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Airway Management and Respiratory Emergencies, Exams of Nursing

Various aspects of airway management and respiratory emergencies, including identifying and responding to airway obstructions, ventilation techniques, and common respiratory conditions. It provides information on topics such as the anatomy and physiology of the respiratory system, signs and symptoms of respiratory distress, and appropriate interventions for different scenarios. The document aims to equip readers with the knowledge and skills necessary to effectively assess and manage respiratory emergencies in a variety of settings, from pre-hospital care to in-hospital treatment. By studying this document, readers can gain a deeper understanding of the respiratory system, common respiratory pathologies, and the principles of effective airway management, which are crucial for providing high-quality patient care.

Typology: Exams

2023/2024

Available from 09/17/2024

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Download Airway Management and Respiratory Emergencies and more Exams Nursing in PDF only on Docsity! Fisdap/NREMT Respiratory Practice Questions with 100 % Verified Solutions Where does the stimulus to breathe originate? A) spinal cord B) diaphragm C) heart D) brainstem - Solution D) brainstem What is the proper way to measure an oropharyngeal airway? A) the nose to the xiphoid process B) from the center of the mouth to the angle of the jaw C) from the tip of the nose to the lobe of the ear D) by the size of the patient's thumb - Solution B) from the center of the mouth to the angle of the jaw During respiration, where does the process of gas exchange occur? A) trachea B) alveoli C) epiglottis D) bronchioles - Solution B) alveoli A conscious 32 y/o patient complains of difficulty breathing. He is coughing while pointing to his throat. What should you do? A) give four strong blows to the back B) place him supine and begin CPR C) encourage him to keep coughing D) administer abdominal thrusts - Solution C) encourage him to keep coughing A 34 y/o female has fallen from a height of 10 feet. She is unresponsive with snoring respirations. What should you do? A) use the jaw-thrust maneuver B) support her head and neck with a rolled towel C) attempt the chin lift maneuver D) apply a certerm-5vical collar - Solution A) use the jaw-thrust maneuver How much oxygen will a pocket mask on room air deliver? A) 92% B) 17% C) 10% D) 23% - Solution B) 17% An unresponsive 44 y/o male has an oral airway and is being ventilated. He suddenly regains consciousness and starts to gag. What should you do? A) insert a nasal airway B) request ALS to sedate the patient C) remove the airway and apply high-flow oxygterm-5en D) suction the airway and leave the adjunct in place - Solution C) remove the airway and apply high-flow oxygen Which of the following is a musical, squeaking or whistling sound heard on inspiration and expiration while auscultatingterm-67 lung fields? A) gurgling B) snoring C) stridor D) wheezing - Solution D) wheezing A 29 y/o male crashed his motorcycle. He is unconscious and the lower portion of his jaw is torn from his face. He has gurgling respirations with bleeding into the throat. What should you do? A) insert an OPA B) perform a head tilt-chin lift and apply a nonrebreather mask C) apply a nasal cannula and suction as needed D) apply a c-collar and administer blow-by oxygen - Solution C) apply NC and suction as needed An OPA is used to lift the tongue and requires supporting structures of the jaw, so an OPA would be ineffective for this patient. Oxygen should be administered, however, and the NC will provide greater concentration than any of the other listed methods. You find a patient in the tripod position. What should you suspect? A) a cardiac emergency B) GI distress C) respiratory distress D) a TIA - Solution C) respiratory distress D) remove the pieces of teeth with a finger sweep - Solution C) roll him onto his side A patient should not be suctioned for longer than 10 seconds. If you have been suctioning for longer than 10 seconds, you should pause and administer two rescue breaths before resuming suction. A 22 y/o intoxicated male responds to voice by moaning. You note vomit in his airway. What should you do? A) suction the mouth B) insert a nasal airway C) turn the patient on his side D) manually stabilize c-spine - Solution A) suction the mouth A 24 y/o male is lying supine and is unresponsive. You have opened his airway with a head tilt-chin lift maneuver and determined that he is apneic with a bradycardic pulse. You attempt to ventilate, but are unsuccessful. What should you do? A) check for a carotid pulse B) begin continuous chest