Quiz 5 - Emergency Medicine & Airway Management / Ventilation

Question 1

A 5-mL prefilled syringe of lidocaine contains 100 mg. How many mg/mL are present?

A. 30

B. 10

C. 50

D. 20

Answer 1

D. 20

Question 2

The correct dose of IV dextrose for an adult is:

A. 100 mL of a 50% solution.

B. 2 to 4 g/kg of a 50% solution.

C. 500 mg/kg of a 25% solution.

D. 12.5 to 25 g of a 50% solution.

Answer 2

D. 12.5 to 25 g of a 50% solution.

Question 3

A patient with orthopnea:

A. awakens at night with dyspnea.

B. has dyspnea while lying flat.

C. has blood-tinged sputum.

D. is breathing through pursed lips.

Answer 3

B. has dyspnea while lying flat.

Question 4

If a particular treatment is in an “indeterminate” class, this means that:

A. scientific evidence has concluded that the treatment may be considered for select conditions.

B. extensive research has concluded that the treatment has a greater potential to cause harm.

C. there is not enough scientific evidence to make a recommendation for or against the treatment.

D. preliminary research has indicated that it would be reasonable to administer the treatment.

Answer 4

C. there is not enough scientific evidence to make a recommendation for or against the treatment.

Question 5

Compared to mouth-to-mouth ventilation, mouth-to-mask ventilation is more advantageous in that it:

A. can be used in conjunction with supplemental oxygen.

B. is less likely to result in hyperventilation of the rescuer.

C. carries a lower risk of gastric distention and vomiting.

D. allows greater tidal volume to be delivered to the patient.

Answer 5

A. can be used in conjunction with supplemental oxygen.

Question 6

The King LT-D airway features a:

A. port through which gastric contents can be suctioned from the stomach.

B. universal size with two inflation ports and is used for patients of any age.

C. straight tube with two inflatable cuffs that hold an equal amount of air.

D. curved tube with ventilation ports located between two inflatable cuffs.

Answer 6

D. curved tube with ventilation ports located between two inflatable cuffs.

Question 7

Diazepam and midazolam provide all of the following therapeutic effects, EXCEPT:

A. retrograde amnesia.

B. analgesia.

C. anxiolysis.

D. sedation.

Answer 7

B. analgesia.

Question 8

Poor lung compliance during your initial attempt to ventilate an unconscious, apneic adult should be treated by:

A. reopening the airway and reattempting to ventilate.

B. administering 15 subdiaphragmatic thrusts at once.

C. performing 30 chest compressions and reassessing.

D. sweeping the patient’s mouth with your fingers.

Answer 8

A. reopening the airway and reattempting to ventilate.

Question 9

If intubation of a child is unsuccessful after two attempts, your MOST appropriate action is to:

A. have your partner attempt to intubate as you apply gentle posterior pressure to the cricoid cartilage.

B. discontinue attempts to intubate, ventilate the child with a bag-mask device, and transport immediately.

C. insert a multilumen airway device and confirm placement by means of auscultation of breath sounds and capnography.

D. turn the child on his or her side, apply manual pressure to the epigastrium to relieve distension, and reattempt intubation.

Answer 9

B. discontinue attempts to intubate, ventilate the child with a bag-mask device, and transport immediately.

Question 10

The use of capnography in patients with prolonged cardiac arrest may be limited because:

A. the paramedic often ventilates the patient too slowly.

B. of acidosis and minimal carbon dioxide elimination.

C. of an excess buildup of nitrogen in the blood.

D. metabolic alkalosis damages the colorimetric paper.

Answer 10

B. of acidosis and minimal carbon dioxide elimination.

Question 11

After opening an unresponsive patient’s airway, you determine that his respirations are rapid, irregular, and shallow. You should:

A. intubate him at once.

B. begin positive-pressure ventilations.

C. apply a nonrebreathing mask.

D. suction his mouth for 15 seconds.

Answer 11

B. begin positive-pressure ventilations.

Question 12

Pralidoxime (2-PAM) reverses the effects of organophosphate poisoning by:

A. increasing vagal tone.

B. deactivating cholinesterase.

C. reactivating cholinesterase.

D. blocking the vagus nerve.

Answer 12

C. reactivating cholinesterase.

Question 13

A 50-year-old woman presents with acute respiratory distress while eating. Upon your arrival, you note that she is conscious, coughing, and wheezing between coughs. Further assessment reveals that her skin is pink and moist. In addition to transporting her to the hospital, you should:

A. deliver positive-pressure ventilations via bag-mask device.

B. look in her mouth and attempt to visualize a foreign body.

C. perform abdominal thrusts until she becomes unconscious.

D. encourage her to cough and closely monitor her condition.

Answer 13

D. encourage her to cough and closely monitor her condition.

Question 14

Nitroglycerin is indicated for patients with __________ chest pain.

