JBL Quizzes Flashcards
A 21-year-old woman experienced an acute onset of pleuritic chest pain and dyspnea while playing softball. She is noticeably dyspneic, has an oxygen saturation of 93% on room air, and has diminished breath sounds to the upper right lobe. What should you do?
A) Assist her ventilations to increase her oxygen saturation
B) Perform a needle decompression to the right side of her chest
C) Apply a continuous positive airway pressure unit and start an intravenous line en route to the hospital
D) Administer high-flow supplemental oxygen and transport at once
D) Administer high-flow supplemental oxygen and transport at once
A 29-year-old woman is experiencing a severe asthma attack. Her husband reports that she was admitted to an intensive care unit about 6 months ago and had a breathing tube in place. Prior to your arrival, the patient took three puffs of her rescue inhaler without effect. She is anxious and restless, is tachypneic, and has audible wheezing. What should you do?
A) Begin assisting her ventilations with a bag-mask device and 100% oxygen and prepare to intubate her trachea
B) Start an intravenous line of normal saline, administer methylprednisolone via intravenous push, and transport as soon as possible
C) Apply a continuous positive airway pressure unit, transport immediately, and attempt to establish vascular access en route to the hospital
D) Attempt to slow her breathing with respiratory coaching, administer a nebulized bronchodilator, and transport
C) Apply a continuous positive airway pressure unit, transport immediately, and attempt to establish vascular access en route to the hospital
A 36-year-old man with a history of asthma presents with severe respiratory distress and an altered mental status. You attempt to administer a nebulized beta-2 agonist, but his poor respiratory effort is inhibiting effective drug delivery via the nebulizer. What should you do?
A) Assist him with a metered-dose inhaler bronchodilator
B) Start an intravenous line of normal saline and administer a steroid
C) Apply high-flow oxygen via a nonrebreathing mask
D) Assist his ventilations and establish vascular access
D) Assist his ventilations and establish vascular access
A 76-year-old woman with chronic obstructive pulmonary disease presents with respiratory distress that has worsened progressively over the past 2 days. She is breathing through pursed lips and has a prolonged expiratory phase and an oxygen saturation of 76% on home oxygen at 2 L/min. What should you do?
A) Administer a beta-2 agonist via nebulizer
B) Auscultate her lungs for adventitious breath sounds
C) Increase her oxygen flow rate to 6 L/min
D) Place her in a position that facilitates breathing
D) Place her in a position that facilitates breathing
A hyperventilating patient:
A) may be acidotic and trying to increase her or his pH level.
B) is most effectively treated by administering a sedative drug.
C) presents with tachypnea and marked use of accessory muscles.
D) should rebreathe her or his carbon dioxide to effect resolution.
A) may be acidotic and trying to increase her or his pH level.
A patient with status asthmaticus commonly presents with:
A) accessory muscle use and inspiratory wheezing.
B) compensatory respiratory alkalosis and stridor.
C) physical exhaustion and inaudible breath sounds.
D) audible expiratory wheezing and severe cyanosis.
C) physical exhaustion and inaudible breath sounds.
A person who experiences sharp chest pain followed by increasing dyspnea after he or she coughs most likely has:
A) a pneumothorax.
B) a pleural effusion.
C) pleurisy.
D) acute pneumonia.
A) a pneumothorax.
A pulse oximetry reading would be least accurate in a patient with:
A) poor peripheral perfusion.
B) warm extremities.
C) persistent tachycardia.
D) chronic hypoxia.
A) poor peripheral perfusion.
Bronchial plugging is caused by:
A) hypermagnesemia.
B) fluid overload.
C) hypersecretion of mucus.
D) ascites.
C) hypersecretion of mucus.
Difficulty with exhalation is most characteristic of:
A) a mild asthma attack.
B) upper airway obstruction.
C) obstructive lung disease.
D) supraglottic swelling.
C) obstructive lung disease.
Patients with chronic obstructive pulmonary disease typically experience an acute exacerbation of their condition because of:
A) environmental changes such as weather or the inhalation of trigger substances.
B) progressively worsening pneumonia that results in a diminished cough reflex.
C) a secondary condition such as congestive heart failure or a pneumothorax.
D) chronic noncompliance with their prescribed medications and home oxygen.