compressions C) reposition the airway and give two ventilations D) attempt to give 2 more forceful ventilations - Solution C) reposition the airway and give two ventilations What is the name of the tracheal ring that sits directly inferior to the larynx? A) cuneiform cartilage B) corniculate cartilage C) thyroid cartilage d) cricoid cartilage - Solution d) cricoid cartilage Which structure contains the vocal cords? A) larynx B) trachea C) pharynx D) sternum - Solution A) larynx How much air is inspired during a single inhalation? A) 200 mL B) 150 mL C) 500 mL D) 750 mL - Solution C) 500 mL A 33 y/o male has respirations of 22 breaths/min. How should you administer oxygen to him? A) NRB at 15 L/min B) simple rebreather mask at 4 L/min C) BVM at 8 L/min D) Venturi mask at 8 L/min - Solution A) NRB at 15 L/min What is the normal TV in an adult male? A) 1000 mL B) 350 mL C) 750 mL D) 500 mL - Solution D) 500 mL An unresponsive 64 y/o male has a stoma. He is supine and apneic. What should you do? A) assist his ventilations with an adult BVM and cover the stoma B) place a pediatric-sized BVM over the stoma and ventilate C) obtain a set of vitals and place an AED D) apply a c-collar and perform a jaw thrust maneuver - Solution B) place a pediatric-sized BVM over the stoma and ventilate A stoma is an artificial opening used as an airway. They can create a unique challenge when ventilating a patient. You should place a smaller size mask over the opening and attempt to ventilate. These airways often become clogged with mucus. Prepare to suction as needed. What is the name of the smooth, moist epithelial layer that covers the lungs? A) parietal peritoneum B) visceral pleura C) visceral peritoneum D) parietal pleura - Solution B) visceral pleura Why is it important to avoid touching the back of the throat when suctioning? A) it causes the upper airway to spasm uncontrollably B) it will cause contamination of the catheter C) tachycardia can occur due to vagus nerve stimulation D) it can stimulate the gag reflex and cause vomiting - Solution D) it can stimulate the gag reflex and cause vomiting Room air contains what percentage of oxygen? A) 21 B) 100 C) 36 D) 10 - Solution A) 21 A 7 y/o boy is found supine at the base of a 15 foot high jungle gym. His teacher is unsure if he fell from the equipment. Vital signs are BP 100/90, RR 0, pulse 42 bpm, SpO2 93%. What should you do? A) open his airway with a jaw thrust maneuver B) start CPR C) insert an OPA D) open his airway with a head tilt-chin lift maneuver - Solution A) open his airway with a jaw thrust maneuver The patient is not breathing, so you first need to ensure that he has an open airway. The jaw thrust would be most appropriate to reposition his airway because you cannot be sure that the patient did not fall from the playground equipment and sustain a c-spine injury. It might also be appropriate to insert an OPA, but the airway should be repositioned first. A 36 y/o male complains of a sore throat with drooling. He is having difficulty breathing with stridor. His skin is pink and hot to the touch. What should you suspect? A) pneumonia B) bronchitis C) epiglottitis D) tonsillitis - Solution C) epiglottitis What is oxygen deficiency in the body called? A) hypoxemia B) hyperoxia C) hypoxia D) hypercarbia - Solution C) hypoxia An 18 y/o female with a suspected c-spine injury has a significant amount of blood in her mouth. What should you do? If the patient cannot speak full sentences while responding to questions, you should suspect respiratory distress or cardiac compromise. This is a very important finding especially if the patient was resting when it started. If you are suctioning emesis out of a mouth that has chunks that are too large to fit into a Yankauer, it is okay to just use the suction tubing to suction the airway. A) true B) false - Solution B) false An 18 y/o male complains of bilateral chest pain. Lung sounds reveal coarse rhonchi throughout all fields. His skin color is pale and he is warm to the touch. Vitals are BP 124/90, pulse 88 bpm, RR 16 breaths/min, SpO2 96%. What should you suspect? A) pneumonia B) emphysema C) chronic bronchitis D) pulmonary edema - Solution A) pneumonia A lethargic 22 month old male presents with hoarseness and coughing. He has sternal retractions and his belly and chest move in opposite directions with each breath. He is breathing at a rate of 64 breaths/min. What should you suspect? A) cardiopulmonary failure B) cardiopulmonary arrest C) respiratory distress D) respiratory failure - Solution D) respiratory failure Which of the following is a sign or symptom of SARS? A) rash and sore throat B) high fever and diarrhea C) dark urine and jaundice D) persistent low grade fever - Solution