EMT 221 Review Flashcards
What is the medical term used to refer lung sounds auscultated in the mid-axillary region? A) Tracheal B) Vesicular C) Bronchial D) Bronchovesicular
D) Bronchovesicular
Which of the following is the principle reason for securing an endotracheal tube?
A) To confirm proper placement
B) To reduce the likelihood of aspiration
C) To prevent the tube form entering the esophagus
D) To reduce the likelihood of an inadvertent extubation
D) To reduce the likelihood of an inadvertent extubation
Which of the following sedatives would work best for a patient in need of intubation who is conscious and hypotensive? A) Sodium thiopental B) Midazolam C) Etomidate D) Diazepam
C) Etomidate
Rescuers are transporting an unresponsive patient they suspect has overdosed on high blood pressure medications. The supine patient begins vomiting forcefully and rigid suctioning of the oropharynx is started. They quickly recognize the pa”ent is likely aspirating his stomach contents because suction is not keeping up with the volume of emesis. Which beneficial treatment have the rescuers neglected to exercise?
A) Rolling the patient into the left recumbent position
B) Applying the light anterior pressure on the cricoid cartilage
C) Increasing the suction power to the maximum strength
D) Using a soft suction catheter instead of a rigid one
A) Rolling the patient into the left recumbent position
Rescuers are preparing to transfer a 52-year-old female with a mild pneumothorax to a larger hospital for further treatment. According to the physician arranging the transfer, he suspects her lung was punctured during a central line insertion two days ago. During the transfer the pa”ent begins experiencing severe dyspnea and pulsus paradoxus. Which description BEST explains what the rescuers see?
A) The trouble breathing has worsened and suddenly loses her pulse in both arms
B) Shortness of breath has increased and there is a drop of systolic blood pressure during inhalations
C) The patient’s breathing becomes labored and her skin becomes mottles below the chest
D) The rescuers witness trouble breathing and decrease in coronary artery perfusion
B) Shortness of breath has increased and there is a drop of systolic blood pressure during inhalations
Identify which technique will work best for ventilating a non-breathing stoma patient.
A) Use a pediatric bag-valve -mask device
B) Ventilate the patient with a standard pocket mask
C) Use Use an adult bag valve connected to a pediatric mask
D) Perform direct mouth-to-stoma ventilations with a barrier
C) Use Use an adult bag valve connected to a pediatric mask
Rescuers are inserting double lumen style airway into a traumatic arrest victim. Select the statement that most accurate regarding the combitube and trauma patients.
A) Insertion requires a minimum of three rescuers
B) You do not need to pre-oxygenate before insertion
C) The majority of the time this tube is inserted blindly into the esophagus
D) Insertion of the double lumen airway is contraindicated in trauma patients
C) The majority of the time this tube is inserted blindly into the esophagus
Which of the following pieces of of equipment should be available during nasotracheal intubation? A) Curved or straight blade B) Intubation blade handle C) Water soluble lubricant D) Pliable metal wire stylet
C) Water soluble lubricant
The primary location of the body's monitoring of C02 concentrations occurs in receptors found in the: A) Medulla B) Aortic arch C) Carotid arteries D) Coronary arteries
A) Medulla
What is the name of the area between the epiglottis and the tongue? A) Trachea B) Vallecular C) Esophagus D) Glottis opening
B) Vallecular
Which of the following is true regarding an infant’s airway?
A) Infants typically breathe through their mouth
B) Swelling in the airway is typically not their concern
C) The opening at the cricoid ring is smaller than in the vocal cords
D) The tongue is smaller in proportion to the airway than that of the adult
C) The opening at the cricoid ring is smaller than in the vocal cords
Which of the following tanks would least likely be used as a portable oxygen bottle carried into a scene by rescuers A) D Cylinder B) E Cylinder C) M Cylinder D) Super D Cylinder
C) M Cylinder
What is the process of air moving into and out of the lungs? A) Ventilation B) Diffusion C) Respiration D) Oxygenation
A) Ventilation
You are transferring a 27 -year-old male with a known C_6 fracture with a cord involvement. Which of the following findings would be MOST consistent with this injury?
A) Decrease in tidal volume, normal respiratory rate
B) Increase in tidal volume, normal respiratory rate
C) Decrease in tidal volume, increase in respiratory rate
D) Increase in tidal volume, decrease in respiratory rate
A) Decrease in tidal volume, normal respiratory rate
All of the following are terms used to describe a soft suction catheter except: A) Soft B) Oral C) Sterile D) French
B) Oral
The end tidal CO2 detector of an intubated patient in cardiac arrest does not change color. After visually confirming the tube passing through the vocal cords, what should the paramedic suspect? A) The tube is definitely misplaced B) The tube is in the esophagus C) There may be low cardiac output D) The C02 detector is defective
C) There may be low cardiac output
Rescuers are preparing to transfer a critical patient from an emergency room to a higher level trauma center. Which of the following conditions would be an absolute contraindication for applying an automatic transport ventilator?
