Chapter 14 Workbook

Question 1

The steps used to reestablish artificial ventilation and circulation in a patient who is not breathing and has no pulse

Answer 1

Cardiopulmonary resuscitation (CPR)

Question 2

Opening the airway without causing manipulation to the cervical spine

Answer 2

Jaw thrust maneuver

Question 3

Noninvasive emergency lifesaving care used to treat airway obstructions, respiratory arrest, and cardiac arrest

Answer 3

Basic life support (BLS)

Question 4

Procedures such as cardiac monitoring, intravenous (IV) medications, and advanced airway adjuncts

Answer 4

Advanced life support (ALS)

Question 5

The method of dislodging food or other material from the throat of a conscious choking victim

Answer 5

Abdominal thrust maneuver

Question 6

The stomach becoming filled with air

Answer 6

Gastric distention

Question 7

Depresses the sternum via a plunger mounted on a backboard

Answer 7

Mechanical piston device

Question 8

Used to maintain an open airway in an adequately breathing patient with a decreased level of consciousness

Answer 8

Recovery position

Question 9

Opening the airway in a patient who has not sustained trauma to the cervical spine

Answer 9

Head tilt–chin lift maneuver

Question 10

A valve device that helps to draw more blood back to the heart during chest compressions

Answer 10

Impedance threshold device (ITD)

Question 11

After _______ without oxygen, brain damage is very likely.
A. 1 minute
B. 3 minutes
C. 4 minutes
D. 6 minutes

Answer 11

D. 6 minutes

Question 12

All of the following are considered advanced lifesaving procedures EXCEPT:
A. cardiac monitoring
B. bag-mask ventilation
C. administration of IV fluids and medications
D. use of advanced airway adjuncts

Answer 12

B. bag-mask ventilation

Question 13

In a conscious infant who is choking, you would first give five back slaps, followed by:
A. attempting to breathe
B. five chest thrusts
C. checking the pulse
D. five abdominal thrusts

Answer 13

B. five chest thrusts

Question 14

In addition to checking level of consciousness, it is also important to protect the ___ from further injury while assessing the patient and performing CPR.
A. neck
B. ribs
C. internal organs
D. facial structures

Answer 14

A. neck

Question 15

In most cases, cardiac arrest in infants and children results from:
A. toxic ingestion
B. anaphylaxis
C. congenital heart disease
D. respiratory arrest

Answer 15

D. respiratory arrest

Question 16

Common causes of respiratory arrest in infants and children include:
A. foreign body obstruction
B. vomiting
C. poor feeding
D. chronic obstructive pulmonary disease (COPD)

Answer 16

A. foreign body obstruction

Question 17

Resuscitation would NOT be initiated if which of the following obvious signs of death were present:
A. bleeding
B. dependent edema
C. decapitation
D. pale skin

Answer 17

C. decapitation

Question 18

Once you begin CPR in the field, you must continue until:
A. the fire department arrives
B. the funeral home arrives
C. a person of equal or higher training relieves you
D. law enforcement arrives and assumes responsibility

Answer 18

C. a person of equal or higher training relieves you

Question 19

If you encounter a pregnant patient in cardiac arrest, your priorities are to provide high-quality CPR and:
A. relieve pressure off the aorta and vena cava
B. rapid transport for emergency caesarian section
C. intermittent abdominal thrusts
D. increase pressure on the aorta and vena cava

Answer 19

A. relieve pressure off the aorta and vena cava

Question 20

To perform a ___, place your fingers behind the angles of the patient’s lower jaw and then move the jaw forward.
A. head tilt–chin lift maneuver
B. jaw-thrust maneuver
C. tongue–jaw lift maneuver
D. head–jaw lift maneuver

Answer 20

B. jaw-thrust maneuver

Question 21

Providing fast, aggressive ventilations could result in:
A. excessive bleeding
B. rupture of the bronchial tree
C. gastric distention
D. damage to the oral pharynx

Answer 21

C. gastric distention

Question 22

A(n) ___ is an opening that connects the trachea directly to the skin.
A. ileostomy
B. stoma
C. laryngectomy
D. colostomy

