Chapter 23 Deck

Question 1

A 21-year-old woman experienced an acute onset of pleuritic chest plain and dyspnea while playing softball. She is noticeably dyspneic, has an oxygen saturation of 93% on room air, and has diminished breath sounds to the upper right lobe. What should you do?

Answer 1

Administer high-flow supplemental oxygen and transport at once.

Question 2

A 29-year-old woman is experiencing a severe asthma attack. Her husband reports that she was admitted to an intensive care unit about 6 months ago and had a breathing tube in place. Prior to your arrival, the patient took three puffs of her rescue inhaler without effect. She is anxious and restless, is tachypneic, and has audible wheezing. What should you do?

Answer 2

Apply a continuous positive airway pressure unit, transport immediately, and attempt to establish vascular access en route to the hospital.

Question 3

A 36-year-old man with a history of asthma presents with severe respiratory distress and altered mental status. You attempt to administer a nebulized beta-2 agonist, but his poor respiratory effort is inhibiting effective drug delivery via the nebulizer. What should you do?

Answer 3

Assist his ventilations and establish vascular access.

Question 4

A 76-year-old woman with chronic obstructive pulmonary disease presents with respiratory distress that has worsened progressively over the past 2 days. She is breathing through Pursed Lips and has a prolonged expiratory phase and an oxygen saturation of 76% on home oxygen at 2L/min. What should you do?

Answer 4

Place her in a position that facilitates breathing.

Question 5

A hyperventilating patient:

Answer 5

May be acidotic and trying to increase her or his pH level.

Question 6

A patient with status Asthmaticus commonly presents with:

Answer 6

Physical exhaustion and inaudible breath sounds.

Question 7

A person who experiences sharp chest pain followed by increasing dyspnea after he or she coughs most likely has:

Answer 7

A pneumothorax

Question 8

A pulse oximetry reading would be least accurate in a patient with:

Answer 8

Poor peripheral perfusion.

Question 9

Difficulty with exhalation is more characteristic of:

Answer 9

Obstructive lung disease.

Question 10

Patients with chronic obstructive pulmonary disease typically experience an acute exacerbation of their condition because of:

Answer 10

Environmental changes such as weather or the inhalation of trigger substances.

Question 11

Patients with obvious respiratory failure require immediate:

Answer 11

Ventilation support.

Question 12

Patients with pneumonia often experience a coughing fit when they roll from one side to the other because:

Answer 12

Pneumonia often occurs in the lung bases, typically on only one side.

Question 13

Pneumonitis is especially common in older patients with:

Answer 13

Chronic food aspiration.

Question 14

Reactive airway disease is characterized by:

Answer 14

Bronchospasm, edema, and mucus production.

Question 15

The barrel-chest appearance classically seen in patients with emphysema is secondary to:

Answer 15

Air trapping in the lungs.

Question 16

The classic presentation of chronic bronchitis is:

Answer 16

Excessive mucus production and a chronic or recurrent productive cough.

Question 17

The hypoxic drive is a phenomenon in which:

Answer 17

Bicarbonate ions migrate into the cerebrospinal fluid of a chronically hypoventilating patient, making the brain think that acid and base are in balance.

Question 18

The primary treatment for bronchospasm is:

Answer 18

Bronchodilator therapy.

Question 19

You are transporting a patient with a history of emphysema. The patient called 9-1-1 because his shortness of breath has worsened progressively over the past few days. He is on high-flow oxygen via non-rebreathing mask and has an intravenous line of normal saline in place. The cardiac monitor shows sinus tachycardia, and the pulse oximeter reads 85%. What should you do?

Answer 19

Apply continuous positive airway pressure or bilevel positive airway pressure and the reassess his breathing status.

Question 20

A 32-year-old male patient with a thin build presents with altered mental status, Cyanosis, tachycardia, and decreased breath sounds on his left side. What should you suspect?

Answer 20

Spontaneous pneumothorax

Question 21

The patient present with a barrel chest, muscle wasting, and pursed-lip breathing. These symptoms are a sign of which condition?

Answer 21

Emphysema.

Question 22

A patient who is coughing up Purulent sputum is more likely experiencing:

Answer 22

An infection.

