Quiz Packet Flashcards
The phrenic nerve originates from which spinal nerves?
A) C1 - C2 - C3
B) C3 - C4 - C5
C) C5 - C6 - C7
D) C6 - C7 - T1
B) C3 - C4 - C5
What is an aspect of expiration?
A) Always active to counter the active inspiratory center
B) Inactive during quiet respiration
C) Controlled by the fifth cranial nerve
D) Necessary for normal respiration
B) Inactive during quiet respiration
What structure contains the chemoreceptors?
A) Cerebrum
B) Blood vessels in the extremities
C) Spinal cord
D) Arch of the aorta
D) Arch of the aorta
When stretch receptors are stimulated by expansion of the lungs, information is conveyed to the medulla by which nerve?
A) Intercostal
B) Vagus
C) Phrenic
D) Diaphragmatic
B) Vagus
What structure contains the pneumotaxic center?
A) Pons
B) Hypothalamus
C) Cerebellum
D) Medulla oblongata
A) Pons
What is the major difference between the right mainstem bronchus and the left mainstem bronchus?
A) Shorter
B) Narrower
C) More angled from the trachea
D) Made of thicker membrane
A) Shorter
The intrathoracic pressure is normally _______.
A) Much higher than the atmospheric pressure
B) Less than atmospheric pressure
C) Equal to the atmospheric pressure
D) Slightly higher than atmospheric pressure
B) Less than atmospheric pressure
Air normally moves into the lungs from the _______.
A) Pressure gradient created when the lungs expand
B) Higher pressure within the lungs during inspiration
C) Positive pressure forcing air into the lungs
D) Increased intrathoracic pressure during inspiration
A) Pressure gradient created when the lungs expand
What is diffusion?
A) The active transport of gas with energy expended
B) A gaseous substance dissolving in a liquid substance
C) The movement of a gas from a lower pressure to a higher pressure across a semipermeable membrane
D) The movement of a gas from a higher pressure to a lower pressure across a semipermeable membrane
D) The movement of a gas from a higher pressure to a lower pressure across a semipermeable membrane
The normal movement of the diaphragm during inspiration _________.
A) Causes the diaphragm to move up
B) Decreases the side-to-side dimensions of the chest
C) Flattens the diaphragm
D) Causes passive inhalation
C) Flattens the diaphragm
The ease with which the lungs expand during inspiration is known as what aspect?
A) Pulmonary pressure
B) Compliance
C) Inspiratory pressure gradient
D) Atmospheric
B) Compliance
What is the function of pulmonary surfactant?
A) Increases airway pressures within the lungs
B) Lowers the surface tension, preventing alveolar collapse
C) Increases the attractive forces between the water molecules in the lungs
D) Lowers the recoil in the elastic fibers in the alveolar walls
B) Lowers the surface tension, preventing alveolar collapse
Scalene and sternocleidomastoid muscles are normally used during what occurrence?
A) During normal quiet breathing
B) During mouth breathing
C) As voluntary muscles if a patient chooses to take a deep breath
D) As accessory muscles during labored breathing
D) As accessory muscles during labored breathing
Which of the following is the most correct statement regarding physiologic dead space?
A) Normally 10 times the volume of anatomic dead space
B) Created by the upper respiratory tract and nonrespiratory bronchioles
C) Increased in patients with respiratory diseases such as emphysema
D) Composed of the nonfunctional alveoli
C) Increased in patients with respiratory diseases such as emphysema
Tidal volume is the amount of air _______.
A) Inhaled or exhaled during a normal breath
B) Left in the lungs after a forceful exhalation
C) One can inhale after a maximal inhalation
D) Always present in the alveoli
A) Inhaled or exhaled during a normal breath
Minute volume is the amount of air _______.
A) That can be inhaled after a maximal inhalation
B) In the tidal volume multiplied by the respiratory rate
C) In the dead space moved in and out of the respiratory tract each minute
D) Available for gas exchange in every minute
B) In the tidal volume multiplied by the respiratory rate
A patient with a tidal volume of 500 mL, a dead space of 100 mL, and a respiratory rate of 10 breaths per minute has a minute alveolar ventilation of ______L per minute.
A) 6
B) 5
C) 4
D) 3
C) 4
A hiccup results from the stimulation of which structure?
A) Lungs
B) Nasal passages
C) Diaphragm
D) Intercostal muscles
C) Diaphragm
What gas is most prevalent in the atmosphere?