Answer 22

B. stoma

Question 23

___ position helps to maintain a clear airway in a patient with a decreased level of consciousness who has not had traumatic injuries and is breathing on his or her own.
A. The recovery
B. The lithotomy
C. Trendelenburg’s
D. Fowler’s

Answer 23

A. The recovery

Question 24

In the adult, cardiac arrest is determined by the absence of the pulse at the ___ artery.
A. femoral
B. radial
C. ulnar
D. carotid

Answer 24

D. carotid

Question 25

In the adult, the proper hand placement for chest compressions is accomplished by placing the heel of one hand: A. on the lower half of the sternum B. near the clavicles C. over the xiphoid process D. between the nipples

Answer 25

A. on the lower half of the sternum

Question 26

Which of the following is NOT a common complication from performing chest compressions? A. Fractured ribs B. Lacerated liver C. Fractured sternum D. Lacerated pancreas

Answer 26

D. Lacerated pancreas

Question 27

When checking for a pulse in an infant, you should palpate the ___ artery. A. radial B. brachial C. carotid D. femoral

Answer 27

B. brachial

Question 28

The rate of compressions for an infant is ___ compressions per minute. A. 70 to 80 B. 80 to 100 C. 100 to 120 D. 120 to 150

Answer 28

C. 100 to 120

Question 29

The ratio of compression to ventilation for infants and children is ___ when performing two-rescuer CPR. A. 1:5 B. 5:1 C. 15:2 D. 2:15

Answer 29

C. 15:2

Question 30

Sudden airway obstruction is usually easy to recognize in someone who is eating or has just finished eating because they suddenly: A. are able to speak clearly B. turn pink C. make exaggerated efforts to breathe D. start screaming

Answer 30

C. make exaggerated efforts to breathe

Question 31

You should suspect an airway obstruction in the unresponsive patient if: A. the patient is breathing B. you do not produce visible chest rise with ventilations C. there is no pulse D. you have adequate chest rise with each ventilation

Answer 31

B. you do not produce visible chest rise with ventilations

Question 32

You should use ____ for women in advanced stages of pregnancy who are conscious and suffering from a foreign body airway obstruction. A. the blind finger sweep B. back slaps C. the abdominal-thrust maneuver D. chest thrusts

Answer 32

D. chest thrusts

Question 33

For a patient with a mild airway obstruction, you should: A. begin chest compressions B. attempt a finger sweep to remove the foreign body C. not interfere with the patient’s attempt to expel the foreign body D. immediately perform abdominal thrusts

Answer 33

C. not interfere with the patient’s attempt to expel the foreign body

Question 34

During the primary assessment, you need to quickly evaluate the patient’s airway, breathing, circulation, and level of consciousness.

Answer 34

True

Question 35

All unconscious patients need all elements of BLS.

Answer 35

False

Question 36

A person who is unresponsive may or may not need CPR.

Answer 36

True

Question 37

The recovery position should be used to maintain an open airway in a patient with a head or spinal injury.

Answer 37

False

Question 38

You should use a bag-mask device when providing artificial ventilations in the prehospital environment.

Answer 38

True

Question 39

You should not start CPR if the patient has obvious signs of irreversible death.

Answer 39

True

Question 40

When performing CPR, you must allow the chest to fully recoil between each compression.

Answer 40

True

Question 41

The ratio of compressions to ventilations for one-person CPR on an adult is 2:1.

Answer 41

False

Question 42

Short, jabbing compressions are more effective than rhythmic compressions.

Answer 42

False

Question 43

A mask with a one-way valve or other barrier device can be used to provide rescue breathing to a child or infant with a stoma if a bag-mask device is unavailable.

Answer 43

True

Question 44

Families typically expect EMS providers to stop resuscitation and leave their loved one on scene.

Answer 44

False

Question 45

When an AED with adult pads is used on an infant, it may be necessary to use anterior-posterior pad placement based on the manufacturer’s recommendations.

Answer 45

True

Question 46

In the adult, the sternum should be depressed 2 to 2.4 inches (5 to 6 cm) during chest compressions.

