EMT 221 Review Flashcards
(120 cards)
1
Q
What is the medical term used to refer lung sounds auscultated in the mid-axillary region? A) Tracheal B) Vesicular C) Bronchial D) Bronchovesicular
A
D) Bronchovesicular
2
Q
Which of the following is the principle reason for securing an endotracheal tube?
A) To confirm proper placement
B) To reduce the likelihood of aspiration
C) To prevent the tube form entering the esophagus
D) To reduce the likelihood of an inadvertent extubation
A
D) To reduce the likelihood of an inadvertent extubation
3
Q
Which of the following sedatives would work best for a patient in need of intubation who is conscious and hypotensive? A) Sodium thiopental B) Midazolam C) Etomidate D) Diazepam
A
C) Etomidate
4
Q
Rescuers are transporting an unresponsive patient they suspect has overdosed on high blood pressure medications. The supine patient begins vomiting forcefully and rigid suctioning of the oropharynx is started. They quickly recognize the pa”ent is likely aspirating his stomach contents because suction is not keeping up with the volume of emesis. Which beneficial treatment have the rescuers neglected to exercise?
A) Rolling the patient into the left recumbent position
B) Applying the light anterior pressure on the cricoid cartilage
C) Increasing the suction power to the maximum strength
D) Using a soft suction catheter instead of a rigid one
A
A) Rolling the patient into the left recumbent position
5
Q
Rescuers are preparing to transfer a 52-year-old female with a mild pneumothorax to a larger hospital for further treatment. According to the physician arranging the transfer, he suspects her lung was punctured during a central line insertion two days ago. During the transfer the pa”ent begins experiencing severe dyspnea and pulsus paradoxus. Which description BEST explains what the rescuers see?
A) The trouble breathing has worsened and suddenly loses her pulse in both arms
B) Shortness of breath has increased and there is a drop of systolic blood pressure during inhalations
C) The patient’s breathing becomes labored and her skin becomes mottles below the chest
D) The rescuers witness trouble breathing and decrease in coronary artery perfusion
A
B) Shortness of breath has increased and there is a drop of systolic blood pressure during inhalations
6
Q
Identify which technique will work best for ventilating a non-breathing stoma patient.
A) Use a pediatric bag-valve -mask device
B) Ventilate the patient with a standard pocket mask
C) Use Use an adult bag valve connected to a pediatric mask
D) Perform direct mouth-to-stoma ventilations with a barrier
A
C) Use Use an adult bag valve connected to a pediatric mask
7
Q
Rescuers are inserting double lumen style airway into a traumatic arrest victim. Select the statement that most accurate regarding the combitube and trauma patients.
A) Insertion requires a minimum of three rescuers
B) You do not need to pre-oxygenate before insertion
C) The majority of the time this tube is inserted blindly into the esophagus
D) Insertion of the double lumen airway is contraindicated in trauma patients
A
C) The majority of the time this tube is inserted blindly into the esophagus
8
Q
Which of the following pieces of of equipment should be available during nasotracheal intubation? A) Curved or straight blade B) Intubation blade handle C) Water soluble lubricant D) Pliable metal wire stylet
A
C) Water soluble lubricant
9
Q
The primary location of the body's monitoring of C02 concentrations occurs in receptors found in the: A) Medulla B) Aortic arch C) Carotid arteries D) Coronary arteries
A
A) Medulla
10
Q
What is the name of the area between the epiglottis and the tongue? A) Trachea B) Vallecular C) Esophagus D) Glottis opening
A
B) Vallecular
11
Q
Which of the following is true regarding an infant’s airway?
A) Infants typically breathe through their mouth
B) Swelling in the airway is typically not their concern
C) The opening at the cricoid ring is smaller than in the vocal cords
D) The tongue is smaller in proportion to the airway than that of the adult
A
C) The opening at the cricoid ring is smaller than in the vocal cords
12
Q
Which of the following tanks would least likely be used as a portable oxygen bottle carried into a scene by rescuers A) D Cylinder B) E Cylinder C) M Cylinder D) Super D Cylinder
A
C) M Cylinder
13
Q
What is the process of air moving into and out of the lungs? A) Ventilation B) Diffusion C) Respiration D) Oxygenation
A
A) Ventilation
14
Q
You are transferring a 27 -year-old male with a known C_6 fracture with a cord involvement. Which of the following findings would be MOST consistent with this injury?
A) Decrease in tidal volume, normal respiratory rate
B) Increase in tidal volume, normal respiratory rate
C) Decrease in tidal volume, increase in respiratory rate
D) Increase in tidal volume, decrease in respiratory rate
A
A) Decrease in tidal volume, normal respiratory rate
15
Q
All of the following are terms used to describe a soft suction catheter except: A) Soft B) Oral C) Sterile D) French
A
B) Oral
16
Q
The end tidal CO2 detector of an intubated patient in cardiac arrest does not change color. After visually confirming the tube passing through the vocal cords, what should the paramedic suspect? A) The tube is definitely misplaced B) The tube is in the esophagus C) There may be low cardiac output D) The C02 detector is defective
A
C) There may be low cardiac output
17
Q
Rescuers are preparing to transfer a critical patient from an emergency room to a higher level trauma center. Which of the following conditions would be an absolute contraindication for applying an automatic transport ventilator?
