NREMT - Airway, Ventilation, & Respiration Exam 2023 (verified)

NREMT - Airway, Ventilation, & Respiration Which of the following sounds indicates an upper airway obstruction in a child who is in respiratory distress? A. Wheezes B. Rales C. Rhonchi D. Stridor - ANSWER D. Stridor An unresponsive 7-month-old female is lying limp in her father's arms. He tells you that she was having an asthma attack but is better now. Her conjunctivae are pale and moist. You are only able to auscultate faint wheezes in her upper chest. Her vital signs are P 76 and R 18. You should first: A. administer oxygen by non-rebreather mask. B. assist with the administration of her nebulized albuterol. C. assess her oxygen saturation level. D. assist her ventilation with a BVM. - ANSWER D. assist her ventilation with a BVM. A 12-year-old male has difficulty breathing. He tells you he has had a cold all week. You auscultate rhonchi in his left lower chest. His vital signs are P 104, R 28, BP 104/74, and SpO2 is 89% on room air. You should suspect: A. septic shock. B. respiratory failure. C. respiratory distress. D. chronic asthma. - ANSWER C. respiratory distress. An 8-year-old female has had trouble breathing for two days. Her father called because she continues to have trouble breathing and he cannot wake her up. You do not hear any sounds when you auscultate her lower lungs and hear faint wheezes in her upper lungs. Her vital signs are P 60, R 26, BP 94/68, and SpO2 is 88% on room air. You should suspect: A. respiratory arrest. B. respiratory distress. C. eupneic respirations. D. respiratory failure. - ANSWER D. respiratory failure. An unresponsive 6-year-old male is taking shallow, irregular respirations once every 15 seconds. He has a weak carotid pulse. His mother tells you that he was playing alone in his room and was fine 30 minutes ago. You should suspect: A. Biot's respirations. B. respiratory arrest. C. Kussmaul's respirations. D. respiratory failure. - ANSWER B. respiratory arrest. A 10-year-old female complains of difficulty breathing after mixing bleach with another cleaner. Her skin and clothing are dry. You smell a strong odor, and your eyes begin to water. What route of exposure should you suspect is causing her dyspnea? A. Ingestion B. Injection C. Absorption D. Inhalation - ANSWER D. Inhalation An 11-year-old male who has a history of cystic fibrosis complains of difficulty breathing. He tells you he has been coughing up thick mucus. His vital signs are P 92, R 24, BP 118/76, and SpO2 is 91% on room air. You should: A. administer humidified oxygen. B. administer a bronchodilator. C. assist his ventilation. D. apply CPAP. - ANSWER A. administer humidified oxygen. A 9-year-old male has partial-thickness burns around his mouth after inhaling steam. He has a history of asthma and has had a cold for three days. His mother tells you he has had chest congestion and she was trying to break up the phlegm. He is drooling and tells you he cannot swallow. You should first: A. assess his vital signs. B. begin transport. C. administer his metered-dose inhaler. D. insert an oropharyngeal airway. - ANSWER B. begin transport. You are preparing to ventilate an 11-month-old female with a BVM. Which of the following ensures that her airway is properly positioned? A. Padding behind her shoulders B. Using cricoid pressure while ventilating her C. Inserting a nasopharyngeal airway D. Placing her in the sniffing position - ANSWER D. Placing her in the sniffing position A 6-month-old female does not respond to you when you stimulate her. Her father tells you that she stopped breathing and turned blue. You observe supraclavicular and sternal retractions at a rate of 38. You should first: A. assist her ventilation. B. administer oxygen by non-rebreather mask. C. assess her vital signs. D. assess her blood glucose level. - ANSWER A. assist her ventilation. A 13-year-old male tells you that he has had a cough for two weeks. He has an episode of coughing, and you hear an inspiratory whoop after each cough. You auscultate rhonchi in his left lower lung. His vital signs are P 100, R 22, BP 118/76, and SpO2 is 93% on room air. You should: A. assist with the administration of his beta1 antagonist. B. assist his ventilation. C. assist with the administration of his beta2 agonist. D. administer oxygen by nasal cannula. - ANSWER D. administer oxygen by nasal cannula. An unresponsive 4-year-old female is apneic but has a carotid pulse of 52. You should first: A. begin chest compressions. B. insert an oropharyngeal airway. C. attach the AED. D. administer oxygen. - ANSWER B. insert an oropharyngeal airway. Which of the following may be a direct impact of positive pressure ventilation on perfusion when ventilating an infant? A. Decreased preload B. Decreased cardiac output C. Increased V/Q mismatch D. Increased