Airway And Breathing IV
(40).webp "Airway And Breathing IV - Quiz")
Yet another installment on airway and breathing. This time covering the remainder of Breon's notes from way long ago.
Questions and Answers
- 1.
An abnormal deficiency in the concentration of oxygen in the blood is __________.
- A.
Hypocarbia
- B.
Hypoventilation
- C.
Hypoxemia
- D.
Hypoxia
Correct Answer
C. HypoxemiaExplanation
Hypoxemia refers to an abnormal deficiency in the concentration of oxygen in the blood. It occurs when there is a low level of oxygen saturation in the bloodstream, which can lead to various symptoms and health complications. Hypocarbia refers to a low level of carbon dioxide in the blood, hypoventilation refers to inadequate breathing, and hypoxia refers to a deficiency in oxygen supply to the tissues. However, hypoxemia specifically focuses on the low concentration of oxygen in the blood.Rate this question:
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- 2.
Which of the following is the leading cause of airway obstruction in an unresponsive patient?
- A.
Edema
- B.
Steak
- C.
Tongue
- D.
Vomitus
Correct Answer
C. TongueExplanation
When a patient becomes unresponsive, the muscles in their body relax, including the muscles in the tongue. This relaxation can cause the tongue to fall back and block the airway, leading to airway obstruction. Edema refers to swelling, which can also cause airway obstruction but is not specifically mentioned in the question. Steak and vomitus can cause airway obstruction in a conscious patient, but in an unresponsive patient, the leading cause is the tongue falling back and blocking the airway.Rate this question:
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- 3.
Which of the following airway structures is unique in that it has a dual function with both the respiratory system and the digestive system?
- A.
Larynx
- B.
Pharynx
- C.
Trachea
- D.
Vallecula
Correct Answer
B. PharynxExplanation
The pharynx is the correct answer because it is a shared structure between the respiratory system and the digestive system. It serves as a passage for both air and food, allowing air to pass through to the trachea and food to pass through to the esophagus. The larynx is primarily involved in the respiratory system, the trachea is solely involved in the respiratory system, and the vallecula is a depression in the pharynx, not a separate structure.Rate this question:
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- 4.
Which of the following lung sounds is associated with fluid accumulating in the smaller airway passages heard on inspiration?
- A.
Crackles (rales)
- B.
Rattles (rhonchi)
- C.
Stridor
- D.
Wheezes
Correct Answer
A. Crackles (rales)Explanation
Crackles (rales) are abnormal lung sounds that are associated with fluid accumulating in the smaller airway passages. These sounds are often heard on inspiration and can indicate conditions such as pneumonia, heart failure, or pulmonary edema. Crackles are characterized by a popping or bubbling sound and can be heard with a stethoscope during a physical examination of the lungs.Rate this question:
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- 5.
Which supplemental oxygen delivery system is capable of delivering fairly precise concentrations of oxygen?
- A.
Nasal cannula
- B.
Nonrebreather mask
- C.
Small-volume nebulizer
- D.
Venturi mask
Correct Answer
D. Venturi maskExplanation
The Venturi mask is capable of delivering fairly precise concentrations of oxygen. It works by mixing oxygen with room air through a series of small holes and valves, allowing the healthcare provider to adjust the oxygen concentration to the desired level. This makes it a suitable option for patients who require specific oxygen concentrations, such as those with chronic respiratory conditions. The other options, such as the nasal cannula, nonrebreather mask, and small-volume nebulizer, may not provide as accurate or adjustable oxygen concentrations.Rate this question:
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- 6.
Which of the following is the MOST critical lifesaving maneuver that you can perform as a paramedic?
- A.
Initiate fluid boluses
- B.
Establishing and maintaining a clear airway
- C.
Applying traction to bilateral femur fractures
- D.
Identifying STEMI on a 12-lead ECG
Correct Answer
B. Establishing and maintaining a clear airwayExplanation
Establishing and maintaining a clear airway is the most critical lifesaving maneuver that a paramedic can perform because it ensures that the patient is able to breathe properly. Without a clear airway, the patient may suffer from respiratory distress or even stop breathing altogether, leading to a life-threatening situation. By clearing the airway of any obstructions and maintaining it, the paramedic can ensure that the patient is able to breathe and receive the necessary oxygen to sustain life. This maneuver takes priority over other interventions as it directly addresses the most immediate threat to the patient's life.Rate this question:
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- 7.