B) high fever and diarrhea A 56 y/o male is sitting at the kitchen table in the tripod position. What should you do? A) apply oxygen by NRB at 10-15 L/min B) give oxygen via NC at 4-6 L/min C) not intervene as long as the patient is speaking D) perform an orotracheal intubation - Solution A) apply oxygen by NRB at 10-15 L/min A 33 y/o male is unconscious after attempting to hang himself. First responders have placed him supine on the ground. Vitals are BP 70/30, pulse 46 bpm, RR 4 breaths/min and shallow. What should you do? A) start CPR B) apply a cervical collar C) assist his ventilations D) insert an oral airway - Solution C) assist his ventilations What is the expected breathing rate for a child under the age of 8? A) 5-10 breaths/min B) 40-60 breaths/min C) 10-20 breaths/min D) 20-40 breaths/min - Solution D) 20-40 breaths/min A 60 y/o female is conscious but in acute respiratory distress. Respirations are rapid with clear, equal breath sounds. What should you do? A) use NC at 2 L/min B) assist her respirations with a BVM C) insert an oral airway D) provide oxygen by NRB mask - Solution D) provide oxygen by NRB mask A 56 y/o male has intercostal retractions and is in the tripod position. Vitals are BP 116/78, pulse 90 bpm, RR 32 breaths/min. What should you do? A) apply an NRB at 15 L/min B) administer albuterol C) administer oxygen by nasal cannula D) assist his ventilations - Solution D) assist his ventilations What is a hazardous, odorless gas resulting from incomplete combustion? A) carbon monoxide B) carbon dioxide C) nitrogen D) sarin - Solution A) carbon monoxide What is the average volume that you should give while ventilating a patient using a BVM? A) 400 mL B) 550 mL C) 500 mL D) 450 mL - Solution C) 500 mL A 97 y/o small and emaciated female complains of SOB. She is in the tripod position using NC at 3 L/min. Lung sounds are distant but clear. What should you suspect? A) emphysema B) asthma C) chronic bronchitis D) allergic reaction - Solution A) emphysema Which of the following is a sign of pneumonia? A) JVD B) productive cough C) distant lung sounds D) crackles - Solution B) productive cough What condition results when the alveoli collapse? A) pneumonia B) pneumothorax C) effusion D) atelectasis - Solution D) atelectasis A 19 y/o underweight female complains of difficulty breathing. She has been coughing up clear sputum and has bilateral rhonchi. She has a light coating of small crystalline granules on her arms and legs. Her father states "this SOB is different from normal". What should you suspect? A) CF B) pneumonia C) asthma attack D) COPD exacerbation - Solution A) CF What is the most appropriate method for opening the airway of a patent with a suspected c-spine injury? A) jaw thrust B) neck lift C) head tilt-chin lift D) head tilt, jaw thrust - Solution A) jaw thrust The tongue is often a source of airway obstruction; it falls back and occludes the: A) larynx B) trachea C) nasopharynx D) pharynx - Solution D) pharynx The lower airway ends at the alveoli, where gas exchange occurs. Oxygen moves to the HGB by passing through a semipermeable membrane. Where does this occur? A) capillary bed B) bronchioles C) capillary blood D) veinules - Solution A) capillary bed To create negative pressure in the thorax, the diaphragm contracts and moves ______. This action expands the volume of the thorax, allowing air to rush into the lungs. A) upward B) outward C) downward D) the diaphragm does not move, the chest wall expands - Solution C) downward When the diaphragm relaxes, it regains its domed shape. This action causes an increase in thoracic pressure, which forces air out of the lungs. To have air forced out of the lungs, the pressure in the thorax must rise above ________ pressure. A) transthoracic B) atmospheric C) transabdominal D) respiratory - Solution B) atmospheric Which of the following ventilatory techniques is likely to yield the LOWEST tidal volumes? A) one person BVM B) two person BVM C) flow-restricted oxygen-powered ventilatory device D) mouth-to-mask - Solution A) one person BVM In order to assist intubation, a paramedic may utilize Sellick's maneuver. In this procedure, which cartilage are you compressing? A) cricoid cartilage B) aryepiglottic cartilage C) thyroid cartilage D) hyoid cartilage - Solution A) cricoid cartilage You are transporting an elderly male patient in respiratory distress with a history of COPD. The patient has very shallow, rapid respirations with minimal chest wall motion and slight wheezing in the upper lung fields. Given this situation, what would you expect the arterial CO2 levels to be? A) not enough information to determine B) normal C) lowered D) elevated - Solution D) elevated You are transporting a 48 y/o male patient