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Respiratory Emergencies Flashcards

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USMLE® Step 1 flashcards
1
Q

Which of the following is the most important intrinsic risk factor for respiratory disease?
Question 1 options:

A)

Environment

B)

Sedentary lifestyle

C)

Family history

D)

Smoking

A

family history

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2
Q

Air entering and leaving the lungs via inspiration and expiration is known as:
Question 2 options:

A)

oxygenation.

B)

ventilation.

C)

respirations.

D)

perfusion.

A

ventilation

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3
Q

The diaphragm is controlled by the ________ nerve.
Question 3 options:

A)

vagus

B)

olfactory

C)

abducens

D)

phrenic

A

phrenic

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4
Q

An example of diffusion in the respiratory system is movement of:
Question 4 options:

A)

oxygen from the alveoli into the pulmonary capillaries.

B)

air from the outside environment into the lungs.

C)

oxygen from the tissues into the systemic capillaries.

D)

carbon dioxide from the alveoli into the pulmonary capillaries.

A

oxygen from the alveoli into the pulmonary capillaries

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5
Q

Airway resistance is increased by:
Question 5 options:

A)

decreased elasticity of the chest wall.

B)

anticholinergic drugs.

C)

bronchospasm.

D)

sympathetic nervous system stimulation.

A

bronchospasm

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6
Q

Which of the following patients are at risk for the most common cause of upper airway obstruction?
Question 6 options:

A)

4-year-old male with croup

B)

5-year-old female with epiglottitis

C)

21-year-old female unconscious and supine on the floor

D)

22-year-old female stung by a wasp

A

21 year old female unconscious and supine on the floor

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7
Q

Normal tidal volume in an average 70 kg adult is approximately ________ e.
Question 7 options:

A)

750

B)

1,500

C)

1,000

D)

500

A

500

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8
Q

After a normal inspiration and expiration, an adult patient has about 2,400 mL of air remaining in the lungs, known as the:
Question 8 options:

A)

residual volume.

B)

functional residual capacity.

C)

expiratory reserve volume.

D)

vital capacity.

A

functional residual capacity

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9
Q

A 19-year-old female with difficulty breathing produces a peak expiratory flow rate of 425 lpm, indicating:

Question 9 options:

A)

normal ventilatory state.

B)

mild bronchoconstriction.

C)

severe bronchoconstriction.

D)

moderate bronchoconstriction.

A

a normal ventilatory state

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10
Q

Stretch receptors in the lungs send a signal to the inspiratory center of the medulla, inhibiting its stimulation of the phrenic and intercostal nerves. This is called the ________ reflex.
Question 10 options:

A)

Cushing’s

B)

Hering-Breuer

C)

Moro

D)

Cheyne-Stokes

A

Herine-Breuer

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11
Q

The most important factor in determining the respiratory rate is:
Question 11 options:

A)

alveolar pO2.

B)

alveolar pCO2.

C)

arterial pO2.

D)

arterial pCO2.

A

arterial pCO2

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12
Q

You are working in the ED caring for a 55-year-old female with a long history of COPD. She is more short of breath today than usual and states she has an increased cough. She has a tympanic temperature of 99.8°F. You have drawn arterial blood gases with the patient on room air and when the report comes back, it shows that the patient has a pO2 of 52 mmHg. Which of the following is most likely?
Question 12 options:

A)

You have inadvertently drawn a venous sample.

B)

This is the typical value for this patient.

C)

The patient is critically hypoxic and requires assisted ventilation.

D)

The lab performed the test incorrectly.

A

this is the typical value for this patient

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13
Q

Your ICU patient has ARDS with a pO2 of 62 mmHg, despite mechanical ventilation and oxygenation. Which of the following best explains this finding?
Question 13 options:

A)

It is a problem with the blood gas sample collection.

B)

It is a problem with perfusion.

C)

It is a problem with gas diffusion in the lung.

D)

It is a problem with ventilation.

A

it is a problem with gas diffusion in the lung

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14
Q

Most carbon dioxide from cellular metabolism reaches the alveoli by being transported:
Question 14 options:

A)

as bicarbonate ion.