A) a patient with a suspected pneumothorax
B) A patient who is paralyzed from the neck down
C) Any patient medicated with a strong sedative medication
D) Any patient you suspect will stop breathing during the transfer
A
A) a patient with a suspected pneumothorax
18
Q
You determine your unconscious patient must be moved downstairs by using a small elevator. If you are limited to the amount of equipment that will fit on the elevator, choose a piece of equipment that MUST be with you for the trip downstairs. A) Suction equipment B) Extra 02 bottles C) Leather restraints D) Extra nasal cannula
A
A) Suction equipment
19
Q
Which description BEST describes proper 02 flow for a non-rebreather mask?
A) 2 to 6 L/min
B) 6 to 8 L/min
C) So the reservoir bag deflates completely on deep breaths
D) So the reservoir bag does not deflate more than one third
A
D) So the reservoir bag does not deflate more than one third
20
Q
EMS providers are having difficulty visualizing the vocal cords of a five-year-old female during intubation. Which of the following techniques would improve intubation success?
A) Placing a towel roll underneath the occipital lobe of her head
B) Performing posterior/superior pressure on the larynx/cricoid membrane
C) Inserting a sterile French catheter into the patient’s nose to trigger a gag reflex
D) Tipping the patient’s head and chin downward toward the chest during visualization
A
B) Performing posterior/superior pressure on the larynx/cricoid membrane
21
Q
All of the following activities will likely increase carbon dioxide levels within the bloodstream EXCEPT: A) Anaerobic metabolism B) Narcotic overdose C) Hyperventilation D) Exercise
A
C) Hyperventilation
22
Q
You are called to the scene of a patient with a decreased level of consciousness and an intact gag reflex. Which of the following would be the MOST appropriate initial ac”on to correct this issue?
A) Placement of an OPA
B) Placement of an NPA
C) Placement of an LMA
D) Suctioning the upper airway
A
B) Placement of an NPA
23
Q
You have a patient who has suffered a brain stem injury with increasing intracranial pressure. Which of the following types of respirations would you LEAST likely expect to see? A) Biot's B) Kussmaul C) Cheyne-Stokes D) Central neurogenic hyperventilation
A
B) Kussmaul
24
Q
Which of the following would be the BEST to use for a patient experiencing respiratory distress with adequate breathing? A) Non-breather mask B) Bag-valve mask C) Nasal Canula D) Suctioning
A
A) Non-breather mask
25
```
During Intubation the rescuer inserts an advanced airway too deeply. Where should be he suspect the distal end of the ETT lies?
A) Inside the right bronchus
B) Just superior to the carina
C) Within the left main bronchus
D) In the bronchioles of the left lung
```
A) Inside the right bronchus
26
You are eating lunch with a friend whom appears to start choking on a piece of food. What should you do FIRST?
A) Begin chest compressions to dislodge the object
B) Straddle him and perform abdominal thrusts
C) Perform abdominal thrusts from behind
D) Ask/ confirm whether he is choking
D) Ask/ confirm whether he is choking
27
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You have just placed an esophageal tracheal dual lumen airway and ventilated down tube#1. You hear gastric sounds and no lung sounds. What should you do NEXT?
A) Pull back slightly on the tube
B) Ventilate down tube #2
C) Continue ventilating
D) Remove the tube
```
B) Ventilate down tube #2
28
```
Identify the structure located at the division of the trachea into the right and left bronchus.
A) Esophagus
B) Bronchioles
C) Carina
D) Alveolus
```
C) Carina
29
```
Which of the following was the primary reason to use cricoid pressure during an intubation attempt?
A) To minimize risk of aspiration
B) to place the airway more anterior
C) To move the tongue more anterior
D) To cause the vocal cords to open more
```
A) To minimize risk of aspiration
30
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The adult patient you are assessing is breathing 16 times per minute and has pale skin. Which other signs or symptoms would you expect to find if you suspected she was breathing inadequately?
A) Weak pulse
B) Slow heart rate
C) Shallow breathing
D) Good breath sounds
```
C) Shallow breathing
31
Identify which of the following scenarios may benefit from application of humidified oxygen.
A) 56 year old male complaining of chest pain
B) 25 year old female with abdominal pain
C) 16 year old male with with severe epistaxis
D) 4 year old with suspected croup
D) 4 year old with suspected croup
32
During ventilation of an 8 month old infant you determine the chest is not rising and falling properly. What should you do to improve ventilations with this age group?