A) Oxygen
B) Carbon dioxide
C) Water vapor
D) Nitrogen
D) Nitrogen
Blood in the pulmonary vein is ______.
A) Transported to the right and left lungs
B) Transported to the right atrium
C) High in carbon dioxide
D) High in oxygen
D) High in oxygen
Which reading is a normal PO2?
A) 80 - 100 mm Hg
B) 100 - 110 mm Hg
C) 120 - 140 mm Hg
D) 140 - 150 mm Hg
A) 80 - 100 mm Hg
Which reading is a normal PCO2?
A) 25 mm Hg
B) 65 mm Hg
C) 45 mm Hg
D) 55 mm Hg
C) 45 mm Hg
Most of the oxygen in blood is carried ________.
A) Dissolved in plasma
B) Attached to hemoglobin
C) As carboxyhemoglobin
D) Attached to leukocytes
B) Attached to hemoglobin
Which of the following is not a component of the alveolar wall?
A) Surfactant
B) Epithelial cells
C) Basement membrane
D) Interstitial fluid
D) Interstitial fluid
What is the most important factor in determining the extent to which oxygen combines with hemoglobin?
A) Partial pressure of oxygen in the blood plasma
B) Relative number of red blood cells in the plasma
C) Number of oxygen receptor sites on the hemoglobin
D) Partial pressure of oxygen in the lungs
A) Partial pressure of oxygen in the blood plasma
Which is likely to decrease carbon dioxide production?
A) Resting quietly
B) Anaerobic metabolism
C) Ketoacidosis
D) Exercise
A) Resting quietly
The majority of carbon dioxide in the blood is carried ________.
A) Dissolved in plasma
B) Attached to hemoglobin
C) As bicarbonate ion
D) Inside red blood cells
C) As bicarbonate ion
What occurs as a result of hyperventilation?
A) Dilated cerebral vessels
B) Hypercarbia
C) Improved cerebral perfusion
D) Low carbon dioxide levels
D) Low carbon dioxide levels
What is the major determinant(s) in controlling respiration?
A) Oxygen content in the blood
B) Impulses generated within the lungs
C) Partial pressure of carbon dioxide
D) pH of capillary blood
C) Partial pressure of carbon dioxide
A patient with chronic bronchitis is likely to rely on what mechanism to stimulate respiratory drive?
A) Hypoxia
B) Elevated carbon dioxide levels
C) Changes in pH
D) Increased bicarbonate ions
A) Hypoxia
A 45-year-old man chokes on a piece of steak during dinner; he is coughing forcefully. How should the paramedic continue?
A) Perform back blows
B) Attempt a finger sweep
C) Monitor the patient
D) Give abdominal thrusts
C) Monitor the patient
What is the primary cause of airway obstruction in unconscious patients?
A) The tongue
B) Loose-fitting dentures
C) Toys or other small objects
D) Incompletely chewed food
A) The tongue
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 CO2 detector is defective
C) There may be low cardiac output
A drop in systolic blood pressure of 10 mm Hg or more during inspiration is known as which occurrence?
A) Pericardial tamponade
B) Pulsus paradoxus
C) Orthostatic change
D) Pulse pressure
B) Pulsus paradoxus
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 respiratory pattern is characterized by an irregular pattern, rate and volume, with intermittent periods of apnea?
A) Cheyne-Stokes
B) Biots
C) Central neurogenic hyperventilation
D) Agonal
B) Biots
Which respiratory pattern is characterized by rapid,- regular respirations?
A) Cheyne-Stokes
B) Biots
C) Central neurogenic hyperventilation
D) Agonal
C) Central neurogenic hyperventilation
What is the component of the oxygen delivery system in which 50 psi oxygen is reduced to 30 psi oxygen for safe patient delivery?
A) Therapy regulator
B) PIN index safety system
C) Flowmeter
D) Oxygen tank head
A) Therapy regulator
What is the safe residual amount of oxygen a cylinder can contain when considered empty?
A) 200 psi
B) 500 psi
C) 1000 psi
D) 2000 psi
A) 200 psi
What is an advantage of liquid oxygen (LOX) over gaseous oxygen?
A) The oxygen content in LOX is much higher
B) A larger volume of LOX can be stored in a smaller space
C) LOX is much cheaper than gaseous oxygen
D) There are no special requirements for LOX storage and cylinder transfer
B) A larger volume of LOX can be stored in a smaller space
The maximum acceptable flow rate for a nasal cannula is ___ L/min.