A. somatic

B. ischemic

C. pleuritic

D. traumatic

Answer 14

B. ischemic

Question 15

If it is reasonable to administer a particular treatment to a patient, the American Heart Association assigns the treatment a class:

A. I.

B. III.

C. IIb.

D. IIa.

Answer 15

D. IIa.

Question 16

An 8-year-old child in cardiac arrest has been intubated. When ventilating the child, the paramedic should:

A. deliver 8 to 10 breaths per minute.

B. observe for full chest expansion.

C. allow partial exhalation between breaths.

D. deliver one breath every 15 seconds.

Answer 16

A. deliver 8 to 10 breaths per minute.

Question 17

In contrast to negative-pressure ventilation, positive-pressure ventilation:

A. may impair blood return to the heart.

B. causes decreased intrathoracic pressure.

C. is the act of normal, unassisted breathing.

D. moves air into the esophagus and trachea

Answer 17

A. may impair blood return to the heart.

Question 18

Following ET intubation, the ideal time to attach the capnography T-piece is:

A. after auscultating the lungs and epigastrium.

B. when the bag is attached to the ET tube.

C. after 6 to 8 positive pressure breaths.

D. immediately after removing the stylet

Answer 18

B. when the bag is attached to the ET tube.

Question 19

After properly positioning the patient’s head for intubation, you should open his or her mouth and insert the blade:

A. into the right side of the mouth and sweep the tongue to the left.

B. in the midline of the mouth and gently sweep the tongue to the left.

C. into the left side of the mouth and move the blade to the midline.

D. in the midline of the mouth and gently lift upward on the tongue.

Answer 19

A. into the right side of the mouth and sweep the tongue to the left.

Question 20

Biot respirations are characterized by:

A. increased respirations followed by apneic periods.

B. deep, gasping respirations that are often rapid but may be slow.

C. slow, shallow irregular respirations or occasional gasping breaths.

D. an irregular pattern of breathing with intermittent periods of apnea.

Answer 20

D. an irregular pattern of breathing with intermittent periods of apnea.

Question 21

Ondansetron hydrochloride (Zofran) prevents nausea and vomiting by:

A. stimulating histamine receptors.

B. blocking histamine receptors.

C. blocking serotonin receptors.

D. stimulating serotonin receptors.

Answer 21

C. blocking serotonin receptors.

Question 22

Which of the following statements regarding field extubation is correct?

A. It is generally better to sedate the patient rather than extubate.

B. Extubation should be performed with the patient in a supine position.

C. The patient should be extubated if spontaneous breathing occurs.

D. The risk of laryngospasm following extubation is relatively low.

Answer 22

A. It is generally better to sedate the patient rather than extubate.

Question 23

Which of the following factors would MOST likely produce a falsely normal pulse oximetry reading?

A. Carboxyhemoglobin

B. A dimly lit environment

C. Heart rate above 120 beats/min

D. Peripheral vasodilation

Answer 23

A. Carboxyhemoglobin

Question 24

An intubated 33-year-old man is becoming agitated and begins moving his head around. Your estimated time of arrival at the hospital is 15 minutes. You should:

A. chemically paralyze him with vecuronium.

B. administer a sedative medication.

C. suction his airway and carefully extubate.

D. physically restrain his head to the stretcher.

Answer 24

B. administer a sedative medication.

Question 25

The normal alveolar volume in a healthy adult is:

A. 250 mL.

B. 400 mL.

C. 300 mL.

D. 350 mL.

Answer 25

D. 350 mL.

Question 26

Physiologic effects of CPAP include:

A. increased alveolar surface tension.

B. increased intrathoracic pressure.

C. opening of collapsed alveoli.

D. forcing of fluid into the alveoli.

Answer 26

C. opening of collapsed alveoli.

Question 27

Which of the following statements regarding morphine sulfate is correct?

A. For a suspected acute myocardial infarction, morphine should be given prior to nitroglycerin.

B. Although morphine is an opioid, its effects cannot be effectively reversed with naloxone (Narcan).

C. To be of most benefit, morphine should be given in a dose of 5 to 10 mg over 20 to 30 seconds.

D. Morphine is indicated for patients with unstable angina if nitroglycerin does not relieve their pain.

Answer 27

D. Morphine is indicated for patients with unstable angina if nitroglycerin does not relieve their pain.

Question 28

What is the mechanism of action of adenosine (Adenocard)?

