FISDAP Airway Exam 2024 Entry with 100% Correct Answers, Exams of Nursing

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FISDAP Airway Exam 2024 Entry with

100% Correct Answers.

True or false: the lungs are completely equal in the midsaggital plane. - Correct Ans: ✔✔False, right lungs has 3 lobes, left lung only has 2 lobes. Together they have 5 total. Also, the right bronchi is inferior to the left bronchi. What are the structures of the lungs in order of ventilation? - Correct Ans: ✔✔bronchioles, and alveoli True or false: the lungs use muscles found in the lateral lobes to expand and contract? - Correct Ans: ✔✔False: the lungs are hollow organs and contain no muscles. When the diaphragm contracts it expands the thoracic cavity. The pleural space has a negative pressure and the lungs expand. This results in a slightly negative pressure (compared to the atmosphere) and air rushes in. True or false: Air rushes into the lungs because of negative pressure. - Correct Ans: ✔✔True, when the lungs expand, they are creating a vacuum because they are expanding the volume of the container. This increase in volume causes influx of air into the container until the pressure is equalized with the atmosphere. True or false: The parietal pleura lines the lungs and the visceral pleura lines the lungs. The space between is called the anterior pleura. -

Correct Ans: ✔✔False: the visceral pleura lines the lungs, the parietal pleura lines the body cavity and the pleural space is the space in between both where body fluid allows for both to smoothly glide. What muscles are involved in inhalation? - Correct Ans: ✔✔The diaphragm, cervical muscles (neck), intercostals, abdominal muscles, and pectoral muscles. What muscles are involved in expiration? - Correct Ans: ✔✔none, expiration (if done passively) is achieved by the relaxation of the diaphragm. What is the primary driver of respiration? (Why would we increase/decrease RR?) - Correct Ans: ✔✔The CSF in the brain has chemoreceptors sensitive to CO2. When there is too much CO2. The pH changes. These sensors feed back to the medulla oblongata, which stimulates the phrenic nerve which innervates the diaphragm. They cause an increase in activity of the diaphragm. This increases the RR which causes us to increase tidal volume. This means more CO2 is exhaled. And brings our pH back to normal. We also have the less sensitive hypoxic drive What is hypoxic drive? - Correct Ans: ✔✔Backup system to control respiration. Chemoreceptors in brain, aorta, and carotid arteries. But

they are "satisfied" by a small amount of O2, which means it is not as sensitive as pH control of CO What two areas of the brain are involved in respiration? - Correct Ans: ✔✔medulla-controls rhythm, initiates inspiration, sets base pattern for respirations, and stimulates diaphragm to contract. pons-changes depth of inspiration, expiration or both. True or false: arteries bring oxygenated blood to organs/capillaries - Correct Ans: ✔✔True in most cases with one exception. Arteries (away) bring blood away from the heart. Usually this is oxygenated blood. But the pulmonary arteries bring oxygen poor blood away from the heart, to the lungs to be oxygenated. What is the tidal volume? - Correct Ans: ✔✔amount of air moved in/out of lungs in single breath. Usually 500 ml in adult What is inspiratory reserve volume? - Correct Ans: ✔✔Deepest breath you can take after normal respiration What is expiratory reserve volume/Vital Capacity? - Correct Ans: ✔✔maximum amount you can breathe out after normal breath.

What is residual volume? - Correct Ans: ✔✔Remaining gas in lungs after exhalation. This is to keep lungs inflated What is dead space? What structures are considered part of dead space? - Correct Ans: ✔✔Part of respiratory system not involved in active respiration. Air moves through here but little to no respiration occurs. Mouth, trachea, bronchi and bronchioles considered dead space What is minute volume? What does it measure? - Correct Ans: ✔✔Minute volume = RR x tidal volume. Volume of air moving through lungs in 1 minute. Can be estimated quickly. Count RR rate. If normal check to see chest rise and fall (tidal volume). If chest rise and fall is weak and/or little air coming out of nose, then the person has small minute volume. Alveolar Minute Volume - Correct Ans: ✔✔Volume of air moved through lungs in 1 minute minus the dead space. Alveolar Minute Volume = (tidal volume - dead space) x RR Alveolar Ventilation - Correct Ans: ✔✔Volume of air that reaches alveoli. Alveolar ventilation = tidal volume - dead space

