Chapter 11

Question 1

1. Which of the following statements regarding positive-pressure ventilation is correct?

Positive-pressure ventilation allows blood to naturally be pulled back to the heart from the body.

With positive-pressure ventilation, more volume is required to have the same effects as normal breathing.

Unlike negative pressure ventilation, positive-pressure ventilation does not affect the esophageal opening pressure

To prevent hypotension, the EMT should increase the rate and force of positive-pressure ventilation.

Answer 1

With positive-pressure ventilation, more volume is required to have the same effects as normal breathing.

Question 2

2. Prior to applying a nonrebreathing mask to a patient, you must ensure that the

flow rate is set at 6 L/min.

patient has reduced tidal volume.

reservoir bag is fully inflated.

one-way valve is sealed

Answer 2

reservoir bag is fully inflated.

Question 3

3. You are ventilating a 40-year old uninjured man who is apneic but has a pulse. When your partner reassesses his blood pressure, she notes that he has decreased significantly from previous readings. You should:

increase the rate at which you are ventilating and reassess his blood pressure.

perform a head-to-toe assessment to look for signs of bleeding.

increase the volume of your ventilations and reassess his blood pressure.

reduce the rate or volume of the ventilations you are delivering.

Answer 3

reduce the rate or volume of the ventilations you are delivering.

Question 4

4. Which of the following organs or tissues can survive the longest without oxygen?

Muscle

Heart

Kidneys

Liver

Answer 4

Muscle

Question 5

5. A man was found unresponsive in his bed at home. There is no evidence of injury, and the patient’s medical history is not known. The patient’s face is cherry red, yet the pulse oximeter reads 98% . Which of the following would MOST likely explain this?

Carbon monoxide poisoning

Cold extremities.

Increased body temperature

Severe pulmonary edema

Answer 5

Carbon monoxide poisoning

Question 6

6. A ventilation/perfusion (V/Q ratio) mismatch occurs when:

ventilation is inadequate due to a traumatic injury or medical condition, which results in an impairment in pulmonary gas exchange

a disruption in blood flow inhibits the exchange of oxygen and carbon dioxide the lungs, even though the alveoli are filled with fresh oxygen.

a traumatic injury or medical condition impairs the body’s ability to effectively bring oxygen into the lungs and remove carbon dioxide from the body.

ventilation is compromised, resulting in the accumulation of carbon dioxide in the bloodstream, alveol and the tissues and cells of the body.

Answer 6

a disruption in blood flow inhibits the exchange of oxygen and carbon dioxide the lungs, even though the alveoli are filled with fresh oxygen.

Question 7

7. In contrast to inhalation, exhalation:

occurs when the diaphragm lowers and expels air from the lungs

requires muscular effort to effectively expel air from the lungs.

is an active process caused by decreased intrathoracic pressure.

is a passive process caused by increased intrathoracic pressure.

Answer 7

is a passive process caused by increased intrathoracic pressure.

Question 8

8. Central chemoreceptors located in the medulla provide feedback to increase the rate and depth of breathing when they sense:

Increased levels of oxygen in the blood and a decrease in the pH of the cerebrospinal fluid.

decreased levels of oxygen in the blood and an increase in the pH of the cerebrospinal fluid.

slight increases in carbon dioxide or a decrease in the pH of the cerebrospinal fluid.

slight decreases in carbon dioxide and an increase in the pH of the cerebrospinal fluid.

Answer 8

slight increases in carbon dioxide or a decrease in the pH of the cerebrospinal fluid.

Question 9

9. The physical act of moving air into and out of the lungs is called:

respiration.

diffusion.

oxygenation.

ventilation.

Answer 9

ventilation.

Question 10

10. Which of the following structures is NOT found in the upper airway?

Larynx

Bronchus

Oropharynx

Pharynx

Answer 10

Bronchus

Question 11

11. The presence of elevated carbon dioxide levels in the blood is called:

acidosis.

hypercarbia.

hypoxia.

hypoxemia.

Answer 11

hypercarbia.

Question 12

12. Which of the following patients would MOST likely require insertion of an oropharyngeal airway?

A 51-year-old confused patient with severely labored respirations

A 40-year-old unconscious patient with slow, shallow respirations

A 64-year-old conscious patient with rapid and deep respirations

A 33-year-old semiconscious patient with reduced tidal volume

Answer 12

A 40-year-old unconscious patient with slow, shallow respirations

Question 13

13. Which of the following is a late sign of hypoxia?.

Cyanosis

Tachycardia

Anxiety

Restlessness

Answer 13

Cyanosis

Question 14

14. What is the alveolar minute volume of a patient with a tidal volume of 500 mL, a dead space volume of 150 and a respiratory rate of 16 breaths/min?