B)

bound to hemoglobin.

C)

dissolved in plasma.

D)

as carbonic anhydrase.

A

as bicarbonate ion

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15
Q

Pulmonary embolism is a problem of:
Question 15 options:

A)

perfusion of the lungs.

B)

ventilation of lungs.

C)

interstitial edema.

D)

thickness of the respiratory membrane.

A

perfusion of the lungs

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16
Q

Normal exhalation involves all of the following EXCEPT:
Question 16 options:

A)

relaxation of the diaphragm.

B)

decreased intrathoracic volume.

C)

elastic recoil of lung tissue.

D)

phrenic nerve stimulation.

A

phrenic nerve stimulation

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17
Q

Obstructive sleep apnea is a problem of the:
Question 17 options:

A)

upper airway.

B)

phrenic nerve.

C)

medulla oblongata.

D)

larynx and vocal cords.

A

upper airway

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18
Q

Which of the following provides evidence that a patient is using accessory muscles to breathe?
Question 18 options:

A)

There is noticeable contraction of the intercostal muscles.

B)

The patient is sitting up, leaning forward to breathe.

C)

The patient’s lips are pursed.

D)

The patient is using his diaphragm with inspiration.

A

there is a noticeable contraction of the intercostal muscles

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19
Q

You have been called to treat a patient complaining of difficulty breathing. Which of the findings should concern you the most?
Question 19 options:

A)

The patient is sitting in the “tripod” position.

B)

The patient is confused, agitated, and angry that you are trying to help him.

C)

The patient has a heart rate of 126.

D)

The patient can speak only one to two words between breaths.

A

the patient is confused, agitated, and angry that you are trying to help him

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20
Q

Your patient complains of coughing up “greenish-brown” sputum. This is most consistent with:
Question 20 options:

A)

seasonal allergies.

B)

cancer.

C)

pulmonary edema.

D)

bronchitis.

A

bronchitis

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21
Q

As you are palpating your patient’s chest, he speaks, and you can feel the vibration through the chest wall. You should document this as:

Question 21 options:

A)

crepitus.

B)

bronchovesicular sounds.

C)

tactile fremitus.

D)

a pleural friction rub.

A

tactile fremitus

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22
Q

Capnometry measures the partial pressure of CO2 in:
Question 22 options:

A)

expired air.

B)

arterial blood.

C)

inspired air.

D)

venous blood.

A

expired air

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23
Q

ETCO2 is recorded during phase ________ of the capnogram.
Question 23 options:

A)

IV

B)

I

C)

III

D)

II

A

III

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24
Q

Your patient is a 23-year-old female who is 30 weeks pregnant. She choked on some cheese while eating a piece of pizza. When asked if she can speak, she replies “yes,” although with some difficulty. Your next step should be to:
Question 24 options:

A)

attempt to remove the bolus of cheese with Magill forceps.

B)

perform a series of chest thrusts.

C)

perform a series of abdominal thrusts.

D)

ask the patient to cough as hard as she can.

A

ask the patient to cough as hard as she can

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25
Q

Your patient is a 20-year-old male with a peanut allergy who inadvertently ate some candy containing peanuts. He is complaining of a “lump” in his throat, his voice is hoarse with mild inspiratory stridor, and he appears anxious. You are giving oxygen by nonrebreathing mask and have started an IV. Next, you should:
Question 25 options:

A)

administer 0.4 mg of 1:1000 epinephrine SQ and 50 mg diphenhydramine IV.

B)

place the patient in a supine position and prepare for transtracheal ventilation.

C)

administer 2.5 mg albuterol by nebulizer.

D)

administer an induction agent and a paralytic and perform endotracheal intubation.

A

administer 0.4 mg of 1:1000 epi SQ and 50 mg diphenhydramine IV

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26
Q

Your patient is a 60-year-old male with an acute exacerbation of COPD. You may consider giving the patient ipratropium because, in addition to reversing bronchospasm, it is helpful in:
Question 26 options:

A)

reducing inflammation.

B)

stimulating the respiratory center in the medulla.

C)

expectoration of mucus.

D)

drying bronchial secretions.

