Which of the following findings for a patient complaining of dyspnea is of greatest concern?
Stridor on inspiration
Pulse ox of 95 percent
Normoresonance on the left side
ETCO Subscript 2 of 37 mmHg
The initial phase of an asthma reaction includes:
an increase in vital capacity and hypercarbia.
pharynx edema and hypotension.
contraction of the bronchial smooth muscle and leakage of fluid from peribronchial capillaries.
increased mucus production and tachycardia.
What is the sensation felt by placing a hand on the chest that vibrates during speech?
Percussion
Crepitus
Tactile fremitus
Bruit
Why is the use of Lasix or nitroglycerin often of no benefit to the patient suffering from noncardiogenic pulmonary edema (ARDS)?
Because the reason for the pulmonary edema is not related to the cardiac pump (left ventricle)
Because ARDS depresses the blood pressure and makes either drug contraindicated
Because the patient with ARDS often has renal and cardiac complications that render both drugs ineffective
Because ARDS is often fatal, and no intervention has been shown to be beneficial
The primary muscles, along with the abdominal muscles, used in periods of heavy respiratory demand are the
sternocleidomastoid and scalene muscles.
pectoral major and masseter muscles.
anconeus and trapezius muscles.
latissimus dorsi and soleus muscles.
Found where the trachea divides into the left and right mainstem bronchi, stimulation of the _____ can result in violent coughing
Diaphragm
Turbinates
Carina
Kiesselbach's plexus
Risk factors for pneumonia include:
Age and immuno-compromising diseases
Cardiac output and environmental exposure
Exposure to hot temperatures and drug abuse
Altered mental status and poor vital signs
What is the underlying pathophysiological change to the lungs that causes the patient to develop adult respiratory distress syndrome (ARDS)?
Increased fluid accumulation in the perialveolar interstitial spaces
Increased surfactant production that thickens the alveolar wall
Increased lung resistance due to overwhelming bronchoconstriction
Increased pulmonary vein pressure from a failing left ventricle
Which of the following patients display findings of respiratory failure?
Respiratory rate of 32/min, ETCO Subscript 2 of 50 mmHg, intercostal retractions are noted, and tachycardia
Peripheral cyanosis, expiratory wheezing, respiratory rate of 26/min
Central cyanosis, 1-2 word dyspnea, pulse ox of 84 percent
Absent alveolar breath sounds to left apical zone, pulse ox of 93 percent, minor confusion
What is the underlying pathology of a patient with an upper respiratory infection?
Inflammation of upper airway structures from a virus or bacteria
Swelling to the bronchioles with diminished alveolar sounds
Infections to the upper airway structures from chronic bronchitis
Exposure to toxic fumes causing irritation to the mouth, nose, and trachea
A patient in your care is coughing up blood. This is documented as which of the following?
Hyperoxia
Hemopoiesis
Hyperpnea
Hemoptysis
When the walls of the alveoli and small bronchioles are destroyed, as occurs in emphysema, vital capacity remains relatively the same while what increases?
Forced expiratory volume
Anatomical dead space
Residual volume
Inspiratory reserve volume
What is the type of respiratory problem that occurs when the patient develops an infectious process in one part of a lung that continues to spread throughout adjacent alveoli, which ultimately decreases ventilation and oxygenation?
Emphysema
Lower airway obstruction
Acute respiratory distress syndrome
Pneumonia
A patient with an airway obstruction between which two anatomical points will be unable to ventilate at all?
Right mainstem and alveoli
Glottis opening and carina
Nasopharynx and oropharynx
None of the above
Along with cigarette smoking, exposure to asbestos, hydrocarbons, radiation, and fumes from metal production have been associated risk factors for what lung disease?
Tension pneumothorax
Hyperventilation
Congestive heart failure
Cancer
A 20-year-old male runner comes up to you at the finish line of a cross country meet and says he "can't breathe." Physical exam reveals a 6'5", very thin male with acute, sharp pleuritic chest pain, and pale and diminished lung sounds are auscultated in the apex area of the right lung. What has likely happened to him?
The hilum of the right lung has ruptured.
The patient has had an acute loss of surfactant production.
Air has entered in between the visceral and parietal pleura. Your answer is correct.D.
Blood has entered in between the visceral and parietal pleura.
You are called to the home of a patient with a neuromuscular disease that has left him dependent on mechanical ventilation through a stoma for survival. The family summoned EMS due to the ventilator alarming "low minute ventilation." What should the paramedic do regarding management of this patient?
Suction out the stoma and reattach the ventilator
Assure the stoma is patent and begin ventilations with a bag-valve-mask (BVM)
Perform an RSI procedure and intubate the patient around the stoma tube
Remove the ventilator and allow the patient to breathe on his own
Your patient is a thin 59-year-old male in respiratory distress. He presents in a tripod position and appears to be working to breathe, pursing his lips. He is on home oxygen at 2 Lpm via nasal cannula and takes Atrovent and Proventil as his medications. You immediately notice his barrel-chested appearance, increased anterior/posterior chest diameter and pink complexion. Most likely, this patient suffers from which of the following?
Chronic bronchitis
ARDS