A) Place a small towel roll under the shoulders
B) Tip the head back further until chest rise improves
C) Lift the jaw forward until the ventilations are easier
D) Ventilate at a quicker pace to allow air to enter the chest
A) Place a small towel roll under the shoulders
33
Choose the patient to whom you would apply a nasal cannula instead of a non-rebreather face mask.
A) Patients who refuse to wear a mask because of claustrophobic sensation
B) Pediatric and geriatric patients who are having difficulty breathing
C) Patients with a long term history of emphysema and/or bronchitis
D) Any patients with severe allergies to latex based materials
A) Patients who refuse to wear a mask because of claustrophobic sensation
34
You are called to treat a 27-year-old male who was found unconscious on the side of the road. Which of the following would be the preferred method to initially open this patient's airway?
A) Head tilt chin lift
B) Head tile neck lift
C) Jaw lift with manual cervical spine control
D) jaw thrust with manual cervical spine control
D) jaw thrust with manual cervical spine control
35
```
Which equipment would a rescuer MOST likely use to clear oral secretions from an adult patient's airway while at a home scene?
A) Bite stick
B) Soft/sterile catheter
C) Mounted suction device
D) Hand powered suction unit
```
D) Hand powered suction unit
36
You are preparing to suction the mouth of an adult patient who is not breathing. Which of the following is true regarding what you should do when suctioning this patient?
A) Have a container of sterile water on hand
B) Apply suction upon insertion of catheter
C) Ventilate the patient 60 times per minute
D) Select the soft flexible style catheter
A) Have a container of sterile water on hand
37
Which of the following is appropriate regarding suctioning through an ET tube?
A) The suction catheter should go down to the carina
B) Suctioning should never last longer than 20 seconds
C) The patient must always be preoxygenated prior to suctioning
D) The larger the number of French units the smaller the diameter of the suction catheter
C) The patient must always be preoxygenated prior to suctioning
38
Which of the following methods would be the MOST effective to ventilate an unresponsive pa"ent who is suffering from adult respiratory distress syndrome where you were unable to secure the airway with an endotracheal tube?
A) Mouth to mask ventilation with supplemental oxygen
B) 2 person bag valve mask ventilation with adjustable peep setting
C) 1 person BVM ventilation and the administration of a loop diuretic
D) Insertion of esophageal tracheal dual lumen airway and positive pressure ventilation
D) Insertion of esophageal tracheal dual lumen airway and positive pressure ventilation
39
For which of the following patients showing signs of severe respiratory distress should you limit the amount of oxygen you provide?
A) Asthma patient
B) A patient with emphysema
C) A patient with chronic bronchitis
D) You should initially provide oxygen for any patient in distress
D) You should initially provide oxygen for any patient in distress
40
You and your partner are resuscitating a 65-year-old COPD patient. It becomes obvious that the patient will require intubation to survive. Defend the BEST reason for inserting a stylet into the endotracheal tube during setup of your partner's equipment.
A) It will keep the 15 mm adapter in place during insertion
B) It will be available if it is needed and harmless if it is not
C) All rescuers are required to use a stylet even if it does not seem necessary
D) It takes 3-4 minutes to prepare and insert a stylet if it is needed for the procedure later on
B) It will be available if it is needed and harmless if it is not
41
During a transfer, rescuers determine a patient is no longer breathing on his own. Which of the following is the BEST reason for choosing a bag-valve-mask device instead of performing rescue breathing (mouth-to- mouth)?
A) It significantly reduces the infectious disease risk to the rescuers performing ventilations
B) It is the best way to prevent gastric distention in the respiratory arrest patient
C) It is easier to establish an effective face seal with a bag valve mask device
D) It will likely deliver higher tidal volumes than mouth to mouth ventilations
A) It significantly reduces the infectious disease risk to the rescuers performing ventilations
42
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What is the transfer of oxygen and carbon dioxide between the capillary red blood cells and the tissue cells called?
A) Pulmonary ventilation
B) Internal respiration
C) External respiration
D) Internal ventilation
```
B) Internal respiration
43
Which of the following best describes the proper placement and direction of a nasopharyngeal airway?
A) Bevel toward the septum and insert at an angle parallel to the mouth
B) Bevel toward the septum and insert at an angle of 45 degree cephalic
C) Bevel toward the floor of the nostril and insert at an angle slightly cephalic
D) Bevel toward the floor of the nostril and insert at an angle slightly caudally
A) Bevel toward the septum and insert at an angle parallel to the mouth
44
```
Which of the following is the greatest complication associated with a rapid sequence intubation?
A) Apnea
B) Aspiration
C) Bradycardia
D) Tachycardia
```
B) Aspiration
45
```
The resultant respiratory alkalosis associated with hyperventilation syndrome is due to an excessive loss of what element?
A) 02
B) Na
C) C02
D) N
```
C) C02
46
During oral intubation, you select a straight blade to insert an endotracheal tube. Which statement is MOST accurate for this type of blade?
