EMT - Chapter 16 - Respiratory Emergencies

A conscious and alert 29-year-old female with a history of asthma complains of difficulty breathing that began after her morning jog. The temperature is 40°F. On exam, you hear bilateral expiratory wheezing. After providing supplemental oxygen, you should:

Select one:
A. contact medical control and administer an antihistamine.
B. call medical control and ask how to proceed with treatment.
C. determine if she has been prescribe a beta-agonist inhaler.
D. place her in a recumbent position to facilitate breathing.

Determine if she has been prescribed a beta-agonist inhaler.

A pleural effusion is MOST accurately defined as:

Select one:
A. fluid accumulation outside the lung.
B. a unilaterally collapsed lung.
C. diffuse collapsing of the alveoli.
D. a bacterial infection of the lung tissue.

Fluid accumulation outside the lung.

Albuterol is a generic name for:

Select one:
A. Singular.
B. Alupent.
C. Atrovent.
D. Ventolin.

Ventolin.

Alkalosis is a condition that occurs when:
A. blood acidity is reduced by excessive breathing.
B. dangerous acids accumulate in the bloodstream.
C. the level of carbon dioxide in the blood increases.
D. slow, shallow breathing eliminates too much carbon dioxide.

blood acidity is reduced by excessive breathing.

An alert patient presents with a regular pattern of inhalation and exhalation and breath sounds that are clear and equal on both sides of the chest. These findings are consistent with:

Select one:
A. respiratory insufficiency.
B. adequate air exchange.
C. an obstructed airway.
D. respiratory difficulty.

adequate air exchange.

Asthma is caused by a response of the:

Select one:
A. cardiovascular system.
B. respiratory system.
C. endocrine system.
D. immune system.

Immune system.

At the onset of an acute asthma attack, patients commonly experience difficulty breathing and:

Select one:
A. profound cyanosis.
B. rales and rhonchi.
C. expiratory wheezing.
D. audible stridor.

Expiratory wheezing.

Common signs and symptoms of acute hyperventilation syndrome include:

Select one:
A. anxiety, dizziness, and severe bradypnea.
B. tachypnea and tingling in the extremities.
C. altered mental status and bradycardia.
D. unilateral paralysis and slurred speech.

Tachypnea and tingling in the extremities.

Dyspnea is MOST accurately defined as:

Select one:
A. shortness of breath or difficulty breathing.
B. labored breathing with reduced tidal volume.
C. a marked increase in the exhalation phase.
D. a complete cessation of respiratory effort.

shortness of breath or difficulty breathing.

Harsh, high-pitched inspiratory sounds are characteristic of:

Select one:
A. stridor.
B. wheezing.
C. rales.
D. rhonchi.

stridor.

Hyperventilation could be associated with all of the following, EXCEPT:

Select one:
A. high blood glucose levels.
B. a narcotic overdose.
C. an overdose of aspirin.
D. a respiratory infection.

A narcotic overdose.

In order for efficient pulmonary gas exchange to occur:

Select one:
A. there must be low quantities of pulmonary surfactant to allow for full alveolar expansion.
B. the percentage of inhaled carbon dioxide must exceed the percentage of inhaled oxygen.
C. the pulmonary capillaries must be completely constricted and the alveoli must be collapsed.
D. oxygen and carbon dioxide must be able to freely diffuse across the alveolar-capillary membrane.

oxygen and carbon dioxide must be able to freely diffuse across the alveolar-capillary membrane.

In what area of the lungs does respiration occur?

Select one:
A. Trachea
B. Alveoli
C. Capillaries
D. Bronchi

Alveoli

The two processes that occur during respiration are:

Select one:
A. inspiration and expiration.
B. oxygenation and ventilation.
C. diffusion and oxygenation.
D. ventilation and diffusion

inspiration and expiration.

When assessing for fluid collection in the lungs during auscultation of lung sounds, you should:

Select one:
A. pay special attention to the exhalation phase because this is when you will likely hear rales or rhonchi.
B. start at the lower lung fields and determine at which level you start hearing clear breath sounds.
C. Auscultate the posterior chest first and compare the apex of one lung to the base of the opposite lung.
D. note the presence of a high-pitched whistling sound, which is an indicator of fluid in the lungs.

Start at the lower lung fields and determine at which level you start hearing clear breath sounds.

When auscultating the lungs of a patient with respiratory distress, you hear adventitious sounds. This means that the patient has:

Select one:
A. abnormal breath sounds.
B. normal breath sounds.
C. diminished breath sounds.
D. an absence of breath sounds.

Abnormal breath sounds.

