unit 3 exam airway management

Question 1

Which of the following structures is contained
within the mediastinum?

Select one:

a. Lungs
b. Larynx
c. Bronchioles
d. Esophagus

Answer 1

esophagus

Question 2

While providing CPAP to a patient in severe respiratory distress, you note that his heart rate has increased by 20 beats/min. He is conscious, but is no longer following verbal commands. You should:

Select one:

a. remove the CPAP device and ventilate him with a bag-valve mask.
b. remove the CPAP device and place a King airway
c. increase the amount of pressure that the CPAP device is delivering.
d. remove the CPAP device and apply oxygen by nonrebreathing mask.

Answer 2

remove the CPAP device and ventilate him with a bag-valve mask.

Question 3

Central chemoreceptors located in the medulla provide feedback to increase the rate and depth of breathing when they sense:

Select one:
a. slight increases in carbon dioxide or a decrease
in the pH of the cerebrospinal fluid.
b. slight decreases in carbon dioxide and an
increase in the pH of the cerebrospinal fluid.
c. decreased levels of oxygen in the blood and an
increase in the pH of the cerebrospinal fluid.
d. increased levels of oxygen in the blood and a
decrease in the pH of the cerebrospinal fluid.

Answer 3

slight increase in carbon dioxide or a decrease in the pH of the cerebrospinal fluid.

Question 4

Prior to applying a nonrebreathing mask to a patient, you must ensure that the:

Select one:

a. reservoir bag is fully inflated.
b. one-way valve is sealed.
c. flow rate is set at 6 L/min
d. patient has reduced tidal volume.

Answer 4

reservoir bag is fully inflated.

Question 5

The leaf-shaped structure located superior to
the larynx is called the:

Select one:

a. epiglottis
b. vallecula.
c. cricoid ring
d. thyroid cartilage.

Answer 5

epiglottis

Question 6

In contrast to inhalation, exhalation:

Select one:
a. requires muscular effort to effectively expel
air from the lungs
b. is a passive process caused by increased
intrathoracic pressure.
c. occurs when the diaphragm lowers and expels air
from the lungs.
d. is an active process caused by decreased intrathoracic
pressure.

Answer 6

is a passive process caused by increased intrathoracic pressure.

Question 7

To select the proper size oropharyngeal airway, you should measure from the:

Select one:

a. corner of the mouth to the earlobe.
b. center of the mouth to the posterior ear.
c. corner of the mouth to the superior ear.
d. angle of the jaw to the center of the mouth.

Answer 7

corner of the mouth to the earlobe.

Question 8

Without adequate oxygen, the body’s cells:

Select one:
a. rely solely on glucose, which is completely converted into adenosine triphosphate.
b. cease metabolism altogether, resulting in carbon dioxide accumulation in the blood.
c. begin to metabolize fat, resulting in the
production and accumulation of ketoacids.
d. incompletely convert glucose into energy, and lactic acid accumulates in the blood.

Answer 8

incompletely convert glucose into energy, and lactic acid accumulates in the blood.

Question 9

Inhalation occurs when the:

Select one:
a. diaphragm and intercostal muscles relax and
cause an increase in intrathoracic pressure.
b. diaphragm and intercostal muscles ascend and
cause an increase in intrathoracic pressure.
c. diaphragm and intercostal muscles contract and cause a decrease in intrathoracic pressure.
d. diaphragm ascends and the intercostal muscles contract, causing a decrease in intrathoracic pressure.

Answer 9

diaphragm and intercostal muscles contract and cause a decrease in intrathoracic pressure.

Question 10

The MOST significant complication associated with oropharyngeal suctioning is:

Select one:

a. hypoxia due to prolonged suction attempts.
b. oral abrasions from vigorous suction attempts.
c. clogging of the catheter with thick secretions.
d. vomiting from stimulating the anterior airway.

Answer 10

hypoxia due to prolonged suction attempts.

Question 11

Gas exchange in the lungs is facilitated by:

Select one:

a. adequate amounts of surfactant.
b. water or blood within the alveoli.
c. surfactant-destroying organisms.
d. pulmonary capillary constriction.

Answer 11

adequate amounts of surfactant.

Question 12

Intrapulmonary shunting occurs when:

Select one:

a. the presence of pulmonary surfactant causes a decrease in alveolar surface tension, thus impairing the exchange of gases in the lungs.
b. a decrease in respiratory rate and depth causes carbon dioxide accumulation in the alveoli and an overall decrease in blood oxygen levels.
c. blood coming from the right side of the heart bypasses nonfunctional alveoli and returns to the left side of the heart in an unoxygenated state.
d. any impairment in circulatory function causes a reduced ability for oxygen and carbon dioxide to diffuse across the alveolar–capillary membrane.

