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100 Cards in this Set
- Front
- Back
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Q. A size 3 or 4 LMA:
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will accommodate the passage of a 6.0mm ET tube
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Q. The MOST effective way to minimize the risk of hypoxia while intubating a child is to:
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limit your intubation attempt to 20 seconds.
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Q. Patients with decompensated asthma or COPD that require positive-pressure ventilation:
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may develop a pneumothorax or experience a decrease in venous return to the heart if they are ventilated too rapidly
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Q. Which of the following statements regarding translaryngeal catheter ventilation is MOST correct?
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ventilation is achieved by the use of a high-pressure jet ventilator
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Q. Approximately how far should you insert a 5.0mm ET tube in a 4-year-old child?
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15 cm (diameter x 3)
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Q. Wheezing is resolved with medications that:
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relax the smooth muscle of the bronchiole
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Q. An elderly woman with COPD presents with peripheral edema. The patient is conscious but agitated. She is breathing with slight difficulty but has adequate tidal volume. During your assessment, you note that her jugular veins engorge when you apply pressure to her right upper abdominal quadrant. She tells you that she takes a “water pill” and Vasotec for high blood pressure. You should:
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suspect acute right heart failure and administer oxygen
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Q. Digital intubation is absolutely contraindicated if the patient:
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is unconscious but breathing
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Q. Apneustic breathing is characterized by:
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short, brisk inhalations with a long pause before exhalation
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Q. Patients with pneumonia often experience a coughing fit when they roll from one side to the other because:
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pnuemonia often occurs in the lung bases, typically on only one side
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Q. Intubation of a patient with severe asthma:
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is often a last resort because asthmatics are difficult to ventilate and are prone to pneumothoraces
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Q. Which of the following is NOT performed before, during, or after insertion of a nasogastric (NG) tube in a conscious patient?
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keeping the patients head in a flexed position during insertion of the tube
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Q. The cricothyroid membrane is the ideal site for making a surgical opening into the trachea because:
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no important structures lie between the skin covering the cricothyroid membrane and the airway
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Q. Intrapulmonary shunting occurs when:
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nonfunctional alveoli inhibit pulmonary gas exchange
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Q. What function do the nasal turbinates serve?
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warming and humidifying inhaled air
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Q. You are transporting an intubated patient and note that the digital capnometry reading has quicky fallen below 30 mmHg. You should:
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take immediate measures to confirm proper placement of the ET tube
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Q. The anterior portion of the palate is formed by the:
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maxilla and palatine bones
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Q. In contrast to the right lung, the left lung:
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has two lobes
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Q. When placing a dislodged tracheostomy tube, it is MOST important that you:
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take appropriate BSI precautions
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Q. A patient who is coughing up thick pulmonary secretions should NOT take:
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an antitussive
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Q. A patient with quiet tachypnea is MOST likely experiencing:
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shock
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Q. One of the hallmarks of a pulmonary embolism is:
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cyanosis that does not resolve with oxygen therapy
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Q. Neuromuscular blocking agents:
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convert a breathing patient with a marginal airway into an apneic patient with no airway
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Q. Several cycles of basic life support maneuvers have failed to relieve a severe airway obstruction in an unconscious 44-year-old woman. You should:
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perform direct laryngoscopy and attempt to remove the obstruction with Magill forceps
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Q. End-tidal carbon dioxide (ETCO2) detection is a reliable method for confirming proper ET tube placement because:
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carbon dioxide is not present in the esophagus
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Q. When auscultating the lungs of a patient with pulmonary edema, you will MOST likely hear:
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crackles in the bases of the lungs at the end of inspiration
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Q. The ___ are pyramid-like structures that form the posterior attachment of the vocal cords.
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arytenoid cartilages
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Q. Chronic obstructive pulmonary disease (COPD) is characterized by:
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changes in pulmonary structure and function that are progressive and irreversible
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Q. Which of the following findings is MOST clinically significant in a 30-year-old woman with difficulty breathing and a history of asthma?
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Prior ICU admission for her asthma
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Q. Open cricothyrotomy is generally contraindicated in all of the following situations, EXCEPT:
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any patient who is younger than 16 years of age
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Q. Which of the following is NOT a contraindication for nasotracheal intubation?
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spinal injury
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Q. When administering a nebulized bronchodilator, the oxygen flow rate should be set to at least ___ liters per minute.
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6
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Q. Common clinical findings in patients with obstructive lung disease include all of the following, EXCEPT:
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a decreased expiratory pause
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Q. The MOST significant complication associated with the use of multilumen airways is:
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unrecognized displacement of the tube into the esophagus
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Q. Which of the following patients has the lowest minute volume?