A) a patient with a suspected pneumothorax
B) A patient who is paralyzed from the neck down
C) Any patient medicated with a strong sedative medication
D) Any patient you suspect will stop breathing during the transfer
A) a patient with a suspected pneumothorax
You determine your unconscious patient must be moved downstairs by using a small elevator. If you are limited to the amount of equipment that will fit on the elevator, choose a piece of equipment that MUST be with you for the trip downstairs. A) Suction equipment B) Extra 02 bottles C) Leather restraints D) Extra nasal cannula
A) Suction equipment
Which description BEST describes proper 02 flow for a non-rebreather mask?
A) 2 to 6 L/min
B) 6 to 8 L/min
C) So the reservoir bag deflates completely on deep breaths
D) So the reservoir bag does not deflate more than one third
D) So the reservoir bag does not deflate more than one third
EMS providers are having difficulty visualizing the vocal cords of a five-year-old female during intubation. Which of the following techniques would improve intubation success?
A) Placing a towel roll underneath the occipital lobe of her head
B) Performing posterior/superior pressure on the larynx/cricoid membrane
C) Inserting a sterile French catheter into the patient’s nose to trigger a gag reflex
D) Tipping the patient’s head and chin downward toward the chest during visualization
B) Performing posterior/superior pressure on the larynx/cricoid membrane
All of the following activities will likely increase carbon dioxide levels within the bloodstream EXCEPT: A) Anaerobic metabolism B) Narcotic overdose C) Hyperventilation D) Exercise
C) Hyperventilation
You are called to the scene of a patient with a decreased level of consciousness and an intact gag reflex. Which of the following would be the MOST appropriate initial ac”on to correct this issue?
A) Placement of an OPA
B) Placement of an NPA
C) Placement of an LMA
D) Suctioning the upper airway
B) Placement of an NPA
You have a patient who has suffered a brain stem injury with increasing intracranial pressure. Which of the following types of respirations would you LEAST likely expect to see? A) Biot's B) Kussmaul C) Cheyne-Stokes D) Central neurogenic hyperventilation
B) Kussmaul
Which of the following would be the BEST to use for a patient experiencing respiratory distress with adequate breathing? A) Non-breather mask B) Bag-valve mask C) Nasal Canula D) Suctioning
A) Non-breather mask
During Intubation the rescuer inserts an advanced airway too deeply. Where should be he suspect the distal end of the ETT lies? A) Inside the right bronchus B) Just superior to the carina C) Within the left main bronchus D) In the bronchioles of the left lung
A) Inside the right bronchus
You are eating lunch with a friend whom appears to start choking on a piece of food. What should you do FIRST?
A) Begin chest compressions to dislodge the object
B) Straddle him and perform abdominal thrusts
C) Perform abdominal thrusts from behind
D) Ask/ confirm whether he is choking
D) Ask/ confirm whether he is choking
You have just placed an esophageal tracheal dual lumen airway and ventilated down tube#1. You hear gastric sounds and no lung sounds. What should you do NEXT? A) Pull back slightly on the tube B) Ventilate down tube #2 C) Continue ventilating D) Remove the tube
B) Ventilate down tube #2
Identify the structure located at the division of the trachea into the right and left bronchus. A) Esophagus B) Bronchioles C) Carina D) Alveolus
C) Carina
Which of the following was the primary reason to use cricoid pressure during an intubation attempt? A) To minimize risk of aspiration B) to place the airway more anterior C) To move the tongue more anterior D) To cause the vocal cords to open more
A) To minimize risk of aspiration
The adult patient you are assessing is breathing 16 times per minute and has pale skin. Which other signs or symptoms would you expect to find if you suspected she was breathing inadequately? A) Weak pulse B) Slow heart rate C) Shallow breathing D) Good breath sounds
C) Shallow breathing
Identify which of the following scenarios may benefit from application of humidified oxygen.
A) 56 year old male complaining of chest pain
B) 25 year old female with abdominal pain
C) 16 year old male with with severe epistaxis
D) 4 year old with suspected croup
D) 4 year old with suspected croup
During ventilation of an 8 month old infant you determine the chest is not rising and falling properly. What should you do to improve ventilations with this age group?
A) Place a small towel roll under the shoulders
B) Tip the head back further until chest rise improves
C) Lift the jaw forward until the ventilations are easier
D) Ventilate at a quicker pace to allow air to enter the chest
A) Place a small towel roll under the shoulders
Choose the patient to whom you would apply a nasal cannula instead of a non-rebreather face mask.
A) Patients who refuse to wear a mask because of claustrophobic sensation
B) Pediatric and geriatric patients who are having difficulty breathing
C) Patients with a long term history of emphysema and/or bronchitis
D) Any patients with severe allergies to latex based materials
A) Patients who refuse to wear a mask because of claustrophobic sensation
You are called to treat a 27-year-old male who was found unconscious on the side of the road. Which of the following would be the preferred method to initially open this patient’s airway?