systemic resistance - ANSWER A. Decreased preload Which of the following respiratory conditions in children over 2 years old has similar lung sounds to an infant who has bronchiolitis? A. Pulmonary edema B. Asthma C. Pneumonia D. Pertussis - ANSWER B. Asthma A 3-year-old male is in respiratory distress. His mother tells you that he has a fever of 102 degrees F. She tells you he cannot swallow and is drooling. He is sitting up, leaning forward and you hear inspiratory stridor. You should: A. administer oxygen. B. place him in the recovery position. C. insert an oropharyngeal airway. D. suction his airway. - ANSWER A. administer oxygen. A 5-year-old female who has a history of asthma complains of trouble breathing. She is exhaling through pursed lips, and you auscultate wheezes. Her vital signs are P 110, R 32, BP 106/68, and SpO2 is 89% on room air. After administering oxygen, you should next: A. titrate oxygen administration to 94%. B. reassess her vital signs. C. assist with the administration of her metered dose inhaler. D. assist her ventilation with a BVM. - ANSWER C. assist with the administration of her metered dose inhaler. A 7-year-old male who has had a cold for a week tells you that he can't breathe. He has had a nonproductive cough for a day, and he is lying on his right side in the fetal position. His skin feels hot to the touch. He has a history of asthma, and you auscultate rhonchi in his right chest. His vital signs are P 118, R 24, BP 82/64, and SpO2 is 91% on room air. You should: A. place him in Fowler's position. B. assist with the administration of his MDI. C. assist his ventilation. D. administer oxygen. - ANSWER D. administer oxygen. An unresponsive 76-year-old female is lying in bed, and you hear snoring respirations. What should you suspect is partially occluding her airway? A. Liquid B. Her tongue C. Laryngotracheobronchitis D. Food - ANSWER B. Her tongue When assessing lung sounds in an adult who is sitting upright, where should you place your stethoscope to auscultate alveolar ventilation? A. Third intercostal space, anterior axillary line B. Sixth intercostal space, midscapular line C. Second intercostal space, midclavicular line D. Fourth intercostal space, midaxillary line - ANSWER B. Sixth intercostal space, midscapular line A 32-year-old male complains of difficulty breathing. He admits to smoking crack cocaine an hour before the problem started. You hear inspiratory stridor and observe drooling. His vital signs are P 108, R 18, BP 142/88, and SpO2 is 95% on room air. You should suspect: A. agitated delirium. B. laryngotracheobronchitis. C. epiglottitis. D. cocaine overdose. - ANSWER C. epiglottitis. A 39-year-old female is lying in bed. When you assess her, which of the following findings indicate an inadequate airway? A. She has chest wall expansion with little abdominal wall movement. B. She has an open pill bottle next to her bed. C. She is unresponsive and snoring. D. She is lying on her side. - ANSWER C. She is unresponsive and snoring. An unresponsive 45-year-old male was found lying on the ground outside. You do not see any obvious signs of trauma. He has snoring respirations and a carotid pulse. After opening his airway, you should next: A. suction his airway. B. insert an oropharyngeal airway. C. assist his ventilation. D. administer oxygen by non-rebreather mask. - ANSWER B. insert an oropharyngeal airway. An unresponsive 30-year-old female was the unrestrained driver involved in a car crash. Your partner stabilizes her head and tells you she is breathing and has a carotid pulse. As you examine her airway, you see blood, broken teeth, and hear gurgling sounds. You should first: A. insert an oropharyngeal airway. B. assist her ventilation. C. apply a cervical collar. D. suction her airway. - ANSWER D. suction her airway. Bystanders tell you that an unresponsive 22-year-old male fell 10 feet off a ladder and landed head first. You hear irregular, gasping respirations and palpate a carotid pulse. You should first: A. insert a nasopharyngeal airway. B. perform a jaw-thrust maneuver. C. apply a cervical collar. D. assess his vital signs. - ANSWER B. perform a jaw-thrust maneuver. An unresponsive 24-year-old female is lying on a sofa with an empty vodka bottle nearby. You hear snoring respirations, and when you attempt to insert an oropharyngeal airway, she begins to gag. You should: A. insert a nasopharyngeal airway. B. insert the next size smaller oropharyngeal airway. C. rotate the oropharyngeal airway into place and prepare to suction her airway. D. rotate the oropharyngeal airway into place and place her in the recovery position. - ANSWER A. insert a nasopharyngeal airway. You are ventilating an unresponsive 47-year-old male who is in respiratory arrest. How should you determine that you are delivering adequate