A) Insertion of the blade must be done in a slower fashion than a straight blade
B) The curved blade is designed to move the tongue out of the way
C) You will lift the epiglottis directly with the tip of the blade
D) You should hold the handle and blade in your right hand
C) You will lift the epiglottis directly with the tip of the blade
47
```
Which region of the brain is responsible for control of autonomic functions such as heart rate, blood pressure and digestive activities?
A) Pons
B) Diencephalon
C) Medulla oblongata
D) Cerebellum
```
C) Medulla oblongata
48
You are attempting to ventilate an apneic patient with a bag-valve-mask, but you are unsuccessful. You note that the face seal is not adequate. What should you do NEXT to improve ventilations if you suspect a neck injury?
A) Insert an oral or nasal pharyngeal airway
B) Assure that oxygen is attached to the 02 reservoir
C) Tip the patient's head back further and reattempt to ventilate
D) Have an assistant secure the mask to the patient's face while immobilizing the head
D) Have an assistant secure the mask to the patient's face while immobilizing the head
49
Two rescuers are assisting ventilations on an unconscious patient. If one rescuer compresses the bag valve mask, the other rescuer should
A) Place his hands on the victims chest to assess rise and fall
B) Pinch off airflow to the patients nose
C) Hold the face mask in one place
D) Auscultate lung sounds
C) Hold the face mask in one place
50
Which of the following is the most important reason why we confirm breath sounds after placing an advanced airway?
A) An improperly placed advanced airway can be fatal
B) To recognize if we have a right main stem intubation
C) To demonstrate to the family competency in the skill
D) Assessing breath sounds breath sounds is part of the standard of care
A) An improperly placed advanced airway can be fatal
51
```
When is the glottis the largest?
A) During pauses
B) When coughing
C) Upon inspiration
D) Upon exhalation
```
C) Upon inspiration
52
On an unresponsive patient that is breathing, which of the following is the BEST reason to perform an advanced airway procedure?
A) It removes the need for suctioning
B) It provides a route for medication
C) It protects the airway from aspiration
D) It makes ventilating the patient
C) It protects the airway from aspiration
53
```
The percentage of arterial hemoglobin saturated with oxygen molecules is known as:
A) P02
B) Sa02
C) Fi02
D) 02/mm/Hg
```
B) Sa02
54
```
You arrive on scene to find an adult complaining of difficulty breathing. Breathing rate is 20 times per minute with adequate volume. His lung sounds are clear and equal without accessory muscle usage. His color is normal and his pulse oximeter reading is 100% on room air. How would you describe this patient's respiratory status?
A) Adequate
B) Inadequate
C) Respiratory failure
D) Respiratory distress
```
A) Adequate
55
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You are caring for a patient with a severe head injury. You observe very little chest wall movement, his skin is dry and his lips are becoming dusky-blue in color. The change in lip
color is most likely due to:
A) Hypoxia
B) Hypothermia
C) Hypovolemia
D) Hypotension
```
A) Hypoxia
56
You are called to the scene of a 27-year-old trauma pa"ent who is supine, unresponsive to verbal stimuli, and having agonal breathing. The patient has blood coming from his mouth secondary to a lacerated tongue. He is currently pinned under his car from the legs down. Assessment reveals the patient has an intact gag reflex. Which of the following would be the BEST method to secure his airway?
A) performing a nasotracheal intubation
B) Performing a modified jaw thrust and suctioning
C) Performing a modified jaw thrust and inserting an OPA
D) Providing the patient with succinylcholine and placing an ETDLA
A) performing a nasotracheal intubation
57
```
Identify the biggest consequence of NOT recognizing an improperly placed endotracheal tube in the esophagus
A) Flatulence
B) Aspiration
C) Stomach rupture
D) Air embolism
```
B) Aspiration
58
Which of the following patients will MOST likely require orotracheal intubation?
A) An adult patient in cardiac arrest
B) A teenager who has overdosed on Tylenol
C) An unresponsive infant breathing 40 times per minute
D) As status epilepticus patient who has seized for 10 minutes
A) An adult patient in cardiac arrest
59
Gastric distention:
A) Occurs when ventilation is performed without adequate airway positioning
B) May occur in the intubated patient if ventilator volumes are excessive
C) Will significantly increase the risk of aspiration and decrease the ventilator capacity of the lungs
D) all of the answers are correct
D) all of the answers are correct
60
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In general, which of the following is the preferred method for gastric decompression when gastric distention is present and the patient is unresponsive?
A) Orogastric tube placement
B) Nasogastric tube placement
C) Esophageal tracheal tube placement
D) Both A and B are acceptable methods
```
D) Both A and B are acceptable methods
61
Which of the following pa"ents would MOST likely require ventilatory assistance with a bag- valve-mask device?
A) A patient with varicella virus
B) a patient with multiple sclerosis
C) A patient with Kussmaul respirations
D) A patient with hyperventilation syndrome
B) a patient with multiple sclerosis
62
During assessment of a sick patient, you determine the patient's blood oxygen concentration is 95% on room air. Which of the following actions will increase oxygen concentration within the blood stream the BEST?