All of the following are commonly neglected skills related to airway management EXCEPT:
- A.
Failure to recognize respiratory distress and failure
- B.
Failure to use manual methods for opening the airway
- C.
Failure to make sure the patient is being appropriately oxygenated
- D.
Failure to ensure that oxygen tanks are changes when needed
- E.
Failure to do BLS before ALS skills
- F.
Failure to protect the airway
Correct Answer
D. Failure to ensure that oxygen tanks are changes when neededExplanation
The correct answer is "Failure to ensure that oxygen tanks are changed when needed." This answer is the exception because it does not pertain to a neglected skill related to airway management. The other options all involve important aspects of airway management that can be overlooked, such as recognizing respiratory distress, using manual methods to open the airway, ensuring proper oxygenation, performing BLS before ALS skills, and protecting the airway.Rate this question:
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- 8.
Which of the following is the LEAST concern when assessing breathing as part of the initial assessment?
- A.
Rate
- B.
Effort
- C.
Regularity
- D.
Odor
Correct Answer
D. OdorExplanation
When assessing breathing as part of the initial assessment, the least concern would be odor. While rate, effort, and regularity are important factors to consider in evaluating a person's breathing, odor is not typically a significant concern in this context. Odor may be relevant in other assessments, such as assessing for potential infections or respiratory conditions, but it is not a primary consideration when initially assessing breathing.Rate this question:
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- 9.
Suppose A represents normal breathing. Which of the following breathing patterns represents bradypnea?
- A.
B
- B.
C
- C.
D
- D.
E
- E.
F
- F.
G
- G.
H
- H.
I
- I.
J
Correct Answer
A. BExplanation
Bradypnea is a medical term used to describe abnormally slow breathing. In the given options, option B is the correct answer because it represents a slower breathing pattern compared to normal breathing (option A).Rate this question:
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- 10.
Suppose A represents normal breathing. Which of the following breathing patterns represents Cheyne-Stokes respirations?
- A.
B
- B.
C
- C.
D
- D.
E
- E.
F
- F.
G
- G.
H
- H.
I
- I.
J
Correct Answer
F. GExplanation
Cheyne-Stokes respirations are characterized by a cyclical pattern of gradually increasing and then decreasing depth of breathing, followed by a period of apnea. In option G, there is a clear pattern of gradually increasing and then decreasing depth of breathing, with a period of apnea between each cycle. Therefore, option G represents Cheyne-Stokes respirations.Rate this question:
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- 11.
Suppose A represents normal breathing. Which of the following breathing patterns represents Biot's respirations?
- A.
B
- B.
C
- C.
D
- D.
E
- E.
F
- F.
G
- G.
H
- H.
I
- I.
J
Correct Answer
H. I -
- 12.
Suppose A represents normal breathing. Which of the following breathing patterns represents hyperpnea?
- A.
B
- B.
C
- C.
D
- D.
E
- E.
F
- F.
G
- G.
H
- H.
I
- I.
J
Correct Answer
C. DExplanation
Hyperpnea is a breathing pattern characterized by an increase in the depth and rate of breathing. Option D represents hyperpnea because it shows an increase in both the depth and rate of breathing compared to normal breathing represented by option A.Rate this question:
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- 13.
Suppose A represents normal breathing. Which of the following breathing patterns represents Kussmaul's respirations?
- A.
B
- B.
C
- C.
D
- D.
E
- E.
F
- F.
G
- G.
H
- H.
I
- I.
J
Correct Answer
G. HExplanation
Kussmaul's respirations are characterized by deep, labored breathing. In this breathing pattern, the breaths are abnormally deep, rapid, and may be accompanied by a fruity or acetone-like odor. The correct answer, H, represents Kussmaul's respirations because it is the only option that describes abnormal breathing patterns, which is consistent with Kussmaul's respirations.Rate this question:
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- 14.
Suppose A represents normal breathing. Which of the following breathing patterns represents sighing?
