Deck 10: Respiration and Artificial Ventilation

Question 1

Which of the following patients does NOT require the administration of supplemental oxygen?

A) A 60-year-old woman with a history of chronic obstructive pulmonary disease (COPD) who can speak two or three words at a time without a breath
B) A 6-year-old male with a history of asthma whose breath sounds are silent and who is drowsy
C) A 31-year-old male who is unresponsive due to an overdose of narcotics
D) A 24-year-old woman who is breathing 28 times per minute after being in an argument with her husband

Answer 1

A 24-year-old woman who is breathing 28 times per minute after being in an argument with her husband

Question 2

You have arrived at the scene of a call for a "man down." As you enter the residence you note that your patient is a male in his mid-60s who is awake but does not seem to acknowledge your presence.He is perspiring profusely,has cyanosis of his ears and lips,and has rapid,shallow respirations.Which of the following should you do first?

A) Check for a radial pulse.
B) Obtain the patient's medical history.
C) Listen to his lung sounds.
D) Assist ventilations with a bag-valve mask and supplemental oxygen.

Answer 2

Assist ventilations with a bag-valve mask and supplemental oxygen.

Question 3

For life to be maintained,a balance of oxygen and carbon dioxide is needed.The condition when oxygen levels are low is called:

A) hypotension.
B) hypercarbia.
C) hyperventilation.
D) hypoxia.

Answer 3

hypoxia.

Question 4

Why is inhalation described as an active process?

A) It requires the diaphragm to relax and use energy to move, creating a positive pressure.
B) It requires chest muscles to relax and use energy to move, creating a positive pressure.
C) It requires chest muscles to contract and use energy to move, creating a negative pressure.
D) It uses oxygen to assist chest muscles to contract, creating a negative pressure.

Question 5

What is the relatively rare condition that can cause respiratory depression?

A) Lungs can react unfavorably to oxygen when the concentration is too high for a long period of time and this can depress breathing.
B) Chronic obstructive pulmonary disease (COPD) has changed the stimulus to breathe to the hypoxic drive and high concentration can depress breathing.
C) High concentration of oxygen can depress breathing when the patient has an allergic reaction from the oxygen.
D) The eyes can develop scar tissue on the retina from a high concentration of oxygen.

Question 6

The movement of oxygen and carbon dioxide across the cell membranes from the capillaries is called:

A) external respiration.
B) dehydration.
C) internal respiration.
D) oxygenation.

Question 7

In assessing a patient's breathing,what is your first question?

A) Is he breathing?
B) Is he alive or dead?
C) Is his breathing adequate or inadequate?
D) Is he big sick or little sick?

Question 8

Which of the following statements BEST describes the exchange of gas in the alveoli?

A) Blood moves by way of the pulmonary capillaries, air arrives at the alveoli, and osmosis occurs.
B) Blood moves from the left heart to the lungs, air arrives in the alveoli sacks, and diffusion occurs.
C) Air moves into the airway, blood arrives via the pulmonary veins, and osmosis occurs.
D) Air moves into the alveoli, blood is transported by the pulmonary capillaries, and diffusion occurs.

Question 9

Which of the following BEST describes inadequate breathing?

A) The respiratory rate is slower than normal.
B) The minute volume is less than normal.
C) The minute volume is greater than normal.
D) The respiratory rate is faster than normal.

Question 10

Why does a patient involved in an auto crash who has major internal abdominal bleeding require oxygen to maintain internal respiration?

A) The red blood cells have a reduction of hemoglobin that reduces the amount of oxygen that can be transported.
B) A lack of oxygen in the air decreases the oxygen diffused into the bloodstream, which creates an increase of carbon dioxide.
C) The swelling of the abdominal space causes the diaphragm to be restricted, which will reduce the thorax space.
D) A lack of circulating volume decreases the oxygen and carbon dioxide transport capability.

Question 11

The process of air moving in and out of the chest is called:

A) tidal volume.
B) inhalation.
C) respiration.
D) ventilation.

Question 12

Which of the following describes why fast respiration may decrease minute volume?

A) The lungs may not have the time to fill and exchange gas.
B) The rate causes turbulence in the trachea that increases the friction and decreases the amount of air movement.
C) It is due to the delay in the movement of the intercostal muscles and the pleural space.
D) The rate does not decrease minute volume; it actually increases.

Question 13

A 16-year-old patient presents with labored breathing and increased respiratory rate,increased heart rate,and leaning forward with his hands on his knees.His skin is pink and his accurate pulse oximetry is 96.This patient is suffering from respiratory:

A) failure.
B) hypoxia.
C) distress.
D) arrest.

Question 14

When does respiratory distress change to respiratory failure?