A) Allow more oxygen to transfer to the hemoglobin molecules
B) Dissolve more oxygen into the plasma of the blood
C) Increase the inspired O2 levels to 5-10 Torr per breath
D) Decrease the surfactant layer between alveoli and capillaries
A) Allow more oxygen to transfer to the hemoglobin molecules
63
While ventilating a patient with a flow-restricted oxygen-powered ventilation device, you should:
A) Listen for the alarm indicating the relief valve is activating
B) Avoid tipping the head back, even in non traumatic patients
C) Never use it on a patient who has a suspected abdominal injury
D) Determine if the patient has ever had cardiac bypass surgery
A) Listen for the alarm indicating the relief valve is activating
64
You have elected to intubate a child because he is struggling to breathe. Which guideline will help you estimate the endotracheal tube size?
A) Use the child's weight divided by 8 formula
B) Measure from the teeth to the cricoid cartilage area
C) Choose a tube the same diameter as his little finger
D) Take the measurement from his middle digit to wrist
C) Choose a tube the same diameter as his little finger
65
What are you listening for when you first assess breathing during the primary (initial) assessment?
A) Crepitus and pleural rub
B) lung sounds to assess volume
C) lung sounds for equality and moisture
D) bilateral sounds and inappropriate noises
D) bilateral sounds and inappropriate noises
66
How can chronic bronchitis be defined?
A) Inflammatory changes and excessive mucus production in the bronchial tree
B) Chronic enlargement of the alveoli with loss of elasticity
C) Recurrent reactive bronchospasm
D) A chronic fungal infection leading to pus-filled epithelial tissue and bronchoconstriction
A) Inflammatory changes and excessive mucus production in the bronchial tree
67
Which of the following adult patient would require ventilator assistance?
A) Tidal volume 300 cc, respiratory rate of 14
B) Tidal volume 325 cc, respiratory rate of 26
C) Tidal volume 500 cc, respiratory rate of 12
D) Tidal volume 700 cc, respiratory rate of 10
B) Tidal volume 325 cc, respiratory rate of 26
68
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You are dispatched to a 45-year-old male who has fallen from a roof. You discover he has an obvious head injury, two broken legs, and has vomited several times. What is your HIGHEST priority for this patient?
A) Covering his head wound
B) Updating ALS transport
C) Suctioning his airway
D) Stabilizing his legs
```
C) Suctioning his airway
69
All of the following are true when using a nasopharyngeal airway EXCEPT:
A) It must be measured prior to insertion
B) It is always inserted in the patient's right nostril
C) It is removed when the patient begins gagging
D) It should be lubricated with a water-based lubricant
B) It is always inserted in the patient's right nostril
70
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Kussmaul respirations would be MOST easily confused with:
A) Biot's respirations
B) Agonal respirations
C) Cheyne-Stokes respirations
D) Central neurogenic hyperventilation
```
A) Biot's respirations
71
```
Two medications are found to be chemically equivalent for their relative therapeutic effectiveness. This is called:
A) Assay
B) Bioassay
C) Bioavailability
D) Bioequivalence
```
D) Bioequivalence
72
You are ventilating an asthma patient and despite your best efforts, the patient's condition seems to be getting worse. Which of the following is the BEST indicator of effective ventilations?
A) The patient becomes quiet and stops breathing on his own
B) The patient's stomach begins expanding with ventilations
C) The patient's color change from cyanotic to mottled
D) The patient's chest rises and falls with ventilations
D) The patient's chest rises and falls with ventilations
73
During your assessment of an unconscious patient you find he has had a laryngectomy. How would you describe this to an EMT student?
A) It is a surgical fistula just above the voicebox
B) It is an alternative airway created just below the larynx
C) It is a temporary airway opening just distal to the carina
D) It is a procedure in which a needle is inserted into the trachea
D) It is a procedure in which a needle is inserted into the trachea
74
The BEST way to measure an oropharyngeal airway is from the:
A) Tip of the nose to the corner of the ear
B) Corner of the mouth to the tip of the ear lobe
C) Corner of the mouth to the top of the ear lobe
D) Center of the jaw to the edge of the ear
B) Corner of the mouth to the tip of the ear lobe
75
During resuscitation of a cardiac arrest victim it becomes immediately necessary to suction the victim's upper airway. Which recommendation is critical to remember when suctioning the patient's mouth with a rigid catheter?
A) Assure suction draws at least 300 mmHg of vacuum
B) Insert the catheter only as far as you can visualize the tip
C) When available, use of a soft, sterile catheter is preferred
D) Suction should be activated upon insertion of the catheter
B) Insert the catheter only as far as you can visualize the tip
76
```
Atelectasis is BEST described as:
A) Bleeding within the bronchioles
B) Inhalation of food or vomit
C) Trachea deviation to the left
D) Collapse of the alveolar sacs
```
D) Collapse of the alveolar sacs
77
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Which of the following would be the proper drip rate of a 10 cc/kg infusion for a 4-kg neonate using a 15 g!s set over a 15-minute time frame?