- A.
B
- B.
C
- C.
D
- D.
E
- E.
F
- F.
G
- G.
H
- H.
I
- I.
J
Correct Answer
D. E -
- 15.
Suppose A represents normal breathing. Which of the following breathing patterns represents air trapping?
- A.
B
- B.
C
- C.
D
- D.
E
- E.
F
- F.
G
- G.
H
- H.
I
- I.
J
Correct Answer
E. F -
- 16.
Suppose A represents normal breathing. Which of the following breathing patterns represents ataxia?
- A.
B
- B.
C
- C.
D
- D.
E
- E.
F
- F.
G
- G.
H
- H.
I
- I.
J
Correct Answer
I. JExplanation
Breathing pattern J represents ataxia. Ataxia is a neurological condition that affects coordination and balance. In the context of breathing, ataxic breathing is characterized by irregular and unpredictable breathing patterns, with varying depths and rates of breaths. This can include periods of apnea (temporary cessation of breathing) followed by rapid, shallow breaths. Therefore, breathing pattern J is the correct answer as it represents ataxia.Rate this question:
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- 17.
Suppose A represents normal breathing. Which of the following breathing patterns represents tachypnea?
- A.
B
- B.
C
- C.
D
- D.
E
- E.
F
- F.
G
- G.
H
- H.
I
- I.
J
Correct Answer
B. CExplanation
Tachypnea refers to rapid breathing, which is characterized by an increased respiratory rate. In the given options, option C represents tachypnea as it indicates a breathing pattern that is faster than normal.Rate this question:
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- 18.
Which of the following is NOT a typical descriptor for respiratory effort?
- A.
Work of breathing
- B.
Accessory muscle use
- C.
External assistance
- D.
Nasal flaring
- E.
Chest excursion
- F.
Pursed-lip breathing
- G.
Retractions
- H.
Positioning
- I.
Adventitious sounds
Correct Answer
C. External assistanceExplanation
External assistance is not a typical descriptor for respiratory effort. The other options such as work of breathing, accessory muscle use, nasal flaring, chest excursion, pursed-lip breathing, retractions, positioning, and adventitious sounds are all commonly used to describe the effort exerted by an individual during respiration. External assistance refers to the use of devices or interventions from outside sources to aid in breathing, which is not a direct measure of the individual's own respiratory effort.Rate this question:
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- 19.
Which of the following is not an ideal place to auscultate lung sounds during a time-limited physical exam in the back of an ambulance?
- A.
Anterior chest, midclavicular, 1 inch below the collarbone
- B.
Lateral chest, fifth intercostal space, midaxillary
- C.
Posterior bases, back below the shoulder blades
- D.
Inferior thorax, adjacent to the 8th intercostal border
Correct Answer
D. Inferior thorax, adjacent to the 8th intercostal borderExplanation
The correct answer is "Inferior thorax, adjacent to the 8th intercostal border." This is not an ideal place to auscultate lung sounds during a time-limited physical exam in the back of an ambulance because it is not a typical location for listening to lung sounds. The other options are all commonly used areas for auscultation and are more likely to provide accurate lung sound assessment.Rate this question:
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- 20.
Crackles indicates a fluid problem in the lungs that interferes with the diffusion of oxygen, but not so much the diffusion of carbon dioxide.
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
Crackles are abnormal lung sounds that indicate the presence of fluid in the lungs. This fluid can interfere with the diffusion of oxygen, making it harder for oxygen to pass from the lungs into the bloodstream. However, the diffusion of carbon dioxide, which is the waste product that needs to be removed from the body, is not as affected by the presence of fluid in the lungs. Therefore, it is true that crackles indicate a fluid problem in the lungs that interferes with the diffusion of oxygen, but not so much the diffusion of carbon dioxide.Rate this question:
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- 21.
The hypocapnia associated with cardiac arrest patients can create a false negative confirmation of ETT placement.
