Respiratory

Question 1

S/S 87 y.o. male with difficulty breathing supine in bed with agonal respirations after PPE and scene safe, What is your first intervention?

Answer 1

Ventilate

Question 2

What is a tension pneumothorax?

Answer 2

An accumulation of air in the pleural space under pressure, compressing the lungs and decreasing venous return to the heart. As intrathoracic pressure increases, the patient develops hypotension, tracheal deviation and neck vein distension.

Question 3

An infant or child who exhibits wheezing, increased breathing effort on exhalation, or rapid breathing without stridor probably has?

Answer 3

A lower airway disease ( bronchitis or asthma )

Question 4

What is the required amount of suctioning that a suction unit must provide?

Answer 4

30 L/min, 300 mmhg

Question 5

Which of the following patients has regular respirations?
A. 6 month old breathing at 22 breaths per minute
B. A 26 y.o. with Cheyne-stokes breathing at 10 breaths per minute
C. 10 y.o. breathing at 28 times per minute with intercostal retractions
D. a 30 y.o. breathing at 20 times per minute slightly irregular.

Answer 5

D. a 30 y.o. breathing at 20 times per minute is breathing slightly irregular, they are within range and considered adequate.
Rationale
Normal infant is 30 to 60 breaths per minute
Cheyne stokes breathing is normally seen in head injury and normally not an adequate breathing pattern
A 10 y.o. is using intercostal muscles to breath this is normally a sign of trouble breathing

Question 6

In neonate resuscitation when do you initiate Bag valve resuscitation?

Answer 6

When the pulse rate is below 100 beats per minute.

Question 7

If meconium is seen in the amniotic fluid what do you suction first?

Answer 7

Mouth then nose.

Question 8

What is the compression to ventilation rate for neonatal resuscitation?

Answer 8

3:1- Why, the compromise of gas exchange is nearly always the primary cause

Question 9

The signs of bradycardia, hypertension, and irregular breathing in a head injury is called?

Answer 9

Cushing’s Reflex

Question 10

What is a Tension pneumothorax?

Answer 10

An accumulation of air in the pleural space under pressure, compressing the lungs and decreasing venous return to the heart. As intrathoracic pressure increases, the patient develops hypotension, tracheal deviation and neck vein distension.

Question 11

An infant or child who exhibits wheezing, increased breathing effort on exhalation, or rapid breathing without stridor probably has?

Answer 11

A lower airway disease ( bronchitis or asthma )

Question 12

What is the required amount of suctioning that a suction unit must provide?

Answer 12

30 L/Min, 300/mmhg

Question 13

S/S 64 y.o. c/o trouble breathing, chest pain and congestion. lung sounds crackles bilateral. What is a probable cause?

Answer 13

Left ventricular failure-
Rationale these are signs of possible failure of the left ventricle. The pump portion of the heart is unable to pump efficiently and fluid begins to back up into the lungs.

Question 14

What is the most common cause of cardiac arrest in children?

Answer 14

Respiratory Arrest

Question 15

You and your partner Greg are called to a hockey arena where a fan was struck in the side of the chest with a hockey puck that was hit over the protective glass and into the crowd. The man is having a painful time breathing at about 16 a minute. He says his ribs really hurt. What should your treatment include?
A. A chest compression wrap while having the patient maintain his exhaled state
B. Bag valve mask with oxygen attached
C. Sweeping the tongue out of the way to look for airway obstructions
D. High flow O2 with NRM and rapid transport

Answer 15

High flow O2 with NRM and rapid transport

Rationale: As long as the patient is able to talk and keep their respirations within range, then high flow O2 and transport would be your best choice.