A

drying bronchial secretions

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27
Q

Which of the following characteristics is least associated with emphysema?
Question 27 options:

A)

Barrel chest appearance

B)

Cor pulmonale

C)

Polycythemia

D)

Productive cough throughout the day

A

productive cough throughout the day

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28
Q

When using CPAP in patients with COPD, in general, PEEP should be:
Question 28 options:

A)

> 10 mm Hg.

B)

> 10 cm H2O.

C)

< 10 cm H2O.

D)

< 10 mm Hg.

A

<10 mm H20

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29
Q

Your patient is a 15-year-old asthmatic who has been having difficulty breathing for 45 minutes but does not have his Xopenex inhaler with him. Capnography shows an ETCO2 of 45 mmHg. The best way to interpret this finding is:
Question 29 options:

A)

the patient’s ETCO2 first dropped as he began to hyperventilate but now is rising again and may continue to rise to dangerous levels.

B)

this is a high ETCO2, and the patient requires immediate ventilatory assistance to prevent respiratory arrest.

C)

this is a low ETCO2 indicating that the patient is hyperventilating and thus in the early stages of an asthma attack.

D)

this is a normal ETCO2, indicating that this is a mild asthma attack.

A

the patients ETCO2 first dropped as he began to hyperventilate but now is rising again and may continue to rise to dangerous levels

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30
Q

Your patient is a 24-year-old male Chinese citizen on vacation in the United States. He is in moderate distress, complaining of difficulty breathing and gives a four-day history of runny nose, sore throat, fever, chills, and general malaise with a productive cough. His sputum production was significantly worse when he woke this morning, and he developed difficulty breathing this afternoon. HR = 134, BP = 132/84, RR = 26, SaO2 = 90%. This presentation is most consistent with:
Question 30 options:

A)

tuberculosis.

B)

SARS.

C)

pneumonia.

D)

hantavirus pulmonary syndrome.

A

SARS

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31
Q

In which of the following situations is a significant amount of carboxyhemoglobin most likely to be present?
Question 31 options:

A)

A patient who is being treated with nitrites for cyanide poisoning

B)

A patient who inhaled anhydrous ammonia fumes

C)

A patient found unresponsive in an apartment in which there is a gas furnace

D)

A patient with COPD who is short of breath with an SpO2 of 90 percent

A

a patient found unresponsive in an apartment in which there is a gas furnace

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32
Q

Your patient is a 68-year-old male complaining of difficulty breathing for two days. He is sitting up, conscious, alert, and oriented and appears to be in mild respiratory distress. Physical examination reveals cool, dry, pink skin; he is thin with well-defined accessory muscles, and you note diffuse wheezing to all lung fields. HR = 102, BP = 136/96, RR = 20, SaO2 = 92%. The patient gives a 20-pack-a-year history of smoking. These findings are most typical of:
Question 32 options:

A)

emphysema.

B)

congestive heart failure.

C)

chronic bronchitis.

D)

asthma.

A

emphysema

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33
Q

You have applied a CO-oximeter to your patient, and it is displaying an SpCO of 15 percent. Which of the following is the most appropriate interpretation of this finding?
Question 33 options:

A)

This is a normal reading for a smoker and nothing to worry about.

B)

This is a normal reading for a nonsmoker and nothing to worry about.

C)

This is consistent with mild carbon monoxide poisoning.

D)

This is consistent with a fatal level of carbon monoxide poisoning.

A

this is consistent with mild carbon monoxide poisoning

34
Q

You are working at the triage desk in the ED when a young man on crutches approaches the desk. He appears moderately short of breath. He states he had a cast put on his left leg seven days ago after surgery for a ruptured Achilles tendon. This morning, while he was watching television, he suddenly became short of breath. He has a history of asthma, for which he takes Xopenex as needed, and is taking Tylenol with codeine for pain related to his surgery. The patient’s lung sounds are clear and equal, SpO2 is 90 percent on room air, heart rate is 100 and regular, respirations are 24 and slightly labored, blood pressure is 128/88, and the patient is afebrile. These findings are most consistent with:
Question 34 options:

A)

pulmonary embolism associated with immobilization of the lower extremity.