A) Head tilt chin lift
B) Head tile neck lift
C) Jaw lift with manual cervical spine control
D) jaw thrust with manual cervical spine control
D) jaw thrust with manual cervical spine control
Which equipment would a rescuer MOST likely use to clear oral secretions from an adult patient's airway while at a home scene? A) Bite stick B) Soft/sterile catheter C) Mounted suction device D) Hand powered suction unit
D) Hand powered suction unit
You are preparing to suction the mouth of an adult patient who is not breathing. Which of the following is true regarding what you should do when suctioning this patient?
A) Have a container of sterile water on hand
B) Apply suction upon insertion of catheter
C) Ventilate the patient 60 times per minute
D) Select the soft flexible style catheter
A) Have a container of sterile water on hand
Which of the following is appropriate regarding suctioning through an ET tube?
A) The suction catheter should go down to the carina
B) Suctioning should never last longer than 20 seconds
C) The patient must always be preoxygenated prior to suctioning
D) The larger the number of French units the smaller the diameter of the suction catheter
C) The patient must always be preoxygenated prior to suctioning
Which of the following methods would be the MOST effective to ventilate an unresponsive pa”ent who is suffering from adult respiratory distress syndrome where you were unable to secure the airway with an endotracheal tube?
A) Mouth to mask ventilation with supplemental oxygen
B) 2 person bag valve mask ventilation with adjustable peep setting
C) 1 person BVM ventilation and the administration of a loop diuretic
D) Insertion of esophageal tracheal dual lumen airway and positive pressure ventilation
D) Insertion of esophageal tracheal dual lumen airway and positive pressure ventilation
For which of the following patients showing signs of severe respiratory distress should you limit the amount of oxygen you provide?
A) Asthma patient
B) A patient with emphysema
C) A patient with chronic bronchitis
D) You should initially provide oxygen for any patient in distress
D) You should initially provide oxygen for any patient in distress
You and your partner are resuscitating a 65-year-old COPD patient. It becomes obvious that the patient will require intubation to survive. Defend the BEST reason for inserting a stylet into the endotracheal tube during setup of your partner’s equipment.
A) It will keep the 15 mm adapter in place during insertion
B) It will be available if it is needed and harmless if it is not
C) All rescuers are required to use a stylet even if it does not seem necessary
D) It takes 3-4 minutes to prepare and insert a stylet if it is needed for the procedure later on
B) It will be available if it is needed and harmless if it is not
During a transfer, rescuers determine a patient is no longer breathing on his own. Which of the following is the BEST reason for choosing a bag-valve-mask device instead of performing rescue breathing (mouth-to- mouth)?
A) It significantly reduces the infectious disease risk to the rescuers performing ventilations
B) It is the best way to prevent gastric distention in the respiratory arrest patient
C) It is easier to establish an effective face seal with a bag valve mask device
D) It will likely deliver higher tidal volumes than mouth to mouth ventilations
A) It significantly reduces the infectious disease risk to the rescuers performing ventilations
What is the transfer of oxygen and carbon dioxide between the capillary red blood cells and the tissue cells called? A) Pulmonary ventilation B) Internal respiration C) External respiration D) Internal ventilation
B) Internal respiration
Which of the following best describes the proper placement and direction of a nasopharyngeal airway?
A) Bevel toward the septum and insert at an angle parallel to the mouth
B) Bevel toward the septum and insert at an angle of 45 degree cephalic
C) Bevel toward the floor of the nostril and insert at an angle slightly cephalic
D) Bevel toward the floor of the nostril and insert at an angle slightly caudally
A) Bevel toward the septum and insert at an angle parallel to the mouth
Which of the following is the greatest complication associated with a rapid sequence intubation? A) Apnea B) Aspiration C) Bradycardia D) Tachycardia
B) Aspiration
The resultant respiratory alkalosis associated with hyperventilation syndrome is due to an excessive loss of what element? A) 02 B) Na C) C02 D) N
C) C02
During oral intubation, you select a straight blade to insert an endotracheal tube. Which statement is MOST accurate for this type of blade?
A) Insertion of the blade must be done in a slower fashion than a straight blade
B) The curved blade is designed to move the tongue out of the way
C) You will lift the epiglottis directly with the tip of the blade
D) You should hold the handle and blade in your right hand
C) You will lift the epiglottis directly with the tip of the blade
Which region of the brain is responsible for control of autonomic functions such as heart rate, blood pressure and digestive activities? A) Pons B) Diencephalon C) Medulla oblongata D) Cerebellum
C) Medulla oblongata
You are attempting to ventilate an apneic patient with a bag-valve-mask, but you are unsuccessful. You note that the face seal is not adequate. What should you do NEXT to improve ventilations if you suspect a neck injury?
A) Insert an oral or nasal pharyngeal airway
B) Assure that oxygen is attached to the 02 reservoir
C) Tip the patient’s head back further and reattempt to ventilate
D) Have an assistant secure the mask to the patient’s face while immobilizing the head
D) Have an assistant secure the mask to the patient’s face while immobilizing the head