Question 16

A respiration rate would be considered within normal limits for an adult at\_\_\_\_ per minute, for a 6-12 year old child at \_\_\_\_ per minute, and for an infant at\_\_\_\_ per minute.
A. 16 - 25 - 40
B. 22 - 32 - 42
C. 20 - 40 - 60
D. 10 - 20 - 40

Answer 16

A. 16 - 25 - 40
Rationale: According to the NES, normal adult respiratory rates are from 16-20, school age children (6-12) are 20-30, and infants are initially 40-60 and then drop to 30-40 after the first few minutes. Note: Respiratory rates for late adulthood, 61+, is dependent on the patient’s physical and health status.

Question 17

You arrive on the scene to find a woman who is complaining of difficulty breathing after being struck in the chest with a swing. Upon auscultation of her lungs you have clear lungs on the right and no breath sounds on the left. This woman is likely has a \_\_\_\_\_\_ and would be suffering from \_\_\_\_\_ as the collapsed lung is incapable of oxygenating the blood.
A. Flail chest / hyperventilation
B. Hemoptysis/ Hypoventilation
C. Pneumothorax/ Hypoxia
D. Cardiac contusion/ Hyperkalemia

Answer 17

C. Pneumothorax/ Hypoxia
Rationale:
Flail chest is possible but with paradoxical movement normally lungs sounds present bilaterally
Hemoptysis is coughing up of blood not listed
Cardiac contusion would present with chest pain

Question 18

Your patient is a 41 year old female who was found lying prone in the kitchen. She does not appear to be conscious and there is a pool of saliva next to her head. You and your partner log roll her into a supine position while maintaining c-spine stabilization. Just as you get the woman rolled over her husband tells you that she has a previous history of heart attacks. What would be the most appropriate course of action to take next?
A. Do a jaw thrust to open her airway
B. Have your partner get the AED, Attach it to the patient, and analyze
C. Verify a palpable pulse, attach the AED, and prepare to analyze
D. Suction the airway prior to opening the airway

Answer 18

A. Do a jaw thrust to open her airway
Rationale:
If a patient has no pulse you would start compressions
before attaching the AED for each of the AED answers

Open the airway prior to suctioning and suction prior to Bagging a patient

Question 19

How does a SPO2 monitor work and what can contribute to false readings?

Answer 19

The infrared light reads the amount of red blood cells carrying oxygen in the blood.
Carbon monoxide has a stronger bond to hemoglobin (red blood cells) than oxygen and attaches to the red blood cells easier than oxygen leaving the oxygen stranded without a transport giving a false reading

Question 20

In what space of the body will you find the Pancreas?
A. Peritoneal space
B. Pericardial space
C. Retroperitoneal space
d. Pleural space

Answer 20

C. Retroperitoneal space
Rationale: The Peritoneal space is in front of the retroperitoneal space and contains the stomach, liver, spleen and gall bladder. The Retroperitoneal space contains the pancreas, kidneys, aorta inferior vena cava, ureter and parts of the colon

Question 21

Which of the following choices is a normal respiratory rate for school age children?
A. 30-60 BPM
B. 24-40 BPM
C. 18-30 BPM
D. 12-16 BPM

Answer 21

C. 18-30 BPM

School age is 6-12 years of age

Question 22

What should be done to a French tip catheter after suctioning a patient’s airway?
A. Put it in the sharps container
B. Take it home for your kids to play with
C. Throw it away
D. Flush with sterile water in preparation for additional suctioning

Answer 22

D. Flush with sterile water in preparation for additional suctioning

Rationale: Anticipating the need for additional suctioning should be followed by cleansing of the catheter with sterile water

Question 23

Cellular respiration and cellular metabolism are best described as:
A. The exchange of respiratory gases between the systemic capillaries and the surrounding tissue beds
B. The use of oxygen and carbohydrates to produce energy and the creation of carbon dioxide and water by-products
C. The exchange of respiratory gases between the alveoli and the pulmonary capillary bed
D. The use of oxygen to create hemoglobin in the blood stream

Answer 23

B. The use of oxygen and carbohydrates to produce energy and the creation of carbon dioxide and water by-products

Rationale: The exchange of gases between the capillaries and tissue beds is respiration but does not include metabolism