Flight Paramedic Advanced Airway Management Exam 2024-2025, Exams of Management Accounting

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FLIGHT PARAMEDIC ADVANCED AIRWAY

MANAGEMENT EXAM 2024-2025 q

Pulse oximetry is used to measure the: A. exchange of oxygen and carbon dioxide at the cellular level. B. amount of oxygen dissolved in the plasma portion of the blood. C. percentage of carbon dioxide that is eliminated from the body. D. percentage of hemoglobin that is saturated with oxygen. - ANSWER>>D. percentage of hemoglobin that is saturated with oxygen.

A patient with a suppressed cough mechanism: A. will have a positive eyelash reflex. B. often requires ventilation support. C. should be intubated at once. D. is at serious risk for aspiration. - ANSWER>>D. is at serious risk for aspiration.

According to the most current guidelines for emergency cardiac care, the MOST reliable method for monitoring correct ET tube placement is: A. the esophageal detector device. B. pulse oximetry. C. waveform capnography. D. colorimetric capnography. - ANSWER>>C. waveform capnography.

An increasing peak expiratory flow reading in a patient with respiratory distress suggests that the patient is: A. no longer experiencing bronchospasm. B. experiencing worsened hypoxemia. C. responding to bronchodilator therapy. D. in need of further bronchodilator therapy. - ANSWER>>C. responding to bronchodilator therapy.

Asymmetric chest wall movement is characterized by: A. one side of the chest moving less than the other. B. chest rise that is minimally visible. C. alternating movement of the chest and abdomen. D. a part of the chest wall that bulges during exhalation. - ANSWER>>A. one side of the chest moving less than the other.

Capnography can serve as an indicator of: A. proper ventilatory depth. B. cerebral perfusion pressure. C. coronary perfusion pressure. D. chest compression effectiveness. - ANSWER>>D. chest compression effectiveness.

Capnography is a reliable method for confirming proper ET tube placement because: A. capnographers measure the amount of carbon dioxide in inhaled air. B. carbon dioxide is rarely present in the esophagus. C. capnographers measure the amount of exhaled oxygen. D. it is a reliable indicator of the patient's PaO2 level. - ANSWER>>B. carbon dioxide is rarely present in the esophagus.

Changes in the rate and depth of breathing are regulated primarily by the: A. pH of the CSF. B. saturation of oxygen and hemoglobin. C. amount of oxygen in the blood plasma. D. pH of venous blood. - ANSWER>>A. pH of the CSF.

Compared to mouth-to-mouth ventilation, mouth-to-mask ventilation is more advantageous in that it: A. carries a lower risk of gastric distention and vomiting. B. allows greater tidal volume to be delivered to the patient. C. is less likely to result in hyperventilation of the rescuer. D. can be used in conjunction with supplemental oxygen. - ANSWER>>D. can be used in conjunction with supplemental oxygen.

Complications associated with the one-person bag-mask ventilation technique are MOST often related to: A. unrecognized rescuer fatigue. B. inadequate tidal volume delivery. C. improper manual head positioning. D. hyperinflation of the lungs. - ANSWER>>B. inadequate tidal volume delivery.

A Continuous Positive Airway Pressure, or CPAP, is NOT appropriate for patients with: A. evidence of congestive heart failure. B. acute or chronic bronchospasm.

C. an oxygen saturation of less than 90%. D. slow, and shallow respiratory effort. - ANSWER>>D. slow, and shallow respiratory effort.

From an airway management perspective, the MOST important anatomic consideration regarding an adult's tongue is: A. that it attaches directly to the mandible and hyoid bone. B. its tendency to fall back and occlude the posterior pharynx. C. its proportionately large size compared to a child's tongue. D. that it is easily lacerated, but bleeds minimally. - ANSWER>>B. its tendency to fall back and occlude the posterior pharynx.

If an unresponsive patient does not have a gag reflex, an oropharyngeal airway: A. should only be inserted if the patient is not breathing. B. should be inserted whether the patient is breathing or not. C. must be inserted by depressing the tongue with a tongue blade. D. will effectively prevent aspiration if the patient vomits. - ANSWER>>B. should be inserted whether the patient is breathing or not.

In contrast to a curved laryngoscope blade, a straight laryngoscope blade is designed to: A. move the patient's tongue to the left. B. fit into the vallecular space at the base of the tongue. C. extend beneath the epiglottis and lift it up. D. indirectly lift the epiglottis to expose the vocal cords. - ANSWER>>C. extend beneath the epiglottis and lift it up.

Generally, a multilumen airway should not be used in patients who are: A. younger than 16 years of age. B. greater than 6 ft tall. C. older than 65 years of age. D. less than 4 ft 5 in tall. - ANSWER>>A. younger than 16 years of age.

The process of moving air into and out of the lungs is called: A. respiration. B. ventilation. C. exhalation. D. inhalation. - ANSWER>>B. ventilation.

