Chapter 10

100問 • 11ヶ月前

問題一覧

Which of these sequences best describes the path that oxygen must travel to get into the cells of the body?

Oropharynx, larynx, trachea, carina, bronchioles

You are assessing an unresponsive patient who overdosed on a narcotic pain medication. Given the situation, what is the greatest concern regarding potential airway occlusion?

Relaxation of the tongue

Which of these patients should the Emergency Medical Technician recognize as having a potential occlusion of the upper airway?

A 3-year-old male with a fever and swelling of the larynx

Which statement indicates that the Emergency Medical Technician has an accurate understanding of the bronchioles?

They are small passages located in the lower airway that have smooth muscle surrounding them."

Assessment findings on an elderly patient with congestive heart failure indicate that fluid is starting to collect and fill her alveoli. Based on this pathophysiology, which pulmonary complication should the Emergency Medical Technician treat the patient for?

Decreased gas exchange

If an injured patient has lost all use of his diaphragm, the Emergency Medical Technician should recognize that the patient:

Has lost a major portion of his ability to breathe.

The Emergency Medical Technician exhibits an accurate understanding of breathing when he states:

Inhalation requires energy, while exhalation for most patients is a passive process."

When a person's diaphragm contracts and the intercostal muscles pull the ribs upward, what will occur relative to the exchange of air and/or gases?

Air will flow into the lungs.

Which of these patients is most likely to lose neurologic control and thus regulation of the respiratory system?

A 31-year-old patient with a severe head injury

When completing a primary assessment, what would be a good indication that the patient has an open airway?

The patient speaks with ease.

You have been called to an extended care facility for a 77-year-old female patient with Parkinson's disease. According to the nursing staff, she is more confused than normal and is to be transported to the emergency department for evaluation. Since the patient neither understands nor can answer any of your questions, which sign provides the best evidence that her breathing is adequate?

Pulse oximeter reading at 98%

Your medical director is holding an in-service program focusing on the prehospital management of adult patients with respiratory complaints. He asks the group to explain how they can determine if the patient is breathing adequately. Which response is most appropriate?

For an adult patient to be breathing adequately, the rate should be within 8 to 24 breaths/min with a full chest rise with each breath."

You have been called for a patient who has overdosed on drugs and alcohol. The patient is responsive to painful stimuli, has shallow respirations, and is breathing at a rate of 8 times per minute, but exhibits no cyanosis. What is the priority treatment?

Inadequate respirations; start positive pressure ventilation with supplemental oxygen

Which of these patients should the Emergency Medical Technician suspect as being mildly hypoxic?

An 18-year-old male who is restless, has shallow respirations, and is breathing at a rate of 16 times per minute, with no cyanosis

The Emergency Medical Technician (EMT) believes that a patient is mildly hypoxic based on findings from the primary assessment. Which other sign could the EMT use to confirm his suspicion of mild hypoxia?

Sleepy appearance

Which of these patients would benefit from the head-tilt, chin-lift manual airway maneuver as opposed to any other initial airway management technique?

A 39-year-old male who just had a seizure and has snoring respirations

A 2-year-old boy who just seized must have his airway opened. When performing the head-tilt, chin-lift airway maneuver, the Emergency Medical Technician must remember:

If necessary, the head should be only slightly extended.

You have arrived on the scene of an assault in which several people were injured. You are directed to assist another crew with a patient who has been shot. As you approach, you are told that the patient has slow and irregular breathing that is inadequate. You observe the patient being ventilated with a bag-valve mask while another Emergency Medical Technician maintains her airway with the jaw-thrust maneuver. Based on your observation, where might you expect this patient was shot?

Head

Why is the jaw-thrust maneuver indicated for a patient with a possible spinal injury?

It manipulates the head and cervical spine less than the head-tilt, chin-lift maneuver.

Which statement regarding airway management in the trauma patient is correct?

Performing the head-tilt, chin-lift maneuver on a patient with a possible spinal injury could further injure or paralyze the patient.

The Emergency Medical Technician should use the jaw-thrust maneuver to open the airway for the patient with which type of presentation?

Unresponsive after falling from a porch

The Emergency Medical Technician is correctly performing the jaw-thrust airway maneuver when she:

Places her hands on the side of the patient's head and lifts the jaw upward.