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Tidal volume of 350 mL; respiratory rate of 12 breaths/min
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Q. The cricothyroid membrane:
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is relatively avascular and is covered by skin and minimal subcutaneous tissue
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Q. The upper airway of an adult consists of all the structures above the:
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vocal cords
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Q. Digital clubbing is MOST indicative of:
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chronic hypoxia
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Q. A critical step when using a continuous positive airway pressure (CPAP) unit to treat a patient with severe respiratory distress is:
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ensuring an adequate mask seal with minimal leakage
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Q. Whether you are using the PtL or the Combitube:
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both devices are inserted blindly into the posterior pharynx
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Q. Paradoxical respiratory movement is characterized by:
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the epigastrium and thorax moving in opposite directions
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Q. What type of medication dries secretions in the airway and prevents the cilia from removing them effectively?
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antihistamine
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Q. If you see a soft tissue bulge on either side of the airway when performing nasotracheal intubation:
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you have probably inserted the tube into the pyriform fossa
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Q. The diaphragm of the stethoscope is designed to auscultate:
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high-pitched sounds
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Q. Unlike bronchodilator therapy, corticosteroid therapy:
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takes a few hours to produce bronchial edema
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Q. Which of the following statements regarding pediatric endotracheal intubation in the prehospital setting is MOST correct?
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Bag-mask ventilation can be as effective as intubation for EMS systems that have short transport times
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Q. A hyperventilating patient:
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may be acidotic and is trying to decrease his or her pH level
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Q. A 76-year-old woman with empyhsema presents with respiratory distress that has worsened progressively over the past two days. She is breathing through pursed lips and has a prolonged expiratory phase and an oxygen saturation on 76%. She is on home oxygen at 2L/min. Your initial action should be to:
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place her in a position that facilitates breathing
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Q. If a patient’s initial presentation makes you suspicious about a particular respiratory condition, you must:
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confirm your suspicions with a thorough assessment
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Q. You are attempting to intubate a 5-year-old girl when you note that her heart rate has fallen from 120 beats/min to 80 beats/min. A patent IV line has been established. The MOST appropriate action is to:
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abort the attempt and ventilate with a bag-mask device and 100% oxygen
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Q. ___ breath sounds are the MOST commonly heard breath sounds, and have a much more obvious inspiratory component.
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vesicular
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Q. A 66-year-old man with chronic bronchitis presents with severe respiratory distress. The patient’s wife tells you that he takes medications for high blood pressure and bronchitis, is on home oxygen threapy, and has recently been taking an over-the-counter antitussive. She further tells you that he has not been compliant with his oxygen therapy. Auscultation of his lungs reveals diffuse rhonchi. What is the MOST likely cause of this patient’s respiratory distress?
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recent antitussive use
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Q. The MOST common complication associated with nasotracheal intubation is:
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bleeding
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Q. Uncontrollable coughing and hemoptysis in a cigarette smoker are clinical findings MOST consistent with:
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lung cancer
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Q. On either side of the glottis, tissue forms a pocket called the:
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piriform fossa
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Q. Which of the following statements regarding anatomic dead space is MOST correct?
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anatomic dead space is about 1 mL per pound of body weight.
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Q. After inserting the needle into through the cricothyroid membrane, you should next:
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insert the needle about 1 cm farther and then aspirate with a syringe.
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Q. It would be appropriate to insert a nasopharyngeal airway in patients who:
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have an altered mental status with an intact gag relfex
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Q. When nasally intubating a patient, the ET tube is advanced:
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when the patient inhales
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Q. Pneumonitis is especially common in older patients with:
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chronic food aspiration
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Q. The external jugular veins run ___ and are located ___ to the cricothyroid membrane.
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vertically; lateral
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Q. Surfactant is:
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a proteinaceous substance that decreases surface tension on the alveolar walls
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Q. With regards to pulse oximetry, the more hypoxic a patient becomes:
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the faster he or she will desaturate
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Q. The pulse oximeter would be LEAST useful when:
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determining how much oxygen to give a patient
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Q. You would MOST likely observe a grossly low respiratory rate and volume in a patient who overdosed on:
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heroin
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Q. Abnormal breath sounds associated with pneumonia and congestive heart failure are MOST often heard in the:
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bases of the lungs
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Q. Once you have confirmed that the lighted stylet-ET tube comination has entered the trachea, you should:
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hold the stylet in place and advance the tube about 2 to 4 cm into the trachea.
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Q. Compared with an onen cricothyrotomy, needle cricothyrotomy:
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allows for subsequent attempts to intubate the patient
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Q. Which of the following medications is a parasympathetic bronchodilator?