Name the characteristics of normal breathing - Correct Ans: ✔✔1. Normal rate (12-20)

2. regular pattern of inhalation/exhalation
3. clear bilateral lung sounds
4. regular and equal chest rise/fall
5. adequate depth (tidal volume) What are the characteristics of inadequate breathing (adults)? - Correct Ans: ✔✔Chapter 6
6. labored breathing (activating accessory muscles of respiration)
7. 12< or >20 breaths/minute
8. muscle retractions above clavicles or between ribs and below rib cage
9. pale/cyanotic skin
10. cool, damp, clammy skin
11. tripod position Chapter 10
12. 12< or 20>
13. irregular rhythm
14. diminished, absent or noisy auscultated breath sounds
15. reduced flow of expired air at nose/mouth
16. unequal or inadequate chest expansion

6. labored breathing
7. shallow depth
8. pale, cyanotic, cool or moist skin
9. retractions around ribs or above clavicles What are agonal gasps? What should you do if a pt has agonal gasps? - Correct Ans: ✔✔Pt in cardiac arrest has occasional gasping breaths because respiratory center in brain continues to send signals to breathing muscles. Artificial ventilations and chest compressions. Where are the alpha-1 receptors located? What is their effect? - Correct Ans: ✔✔location-blood vessels constricted blood vessels, skin is pale, cool, clammy They essentially increase BP Where are the Beta-1 receptors located? What is their effect? - Correct Ans: ✔✔location-heart effect- increased HR, increased force of contraction They essentially increase CO since CO = HR x SV

Where are the Beta-2 receptors located? What is their effect? - Correct Ans: ✔✔location - lungs (beta-2 is beta-tube) effect - bronchodilation (more air enters lungs) Where are the muscarinic receptors located? What is their effect? - Correct Ans: ✔✔location - heart effect - decreased HR, decreased force of contraction Muscarinic is parasympathetic system and do complete opposite of Beta-1 which is sympathetic What hormones activate the sympathetic nervous system? - Correct Ans: ✔✔Epineprhine and norepineprhine, which are released from he adrenal gland after stimulation by the sympathetic nervous system. These hormones stimulate heart and blood vessels. What is pathophysiology? - Correct Ans: ✔✔Study of how normal physiologic processes are affected by disease

What is respiratory compromise? - Correct Ans: ✔✔Inability of body to move gas effectively. Can result in decreased O2 (hypoxia) and increased CO2 (hypercarbia) What factors can impair ventilation? - Correct Ans: ✔✔1. Obstruction a. foreign objects - toys, food, teeth tongue etc b. physiological - induced by asthma, allergic rxns, infection

2. Impairment a. brain injury - to medulla/pons b. breathing muscles - diaphragm, c. nerves - neuromuscular disease like cerebral palsy can affect phrenic nerve
3. Other factors a. drugs - opioids can reduce RR b. loss of consciousness - can cause impaired ventilation c. trauma to chest wall - impair expansion of lungs What factors can impair respiration? - Correct Ans: ✔✔1. air (too little O2, too much CO2, toxins like CO)
4. impaired movement of gas across cell membrane (due to fluid in alveoli, mucus or other secretions)

3. Blood vessels become clogged (pulmonary embolism) What is the V/Q ratio? - Correct Ans: ✔✔How much gas is being moved effectively, versus how much blood is flowing around the alveoli where gas exchange (perfusion occurs) example - pt w/ pulmonary embolism might have regular ventilation, but blockage might impair exchange or perfusion. So Q is compromised. What happens in the body when there is respiratory compromise? - Correct Ans: ✔✔1. O2 levels fall and CO2 levels rise
4. Brain detects increase in CO
5. Body increases RR to try to manage CO2 levels
6. If increased respiration does not clear CO2, then blood is acidic
7. Blood o2 levels begin to fall, activating hypoxic drive
8. Cells that are able switch to anaerobic metabolism, producing lactic acid which further drops pH Glottis - Correct Ans: ✔✔Space between vocal cords and narrowest portion of adult's airway. Lateral borders of glottis are the vocal cords. They contain defense reflexes that protect lower airway, and spasm to prevent foreign substances from entering trachea