B)

allergic reaction to codeine.

C)

asthma exacerbated by recent anesthesia.

D)

pneumonia secondary to recent anesthesia.

A

a pulmonary embolism associated with immobilization of the lower extremity

35
Q

You are caring for a patient with Guillain-Barré syndrome. The most likely cause of hypoxia in this patient would be:
Question 35 options:

A)

inadequate lung volume.

B)

impaired ventilation.

C)

increased thickness of the respiratory membrane.

D)

impaired perfusion.

A

impaired ventilation

36
Q

Which of the following statements about adult respiratory distress syndrome (ARDS) is FALSE?
Question 36 options:

A)

Pulmonary edema and disruption of the alveolar-capillary membrane contribute to respiratory failure in ARDS.

B)

The causes of ARDS include pancreatitis, oxygen toxicity, sepsis, and tumor destruction.

C)

PEEP is often required to adequately ventilate ARDS patients.

D)

The mortality rate is 20 to 30 percent.

A

the mortality rate is 20 to 30 percent

37
Q

The amount of air moved in and out of the lungs during a normal, quiet respiration is called:

Question 37 options:

A)

tidal volume.

B)

dead space volume.

C)

inspiratory capacity.

D)

functional reserve capacity.

A

tidal volume

38
Q

The carpopedal spasms that occur due to hyperventilation syndrome are a result of a relative ________, secondary to ________.
Question 38 options:

A)

hypocalcemia, increase in bound calcium

B)

hypercalcemia, respiratory alkalosis

C)

hypocalcemia, decrease in unbound calcium

D)

hyponatremia, respiratory alkalosis

A

hypocalcemia, increase in bound calcium

39
Q

Your patient is a 52-year-old male complaining of shortness of breath. He is sitting up, alert, and oriented and appears to be in moderate respiratory distress. He states that he “always gets a chest cold in the winter” and describes a three-week history of productive cough and increasing shortness of breath. Physical examination reveals coarse rhonchi to the upper lobes bilaterally, air movement is decreased in the bases, and his skin is cool with peripheral cyanosis. You note that he is overweight and describes an 18-pack-a-year smoking history. Based on these clinical exam findings, the most clinically relevant finding you might also expect is:
Question 39 options:

A)

barrel chest and increased anterior/posterior chest diameter.

B)

JVD, ankle edema, and hepatic congestion.

C)

pulmonary edema and hypotension.

D)

pursed-lipped breathing.

A

JVD, ankle edema and hepatic congestion

40
Q

An increased hydrogen ion concentration in the cerebrospinal fluid results in a(n) ________ respiratory rate.
Question 40 options:

A)

erratic

B)

increased

C)

decreased

D)

unchanged

A

increased

41
Q

Your patient is a 16-year-old male who attempted suicide. He is unconscious and apneic, lying supine on a garage floor. The family states they found the patient unconscious in the front seat of a car that was running in an enclosed garage. HR = 70, BP = 100/60, RR = 0. In addition to an IV of normal saline, which of the following is the most appropriate?
Question 41 options:

A)

Intubate, remove the patient from the garage, and transport to a hospital with a hyperbaric chamber.

B)

Remove the patient from the garage, intubate, and transport to the nearest hospital.

C)

Remove the patient from the garage, initiate BVM ventilations with 100 percent oxygen, intubate, and transport to a hospital with a hyperbaric chamber.

D)

Remove the patient from the garage, initiate BVM ventilations with 100 percent oxygen, intubate, and transport to the nearest facility.

A

remove the patient from the garage, intubate BVM ventilations with 100 percent oxygen, intubate and transport to a hospital with hyperbaric chamber

42
Q

Lung perfusion depends on all of the following EXCEPT:
Question 42 options:

A)

an intact alveolar membrane.

B)

adequate blood volume.

C)

intact pulmonary capillaries.

D)

efficient pumping of blood by the heart.