When the level of carbon dioxide rises above normal:

Select one:
A. the brain stem inhibits respirations.
B. respirations increase in rate and depth.
C. respirations decrease in rate and depth.
D. exhalation lasts longer than inhalation.

respirations increase in rate and depth.

Which of the following conditions would be LEAST likely to result in hypoxia?

Select one:
A. Narcotic overdose
B. Pleural effusion
C. Pulmonary edema
D. Severe anxiety

Severe anxiety

Which of the following is MOST characteristic of adequate breathing?

Select one:
A. 20 breaths/min with shallow movement of the chest wall and pallor
B. 22 breaths/min with an irregular pattern of breathing and cyanosis
C. 24 breaths/min with bilaterally equal breath sounds and pink skin
D. 30 breaths/min with supraclavicular retractions and clammy skin

24 breaths/min with bilaterally equal breath sounds and pink skin

Which of the following statements regarding pulse oximetry is correct?

Select one:
A. Caution must be exercised when using the pulse oximeter on a patient with carbon monoxide poisoning because falsely low readings are common.
B. The pulse oximeter is a valuable assessment tool that measure the percentage of red blood cells that contain hemoglobin molecules.
C. Pulse oximetry measures the percentage of hemoglobin that is saturated with oxygen but does not measure the actual hemoglobin content of the blood.
D. Most otherwise healthy patients can maintain adequate oxygenation and good skin color with oxygen saturation reading as low as 70% to 80%.

Pulse oximetry measures the percentage of hemoglobin that is saturated with oxygen but does not measure the actual hemoglobin content of the blood.

A young female is unconscious after intentionally ingesting a large amount of aspirin. You will MOST likely find her respirations:

Select one:
A. deep and rapid.
B. slow and deep.
C. rapid and shallow.
D. slow and shallow.

deep and rapid.

Which of the following statements regarding hypoxic drive is correct?

Select one:
A. The hypoxic drive stimulates a person to breathe on the basis of low oxygen levels.
B. The hypoxic drive serves as the primary stimulus for breathing in healthy individuals.
C. Chronic carbon dioxide elimination often results in activation of the hypoxic drive.
D. 100% supplemental oxygen will always cause apnea in patients with a hypoxic drive.

The hypoxic drive stimulates a person to breathe on the basis of low oxygen levels.

When auscultating an elderly woman's breath sounds, you hear low-pitched "rattling" sounds at the bases of both of her lungs. This finding is MOST consistent with which of the following conditions?

Select one:
A. Early pulmonary edema
B. Acute asthma attack
C. Widespread atelectasis
D. Aspiration pneumonia

Aspiration pneumonia

You are dispatched to a residence for a 67-year-old female who was awakened by shortness of breath and sharp chest pain. Her husband tells you that she was recently discharged from the hospital after having hip surgery. Your assessment reveals dried blood around her mouth, facial cyanosis, and an oxygen saturation of 88%. You should suspect:

Select one:
A. acute pulmonary edema.
B. spontaneous pneumothorax.
C. acute pulmonary embolism.
D. right-sided heart failure.

Acute pulmonary embolism.

An alert patient presents with a regular pattern of inhalation and exhalation and breath sounds that are clear and equal on both sides of the chest. These findings are consistent with:

Select one:
A. respiratory insufficiency.
B. respiratory difficulty.
C. adequate air exchange.
D. an obstructed airway.

Adequate air exchange.

The respiratory distress that accompanies emphysema is caused by:

A. Repeated exposure to cigarette smoke.
B. Acute fluid accumulation in the alveoli.
C. Chronic stretching of the alveolar walls.
D. Massive construction of the bronchioles.

Chronic stretching of the alveolar walls

You receive a call for a 70 year old female with respiratory distress. Her husband tells you that she has congestive heart failure; however, he does not think that she has been taking her medications as prescribed. The patient is laboring to breathe, appears tired, and has a diagnosis around her lips. You should:

A. Apply a pulse oximeter and assess her vital signs.
B. Obtain a complete list of all her medications.
C. Administer oxygen via a non rebreathing mask.
D. Assist her ventilations with a bag mask device.

Assist her ventilations with a bag mask device

You are assisting an asthma patient with his prescribed metered dose inhaler. After the patient exhales, and before inhaling, the patient should put his or her lips around the inhaler, take a deep breath and deep pressed to inhale. You should:

A. Immediately reapply the oxygen mask and reassess his condition.
B. Allowing him to breathe room air and assess his oxygen saturation.
C. Advise him to Exhale forcibly to ensure medication absorption.
D. Instruct him to hold his breath for as long as he comfortably can.

Instruct him to hold his breath for as long as he jumped or blue can