The pulse oximeter would be LEAST useful when:

A. identifying deterioration of the cardiac patient. B. assessing vascular status in orthopaedic trauma. C. determining if a patient should receive oxygen. D. monitoring oxygenation status during intubation. - ANSWER>>C. determining if a patient should receive oxygen.

The trachea and mainstem bronchi: A. are approximately 10 to 12 cm in length and are joined together at the hilum. B. constrict violently when their beta-2 receptors are stimulated excessively. C. are lined with beta-2 receptors that result in bronchodilation when stimulated. D. do not contain mucous-producing cells in patients without a respiratory disease. - ANSWER>>C. are lined with beta-2 receptors that result in bronchodilation when stimulated.

The Venturi mask is MOST useful in the prehospital setting when: A. a COPD patient requires a long-range transport. B. patients cannot tolerate a nonrebreathing mask. C. high-flow oxygen is required for severe hypoxia. D. a patient requires less than 15% oxygen. - ANSWER>>A. a COPD patient requires a long-range transport.

When ventilating a patient with a bag-mask device, you note increased compliance. This means that: A. the patient likely has an upper airway obstruction. B. air can be forced into the lungs with relative ease. C. you are meeting resistance when ventilating. D. a lower airway obstruction should be suspected. - ANSWER>>B. air can be forced into the lungs with relative ease.

Which of the following findings is MOST clinically significant in a 30-year-old woman with difficulty breathing and a history of asthma? A. Prior ICU admission for her asthma B. Oral temperature of 97.9°F C. 3 mm Hg drop in systolic BP during inhalation D. Expiratory wheezing on exam - ANSWER>>A. Prior ICU admission for her asthma

Which of the following statements regarding oxygen is correct? A. Oxygen is a highly flammable gas. B. Grease prevents oxygen from exploding.

C. Oxygen supports the process of combustion. D. Oxygen must be stored in a warm environment. - ANSWER>>C. Oxygen supports the process of combustion.

With regard to intubation difficulty, neck mobility problems are MOST commonly associated with: A. elderly patients. B. small children. C. tall, thin patients. D. female patients. - ANSWER>>A. elderly patients.

You are treating a patient with respiratory failure due to a respiratory cause. You have intubated the patient and confirmed proper placement. During your care, the patient's ETCO drops significantly. You immediately should: A. stop and check for responsiveness. If unresponsive, check for a carotid pulse, and begin CPR if it is absent. B. stop and hyperventilate the patient at a rate of 24 breaths/min. C. apply posterior cricoid pressure and continue ventilating the patient. D. remove the ETT and insert a King Airway device. - ANSWER>>A. stop and check for responsiveness. If unresponsive, check for a carotid pulse, and begin CPR if it is absent.

You should insert the ET tube between the vocal cords until the: A. distal end of the cuff is 1 to 2 cm past the vocal cords. B. centimeter marking reads 15 cm at the patient's teeth. C. tube meets resistance as it makes contact with the carina. D. proximal end of the cuff is 1 to 2 cm past the vocal cords. - ANSWER>>D. proximal end of the cuff is 1 to 2 cm past the vocal cords.

Leaf shaped structure that prevents food and liquid from getting into the larynx during swallowing is the... a. cricoid b. uvula c. epiglottis d. vallecula - ANSWER>>c. epiglottis

What is the preferred device to deliver oxygen to a conscious patient who is breathing, yet displaying signs of respiratory distress? a. non-rebreather mask

b. venturi mask c. nasal cannula d. partial-rebreather mask - ANSWER>>a. non-rebreather mask

In what position should the patient's head and neck be placed to facilitate direct laryngoscope, visualize vocal cords and insertion of an endotracheal tube? a. neutral b. sniffing c. head tilt d. slightly flexed - ANSWER>>b. sniffing

Which abnormal respiratory pattern do you see in the patient suffering diabetic ketoacidosis? a. bradypnea b. Kussmal's c. Cheyne-Stokes d. tachypnea - ANSWER>>b. Kussmal's

A 21-year-old man experienced an acute onset of pleuritic chest pain and dyspnea while playing softball. He is noticeably dyspneic, has an oxygen saturation of 93% on room air, and has diminished breath sounds to the upper right lobe. The MOST appropriate treatment for this patient involves: A. assisting his ventilations in order to increase his oxygen saturation. B. applying a CPAP unit and starting an IV line en route to the hospital. C. performing a needle decompression to the right side of his chest. D. administering high-flow supplemental oxygen and transporting at once. - ANSWER>>D. administering high-flow supplemental oxygen and transporting at once.

A hyperventilating patient: A. presents with tachypnea and marked use of accessory muscles. B. may be acidotic and is trying to decrease his or her pH level. C. should rebreathe his or her carbon dioxide to effect resolution. D. is most effectively treated by administering a sedative drug. - ANSWER>>B. may be acidotic and is trying to decrease his or her pH level.

A morbidly obese man called 9-1-1 because of difficulty breathing. When you arrive, you find the 39-year-old patient lying supine in his bed. He is in marked respiratory distress and is only able to speak in two-word sentences. He has a history of hypertension, but denies any respiratory conditions. What should you do FIRST?