A

an intact alveolar membrane

43
Q

Your patient is a 24-year-old male who has been an in-patient in a rehabilitation hospital following surgical fixation of a fractured pelvis. Staff reports sudden development of hypotension and severe respiratory distress about 30 minutes ago. There is no other significant history. Physical exam findings include cold, diaphoretic skin with peripheral cyanosis; jugular venous distension; clear breath sounds bilaterally; and vitals as follows: HR = 134, BP = 74/50, RR = 28, SaO2 = 84%. Which of the following is most likely?

Question 43 options:

A)

Spontaneous tension pneumothorax

B)

Pulmonary embolism

C)

Myocardial infarction

D)

Idiopathic congestive heart failure

A

pulmonary embolism

44
Q

Which of the following statements about pulse oximetry is FALSE?
Question 44 options:

A)

Pulse oximetry should be used on all patients with respiratory complaints.

B)

Pulse oximetry values can be expected to decrease within seconds in cases of developing hypoxia.

C)

Pulse oximetry has the ability to noninvasively measure total hemoglobin (SpHb) in addition to SpO2 and other parameters.

D)

Oxygen saturation is the percentage of hemoglobin that is bound with some molecular structure.

A

pulse oximetry values can be expected to decrease within seconds in cases of developing hypoxia

45
Q

Which of the following is the most important determinant of ventilatory rate?
Question 45 options:

A)

Arterial PO2

B)

Arterial PCO2

C)

Venous PCO2

D)

Venous PO2

A

arterial PCO2

46
Q

Which of the following is the purpose of lung surfactant?
Question 46 options:

A)

Aid in the facilitated diffusion of oxygen across the alveolar membrane.

B)

Aid in the facilitated diffusion of carbon dioxide and oxygen across the alveolar membrane.

C)

Decrease the surface tension of water in the alveoli.

D)

Destroy and remove foreign material from the alveoli.

A

decrease the surface tension of water in the alveoli

47
Q

You have intubated a 66-year-old female who was experiencing an acute exacerbation of her emphysema. What special consideration does this patient, with her specific pathology, require?
Question 47 options:

A)

She requires hyperventilation to blow off excess CO2.

B)

She requires frequent, deep suctioning.

C)

While ventilating, you must allow for a prolonged expiratory phase.

D)

Oxygen flow should be limited to 4 lpm because of the hypoxic drive common in COPD patients.

A

while ventilating you must allow from a prolonged expiratory phase

48
Q

Your patient is a 72-year-old female, alert and oriented, sitting up in bed at a nursing home. She is in mild respiratory distress. The staff describes a four-day history of fever, malaise, and productive cough. The patient also states that she has been experiencing chills and chest pain with deep inspiration. Physical examination reveals rales and rhonchi in the right upper lobe and warm, moist skin. HR = 116, BP = 104/76, RR = 20, SaO2 = 93%. Based on the clinical exam findings, the most appropriate diagnosis would be:
Question 48 options:

A)

emphysema.

B)

congestive heart failure.

C)

pneumonia.

D)

chronic bronchitis.

A

pneumonia

49
Q

Which of the following structures FIRST allows gas exchange as air enters the lungs?
Question 49 options:

A)

Terminal bronchioles

B)

Alveolar ducts

C)

Alveolar sacs

D)

Respiratory bronchioles

A

respiratory bronchioles

50
Q

Which of the following is NOT a role of the upper respiratory system?
Question 50 options:

A)

Carry out gas exchange with inspired air

B)

Warm inspired air

C)

Humidify inspired air

D)

Filter inspired air

A

carry out gas exchange with inspired air

51
Q

Which of the following would result in an increased respiratory rate?
Question 51 options:

A)

Stimulation of baroreceptors by an increase of PCO2

B)

An increase of cerebrospinal fluid pH

C)

A decrease of cerebrospinal fluid PO2

D)

Stimulation of chemoreceptors by an increase of PCO2

A

stimulation of chemoreceptors by an increase of PCO2

52
Q

A 72-year-old female has a one-week history of 101°F fever, chills, and dark-brown sputum production. She also has rhonchi and rales throughout her right lung. If this condition is left untreated, it could result in:
Question 52 options:

A)

septic shock.

B)

chronic bronchitis.

C)

cardiogenic shock.