A) 15 gtts/min
B) 40 gtts/min
C) 56 gtts/min
D) 80 gtts/min
```
B) 40 gtts/min
78
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Acute extrapyramidal symptoms from cholinergic blockade in the basal ganglia of the cerebral hemispheres, is a common side effect of haloperidol. This is typically treated with which one of the following drugs?
A) Atropine
B) Diphenhydramine
C) Dopamine
D) Serotonin
```
B) Diphenhydramine
79
While on the scene of a stroke patient, you witness the patient become unresponsive. Presuming the patient is already on high-flow oxygen via non-rebreather mask, what is the rescuer's HIGHEST priority?
A) Sit the patient in an upright position
B) Initiate an IV of normal saline solution
C) Consider the need for an advanced airway
D) Apply a pulse oximetry monitor to the patient
C) Consider the need for an advanced airway
80
While preparing intubation for a 4-year-old patient in respiratory distress, your partner asks you to get her the right size ETT tube. What is the BEST choice for estimating the correct size?
A) Use the formula of 4 + (age in years/4)
B) Calculate the weight in kilograms and divide by 8
C) Reference the child's thumb as appropriate diameter
D) Measure from the corner of the mandible to the cricoid cartilage
A) Use the formula of 4 + (age in years/4)
81
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Which of the following should you do NEXT after placing the esophageal tracheal dual lumen airway?
A) Inflate cuff #1
B) Inflate cuff #2
C) Ventilate tube #1
D) Ventilate tube #2
```
A) Inflate cuff #1
82
Which of the following would be a sign of poor bag-valve-mask ventilations?
A) The pulse oximetry changes from 94% to 97%
B) The chest rises and falls with ventilations
C) There are absent lung sounds during auscultation
D) The patient's skin color becomes less cyanotic
C) There are absent lung sounds during auscultation
83
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You are dispatched to a 25-year-old male choking in a break room at a factory. The patient is coughing uncontrollably and telling you he is choking on food. What is the BEST description of his condition?
A) Complete airway obstruction
B) Partial airway obstruction
C) Anatomical obstruction
D) Foreign body occlusion
```
B) Partial airway obstruction
84
Review the list below and choose the technique that is viewed by experts as the BEST way to secure an endotracheal tube?
A) Tape the tube in place
B) Tie the tube with a roller bandage
C) Apply a manufactured securing device
D)Use spirit gum or other spray type adhesives
C) Apply a manufactured securing device
85
One of the MOST important concepts to remember when dealing with a patient who has a stoma is:
A) A stoma patient requires very special equipment emergency ventilations
B) You are required to use a pocket mask ventilate this patient
C) The victim will likely need suctioning prior to ventilations
D) You should use an infant bag-valve-mask device for the patient
C) The victim will likely need suctioning prior to ventilations
86
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How would a rescuer improve a patient's FiO2 level on a non-breathing, ventilated patient?
A) Increase rate of ventilation
B) Increase oxygen flow rate
C) Decrease expiratory time
D) Decrease respiratory rate
```
B) Increase oxygen flow rate
87
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What does capnography measure?
A) Carbon dioxide levels in tissues
B) Oxygen levels in the lungs
C) Carbon dioxide levels in exhaled air
D) Oxygen levels in the blood
```
C) Carbon dioxide levels in exhaled air
88
You have just placed an advanced airway in a patient with a respiratory condition and his heart rate decreased. Which of the following BEST explains the decreasing heart rate?
A) A decreased heart rate is an expected complication
B) The patient has a cardiac problem as well
C) You have placed the airway incorrectly
D) The patient has esophageal varices
A) A decreased heart rate is an expected complication
89
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What is the characteristic of the right main-stem bronchus?
A) Shorter
B) Narrower
C) More angled from the trachea
D) Made of thicker membrane
```
A) Shorter
90
Which of the following patients would benefit the MOST from an advanced airway?
A) An unresponsive infant with epiglottis
B) An unresponsive adult with no gag reflex
C) A responsive adult with respiratory distress
D) An unresponsive adult with an airway obstruction
B) An unresponsive adult with no gag reflex
91
Rescuers have decided a medical pa"ent must be intubated. Which of the following recommendations would be HARMFUL in a non-trauma"c respiratory arrest victim?
A) Ventilating for 1 to 2 minutes prior to tube insertion
B) Ventilating the esophagus 5 to 10 times after insertion
C) Tilting the head backward to more easily visualize the cords
D) Having another rescuer ascultate lung sounds after intubation
B) Ventilating the esophagus 5 to 10 times after insertion
92
Choose the MOST accurate description of the Sellick maneuver
A) It is another name for the head-tilt chin-lift position
B) To perform this procedure, you push the cricoid cartilage posteriorly
C) The maneuver is done to prevent patients from biting down on an orotracheal tube
D) The procedure will eliminate the need for a jaw thrust maneuver in trauma patients
B) To perform this procedure, you push the cricoid cartilage posteriorly
93
In which situation would you choose a modified secondary assessment (focused exam) over a rapid secondary assessment (rapid trauma exam)?