You arrive at a residence for a male patient who is unresponsive. As you enter the room, you observe an obese man lying on a recliner. His eyes are closed, and he has gurgling respirations. While your partner is quickly performing a primary assessment, you should immediately prepare to:

Suction the airway.

While you are transporting a patient with altered mental status, he suddenly vomits partially digested food along with large blood clots. The vomitus is too big for the rigid suction catheter. The Emergency Medical Technician should immediately place the patient on his side and:

Perform a finger sweep.

You must suction the oropharynx of a male patient who has a swallowing dysfunction as a residual effect from a previous stroke. He also has a history of smoking and lung cancer. What would be the most appropriate suction catheter for use with this patient?

Yankauer

A young child with multiple physical and developmental abnormalities has a severe nosebleed. You must suction his nasopharynx to decrease the amount of blood he is swallowing. Which action should be part of this care?

Insert a soft catheter into the nose the same length as the distance from the tip of the patient's nose to the tip of his ear

You are caring for a 46-year-old male patient who is unresponsive. Which statement made by your partner indicates the need to immediately stop suctioning the patient's airway and resume positive pressure ventilation?

His heart rate is 48 beats per minute."

Which statement made by an Emergency Medical Technician shows that she understands how to suction patients in a field setting?

I activate the suction device only when I am withdrawing the suction catheter."

You must suction frothy secretions from the mouth and pharynx of a 31-year-old male patient whose respiration rate is 4 breaths/min. Which process to do so is most appropriate given the patient's condition?

Suction for no more than 15 seconds at a time if possible

Which statement made by an Emergency Medical Technician (EMT) with whom you are working for the first time shows he understands the use of the pocket mask?

In comparison to the bag-valve mask, the pocket mask can allow for just as good, if not better, tidal volume."

You have opened an apneic patient's airway using the head-tilt, chin-lift maneuver and are ready to ventilate with a pocket mask. The first ventilation you attempt is unsuccessful. You should immediately:

Reposition the patient's head.

When using a pocket mask to ventilate an unresponsive adult patient, the Emergency Medical Technician must always:

Maintain the head-tilt, chin-lift maneuver or jaw-thrust maneuver.

You are assessing a young male patient who was ejected from an automobile at a high rate of speed. He responds to painful stimuli with posturing and displays agonal breathing. His pulse is weak and thready, and his skin is cool and diaphoretic. When addressing this patient's airway and breathing, the Emergency Medical Technician must immediately:

Perform the jaw-thrust maneuver and begin artificial ventilations with the bag-valve mask.

Which configuration on the bag-valve mask (BVM) will enable the Emergency Medical Technician (EMT) to deliver the highest concentration of oxygen to the patient?

BVM with oxygen reservoir attached, receiving oxygen at 15 lpm

Which statement about the bag-valve mask (BVM) is true?

A 15/22 mm adapter allows the BVM to be attached to an advanced airway such as the endotracheal tube.

You have arrived next to a patient who reportedly had a seizure. Assessment reveals him to be apneic with vomitus in the airway. He has a radial pulse, and his skin is cool and diaphoretic. What should you do immediately?

Suction the airway

Which description demonstrates the Emergency Medical Technician (EMT) knows how to correctly position the bag-valve mask (BVM) on the patient's face?

"I place the narrow part of the mask over the bridge of the nose, and the bottom part in the cleft above the chin."

You are teaching a group of firefighters who are taking classes to become Emergency Medical Responders. The topic is artificial ventilation with the bag-valve mask (BVM). Which point related to use of the BVM is important to emphasize?

Maintaining a good mask-to-face seal during one person BVM is difficult.

Which tip should you give a new Emergency Medical Technician about artificially ventilating a patient with the bag-valve mask?

It is important to maintain the head-tilt, chin-lift maneuver or the jaw-thrust maneuver while ventilating the patient."

A 52-year-old male patient with a brain tumor has gone into respiratory arrest, but still has a pulse and blood pressure. You assign the task of mechanically ventilating the patient with the bag-valve mask to a new Emergency Medical Responder. How will you instruct him to ventilate the patient?

