Airway And Breathing I
Quiz borrowed from http://www. Emt-national-training. Com/paramedic-practice-airway-test. Php .
Questions and Answers
- 1.
You are auscultating the lungs of a 23 year old female patient in good respiratory health. You would expect to find what type of lung sounds?
- A.
Vesicular breath sounds
- B.
Bronchovesicular breath sounds
- C.
Bronchial breath sounds
- D.
Moist breath sounds
Correct Answer
A. Vesicular breath soundsExplanation
In a 23-year-old female patient with good respiratory health, you would expect to find vesicular breath sounds. Vesicular breath sounds are normal, low-pitched, soft, and heard over most of the lung fields. They are produced by air moving through the smaller airways and alveoli. Bronchovesicular breath sounds are heard in the area between the bronchi and alveoli, and are typically heard in certain areas of the lungs. Bronchial breath sounds are loud and high-pitched, and are abnormal if heard over peripheral lung areas. Moist breath sounds are abnormal and indicate the presence of fluid or mucus in the lungs.Rate this question:
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- 2.
You arrive on scene to find a 57 year old man who is sitting on a couch appearing to stare at the wall. His breathing is labored and you can hear wet breath sounds that are producing a pink foam dripping from his mouth. You get no response when you try to get his name. Your requests for him to move his arm go without response. His pulse 105 and his BP is 92/40. You do not see any edema, swelling or JVD. This patient likely has ____________.
- A.
Left sided heart failure
- B.
Hypoglycemia
- C.
Right sided CHF
- D.
Tension pneumothorax
Correct Answer
A. Left sided heart failureExplanation
Based on the given information, the patient is experiencing symptoms that are consistent with left sided heart failure. The labored breathing, wet breath sounds, and pink foam dripping from the mouth suggest pulmonary edema, which is a characteristic feature of left sided heart failure. The lack of response to stimuli and the vital signs, such as elevated pulse and low blood pressure, further support this diagnosis. There are no indications of hypoglycemia, right sided heart failure, or tension pneumothorax mentioned in the scenario.Rate this question:
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- 3.
A Macintosh blade is inserted into the______________ and the epiglottis is elevated to visualize the chords during endotracheal intubation.
- A.
Vermitium
- B.
Travicula
- C.
Glottic Opening
- D.
Vallecula
Correct Answer
D. ValleculaExplanation
A Macintosh blade is a medical instrument used for endotracheal intubation, a procedure in which a tube is inserted into the trachea to assist with breathing. During this procedure, the epiglottis, a flap of cartilage in the throat, needs to be lifted or elevated in order to visualize the vocal cords and guide the insertion of the tube. The correct answer, Vallecula, refers to the space between the base of the tongue and the epiglottis where the Macintosh blade is inserted to elevate the epiglottis and visualize the vocal cords.Rate this question:
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- 4.
The newest AHA CPR guidelines specify that the tidal volume for rescue breaths should __________________.
- A.
Be 500 ml for everyone except infants
- B.
Make the chest rise
- C.
Be increased
- D.
Be between 500 ml and 800 ml
Correct Answer
B. Make the chest riseExplanation
The correct answer is "make the chest rise." According to the newest AHA CPR guidelines, the tidal volume for rescue breaths should be sufficient to make the chest rise. This ensures that enough air is being delivered to the lungs to support respiration. The guidelines do not specify a specific volume range, as the focus is on achieving visible chest rise during rescue breaths.Rate this question:
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- 5.
Which breath sounds would you likely hear from a person who's alveoli contain fluid?
- A.
Wheezes
- B.
Crackles
- C.
Rhonchi
- D.
Stridor
Correct Answer
B. CracklesExplanation
When the alveoli contain fluid, it causes the air to pass through the fluid-filled spaces, creating crackling sounds known as crackles. These sounds are typically heard during inspiration and can indicate conditions such as pneumonia, congestive heart failure, or pulmonary edema. Wheezes, on the other hand, are high-pitched whistling sounds caused by narrowed airways, while rhonchi are low-pitched snoring sounds caused by airway blockage. Stridor is a harsh, high-pitched sound that occurs when there is a blockage or narrowing of the upper airway.Rate this question:
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- 6.