A) Your general impression is poor and there is significant mechanism
B) Your general impression is poor, but there is no significant mechanism
C) Your general impression is poor, but there is no significant mechanism
D) Your impression is stable and there is no significant mechanism
D) Your impression is stable and there is no significant mechanism
94
Which action will MOST likely cause gastric distention to occur in an adult patient?
A) Excessive force during abdominal palpation
B) Excessive bag-valve-mask ventilation
C) Constipation for several days
D) Nasogastric tube insertion
B) Excessive bag-valve-mask ventilation
95
```
When there is a physiologic reason for a decrease in tidal volume, the body will compensate by:
A) Decrease the heart rate
B) Reducing the need for oxygen
C) Increasing the blood pressure
D) Increasing the respiratory rate
```
D) Increasing the respiratory rate
96
What is diffusion?
A) The active transport of gas with energy expended
B) A gaseous substance dissolving in a liquid substance
C) The movement of gas from a lower pressure to a higher pressure across a semipermeable membrane
D) The movement of a gas from a higher pressure to a lower pressure across a semipermeable membrane
D) The movement of a gas from a higher pressure to a lower pressure across a semipermeable membrane
97
What is physiological dead space?
A) Created by the upper respiratory tract and nonrespiratory bronchioles
B) Composed of the nonfunctional alveoli
C) Increased in patients with respiratory diseases such as emphysema
D) Normally 10 times the volume of anatomic dead space
C) Increased in patients with respiratory diseases such as emphysema
98
Identify which of the following statements is most TRUE regarding pulmonary circulation.
A) Oxygen rich blood returns to the left side of the heart via the pulmonary vein
B) The majority of inspired air into the alveolar sacs for exchange is carbon dioxide
C) Oxygen and carbon dioxide gases are exchanged only during expiratory phase of respiration
D) Oxygen molecules are transported across the alveolar membrane unto microscopic venules
A) Oxygen rich blood returns to the left side of the heart via the pulmonary vein
99
Your unconscious trauma patient has just vomited dark red blood. Select the BEST reason for suctioning this patient's oral and nasal cavity after he has vomited.
A) To reduce the risk of aspiration pneumonia complications
B) To reduce intracranial pressure (ICP) caused by vomiting
C) To measure, then quantify, volume of blood loss within the stomach
D) To reduce the chance the patient will vomit more blood later on
A) To reduce the risk of aspiration pneumonia complications
100
```
Which of these is poorly affected when you properly provide bag-valve-mask ventilations?
A) Alveolar pressures
B) Carbon dioxide removal
C) Cerebral perfusion pressures
D) Venous blood return
```
D) Venous blood return
101
```
Which of the following is a contraindication for an open cricothyrotomy but NOT a contraindication for a needle cricothyrotomy?
A) Tracheal transection
B) Crush injuries to the larynx
C) Patients under the age of 12
D) Inability to identify landmarks
```
C) Patients under the age of 12
102
```
Medical control has ordered rescuers to extubate a patient who is resisting ventilations through an endotracheal tube. Which of the following complications should rescuers anticipate upon removal of the ETT?
A) Laryngospasm
B) petite mal seizure
C) Reflex bradycardia
D) Bronchoconstriction
```
A) Laryngospasm
103
```
You are called to treat a patient with severe dyspnea. Which of the following tank sizes would be the most appropriate to bring to the pa"ent's side when you anticipate a 10-minute transfer from the patient's bed to the ambulance?
A) A D tank with 1200 psi
B) An E tank with 700 psi
C) An M tank with 300 psi
D) A K tank with 250 psi
```
A) A D tank with 1200 psi
104
```
During assessment of a patient with an altered mental status, which treatment or assessment must be your highest priority?
A) Administering of instant glucose
B) Maintaining an open, patent airway
C) Assessing for any traumatic injuries
D) Contacting medical control authority
```
B) Maintaining an open, patent airway
105
The endotracheal(ET) tube size refers to the ___ in millimeters?
A) External diameter
B) internal diameter
C) Length
D) Length of tube that will pass beyond the vocal cords
B) internal diameter
106
A 25-year-old male is complaining of trouble breathing and chest tightness after trying to put out a car fire in an auto repair shop. What do you suspect is the MOST likely cause of his distress?
A) Foreign body airway obstruction
B) Ischemic injury of the myocardium
C) Congestive heart failure complications
D) Acute swelling within the lower airways
D) Acute swelling within the lower airways
107
A rescuer is preparing intubation equipment for his partner. Which statement BEST describes proper technique for preparing the stylet?