A. Assess his oxygen saturation level. B. Begin assisting his ventilations. C. Administer a beta-2 agonist drug. D. Sit him up or place him on his side. - ANSWER>>D. Sit him up or place him on his side.

A patient with orthopnea: A. is awakened from sleep with severe dyspnea. B. generally has a slow, shallow respiratory pattern. C. seeks a sitting position when short of breath. D. prefers to lie flat in order to facilitate breathing. - ANSWER>>C. seeks a sitting position when short of breath.

A pulse oximetry reading would be LEAST accurate in a patient: A. whose extremities are warm. B. with poor peripheral perfusion. C. with chronic hypoxia. D. with persistent tachycardia. - ANSWER>>B. with poor peripheral perfusion.

Abnormal breath sounds associated with pneumonia and congestive heart failure are MOST often heard in the: A. midaxillary line. B. right middle lobe. C. apices of the lungs. D. bases of the lungs. - ANSWER>>D. bases of the lungs.

Apneustic breathing is characterized by: A. short, brisk inhalations with a long pause before exhalation. B. a crescendo-decrescendo pattern of breathing with apneic periods. C. a sustained pattern of tachypnea and increased tidal volume. D. regular respirations with a normal rate and adequate tidal volume. - ANSWER>>A. short, brisk inhalations with a long pause before exhalation.

COPD is characterized by: A. narrowing of the smaller airways that is often reversible with prompt treatment. B. changes in pulmonary structure and function that are progressive and irreversible. C. widespread alveolar collapse due to increased pressure during the exhalation phase.

D. small airway spasms during the inhalation phase, resulting in progressive hypoxia. - ANSWER>>B. changes in pulmonary structure and function that are progressive and irreversible.

Emphysema is caused by: A. an abundance of pulmonary surfactant. B. chronic destruction of the alveolar walls. C. excessive mucus production in the bronchi. D. progressive weakening of the lung parenchyma. - ANSWER>>B. chronic destruction of the alveolar walls.

Polycythemia is a condition in which: A. fewer red blood cells are produced, resulting in decreased oxygenation. B. an abundance of red blood cells causes severe thinning of the blood. C. increased platelet production causes the blood to become abnormally thick. D. excess red blood cells are produced in response to chronic hypoxia. - ANSWER>>D. excess red blood cells are produced in response to chronic hypoxia.

Respiratory alkalosis is the result of: A. excess carbon dioxide elimination. B. carbon dioxide retention. C. slow and shallow respirations. D. increased hydrogen ion production. - ANSWER>>A. excess carbon dioxide elimination.

The classic presentation of chronic bronchitis is: A. excessive mucus production and a chronic or recurrent productive cough. B. expiratory wheezing and jugular venous distention due to pulmonary hypertension. C. a thin male with pursed-lip breathing and a history of heavy cigarette smoking. D. a dry, hacking cough and a barrel chest due to chronic pulmonary air trapping. - ANSWER>>A. excessive mucus production and a chronic or recurrent productive cough.

___________ respirations are characterized by a grossly irregular pattern of breathing that may be accompanied by lengthy periods of apnea. A. Cheyne-Stokes B. Eupneic C. Biot D. Agonal - ANSWER>>C. Biot

While obtaining a history from a patient, you learn that she has difficulty sleeping at night. She tells you that she becomes very restless as the night goes on, and that it gets harder and harder for he to breathe when she lies flat. She has tried adding pillows, but the condition returns each evening. This finding may be referred to as... a. hepatopulmonry syndrome b. paroxysmal nocturnal dyspnea c. aggravated dyspnea d. eupnea - ANSWER>>b. paroxysmal nocturnal dyspnea

Epinephrine stimulates beta2 receptors, thereby directly resulting in... a. increase mucus production b. bronchconstriction c. bronchial smooth muscle relaxation d. increased heart rate - ANSWER>>c. bronchial smooth muscle relaxation

Clubbing of the fingertips and peripheral cyanosis are associated with... a. chronic pulmonary infections b. atrial fibrillation c. pneumonia d. chronic hypoxia - ANSWER>>d. chronic hypoxia

Upon arrival at a local clinic, you are told that you are to transport a 55 y/o male with respiratory distress. The clinician advised you that the patient is experiencing a pleural effusion with an associated friction rub. He is referring to fluid within the ... a. pleural hylium b. respiratory bronchials c. pleural space d. alveolar ducts - ANSWER>>c. pleural space

The signs and symptoms associated with hyperventilation syndrome result from... a. a respiratory alkalosis without an underlying pathology b. a metabolic acidosis secondary to anxiety c. a respiratory alkalosis resulting from a systemic metabolic pathology d. a respiratory pathology resulting in a metabolic acidosis - ANSWER>>a. a respiratory alkalosis without an underlying pathology

Which disease is characterized by excessive mucus production within the bronchial tree and a recurrent productive cough?