Deliver 10 breaths per minute

You are artificially ventilating an adult male patient who is in respiratory arrest with a bag-valve mask. Which finding would demonstrate that you are ventilating this patient properly?

Adequate chest rise and fall

While a 61-year-old female patient in cardiac arrest receives emergency care, you note that her abdomen grows larger with each ventilation provided from a bag-valve mask. Which instructions should you provide to your partner?

Let's slow the ventilation rate to 10 per minute, providing each breath over 1 second."

You are having a difficult time getting air from the bag-valve mask to pass into the lungs of a patient with suspected stroke. It looks like the ventilation keeps going into the stomach. What should your first action be?

Perform the head-tilt, chin-lift maneuver again

You arrive at a residence to assist another crew with a patient in cardiac arrest. As you enter the room, a brand new Emergency Medical Technician informs you that he is having difficulty maintaining the mask seal to the patient's face while ventilating with the bag-valve mask. Which response shows that you understand and can help with the problem?

Let me maintain the face-to-mask seal while you squeeze the bag."

The high-flow nasal cannula should not be used on which patient (select best answer)?

An apneic male who has overdosed on a narcotic medication

The Emergency Medical Technician shows that he is correctly using the high-flow nasal cannula system when he:

Sets the oxygen liter flow to 50 liters per minute.

Which of these is a correct statement about the ventilation of a nonbreathing patient through a stoma?

The Emergency Medical Technician should ventilate through the stoma with a child-sized face mask attached to a bag-valve mask.

The Emergency Medical Technician (EMT) has just placed an oropharyngeal airway in a patient. By doing so, what has the EMT accomplished?

Displaced the tongue away from the back of the airway

The Emergency Medical Technician shows that she understands how to use an oropharyngeal airway when she states:

"I must remain alert for vomiting or spasm of the vocal cords even with proper insertion."

For which of these patients is placement of an oropharyngeal airway indicated?

An unresponsive patient who has no gag or cough reflex

You are observing an Emergency Medical Technician (EMT) insert an oropharyngeal airway into the airway of a 36-year-old male patient who has overdosed on a street drug. Which observation indicates a correct technique?

The airway is inserted into the mouth upside-down, and then turned 180 degrees once it contacts the soft palate.

While assisting with the review of airway skills with new Emergency Medical Technician (EMT) hires, which of these statements from a new EMT demonstrates he knows how to properly size an oral airway prior to placement?

The airway should approximate the distance from the front teeth to the angle of the jaw."

The Emergency Medical Technician (EMT) should recognize that the oropharyngeal airway has been appropriately inserted when:

Its flange rests on the teeth.

While the Emergency Medical Technician (EMT) is inserting an oropharyngeal airway, the patient gags. The EMT should:

Remove the airway and maintain the head-tilt, chin-lift maneuver.

You are transferring an unresponsive patient from her house to the ambulance on the stretcher. An oral airway has been placed and ventilations with the bag-valve mask are being administered. Over a short period of time, the patient begins to regain consciousness and starts to gag. Your immediate action should be to:

Remove the oral airway.

When inserting a nasopharyngeal airway, the Emergency Medical Technician should remember that:

The nasal mucosa may bleed even with proper insertion.

The Emergency Medical Technician is appropriately sizing the nasal airway when she measures the:

Distance from the tip of the nose to earlobe.

Which of these statements best describes the Emergency Medical Technician's understanding of oxygen?

It is a gas classified as a drug.

Which of these statements about different sizes of oxygen cylinders is true?

G and E tanks have the same psi when full.

You must transport a patient with carbon monoxide poisoning to a specialized facility for treatment. Transport time is estimated at 1.5 hours. The patient is on a nonrebreather face mask with a continuous oxygen flow of 15 lpm. In the ambulance, you have a G tank with 1,100 psi inside. Knowing that the cylinder constant is 2.41, which action should the EMT take in relation to the amount of available oxygen and transport time?

Complete the transport, and replace the G cylinder when back at the station.

You are watching an Emergency Medical Technician (EMT) prepare the ambulance for the upcoming shift. With regard to oxygen cylinders and equipment, which action requires immediate intervention?

The EMT cleans a dirty oxygen tank by spraying it with a petroleum-based agent cleanser.