Answer 12

blood coming from the right side of the heart bypasses nonfunctional alveoli and returns to the left side of the heart in an unoxygenated state.

Question 13

A nasopharyngeal airway is inserted:

Select one:

a. with the bevel facing the septum if inserted into the right nare.
b. into the larger nostril with the tip pointing away from the septum. Incorrect
c. with the bevel pointing downward if inserted into the left nare.
d. into the smaller nostril with the tip following the roof of the nose.

Answer 13

with the bevel facing the septum if inserted into the right nare.

Question 14

Complications associated with using a manually triggered ventilation device include:

Select one:

a. lung tissue injury and gastric distention.
b. inadequate ventilation and hypercarbia.
c. inadequate oxygenation and tracheal injury.
d. reduced tidal volume delivery and hypoxia.

Answer 14

lung tissue injury and gastric distention.

Question 15

Which of the following organs or tissues can survive the longest without oxygen?

Select one:

a. Muscle
b. Heart
c. Liver
d. Kidneys

Answer 15

muscle

Question 16

Which of the following statements regarding
oxygenation and ventilation is correct?

Select one:

a. In carbon monoxide (CO) poisoning, ventilation is impaired because CO binds to oxygen very quickly.
b. Oxygenation is the movement of air into and out of the lungs, whereas ventilation is the exchange of gases.
c. In mines or confined places, where oxygen levels are low, ventilation may continue despite adequate oxygenation.
d. Oxygenation without adequate ventilation can occur in climbers who quickly ascend to an altitude of lower atmospheric pressure.

Answer 16

in mines or confined places, where oxygen levels are low, ventilation may continue despite adequate oxygenation.

Question 17

Suctioning the oral cavity of an adult should be
accomplished within:

Select one:

a. 5 seconds.
b. 10 seconds.
c. 15 seconds
d. 20 seconds.

Answer 17

15 seconds.

Question 18

An unconscious patient found in a prone position must be placed in a supine position in case he or she:

Select one:

a. requires CPR.
b. begins to vomit.
c. regains consciousness
d. has increased tidal volume.

Answer 18

requires CPR.

Question 19

The proper technique for sizing an oropharyngeal airway before insertion is to measure the device from:

Select one:

a. the tip of the nose to the earlobe.
b. the bridge of the nose to the tip of the chin
c. the corner of the mouth to the earlobe.
d. the center of the jaw to the earlobe.

Answer 19

the corner of the mouth to the earlobe.

Question 20

Which of the following statements regarding positive-pressure ventilation is correct?

Select one:

a. With positive-pressure ventilation, more volume is required to have the same effects as normal breathing.
b. Positive-pressure ventilation allows blood to naturally be pulled back to the heart from the body.
c. To prevent hypotension, the EMT should increase the rate and force of positive-pressure ventilation.
d. Unlike negative-pressure ventilation, positive-pressure ventilation does not affect the esophageal opening pressure.

Answer 20

with positive-pressure ventilation, more volume is required to have the same effects as normal breathing.

Question 21

The partial pressure of oxygen in the alveoli is _______ mm Hg, while the partial pressure of carbon dioxide in the alveoli is _______ mm Hg.

Select one:

a. 70, 28
b. 88, 30
c. 90, 50
d. 104, 40

Answer 21

104, 40

Question 22

The process of exchanging oxygen and carbon dioxide between the alveoli and the blood of the capillaries is called:

Select one:

a. external respiration.
b. cellular metabolism.
c. pulmonary ventilation.
d. alveolar ventilation

Answer 22

external respiration.

Question 23

Which of the following would cause an increase in the amount of exhaled carbon dioxide?

Select one:

a. Increased cardiac output
b. Cardiopulmonary arrest
c. Anaerobic metabolism
d. Excessive ventilation

Answer 23

increased cardiac output.

Question 24

Based on current guidelines, in which of the following situations should supplemental oxygen be administered?

Select one:

a. Exposure to carbon monoxide and an oxygen saturation of 95%
b. Signs of myocardial infarction and an oxygen saturation of 97%
c. Any diabetic patient whose oxygen saturation is less than 98%
d. Any elderly patient whose oxygen saturation is less than 95%

Answer 24

exposure to carbon monoxide and an oxygen saturation of 95%.

Question 25

An oxygen cylinder should be taken out of service and refilled when the pressure inside it is less than:

Select one:

a. 500 psi.
b. 200 psi.
c. 1,000 psi.
d. 1,500 psi.

Answer 25

500 psi.

Question 26

Which of the following oxygen flowmeters is NOT affected by gravity and can be used in any position when attached to an oxygen cylinder?