a. Chronic Bronchitis b. Asthma c. Pneumonia d. Emphysema - ANSWER>>a. Chronic Bronchitis

Normally, the body's stimulus to breathe is based on ... a. venule pH b. an increase in arterial CO c. elevated CSF pH d. both arterial oxygen and carbon dioxide levels - ANSWER>>b. an increase in arterial CO

You are preparing to transport a patient from one medical facility to another. You are advised that the patient is wearing a CPAP mask. Based solely on this information, to correctly determine... a. that the patient is intubated and that you must have your stethoscope available to listen to breath sounds b. the patient is apneic, and you must secure a BVM device c. the patient is sedated and unconscious d. that the patient is breathing spontaneously - ANSWER>>d. that the patient is breathing spontaneously

A disadvantage of Endotracheal intubation is that it: A. bypasses the upper airway's physiologic functions of warming, filtering, and humidifying. B. is associated with a high incidence of vocal cord damage and bleeding into the oropharynx when performed properly. C. is only a temporary method of securing the patient's airway until a more definitive device can be inserted. D. does not eliminate the incidence of gastric distention and can result in pulmonary aspiration.

• ANSWER>>A. bypasses the upper airway's physiologic functions of warming, filtering, and humidifying.

A foreign-body airway obstruction should be suspected in a child who presents with: A. progressive respiratory distress and hoarseness. B. an episode of acute respiratory distress without a fever. C. a productive cough and flushed skin. D. diffuse wheezing and nasal flaring. - ANSWER>>B. an episode of acute respiratory distress without a fever.

A size 3 or 4 LMA: A. is appropriate to use in children younger than 6 years of age. B. will accommodate the passage of a 6.0-mm ET tube. C. is less likely to become dislodged than smaller sizes. D. is most suitable for use in morbidly obese patients. - ANSWER>>B. will accommodate the passage of a 6.0-mm ET tube.

After inserting the Combitube to the proper depth, you should next: A. inflate the pharyngeal cuff with 100 mL of air. B. apply a cervical collar to minimize head movement. C. inflate the distal cuff with 5 mL of air. D. ventilate through the pharyngeal tube. - ANSWER>>A. inflate the pharyngeal cuff with 100 mL of air.

During the performance of a needle cricothyrotomy, after inserting the needle into through the cricothyroid membrane, you should next: A. change your angle to 90° and advance the catheter over the needle. B. aspirate with the syringe and then insert the needle about 2 cm farther. C. advance the catheter over the needle until the hub is flush with the skin. D. insert the needle about 1 cm farther and then aspirate with the syringe. - ANSWER>>D. insert the needle about 1 cm farther and then aspirate with the syringe.

After properly positioning the patient's head for intubation, you should open his or her mouth and insert the curved laryngoscope blade: A. into the right side of the mouth and sweep the tongue to the left. B. in the midline of the mouth and gently lift upward on the tongue. C. into the left side of the mouth and move the blade to the midline. D. in the midline of the mouth and gently sweep the tongue to the left. - ANSWER>>A. into the right side of the mouth and sweep the tongue to the left.

All of the following are complications associated with orotracheal intubation, EXCEPT: A. barotrauma from forceful ventilation. B. laryngeal swelling. C. bilateral chest rise. D. damage to the vocal cords. - ANSWER>>C. bilateral chest rise.

An ET tube that is too large for a patient: A. will make ventilating the patient more difficult.

B. will lead to an increased resistance to airflow during ventilations. C. would be much more likely to enter the esophagus. D. can be difficult to insert and may cause trauma to the air passage. - ANSWER>>D. can be difficult to insert and may cause trauma to the air passage.

Atelectasis occurs when: A. there is a deficiency of surfactant causes alveolar collapse. B. deoxygenated blood diffuses across the alveoli. C. the alveoli are overinflated and rupture. D. the surface tension on the alveolar walls is decreased. - ANSWER>>A. there is a deficiency of surfactant causes alveolar collapse.

A high-pressure ventilator when used with a needle cricothyrotomy, would potentially cause an increase in intrathoracic pressure, ___________ and ___________. A. barotrauma, a pneumothorax B. hypercarbia, hypoxia C. esophageal rupture, significant hemorrhage D. hypoventilation, hypocarbia - ANSWER>>A. barotrauma, a pneumothorax

Before intubating a patient who has been chemically sedated and paralyzed, it is MOST important for the paramedic to: A. hyperventilate the patient at 24 breaths/min. B. administer 0.5 mg of atropine sulfate. C. suction the oropharynx to clear any secretions. D. adequately pre-oxygenate with 100% oxygen. - ANSWER>>D. adequately pre-oxygenate with 100% oxygen.

Compared to orotracheal intubation, nasotracheal intubation is less likely to result in hypoxia because: A. nasotracheal intubation does not involve direct visualization of the vocal cords. B. the procedure should be performed in less than 10 seconds. C. patients requiring nasotracheal intubation are usually stable. D. nasotracheal intubation must be performed on spontaneously breathing patients. - ANSWER>>D. nasotracheal intubation must be performed on spontaneously breathing patients.