You arrive at work and note that the portable oxygen tank in the ambulance is now yellow instead of green, as during the previous shift. As a knowledgeable Emergency Medical Technician, you should:

Remove the tank and retrieve a green cylinder.

A paramedic has asked you to place the patient on a nonrebreather mask at 15 liters per minute. To administer oxygen at this flow rate, you should:

Select "15" on the oxygen therapy regulator.

You are checking the D oxygen tank in the ambulance and note that the reading on the pressure regulator is 1,000 psi. You should recognize that the tank is:

Half full.

When providing oxygen via nonrebreather face mask, which piece of equipment is essential for the Emergency Medical Technician to have?

Therapy regulator

When using a therapy regulator, what can be readily observed by the Emergency Medical Technician?

Liter flow (flow rate) of oxygen leaving the cylinder

Which of these statements indicates that the Emergency Medical Technician has a correct understanding of the use of oxygen in the prehospital setting?

Oxygen should never, ever be withheld from a patient whom you think may need it."

Which action should you perform when attaching a therapy regulator to a new oxygen tank?

Open the cylinder valve for 1 second prior to attaching the regulator.

Which of these actions indicates that the Emergency Medical Technician is correctly using a nonrebreather face mask on an adult patient?

He fully inflates the reservoir prior to placing the mask on the patient.

When properly using a nonrebreather face mask, which of these statements is true?

The concentration of inhaled oxygen will be approximately 90%.

You are assessing a patient with altered mental status. Which of these assessment findings contraindicates the use of the nonrebreather face mask?

Respiratory rate of 18 breaths/min, with poor tidal volume

Assessment findings for an alert and oriented patient complaining of shortness of breath reveal an open airway and strong radial pulse, accompanied by skin that is cool and diaphoretic. The depth of respirations is adequate, and breath sounds include wheezing throughout the lungs. Vital signs are a pulse of 124, respiratory rate of 24 breaths/min, blood pressure of 146/82 mmHg, and SpO2 of 93%. The patient has a history of asthma, for which he takes medications. How should you initiate oxygen therapy on this patient?

Nasal cannula

Despite coaching and explaining the benefits of a nonrebreather face mask, a hypoxic patient with moderate shortness of breath in conjunction with lung cancer states that she cannot tolerate the mask over her face. The more she panics, the worse the shortness of breath becomes. What is your best course of action?

Disconnect the nonrebreather mask and replace it with a nasal cannula.

What is the preferred method of providing high-concentration oxygen to a breathing patient in the prehospital setting?

Nonrebreather face mask

Which oxygen administration systems will provide the patient with the greatest amount of oxygen?

Nonrebreather face mask at 15 liters per minute of oxygen

When monitoring a patient receiving oxygen through a nasal cannula, which of these observations warrants immediate intervention?

Oxygen flow rate of 15 liters per minute

An elderly male patient who is short of breath is on home oxygen. He is wearing a nasal cannula connected to an oxygen tank with the flow regulator set to 3 liters per minute. As a knowledgeable Emergency Medical Technician, you should recognize that the patient is getting approximately what percentage of oxygen with each breath?

32%

Which of these statements regarding the use of a nasal cannula is true?

When the nasal cannula is set to the highest appropriate oxygen flow rate, a large portion of the air inspired by the patient is still ambient air."

Which of these statements about an automatic transport ventilator (ATV) is true?

It can help minimize gastric distention associated with positive pressure ventilation.

You are using an automatic transport ventilator (ATV) for a patient who has an insufficient respiratory effort. What is the best indicator of adequate artificial ventilation by the ATV?

The patient's chest rises and falls with each mechanical ventilation.

What is a benefit of using a humidification system when administering oxygen?

Oxygen therapy is less drying to the upper respiratory tract.

A patient was eating dinner when a piece of food became caught in his throat. Although coughing has failed to remove the food, he remains able to move an adequate amount of air into and out of his lungs. A nasal cannula has been applied and vital signs are stable. During transport, the patient suddenly begins to exhibit stridorous respirations. Your immediate action should be to:

Perform abdominal thrusts.

When providing an in-service program on ventilating the geriatric patient, you should emphasize which point with regard to a patient who has dentures?

Loose appliances should be removed if they interfere with the airway or the seal between the mask and face.