A) 4
B) 6
C) 8
D) 10
B) 6
A nasal cannula delivers ____% oxygen at a flow rate of 6 L/min in optimal conditions.
A) 35
B) 44
C) 58
D) 66
B) 44
The minimum oxygen flow rate for any face mask is ____ L/min.
A) 2
B) 4
C) 6
D) 8
B) 4
Oxygen concentrations of ____ can be delivered using a simple face mask at a flow rate of 6 - 10 L/min.
A) 20% - 40%
B) 35% - 60%
C) 80% - 90%
D) 100%
B) 35% - 60%
What is an advantage of a Venturi mask?
A) High concentrations of oxygen can be delivered
B) It uses less oxygen but delivers a higher concentration
C) It can be used to deliver a precise concentration of oxygen
D) It is color coded for easy recognition in dimly lit environments
C) It can be used to deliver a precise concentration of oxygen
What is the most reliable indication that adequate tidal volumes are being delivered during artificial ventilation?
A) The oxygen saturation improves
B) The patient’s color improves
C) Adequate chest rise is observed
D) The stomach inflates slightly
C) Adequate chest rise is observed
When delivering mouth-to-mask ventilations with supplemental oxygen, what should occur?
A) It is not for the patient’s chest rise to be visible
B) Deliver each breath over 10 seconds
C) Slow the ventilatory rate to 1 breath every 8 seconds
D) Provide a minimum flow rate of 10 to 12 L/min
D) Provide a minimum flow rate of 10 to 12 L/min
The greatest difficulty in using a bag-mask device for ventilation is maintaining which aspect?
A) Proper oxygen flow
B) Adequate mask seal
C) Consistent bag inflation
D) Adequate ventilation rate
B) Adequate mask seal
What concentration of oxygen does a bag-mask device with a reservoir and an adequate oxygen source (at least 15 L/min) deliver?
A) 21%
B) 40% - 60%
C) 80%
D) 100%
D) 100%
A bag-mask device for neonates, infants and children should include which aspect?
A) Be equipped with a fish-mouth-operated outlet valve
B) Have a pop-off valve to prevent over-inflation of the lungs
C) Have a minimum volume of 450 mL
D) Be used with an oxygen flow rate of 6 to 8 L/min
C) Have a minimum volume of 450 mL
Before a second attempt at intubation, a patient should be well ventilated with 100% oxygen for ____ to ____ seconds.
A) 5, 10
B) 15, 30
C) 1, 2
D) 3, 5
B) 15, 30
In which position is the head and neck placed when using the sniffing position?
A) Flex the neck and extend the head
B) Flex the neck so the chin is close to the chest
C) Flex the head and neck forward
D) Flex the head and extend the neck
A) Flex the neck and extend the head
What is the maximum depth that a catheter should be inserted when suctioning a tracheotomy or stoma?
A) 3 to 5 cm
B) 3 to 5 inches
C) 5 to 10 cm
D) 5 to 10 inches
B) 3 to 5 inches
To apply cricoid pressure, place firm pressure against which structure?
A) Hyoid bone
B) Thyroid cartilage
C) Cricoid cartilage
D) Cricothyroid membrane
C) Cricoid cartilage
Automatic transport ventilators are typically contraindicated in which type of patients?
A) Unresponsive
B) Breathing spontaneously
C) Under 5 years of age
D) Semi-responsive
C) Under 5 years of age
A catheter that is flexible and designed to suction smaller portions of the airway or through an endotracheal tube is known as a _____ catheter.
A) Whistle-tip
B) Yankauer
C) Tonsil-tip
D) Pharyngeal
A) Whistle-tip
In ideal circumstances, suctioning of an adult patient should not exceed ___ seconds.
A) 5
B) 10
C) 15
D) 20
B) 10
Suctioning (application of negative pressure) should be activated during:
A) Insertion of the suction catheter
B) Extraction of the suction catheter
C) Both insertion and extraction
D) Either insertion or extraction (it makes no difference)
B) Extraction of the suction catheter
Placement of a nasogastric or orogastric tube is confirmed by which assessment aspect?
A) Lack of resistance noted upon insertion
B) Auscultating over the epigastrium while injecting 30 to 50 mL of air
C) Palpating the epigastrium during insertion
D) Noting resistance to aspiration
B) Auscultating over the epigastrium while injecting 30 to 50 mL of air
The nasopharyngeal airway should be measured from which point?