tidal volume? A. Fully deflate the BVM. B. Look for slight chest rise. C. Auscultate for bronchial breath sounds. D. Assess his pulse oximetry. - ANSWER B. Look for slight chest rise. Which of the following is the preferred method to ventilate a patient who is in respiratory arrest? A. Single-rescuer, BVM ventilation B. Two-rescuer, BVM ventilation with cricoid pressure C. Single-rescuer, BVM ventilation with cricoid pressure D. Two-rescuer, BVM ventilation - ANSWER D. Two-rescuer, BVM ventilation How does positive pressure ventilation impact cardiac output? A. It decreases intrathoracic pressure which increases preload. B. It decreases myocardial oxygen demand. C. It increases systemic vascular resistance. D. It increases intrathoracic pressure which decreases preload. - ANSWER D. It increases intrathoracic pressure which decreases preload. A 70-year-old male has difficulty breathing. When assessing him, which of the following should influence your decision to assist his ventilation with a BVM? A. An SpO2 below 90% on room air B. A decrease in his mental status C. A history of COPD D. An increase in his respiratory rate - ANSWER B. A decrease in his mental status You are assessing a 43-year-old female who complains of difficulty breathing. How should you determine if her minute ventilation is adequate? A. Evaluate her mental status and tidal volume. B. Evaluate if her current minute ventilation is 30 percent more than her resting volume. C. Determine if her dead space has increased in proportion to her respiratory rate. D. Evaluate her SpO2 and her respiratory rate and depth. - ANSWER A. Evaluate her mental status and tidal volume. A 66-year-old male complains of difficulty breathing. He tells you that his asthma attack began 20 minutes ago, and his inhaler isn't helping. You auscultate wheezes in all lung fields and good chest rise with accessory muscle use. His vital signs are P 96, R 24, BP 146/88, and SpO2 is 93% on room air. You should suspect his minute ventilation is: A. adequate and administer CPAP. B. inadequate and administer oxygen. C. adequate and administer oxygen. D. inadequate and assist his ventilation. - ANSWER C. adequate and administer oxygen. A 55-year-old female is in respiratory arrest. When ventilating her, you should squeeze the bag once every: A. six seconds, enough to cause barely visible chest rise. B. five seconds, enough to cause her chest to rise two inches. C. twelve seconds, enough to cause barely visible chest rise. D. ten seconds, enough to cause her chest to rise two inches. - ANSWER A. six seconds, enough to cause barely visible chest rise. Which of the following prevents the over-inflation of the lungs during normal respiration? A. Cushing reflex B. Stretch receptors C. Baroreceptor reflex D. Chemoreceptors - ANSWER B. Stretch receptors A 63-year-old male complains of shortness of breath. His skin is cyanotic, and you auscultate wheezes in all lung fields. His vital signs are P 72, R 26, BP 142/88, and SpO2 is 92% on room air. You should suspect: A. increased capillary shunting. B. increased cell membrane permeability. C. decreased cardiac output. D. decreased alveolar ventilation. - ANSWER D. decreased alveolar ventilation. A 29-year-old female complains of difficulty breathing and numbness in her lips. She tells you that she has a lot of stress and cannot take it anymore. Her vital signs are P 104, R 28 and deep, BP 118/88, and SpO2 100% on room air. You should suspect: A. thyroid storm. B. metabolic alkalosis. C. increased alveolar ventilation. D. decreased systemic vascular resistance. - ANSWER C. increased alveolar ventilation. A 64-year-old male is having an asthma attack. Which class of medication can help improve his alveolar ventilation? A. Beta1 agonist B. Beta2 agonist C. Beta1 antagonist D. Beta2 antagonist - ANSWER B. Beta2 agonist What causes the prolonged expiratory phase of the respiratory cycle in a patient who is having an asthma attack? A. Ruptured blebs B. Bronchiole constriction C. Pulmonary venous hypertension D. Thick, sticky mucus production - ANSWER B. Bronchiole constriction Which process allows gas exchange between the alveoli and capillaries? A. Osmosis B. Oncotic pressure C. Active transport D. Simple diffusion - ANSWER D. Simple diffusion You are assisting the ventilation of a 57-year-old female who is in respiratory failure. Her initial vital signs were P 102, R32, BP 142/84, and SpO2 was 88% on room air. After five minutes of assisted ventilation, her vital signs are P 96, R 18 assisted with slight chest rise, BP 108/80, and SpO2 is 95% on oxygen 15 L/minute by BVM. You should: A. decrease the tidal volume of your ventilation. B. decrease your ventilation rate. C. increase the tidal volume of your ventilation. D. increase the oxygen flow rate. - ANSWER B. decrease your ventilation rate.