Answer 46

True

Question 47

In adults, the compression-to-breath ratio is always 30:2 in two-rescuer CPR.

Answer 47

True

Question 48

A Physician Orders for Life-Sustaining Treatment (POLST) must be signed by an authorized medical provider to be valid.

Answer 48

True

Question 49

Permanent brain damage is possible if the brain is without oxygen for ________ to ________ minutes.

Answer 49

4, 6

Question 50

If the patient’s chest is ________, then the electrical current may move across the ________ rather than between the pads to the patient’s heart.

Answer 50

wet, skin

Question 51

Because of the urgent need to start CPR in a pulseless, nonbreathing patient, you must complete a primary assessment as soon as possible and begin CPR with ________ ________.

Answer 51

chest compressions

Question 52

If you encounter a patient who has a hard lump beneath the skin in the chest near the heart, you should assume the patient has a(n) ________.

Answer 52

pacemaker

Question 53

________ ________, such as living wills, may express the patient’s wishes, but these documents are not binding for all health care providers.

Answer 53

Advance directives

Question 54

For CPR to be effective, the patient must be lying supine on a(n) ________ ________ surface.

Answer 54

firm, flat

Question 55

Without an open ________, rescue breathing will not be effective.

Answer 55

airway

Question 56

The ________ ________ _________ should be applied to an adult cardiac arrest patient as soon as it is available.

Answer 56

automated external defibrillator

Question 57

Assess for a pulse in an adult patient by palpating the ________ artery.

Answer 57

carotid

Question 58

A(n) ________ ________ ________ is a device that depresses the sternum via a compressed gas-powered or electric-powered plunger mounted on a backboard.

Answer 58

mechanical piston device

Question 59

Short Answers List the four obvious signs of death, in addition to absence of pulse and breathing, that are used as a general rule against starting CPR.

Answer 59

1. Rigor mortis, or stiffening of the body after death 2. Dependent lividity (livor mortis), a discoloration of the skin due to pooling of blood 3. Putrefaction or decomposition of the body 4. Evidence of nonsurvivable injury, such as decapitation

Question 60

Short Answers List the six components of the American Heart Association’s chain of survival.

Answer 60

1. Recognition and activation of EMS 2. Immediate, high-quality CPR 3. Rapid defibrillation 4. Basic and advanced EMS 5. Advanced life support and postarrest care 6. Recovery

Question 61

Short Answers List five respiratory problems leading to cardiac arrest in children.

Answer 61

1. Injury, both blunt and penetrating 2. Infections of the respiratory tract or another organ system 3. A foreign body airway obstruction 4. Submersion (drowning) 5. Electrocution 6. Poisoning or drug overdose 7. Sudden infant death syndrome (SIDS)

Question 62

Short Answers Describe how to perform the head tilt–chin lift maneuver.

Answer 62

To perform the head-tilt chin-lift maneuver, make sure the patient is supine. Place one hand on the patient’s forehead and apply firm backward pressure with your palm to tilt the head back. Next, place the tips of your fingers of your other hand under the lower jaw near the bony part of the chin. Lift the chin upward, bringing the entire lower jaw with it, helping to tilt the head back.

Question 63

Short Answers Describe how to perform the jaw-thrust maneuver.

Answer 63

To perform the jaw-thrust maneuver, place your fingers behind the angle of the lower jaw on both sides and move the jaw upward. Keep the head in a neutral position. If the mouth remains closed, use your thumbs to pull the patient’s lower jaw down to allow breathing.

Question 64

Short Answers Describe the process of chest compressions during one-rescuer adult CPR.

Answer 64

Take standard precautions. Once you have determined that the patient is unresponsive, call for additional help. Check for breathing and a carotid pulse for no more than 10 seconds. Ensure that the patient is on a firm, flat surface in a supine position. Place your hands in the proper position. Give 30 compressions at a rate of 100 to 120 per minute for an adult. Using a rhythmic motion, apply pressure vertically from your shoulders down through both arms to depress the sternum 2 inches to 2.4 inches (5 cm to 6 cm) in an adult, then rise up gently and fully. Count the compressions aloud.

