Question 1
Question
Which of the following findings for a patient complaining of dyspnea is of greatest concern?
Question 2
Question
The initial phase of an asthma reaction includes:
Answer
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an increase in vital capacity and hypercarbia.
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pharynx edema and hypotension.
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contraction of the bronchial smooth muscle and leakage of fluid from peribronchial capillaries.
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increased mucus production and tachycardia.
Question 3
Question
What is the sensation felt by placing a hand on the chest that vibrates during speech?
Answer
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Percussion
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Crepitus
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Tactile fremitus
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Bruit
Question 4
Question
Why is the use of Lasix or nitroglycerin often of no benefit to the patient suffering from noncardiogenic pulmonary edema (ARDS)?
Answer
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Because the reason for the pulmonary edema is not related to the cardiac pump (left ventricle)
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Because ARDS depresses the blood pressure and makes either drug contraindicated
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Because the patient with ARDS often has renal and cardiac complications that render both drugs ineffective
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Because ARDS is often fatal, and no intervention has been shown to be beneficial
Question 5
Question
The primary muscles, along with the abdominal muscles, used in periods of heavy respiratory demand are the
Answer
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sternocleidomastoid and scalene muscles.
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pectoral major and masseter muscles.
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anconeus and trapezius muscles.
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latissimus dorsi and soleus muscles.
Question 6
Question
Found where the trachea divides into the left and right mainstem bronchi, stimulation of the _____ can result in violent coughing
Answer
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Diaphragm
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Turbinates
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Carina
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Kiesselbach's plexus
Question 7
Question
Risk factors for pneumonia include:
Answer
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Age and immuno-compromising diseases
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Cardiac output and environmental exposure
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Exposure to hot temperatures and drug abuse
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Altered mental status and poor vital signs
Question 8
Question
What is the underlying pathophysiological change to the lungs that causes the patient to develop adult respiratory distress syndrome (ARDS)?
Answer
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Increased fluid accumulation in the perialveolar interstitial spaces
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Increased surfactant production that thickens the alveolar wall
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Increased lung resistance due to overwhelming bronchoconstriction
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Increased pulmonary vein pressure from a failing left ventricle
Question 9
Question
Which of the following patients display findings of respiratory failure?
Answer
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Respiratory rate of 32/min, ETCO Subscript 2 of 50 mmHg, intercostal retractions are noted, and tachycardia
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Peripheral cyanosis, expiratory wheezing, respiratory rate of 26/min
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Central cyanosis, 1-2 word dyspnea, pulse ox of 84 percent
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Absent alveolar breath sounds to left apical zone, pulse ox of 93 percent, minor confusion
Question 10
Question
What is the underlying pathology of a patient with an upper respiratory infection?
Answer
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Inflammation of upper airway structures from a virus or bacteria
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Swelling to the bronchioles with diminished alveolar sounds
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Infections to the upper airway structures from chronic bronchitis
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Exposure to toxic fumes causing irritation to the mouth, nose, and trachea
Question 11
Question
A patient in your care is coughing up blood. This is documented as which of the following?
Answer
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Hyperoxia
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Hemopoiesis
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Hyperpnea
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Hemoptysis
Question 12
Question
When the walls of the alveoli and small bronchioles are destroyed, as occurs in emphysema, vital capacity remains relatively the same while what increases?
Question 13
Question
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?
Question 14
Question
A patient with an airway obstruction between which two anatomical points will be unable to ventilate at all?
Answer
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Right mainstem and alveoli
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Glottis opening and carina
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Nasopharynx and oropharynx
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None of the above
Question 15
Question
Along with cigarette smoking, exposure to asbestos, hydrocarbons, radiation, and fumes from metal production have been associated risk factors for what lung disease?
Answer
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Tension pneumothorax
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Hyperventilation
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Congestive heart failure
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Cancer
Question 16
Question
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?
Answer
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The hilum of the right lung has ruptured.
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The patient has had an acute loss of surfactant production.
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Air has entered in between the visceral and parietal pleura.
Your answer is correct.D.
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Blood has entered in between the visceral and parietal pleura.
Question 17
Question
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?
Answer
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Suction out the stoma and reattach the ventilator
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Assure the stoma is patent and begin ventilations with a bag-valve-mask (BVM)
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Perform an RSI procedure and intubate the patient around the stoma tube
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Remove the ventilator and allow the patient to breathe on his own
Question 18
Question
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?
Answer
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Chronic bronchitis
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Emphysema
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ARDS
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Pneumonia