Chapter 16 Workbook Flashcards by Tom Bowl

The exchange of oxygen and carbon dioxide

Respiration

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Fluid buildup within the alveoli and lung tissue

Pulmonary edema

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An infection that can produce severe inflammation of the upper airway

Epiglottitis

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A disease of the lungs in which the alveoli lose elasticity due to chronic stretching

Emphysema

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Fluid outside the lung

Pleural effusion

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A disease that can lay dormant in the lungs for decades, then reactivate

Tuberculosis

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Difficulty breathing

Dyspnea

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An infection of the lung tissue leading to impaired gas exchange

Pneumonia

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A condition in which the body’s cells and tissues do not have enough oxygen

Hypoxia

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Ongoing irritation of the trachea and bronchi

Chronic bronchitis

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Overbreathing to the point that the level of carbon dioxide in the blood falls below normal

Hyperventilation

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A substance that leads to an allergic reaction

Allergen

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A blood clot or other substance in the circulatory system that travels to a blood vessel where it causes a blockage

Embolus

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An acute spasm of the bronchioles, associated with excessive mucus production and swelling of the mucous lining

Asthma

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Accumulation of air in the pleural space

Pneumothorax

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A blood clot lodged in the pulmonary artery is referred to as a:
A. myocardial infarction
B. stroke
C. pulmonary embolism
D. pulmonary effusion

C. pulmonary embolism

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The oxygen–carbon dioxide exchange takes place in the:
A. trachea
B. bronchial tree
C. alveoli
D. blood

C. alveoli

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The letter “S” in the pneumonic PASTE refers to:
A. symptoms
B. sputum
C. severity
D. sickness

B. sputum

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If carbon dioxide levels drop too low, the person automatically breathes:
A. normally
B. rapidly and deeply
C. slower and less deeply
D. fast and shallow

C. slower and less deeply

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If the level of carbon dioxide in the arterial blood rises above normal, the patient breathes:
A. normally
B. rapidly and deeply
C. slower and less deeply
D. fast and shallow

B. rapidly and deeply

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Inflammation and swelling of the pharynx, larynx, and trachea resulting in a “seal bark” is typically caused by:
A. emphysema
B. chronic bronchitis
C. croup
D. epiglottitis

C. croup

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The rate of breathing is typically increased when:
A. oxygen levels increase
B. oxygen levels decrease
C. carbon dioxide levels increase
D. carbon dioxide levels decrease

C. carbon dioxide levels increase

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________ is a sign of hypoxia of the brain.
A. Altered mental status
B. Decreased pulse rate
C. Decreased respiratory rate
D. Delayed capillary refill time

A. Altered mental status

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An obstruction to the exchange of gases between the alveoli and the capillaries may result from:
A. epiglottitis
B. pneumonia
C. a cold
D. croup

B. pneumonia

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Pulmonary edema can develop quickly after a major: A. heart attack B. episode of syncope C. brain injury D. trauma

A. heart attack

Pulmonary edema may be produced by: A. cigarette smoking B. seasonal allergies C. inhaling toxic chemical fumes D. carbon monoxide poisoning

C. inhaling toxic chemical fumes

________ is a loss of the elastic material around the air spaces as a result of chronic stretching of the alveoli. A. Emphysema B. Bronchitis C. Pneumonia D. Diphtheria

A. Emphysema

________ is a genetic disorder that affects the lungs and digestive system. A. Chronic obstructive pulmonary disease B. Cystic fibrosis C. Pertussis D. Bronchiolitis

B. Cystic fibrosis

Which of the following signs and symptoms will help distinguish chronic obstructive pulmonary disease (COPD) from congestive heart failure? A. Dyspnea B. Dependent edema C. Wheezing D. Skin color changes

B. Dependent edema

A pneumothorax is a partial or complete accumulation of air in the: A. pleural space B. alveoli C. abdomen D. subcutaneous tissue

A. pleural space

Asthma produces a characteristic ________ as patients attempt to exhale through partially obstructed air passages. A. rhonchi B. stridor C. wheezing D. rattle