D)

pneumonia.

A

septic shock

53
Q

An intrinsic risk factor is one that is influenced:
Question 53 options:

A)

by a carcinogen.

B)

outside the patient.

C)

within the patient.

D)

by the atmosphere.

A

within the patient

54
Q

Ventilation is:
Question 54 options:

A)

the mechanical process of moving air in and out of the lungs.

B)

the diffusion of the gas at the cellular level.

C)

the diffusion of gases at the alveoli.

D)

done to allow the gas to escape the chest wall.

A

the mechanical process of moving air in and out of the lungs

55
Q

The diaphragm is innervated by the:
Question 55 options:

A)

renic nerve.

B)

pulmonary nerve.

C)

phrenic nerve.

D)

renal nerve.

A

phrenic nerve

56
Q

Lung compliance is described as:
Question 56 options:

A)

the rate at which the chest expands.

B)

the ease with which the chest expands.

C)

the diameter of the chest wall.

D)

the depth at which the chest expands.

A

the ease with which the chest expands

57
Q

The average adult tidal volume is:
Question 57 options:

A)

2400 mL.

B)

750 mL.

C)

500 mL.

D)

1200 mL.

A

500 mL

58
Q

The most important determinant of ventilatory rate is:
Question 58 options:

A)

arterial NaHCO3.

B)

arterial PO.

C)

SpPO.

D)

arterial PCO2.

A

arterial PCO2

59
Q

A patient with COPD should present with a PO2 of:
Question 59 options:

A)

70-80 mmHg.

B)

94-96 mmHg.

C)

50-60 mmHg.

D)

35-45 mmHg.

A

50- 60 mmHg

60
Q

A majority of carbon dioxide in the body is transported as:
Question 60 options:

A)

hydrogen ion.

B)

plasma.

C)

hemoglobin.

D)

bicarbonate ion.

A

bicarbonate ion

61
Q

A sudden disruption of pulmonary perfusion caused by a blood clot is known as:
Question 61 options:

A)

pulmonary edema.

B)

pulmonary occlusion.

C)

pulmonary embolism.

D)

pulmonary diffusion.

A

pulmonary embolism

62
Q

Obstructive sleep apnea is an example of:
Question 62 options:

A)

COPD.

B)

upper airway obstruction.

C)

CHF.

D)

lower airway obstruction.

A

upper airway obstruction

63
Q

You are called to the home of a patient who suddenly “stopped breathing.” The patient has a history of a neoplasm at C-3 and C-4. You suspect:
Question 63 options:

A)

impingement on the phrenic nerve.

B)

lung cancer.

C)

myocardial infarction.

D)

cervical fractures.

A

impingement on the phrenic nerve

64
Q

Pulmonary shunting can be seen in patients with suspected:
Question 64 options:

A)

hypovolemic shock.

B)

pulmonary embolism.

C)

hemothorax.

D)

tension pneumothorax.

A

pulmonary embolism

65
Q

Which of the following is NOT part of the respiratory status assessment?
Question 65 options:

A)

Respiratory effort

B)

Lung compliance

C)

Mental status

D)

Color

A

lung compliance

66
Q

You are assessing your respiratory patient. Of the following findings, which would concern you the most?
Question 66 options:

A)

Tachycardia

B)

Intercostal retractions

C)

Altered mental status

D)

Stridor

A

altered mental status

67
Q

Your patient is complaining of “coughing up blood,” or, in medical terms:
Question 67 options:

A)

hemopulmonary spasm.

B)

neoplasm.

C)

hemoptysis.

D)

hemothorax.

A

hemoptysis

68
Q

You are evaluating a patient complaining of having a productive cough. The patient states the sputum is green to brown. You suspect:
Question 68 options:

A)

infection.

B)

allergies.

C)

inflammation.

D)

hemoptysis.

A

infection

69
Q

You are assessing a patient who is presenting with shortness of breath, JVD, and tracheal deviation. You suspect:
Question 69 options:

A)

tracheal tugging.

B)

tension pneumothorax.

C)

subcutaneous emphysema.

D)

flail chest.