A) environmental changes such as weather or the inhalation of trigger substances.
Patients with obvious respiratory failure require immediate:
A) tracheal intubation.
B) ventilation support.
C) bronchodilator therapy.
D) passive oxygenation.
B) ventilation support.
Patients with pneumonia often experience a coughing fit when they roll from one side to the other because:
A) most cases of pneumonia occur in conjunction with bronchospasm.
B) pneumonia often occurs in the lung bases, typically on only one side.
C) movement loosens pulmonary secretions and stimulates coughing.
D) the secretions in their lungs suddenly disperse and impair breathing.
B) pneumonia often occurs in the lung bases, typically on only one side.
Pneumonitis is especially common in older patients with:
A) chronic food aspiration.
B) immunocompromise.
C) frequent infections.
D) a history of a stroke.
A) chronic food aspiration.
Reactive airway disease is characterized by:
A) chronic bronchoconstriction of varying severity.
B) acute, reversible swelling of the laryngeal muscles.
C) excessive mucus production and a chronic cough.
D) bronchospasm, edema, and mucus production.
D) bronchospasm, edema, and mucus production.
The barrel-chest appearance classically seen in patients with emphysema is secondary to:
A) carbon dioxide retention.
B) chest wall hypertrophy.
C) widespread atelectasis.
D) air trapping in the lungs.
D) air trapping in the lungs.
The classic presentation of chronic bronchitis is:
A) expiratory wheezing and jugular vein distention due to pulmonary hypertension.
B) excessive mucus production and a chronic or recurrent productive cough.
C) a thin adult with pursed-lip breathing and a history of heavy cigarette smoking.
D) a dry, hacking cough and a barrel chest due to chronic pulmonary air trapping.
B) excessive mucus production and a chronic or recurrent productive cough.
The hypoxic drive is a phenomenon in which:
A) bicarbonate ions migrate into the cerebrospinal fluid of a chronically hypoventilating patient, making the brain think that acid and base are in balance.
B) a chronically hypoxic patient’s primary respiratory drive is stimulated by increased levels of carbon dioxide in the arterial blood.
C) high levels of oxygen rapidly depress the respiratory rate and depth of a patient with chronic obstructive pulmonary disease, leading to worsened hypoxia and severe acidosis.
D) a relatively large percentage of patients with chronic obstructive pulmonary disease become acutely apneic after receiving high-flow oxygen.
A) bicarbonate ions migrate into the cerebrospinal fluid of a chronically hypoventilating patient, making the brain think that acid and base are in balance.
The primary treatment for bronchospasm is:
A) humidified oxygen.
B) corticosteroid therapy.
C) assisted ventilation.
D) bronchodilator therapy.
D) bronchodilator therapy.
You are transporting a patient with a history of emphysema. The patient called 9-1-1 because his shortness of breath has worsened progressively over the past few days. He is on high-flow oxygen via nonrebreathing mask and has an intravenous line of normal saline in place. The cardiac monitor shows sinus tachycardia, and the pulse oximeter reads 85%. What should you do?
A) Insert a nasopharyngeal airway, administer a beta-2 agonist via nebulizer, and contact medical control for further orders
B) Remove the nonrebreathing mask and apply a nasal cannula
C) Administer a sedative and a paralytic and then intubate his trachea
D) Apply continuous positive airway pressure or bilevel positive airway pressure and then reassess his breathing status
D) Apply continuous positive airway pressure or bilevel positive airway pressure and then reassess his breathing status
A 75-year-old male patient presents with small reactive pupils. You should suspect:
A) Pontine dysfunction.
B) midbrain dysfunction.
C) diencephalic dysfunction.
D) third cranial nerve dysfunction.
C) diencephalic dysfunction.
A brain tumor would be found in the:
A) cerebellum.
B) spinal cord.
C) pons.
D) cranial cavity.
D) cranial cavity.
A computed tomography scan shows that a patient has a blood vessel pushing on a facial nerve. This condition will probably lead to:
A) hemifacial spasm.
B) intractable seizures.
C) Parkinson disease.
D) trigeminal neuralgia.
A) hemifacial spasm.
A neoplasm is defined as a(n):
A) normal cell.
B) abnormal growth.
C) damaged cell.
D) cancerous tumor.
B) abnormal growth.