C. wheezing

An allergic response to certain foods or some other allergen may produce an acute: A. bronchodilation B. asthma attack C. vasoconstriction D. insulin release

B. asthma attack

In most cases, what is the treatment of choice for anaphylaxis? A. Epinephrine B. High-flow oxygen C. Antihistamines D. Albuterol

A. Epinephrine

A collection of fluid outside the lungs on one or both sides of the chest is called a: A. pulmonary edema B. subcutaneous emphysema C. pleural effusion D. tension pneumothorax

C. pleural effusion

Always consider ________ in patients who were eating just before becoming short of breath. A. upper airway obstruction B. spontaneous pneumothorax C. lower airway obstruction D. bronchoconstriction

A. upper airway obstruction

______ is defined as overbreathing to the point that the level of arterial carbon dioxide falls below normal. A. Reactive airway syndrome B. Hyperventilation C. Tachypnea D. Pleural effusion

B. Hyperventilation

Which of the following is NOT an indication of inadequate breathing? A. Accessory muscle use B. Cyanosis C. A regular pattern of inspiration and expiration D. Unequal chest expansion

C. A regular pattern of inspiration and expiration

You respond to the home of a 78-year-old man having difficulty breathing. He is sitting at the kitchen table in a classic tripod position, wearing a nasal cannula. He is cyanotic, smoking, and has his shirt unbuttoned. His respirations are 30 breaths/min and shallow, his pulse rate is 110 beats/min, and his blood pressure is 136/88 mm Hg. Your first thought as an EMT should be to: A. apply a nonrebreathing mask at 15 L/min. B. call for backup. C. assess the airway status. D. determine scene safety.

D. determine scene safety.

You respond to the home of a 78-year-old man having difficulty breathing. He is sitting at the kitchen table in a classic tripod position, wearing a nasal cannula. He is cyanotic, smoking, and has his shirt unbuttoned. His respirations are 30 breaths/min and shallow, his pulse rate is 110 beats/min, and his blood pressure is 136/88 mm Hg. His brainstem senses the elevated level of ______ in the arterial blood, causing the rapid respirations. A. carbon dioxide B. oxygen C. insulin D. tobacco

A. carbon dioxide

You respond to the home of a 78-year-old man having difficulty breathing. He is sitting at the kitchen table in a classic tripod position, wearing a nasal cannula. He is cyanotic, smoking, and has his shirt unbuttoned. His respirations are 30 breaths/min and shallow, his pulse rate is 110 beats/min, and his blood pressure is 136/88 mm Hg. Proper management of this patient might include: A. application of a CPAP device B. chest compressions C. suctioning D. epinephrine

A. application of a CPAP device

You respond to the home of a 78-year-old man having difficulty breathing. He is sitting at the kitchen table in a classic tripod position, wearing a nasal cannula. He is cyanotic, smoking, and has his shirt unbuttoned. His respirations are 30 breaths/min and shallow, his pulse rate is 110 beats/min, and his blood pressure is 136/88 mm Hg. Which of the following is NOT a sign or symptom of his inadequate breathing? A. He was cyanotic. B. His blood pressure was 136/88. C. He was in a tripod position. D. His pulse rate was over 100 beats/min (tachycardia).

B. His blood pressure was 136/88.

You respond to the home of a 78-year-old man having difficulty breathing. He is sitting at the kitchen table in a classic tripod position, wearing a nasal cannula. He is cyanotic, smoking, and has his shirt unbuttoned. His respirations are 30 breaths/min and shallow, his pulse rate is 110 beats/min, and his blood pressure is 136/88 mm Hg. What should you do during the reassessment of this patient? A. Assess vital signs every 2 minutes. B. Repeat the primary assessment. C. Reassess what time your shift ends. D. Repeat the initial history.

B. Repeat the primary assessment.

Which of the following is a question you would NOT typically ask during the history taking of a patient with dyspnea? A. What has the patient already done for the breathing problem? B. Does the patient use a prescribed inhaler? C. Does the patient have any allergies? D. What time did the patient wake up this morning?