Which of these statements best describes the purpose of a Venturi mask?

Precise concentrations of oxygen can be delivered with this device.

You are starting to ventilate a patient with a laryngectomy and stoma. As you provide the first few ventilations, you note that the air passes easily into the patient, but does not cause the chest to rise. Your next action should be to:

Seal the patient's mouth and nose.

A patient with a stoma and tracheostomy tube is responsive to painful stimuli. He has shallow respirations and is breathing at a rate of 6 times per minute. He has cyanosis of the fingertips and a weak, rapid radial pulse. Which strategy should be used in providing respiratory care to this patient?

Attach the bag-valve device directly to the tracheostomy tube.

A 21-year-old female patient has overdosed on an unknown drug. She has snoring respirations and an intact gag reflex. She has weak respiratory effort and is slightly cyanotic. Given these assessment findings, your care should include:

Insertion of a nasal airway.

What is obstructing the airway when snoring is heard?

The tongue

A patient who inhaled superheated steam in an industrial fire is most likely to exhibit which abnormal upper airway noise?

Stridor

Which of these statements, when made by the Emergency Medical Technician, reflects correct knowledge regarding the use of oxygen in a patient with a suspected acute coronary syndrome who denies dyspnea, has a pulse oximeter reading of 96%, and has acceptable vital signs?

Oxygen administration is no longer considered standard therapy for this patient."

A patient with chest discomfort has these vital signs: pulse, 88; respirations, 14breaths/min; blood pressure, 154/84 mmHg; and SpO2, 97% on room air. In this situation, the Emergency Medical Technician would address oxygen therapy by:

Withholding the use of oxygen.

A patient complaining of shortness of breath and a history of asthma has these vital signs: pulse, 96; respirations, 20 breaths/min; blood pressure, 132/86 mmHg; and SpO2, 92% on room air. Mild wheezing is noted bilaterally, and the patient states that she has run out of her rescue inhaler (albuterol). Regarding the patient's respiratory status, how should you initially administer oxygen?

2 lpm O2 through a nasal cannula

You are administering oxygen at 2 lpm through a nasal cannula to a confused patient. During transport, you note the SpO2 to be 91%, up from 90% on scene. The patient remains confused. What would your next action be?

Increase the oxygen flow to 4 lpm.

You are by the side of an elderly patient who fell 5 feet from a ladder, landing on a concrete porch and hitting his lower back and buttocks. Assessment reveals an intact airway, adequate respirations, rapid radial pulse, and skin that is pale, cool, and diaphoretic. The patient complains of lower back and left leg pain. No deformity to the extremity is noted; however, the lower back is tender on palpation and he states his belly is "burning." The vital signs obtained are: pulse, 132; respirations, 20 breaths/min; blood pressure, 102/88 mmHg; and SpO2, 97% on room air. Regarding oxygen therapy, you would:

Administer oxygen at 15 lpm through a nonrebreather mask.

A listless and lethargic 84-year-old male patient responds to physical stimuli with garbled speech. His respirations show poor effort and are rapid and labored, with a room air SpO2 of 84%. Additionally, you cannot appreciate breath sounds in his right lung. The best form of oxygen therapy for this patient would be:

Positive pressure ventilation.

Your paramedic partner has applied continuous positive airway pressure (CPAP) to a patient in respiratory distress from congestive heart failure (CHF). As an Emergency Medical Technician, you realize that this treatment should benefit the patient by:

Displacing fluid in the alveoli back into the bloodstream.

The Emergency Medical Technician would recognize that administering continuous positive airway pressure at a pressure that is too high can cause:

Lung collapse.

To receive treatment with continuous positive airway pressure, the patient must exhibit:

Ability to breathe on his own adequately.

For which of these disease processes would continuous positive airway pressure be most beneficial?

CHF with moderate to severe dyspnea

100

Which of these statements made by another crew member would cause you to not implement continuous positive airway pressure (CPAP) for a patient?

His respirations are agonal and slow."

Chapter 1

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Chapter 1

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Chapter 2

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Chapter 2

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Chapter 4

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Chapter 4

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Chapter 5

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Chapter 6

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Chapter 8

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Chapter 9

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Chapter 10 Part 2

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Chapter 11

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