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
The statement is true because hypocapnia, which is a decrease in carbon dioxide levels in the blood, can occur in cardiac arrest patients. This can lead to a false negative confirmation of endotracheal tube (ETT) placement. Hypocapnia causes vasoconstriction and reduces blood flow to the lungs, making it difficult to detect the presence of exhaled carbon dioxide, which is typically used to confirm correct ETT placement. Therefore, it is important to consider this possibility and use additional methods to confirm ETT placement in cardiac arrest patients.Rate this question:
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- 22.
Which of the following carboxyhemoglobin values is normal for smokers?
- A.
0-5%
- B.
5-10%
- C.
10-15%
- D.
>15%
Correct Answer
B. 5-10%Explanation
Carboxyhemoglobin is a compound formed when carbon monoxide binds to hemoglobin in the blood. Smokers have higher levels of carboxyhemoglobin due to the inhalation of carbon monoxide in cigarette smoke. A normal carboxyhemoglobin value for smokers is typically between 5-10%. This range indicates that the individual has been exposed to some level of carbon monoxide but is not experiencing dangerously high levels.Rate this question:
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- 23.
Per PA BLS protocol 227, measurements of SpCO should be used to drive oxygenation decisions.
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
According to PA BLS protocol 227, measurements of SpCO should not be used to drive oxygenation decisions.Rate this question:
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- 24.
Per Fick's principle, there are three main factors related to respiratory pathophysiology. These are (select all):
- A.
Ventilation
- B.
Diffusion
- C.
Circulation
- D.
Perfusion
Correct Answer(s)
A. Ventilation
B. Diffusion
D. PerfusionExplanation
Per Fick's principle, ventilation, diffusion, and perfusion are the three main factors related to respiratory pathophysiology. Ventilation refers to the movement of air in and out of the lungs, diffusion is the process by which oxygen and carbon dioxide are exchanged between the alveoli and the blood, and perfusion is the flow of blood through the pulmonary capillaries. These three factors work together to ensure efficient gas exchange in the lungs.Rate this question:
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- 25.
Which of the following is NOT a complication associated with pulmonary aspiration?
- A.
May stimulate a spontaneous pneumothorax
- B.
May occlude airway and cause hypoventilation of distal lung tissue
- C.
May damage lung parachyma
- D.
May result in pneumonia
Correct Answer
A. May stimulate a spontaneous pneumothoraxExplanation
Pulmonary aspiration refers to the inhalation of foreign material into the lungs. It can lead to various complications, such as occlusion of the airway and hypoventilation of distal lung tissue, which can cause respiratory distress. It can also damage the lung parenchyma, leading to inflammation and impaired lung function. Additionally, aspiration can result in pneumonia, as the inhaled material can introduce bacteria into the lungs. However, it is not associated with stimulating a spontaneous pneumothorax, which is the abnormal collection of air in the pleural space.Rate this question:
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- 26.
There is little risk associated with the placement of a chest needle following proper technique on a patient that you thought had a tension pneumothorax, but in fact did not.
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
The statement is true because if a patient is suspected to have a tension pneumothorax and a chest needle is placed using proper technique, there is minimal risk involved. This is because the procedure is performed with caution and precision, ensuring that the needle is inserted in the correct location to relieve any potential tension. However, it is important to note that this answer assumes the proper technique is followed and the healthcare professional is skilled in performing the procedure.Rate this question:
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- 27.
Which basic airway management approach is most appropriate on an unconcious patient with suspected cervical spine injury?
- A.
Head tilt, chin lift
- B.
Modified jaw thrust
- C.
Sellick maneuver
- D.
Extended jaw thrust
Correct Answer
B. Modified jaw thrustExplanation
The modified jaw thrust is the most appropriate basic airway management approach for an unconscious patient with a suspected cervical spine injury. This technique involves using the fingers to lift the jaw forward without tilting the head, which helps to open the airway while minimizing movement of the neck. The head tilt, chin lift maneuver and extended jaw thrust may cause unnecessary movement of the cervical spine, potentially worsening the injury. The Sellick maneuver, also known as cricoid pressure, is used to prevent regurgitation during intubation and is not specifically indicated for managing the airway in a patient with a cervical spine injury.Rate this question:
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- 28.
Should you attempt to place a nasopharyngeal airway in a patient with suspected basilar skull fracture?
- A.
Yes
- B.