Question 65

Short Answers List and describe the method for “switching positions” during two-rescuer adult CPR.

Answer 65

Rescuer one should finish the cycle of 30 compressions while a second rescuer moves to the opposite side of the chest and moves into position to begin compressions. Rescuer one delivers two ventilations, and then rescuer two should take over compressing by administering 30 compressions.

Question 66

Short Answers Describe the process of abdominal thrusts for a standing patient with a foreign body airway obstruction.

Answer 66

Standing: Stand behind the patient and wrap your arms around his or her abdomen. Make a fist with one hand, then grasp the fist with the other hand. Place the thumb side of the fist against the patient’s abdomen between the umbilicus and the xiphoid process. Press your fist into the patient’s abdomen in quick inward and upward thrusts until the object is expelled or the patient becomes unconscious.

Question 67

Short Answers Describe the process for chest thrusts on a standing and a supine patient.

Answer 67

Standing: Stand behind the patient and wrap your arms under the armpits and around the patient’s chest. Make a fist with one hand, then grasp the fist with the other hand. Place the thumb side of the fist against the patient’s sternum. Press your fist into the patient’s chest and perform backward thrusts until the object is expelled or the patient becomes unconscious. Supine: Kneel next to the patient. Place your hands as you would to deliver chest compressions. Deliver 30 chest compressions, open the airway, and look in the mouth. If the object is visible, remove it. If not, continue the cycle of chest compressions and opening the airway.

Question 68

Short Answers Describe the process for removing a foreign body airway obstruction in a responsive infant.

Answer 68

1. Hold the infant face down, with the body resting on your forearm. Support the infant’s jaw and face with your hand and keep the head lower than the body. 2. Deliver five back slaps between the shoulder blades, using the heel of your hand. 3. Place your free hand behind the infant’s head/back and turn the infant faceup. 4. Give five quick chest thrusts on the sternum using two fingers. 5. Check the airway. If the object is visible, then remove it.

Question 69

Ambulance Calls You are dispatched to a “person down.” The dispatcher informs you that the caller said the patient is not breathing. On arrival, you find a 78-year-old woman in bed, apneic, and pulseless. In the process of moving the patient to place a CPR board underneath her, you note the discoloration of her back and hips known as extreme dependent lividity. How would you best manage this patient?

Answer 69

Question the family about the last time they spoke with her. Explain that she has been down too long for CPR to be effective. Comfort family members. Notify your dispatcher to alert the supervisor and either law enforcement, the coroner, or a funeral home according to local protocols.

Question 70

Ambulance Calls You are off-duty when you hear a dispatch for “chest pain” at a private residence near you. You arrive to find the patient’s family members attempting to apply an AED they bought over the Internet. The patient currently has a pulse and is breathing. How would you best manage this situation?

Answer 70

With the FDA’s approval of AEDs for home use, it will become more common to see them being used by the lay provider. Simply purchasing an AED does not ensure appropriate usage during real-life events. Training by knowledgeable, skilled instructors is needed to minimize confusion and inappropriate AED use. Remove the AED and explain to them that AEDs are meant to be used only when a person is not breathing and has no pulse. Emphasize that it is appropriate to have the AED nearby in the event that a person goes into cardiorespiratory arrest, but that it is not to be applied until then. After the patient has been transported to the hospital, tell the friends and family that you appreciate their willingness to be prepared for emergencies and that you would like to see them be successful in their usage of their AED. If you or your department offers CPR/AED courses, offer to train them and/or point them in the right direction to receive the appropriate training.

Question 71

Ambulance Calls You are dispatched to an “unconscious man” at a private residence. You arrive to find the man lying in the grass in the backyard. There is a ladder and equipment on the rooftop. It appears he was working on the roof of his two-story home. No one witnessed the event. The man is breathing and has a pulse. How would you best manage this patient?

Answer 71

Given the scene, you must assume that there is the likelihood for trauma. This means that you must assess and maintain his airway without manipulating his spine. Use the jaw-thrust maneuver and apply full cervical spine precautions. Also, consider possible causes of his unconscious state, including any scene hazards and potential medical conditions.