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1

a 19 year old woman ingested a large quantity of darvon. she is responsive to pain only and has a slow, shallow respirations. the most appropriate airway management for the patient involves:
A) inserting an oral airway and assisting ventillations with a bag mask device
B) inserting a nasal airway and assisting ventillations with a bag mask device
C) inserting an oral airway and administering O2 via nonrebreathing mask
D) suctioning her airway, inserting an oral airway, and administering 100% O2

B

2

when performing an open cricothyrotomy you should first:
A) maintain aseptic technique as you cleanse the area with iodine
B) slide your index finger between the thyroid and cricoid cartilages
C) palpate for the V notch of the thyroid cartilage and stabilize the larynx
D) hyperextend the patients neck and then palpate the cricoid cartilage

C

3

after inserting the ET tube between the vocal cords, yoiu should remove the stylet from the tube and then:
A) attach the bag mask device and ventillate
B) secure the tube with a commercial device
C) attach an ETCO2 detector to the tube
D) inflate the distal cuff with 5-10 mL of air

D

4

in contrast to negative pressure ventillation positive pressure ventillation occurs when:
A) the diaphragm contracts
B) air is drawn into the lungs
C) intrathoracic pressure falls
D) air is forced into the lungs

D

5

surfactant is
A) produced by the mucus cells of the left and right mainstem bronchi
B) quickly destroyed in patients who have a severe upper airway obstruction
C) a phospholipid compound that decreases surface tension on the alveolar walls
D) a lubricating substance that increases alveolar surface tension during breathing

C

6

after correctly positioning the laryngoscope blade in the patients mouth you should
A)ask your partner to apply firm posterior pressure to the cricoid cartilage
B) gently pry back on the laryngoscope to obtain a view of the vocal cords
C) exert gentle traction at a 45 degree angle to the floor as you lift the patients jaw
D) pull slightly back on the larngoscope blade in order to view the epiglottis

C

7

the fraction of inspired O2 (FIO2) increases with:
A) increased tidal volume
B) forceful inhalation
C) supplemental oxygen
D) an increased in respirations

C

8

if you must insert the ET tube into the patients left nostril you should:
A) insert the tube straight back without rotating it
B) insert the tube with the beveled tip facing upward
C) ensure that the bevel is facing away from the septum
D) rotate the tube 180 degrees as its tip enters the nasopharynx

d

9

an intubated 33 year old man is becoming agitated and begins moving his head around. your estimated time of arrival at the hospital is 15 minutes. YOU should:
A) administer a sedative medication
B) suction his airway and carefully extubate
C) chemically paralyze him with vecuronium
D) physically restrain his head to the stretcher

A

10

proper placement of the king LT airway is performed by all of the following techniques, EXCEPT:
A) ausculation of bilateral breath sounds
B) the esophageal
C) quantitative waveform capnography
D) observation for symmetrical chest rise

B

11

the oropharynx:
A) contains the adenoids on its posterior wall
B) forms the posterior portion of the oral cavity
C) is bordered superiorly by the hard palate only
D) consists of the anterior portion of the oral cavity

B

12

which of the following medications does NOT possess hypnotic properties:
A) Versed
B) Brevital
C) Alfentanil
D) Etomidate

C

13

all of the following factors would increase a persons respiratory rate, except:
A) narcotic analgesic use
B) increased metabolism
C) the use of amphetamines
D) a rise in body temperature

A

14

orotracheal intubation should be performed with the patients head:
A) slightly flexed
B) hyperextended
C) in a neutral position
D) in the sniffing position

D

15

oxygen that is dissolved in the blood plasma:
A) can be measured with a pulse oximeter
B) makes up the partial pressure of oxygen
C) is quickly absorbed by bicarbonate ions
D) cannot participate in pulmonary respiration

B

16

if the ET tube has been positioned properly in the trachea:
A) breath sounds should be somewhat louder on the right side and the epigastrium should be silent.
B)you should see not see vapor mist in the ET tube during exhalation when ventilating with a bag-mask
C)breath sounds should be loud at the apieces of the lungs but somewhat diminished at the bases
D) the bag mask device should be easy to compress and you should see corresponding chest expansion

D

17

which of the following medications is safest to use in patients with borderline hypotension or hypovelimia?
A) Brevital
B) Pentothal
C) Sublimaze
D) Etomidate

D

18

if the patients oxygen saturation drops at any point during rapid-sequence intubation, you should:
A) stop and hyperventilate the patient at a rate of 24 breaths/min
B) abort the intubation attempt and ventilate with a bag-mask device
C) apply posterior cricoid pressure and continue the intubation attempt
D) continue the intubation attempt and monitor the cardiac rhythm closely

B

19

before intubating a patient who has been chemically sedated and paralyzed, it is most important for the paramedic to
A) administer 0.5 mg of atropine sulfate
B) hyperventilate the patient at 24 breaths/min
C) adequately preoxygeneate with 100% oxygen
D) suction the oropharynx to clear any secreations

C

20

during ventilation with the LMA, the paramedic should:
A) observe the patient for signs of inadequate ventilation
B) maintain the patient's head in a slightly flexed position
C) suction the patient's oropharynx at least every two minutes
D) hyperventilate the patient to maximize tidal volume delivery

A

21

Changes in the rate and depth of breathing are regulated primarily by the
A) PH of venous blood
B) PH of the CSF
C) saturation of oxygen and hemoglobin
D) amount of oxygen in the blood plasma

B

22

after inserting the needle into through the cricothyroid membrane you should next:
A) change the angle to 90 degree and advance the catherter over the needl
B) aspirate with the syringe and then insert the needle about 2 cm farther
C) insert the needle about 1 centimeter farther and then aspirate the syringe
D) advance the catheter over the needle untill the hub is flush with the skin

C

23

approximitly ______mL of air remains in the anatomic dead space of an adult with a tidal volume of 500mL
A) 100
B) 125
C) 150
D) 175

C

24

on a capnographic waveform, point ____ is the maximal ETCO2 and is the best reflection of the alveolar CO2 level
A) B
B) C
C) D
D) E

C

25

which of the following conditions would MOST likely cause laryngeal spasm and edema?
A) Croup
B) inhalation injury
C) Viral pharyngitis
D) Mild asthma attack

B