between medical facilities. During the history, you learn that the patient was involved in a fall at work and suffered a hip fracture and a head injury. The patient is now presenting with labored breathing at 30/min that has progressively worsened over the last 24 hours, a heart rate of 104 bpm, and a blood pressure of 98/70. On auscultation, you hear diffuse rales. The patient denies any complaints of pain other than those related to his recent fall. What is the most likely caused of the patient's respiratory distress? A) cardiogenic shock B) CHF C) acute bronchitis D) adult respiratory distress syndrome - Solution D) adult respiratory distress syndrome Which of the following is the most effective method for administering ventilations to an apneic patient? A) two person BVM B) FROPVD C) one person BVM D) mouth-to-mouth - Solution A) two person BVM A blue or grayish discoloration of the skin caused by lack of oxygen in the blood is called? A) suffocation B) cyanosis C) tinting D) none of the above - Solution B) cyanosis You are performing rescue breaths using an Ambu bag attached to 100% O2. After several breaths you notice the patient's SpO2 has dropped significantly. What should you do next? A) increase the rate of respirations B) reposition the patient's head C) change the seal on the mask D) remove the oral airway from the patient's mouth - Solution B) reposition the patient's head What is the proper amount of air that should be injected to the cuff of an ET tube? A) 1 cc B) 25 cc C) 10 cc D) 100 cc - Solution C) 10 cc The space between the base of the tongue and the epiglottis is called? A) tonsils B) cricoid C) larynx D) vallecula - Solution D) vallecula What condition is characterized by gasping, labored breathing, and strange vocalizations? A) agonal breaths B) stridor C) obstructed airway D) wheezing - Solution A) agonal breaths What is the maximum amount of time that may pass while attempting an intubation? A) 10 seconds B) 30 seconds C) 1 minute D) 10 minutes - Solution B) 30 seconds The Sellick maneuver is designed to: A) reduce the risk of vomiting B) move the vallecula into view C) move the carina into view D) collapse the trachea - Solution A) reduce the risk of vomiting After placing an ET tube and performing an auscultation, you notice lung sounds on the right are present, but lung sounds on the left are absent or diminished. What should you do? A) gently back the tube out 3-4 inches with the cuff inflated B) leave it and begin respirations C) deflate the cuff and back the tube out 3-4 cm D) remove the tube and reattempt the intubation - Solution C) deflate the cuff and back the tube out 3-4 cm Medical control has ordered you to assist a patient with a MDI. Before assisting this patient, you must ensure what? A) it is not leaking B) it is their medication and is within the expiration date C) they are not choking D) the hospital has more of the same medication for arrival - Solution B) it is their medication and is within the expiration date A spontaneous PTX is: A) more common in women than men B) caused by an impact to the chest that penetrates the lung C) a sudden accumulation of air in the pleural space D) only seen in people with COPD - Solution C) a sudden accumulation of air in the pleural space An intervention for someone who is apneic would be? A) OPA B) BVM mask C) intubation D) all of the above - Solution D) all of the above Paradoxical motion of the chest during exhalation is often caused by what type of injury? A) PTX B) hemopneumothorax C) clavicle fracture D) flail chest - Solution D) flail chest Cardiac arrest in children is most often caused by: A) chest trauma B) respiratory compromise C) hypovolemia D) irregular rhythm - Solution B) respiratory compromise The first step in artificial ventilation with a BVM in patients with no suspected trauma is to: A) position the mask correctly on the face using both hands B) place the patient's head in a hyperextended, sniffing position C) insert an airway adjunct and select the correct mask size D have an assistant squeeze the bag until the patient's chest rises - Solution B) place the patient's head in a hyperextended, sniffing position A 70 y/o patient is complaining of SOB. She has a history of emphysema. You should: A) withhold oxygen, since these patients do not respond to oxygen B) withhold oxygen, because you could eliminate the hypoxic drive C) administer oxygen, because in most cases, the hypoxic drive will not be a problem D) withhold oxygen, because these patients become apneic if they receive high-flow oxygen - Solution C) administer oxygen, because in most cases, the hypoxic drive will not be a problem A danger of using a rigid suction catheter with infants and young children is that