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Exam 16: Respiratory Emergencies

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Question 21

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You are treating a patient who states that he has been short of breath for the past month. Tonight, his breathing just "got too bad" and he decided to call 911. The 67-year-old male is alert and oriented and has a patent airway. He is breathing 24 times per minute but appears to have an adequate tidal volume. His pulse is strong and regular, and his skin is warm. Vital signs are: pulse 92 beats per minute, respirations 22, blood pressure 128/66 mmHg, and SpO₂ 93% while on home oxygen at 2 lpm. What instruction would you give to your partner regarding this patient's care?

A) "Let's try 3 liters of oxygen through a nasal cannula."
B) "He seems pretty stable; we can refer him to his family doctor."
C) "Why don't we see how he tolerates a nasal airway?"
D) "Let's go ahead and put him on 15 lpm of oxygen."

E) All of the above
F) A) and D)

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Question 22

Multiple Choice

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The EMT understands adequate breathing when he states:

A) "If the respiratory rate is between 10 and 20, the breathing is most likely adequate."
B) "If the patient is breathing faster than 22 times a minute, it is inadequate."
C) "Normal and adequate breathing is specific to the patient and is determined by assessment."
D) "If the rate is between 10 and 20, with an intact airway and clear breath sounds, it is adequate."

E) None of the above
F) A) and D)

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Question 23

Multiple Choice

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You realize the EMT is properly ventilating an unresponsive adult male patient when he:

Which of the following respiratory sounds would make you suspicious of an upper airway problem?

You have been called for a 3-year-old male who is "not breathing right." Aside from a notable expiratory wheeze, which one of the following would be cause for most concern?

On scene, you find a 2-year-old male in significant respiratory distress. He is responsive to verbal stimuli and exhibits noisy respirations through an open airway. His breathing is shallow at a rate of 44 breaths per minute. His pulse is rapid. Assessment of the skin shows it to be cool and diaphoretic with cyanosis to the extremities and around the mouth. What is the immediate priority for this patient?

The best way to gauge the effectiveness of oxygen therapy would be to monitor the:

Pursed lip breathing is most commonly observed on a patient who suffers from:

You have been called to a home for an 18-year-old male who informs you that he experienced a sudden onset of shortness of breath and back pain while watching television. He also informs you that he has a history of spontaneous pneumothorax, and the current symptoms he is experiencing are identical to those he felt with a previous pneumothorax. Assessment reveals the patient to be slightly dyspneic with breath sounds clear and intact bilaterally. During transport, what is most critical to continually monitor on this patient?

When administering albuterol to a patient with shortness of breath, the EMT realizes that the therapeutic effect of this medication is achieved by:

Auscultation of breath sounds in a patient complaining of shortness of breath reveals wheezing. Which one of the following conditions is responsible for this finding?

Following a call in which you treated a pediatric patient suffering from croup, a new EMT who is in orientation asks you how you can differentiate croup from epiglottitis. Which one of the following responses would be most appropriate?

As you enter a room for an unknown medical emergency, you find an unresponsive male with snoring respirations lying supine in bed. Which one of the following actions should you take immediately?

You have a patient that you suspect of being infected with pertussis (whooping cough) . While performing the primary assessment, you note a deep cough with clear breath sounds. Her vital signs are: pulse 108, respirations 16, and SpO₂ at 96% on room air. Given this scenario, which one of the following would be most appropriate?

A patient who is nonverbal from a previous stroke is in severe respiratory distress. Family states that she has multiple medical problems including high blood pressure, diabetes, heart failure, and chronic obstructive pulmonary disease (emphysema and chronic bronchitis) . When assessing the patient, which one of the following signs or symptoms should raise your suspicion that the patient is suffering from heart failure, as opposed to COPD or asthma?

When instructing a patient on how to use a small-volume nebulizer, which one of the following statements would be correct?

You are starting to assess a patient's breath sounds and have just listened to the upper right back. You would next listen to the:

A patient requires several doses of medication from her metered-dose inhaler. At a minimum, how long should the EMT wait between administrations?

A patient with an unknown medical problem is responsive to painful stimuli and breathing poorly at a rate of 8 per minute. The airway is patent and skin warm and moist. His radial pulse is strong and irregular. Breath sounds are clear. Vital signs are pulse 84, blood pressure 256/120, and SpO₂ 81%. Your best treatment of the patient's breathing would be:

Which of the following pieces of information would heighten the EMT's suspicion that a child with a persistent cough may have pertussis (whooping cough) ?