A Continuous Positive Airway Pressure, or CPAP, is NOT appropriate for patients with: A. slow, and shallow respiratory effort. B. evidence of congestive heart failure.

C. acute or chronic bronchospasm. D. an oxygen saturation of less than 90%. - ANSWER>>A. slow, and shallow respiratory effort.

Generally, a multilumen airway should not be used in patients who are: A. less than 4 ft 5 in tall. B. older than 65 years of age. C. greater than 6 ft tall. D. younger than 16 years of age. - ANSWER>>D. younger than 16 years of age.

An indication for CPAP would most likely include: A. severe opiate toxicity. B. cardiopulmonary arrest. C. acute pulmonary edema. D. acute bacterial pneumonia. - ANSWER>>C. acute pulmonary edema.

Multilumen airways are typically contraindicated in patients with: A. traumatic cardiac arrest. B. cervical spine trauma. C. a history of gastric ulcers. D. esophageal cancer. - ANSWER>>D. esophageal cancer.

Needle cricothyrotomy is usually contraindicated in patients with: A. an obstruction located above the catheter insertion site. B. massive maxillofacial trauma and trismus. C. uncontrolled oropharyngeal bleeding. D. a suspected injury to the cervical spine. - ANSWER>>A. an obstruction located above the catheter insertion site.

Nondepolarizing neuromuscular blocking agents include all of the following, EXCEPT: A. vecuronium bromide. B. succinylcholine chloride. C. rocuronium bromide. D. pancuronium bromide. - ANSWER>>B. succinylcholine chloride.

An open cricothyrotomy is indicated when: A. endotracheal intubation is unsuccessful after three attempts. B. the patient has a head injury that precludes nasotracheal intubation. C. all other methods of advanced airway management have failed.

D. you are unable to secure a patent airway with less invasive means. - ANSWER>>D. you are unable to secure a patent airway with less invasive means.

Paramedics must use extreme caution when accessing the airway via the cricothyroid membrane because: A. the thyroid cartilage is smaller than the cricoid cartilage and makes the cricothyroid membrane difficult to locate. B. cricothyrotomy is associated with a high incidence of inadvertent laceration of a carotid artery. C. the cricothyroid membrane is highly vascular and tends to bleed profusely when it is incised. D. the cricothyroid membrane is bordered laterally and inferiorly by the highly vascular thyroid gland. - ANSWER>>D. the cricothyroid membrane is bordered laterally and inferiorly by the highly vascular thyroid gland.

The proper insertion of the LMA involves: A. lifting the patient's jaw upward and blindly inserting the LMA until you meet resistance. B. inserting the LMA along the roof of the mouth and using your finger to push the airway against the hard palate. C. inserting the LMA into the patient's mouth by following the natural curvature of the patient's tongue. D. flexing the patient's neck forward, depressing the tongue with a tongue blade, and blindly inserting the LMA. - ANSWER>>B. inserting the LMA along the roof of the mouth and using your finger to push the airway against the hard palate.

The proper insertion of the needle into the cricothyroid membrane involves a ______ angle aiming towards the patient's ________. A. 90°, feet B. 45°, posterior trachea C. 90°, posterior trachea D. 45°, feet - ANSWER>>D. 45°, feet

Proper placement of the King LT airway is confirmed by all of the following techniques, EXCEPT: A. the use of an esophageal detector device. B. the use of quantitative waveform capnography. C. auscultation for adequate bilateral breath sounds. D. observation for symmetrical chest rise. - ANSWER>>A. the use of an esophageal detector device.

A sign of clinical improvement during CPAP therapy may include: A. an increase in the patient's heart rate. B. a decrease in the patient's systolic BP. C. an increase in the ease of speaking. D. increased ETCO2 reading. - ANSWER>>C. an increase in the ease of speaking.

The King LT airway can be used to: A. establish a patent airway in patients of any age and body size with a single device. B. maintain a patent airway in unconscious patients who are spontaneously breathing and in need of an advanced airway. C. administer certain cardiac medications directly into the trachea. D. suction pulmonary secretions from the tracheobronchial tree. - ANSWER>>B. maintain a patent airway in unconscious patients who are spontaneously breathing and in need of an advanced airway.

The LMA is: A. typically is associated with a higher risk of damage to the vocal cords than intubation. B. especially effective for patients suffering CHF and who require high pulmonary pressures. C. a suitable airway device for use in morbidly obese patients. D. an alternative airway device to bag-mask ventilation when intubation is not possible. - ANSWER>>D. an alternative airway device to bag-mask ventilation when intubation is not possible.

The key disadvantage of the LMA is that it: A. does not provide adequate protection against the risk of aspiration. B. is technically more difficult to perform than intubation. C. may spontaneously dislodge in the majority of patients. D. is typically associated with significant upper airway swelling. - ANSWER>>A. does not provide adequate protection against the risk of aspiration.