Question 23

An older woman was recently discharged from the hospital for a hip fracture. She presents with acute dyspnea, Pallor, and Diaphoresis. Despite high-flow oxygen, her oxygen saturation is 78%. Her medical history is significant for emphysema and hypertension. What should you suspect?

Answer 23

Acute pulmonary embolism.

Question 24

Chronic obstructive pulmonary disease is characterized by:

Answer 24

Changes in pulmonary structure and function that are progressive and irreversible.

Question 25

Emphysema is caused by:

Question 26

Hepatomegaly and jugular venous distention are suggestive of:

Answer 26

Right-sided heart failure.

Question 27

If a patient's initial presentation makes you suspicious about a particular respiratory condition, you must:

Answer 27

Confirm your suspicions with a thorough assessment.

Question 28

Intubation of a patient with severe asthma:

Answer 28

Is often a last resort because people with asthma are difficult to ventilate and are prone to pneumothoraces.

Question 29

Patients with decompensated asthma who require positive-pressure ventilation:

Answer 29

May develop a pneumothorax or experience a decrease in venous return to the heart if they are ventilated too rapidly.

Question 30

The most clinically significant finding when questioning a patient with a chronic respiratory disease is:

Answer 30

Prior intubation for the same problem.

Question 31

The most common complaint of patients with a respiratory disease is:

Answer 31

Dyspnea.

Question 32

Uncontrolled coughing and hemoptysis in a cigarette smoker are clinical findings most consistent with:

Answer 32

Lung cancer.

Question 33

Upon assessing a patient, the patient coughs into a tissue. you notice that their sputum is frothy with a pink tinge of color. You recognize that this type of sputum can be caused by:

Answer 33

Pulmonary edema.

Question 34

What clinical findings is suggestive of pneumonia in a patient with COPD?

Answer 34

Fever and localized crackles.

Question 35

What is the most common cause of Mycoplasma pneumonia?

Answer 35

Infection.

Question 36

What medication is an anticholinergic bronchodilator?

Answer 36

Ipratropium.

Question 37

You are dispatched to a residence for a 59-year-old man with difficulty breathing. The patient, who has a history of COPD, is conscious and alert. During you assessment, he tells you that he developed chills, fever, and a productive cough 2 days ago. Auscultation of his lungs reveals rhonchi to the left lower lobe. What should you suspect?

Answer 37

Pneumonia

Question 38

You are dispatched to a residence for a young woman with difficulty breathing. When you arrive, you find the patient sitting in a tripod position, noticeably dyspneic and tachypneic. She tells you that she experienced a sudden sharp pain to the left side of her chest and then started having trouble breathing. She states that her left leg has been painful, red, and swollen. What should you suspect?

Answer 38

Acute pulmonary embolism.

Question 39

A man with morbid obesity called 9-1-1 because of difficulty breathing. When you arrive, you find the 39-year-old patient lying supine in his bed. He is in marked respiratory distress and can speak in only two-word sentences. He has a history of hypertension but denies any respiratory conditions. What should you do?

Answer 39

Sit him up or place him on his side.

Question 40

A patient with a history of asthma is at greatest risk for respiratory arrest if he or she:

Answer 40

Was previously intubated for his or her condition.

Question 41

Digital clubbing is more indicative of:

Answer 41

Chronic hypoxia.

Question 42

Hypoventilating patients:

Answer 42

Become hypercapneic and acidotic.

Question 43

One of the hallmarks for a pulmonary embolism is:

Answer 43

Cyanosis that does not resolve with oxygen therapy.

Question 44

Unlike bronchodilator therapy, corticosteroid therapy:

Answer 44

Takes a few hours to reduce bronchial edema.

Question 45

What is the primary goal of prehospital care for a patient with chronic obstructive pulmonary disease who is in distress?

Answer 45

Correcting hypoxemia.

Question 46

What conditions or factors would place a patient at greatest risk for aspiration pneumonia?

Answer 46

Brain injury.

Question 47

With regard to pulse oximetry, the more hypoxic a patient becomes:

Answer 47

The faster her or she will desaturate.