Carina - Correct Ans: ✔✔The branching area of the left and right bronchi Mediastinum - Correct Ans: ✔✔Area between the lungs which is surrounded by tough connective tissue. Contains heart, great vessels, esophagus, trachea, major bronchi and nerves. What is the term used to describe the amount of gas in air or dissolved in fluid? How is this relevant to ventilation? How is this relevant to respiration? - Correct Ans: ✔✔Partial pressure of gas, measured in mmHg. When lungs expand, partial pressure of air is less than that in atmosphere. Air rushes in during ventilation. Inhalation In oxygen rich lungs, PO2 > PO2 oxygen poor blood. O2 diffuses across alveoli into blood. In CO2 rich blood, PCO2 > PCO2 of lungs so CO2 diffuses from blood to lungs, and then is exhaled out What does it mean if someone says they are "keeping the airways patent"? - Correct Ans: ✔✔Keeping airway patent = maintaining open airway so air can enter/leave lungs freely

How is regulation of breathing different in those with COPD? What does research indicate about assisting in respiration with COPD sufferers? - Correct Ans: ✔✔COPD sufferers have difficulty removing CO2 from body. Overtime, respiratory control centers in brain adjust to this new baseline of CO2. In late stage COPD hypoxic drive is activated. Some research suggests that providing high flow O2 could negatively affect body's drive to breathe. What is Dyspnea? - Correct Ans: ✔✔Shortness of breath Signs and symptoms of Hypoxia? - Correct Ans: ✔✔Early

1. Restlessness
2. Irritability
3. apprehension
4. tachycardia
5. anxiety Late
6. mental status changes
7. weak (thready) pulse
8. cyanosis
9. Dyspnea

Cellular respiration (Metabolism)? - Correct Ans: ✔✔Cells take energy from nutrients through series of chemical processes. What is the difference between external and internal respiration? - Correct Ans: ✔✔External - process of breathing fresh air into respiratory system and exchanging O2 and CO2 between alveoli and blood in pulmonary capillaries internal - exchange of oxygen and CO2 between systemic circulatory systems and cells of body What are the critical periods in which a cell needs O2? - Correct Ans: ✔✔ 0 - 1 minute: cardiac irritability 0 - 4 minute: brain damage not likely 4 - 6 minute: brain damage possible 6 - 10 minute: brain damage likely more than 10: irreversible brain damage What is intrapulmonary shunting? What is the cause of it? - Correct Ans: ✔✔It's when blood enters lungs from right side of heart bypasses alveoli and return to left side of heart in unoxygenated state. Can be caused by nonfunctional alveoli due to diseases

What factors can lead to hypoxia due to circulatory compromise? - Correct Ans: ✔✔1. obstruction of blood flow due to a. pulmonary embolism b. pneumothorax c. heart failure d. cardiac tamponade

2. Decreased ability of blood to carry O a. blood loss b. anemia c. shock (vasodilatory shock) What is labored breathing? How do you tell someone has it? - Correct Ans: ✔✔Pt with inadequate breathing may appear to be working hard to breathe. Look for use of accessory muscles which are not used during normal breathing What are Cheyne-Stokes Respirations? What do they indicate? - Correct Ans: ✔✔Irregular respiration where pt breathes w/ increasing rate/depth that is followed by apnea, followed again by period of increasing rate/depth of respiration.

Can occur in people with strokes/head trauma What are ataxic respirations? - Correct Ans: ✔✔When pt has irregular ineffective respirations that may or may not have identifiable pattern What are Kussmaul respirations? What do they indicate? - Correct Ans: ✔✔Deep, rapid respirations Seen in pt's with metabolic acidosis, or those with diabetes You arrive on scene with a pt that is conscious but experiencing respiratory distress. What are two devices that can assess their respiration? - Correct Ans: ✔✔1. Pulse oximetry (measures O2 bound to hemoglobin)

2. Capnography device (measures end tidal CO2) How would you use a pulse oximeter? - Correct Ans: ✔✔1. clean pt's finger, and remove nail polish as needed. Place finger into probe and turn on.
3. Palpate radial pulse to ensure accuracy and correlation w/ pulse ox Normal reading between 98-100. Less than 90% pt requires treatment unless chronic condition. Oxygen applied when SPO2 drops below 94%

What can cause an inaccurate pulse ox? - Correct Ans: ✔✔1. Hypovolemia

2. Severe peripheral vasoconstriction (chronic hypoxia, smoking or hypothermia)
3. Time delay in detecting respiratory insufficiency
4. Dark/metallic nail polish
5. Dirty fingers
6. CO poisoning You encounter an unconscious pt. They have a pulse but inadequate breathing. What should you do if they are a) found in their bed or b) found underneath a tree? - Correct Ans: ✔✔You need to open the airway. If head trauma is suspected, use a jaw thrust. If head trauma is not suspected, use a head-tilt-chin-lift maneuver You encounter an unconscious pt. They have a pulse but inadequate respirations. You open the airway and find vomit. What should you do?