A) When the respiratory challenge continues, the systems fail with the demand for oxygen, pupils dilate, and the skin becomes hot and dry.
B) When the respiratory challenge continues, the systems cannot keep up with the demand, and skin color and mental status change.
C) When the patient who is short of breath, with noisy respiration, presents in the tripod position but then suddenly has the condition clear up and return to normal.
D) When the compensatory mechanism is no longer needed and the patient goes into arrest.

Question 15

What signs and symptoms would indicate inadequate breathing in a patient?

A) Increased effort to breathe, increased depth of respiration, pink dry skin, normal mental status
B) Rapid breathing, pale skin, and a normal mental status
C) Decreased depth of respiration, decreased rate of breathing, hot clammy skin, normal mental status
D) Increased effort to breathe, cyanosis, cool clammy skin, altered mental status

Question 16

What are the signs of hypoxia?

A) Warm dry skin, with difficulty in breathing, and hypertension
B) Commonly seen as blue or gray skin, deterioration of patient's mental status like confusion or restlessness
C) Disease process that robs the patient of adequate breathing and perfusion
D) Shock caused from the lack of blood flowing to the vital organs like the brain and heart that is irreversible

Question 17

The normal stimulus to breathe is stimulated by the chemoreceptors that measure the change of what two gases?

A) Low hydrogen and high carbon monoxide
B) High carbon monoxide and low oxygen
C) High hydrogen and low carbon dioxide
D) High carbon dioxide and low oxygen

Question 18

To calculate the minute volume,you need to multiply what two measurements?

A) Tidal volume and respiratory rate
B) Alveolar ventilation and respiratory rate
C) Respiratory rate and bronchial dilation
D) Tidal volume and dead space air

Question 19

The movement of oxygen and carbon dioxide between the alveoli and circulating blood is called:

A) internal respiration.
B) osmosis.
C) cellular respiration.
D) pulmonary (external) respiration.

Question 20

Your patient is a motorcyclist who was ejected after striking a guard rail.The patient is unresponsive to painful stimuli and is breathing shallowly six to eight times per minute.Which of the following should you do first?

A) Use a bag-valve mask with supplemental oxygen.
B) Perform a rapid trauma assessment.
C) Apply a cervical collar.
D) Apply a nonrebreather mask with an oxygen flow rate of 15 lpm.

Question 21

Before applying a nonrebreather mask,the EMT should take what action?

A) Insert a properly sized oropharyngeal airway.
B) Connect the mask to a humidified oxygen source and wait for the patient's heart rate to slow.
C) Make sure the oxygen supply has greater than 2,000 psi in the tank.
D) Inflate the reservoir bag and make sure the bag does not deflate during inspiration.

Question 22

What device is used to perform mouth-to-mask ventilation?

A) Pocket face mask
B) Bag-valve mask
C) Stoma
D) Automatic transport ventilator

Question 23

A ________ is NOT typically used in the prehospital setting for oxygen administration.

A) nasal cannula
B) partial rebreather mask
C) regulator
D) tracheostomy mask

Question 24

You are attempting to replace the oxygen cylinder in your truck.After removing the regulator from the old cylinder,removing the old cylinder,and placing the new cylinder in the oxygen compartment,you attempt to connect the regulator.The new cylinder has a yellow stripe around it instead of a green one but was stored with the green cylinders.You are unable to get the regulator to seat properly and it will not turn.You should:

A) attempt to force the regulator onto the cylinder.
B) remove the cylinder and get a green cylinder.
C) replace the oxygen regulator with a new one.
D) put the old cylinder back on the truck.

Question 25

You are ventilating an adult patient with a bag-valve mask when you notice that his abdomen is getting bigger.You should:

A) apply cricoid pressure.
B) decrease the flow of oxygen.
C) apply pressure to the abdomen.
D) suction the airway.

Question 26

You are transporting a 44-year-old female with chest pain and sudden respiratory distress.She is agitated,anxious,and refuses to have a nonrebreather mask applied.Which of the following is the best option?

A) Use a nasal cannula instead.
B) Have her breathe into a paper bag to control her hyperventilation.
C) Do not make further attempts to administer oxygen as it will only agitate the patient further.
D) Consult with medical control about restraining the patient.

Question 27

Which of the following is acceptable for maintaining a seal between an oxygen cylinder and regulator?

A) Pop-off valve
B) Gasket
C) Grease plug
D) Medical grade adhesive tape

Question 28

You are aggressively ventilating an adult patient with a bag-valve mask when you notice that his previously strong pulse is getting weaker.You should:

A) increase the concentration of oxygen.
B) reduce the concentration of oxygen.
C) reduce the volume of the ventilations.
D) begin chest compressions.