Select one:

a. Bourdon-gauge flowmeter
b. Vertical-position flowmeter
c. Ball-and-float flowmeter
d. Pressure-compensated flowmeter

Answer 26

Bourdon-gauge flowmeter

Question 27

After ___________ minutes without oxygen, brain
damage is very likely

Select one:

a. 0 to 4
b. 4 to 6
c. 6 to 10
d. more than 10

Answer 27

6 to 10

Question 28

Which of the following is a late sign of
hypoxia?

Select one:

a. Anxiety
b. Cyanosis
c. Tachycardia
d. Restlessness

Answer 28

cyanosis

Question 29

As the single EMT managing an apneic patient’s airway, the preferred initial method of providing ventilations is the:

Select one:

a. mouth-to-mask technique with a one-way valve.
b. mouth-to-mouth technique.
c. one-person bag-valve mask.
d. manually triggered ventilation device.

Answer 29

mouth-to-mask technique with a one-way valve.

Question 30

You are ventilating a 40-year-old uninjured man who is apneic but has a pulse. When your partner reassesses his blood pressure, she notes that it has decreased significantly from previous readings. You should:

Select one:

a. reduce the rate or volume of the ventilations you are delivering.
b. perform a head-to-toe assessment to look for signs of bleeding.
c. increase the volume of your ventilations and reassess his blood pressure.
d. increase the rate at which you are ventilating and reassess his blood pressure.

Answer 30

reduce the rate or volume of the ventilations you are delivering.

Question 31

The diaphragm is innervated by the _________ nerve, which allows it to contract.

Select one:

a. vagus
b. phrenic
c. hypoglossal
d. vestibulocochlear

Answer 31

phrenic

Question 32

All of the following are signs of hypoxia,
EXCEPT

Select one:

a. tachycardia.
b. dehydration.
c. cyanosis.
d. weak pulse.

Answer 32

dehydration.

Question 33

You are ventilating an apneic woman with a bag-valve mask. She has dentures, which are tight fitting. Adequate chest rise is present with each ventilation, and the patient’s oxygen saturation reads 96%. When you reassess the patency of her airway, you note that her dentures are now loose, although your ventilations are still producing adequate chest rise. You should:

Select one:

a. remove her dentures, resume ventilations, and assess for adequate chest rise.
b. attempt to replace her dentures so that they fit tightly and resume ventilations.
c. leave her dentures in place, but carefully monitor her for an airway obstruction.
d. remove her dentures at once and increase the rate and volume of your ventilations.

Answer 33

remove her dentures, resume ventilations, and assess for adequate chest rise.

Question 34

While eating dinner, your partner suddenly grabs his throat and has a panicked look on his face. He has a weak cough, faint inspiratory stridor, and cyanosis around the lips. You should:

Select one:

a. stand behind him and administer abdominal thrusts.
b. encourage him to cough as forcefully as he can.
c. deliver up to five back blows and reassess him.
d. place him in a supine position and open his airway. I

Answer 34

stand behind him and administer abdominal thrusts.

Question 35

Your protocols state that during the first few minutes of working on a cardiac arrest patient, you should provide passive ventilation. This means that you will:

Select one:

a. allow recoil of the chest between compressions to draw air into the lungs.
b. deliver positive-pressure ventilation at rate of only 5 or 6 breaths/min.
c. ventilate with a bag-valve mask that is not attached to oxygen.
d. time your positive-pressure ventilations to occur during chest recoil.

Answer 35

allow recoil of the chest between compressions to draw air into the lungs.

Question 36

The pressure of gas in a full cylinder of oxygen is approximately _______ pounds per square inch (psi).

Select one:

a. 2,000
b. 500
c. 1,000
d. 3,000

Answer 36

2,000

Question 37

Which of the following factors will cause a
decreased minute volume in an adult?

Select one:

a. Shallow breathing
b. Increased tidal volume
c. Respirations of 20 breaths/min
d. Slight decrease in respiratory rate

Answer 37

shallow breathing

Question 38

thyroid cartilage.

Select one:

a. alveoli
b. the trachea.
c. the epiglottis.
d. bronchioles.

Answer 38

the epiglottis.

Question 39

You and your partner are caring for a critically injured patient. Your partner is controlling severe bleeding from the patient’s lower extremities as you attempt ventilations with a bag-valve mask. After repositioning the mask several times, you are unable to effectively ventilate the patient. You should:

Select one:

a. begin ventilations using the mouth-to-mask technique.
b. hyperextend the patient’s head and reattempt ventilations
c. continue attempted ventilations and transport immediately.
d. suction the patient’s airway for 30 seconds and reattempt ventilations.

Answer 39

begin ventilations using the mouth-to-mask technique.