stimulating the back of the throat can: A) cause changes in the heart rhythm B) be ineffective in suctioning C) lead to immediate vomiting D) cause the tongue to fall into the airway - Solution A) cause changes in the heart rhythm Your patient is a 35 y/o trauma victim who is not breathing. You are unable to open the airway by means of the jaw thrust and suctioning. You should: A) attempt a mouth-to-mask ventilation B) use the head tilt-chin lift maneuver C) ventilate with a BVM unit D) insert an airway through a tracheostomy - Solution D) use the head tilt- chin lift Which statement about inadequate breathing is correct? A) a breathing rate that is either too fast or too slow may indicate inadequate breathing B) inadequate breathing is much less common in small children than in older adults C) increased effort of breathing is often a normal sign and is not associated with inadequate breathing D) a patient breathing very deeply or shallowly is compensating for an abnormal respiratory rate - Solution A) a breathing rate that is either too fast or too slow may indicate inadequate breathing What is the structure that prevents food and liquid from entering the trachea during swallowing? A) larynx B) cricoid cartilage C) epiglottis D) diaphragm - Solution C) epiglottis What differences in a child's airway might make airway management more difficult than in an adult? A) smaller jaw, smaller teeth B) longer airway and small tongue C) a smaller jaw and proportionally larger tongue D) there are no anatomic differences that affect airway management in children vs. adults - Solution C) a smaller jaw and proportionally larger tongue A normal RR for an adult is _______ while a normal RR for a newborn is _______. A) 12-20 breaths/min and 30-60 breaths/min B) 12-20 breaths/min and 16-24 breaths/min C) 22-30 breaths/min and 50 breaths/min D) 8-16 breaths/min and 20-40 breaths/min - Solution A) 12-20 breaths/min and 30-60 breaths/min What is the FIRST thing you should do before inserting an NPA? A) tilt the head back, lube the airway, and insert it into the nostril B) put down the Ambu bag and start mouth to mouth resuscitation using a barrier device C) do a finger sweep of the mouth to make sure it is clear D) squeeze the bag much faster - Solution A) reposition the head and make sure you have a tight seal with the mask You're on scene at a high school football game. A football player collapses to the ground. He has a pulse, a RR of 4 breaths/min, breaths are very shallow, and he is grunting slightly. Airway management should include: A) doing a head tilt-chin lift maneuver, placing an oral airway, and transporting B) placing a nasal airway and a NRB with oxygen flow of 10 L/min C) performing manual ventilation with supplemental oxygen D) administering supplemental oxygen with a nasal cannula at 2 LPM - Solution C) performing manual ventilation with supplemental oxygen The lungs are made up of how many lobes? A) 5 B) 2 C) 4 D) 6 - Solution A) 5 You arrive on the scene of a car accident and are treating a 35 y/o patient. He is unresponsive and not breathing. You should open his airway by: A) doing the jaw thrust maneuver B) placing a cervical collar and then doing a head tilt-chin lift C) opening his mouth wide, while slightly hyperextending his neck D) doing the head tilt-chin lift - Solution A) doing the jaw thrust maneuver You have a patient who has a history of asthma and is having SOB. The patient has a doctor's prescription to take 4 puffs of an albuterol MDI every four hours as needed. Your local EMS policies allow you to help the patient self-administer the MDI. What side effect should you watch for from the MDI? A) sleepiness B) increased HR C) bradycardia D) vomiting - Solution B) increased HR You have an unresponsive patient with an intact gag reflex. You attempt to place a nasal airway in his right nostril, but you meet resistance and cannot insert. You should: A) try a smaller size B) push it in with more force C) try the other nostril and be sure you have lubricated the device D) switch to an oral airway - Solution C) try the other nostril and be sure you have lubricated the device You're treating an adult patient who is wearing an NRB. The reservoir bag collapses on inspiration. What action(s) should you take? A) switch to NC B) tell the patient to relax and breathe slower C) make sure the bag is connected to an O2 source and the flow is at least 10 L/min D) tell the patient to take deep breaths and blow out harder - Solution C) make sure the bag is connected to an O2 source and the flow is at least 10 L/min Symptoms of asthma most often include: A) wheezing, SOB, and coughing B) vomiting and confusion C) fever and runny nose D) headache - Solution A) wheezing, SOB, and coughing