Resp HW 1a

Question 1

Uncontrollable coughing and hemoptysis in a cigarette smoker are clinical findings MOST consistent with:
Choose one answer.
	 A. emphysema.  	
	 B. lung cancer.  	
	 C. pleural effusion.  	
	 D. acute bronchitis.

Answer 1

B

Question 2

Pickwickian syndrome is a condition in which respiratory compromise results from:
Choose one answer.
	 A. extreme obesity.  	
	 B. pulmonary edema.  	
	 C. cervical spine injury.  	
	 D. diaphragmatic rupture.

Answer 2

A

Question 3

The presence of diffuse rhonchi (low-pitched crackles) in the lungs indicates:
Choose one answer.
A. right-sided congestive heart failure.
B. isolated consolidation of secretions.
C. thick secretions in the large airways.
D. air being forced through narrowed airways.

Answer 3

C

Question 4

A 36-year-old man with a history of asthma presents with severe respiratory distress. You attempt to administer a nebulized beta-2 agonist, but his poor respiratory effort is inhibiting effective drug delivery via the nebulizer and his mental status is deteriorating. You should:
Choose one answer.
A. assist his ventilations and establish vascular access.
B. start an IV of normal saline and administer a steroid.
C. apply high-flow oxygen via a nonrebreathing mask.
D. assist him with a metered-dose inhaler bronchodilator.

Answer 4

A

Question 5

Hypoventilating patients:
Choose one answer.
A. eliminate too much carbon dioxide.
B. become hypercapneic and acidotic.
C. experience an increase in blood pH.
D. typically do not have an open airway.

Answer 5

B

Question 6

With regard to pulse oximetry, the more hypoxic a patient becomes:
Choose one answer.
A. the slower his or her PaO2 will fall.
B. the faster he or she will desaturate.
C. the slower he or she will desaturate.
D. the less reliable the pulse oximeter is.

Answer 6

B

Question 7

Which of the following statements regarding anatomic dead space is correct?
Choose one answer.
A. Anatomic dead space is about 1 mL per pound of body weight.
B. Air in the dead space participates in pulmonary gas exchange.
C. The amount of dead space increases as tidal volume increases.
D. If tidal volume is 500 mL, 200 mL remains in the dead space.

Answer 7

A

Question 8

Intrapulmonary shunting occurs when:
Choose one answer.
A. nonfunctional alveoli inhibit pulmonary gas exchange.
B. the volume of anatomic dead space suddenly increases.
C. hyperinflated alveoli retain high levels of carbon dioxide.
D. resistance to airflow increases due to bronchoconstriction.

Answer 8

A

Question 9

A hyperventilating patient:
Choose one answer.
A. may be acidotic and is trying to decrease his or her pH level.
B. is most effectively treated by administering a sedative drug.
C. should rebreathe his or her carbon dioxide to effect resolution.
D. presents with tachypnea and marked use of accessory muscles.

Answer 9

A

Question 10

If a patient’s initial presentation makes you suspicious about a particular respiratory condition, you must:
Choose one answer.
A. begin immediate treatment based on your suspicion.
B. make your field impression based on the presentation.
C. confirm your suspicions with a thorough assessment.
D. immediately perform a focused physical examination.

Answer 10

C

Question 11

An elderly woman with COPD presents with peripheral edema. The patient is conscious but agitated. She is breathing with slight difficulty but has adequate tidal volume. During your assessment, you note that her jugular veins engorge when you apply pressure to her right upper abdominal quadrant. She tells you that she takes a “water pill” and Vasotec for high blood pressure. You should:
Choose one answer.
A. expect to hear crackles when you auscultate her lungs.
B. suspect acute right heart failure and administer oxygen.
C. start an IV of normal saline and give her a 250-mL bolus.
D. conclude that she has been noncompliant with her diuretic.

Answer 11

B

Question 12

\_\_\_\_\_\_\_\_ cells are found in the lining of the airways and produce a blanket of mucus that covers the entire lining of the conducting airways.
Choose one answer.
	 A. Kupfer  	
	 B. Alveolar  	
	 C. Ciliary  	
	 D. Goblet

Answer 12

D

Question 13

Which of the following statements regarding epiglottitis is correct?
Choose one answer.
A. Unlike croup, epiglottitis most commonly occurs in the middle of the night, when the outside temperature is cool.
B. Epiglottitis has become relatively rare in children due to vaccinations against the Haemophilus influenzae type b bacterium.
C. Most cases of epiglottitis are progressive in their onset and result in severe swelling of the larynx, trachea, and bronchi.
D. Characteristic signs of epiglottitis include a low-grade fever, a seal-like barking cough, and varying degrees of respiratory distress.