D. What time did the patient wake up this morning?

Generic names for popular inhaled medications include: A. Ventolin B. Flovent C. Albuterol D. Atrovent

C. Albuterol

Contraindications to helping a patient self-administer a metered-dose inhaler include all of the following EXCEPT: A. failure to obtain permission from medical control B. noticing that the patient is in the tripod position C. noticing that the patient has already taken the maximum dose of the medication D. noticing that the medication has expired

B. noticing that the patient is in the tripod position

Contraindications for CPAP include: A. being alert and able to follow commands B. a pulse oximetry reading of less than 90% C. a respiratory rate greater than 26 breaths/min D. hypotension

D. hypotension

A prolonged asthma attack that is unrelieved by epinephrine may progress into a condition known as: A. pleural effusion B. status epilepticus C. status asthmaticus D. reactive airway disease

C. status asthmaticus

Which of the following statements is FALSE regarding influenza? A. It may worsen chronic medical conditions. B. It is primarily a human respiratory disease that has mutated to infect animals. C. It is transmitted by direct contact with nasal secretions and aerosolized droplets. D. It has the potential to become a pandemic.

B. It is primarily a human respiratory disease that has mutated to infect animals.

Pulse oximeters measure the percentage of hemoglobin saturated with: A. carbon dioxide B. carbon monoxide C. oxygen D. iron

C. oxygen

An acute spasm of the smaller airways associated with excessive mucus production and swelling is characteristic of: A. asthma B. chronic bronchitis C. emphysema D. severe acute respiratory syndrome (SARS)

A. asthma

True/False Chronic bronchitis is characterized by spasm and narrowing of the bronchioles due to exposure to allergens.

False

True/False With pneumothorax, the lung collapses because the negative pressure in the pleural space is lost.

True

True/False Anaphylactic reactions occur only in patients with a previous history of asthma or allergies.

False

True/False Decreased breath sounds in asthma occur because fluid in the pleural space has moved the lung away from the chest wall.

False

True/False Patients with carbon monoxide poisoning initially complain of headache, fatigue, and nausea.

True

True/False Pulmonary edema is commonly associated with congestive heart failure.

True

True/False The distinction between hyperventilation and hyperventilation syndrome is straightforward and should guide the EMT's treatment choices.

False

True/False COPD most often results from cigarette smoking.

True

True/False COPD is characterized by long expiration phases.

True

True/False In cystic fibrosis, mucus becomes thick, sticky, and hard to move.

True

True/False When assessing a patient, the general impression will help you decide whether the patient's condition is stable or unstable.

True

True/False The pulse oximeter can be a valuable tool in evaluating oxygenation.

True

True/False Oxygen is typically withheld from COPD patients regardless of their breathing status.

False

True/False Side effects of inhalers used for acute shortness of breath include increased pulse rate, nervousness, and muscle tremors.

True

True/False Patients who are hyperventilating should be treated by having them breathe into a paper bag.

False

True/False Epiglottitis is seen in both the pediatric and adult populations.

True

True/False A respiratory syncytial virus (RSV) infection can cause respiratory illnesses such as bronchiolitis and pneumonia.

True

True/False When assisting a patient with a small-volume nebulizer, the oxygen flowmeter should be set to 6 to 10 L/min.

False

True/False Snoring sounds are indicative of a partial upper airway obstruction.

True

True/False Signs and symptoms of pulmonary emboli include dyspnea, hemoptysis, and tachycardia.

True

The level of _______ _______ sensed by the brainstem stimulates respiration.

carbon dioxide

The level of ________ in the blood is a secondary stimulus for respiration.

oxygen

________ passes from the blood through capillaries to tissue cells.

Oxygen

Carbon dioxide and oxygen are exchanged in the ________.

alveoli

If you suspect a patient has tuberculosis, you should wear gloves, eye protection, and a(n) _______ _______.

N95 respirator

Children with chronic pulmonary medical conditions may use a home ventilator that is connected by a(n) ________ tube.

tracheostomy

________ ________ is an odorless, highly poisonous gas that results from incomplete oxidation of carbon in combustion.

Carbon monoxide

High-pitched sounds heard on inspiration as air tries to pass through an obstruction in the upper airway are commonly referred to as ________.

strider

_______ or _______ are the sounds of air trying to pass through fluid in the alveoli.

Rales or crackles

When asking questions about the present illness during the history and secondary assessment, use the mnemonics ________ and ________ to guide you in your general questioning.