• Correct Ans: ✔✔You should suction the pt using How do you use suction equipment? - Correct Ans: ✔✔Can use rigid (Yankauer/tonsil tips) or nonrigid (french/whistle-tip). Use rigid unless you are suctioning a stoma or suctioning nose/liquid at back of mouth. Make sure to measure for proper size. Don't touch back of throat, don't want to activate gag reflex. Turn on to at least 300 mmHg. Attach appropriate tubing. Suction for no more than 15 seconds for adults, 10 seconds for children, and 5 seconds for infants. Rinse with water.

Asthma Signs and Symptoms? - Correct Ans: ✔✔1. wheezing on inspiration/expiration

2. Bronchospasm Anaphylaxis Signs and Symptoms? - Correct Ans: ✔✔1. Flushed skin/hives (urticaria)
3. Generalized edema
4. hypotension
5. laryngeal edema w/ dyspnea
6. wheezing/stridor Most rxns occur w/in 30 mins, administer epi using epipen. O2 also helps Bronchiolitis signs and symptoms? - Correct Ans: ✔✔1. Dyspnea
7. wheezing
8. Coughing
9. fever
10. dehydration
11. Tachypnea
12. Tachycardia

Often due to RSV infection, severe bronchiole inflammation. Occurs most frequently in infants, especially boys. Provide O2 therapy, allow pt to remain in comfortable position. Reassess frequently and be prepared to manage airway/positive pressure ventilation Bronchitis Signs and Symptoms - Correct Ans: ✔✔1. Chronic cough w/ sputum production

2. Wheezing
3. cyanosis
4. Tachypnea Type of COPD, can be due to tobacco. When excess mucus created. Carbon Monoxide Poisoning - Correct Ans: ✔✔1. flu like symptoms
5. headache
6. dizziness
7. fatigue
8. nausea
9. vomiting
10. chest pain remove them from scene, administer high flow o2 by nonrebreathing mask. May need full airway control w/ airway adjunct and bvm ventilation

CHF - Correct Ans: ✔✔1. Dependent edema

2. Crackles (pulmonary edema)
3. Orthopnea
4. Paroxysmal nocturnal dyspnea Common Cold - Correct Ans: ✔✔1. cough
5. runny/stuffy nose
6. sore throat COPD - Correct Ans: ✔✔slow process of dilation/disruption of airways/alveoli caused by chronic bronchial obstruction Croup - Correct Ans: ✔✔1. fever
7. barking cough
8. stridor
9. mostly seen in pediatric patients inflammation/swelling of pharynx, larynx and trachea. Typically seen in young children Treat w/ humidified O

Diphtheria - Correct Ans: ✔✔1. difficulty breathing/swallowing

2. sore throat
3. thick gray buildup in throat/nose
4. fever Emphysema - Correct Ans: ✔✔1. barrel chest
5. pushed lip breathing (pink puffers)
6. dyspnea on exertion
7. cyanosis
8. wheezing/decreased breath sounds Most common form of COPD. Loss of elastic material in lungs Epiglottitis - Correct Ans: ✔✔1. Dyspnea
9. High fever
10. stridor
11. drooling
12. difficulty swallowing
13. severe sore throat
14. tripod/sniffing position

Life threatening, caused by bacterial infection of epiglottis in children, risk of complete airway obstruction. Try to keep them from crying. Do not put anything in mouths. Provide quick transport to ER, focus on maintaining patent airway Flu - Correct Ans: ✔✔1. cough