The MOST significant complication associated with the use of a multi-lumen airway is: A. unrecognized displacement of the tube deep into the esophagus. B. the stimulation of laryngospasm or vomiting educed during insertion of the tube. C. vocal cord damage if the tube inadvertently enters the trachea. D. pharyngeal or esophageal trauma secondary to poor technique. - ANSWER>>A. unrecognized displacement of the tube deep into the esophagus.

The MOST significant disadvantage associated with needle cricothyrotomy is:

A. the inability to exhale via the glottis. B. the potential for pulmonary aspiration. C. the development of a local infection due to poor technique. D. an air leak around the insertion site. - ANSWER>>B. the potential for pulmonary aspiration.

Typically, ETCO2 is approximately: A. 5 to 10 mm Hg higher than the arterial PaCO2. B. 2 to 5 mm Hg higher than the arterial PaCO2. C. 5 to 10 mm Hg lower than the arterial PaCO2. D. 2 to 5 mm Hg lower than the arterial PaCO2. - ANSWER>>D. 2 to 5 mm Hg lower than the arterial PaCO2.

Using the DOPE mnemonic, which of the following interventions would you MOST likely have to perform first, if you suspect "O" as the cause of acute deterioration in the intubated child? A. Checking the bag-mask device for defects B. Needle decompression of the chest C. The immediate extubation of the child D. Tracheobronchial suctioning - ANSWER>>D. Tracheobronchial suctioning

When administering CPAP therapy to a patient, it is important to remember that: A. acute symptomatic bradycardia has been directly linked to CPAP therapy. B. the increased intrathoracic pressure caused by CPAP may result in hypotension. C. a SpO2 of 100% must be achieved as quickly as possible. D. the head straps must be secured immediately and before turning on the device, in order to achieve an adequate seal. - ANSWER>>B. the increased intrathoracic pressure caused by CPAP may result in hypotension.

When checking the cuff of the LMA prior to insertion, you should: A. inflate the cuff with 50% more air than is required when testing the integrity of the cuff. B. stretch the cuff with your fingers to check for tears or other damage. C. gently, with your fingers, pull on the cuff at the tube's edge, to ensure it's integrity. D. inflate the cuff with 100 mL of air and then deflate it completely. - ANSWER>>A. inflate the cuff with 50% more air than is required when testing the integrity of the cuff.

Which of the following patients may benefit from CPAP? A. A trauma patient who presents with labored breathing and extensive chest wall bruising B. A comatose patient with shallow breathing following an overdosing of heroin C. A patient suffering with pulmonary edema who is unable to follow verbal commands

D. An alert patient with respiratory distress following submersion in water - ANSWER>>D. An alert patient with respiratory distress following submersion in water

Which of the following statements regarding the King LT airway is correct? A. Both the King LT-D and the King LTS-D posses a proximal pharyngeal cuff, a distal cuff, and several openings as ventilation outlets at the distal end of the tube B. In contrast to the King LT-D, the LTS-D is closed at the distal end. C. The King LT airway provides better airway protection than the ET tube. D. The King LT airway has two lumens that effectively seal the esophagus. - ANSWER>>A. Both the King LT-D and the King LTS-D posses a proximal pharyngeal cuff, a distal cuff, and several openings as ventilation outlets at the distal end of the tube

A 29-year-old woman is experiencing a severe asthma attack. Her husband reports that she was admitted to an intensive care unit about 6 months ago, and had a breathing tube in place. Prior to your arrival, the patient took 3 puffs of her rescue inhaler without effect. She is anxious and restless, is tachypneic, and has audible wheezing. You should: A. attempt to slow her breathing with respiratory coaching, administer a nebulized bronchodilator, and transport. B. begin assisting her ventilations with a bag-mask device and 100% oxygen and prepare to intubate her trachea. C. apply a CPAP unit, transport immediately, and attempt to establish vascular access en route to the hospital. D. start an IV of normal saline, administer methylprednisolone via IV push, and transport as soon as possible. - ANSWER>>C. apply a CPAP unit, transport immediately, and attempt to establish vascular access en route to the hospital.

A 36-year-old man with a history of asthma presents with severe respiratory distress. You attempt to administer a nebulized beta-2 agonist, but his poor respiratory effort is inhibiting effective drug delivery via the nebulizer and his mental status is deteriorating. You should: A. assist him with a metered-dose inhaler bronchodilator. B. start an IV of normal saline and administer a steroid. C. assist his ventilations and establish vascular access. D. apply high-flow oxygen via a nonrebreathing mask. - ANSWER>>C. assist his ventilations and establish vascular access.

A 76-year-old woman with emphysema presents with respiratory distress that has worsened progressively over the past 2 days. She is breathing through pursed lips and has a prolonged

expiratory phase and an oxygen saturation of 76%. She is on home oxygen at 2 L/min. Your initial action should be to: A. auscultate her lungs for adventitious breath sounds. B. increase her oxygen flow rate to 6 L/min. C. administer a beta-2 agonist via nebulizer. D. place her in a position that facilitates breathing. - ANSWER>>D. place her in a position that facilitates breathing.

