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Flashcards in Chapter 14 Test Questions Deck (51)
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1
Q

What acid-base derangement initially occurs in a tachypneic patient without a physiologic demand for increased oxygen?

A. Metabolic acidosis

B. Metabolic alkalosis

C. Respiratory acidosis

D. Respiratory alkalosis

A

D. Respiratory alkalosis

2
Q

Which of the following is generally NOT indicated when treating a patient with a tension pneumothorax?

A. Paramedic support

B. Medication therapy

C. Intravenous therapy

D. Ventilatory assistance

A

B. Medication therapy

3
Q

Acute epiglottitis in the adult is characterized by:

A. a productive cough.

B. a low-grade fever.

C. a severe sore throat.

D. a seal-bark cough.

A

C. a severe sore throat.

4
Q

A 59-year-old female with a history of poorly controlled hypertension becomes acutely dyspneic, develops profound cyanosis to the upper chest, and becomes unresponsive. She is pulseless and apneic upon your arrival. As you and your partner are performing the appropriate treatment interventions, you discuss the possible cause of her condition, which is MOST likely a(n):

A. acute myocardial infarction.

B. massive pulmonary embolism.

C. large tension pneumothorax.

D. massive atraumatic hemothorax.

A

B. massive pulmonary embolism.

5
Q

You are treating a 2-year-old boy who is experiencing respiratory distress. During your assessment, you note that the child has mild inspiratory stridor, a barking cough, and a low-grade fever. The child is otherwise conscious, is acting appropriate for his age, and has strong radial pulses. Treatment should include:

A. an IV fluid bolus.

B. a beta antagonist.

C. assisted ventilation.

D. humidified oxygen.

A

D. humidified oxygen.

6
Q

Cystic fibrosis is a genetic disorder that results in:

A. spontaneous collapsing of one or both lungs.

B. excess sodium loss and thick pulmonary secretions.

C. acute pulmonary edema and diffuse bronchospasm.

D. profound dehydration and a fever greater than 102°F.

A

B. excess sodium loss and thick pulmonary secretions.

7
Q

When assessing a patient with difficulty breathing, which of the following findings would lead you to suspect congestive heart failure as the underlying cause?

A. The patient is a long-term smoker and takes corticosteroid medications on a daily basis.

B. The onset of the difficulty breathing was acute and the patient takes prescribed diuretics.

C. The patient is coughing up thick green sputum and has prescriptions for Atrovent and Advair.

D. The patient is receiving home oxygen therapy, has pink skin, and is breathing through pursed lips.

A

B. The onset of the difficulty breathing was acute and the patient takes prescribed diuretics.

8
Q

Approximately 20 minutes after receiving a penicillin injection at the doctor’s office, a 41-year-old female presents with acute respiratory distress, facial swelling, and intense itching to her entire body. Her level of consciousness is decreased and her breathing is labored with minimal chest rise. The MOST appropriate treatment for this patient should include:

A. assisted ventilations, IV of normal saline, and epinephrine.

B. oxygen via a nonrebreathing mask, IV of normal saline, and albuterol.

C. insertion of a King LT airway and a 1,000 mL bolus of normal saline.

D. hyperventilation with a bag-mask device and epinephrine via IV push.

A

A. assisted ventilations, IV of normal saline, and epinephrine.

9
Q

The respiratory syncytial virus (RSV) is a common cause of:

A. pertussis and the flu.

B. MRSA and whooping cough.

C. bronchiolitis and pneumonia.

D. asthma and chronic bronchitis.

A

C. bronchiolitis and pneumonia.

10
Q

Chronic carbon dioxide retention, as seen in patients with certain lung diseases, may cause the patient to:

A. develop extended periods of hypocarbia.

B. experience acute tidal volume increases.

C. breathe on the basis of decreased oxygen.

D. develop tachypnea if given 100% oxygen.

A

C. breathe on the basis of decreased oxygen.

11
Q

A 30-year-old male presents with respiratory distress that began within minutes of being exposed to an unknown chemical at an industrial site. When caring for this patient, it is MOST important to remember that:

A. he will likely require frequent suctioning.

B. he must be properly decontaminated first.

C. aggressive airway management may be needed.

D. inhalation injuries can cause aspiration pneumonia.

A

B. he must be properly decontaminated first.

12
Q

In contrast to bronchitis, pneumonia typically presents with:

A. fever and chills.

B. fluid in the lungs.

C. a productive cough.

D. varying levels of hypoxia.

A

A. fever and chills.

13
Q

The movement and utilization of oxygen in the body is dependent on all of the following, EXCEPT:

A. effective alveolar-capillary osmosis.

B. adequate concentration of inspired oxygen.

C. adequate number of functional erythrocytes.

D. efficient off-loading of oxygen in the tissues.

A

A. effective alveolar-capillary osmosis.

14
Q

You are transporting a 60-year-old male to the hospital for suspected COPD exacerbation. He is receiving 100% oxygen via a nonrebreathing mask. As you reassess him, you note that his respirations have decreased and have become shallow. You should:

A. begin assisting his ventilations.

B. apply a nasal cannula at 4 L/min.

C. remove the oxygen mask and reassess.

D. prepare to insert a multilumen airway.

A

A. begin assisting his ventilations.

15
Q

Which of the following clinical findings is MOST consistent with inadequate breathing?