Question 29

Your patient is a 55-year-old man with a history of chronic bronchitis.You have been called to his home today because of an increase in his level of respiratory distress.The patient is on 2 liters per minute of oxygen by nasal cannula at home.Your assessment reveals difficulty speaking due to shortness of breath,leaning forward to breathe,a productive cough,and a respiratory rate of 32 per minute.Which of the following is true concerning the best course of action for this patient?

A) Because increased blood levels of carbon dioxide are the primary stimulus to breathe, you should encourage the patient to rebreathe his exhaled air from a paper bag.
B) You should increase the patient's oxygen flow rate to deliver adequate amounts of oxygen to his tissues. If his respiratory rate decreases, you can assist him with a bag-valve-mask device.
C) You should increase the patient's oxygen flow rate until his respiratory rate decreases and then resume oxygen administration at 2 liters per minute.
D) You should not increase the patient's oxygen flow rate because of his likely dependence on a hypoxic drive to stimulate breathing.

Question 30

Which of these patients would require a tracheostomy mask for supplemental oxygen administration?

A) A patient with a stoma
B) A patient with quadriplegia
C) A patient with chronic bronchitis
D) A patient with upper airway inflammation

Question 31

What is the percentage of oxygen provided by connecting a high flow of oxygen to the oxygen inlet found on a pocket mask?

A) 50%
B) 21%
C) 100%
D) 16%

Question 32

Which of the following is the best device to deliver high-concentration oxygen to a breathing patient?

A) Simple face mask
B) Nonrebreather mask
C) Nasal cannula
D) Oropharyngeal airway

Question 33

What is NOT one of the basic parts of a bag-valve-mask system?

A) Self-refilling shell
B) Non-jam valve
C) Be nonrebreathing
D) 15/25 respiratory fitting

Question 34

Venturi masks are designed to mix oxygen with:

A) nitrogen.
B) inhaled air.
C) humidified air.
D) carbon monoxide.

Question 35

A 21-year-old patient presents with labored breathing and audible wheezes,heart rate of 124,respiration 36; he has significantly altered mentation.What is the treatment for this patient?

A) Supplement the breaths with high-concentration oxygen through a nonrebreather mask.
B) Use a pocket mask, which will provide adequate oxygen to improve the patient's condition.
C) Ventilate with a bag-valve mask with high oxygen or FROPVD.
D) Give mouth-to-mouth breathing with a nasal cannula, providing the patient with an increase of oxygen.

Question 36

The oxygen flow rate for a nasal cannula should not exceed ________ liters per minute.

A) 8
B) 4
C) 6
D) 2

Question 37

You and your EMT partner are preparing to ventilate an elderly non-trauma patient who has a stoma.Your partner performs the head-tilt,chin-lift maneuver and you ask him to return the patient's head to a neutral position."Why? This is not a pediatric patient!" your partner protests.What would you say?

A) Elderly patients should never have their heads tilted back because spinal curvatures are common and can prevent airway positioning.
B) It is not necessary to position the airway of a stoma breather when providing ventilations.
C) Stoma breathers should only have their airways positioned after placement of the ventilation device.
D) Using the head-tilt, chin-lift prior to clearing any mucus plugs from the stoma can cause airway occlusion.

Question 38

Your patient is a 65-year-old male with a history of COPD.He is sitting up and complaining of a severe shortness of breath.You should:

A) suction the airway with a rigid suction catheter.
B) administer 4 lpm of oxygen via nasal cannula.
C) insert a nasal airway and ventilate.
D) apply a nonrebreather mask giving 15 lpm of oxygen.

Question 39

A nonrebreather mask at 12 to 15 liters per minute will generally provide the patient what percentage of oxygen?

A) 80-100
B) 16-21
C) 24-44
D) 90-100

Question 40

Which of the following oxygen cylinders would normally run out after 50 minutes when flowing at 10 liters per minute?

A) M tank
B) D tank
C) G tank
D) E tank

Question 41

Which of the following colors identifies an oxygen cylinder?

A) Orange and red
B) Black and tan
C) Blue and yellow
D) Green and white

Question 42

Which of the following is necessary to deliver oxygen to patients at a safe pressure?

A) Filter
B) Float ball
C) Regulator
D) Flowmeter

Question 43

The safe residual for an oxygen cylinder is ________ psi.

A) 200
B) 300
C) 500
D) 1,000

Question 44

Concerning the use of humidified oxygen,which of the following is true?

A) It should only be used when assisting ventilations with a bag-valve-mask device.
B) The water in the reservoir should be treated with chlorine tablets to prevent the growth of bacteria.
C) It is not of great benefit during short transports but can make the patient more comfortable.
D) The water reservoir should be changed on a weekly basis.

Question 45

Of the three types of oxygen flowmeters,which one can only be used upright?

A) Bourdon gauge flowmeter
B) Hudson gauge flowmeter
C) Constant flow selector valve
D) Pressure-compensated flowmeter