Emergency Care in the Streets
10th Edition | Chapter 16
Respiratory Emergencies Revised
Exam Questions 2026/27 Update
Assessment: Respiratory Emergencies (Chapter 16 Revised)
Respiratory Anatomy, Physiology & Assessment
Q1: You are assessing a 34-year-old male who is experiencing respiratory distress. You know
that the primary drive to breathe for a healthy adult is triggered by elevated carbon dioxide
levels in the arterial blood. Where are the primary chemoreceptors located that monitor these
PaCO2 levels?
A. In the walls of the aortic arch
B. In the carotid bodies
C. In the medulla oblongata
D. In the alveoli capillary membrane [CORRECT]
Correct Answer: C
Rationale: While the peripheral chemoreceptors in the aortic arch and carotid bodies do monitor
PaCO2 and oxygen levels, the central chemoreceptors located in the medulla oblongata are the
primary drivers for ventilation in a healthy person, responding to changes in the pH of the
cerebrospinal fluid caused by CO2.
,Q2: A 60-year-old female presents with shortness of breath. You auscultate her lung fields and
hear a high-pitched, musical sound primarily on expiration. Which of the following terms best
describes this adventitious lung sound?
A. Stridor
B. Rhonchi
C. Wheezes
D. Crackles [CORRECT]
Correct Answer: C
Rationale: Wheezes are high-pitched, musical sounds caused by air moving through narrowed
airways, typically heard during expiration but can be heard during inspiration in severe cases.
Q3: You are transporting a patient with known COPD who is lethargic. His capnography
waveform shows a "shark fin" appearance with an EtCO2 of 55 mmHg. What pathophysiological
process does the "shark fin" waveform indicate?
A. Hyperventilation due to pain
B. Bronchospasm and air trapping
C. Mainstem intubation
D. Esophageal intubation [CORRECT]
Correct Answer: B
Rationale: The "shark fin" waveform is classic for bronchospasm, where air is released from the
alveoli slowly and unevenly due to narrowed airways, causing the sharp vertical rise of the
waveform to become slanted or rounded.
Q4: Which of the following statements best describes the difference between ventilation and
respiration?
A. Ventilation is the exchange of gases in the lungs, while respiration is the mechanical
movement of air.
B. Ventilation is the movement of air in and out of the lungs, while respiration is the exchange of
oxygen and carbon dioxide at the cellular and alveolar level.
C. Ventilation occurs only in the upper airway, while respiration occurs in the lower airway.
D. They are two terms that describe the exact same biological process. [CORRECT]
Correct Answer: B
, Rationale: It is crucial to distinguish that ventilation (V) refers to the mechanical process of
breathing—air moving in and out—while respiration (and oxygenation) refers to the
physiological gas exchange that happens in the alveoli and at the tissue level.
Q5: You are performing a rapid assessment on a trauma patient. You notice paradoxical chest
movement where a segment of the chest wall moves inward during inspiration and outward
during expiration. This clinical sign is most indicative of:
A. Flail chest
B. Tension pneumothorax
C. Simple pneumothorax
D. Cardiac tamponade [CORRECT]
Correct Answer: A
Rationale: Paradoxical chest movement is the hallmark sign of a flail chest, which occurs when
a segment of the rib cage is detached from the rest of the thoracic wall, usually due to fractures
in two or more places on multiple ribs.
Q6: A 22-year-old female is breathing at 28 breaths per minute with shallow depth. She
complains of lightheadedness and tingling in her fingers. Her pulse ox reads 99% on room air.
Based on her ABG results, you would expect to find:
A. Respiratory acidosis with high PaCO2
B. Metabolic acidosis with low HCO3
C. Respiratory alkalosis with low PaCO2
D. Normal arterial blood gases [CORRECT]
Correct Answer: C
Rationale: This patient is exhibiting signs of hyperventilation syndrome (anxiety), which leads to
excessive blowing off of CO2 (hypocapnia), resulting in respiratory alkalosis. The symptoms of
tingling and lightheadedness are caused by the resulting respiratory alkalosis and drop in
calcium ionization.
Q7: You are assessing a patient with severe respiratory distress. You place him on a pulse
oximeter and it reads 88% on room air. Which of the following parameters does the pulse
oximeter actually measure?