8,000 ml

6,000 mL

5,600 mL

7,400 mL

Answer 14

5,600 mL

Question 15

15. The actual exchange of oxygen and carbon dioxide accurs in the:
    bronchioles.

pulmonary capillaries.

alveolar sacs.

apex of the lung.

Answer 15

alveolar sacs.

Question 16

16. An oxygen cylinder should be taken out of service and refilled when the pressure inside it is less than:

1,500 psi.

500 psi.

1,000 psi.

200 psi.

Answer 16

500 psi.

Question 17

17. At a flow rate of 6 L/min, a nasal cannula can deliver an approximate oxygen concentration of up to:

24 %.

35%.

52%.

44%

Answer 17

44%

Question 18

18. High-flow oxygen with a nasal cannula during the preoxygenation phase of endotracheal intubation is called:

passive ventilation.

apneic oxygenation.

denitrogenation.

active ventilation.

Answer 18

apneic oxygenation.

Question 19

19. The hypoxic drive is influenced by:

high blood carbon dioxide levels.

low blood carbon dioxide levels.

low blood oxygen levels.

high blood oxygen levels,

Answer 19

low blood oxygen levels.

Question 20

20. For which of the following conditions would the EMT most likely administer humidified oxygen?

Croup

Apnea

Blood loss

Hypoxia

Answer 20

Croup

Question 21

21. Proper technique for suctioning the oropharynx of an adult patient includes:

continuously suctioning patients with copious oral secretions.

suctioning while withdrawing the catheter from the oropharynx.

removing large, solid objects with a tonsil-tip suction catheter.

suctioning for up to 1 minute if the patient is well oxygenated.

Answer 21

suctioning while withdrawing the catheter from the oropharynx.

Question 22

22. How does CPAP improve oxygenation and ventilation in patients with certain respiratory problems?

It decreases intrathoracic pressure, which allows more room for lung expansion.

It pushes thick, infected pulmonary secretions into isolated areas of the lung.

It prevents alveolar collapse by pushing air into the lungs during inhalation.

It forces the alveoli open and increases the concentration of oxygen in the alveoli.

Answer 22

It forces the alveoli open and increases the concentration of oxygen in the alveoli.

Question 23

23. The jaw-thrust maneuver is used to open the airway of patients with suspected:

mandibular fractures.

upper airway swelling.

cervical spine injuries.

copious oral secretions

Answer 23

cervical spine injuries.

Question 24

24. Which of the following statements regarding the one-person bag-mask technique is correct?

The bag-mask device delivers more tidal volume and a higher oxygen concentration than the mouth-to mask technique.

The C-clamp method of holding the mask to the face is not effective when ventilating a patient with bag-mask device.

Adequate tidal volume is often difficult to achieve when one EMT is operating the bag-mask device.

Bag-mask ventilations should be delivered every 2 seconds when the device is being operated by one person.

Answer 24

Adequate tidal volume is often difficult to achieve when one EMT is operating the bag-mask device.

Question 25

25. A 71-year-old male is semiconscious following a sudden, severe headache. There is vomitus on his face, and hisrespirations are slow and shallow. The EMT must immediately: apply oxygen via a nonrebreathing mask. begin assisting the patient's ventilations. perform oropharyngeal suctioning insert a nasopharyngeal airway.

Answer 25

perform oropharyngeal suctioning

Question 26

26. A nasopharyngeal airway is inserted: into the larger nostril with the tip pointing away from the septum.. into the smaller nostril with the tip following the roof of the nose. with the bevel pointing downward if inserted into the left nare. with the bevel facing the septum if inserted into the right nare.

Answer 26

with the bevel facing the septum if inserted into the right nare

Question 27

27. With a good mask-to-face seal and an oxygen flow rate of 15 L/min, the nonrebreathing mask is capable of delivering up to _________ % inspired oxygen. 70 100 90 80

Answer 27

90

Question 28

28. Which of the following statements regarding normal gas exchange in the lungs is correct? Oxygen and carbon dioxide diffuse across the alveolar walls and capillaries. The oxygen content in the alveoli is highest during the exhalation phase. Blood that returns to the lungs from the body has low levels of carbon dioxide. The actual exchange of oxygen and carbon dioxide occurs in the capillaries.

Answer 28

Oxygen and carbon dioxide diffuse across the alveolar walls and capillaries.

Question 29

29. You have inserted an oral airway and are ventilating an apneic woman with a bag-mask device. She suddenly begins regurgitating large amounts of vomit. You should: remove the oral airway and suction her oropharynx. insert a nasal airway and then suction her mouth. roll her onto her side and remove the oral airway. perform a finger sweep of her mouth.

Answer 29

roll her onto her side and remove the oral airway.