Answer 13

B

Question 14

CPAP in the emergency setting is used to treat patients with certain obstructive airway diseases by:
Choose one answer.
A. improving patency of the lower airway through the use of positive-end expiratory pressure.
B. maintaining stability of the posterior pharynx, thereby preventing upper airway obstruction.
C. increasing the rate and depth of ventilation, thus improving minute volume and mitigating hypoxia.
D. delivering one pressure during the inspiratory phase and a different pressure during the expiratory phase.

Answer 14

B

Question 15

An increase in the number of EMS calls for patients with chronic respiratory problems MOST commonly occurs:
Choose one answer.
A. during sudden weather changes.
B. during an influenza outbreak.
C. when the relative humidity is low.
D. when people travel during a holiday.

Answer 15

A

Question 16

The most obvious external landmark of the larynx is the:
Choose one answer.
	 A. cricoid cartilage.  	
	 B. hyoid bone.  	
	 C. arytenoid cartilage.  	
	 D. thyroid cartilage.

Answer 16

D

Question 17

Wheezing is resolved with medications that:
Choose one answer.
A. dry up secretions in the lower airway.
B. reduce soft tissue swelling in the larynx.
C. relax the smooth muscle of the bronchioles.
D. cause bronchoconstriction and improved airflow.

Answer 17

C

Question 18

A patient who is experiencing an allergic reaction states that his tongue “feels thick” and speaks at a low volume. You should immediately evaluate for:
Choose one answer.
	 A. angioedema.  	
	 B. hypotension.  	
	 C. a gag reflex.  	
	 D. adventitious breath sounds.

Answer 18

A

Question 19

Use of a spacer device in conjunction with a metered-dose inhaler:
Choose one answer.
A. is only indicated in children under 6 years of age, who are generally not able to use the inhaler effectively.
B. may be required when assisting a patient who is breathing inadequately, but generally results in less medication delivery to the lungs.
C. collects medication as it is released from the canister, allowing more to be delivered to the lungs and less to be lost to the environment.
D. requires the patient to time his or her inhalation to coincide with the discharge of the metered-dose inhaler.

Answer 19

C

Question 20

You are transporting a patient with a long 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 nonrebreathing mask and has an IV of normal saline in place. The cardiac monitor shows sinus tachycardia and the pulse oximeter reads 89%. When you reassess the patient, you note that his respiratory rate and depth have decreased. You should:
Choose one answer.
A. remove the nonrebreathing mask and apply a nasal cannula.
B. administer a sedative and a paralytic and then intubate his trachea.
C. begin assisting his ventilations with a bag-mask and 100% oxygen.
D. insert a nasal airway, apply a CPAP unit, and notify medical control.

Answer 20

C

Question 21

A known heroin abuser is found unconscious on a park bench. Your assessment reveals that his respirations are slow and shallow, and his pulse is slow and weak. You should:
Choose one answer.
A. suction his oropharynx, perform intubation, and then administer naloxone via slow IV push.
B. preoxygenate him with a bag-mask device for 2 to 3 minutes and then intubate his trachea.
C. apply oxygen via nonrebreathing mask, administer naloxone, and be prepared to assist ventilations.
D. assist ventilations with a bag-mask device, administer naloxone, and reassess his ventilatory status.

Answer 21

D

Question 22

Reactive airway disease is characterized by:
Choose one answer.
A. bronchospasm, edema, and mucus production.
B. chronic bronchoconstriction of varying severity.
C. acute, reversible swelling of the laryngeal muscles.
D. excessive mucus production and a chronic cough.

Answer 22

A

Question 23

If the amount of pulmonary surfactant is decreased:
Choose one answer.
A. alveolar surface tension increases.
B. diffuse alveolar hyperinflation occurs.
C. alveoli are able to expand more easily.
D. pulmonary gas exchange is enhanced.

Answer 23

A

Question 24

Use of an automated transport ventilator is NOT appropriate for patients who are:
Choose one answer.
	 A. in cardiac arrest.  	
	 B. apneic with a pulse.  	
	 C. chemically paralyzed.  	
	 D. breathing spontaneously.

Answer 24

D

Question 25

When auscultating the lungs of a patient with early pulmonary edema, you will MOST likely hear:
Choose one answer.
A. inspiratory rhonchi to the bilateral apices of the lungs.
B. crackles in the bases of the lungs at the end of inspiration.
C. faint rhonchi to all lung fields on inspiration and expiration.
D. coarse crackles to the bases of the lungs during inspiration.

Answer 25

B