2. fever
3. sore throat
4. fatigue Hay Fever - Correct Ans: ✔✔coldlike symptoms, caused by allergic response. Hyperventilation - Correct Ans: ✔✔over breathing to the point of arterial CO2 falls below normal. Alkalosis of blood occurs.
5. anxiety
6. dizziness
7. numbness
8. tingling of hands/feet
9. painful spasms of hand/feet
10. Pt's feel they cannot catch breathe

occurs when someone experiences psychological distress. Maybe be as high as 40 breaths/min or low as 20. Verbally instruct pt to slow breathing, and if that doesn't work, give supplemental O2 and provide transport Pertussis - Correct Ans: ✔✔1. coughing spells

2. whooping sound
3. fever airborne bacterial infection, coughing spells can last for a minute where pt turns red. May vomit/want to avoid eat/drink Pleural Effusion - Correct Ans: ✔✔collection of fluid outside lung on one or both sides that compresses lung/lungs and causes dyspnea. Lung sounds = decreased breath sounds from lungs where fluid is. Pt's feel better sitting upright, but only treatment is fluid removal in hospital Pneumonia - Correct Ans: ✔✔1. dyspnea
4. chills/fever
5. cough
6. green, red or rust colored sputum
7. localized wheezing or crackles

Infection of lungs, often secondary infection. Affects people who are chronically/terminally ill. May hear wheezing, crackles, friction rubs or rhonchi. Provide airway support, supplemental O2 pneumothorax - Correct Ans: ✔✔1. sudden chest pain w/ dyspnea

2. decreased breath sounds on affected side
3. subcutaneous emphysema
4. JVD Effects tall and thin people more. Caused when air leaks into pleural space from opening in chest/lung surface. Lung collapses and pleural spaces no longer contact Pulmonary edema - Correct Ans: ✔✔caused by CHF, where heart can't pump blood away as fast as it collects in pulmonary arteries. So you have edema in lungs.
5. difficulty breathing w/ exertion
6. sudden attack of respiratory distress
7. suffocation feeling
8. cold sweats
9. tachycardia
10. cool, diaphoretic, cyanotic kin

7. adventitious breath sounds like crackles/wheezing
8. tachycardia
9. hypertension initially then hypotension pulmonary embolus - Correct Ans: ✔✔1. sharp chest pain
10. sudden onset
11. dyspnea
12. tachycardia
13. clear breath sounds initially
14. hemoptysis (coughing up blood)
15. tachypnea tension pneumothorax - Correct Ans: ✔✔1. severe shortness of breath
16. decreased/altered level of consciousness
17. neck vein distension
18. tracheal deviation (late sign)
19. hypotension, signs of shock (late sign) Respiratory syncytial Virus (RSV) - Correct Ans: ✔✔1. cough
20. wheezing
21. fever
22. dehydration

Look for signs of dehydration, infants w/ RSV often refuse liquids. Humidified O2 can be helpful TB - Correct Ans: ✔✔1. cough

2. fever
3. fatigue
4. productive/bloody sputum bacterial infection, can be dormant for years. High prevalence for people living in close contact. Need to wear gloves, eye protection, N- 95 respirator How would you differentiate COPD and CHF? - Correct Ans: ✔✔COPD emphysema - thin w/ barrel chest, pink puffer, tripod position, flat neck veins, dry lungs, shortness of breath on exertion, rhonchi, wheezing, no mucus bronchitis - obese, difficulty w/ expiration, flat neck veins, blue bloat, lungs wet, shortness of breath on exertion, rhonchi, wheezing, frequent/chronic cough, excessive thick mucous CHF - abdominal distention, edema (sacral/pedal), tachycardia, increased RR, anxiety, inability to lie flat, cyanotic, confused LOC, blue

skin, wet lungs, shortness of breath all the time, sudden onset of shortness, crackles, wheezing, coughing may be present, pink frothy sputum What are the types of normal breath sounds? - Correct Ans: ✔✔1. Vesicular

2. Bronchol-vesicular
3. Bronchial (tubular) What are vesicular breath sounds? - Correct Ans: ✔✔description - soft pitched, low intensity gentle sighing location - over peripheral lung, best heard at base characteristics - best heard on inspiration (5:2) ratio What are bronchiole-vesicular sounds? - Correct Ans: ✔✔description - moderate intensity and moderate pitch blowing sounds, created by air moving through larger bronchi location - between scapula and lateral to sternum characteristics - equal inspiratory and expiratory