SAMPLE, OPQRST

_______ ______ or allergic rhinitis, causes coldlike symptoms, including a runny nose, sneezing, congestion, and sinus pressure.

Hey fever

Medication from a(n) ________ or small-volume ________ is delivered through the respiratory tract to the lung.

inhaler, nebulizer

________ is an airborne bacterial infection that is highly contagious and results in coughing attacks lasting longer than a minute.

Pertussis

________ are lower-pitched sounds caused by secretions or mucus in the larger airways.

Rhonchi

A patient with a barrel chest and a “puffing” style of breathing most likely has ________.

emphysema

A. Bronchiole B. Inflammation or infection C. Obstruction D. Mucus E. Infection F. Alveolus G. Trapped air H. Dilated alveolus

Short Answers List five characteristics of normal breathing.

1. Normal rate 2. Regular pattern of inhalation and exhalation 3. Clear and equal lung sounds on both sides of the chest 4. Regular and equal chest rise and fall 5. Adequate depth 6. Unlabored; without adventitious breath sounds

Short Answers List six conditions where wheezing can be found.

1. Asthma 2. Chronic obstructive pulmonary disease 3. Congestive heart failure/pulmonary edema 4. Pneumonia 5. Bronchitis 6. Anaphylaxis

Short Answers Under what conditions should you not assist a patient with a metered-dose inhaler?

1. Patient is unable to coordinate administration and inhalation. 2. Inhaler is not prescribed for patient. 3. You did not obtain permission from medical control or local protocol. 4. Patient has already met maximum prescribed dose before your arrival. 5. Medication is expired. 6. There are other contraindications specific to the medication.

Short Answers Describe chronic bronchitis.

An ongoing irritation of the respiratory tract; excess mucus production obstructs small airways and alveoli. Protective mechanisms are impaired. Repeated episodes of irritation and pneumonia can cause scarring and alveolar damage, leading to COPD.

Short Answers List complications associated with a tracheostomy tube.

Obstruction with secretions, mucus, foreign bodies, and/or airway swelling; bleeding; leaking; dislodgement; infection.

Short Answers Explain carbon dioxide retention.

A condition characterized by a chronically high blood level of carbon dioxide in which the respiratory center no longer responds to high blood levels of carbon dioxide. In these patients, low blood oxygen causes the respiratory center to respond and stimulate respiration. If the arterial level of oxygen is then raised, as happens when the patient is given additional oxygen, there is no longer any stimulus to breathe; both the high carbon dioxide and low oxygen drives are lost.

Short Answers When ventilating a patient, how would you determine whether your ventilations are adequate.

1. Is the air going in? 2. Does the chest rise and fall with each breath? 3. Is the rate adequate for the age of your patient?

You have been assessing a 17-year-old girl in respiratory distress, and you have just completed the secondary assessment. Your next step is to: A. make a transport decision B. perform a reassessment C. contact medical control D. perform interventions based on your findings

D. perform interventions based on your findings

You have determined that the patient in Question 1 is hyperventilating. Your emergency care would include: A. having her breathe into a small paper sack B. providing oxygen C. having her run in place until the hyperventilation subsides D. No interventions are necessary.

B. providing oxygen

You have been called to a patient who resides in a long-term care facility and who is having difficulty breathing. After assessing and treating life threats to the patient’s airway, breathing, and circulation, your next step in this case is to: A. make a transport decision B. obtain a SAMPLE history C. obtain an OPQRST history D. obtain baseline vital signs

A. make a transport decision

During the reassessment, vital signs should be taken every ______ minutes for the unstable patient. A. 3 B. 5 C. 10 D. 15

B. 5

During the reassessment, vital signs should be taken every ______ minutes for the stable patient. A. 3 B. 5 C. 10 D. 15

D. 15

Chapter 16 Workbook Flashcards

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