Question 40

The hypoxic drive is influenced by:

Select one:

a. high blood oxygen levels.
b. low blood oxygen levels.
c. low blood carbon dioxide levels.
d. high blood carbon dioxide levels

Answer 40

low blood oxygen levels.

Question 41

With a good mask-to-face seal and an oxygen flow rate of 15 L/min, the nonrebreathing mask is capable of delivering up to ______% inspired oxygen.

Select one:

a. 90
b. 70
c. 80
d. 100

Answer 41

90

Question 42

Despite your attempts to coach a conscious young female’s respirations, she continues to hyperventilate with a marked reduction in tidal volume. You should:

Select one:

a. explain to her that you will assist her ventilations.
b. restrain her and provide ventilatory assistance.
c. insert a nasopharyngeal airway and give oxygen.
d. ventilate her at the rate at which she is breathing.

Answer 42

explain to her that you will assist her ventilations.

Question 43

Proper technique for suctioning the oropharynx of an adult patient includes:

Select one:

a. suctioning while withdrawing the catheter from the oropharynx.
b. continuously suctioning patients with copious oral secretions.
c. removing large, solid objects with a tonsil-tip suction catheter.
d. suctioning for up to 1 minute if the patient is well oxygenated.

Answer 43

suctioning while withdrawing the catheter from the oropharynx.

Question 44

A 51-year-old female presents with a sudden onset of difficulty breathing. She is conscious and alert and able to speak in complete sentences. Her respirations are 22 breaths/min and regular. You should:

Select one:

a. administer oxygen via a nonrebreathing mask.
b. insert a nasal airway in case her mental status decreases.
c. perform a secondary assessment and then begin treatment.
d. assist her ventilations with a bag-valve mask.

Answer 44

administer oxygen via a nonrebreathing mask.

Question 45

A 23-year-old male experienced severe head trauma after his motorcycle collided with an oncoming truck. He is unconscious, has rapid and shallow breathing, and has copious bloody secretions in his mouth. How should you manage his airway?

Select one:

a. Alternate 15 seconds of oral suctioning with 2 minutes of assisted ventilation.
b. Suction his oropharynx with a rigid catheter until all secretions are removed.
c. Insert a nasopharyngeal airway and provide suction and assisted ventilations.
d. Provide continuous ventilations with a bag-valve mask to minimize hypoxia.

Answer 45

alternate 15 seconds of oral suctioning with 2 minutes of assisted ventilation.

Question 46

The main advantage of the Venturi mask is:

Select one:

a. the use of its fine adjustment capabilities in the long-term management of physiologically stable patients.
b. the ability to adjust the percentage of inspired oxygen when caring for a critically ill or injured patient.
c. that it does not contain an oxygen reservoir, so the same percentage of oxygen can consistently be administered.
d. the ability to adjust the amount of oxygen administered to the patient by increasing the flow rate on the regulator.

Answer 46

the use of its fine adjustment capabilities in the long-term management of physiologically stable patients.

Question 47

Which of the following statements regarding the one-person bag-valve mask technique is correct?

Select one:

a. Adequate tidal volume is often difficult to achieve when one EMT is operating the bag-valve mask.
b. Bag-valve mask ventilations should be delivered every 2 seconds when the device is being operated by one person.
c. The C-clamp method of holding the mask to the face is not effective when ventilating a patient with a bag-valve mask.
d. The bag-valve mask delivers more tidal volume and a higher oxygen concentration than the mouth-to-mask technique.

Answer 47

adequate tidal volume is often difficult to achieve when one EMT is operating the bag-valve mask.

Question 48

A ventilation/perfusion (V/Q ratio) mismatch
occurs when:

Select one:

a. ventilation is inadequate due to a traumatic injury or medical condition, which results in an impairment in pulmonary gas exchange.
b. a disruption in blood flow inhibits the exchange of oxygen and carbon dioxide in the lungs, even though the alveoli are filled with fresh oxygen.
c. ) ventilation is compromised, resulting in the accumulation of carbon dioxide in the bloodstream, alveoli, and the tissues and cells of the body.
d. a traumatic injury or medical condition impairs the body’s ability to effectively bring oxygen into the lungs and remove carbon dioxide from the body.

Answer 48

a disruption in blood flow inhibits the exchange of oxygen and carbon dioxide in the lungs, even though the alveoli are filled with fresh oxygen.

Question 49

At a flow rate of 6 L/min, a nasal cannula can deliver an approximate oxygen concentration of up to:

Select one:

a. 44%.
b. 24%
c. 35%
d. 52%.

Answer 49

44%

Question 50

The primary waste product of aerobic metabolism
is:

Select one:

a. lactic acid.
b. pyruvic acid.
c. carbon dioxide.
d. adenosine triphosphate.

Answer 50

carbon dioxide.