Your 57 year old patient was a chain smoker for 35 years and is pursing their lips during exhalation. This is likely to:
- A.
Create a back pressure on collapsed alveoli
- B.
Force air out of the lungs faster
- C.
Demonstrate their lung control
- D.
Cause them to hyperventilate
Correct Answer
A. Create a back pressure on collapsed alveoliExplanation
The patient's pursing of the lips during exhalation creates a smaller opening for air to pass through, causing an increase in airway resistance. This increased resistance can lead to the creation of a back pressure on collapsed alveoli, which are small air sacs in the lungs responsible for gas exchange. By creating a back pressure, the collapsed alveoli can be opened up and allow for better ventilation and oxygenation of the lungs.Rate this question:
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- 7.
Hyperventilation lowers the levels of _____________ in the body.
- A.
Hemoglobin
- B.
Ketones
- C.
Carbon dioxide
- D.
Oxygen
Correct Answer
C. Carbon dioxideExplanation
Hyperventilation is the rapid breathing that leads to excessive intake of oxygen and expulsion of carbon dioxide. This causes a decrease in the levels of carbon dioxide in the body.Rate this question:
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- 8.
Albuterol is classified as a_______________.
- A.
Parasympatholytic
- B.
Parasympathomimetic
- C.
Sympatholytic
- D.
Sympathomimetic
Correct Answer
D. SympathomimeticExplanation
Albuterol is classified as a sympathomimetic because it mimics the effects of the sympathetic nervous system. Sympathomimetic drugs stimulate the adrenergic receptors in the body, leading to bronchodilation and relaxation of the smooth muscles in the airways. Albuterol is commonly used as a bronchodilator to relieve symptoms of asthma and other respiratory conditions.Rate this question:
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- 9.
During intubation you should use the teeth as a ______________.
- A.
Place to align the mark on a Combitube
- B.
Fulcrum
- C.
Marker for bulb inflation
- D.
Support for your elbow
Correct Answer
A. Place to align the mark on a CombitubeExplanation
During intubation, the teeth can be used as a place to align the mark on a Combitube. This means that the teeth can serve as a reference point or guide for correctly positioning the Combitube device during intubation. By aligning the mark on the Combitube with the teeth, healthcare professionals can ensure that the device is inserted at the correct depth and angle, optimizing its effectiveness and minimizing potential complications.Rate this question:
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- 10.
After the baby has crowned during delivery you should: (think protocol, NOT NRP)
- A.
Suction the mouth and nose and wait for the mother to push the rest of the baby out
- B.
Suction the mouth and nose then check for prolapsed cord
- C.
Support the head and gently pull the baby out
- D.
Put the mother on high flow O2 and have a cigar with the father
Correct Answer
B. Suction the mouth and nose then check for prolapsed cordExplanation
After the baby has crowned during delivery, it is important to suction the mouth and nose to clear any fluids or mucus that may obstruct the baby's airway. This helps to ensure that the baby can breathe properly once fully delivered. Additionally, checking for a prolapsed cord is crucial at this stage. A prolapsed cord occurs when the umbilical cord slips through the cervix and precedes the baby, which can lead to compression and compromise the baby's oxygen supply. Therefore, checking for a prolapsed cord is essential to address this potentially life-threatening situation promptly.Rate this question:
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- 11.
You and your partner Larry are dispatched to the call of a man with severe stomach pain. When you arrive on scene you find him lying on the floor of the kitchen in the fetal position. There is vomit on his face and he says he is going to throw up again. He denies falling and says the only thing wrong is that his stomach is killing him. Assessing his abdomen you find it to be very tender to the touch and he moans when you palpate his stomach. He is also breathing very fast at 30 a minute. What other signs and symptoms might you find with this patient?