A. Slows conduction through the AV node; can interrupt re-entrant pathways; slows heart rate by acting directly on sinus pacemaker cells

B. Inhibits the action of acetylcholine at postganglionic parasympathetic neuroeffector sites; increases heart rate

C. Decreases heart rate, myocardial contractility, and cardiac output; inhibits dilation of bronchial smooth muscle

D. Blocks sodium channels and myocardial potassium channels; delays repolarization; increases the duration of the action potential

Answer 28

A. Slows conduction through the AV node; can interrupt re-entrant pathways; slows heart rate by acting directly on sinus pacemaker cells

Question 29

Which of the following classifications of medication may potentiate atenolol?

A. Calcium channel blocker

B. Selective beta-2 agonist

C. Alpha-adrenergic agonist

D. Beta-1 receptor agonist

Answer 29

A. Calcium channel blocker

Question 30

Chemoreceptors located in the carotid bodies and aortic arch sense minute changes in the ______ and send signals to the respiratory centers via the _______________ nerves.

A. PaO2, vagus and intercostal

B. PaCO2, glossopharyngeal and vagus

C. PaO2, hypoglossal, vagus, and intercostal

D. PaCO2, phrenic and glossopharyngeal

Answer 30

B. PaCO2, glossopharyngeal and vagus

Question 31

Diltiazem is commonly used for patients with:

A. heart failure and hypotension.

B. high-grade AV heart block.

C. ventricular tachycardia.

D. rapid atrial fibrillation.

Answer 31

D. rapid atrial fibrillation.

Question 32

Glucagon would be ineffective in patients with:

A. significant hypertension.

B. low serum glucose levels.

C. depleted glycogen stores.

D. severe beta-blocker toxicity.

Answer 32

C. depleted glycogen stores.

Question 33

Sodium bicarbonate may be indicated for all of the following conditions, EXCEPT:

A. crush injury.

B. hypokalemia.

C. aspirin overdose.

D. cardiac arrest.

Answer 33

B. hypokalemia.

Question 34

Albuterol is a(n):

A. sympathomimetic drug.

B. selective beta-1 agonist.

C. parasympatholytic drug.

D. beta-adrenergic blocker.

Answer 34

A. sympathomimetic drug

Question 35

Atropine sulfate is classified as a(n) __________________ medication.

A. adrenergic

B. anticholinergic

C. sympathomimetic

D. sympatholytic

Answer 35

B. anticholinergic

Question 36

Negative-pressure ventilation occurs when:

A. air is drawn into the lungs when intrathoracic pressure decreases.

B. the phrenic nerves stop sending messages to the diaphragm.

C. the diaphragm ascends and the intercostal muscles retract.

D. pressure within the chest decreases and air is forced from the lungs.

Answer 36

A. air is drawn into the lungs when intrathoracic pressure decreases.

Question 37

The process of moving air into and out of the lungs is called:

A. respiration.

B. ventilation.

C. exhalation.

D. inhalation.

Answer 37

B. ventilation.

Question 38

A 19-year-old woman ingested a large quantity of Darvon. She is responsive to pain only and has slow, shallow respirations. The MOST appropriate airway management for this patient involves:

A. inserting a nasal airway and assisting ventilations with a bag-mask device.

B. inserting an oral airway and administering oxygen via nonrebreathing mask.

C. inserting an oral airway and assisting ventilations with a bag-mask device.

D. suctioning her airway, inserting an oral airway, and administering 100% oxygen.

Answer 38

A. inserting a nasal airway and assisting ventilations with a bag-mask device.

Question 39

The major advantage of ET intubation is that it:

A. is an easy skill to learn and perform.

B. provides a route for certain medications.

C. protects the airway from aspiration.

D. facilitates tracheal suctioning.

Answer 39

C. protects the airway from aspiration.

Question 40

You are intubating a 60-year-old man in cardiac arrest and have visualized the ET tube passing between the vocal cords. After removing the laryngoscope blade from the patient’s mouth, manually stabilizing the tube, and removing the stylet, you should:

A. secure the ET tube with a commercial device.

B. attach an ETCO2 detector to the tube.

C. inflate the distal cuff with 5 to 10 mL of air.

D. begin ventilations and auscultate breath sounds.

Answer 40

C. inflate the distal cuff with 5 to 10 mL of air.