A critical step when using a CPAP unit to treat a patient with severe respiratory distress is: A. ensuring an adequate mask seal with minimal leakage. B. holding the mask to the noncompliant patient's face. C. starting with CPAP levels above 10 to 15 cm of water. D. setting the oxygen flow rate to at least 6 L/min. - ANSWER>>A. ensuring an adequate mask seal with minimal leakage.

A morbidly obese man called 9-1-1 because of difficulty breathing. When you arrive, you find the 39-year-old patient lying supine in his bed. He is in marked respiratory distress and is only able to speak in two-word sentences. He has a history of hypertension, but denies any respiratory conditions. What should you do FIRST? A. Assess his oxygen saturation level. B. Begin assisting his ventilations. C. Sit him up or place him on his side. D. Administer a beta-2 agonist drug. - ANSWER>>C. Sit him up or place him on his side.

A patient with a history of asthma is at GREATEST risk for respiratory arrest if he or she: A. has used his or her inhaler twice in the previous week. B. was recently evaluated in an emergency department. C. takes a bronchodilator and a corticosteroid. D. was previously intubated for his or her condition. - ANSWER>>D. was previously intubated for his or her condition.

A patient with orthopnea: A. generally has a slow, shallow respiratory pattern. B. seeks a sitting position when short of breath. C. prefers to lie flat in order to facilitate breathing. D. is awakened from sleep with severe dyspnea. - ANSWER>>B. seeks a sitting position when short of breath.

A patient with respiratory distress who is willing to lie flat: A. may be acutely deteriorating. B. should be intubated at once. C. has minimal fluid in the lungs. D. likely has basilar pneumonia. - ANSWER>>A. may be acutely deteriorating.

A person who experiences sharp chest pain followed by increasing dyspnea after he or she coughs MOST likely has: A. a pleural effusion. B. a pneumothorax. C. pleurisy. D. acute pneumonia. - ANSWER>>B. a pneumothorax.

Abnormal breath sounds associated with pneumonia and congestive heart failure are MOST often heard in the: A. midaxillary line. B. bases of the lungs. C. right middle lobe. D. apices of the lungs. - ANSWER>>B. bases of the lungs.

An elderly woman with COPD presents with peripheral edema. The patient is conscious but agitated. She is breathing with slight difficulty but has adequate tidal volume. During your assessment, you note that her jugular veins engorge when you apply pressure to her right upper abdominal quadrant. She tells you that she takes a "water pill" and Vasotec for high blood pressure. You should: A. start an IV of normal saline and give her a 250-mL bolus. B. conclude that she has been noncompliant with her diuretic. C. expect to hear crackles when you auscultate her lungs. D. suspect acute right heart failure and administer oxygen. - ANSWER>>D. suspect acute right heart failure and administer oxygen.

An otherwise healthy adult whose normal hemoglobin level is 12 to 14 g/dL typically will begin to exhibit cyanosis when: A. his or her oxygen saturation falls below 50%. B. hemoglobin levels fall below 12 g/dL. C. about 5 g/dL of hemoglobin is desaturated. D. 10% of his or her hemoglobin is desaturated. - ANSWER>>C. about 5 g/dL of hemoglobin is desaturated.

Bedridden patients with excessive pulmonary secretions are MOST prone to developing: A. pneumonia. B. a pneumothorax. C. a pulmonary embolism. D. bronchospasm. - ANSWER>>A. pneumonia.

COPD is characterized by: A. small airway spasms during the inhalation phase, resulting in progressive hypoxia. B. narrowing of the smaller airways that is often reversible with prompt treatment. C. widespread alveolar collapse due to increased pressure during the exhalation phase. D. changes in pulmonary structure and function that are progressive and irreversible. - ANSWER>>D. changes in pulmonary structure and function that are progressive and irreversible.

CPAP in the emergency setting is used to treat patients with certain obstructive airway diseases by: A. maintaining stability of the posterior pharynx, thereby preventing upper airway obstruction. B. delivering one pressure during the inspiratory phase and a different pressure during the expiratory phase. C. increasing the rate and depth of ventilation, thus improving minute volume and mitigating hypoxia. D. improving patency of the lower airway through the use of positive-end expiratory pressure. - ANSWER>>D. improving patency of the lower airway through the use of positive-end expiratory pressure.

Digital clubbing is MOST indicative of: A. chronic hypoxia. B. peripheral vascular disease. C. acute hypoxemia. D. right heart failure. - ANSWER>>A. chronic hypoxia.

Emphysema is caused by: A. progressive weakening of the lung parenchyma. B. an abundance of pulmonary surfactant. C. chronic destruction of the alveolar walls. D. excessive mucus production in the bronchi. - ANSWER>>C. chronic destruction of the alveolar walls.