- A.
Tachycardia - hypotension - fever
- B.
Bottle of poison - cyanosis and crepitus
- C.
Broken ribs - hypertension and deep rapid breathing
- D.
Rebound tenderness - metabolic acidosis
Correct Answer
A. Tachycardia - hypotension - feverExplanation
In addition to the symptoms mentioned in the scenario, a patient with severe stomach pain may also exhibit tachycardia (rapid heart rate), hypotension (low blood pressure), and fever. These additional signs and symptoms can indicate a more serious condition such as an infection or inflammation in the abdomen. Tachycardia and hypotension may be the body's response to pain and inflammation, while fever can be a sign of infection. These findings would prompt further assessment and intervention to determine the underlying cause and provide appropriate treatment.Rate this question:
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- 12.
Your patient is a 69 year old female who has a history of diabetes. She is breathing very deeply and very rapidly in a state of metabolic acidosis. Her husband said he woke up to her breathing like this and she would not wake up. You know that this woman is most likely in?
- A.
Respiratory rebound stage
- B.
Diabetic coma
- C.
Diabetic shock
- D.
Hypercalcemia
Correct Answer
B. Diabetic comaExplanation
Based on the given information, the patient's history of diabetes, deep and rapid breathing, and unconsciousness, it is likely that she is experiencing a diabetic coma. Diabetic coma is a life-threatening complication of diabetes characterized by severe hyperglycemia (high blood sugar) and metabolic acidosis (excess acid in the body). The deep and rapid breathing is a compensatory mechanism to try to eliminate the excess acid.Rate this question:
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- 13.
Paradoxical motion of the chest during exhalation is often caused by what type of injury?
- A.
Pneumothorax
- B.
Hemopneumothorax
- C.
Fractured clavicle
- D.
Flail chest
Correct Answer
D. Flail chestExplanation
Flail chest is a condition characterized by multiple rib fractures, causing a segment of the chest wall to become detached from the rest. During exhalation, the detached segment moves paradoxically inward instead of outward, leading to a paradoxical motion of the chest. This occurs because the detached segment is no longer able to expand and contract normally with the rest of the chest wall. Pneumothorax, hemopneumothorax, and fractured clavicle do not typically cause paradoxical motion of the chest during exhalation.Rate this question:
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- 14.
Why is the needle inserted on top of the rib during chest decompression?
- A.
To avoid the bundle of His
- B.
To give the syringe something to rest on
- C.
To ensure proper lung inflation
- D.
To avoid nerves, veins, arteries
Correct Answer
D. To avoid nerves, veins, arteriesExplanation
The needle is inserted on top of the rib during chest decompression to avoid nerves, veins, and arteries. This is important to prevent potential damage or injury to these structures, which could lead to complications and further medical issues. By avoiding these vital structures, the procedure can be performed safely and effectively.Rate this question:
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- 15.
Which of the following represents a mnemonic for checking whether an intubation blade is in working condition?
- A.
Sight, bright, tight
- B.
Bright, tight, alright
- C.
Light, tight, bright
- D.
Sight, tight, aight
Correct Answer
C. Light, tight, brightExplanation
The mnemonic "light, tight, bright" is a helpful way to remember the steps for checking if an intubation blade is in working condition. The first step is to ensure that the light source on the blade is functioning properly by checking if it turns on. The second step is to ensure that the blade is securely attached and tightened to the handle. Finally, the last step is to confirm that the light on the blade is bright enough to provide adequate illumination during intubation.Rate this question:
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- 16.
You have been dispatched for a 21 year old male complaining of a rapid heart rate, rapid breathing, and "tingling" in his hands and feet that has progressed to painful cramping. The patient's airway is patent, breathing is fast with adequate tidal volume and good air movement, pulse is rapid and regular, and skin is pink, warm, and dry. The patient notes that he has had "a lot on my mind lately," and that he has been feeling pressured by "friends" to "pop the question" to his girlfriend of six years. The patient denies any past medical history and his physical exam is remarkable only for tachycardia, tachypnea, hypocapnea, and slight hypertension. Which of the following is the least appropriate treatment for this patient?