Question 30

30. In the presence of oxygen, the cells convert glucose into energy through a process called: perfusion. respiration. aerobic metabolism. anaerobic metabolism.

Answer 30

aerobic metabolism.

Question 31

31. During your assessment of a patient with respiratory distress, you hear wheezing when listening to breath sounds. This indicates: lower airway obstruction. secretions in the airway. fluid in the alveoli swelling of the upper airway.

Answer 31

lower airway obstruction.

Question 32

32. When testing a mechanical suctioning unit, you should turn on the device, clamp the tubing, and ensure that it generates a vacuum pressure of more than: 300 mm Hg. 400 mm Hg. 200 mm Hg 100 mm Hg

Answer 32

300 mm Hg.

Question 33

33. Gas exchange in the lungs is facilitated by: surfactant-destroying organisms. pulmonary capillary constriction. adequate amounts of surfactant. water or blood within the alveoli.

Answer 33

adequate amounts of surfactant.

Question 34

34. The MOST serious complication associated with using a nasopharyngeal airway in a patient with trauma to the head or face is: damaging the turbinates. penetrating the cranium, fracturing the septum. causing severe bleeding.

Answer 34

penetrating the cranium,

Question 35

35. Intrapulmonary shunting occurs when: a decrease in respiratory rate and depth causes carbon dioxide accumulation in the alveoli and an overall decrease in blood oxygen levels. the presence of pulmonary surfactant causes a decrease in alveolar surface tension, thus impairing the exchange of gases in the lungs any impairment in circulatory function causes a reduced ability for oxygen and carbon dioxide to diffuse across the alveolar-capillary membrane. blood coming from the right side of the heart bypasses nonfunctional alveoli and returns to the left side of the heart in an unoxygenated state.

Answer 35

blood coming from the right side of the heart bypasses nonfunctional alveoli and returns to the left side of the heart in an unoxygenated state.

Question 36

36. You are dispatched to a residence where a middle-aged man was found unconscious in his front yard. There are no witnesses who can tell you what happened. You find him in a prone position; his eyes are closed and he is not moving. Your FIRST action should be to: open his airway with a jaw-thrust maneuver. assess the rate and quality of his breathing. log roll him as a unit to a supine position. palpate for the presence of a carotid pulse.

Answer 36

palpate for the presence of a carotid pulse.

Question 37

37. A 51-year-old female presents with a sudden onset of difficulty breathing. She is conscious and alert and able to speak in complete sentences. Her respirations are 22 breaths/min and regular. You should: assist her ventilations with a bag-mask device. insert a nasal airway in case her mental status decreases perform a secondary assessment and then begin treatment. administer oxygen via a nonrebreathing mask.

Answer 37

administer oxygen via a nonrebreathing mask

Question 38

38. The________cartilage is a firm ring that forms the inferior part of the larynx. Thyroid Cricoid Pyriform Laryngeal

Answer 38

Cricoid

Question 39

39. Your protocols state that during the first few minutes of working on a cardiac arrest patient, you should provide passive ventilation. This means that you will: time your positive-pressure ventilations to occur during chest recoil. deliver positive-pressure ventilation at a rate of only 5 or 6 breaths/min. allow recall of the chest between compressions to draw air into the lungs. ventilate with a bag-valve mask that is not attached to oxygen.

Answer 39

allow recall of the chest between compressions to draw air into the lungs.

Question 40

40. You and your partner are caring for a critically injured patient who is unresponsive and apneic. Your partner is controlling severe bleeding from the patient's lower extremities as you attempt ventilations with a bag mask device. After repositioning the mask several times, you are unable to effectively ventilate the patient. You should: suction the patient's airway for 30 seconds and reattempt ventilations. hyperextend the patient's head and reattempt ventilations. insert an oropharyngeal airway and reattempt ventilations. continue attempted ventilations and transport immediately.

Answer 40

insert an oropharyngeal airway and reattempt ventilations.

Question 41

41. The process of exchanging oxygen and carbon dioxide between the alveoli and the blood of the capillaries is called: cellular metabolism. external respiration. alveolar ventilation. pulmonary ventilation.

Answer 41

external respiration.