A) Select several sizes or choices for the partner performing intubation
B) Lubricate the stylet and endotracheal tube with a water based product
C) Never insert stylets into the tube until requested to do so by your partner
D) While inserting it, do not allow the stylet to extend past the Murphy eye of the tube
D) While inserting it, do not allow the stylet to extend past the Murphy eye of the tube
108
During intubation of a toddler, you have found that the vocal cords are difficult to visualize. Which technique will assist the rescuers the MOST in visualizing the trachea?
A) Displace the haw with more force anteriorly
B) Flex the head downward toward his chest
C) Perform the Sellick's maneuver/Cricoid pressure
D) Place padding under the shoulders to create a sniffing position
D) Place padding under the shoulders to create a sniffing position
109
```
What is the most accurate term used to describe the ini"al state of the cell's condition during inadequate tissue perfusion (shock)?
A) Hypoxia
B) Necrosis
C) Hypocarbia
D) Hypoxemia
```
A) Hypoxia
110
```
Automatic transport ventilators are typically contraindicated in which type of patients?
A) Unresponsive
B) Breathing spontaneously
C) Under 12 years of age
D) Awake
```
D) Awake
111
```
From which part of the spine do the two phrenic nerves, responsible for moving the diaphragm, originate?
A) C3,C4,C5
B) C4,C5,C6
C) C1,C2,C3
D) T1,T2,T3
```
A) C3,C4,C5
112
Loop diuretics are powerful, short-acting agents that:
A) Inhibit sugar and water reabsorption in the loop of henle
B) Facilitate sugar and water reabsorption in the loop of Henle
C) Inhibit sodium and chloride reabsorption in the loop of Henle
D) Facilitate sodium and chloride reabsorption in the loop of Henle
C) Inhibit sodium and chloride reabsorption in the loop of Henle
113
Contraction of the diaphragm results in:
A) Increase in vertical diameter of the thorax
B) Decrease in vertical diameter of the thorax
C) Increase in intrathoracic pressure
D) Compression of the lungs
A) Increase in vertical diameter of the thorax
114
```
What structure contains the pneumotaxic center?
A) Pons
B) Hypothalamus
C) Cerebellum
D) Medulla oblongata
```
A) Pons
115
```
An example of active transport is:
A) Sodium Potassium pumps
B) Glucose into cell by insulin
C) ATP Production
D) Exocytosis
```
A) Sodium Potassium pumps
116
```
The nervous system is divided into two main divisions. They are:
A) Autonomic and central
B) Autonomic and peripheral
C) Central and peripheral
D) Sympathetic and parasympathetic
```
D) Sympathetic and parasympathetic
117
```
The Reticular Activating System is found where in the brain?
A) Cerebellum
B) Mid Brain
C) Cerebrum
D) Hypothalamus
```
B) Mid Brain
118
```
Respirations are controlled by the Medulla Oblongata and the___?
A) Cerebrum
B) Cerebellum
C) Thalamus
D) Pons
```
D) Pons
119
Which of the following is the correct order of the electrical impulse from the brain to the effector organ/muscle in the sympathetic nervous system?
A) Brain, Spinal Cord, Preganglion Neuron, Cholinergic Fibers, Acetylcholine, Synapse, Nicotinic Cholinergic Receptors, Postganglion Neuron, Adrenergic Fibers, Norepinephrine, Neuro-effector Junction, Adrenergic Receptors (Alpha 1, Beta 1, Beta 2), and Effector Organ/Muscle
B) Brain, Spinal Cord, Cholinergic Fibers, Preganglion Neuron, Acetylcholine, Synapse, Postganglion Neuron, Adrenergic Fibers, Norepinephrine, Neuro-effector Junction, Adrenergic Receptors (Alpha 1, Beta 1, Beta 2), Nicotinic Cholinergic Receptors, and Effector Organ/Muscle
C) Effector Organ/Muscle, Spinal Cord, Cholinergic Fibers, Preganglion Neuron, Acetylcholine, Synapse, Postganglion Neuron, Adrenergic Fibers, Norepinephrine, Neuro-effector Junction, Adrenergic Receptors (Alpha 1, Beta 1, Beta 2), Nicotinic Cholinergic Receptors, and Brain
D) Brain, Spinal Cord, Cholinergic Fibers, Postganglion Neuron, Acetylcholine, Synapse, Preganglion Neuron , Adrenergic Fibers, Norepinephrine, Neuro-effector Junction, Adrenergic Receptors (Alpha 1, Beta 1, Beta 2), Nicotinic Cholinergic Receptors, and Effector Organ/Muscle
A) Brain, Spinal Cord, Preganglion Neuron, Cholinergic Fibers, Acetylcholine, Synapse, Nicotinic Cholinergic Receptors, Postganglion Neuron, Adrenergic Fibers, Norepinephrine, Neuro-effector Junction, Adrenergic Receptors (Alpha 1, Beta 1, Beta 2), and Effector Organ/Muscle
120
```
Beta 2 receptors are found where?
A) Lungs
B) Peripheral Vessels
C) Kidneys
D) Heart
```
A) Lungs