- A.
Lorazepam, 1-mg, PO
- B.
Coaching the patient to slow his breathing down
- C.
Placing the patient in a position of comfort
- D.
Supplemental oxygen
Correct Answer
D. Supplemental oxygenExplanation
Supplemental oxygen is the least appropriate treatment for this patient because his oxygenation status is not compromised. The patient's skin is pink, indicating good perfusion, and his breathing is fast with adequate tidal volume, suggesting that he is effectively oxygenating. Additionally, the patient's symptoms are consistent with a panic attack, which is a psychological condition rather than a respiratory or oxygenation issue. Therefore, providing supplemental oxygen would not address the underlying cause of the patient's symptoms and would not be the most appropriate treatment option.Rate this question:
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- 17.
Which of the following is the least reliable form of confirming placement of an ET tube?
- A.
Direct visualization of the tube passing into the glottic opening
- B.
Regular capnographic waveform that coincides with ventillations
- C.
Presence of bilateral lung sounds
- D.
Failure of the EDD to reinflate after squeezing
Correct Answer
C. Presence of bilateral lung soundsExplanation
The presence of bilateral lung sounds is the least reliable form of confirming placement of an ET tube because it does not guarantee that the tube is in the correct position. Lung sounds can be heard even if the tube is in the esophagus or if it is only partially obstructing the trachea. Therefore, relying solely on the presence of bilateral lung sounds may lead to a false confirmation of tube placement. Other methods such as direct visualization, capnographic waveform, and EDD reinflation are more accurate and should be used in conjunction with lung sounds for confirmation.Rate this question:
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- 18.
Your female patient is 5 foot, 6 inches tall. Which size King LT tube is most appropriate for this patient?
- A.
3
- B.
4
- C.
5
- D.
6
Correct Answer
B. 4Explanation
Based on the patient's height of 5 foot, 6 inches, the most appropriate size King LT tube would be size 4. This is because the King LT tube size is determined based on the patient's height, with size 4 typically recommended for patients between 5 foot and 6 foot tall. Therefore, size 4 would be the correct choice for this patient.Rate this question:
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- 19.
Which of the following is NOT required when administering etomidate to a patient in respiratory failure?
- A.
Two large bore IVs
- B.
Two EMS providers trained at the ALS level or higher
- C.
Airway and resucitative equipment on hand and ready to go
- D.
Medical command orders
Correct Answer
A. Two large bore IVsExplanation
When administering etomidate to a patient in respiratory failure, two large bore IVs are not required. Etomidate is a short-acting intravenous anesthetic used for induction of anesthesia or sedation. While it is important to have two EMS providers trained at the ALS level or higher, airway and resuscitative equipment on hand and ready to go, and medical command orders, the administration of etomidate does not specifically require two large bore IVs. These IVs may be necessary for other purposes, but they are not directly related to the administration of etomidate in this scenario.Rate this question:
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- 20.
Suppose upon assessment of your patient, you find he has an oxygen saturation of 98%, yet still appears to be in respiratory distress. Which of the following conditions is least likely to be cause for this?
- A.
Sepsis
- B.
Leukemia
- C.
Anemia
- D.
Cerebrovascular Accident
Correct Answer
D. Cerebrovascular AccidentExplanation
A cerebrovascular accident, also known as a stroke, is least likely to be the cause of respiratory distress in this scenario. Respiratory distress is typically caused by problems in the lungs or airways, such as sepsis (a severe infection), leukemia (a type of blood cancer), or anemia (a decrease in red blood cells). A stroke primarily affects the brain and may cause neurological symptoms such as weakness or paralysis, but it is less likely to directly cause respiratory distress.Rate this question:
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