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Ipratropium
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Q. The MOST clinically significant finding when questioning a patient with a chronic respiratory disease is:
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prior intubation for the same problem
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Q. A 21-year-old man experienced an acute onset of pleuritic chest pain and dyspnea while playing softball. He is noticeably dyspneic, has an oxygen saturation of 95% on room air, and diminished breath sounds to the upper right lobe. The MOST appropriate treatment for this patient involves:
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administering high flow supplemental oxygen and transporting at once.
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Q. Continuous positive airway pressure (CPAP) in the emergency setting is used to treat patients with certain obstructive airway diseases by:
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improving patency of the lower airway through the use of positive-end expiratory pressure.
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Q. While transporting an intubated 8-year-old boy, he suddenly jerks his head and becomes cyanotic shortly thereafter. His oxygen saturation and capnometry readings are both falling, and he is becoming bradycardic. You attempt to auscultate breath sounds, but are unable to hear because of the drone of the engine. What has MOST likely happened?
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inadvertent extubation
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Q. Removal of a dental appliance after intubating a patient is:
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dangerous and may cause dislodgement of the tube.
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Q. Hepatomegaly and jugular veinous distention are MOST suggestive of:
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right heart failure
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Q. Patients with obvious respiratory failure require immediate:
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ventilation support
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Q. The barrel-chest appearance classically seen in emphysemic patients is secondary to:
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air trapping in the lungs.
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Q. Frothy sputum that has a pink tinge to it is MOST suggestive of:
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congestive heart failure
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Q. The pressure relief valve on an automatic transport ventilator (ATV) may lead to unrecognized hypoventilation in patients with all of the following conditions, EXCEPT:
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prolonged apnea
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Q. You are transporting a middle-aged man on a CPAP unit for severe pulmonary edema. An IV line of normal saline is in place. Prior to applying the CPAP device, the patient was tachypneic and had an oxygen saturation of 90%. When you reassess him, you note that his respirations have increased and his oxygen saturation has dropped to 84%. You should:
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remove the CPAP unit, assist his ventilations with a bag-mask device, and prepare to intubate him.
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Q. Use of a spacer device in conjunction with a metered-dose inhaler:
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collects medication as it is released from the canister, allowing more to be delivered to the lungs and less to be lost to the environment.
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Q. The major advantage of the multilumen airway is that:
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effective ventilation is possible if the tube enters the esophagus or the trachea
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Q. Emphysema is caused by:
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chronic destruction of the alveolar walls
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Q. You should be MOST suspicious of tube misplacement following an open cricothyrotomy if:
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a crackling sensation is noted when palpating the neck.
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Q. Why are children more prone to croup when they acquire a viral infection than adults infected with the same virus?
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A child’s airway is narrower than an adult’s, and even minor swelling can result in obstruction.
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Q. Intubation of the trauma patient is MOST effectively performed:
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by two paramedics
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Q. Two attempts to ventilate an unconscious 10-year-old boy have been unsuccessful. You should next:
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perform chest compressions
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Q. If the ET tube is placed in the trachea properly, the colorimetric paper inside the ETCO2 detector should:
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turn yellow during inspiration
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Q. In contrast to a needle cricothyrotomy, an open cricothyrotomy:
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enables the paramedic to provide greater tidal volume
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Q. Which of the following medications is safest to use in patients with borderline hypotension or hypovolemia?
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Etomidate
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Q. A patient with a suppressed cough mechanism:
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is at high risk for aspiration
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Q. You are dispatched to a residence for a 59-year-old man with difficulty breathing. The patient, who has a history of COPD, is conscious and alert. During your assessment, he tells you that he developed chills, fever, and a productive cough 2 days ago. Auscultation of his lungs reveals rhonchi to the left lower lobe. This patient is MOST likely experiencing:
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pneumonia
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Q. When determining the correct-sized nasogastric tube for a patient, you should measure the tube:
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from the nose to the ear and to the xiphoid process.
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Q. Approximately ___ mL of air remain in the anatomic dead space of an adult with a tidal volume of 500 mL.
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150
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Q. The MOST obvious risk associated with extubation is:
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overestimating the patient’s ability to protect his or her own airway
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Q. A 40-year-old man fell 20 feet from a tree while trimming branches. Your assessment reveals that he is unconscious. You cannot open his airway effectively with the jaw-thrust maneuver. You shoud:
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carefully open his airway with the head tilt-chin lift maneuver.
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Q. A pulse oximetry reading would be LEAST accurate in a patient:
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with poor peripheral perfusion
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Q. If the amount of pulmonary surfactant is decreased:
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alveolar surface tension increases
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Q. Which of the following devices is NOT used to deliver oxygen via positive pressure?
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simple face mask
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Q. When present at low levels, oxygen binds easily to hemoglobin molecules, resulting in:
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large changes in oxygen saturation when small changes in PaCO2 occur.
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