A) The corner of the mouth to the earlobe
B) The tip of the nose to the earlobe
C) The tip of the nose to the corner of the mouth
D) The tip of the nose to the chin
B) The tip of the nose to the earlobe
While inserting the nasal airway, the beveled tip should be directed toward which point?
A) Top of the nose
B) Septum of the nose
C) Floor of the nose
D) Lateral cartilage of the nose
B) Septum of the nose
Oropharyngeal airways are designed to perform which maneuver?
A) Push the tongue into the oropharynx
B) Prevent the tongue from obstructing the glottis
C) Allow for better visualization during endotracheal intubation
D) Provide a guide for suction catheters
B) Prevent the tongue from obstructing the glottis
The endotracheal (ET) tube size refers to the ____ in millimeters.
A) External diameter
B) Internal diameter
C) Length
D) Length of tube that will pass beyond the vocal cords
B) Internal diameter
Cuffed ET tubes may be appropriate for children in what age group?
A) 12-14 years old
B) < 8 years old
C) 8-10 years old
D) 3-5 years old
B) < 8 years old
When using a straight blade to intubate an adult patient, the tip of the blade should be placed in which location?
A) Directly on the epiglottis
B) Under the epiglottis
C) In the vallecula
D) Past the epiglottis at the vocal cords
A) Directly on the epiglottis
Advocates of the curved blade claim which statement?
A) Provides more exposure of the glottis
B) Reduces the need for a stylet
C) Is recommended for use on infants
D) Provides more room for passage of the ET tube
D) Provides more room for passage of the ET tube
When intubating an adult patient with a curved blade, the tip of the blade should be placed in which spot?
A) Under the epiglottis
B) In the vallecula, at the base of the tongue
C) In the vallecula, at the opening of the vocal cords
D) To the right of the epiglottis
B) In the vallecula, at the base of the tongue
Which intubation technique may be performed without the use of specialized equipment?
A) Orotracheal
B) Transluminal
C) Retrograde
D) Digital
D) Digital
The distal cuff of the ET tube should hold ____ mL of air.
A) 5 to 10
B) 10 to 20
C) 15 to 25
D) 20 to 30
A) 5 to 10
Nasotracheal intubation would be the airway procedure of choice for which patient condition?
A) Cardiac arrest
B) Nasal trauma
C) COPD
D) Basilar skull fracture
C) COPD
Which is true of nasotracheal intubation?
A) Use an uncuffed endotracheal tube
B) Use a tube 1 to 1.5 sizes smaller than that used for orotracheal intubation
C) Use a longer endotracheal tube with a stylet
D) Use a tube that is slightly shorter than that used for orotracheal intubation
B) Use a tube 1 to 1.5 sizes smaller than that used for orotracheal intubation
Phenylephrine spray is used during nasotracheal intubation to achieve which goal?
A) Sedate the patient before the procedure
B) Lubricate the nasal passages
C) Anesthetize the nasal passages
D) Constrict the blood vessels
D) Constrict the blood vessels
The laryngeal mask airway ________.
A) Is ideal for conscious patients
B) Provides absolute protection against aspiration
C) Generally protects against aspiration
D) Is well tolerated by a patient with an intact gag reflex
C) Generally protects against aspiration
What is a disadvantage of the laryngeal mask airway (LMA)?
A) Not all patients can be adequately ventilated with an LMA
B) The spine must be manipulated for insertion of an LMA
C) Patients commonly aspirate with this airway technique
D) The LMA must be removed before intubation
A) Not all patients can be adequately ventilated with an LMA
The appropriate size i-gel for insertion in a patient who weighs 16 kg is:
A) 2.5 White
B) 3.0 Yellow
C) 1.5 Light blue
D) 2.0 Gray
D) 2.0 Gray
Which of the following is not a contraindication for placement of a King LT-D Airway?
A) A patient whose height is 3’9”
B) A patient with GCS 7
C) A patient who ingested caustic substances
D) A patient has known esophageal disease
B) A patient with GCS 7
What does capnography measure?
A) Oxygen levels in the blood
B) Oxygen levels in the lungs
C) Carbon dioxide levels in exhaled air
D) Carbon dioxide levels in tissues
C) Carbon dioxide levels in exhaled air
If an endotracheal tube has been correctly placed, bulb esophageal detector devices will _____.