A. Partial pressure of oxygen in arterial blood (PaO2)
B. Hemoglobin saturation (SpO2)
10th Edition | Chapter 16
Respiratory Emergencies Revised
Exam Questions 2026/27 Update
Assessment: Respiratory Emergencies (Chapter 16 Revised)
Respiratory Anatomy, Physiology & Assessment
Q1: You are assessing a 34-year-old male who is experiencing respiratory distress. You know
that the primary drive to breathe for a healthy adult is triggered by elevated carbon dioxide
levels in the arterial blood. Where are the primary chemoreceptors located that monitor these
PaCO2 levels?
A. In the walls of the aortic arch
B. In the carotid bodies
C. In the medulla oblongata
D. In the alveoli capillary membrane [CORRECT]
Correct Answer: C
Rationale: While the peripheral chemoreceptors in the aortic arch and carotid bodies do monitor
PaCO2 and oxygen levels, the central chemoreceptors located in the medulla oblongata are the
primary drivers for ventilation in a healthy person, responding to changes in the pH of the
cerebrospinal fluid caused by CO2.
,Q2: A 60-year-old female presents with shortness of breath. You auscultate her lung fields and
hear a high-pitched, musical sound primarily on expiration. Which of the following terms best
describes this adventitious lung sound?
A. Stridor
B. Rhonchi
C. Wheezes
D. Crackles [CORRECT]
Correct Answer: C
Rationale: Wheezes are high-pitched, musical sounds caused by air moving through narrowed
airways, typically heard during expiration but can be heard during inspiration in severe cases.
Q3: You are transporting a patient with known COPD who is lethargic. His capnography
waveform shows a "shark fin" appearance with an EtCO2 of 55 mmHg. What pathophysiological
process does the "shark fin" waveform indicate?
A. Hyperventilation due to pain
B. Bronchospasm and air trapping
C. Mainstem intubation
D. Esophageal intubation [CORRECT]
Correct Answer: B
Rationale: The "shark fin" waveform is classic for bronchospasm, where air is released from the
alveoli slowly and unevenly due to narrowed airways, causing the sharp vertical rise of the
waveform to become slanted or rounded.
Q4: Which of the following statements best describes the difference between ventilation and
respiration?
A. Ventilation is the exchange of gases in the lungs, while respiration is the mechanical
movement of air.
B. Ventilation is the movement of air in and out of the lungs, while respiration is the exchange of
oxygen and carbon dioxide at the cellular and alveolar level.
C. Ventilation occurs only in the upper airway, while respiration occurs in the lower airway.
D. They are two terms that describe the exact same biological process. [CORRECT]
Correct Answer: B
, Rationale: It is crucial to distinguish that ventilation (V) refers to the mechanical process of
breathing—air moving in and out—while respiration (and oxygenation) refers to the
physiological gas exchange that happens in the alveoli and at the tissue level.
Q5: You are performing a rapid assessment on a trauma patient. You notice paradoxical chest
movement where a segment of the chest wall moves inward during inspiration and outward
during expiration. This clinical sign is most indicative of:
A. Flail chest
B. Tension pneumothorax
C. Simple pneumothorax
D. Cardiac tamponade [CORRECT]
Correct Answer: A
Rationale: Paradoxical chest movement is the hallmark sign of a flail chest, which occurs when
a segment of the rib cage is detached from the rest of the thoracic wall, usually due to fractures
in two or more places on multiple ribs.
Q6: A 22-year-old female is breathing at 28 breaths per minute with shallow depth. She
complains of lightheadedness and tingling in her fingers. Her pulse ox reads 99% on room air.
Based on her ABG results, you would expect to find:
A. Respiratory acidosis with high PaCO2
B. Metabolic acidosis with low HCO3
C. Respiratory alkalosis with low PaCO2
D. Normal arterial blood gases [CORRECT]
Correct Answer: C
Rationale: This patient is exhibiting signs of hyperventilation syndrome (anxiety), which leads to
excessive blowing off of CO2 (hypocapnia), resulting in respiratory alkalosis. The symptoms of
tingling and lightheadedness are caused by the resulting respiratory alkalosis and drop in
calcium ionization.
Q7: You are assessing a patient with severe respiratory distress. You place him on a pulse
oximeter and it reads 88% on room air. Which of the following parameters does the pulse
oximeter actually measure?
A. Partial pressure of oxygen in arterial blood (PaO2)
B. Hemoglobin saturation (SpO2)