If the amount of pulmonary surfactant is decreased: A. diffuse alveolar hyperinflation occurs. B. alveoli are able to expand more easily. C. pulmonary gas exchange is enhanced. D. alveolar surface tension increases. - ANSWER>>D. alveolar surface tension increases.

The barrel-chest appearance classically seen in emphysemic patients is secondary to: A. air trapping in the lungs. B. widespread atelectasis. C. chest wall hypertrophy. D. carbon dioxide retention. - ANSWER>>A. air trapping in the lungs.

The classic presentation of chronic bronchitis is: A. excessive mucus production and a chronic or recurrent productive cough. B. a thin male with pursed-lip breathing and a history of heavy cigarette smoking. C. a dry, hacking cough and a barrel chest due to chronic pulmonary air trapping. D. expiratory wheezing and jugular venous distention due to pulmonary hypertension. - ANSWER>>A. excessive mucus production and a chronic or recurrent productive cough.

The presence of diffuse rhonchi (low-pitched crackles) in the lungs indicates: A. air being forced through narrowed airways. B. thick secretions in the large airways. C. right-sided congestive heart failure. D. isolated consolidation of secretions. - ANSWER>>B. thick secretions in the large airways.

You are dispatched to a residence for a 59-year-old man with difficulty breathing. The patient, who has a history of COPD, is conscious and alert. During your assessment, he tells you that he developed chills, fever, and a productive cough 2 days ago. Auscultation of his lungs reveals rhonchi to the left lower lobe. This patient is MOST likely experiencing: A. pneumonia. B. bronchitis. C. end-stage COPD. D. COPD exacerbation. - ANSWER>>A. pneumonia.

You respond to a taxi cab on the side of the road where the driver and called for medical assistance. On arrival, you find a 40 year old man is complaining of a sudden episode of shortness of breath. he states that it began about 20 minutes ago. He just left the airport after

returning from a trip to Hawaii. He now complains of sharp pain to the left side of his chest. He has no significant medical history, takes no medications, and has no allergies. He admits to being a cigarette smoker for the past 20 years. Assessment reveals, an alert, but anxious patient, no injury reported, BP 122/80, HR 120, RR 34, skin is pink and warm, SaO2 96% on room air, and his lung sounds are clear bilaterally. With this information, you suspect that this patient is experiencing.... a. an acute asthmatic attack b. an acute myocardial infarction c. a spontaneous pneumothorax d. a pulmonary embolus - ANSWER>>d. a pulmonary embolus

Your unit is summoned to respond to a medical clinic for a 16 year old girl who is hyperventilating. When you arrive you find her sitting upright in a chair, along side her mother, appearing to be very anxious. She is speaking in two to three word sentences. Auscultation of the chest reveals inspiratory and expiratory wheezes in all fields. According to the nurse at the clinic, the patient's SaO2 reads 97% on room air. Her respiratory rate at 28/minute, BP: 126/78, HR 112. The nurse states that the patient came into the office complaining of a persistent cough. The girl was sitting in the waiting room, awaiting to be seen by the clinician when she suddenly felt short of breath. Your first impression of this patient leads you to suspect... a. a pulmonary infection b. a possible overdose c. an acute asthmatic attack d. chronic bronchitis - ANSWER>>c. an acute asthmatic attack

________ cells are found in the lining of the airways and produce a blanket of mucus that covers the entire lining of the conducting airways. A. Kupfer B. Ciliary C. Alveolar D. Goblet - ANSWER>>D. Goblet

__________ breath sounds are the MOST commonly heard breath sounds and have a much more obvious inspiratory component. A. Tracheal B. Bronchovesicular C. Bronchial D. Vesicular - ANSWER>>D. Vesicular

In cases where pulmonary edema or atelectasis exist, blood bypasses the alveoli without being oxygenated secondary to malfunctioning alveoli. This situation is referred to as a V/Q mismatch or a. ventilation b. perfusion c. shunting d. intermittent ventilation - ANSWER>>c. shunting

Upon arrival at a local medical clinic, the physician informs you that the patient has a pleural effusion with an associated friction rub. He is referring to... a. a collapse of the alveoli with subsequent irritation b. the seepage of fluid into the pleural space c. the seepage of air within the pleural space inhibiting adequate lung expansion d. the transition of fluid into the interstial spaces located within the pleual tissue - ANSWER>>b. the seepage of fluid into the pleural space

You are called to attend to a 16 year old female suffering respiratory difficulty. When you arrive you find the child in moderate distress. Her mother states that her daughter has a congenital condition that results in abnormal secretion of thick bronchial mucus. This condition is referred to as... a. Myasthenia gravis b. Cystic fibrosis c. Guillian-Barre' Syndrome d. Pickwickian syndrome - ANSWER>>b. Cystic fibrosis

Clubbing of the fingers and peripheral cyanosis are associated with... a. atrial fibrillation b. chronic pulmonary infections c. chronic hypoxia d. acute shock - ANSWER>>c. chronic hypoxia