A) Color change
B) Give a normal CO2 readout
C) Re-inflate more easily
D) Remain collapsed
C) Re-inflate more easily
What does pulse oximetry measure?
A) Amount of oxygen saturation in the blood
B) The ratio of oxygen to carbon dioxide saturation in the blood
C) Amount of hemoglobin saturated with oxygen
C) Amount of hemoglobin saturated with oxygen
What is the correct anatomical landmark for a needle cricothyrotomy?
A) Cricoid ring
B) Thyroid cartilage
C) Cricothyroid membrane
D) Second laryngeal ring
C) Cricothyroid membrane
What is the endotracheal tube size range used for cricothyrotomy?
A) 3.0 to 4.0
B) 5.0 to 6.0
C) 6.0 to 7.0
D) 7.0 to 8.0
C) 6.0 to 7.0
Which is an anatomical difference in a child’s airway as compared to that of an adult?
A) A child’s tongue is small in relation to the size of the mouth
B) The epiglottis is omega-shaped in a child
C) The vocal cords slope from front to back in infants
D) The distance from the vocal cords to the carina gets smaller with age
B) The epiglottis is omega-shaped in a child
The approximation of the correct depth of insertion in centimeters for a 10-year-old child is ____ cm.
A) 10
B) 12
C) 17
D) 22
C) 17
Lung sounds are heard after intubation only over the right lung of an adult patient. The endotracheal tube is at 27 cm at the teeth.
What is the most likely explanation for the findings in the intubation scenario?
A) Right mainstem intubation
B) Occlusion of the endotracheal tube
C) Left-sided pneumothorax
D) Right-sided hypertympany
A) Right mainstem intubation
Lung sounds are heard after intubation only over the right lung of an adult patient. The endotracheal tube is at 27 cm at the teeth.
What is the next appropriate action to take in the intubation scenario?
A) Continue to ventilate the patient
B) Deflate the cuff and withdraw the tube 1 to 2 cm
C) Inflate the cuff with an additional 3 to 5 mL of air
D) Remove the tube
B) Deflate the cuff and withdraw the tube 1 to 2 cm
When intubating using a lighted stylet, you see a dim, indistinct light in the throat. The paramedic has most likely intubated which structure?
A) Right mainstem bronchus
B) Left mainstem bronchus
C) Esophagus
D) Trachea
C) Esophagus
You are treating a COPD patient and you note the following: BP 170/100 mm HG, P 50; ventilation assisted at 1 breath every 5 seconds; SaO2 not obtainable; etCO2 4 mm Hg after performing endotracheal intubation. What action should the paramedic take?
A) Continue ventilation and reassess the patient in 5 minutes
B) Decrease the rate of ventilation to 1 breath every 6 seconds
C) Ensure that the cuff is inflated to the proper volume
D) Extubate the patient, ventilate and re-intubate
B) Decrease the rate of ventilation to 1 breath every 6 seconds
How do the drugs used in neuromuscular blockade cause paralysis?
A) Acting on the calcium pumps in muscle cells
B) Blocking the neuromuscular junction
C) Blocking the sodium and potassium pumps in the muscle cells
D) Blocking the muscular contraction at the sarcomere
B) Blocking the neuromuscular junction
What is the definition of depolarizing agents?
A) Substitute themselves for acetylcholine at the neuromuscular junction
B) Substitute themselves for norepinephrine at the neuromuscular junction
C) Block the uptake of acetylcholine at the neuromuscular junction
D) Block the uptake of norepinephrine at the neuromuscular junction
A) Substitute themselves for acetylcholine at the neuromuscular junction
Depolarizing agents have a ____ as compared to polarizing agents.
A) Quicker onset and shorter duration
B) Quicker onset and longer duration
C) Longer onset and shorter duration
D) Longer onset and longer duration
A) Quicker onset and shorter duration
An example of a depolarizing neuromuscular blocking drug is which drug?
A) Succinylcholine
B) Vecuronium
C) Fentanyl
D) Etomidate
A) Succinylcholine
Which of the following is not one of the six Ps of RSI?
A) Preoxygenation
B) Procedure
C) Paralysis
D) Preparation
B) Procedure
After the administration of succinylcholine, a patient is usually relaxed enough for intubation after _____.
A) 10 seconds
B) 45 seconds
C) 1 minute
D) 5 minutes
B) 45 seconds
