
Select one:
A. albuterol.
B. a beta-antagonist.
C. epinephrine.
D. an antihistamine.

Answer 1

C. epinephrine.

Question 2

A 62-year-old man with a history of congestive heart failure presents with severe respiratory distress and an oxygen saturation of 82%. When you auscultate his lungs, you hear widespread rales. He is conscious and alert, is able to follow simple commands, and can only speak in two- to three-word sentences at a time. You should:
Select one:
A. apply a continuous positive airway pressure (CPAP) device, monitor his blood pressure, and observe him for signs of improvement or deterioration.
B. force fluid from his alveoli by hyperventilating him with a bag-mask device at a rate of at least 20 breaths/min.
C. place him in a position of comfort, deliver oxygen via nasal cannula, and closely monitor his breathing.
D. place him in a supine position and assist his ventilations with a bag-mask device and high-flow oxygen.

Answer 2

A. apply a continuous positive airway pressure (CPAP) device, monitor his blood pressure, and observe him for signs of improvement or deterioration.

Question 3

A conscious and alert 29-year-old woman with a history of asthma complains of difficulty breathing that began after her morning jog. The temperature outside is 40°F (5°C). On examination, you hear bilateral expiratory wheezing. After providing 100% oxygen, you should:
Select one:
A. call medical control and ask how to proceed with treatment.
B. place her in a recumbent position to facilitate breathing.
C. contact medical control and administer an antihistamine.
D. determine if she has been prescribed a beta-agonist inhaler.

Answer 3

D. determine if she has been prescribed a beta-agonist inhaler.

Question 4

A pleural effusion is MOST accurately defined as:
Select one:
A. a unilaterally collapsed lung.
B. a bacterial infection of the lung tissue.
C. diffuse collapsing of the alveoli.
D. fluid accumulation outside the lung.

Answer 4

D. fluid accumulation outside the lung.

Question 5

Acute pulmonary edema would MOST likely develop as the result of: 
Select one:
A. severe hyperventilation.
B. an upper airway infection. 
C. toxic chemical inhalation.
D.   right-sided heart failure.
Feedback
The correct answer is: toxic chemical inhalation.

Answer 5

C. toxic chemical inhalation.

Question 6

Alkalosis is a condition that occurs when:
Select one:
A. dangerous acids accumulate in the bloodstream.
B. blood acidity is reduced by excessive breathing.
C. the level of carbon dioxide in the blood increases.
D. slow, shallow breathing eliminates too much carbon dioxide.

Answer 6

B. blood acidity is reduced by excessive breathing.

Question 7

Hyperventilation could be associated with all of the following, EXCEPT:
Select one:
A. an overdose of aspirin.
B. high blood glucose levels. 
C. a respiratory infection.
D. a narcotic overdose.

Answer 7

D. a narcotic overdose.

Question 8

Rales are caused by \_\_\_\_\_\_\_\_\_.
Select one:
A. air passing through fluid
B. narrowing of the upper airways
C. severe bronchoconstriction
D. mucus in the larger airways

Answer 8

A. air passing through fluid

Question 9

The respiratory distress that accompanies emphysema is caused by:
Select one:
A. repeated exposure to cigarette smoke. Incorrect
B. chronic stretching of the alveolar walls.
C. massive constriction of the bronchioles.
D. acute fluid accumulation in the alveoli.

Answer 9

B. chronic stretching of the alveolar walls.

Question 10

When auscultating the lungs of a patient with respiratory distress, you hear adventitious sounds. This means that the patient has:
Select one:
A. diminished breath sounds.
B. an absence of breath sounds.
C. normal breath sounds.  
D. abnormal breath sounds.

Answer 10

D. abnormal breath sounds.

Question 11

When the level of arterial carbon dioxide rises above normal:
Select one:
A. exhalation lasts longer than inhalation.
B. respirations increase in rate and depth.
C. respirations decrease in rate and depth.
D. the brain stem inhibits respirations.

Answer 11

B. respirations increase in rate and depth.

Question 12

Which of the following is a genetic disorder that predisposes the patient to repeated lung infections?
Select one:
A. Severe acute respiratory syndrome 
B. Ciliac sprue
C. Multiple sclerosis
D. Cystic fibrosis

Answer 12

D. Cystic fibrosis

Question 13

Which of the following is true about a patient experiencing a prolonged tonic/clonic (grand mal) seizure?
Select one:
A. The patient has no airway control.
B. The patient will become hyperglycemic.
C. The patient will hyperventilate.
D. The brain is protected against hypoxia.

Answer 13

A. The patient has no airway control.

Question 14

You are dispatched to an apartment complex where a 21-year-old woman has apparently overdosed on several narcotic medications. She is semiconscious and has slow, shallow respirations. You should:
Select one:
A. apply oxygen via a nonrebreathing mask and transport at once.
B. place her in the recovery position and monitor for vomiting.
C. insert a nasopharyngeal airway and begin assisted ventilation.
D. insert an oropharyngeal airway and perform oral suctioning.

Answer 14

C. insert a nasopharyngeal airway and begin assisted ventilation.

Question 15

Your patient has a chronic respiratory condition. His stimulus to breathe is triggered by low oxygen levels in the blood. This is known as the \_\_\_\_\_\_\_\_\_\_\_.
Select one:
A. hypoxic drive
B. CO2 drive 
C. COPD drive
D. alternate drive

Answer 15

A. hypoxic drive

Question 16

Which of the following conditions would LEAST likely result in hypoxia?
A. Severe anxiety
B. Pleural effusion
C. Prolonged seizures
D. Pulmonary edema

Answer 16

A. Severe anxiety