No
Correct Answer
B. NoExplanation
Placing a nasopharyngeal airway in a patient with suspected basilar skull fracture is not recommended. A basilar skull fracture can lead to leakage of cerebrospinal fluid (CSF) through the nose or ears. Inserting a nasopharyngeal airway can potentially cause further damage to the skull base and exacerbate CSF leakage, leading to complications such as meningitis. It is important to prioritize the patient's safety and consider alternative methods for airway management in this scenario.Rate this question:
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- 29.
What is the maximum time per pass when suctioning a correctly placed ET tube?
- A.
5 or fewer seconds
- B.
5-10 seconds
- C.
10-15 seconds
- D.
20 seconds
Correct Answer
A. 5 or fewer secondsExplanation
When suctioning a correctly placed ET tube, it is important to minimize the amount of time the suction is applied to prevent complications such as hypoxia or damage to the airway. Suctioning for 5 or fewer seconds ensures that the procedure is quick and efficient, reducing the risk of any adverse effects.Rate this question:
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- 30.
Which of the following oxygen delivery devices delivers 35%-60% oxygen when set to a flow rate of 6-10 L/min?
- A.
Nasal cannula
- B.
Simple face mask
- C.
Venturi mask
- D.
Partial rebreather mask
Correct Answer
D. Partial rebreather maskExplanation
Nasal Cannulas
- 25%-45% oxygen
- Flow rate 1-6 L/min
Simple face mask
- 40%-60% oxygen
- Flow rate 6 -10 L/min
Partial Rebreather Mask
- 35%-60% oxygen
- Flow rate 6-10 L/min
Nonrebreathing Mask
- 80%-95% oxygen (yes, text says 100% but this is very hard to achieve due to poor mask seal around face)
- Flow rate10-15 L/min –generally do not use below 12 L/min, make sure reservoir bag stays inflated
Venturi mask
- 24%-50% oxygen
- Flow rate: 4-8 L/minRate this question:
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- 31.
All of the following are examples of supraglottic airways EXCEPT:
- A.
Laryngeal Mask Airway
- B.
Gum Elastic Bougie
- C.
King LTD
- D.
Combitube
Correct Answer
B. Gum Elastic BougieExplanation
The gum elastic bougie is not an example of a supraglottic airway. Supraglottic airways are devices that are placed above the glottis to maintain an open airway during anesthesia or in emergency situations. The laryngeal mask airway, King LTD, and Combitube are all examples of supraglottic airways commonly used in clinical practice. However, the gum elastic bougie is a device used to assist with difficult intubation by guiding the endotracheal tube into the trachea.Rate this question:
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- 32.
Which of the following is a contraindication for the use of a dual lumen airway?
- A.
Provider not trained in proper installation and use
- B.
Patient's under 4-5 feet tall or under 14 years old
- C.
Caustic ingestion
- D.
Mandibular trauma
Correct Answer
D. Mandibular traumaExplanation
Mandibular trauma is a contraindication for the use of a dual lumen airway because it can result in a compromised airway. The mandible, or jawbone, plays a crucial role in maintaining the patency of the airway. If the mandible is fractured or injured, it can lead to displacement or obstruction of the airway, making the use of a dual lumen airway ineffective or potentially harmful. Therefore, it is important to avoid using a dual lumen airway in patients with mandibular trauma and consider alternative airway management techniques.Rate this question:
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- 33.
Which of the following is NOT a contraindication for placing a Kind LTD?
- A.
Three failed ETT placement attempts
- B.
Ingestion of bleach or Drain-O
- C.
Patients with known esophageal disease
- D.
Intact gag reflex
Correct Answer
A. Three failed ETT placement attemptsExplanation
Three failed ETT placement attempts is not a contraindication for placing a Kind LTD. A Kind LTD (Laryngeal Tube Device) is a supraglottic airway device used for emergency airway management. It is inserted blindly into the oropharynx, providing an alternative to endotracheal intubation. While failed ETT placement attempts may indicate difficulty in intubation, it does not specifically contraindicate the use of a Kind LTD. The other options listed, ingestion of bleach or Drain-O, patients with known esophageal disease, and intact gag reflex, are all contraindications for placing a Kind LTD.Rate this question:
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- 34.