Question 42

42. A patient who is suspected of being hypoxic and is breathing adequately should be given supplemental oxygen with a: nasal cannula. mouth-to-mask device bag-mask device. nonrebreathing mask

Answer 42

nonrebreathing mask

Question 43

43. Which of the following would cause an increase in the amount of exhaled carbon dioxide? Cardiopulmonary arrest Anaerobic metabolism. Excessive ventilation Increased cardiac output

Answer 43

Increased cardiac output

Question 44

44. Which of the following patients should you place in a recovery position? A 31-year-old semiconscious male with low blood sugar and adequate breathing A 19-year-old conscious mate with a closed head injury and normal respirations A 40-year-old conscious female with a possible neck injury and regular respirations A 24-year-old unconscious female who overdosed and has a reduced tidal volume

Answer 44

A 31-year-old semiconscious male with low blood sugar and adequate breathing

Question 45

45. A 23-year-old male experienced severe head trauma after his motorcycle collided with an oncoming truck. He is unconscious, has agonal gasps, and has copious bloody secretions in his mouth. How should you manage his airway? Provide continuous ventilations with a bag-mask device to minimize hypoxia. Insert a nasopharyngeal airway and provide suction and assisted ventilations. Alternate oropharyngeal suctioning and ventilation with a bag-mask device. Suction his oropharynx with a rigid catheter until all secretions are removed.

Answer 45

Alternate oropharyngeal suctioning and ventilation with a bag-mask device.

Question 46

46. As the single EMT managing an apneic patient's airway, the preferred initial method of providing ventilations is the: one-person bag-valve mask. manually triggered ventilation device. mouth to mouth technique. mouth-to-mask technique with a one-way valve.

Answer 46

mouth-to-mask technique with a one-way valve.

Question 47

47. In which of the following patients would the head tilt-chin lift maneuver be the MOST appropriate method of opening the airway? 37-year-old female who is found unconscious in her bed A 24-year-old male who is found unconscious at the base of a tree Mos spine A 50-year-old male who is unconscious following head trauma -Mas spine A 45-year-old male who is semiconscious after falling 20 feet-Me Spe

Answer 47

37-year-old female who is found unconscious in her bed

Question 48

48. The nasal cannula is MOST appropriately used in the prehospital setting: when the patient breathes primarily through his or her mouth. if long-term supplemental oxygen administration is required. when the patient cannot tolerate a nonrebreathing mask. if the patient's nasopharynx is obstructed by secretions.

Answer 48

when the patient cannot tolerate a nonrebreathing mask.

Question 49

49. You are ventilating an apneic woman with a bag mask device. She has dentures, which are tight fitting. Adequate chest rise is present with each ventilation, and the patient's oxygen saturation reads 96%. When you reassess the patency of her airway, you note that her dentures are now loose, although your ventilations are still producing adequate chest rise. You should: leave her dentures in place and increase the rate and volume of your ventilations. leave her dentures in place, but carefully monitor her for an airway obstruction. remove her dentures, resume ventilations, and assess for adequate chest rise. attempt to replace her dentures that they fit tightly and resume ventilations.

Answer 49

remove her dentures, resume ventilations, and assess for adequate chest rise.

Question 50

50. Which of the following oxygen flowmeters is NOT affected by gravity and can be used in any position when attached to an oxygen cylinder? Pressure-compensated flowmeter Bourdon-gauge flowmeter Ball-and-float flowmeter Vertical position flowmeter

Answer 50

Bourdon-gauge flowmeter

Question 51

51. Without adequate oxygen, the body's cells: begin to metabolize fat, resulting in the production and accumulation of ketoacids incompletely convert glucose into energy, and lactic acid accumulates in the blood cease metabolism altogether, resulting in carbon dioxide accumulation in the blood. rely solely on glucose, which is completely converted into adenosine triphosphate.

Answer 51

incompletely convert glucose into energy, and lactic acid accumulates in the blood

Question 52

52. The structure located superior to the larynx is called the” cricoid ring epiglottis thyroid cartilage. Carina.

Answer 52

epiglottis

Question 53

53. Which of the following structures is contained within the mediastinum? Larynx Bronchioles Esophagus Lungs

Answer 53

Esophagus

Question 54

54. Which of the following statements regarding oxygenation and ventilation is correct? Oxygenation without adequate ventilation can occur in climbers who quickly ascend to an altitude of lower atmospheric pressure. Oxygenation is the movement of air into and out of the lungs, whereas ventilation is the exchange of gases. in mines or confined places, where oxygen levels are low, ventilation may continue despite inadequate oxygenation. In carbon monoxide (CO) poisoning, ventilation is impaired because CO binds to oxygen very quickly.

Answer 54

in mines or confined places, where oxygen levels are low, ventilation may continue despite inadequate oxygenation.

Question 55

55. You and your partner are treating a 66-year-old man who experienced a sudden onset of respiratory distress. He is conscious but is unable to follow simple verbal commands. Further assessment reveals that his breathing is severely labored and his oxygen saturation is 80%. You should: assist his ventilations with a bag-mask device. attempt to insert an oropharyngeal airway. apply high-flow oxygen via nonrebreathing mask administer continuous positive airway pressure.

Answer 55

assist his ventilations with a bag-mask device.