A. Symmetrical chest movement and warm, dry skin

B. Respirations of 16 breaths/min and reduced tidal volume

C. Increased amount of expired air at the nose and mouth

D. Regular breathing pattern and respirations of 24 breaths/min

A

B. Respirations of 16 breaths/min and reduced tidal volume

16
Q

Which of the following statements MOST accurately describes asthma?

A. Irreversible airway disease that presents with inspiratory wheezing

B. Reversible airway disease caused by an exaggerated immune response

C. Irreversible airway disease that results in increased alveolar surface tension

D. Chronic respiratory disease caused by long-term exposure to toxic substances

A

B. Reversible airway disease caused by an exaggerated immune response

17
Q

Which of the following conditions would be LEAST likely to result in cerebral hypoxia?

A. Muscular dystrophy

B. Acute pulmonary edema

C. Benzodiazepine overdose

D. Methamphetamine overdose

A

D. Methamphetamine overdose

18
Q

A 70-year-old male presents with an acute onset of difficulty breathing that woke him from his sleep. He has a history of hypertension, atrial fibrillation, and several heart attacks. During your assessment, you note dried blood around his mouth. The patient tells you that he cannot lie down because he will “smother.” What additional assessment findings will you MOST likely discover?

A. Diffuse wheezing

B. Pulmonary rales

C. Fever and chills

D. Slow respiratory rate

A

B. Pulmonary rales

19
Q

In contrast to an epidemic, a pandemic:

A. is a disease outbreak that occurs on a global scale.

B. occurs in more of the population than was expected.

C. is usually confined to a specific geographic location.

D. is a disease for which a vaccine is readily available.

A

A. is a disease outbreak that occurs on a global scale.

20
Q

Cheyne-Stokes respirations are characterized by:

A. irregular tachypnea with occasional periods of apnea.

B. impaired respirations with sustained inspiratory effort.

C. tachypnea and hyperpnea with an acetone breath odor.

D. tachypnea and bradypnea with alternating apneic periods.

A

D. tachypnea and bradypnea with alternating apneic periods.

21
Q

Cardiac asthma is a condition in which a patient:

A. with a history of asthma develops wheezing caused by an acute cardiac event.

B. with congestive heart failure experiences wheezing due to constricted bronchi.

C. develops acute respiratory distress when fluid suddenly accumulates in the lungs.

D. inadvertently takes too much of his or her beta-blocker, resulting in bronchospasm.

A

B. with congestive heart failure experiences wheezing due to constricted bronchi.

22
Q

When assessing a female patient with chest pain and shortness of breath, you note that her blood pressure is 80/50 mm Hg, her heart rate is 120 beats/min, and she has cyanosis around her mouth. In addition to supporting her ventilations, you should:

A. establish intravenous access.

B. perform a secondary assessment.

C. prepare for immediate transport.

D. give her a bronchodilator drug.

A

C. prepare for immediate transport.

23
Q

Patients with COPD are highly susceptible to pneumonia because:

A. they cannot effectively expel infected pulmonary secretions.

B. their immune system is inherently weakened by the disease.

C. their age predisposes them to COPD-related lung infections.

D. their hyperactive cough reflex leads to alveolar destruction.

A

A. they cannot effectively expel infected pulmonary secretions.

24
Q

Which of the following respiratory medications is exclusively indicated for chronic asthma treatment or as asthma prevention?

A. Advair

B. Atrovent

C. Alupent

D. Proventil

A

A. Advair

25
Q

A 77-year-old male with a history of emphysema complains of an acute worsening of his shortness of breath and pleuritic chest pain that occurred after a forceful cough. Auscultation of his lungs reveals scattered wheezing on the left side and diminished breath sounds on the right. This patient’s clinical presentation is MOST consistent with:

A. acute pulmonary edema.

B. exacerbated emphysema.

C. acute bacterial pneumonia.

D. spontaneous pneumothorax.

A

D. spontaneous pneumothorax.

26
Q

The process of moving air into and out of the lungs is called:

A. breathing.

B. respiration.

C. ventilation.

D. oxygenation.

A

C. ventilation.

27
Q

Characteristics of adequate breathing in an adult include all of the following, EXCEPT:

A. asymmetrical chest movement.

B. respirations of 14 breaths/min.

C. pink oral mucous membranes.

D. audible breath sounds bilaterally.

A

A. asymmetrical chest movement.

28
Q

The MOST significant risk associated with ventilating a patient too rapidly is:

A. gastric distention and regurgitation.

B. barotrauma and a pneumothorax.

C. inadvertent respiratory alkalosis.

D. excess carbon dioxide elimination.

A

A. gastric distention and regurgitation.

29
Q

A 56-year-old male complains of difficulty breathing. His wife tells you that he complained of chest discomfort a few days prior, but would not allow her to call EMS. Your assessment reveals rales in the apices and bases of both lungs. This patient’s clinical presentation is MOST consistent with:

A. chronic obstructive pulmonary disease (COPD) exacerbation.

B. chronic bronchitis.

C. acute pulmonary embolism.

D. cardiogenic pulmonary edema.

A

D. cardiogenic pulmonary edema.

30
Q

A 20-year-old female presents with acute respiratory distress. Auscultation of her lungs reveals diffuse expiratory wheezing. She is in moderate distress and tells you that she has a prescribed inhaler that she uses when this happens. You should suspect:

A. status asthmaticus.

B. bronchitis exacerbation.

C. an acute asthma attack.

D. bacterial pneumonia.

A

C. an acute asthma attack.

31
Q

You are dispatched for an elderly male with dyspnea. When you arrive, you find the patient sitting in a chair. He is semiconscious and unable to effectively communicate with you. As you perform a primary assessment, your partner applies 100% oxygen and a pulse oximeter, which reads 85%. The MOST reliable indicator of cerebral hypoxia in this patient is his:

A. complaint of dyspnea.

B. mental status alteration.

C. inability to communicate.

D. decreased oxygen saturation.

A

B. mental status alteration.

32
Q

The exchange of oxygen and carbon dioxide, at the cellular level or in the lungs, is called:

A. breathing.

B. respiration.

C. ventilation,

D. oxygenation.

A

B. respiration.

33
Q

Which of the following processes occurs during normal inspiration?

A. An increase in intrathoracic pressure forces air into the lungs

B. The phrenic nerves stimulate the intercostal muscles to contract

C. Air is pulled into the lungs when intrathoracic pressure decreases

D. The diaphragm contract and ascends, increasing the chest diameter

A

C. Air is pulled into the lungs when intrathoracic pressure decreases

34
Q

You are assessing a young male with an acute onset of tachypnea. He is conscious and alert with shallow respirations of 40 breaths/min, and complains of numbness and tingling to his face and hands. The patient’s girlfriend tells you that he has been very worried about his mother, who was recently diagnosed with cancer. Appropriate treatment for this patient includes:

A. a nonrebreathing mask without oxygen.

B. coached breathing and oxygen as needed.

C. carbon dioxide rebreathing with a paper bag.

D. a beta2 agonist if authorized by medical control.

A

B. coached breathing and oxygen as needed.

35
Q

Emphysema, a degenerative disease, is caused by:

A. surfactant destruction and increased alveolar surface tension.

B. excessive mucous production by beta2 cells in the bronchi.

C. widespread constriction of the bronchioles and air trapping.

D. decreased alveolar surface tension caused by excess surfactant.

A

A. surfactant destruction and increased alveolar surface tension.

36
Q

The Hering-Breuer reflex is defined as:

A. an increase in respiratory rate and depth secondary to decreased levels of oxygen in the blood.

B. a feedback loop that sends signals to the apneustic center, resulting in increased tidal volume.

C. a decrease in respiratory rate and depth secondary to decreased carbon dioxide levels in the blood.

D. a feedback loop that inhibits the inspiratory center, which prevents overexpansion of the lungs.

A

D. a feedback loop that inhibits the inspiratory center, which prevents overexpansion of the lungs.

37
Q

A 67-year-old male who smokes three packs of cigarettes per day complains of a productive cough, chills, and generalized weakness. He is in mild respiratory distress; auscultation of his lungs reveals rhonchi to the lower left lobe. This patient’s clinical presentation is MOST consistent with:

A. pneumonia.

B. bronchitis.

C. emphysema.

D. heart failure.

A

A. pneumonia.

38
Q

Common side effects of inhaled medications used for acute shortness of breath include all of the following, EXCEPT:

A. sedation.

B. tachycardia.

C. nervousness.

D. muscle tremors.

A

A. sedation.

39
Q

You are assessing a 52-year-old male with respiratory distress. The MOST ominous sign(s) of severe hypoxemia and imminent cardiac arrest is/are:

A. minimal-word dyspnea and pallor.

B. audible stridor and facial cyanosis.

C. a marked decrease in the heart rate.

D. a marked increase in the heart rate.

A

C. a marked decrease in the heart rate.

40
Q

An anaphylactic reaction impairs effective breathing secondary to:

A. catecholamine release.

B. upper-airway swelling.

C. diffuse alveolar collapse.

D. excess fluid in the alveoli.

A

B. upper-airway swelling.

41
Q

Patients with emphysema are commonly referred to as “pink puffers” because they:

A. develop polycythemia and often grunt during exhalation.

B. produce excess red blood cells and maintain low CO2 levels.

C. grunt when they breathe and maintain high arterial O2 levels.

D. breathe through pursed lips and may develop polycythemia.

A

D. breathe through pursed lips and may develop polycythemia.

42
Q

Typical signs and symptoms of pneumonia include:

A. pleuritic chest pain, fever, and rhonchi.

B. dry cough, high fever, and labored breathing.

C. weakness, crushing chest pain, and wheezing.

D. stridor, chills, shortness of breath, and fever.

A

A. pleuritic chest pain, fever, and rhonchi.

43
Q

Which of the following physiologic processes does NOT occur in patients with COPD?

A. Diffuse alveolar collapse

B. Intrapulmonary air trapping

C. Increased surfactant production

D. Mucous production from beta2 cells

A

C. Increased surfactant production

44
Q

A 60-year-old male presents with shortness of breath and a productive cough of two days’ duration. He denies chest pain or any other associated symptoms. Auscultation of his lungs reveals scattered bilateral rhonchi in all fields. His skin is pink, warm, and dry and the pulse oximeter reads 94% on room air. This patient is MOST likely experiencing:

A. acute asthma.

B. emphysema.

C. bronchitis.

D. pneumonia.

A

C. bronchitis.

45
Q

When assisting a patient with his or her prescribed inhaler, it is important to:

A. ensure that the medication is slightly below room temperature.

B. have the patient exhale deeply prior to inhaling the medication.

C. instruct the patient to hold his or her breath for 20 to 30 seconds.

D. avoid a spacer device, as this decreases the medication’s efficacy.

A

B. have the patient exhale deeply prior to inhaling the medication.

46
Q

When assessing a patient using a pulse oximeter, it is important to remember that:

A. an oxygen saturation of greater than 90% rules out hypoxemia.

B. abnormally bound hemoglobin may produce inaccurate readings.

C. pulse oximetry will determine whether or not to administer oxygen.

D. the pulse oximeter provides an accurate reading of the patient’s PaO2.

A

B. abnormally bound hemoglobin may produce inaccurate readings.

47
Q

You are dispatched to the home of a 64-year-old male patient with lung cancer. The patient complains of acute dyspnea; however, as long as he is sitting upright, his breathing is easier. He denies fever and his breath sounds are decreased over the base of the left lung. What is the MOST likely cause of this patient’s symptoms?

A. Localized bronchospasm in the lungs

B. Consolidation of fluid within the lung

C. Collection of fluid outside of the lung

D. Air in the pleural space with lung collapse

A

C. Collection of fluid outside of the lung

48
Q

You are dispatched to a residence for a 69-year-old female with “breathing problems.” When you arrive, the patient’s husband directs you to his wife, who is sitting on the couch in obvious respiratory distress. She is semiconscious and has labored, shallow respirations. You auscultate her lungs and hear diffuse rhonchi in all lung fields. Which of the following interventions would be of LEAST benefit to her?

A. Assisted ventilations with a bag-mask device

B. IV therapy with up to a 500 mL normal saline bolus

C. Suction of her airway for up to 15 seconds if needed

D. Prompt transport and consideration of a paramedic intercept

A

B. IV therapy with up to a 500 mL normal saline bolus

49
Q

When assessing the severity of nocturnal dyspnea in a patient with a chronic respiratory disease, you should determine:

A. if he or she sleeps on the stomach or back.

B. how many pillows he or she sleeps with at night.

C. how far he or she can walk before dyspnea occurs.

D. if he or she uses a beta2 agonist at least twice per day.

A

B. how many pillows he or she sleeps with at night.

50
Q

Approximately 2 weeks following a total hip replacement, a 70-year-old female complains of a sudden onset of dyspnea and pleuritic chest pain. Your assessment reveals perioral cyanosis, blood-tinged sputum, and wheezing to the base of her right lung. As your partner applies high-flow oxygen, the patient states that she has a history of hypertension. You should be MOST suspicious of:

A. an acute asthma attack.

B. a simple pneumothorax.

C. acute left heart failure.

D. a pulmonary embolism.

A

D. a pulmonary embolism.

51
Q

Cardiomyopathy may lead to pulmonary edema due to:

A. acute injury to the myocardium.

B. a profound decrease in heart rate.

C. reduced contractile force of the heart.

D. weakening of the right side of the heart.

A

C. reduced contractile force of the heart.