The LEMON mnemonic is used to predict the ease of intubation. The letters of LEMON stand for:
- A.
Look, Evaluate, Mallampati Score, Obstructions, Neck Mobility
- B.
Lift, Expose, Maneuver, Observe, Needed
- C.
Larynx, Epiglottis, Mandible, Oropharynx, Nasal Cavity
- D.
Looseness, Environment, Motor Response, Olfaction, Nocioceptors
Correct Answer
A. Look, Evaluate, Mallampati Score, Obstructions, Neck MobilityExplanation
The correct answer is Look, Evaluate, Mallampati Score, Obstructions, Neck Mobility. The LEMON mnemonic is a systematic approach used to assess the ease of intubation. It reminds healthcare providers to look for any potential difficulties or abnormalities in the airway, evaluate the patient's condition and medical history, assess the Mallampati score (which evaluates the visibility of the back of the throat), check for any obstructions or anatomical abnormalities, and assess the patient's neck mobility. This mnemonic helps guide clinicians in assessing and predicting the ease of intubation in order to ensure patient safety during the procedure.Rate this question:
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- 35.
A sufficiently bad LEMON assessment is enough to justify starting with a backup airway device for airway management in a unconscious, respiratory failure patient.
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
A LEMON assessment is a systematic approach used to evaluate the likelihood of difficult airway management. If the assessment indicates that the airway is likely to be difficult, it is necessary to have a backup airway device readily available for the unconscious patient with respiratory failure. Therefore, a sufficiently bad LEMON assessment justifies starting with a backup airway device, making the statement true.Rate this question:
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- 36.
The EDD (esophageal detector device) can only work after the ETT cuff is inflated.
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
Must be done with the cuff deflated.Rate this question:
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- 37.
Some ETT tube designs allow the conscious patient to talk while intubated.
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
ETT (Endotracheal Tube) is a tube that is inserted into the trachea to maintain a patient's airway during surgery or other medical procedures. The purpose of intubation is to ensure that the patient can breathe properly, and it typically involves the use of general anesthesia to induce unconsciousness. Therefore, it is not possible for a conscious patient to talk while intubated. Hence, the correct answer is False.Rate this question:
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- 38.
What procedure is a BAM used for?
- A.
Digital intubation
- B.
Nasotracheal intubation
- C.
Crichothyrotomy
- D.
Orotracheal intubation
Correct Answer
B. Nasotracheal intubationExplanation
A BAM (Bougie-Assisted Nasotracheal Intubation) is used for nasotracheal intubation. This procedure involves inserting a thin, flexible tube through the nose and into the trachea to establish an airway. It is commonly used in situations where oral intubation is not feasible or contraindicated, such as in patients with facial trauma or limited mouth opening. The bougie, a rigid stylet, is used to guide the endotracheal tube into the trachea through the nasal passage.Rate this question:
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- 39.
What Mallampati score would you assign to a patient whose soft and hard palate and base of the uvula are visible, but withou any visibility of the tonsils?
- A.
Class 1
- B.
Class 2
- C.
Class 3
- D.
Class 4
Correct Answer
C. Class 3Explanation
A Mallampati score is used to assess the visibility of certain structures in the mouth to predict the difficulty of intubation during anesthesia. In Class 1, the soft and hard palate, uvula, and tonsils are all visible. In Class 2, the soft and hard palate, uvula, and base of the tonsils are visible. In Class 3, only the soft and hard palate and base of the uvula are visible, without any visibility of the tonsils. Therefore, the correct answer is Class 3 for a patient whose soft and hard palate and base of the uvula are visible, but without any visibility of the tonsils.Rate this question:
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- 40.
A patient assessed to have a Class 4 airway per the Mallampati scoring scheme is likely to be a more difficult to intubate that a patient assessed to have a Class 2 airway.
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
Increased number = increased difficulty.Rate this question:
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- 41.
A patient assessed to have a Class 4 airway per the Mallampati scoring scheme is likely to be a more difficult to intubate that a patient assessed to have a Class 2 airway.
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
Increased number = increased difficulty.Rate this question:
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