A

tension pneumothorax

70
Q

Paradoxical movement is associated with:
Question 70 options:

A)

tension pneumothorax.

B)

hemothorax.

C)

simple pneumothorax.

D)

flail chest.

A

flail chest

71
Q

Upon examining your patient, you note that he has a clubbing of the fingers. You would suspect a history of:
Question 71 options:

A)

hypertension.

B)

neoplasm.

C)

peripheral vascular disease.

D)

hypoxemia.

A

hypoxemia

72
Q

A disorder of lung diffusion that results from increased fluid in the interstitial space is known as:
Question 72 options:

A)

ARDS.

B)

PHTN.

C)

COPD.

D)

AIDS.

A

ARDS

73
Q

The hallmark treatment of ARDS is to:
Question 73 options:

A)

perform renal dialysis to remove the fluid.

B)

treat the increased fluid with diuretics.

C)

treat the underlying condition.

D)

administer corticosteroids.

A

treat the underlying condition

74
Q

Which of the following is NOT a common obstructive lung disease encountered in the prehospital setting?
Question 74 options:

A)

Emphysema

B)

CHF

C)

Asthma

D)

Chronic bronchitis

A

CHF

75
Q

You respond to a patient with difficulty breathing. Upon assessment you notice that the patient is sitting in the tripod position, with marked JVD. The patient has clubbing in the fingers and new pitting edema. You should suspect:
Question 75 options:

A)

cor pulmonale.

B)

CHF.

C)

COPD.

D)

pulmonary neoplasm.

A

cor pulmonale

76
Q

You are performing a physical exam on a patient with emphysema. You note that the patient has a pink hue to her skin. You should suspect:
Question 76 options:

A)

methahemoglobinemia.

B)

cor pulmonale.

C)

carboxyhemoglobinemia.

D)

polycythemia.

A

polycythemia

77
Q

You are caring for a patient with chronic bronchitis. The patient has an SpO2 of 90%. You should:
Question 77 options:

A)

do nothing, as this is an expected reading.

B)

administer supplemental oxygen at high flow, via CPAP.

C)

administer supplemental oxygen at high flow 15 lpm via NRB.

D)

administer supplemental oxygen at low flow, via nasal cannula.

A

administer supplemental oxygen at low flow, via nasal cannula

78
Q

You are called to a patient with severe shortness of breath. Upon arrival, you find your patient in the tripod position, with pursed lips and audible wheezing. SpO2 is at 89% and capnography shows a “shark fin” pattern with an ETCO2 of 50. You should:
Question 78 options:

A)

administer a beta agonist.

B)

administer an alpha agonist.

C)

administer a beta antagonist.

D)

administer an alpha antagonist.

A

administer beta agonist

79
Q

You are called to care for a patient with severe shortness of breath. The patient has an SpO2 of 88%, audible wheezing, and a capnography reading of 54 with a shark fin wave form. You are administering albuterol for the second time without relief. You suspect:
Question 79 options:

A)

status epilepticus.

B)

status asthmaticus.

C)

septic shock.

D)

anaphylaxis.

A

status asthmaticus

80
Q

You arrive on the scene of a patient who complains of worsening shortness of breath for the past few days. The patient presents with an SpO2 of 90%, ETCO2 of 45, normal wave form, crackles, and a temperature of 101.5°F. You should suspect:
Question 80 options:

A)

ARDS.

B)

CHF.

C)

COPD.

D)

pneumonia.

A

pneumonia

81
Q

You are called to the scene of a patient who has just attempted suicide by ingesting detergent. You notice that the patient is coughing and has a hoarse voice. You suspect:
Question 81 options:

A)

subcutaneous emphysema.

B)

laryngeal edema.

C)

nothing, this is a normal finding for this patient.

D)

tracheal rupture.

A

laryngeal edema

82
Q

You arrive to find an unresponsive patient inside a running vehicle in his garage. Your destination should include a hospital with what capability?
Question 82 options:

A)

Hypobaric oxygen

B)

Neurosurgical capabilities

C)

Hyperbaric oxygen

D)

Any hospital

A

hyperbaric oxygen

Medical Emergencies (19 decks)

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