Question 1

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

Accepted Answer

Stridor is a high-pitched, harsh sound that occurs during inspiration and suggests an upper airway obstruction. The other respiratory sounds (wheezing, crackles, and rhonchi) are typically associated with lower respiratory tract problems.

Question 2

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)?

Accepted Answer

Never having childhood immunizations increases the likelihood of a child contracting pertussis, as it is a vaccine-preventable disease. The other answer choices do not necessarily indicate pertussis specifically.

Question 3

A patient in respiratory distress is exhibiting pursed lip breathing. You realize that he is doing this to:

Accepted Answer

Pursed lip breathing is commonly used by patients with respiratory distress to keep their small airways open. This helps to decrease airway resistance and increase oxygen exchange.

Question 4

A patient, with a history of COPD, is breathing 32 times a minute. Her vital signs are: pulse 140, blood pressure 168/102, and SpO₂ 98% on room air. You would classify this as:

Accepted Answer

The patient is experiencing dyspnea, which is difficulty breathing often associated with COPD exacerbation. The breathing rate of 32 breaths per minute is also indicative of respiratory distress. The elevated pulse and blood pressure may be a compensatory response to the respiratory distress. The SpO₂ of 98% suggests adequate oxygenation at the moment, but the patient is at risk for hypoxia if her respiratory status deteriorates.

Question 5

A 26-year-old male has summoned EMS after lifting a heavy box and suddenly experiencing shortness of breath and sharp pain to the left side of his chest that worsens with deep inspiration. Given this description, you immediately become suspicious of a pneumothorax. Which of the following should you perform next to help confirm this suspicion?

Accepted Answer

Auscultating breath sounds can help to confirm the suspicion of a pneumothorax by revealing decreased or absent breath sounds on the affected side. Inquiring about past lung problems may give some insight into the patient's history, but it would not confirm or rule out a present pneumothorax. Obtaining an SpO₂ reading would help assess oxygen saturation, but would not confirm or rule out a pneumothorax. Palpating the chest for subcutaneous emphysema may reveal crepitus, but this is not specific to pneumothorax and may be present in other conditions as well.

Question 6

The EMT is correctly accessing for accessory muscle use when he examines what part of the body?

Accepted Answer

Accessory muscle use is assessed by observing the chest for the use of neck, shoulder, and chest muscles during breathing.

Question 7

Assessment of a 67-year-old male reveals absent lung sounds to the right lung, accompanied by sharp chest pain to the same side. When obtaining a history, which one of the following statements made by the patient's wife would the EMT recognize as most important?

Accepted Answer

The patient's wife stating that he has emphysema is the most important statement because it indicates a pre-existing lung disease that could be exacerbating his current symptoms. This could potentially lead to complications and impact the EMT's treatment plan. The other statements are important to note but are not as immediately relevant to the patient's current condition as his pre-existing lung disease.

Question 8

On scene you suspect that a young female patient is suffering from hyperventilation syndrome. Which one of the following signs would best assist you in confirming this suspicion?

Accepted Answer

Spasm of the hands (carpopedal spasm) is a common sign of hyperventilation syndrome, often due to decreased levels of carbon dioxide in the blood leading to a condition called hypocalcemia, which can cause neuromuscular irritability.

Question 9

You have been called to a residence for an 18-year-old female with shortness of breath and a history of cystic fibrosis. On scene you find the patient to be very thin and sick looking. Her airway is patent and breathing adequate, although slightly labored. Her radial pulse is strong, and she has a constant cough, which produces green- and yellow-colored mucus. Auscultation of the lungs reveals rhonchi to the upper portion of both lungs. Vital signs are pulse 108, respirations 20, blood pressure 98/56 mmHg, and SpO₂ 92%. Based on these findings, appropriate care should include:

Accepted Answer

The answer of You have been called to a residence...

Question 10

You are delivering positive pressure ventilations to a patient who is breathing poorly with absent breath sounds to the right lung. Which of the following instructions would you provide to those who are ventilating the patient?

Accepted Answer

When ventilating a patient with absent breath sounds to one lung, it is important to use the minimal tidal volume possible to prevent overinflation of the good lung and potential lung injury. Choosing option A or D would not address the issue of absent breath sounds to one lung, and option C does not address the need for positive pressure ventilation in this situation.

Question 11

You have been called for a 6-year-old male with shortness of breath. On scene you find the patient with a runny nose and mucus coming from the right nare. Breath sounds are clear and his SpO₂ is 99% on room air. When asked, he states that his throat is very sore. His vital signs are: pulse 124, respirations 20, and temperature 98.9∘F. There is no medical history, according to the mother. Which one of the following statements or instructions would be most appropriate for this situation?

Accepted Answer

While the patient is exhibiting symptoms of a respiratory infection, his vital signs and oxygen saturation indicate that he is stable. Option A is incorrect because aspirin is contraindicated in children due to the risk of Reye's syndrome. Option B is also incorrect because epiglottitis is a medical emergency, but the patient does not exhibit the classic symptoms of stridor or difficulty breathing. Option C is incorrect because there is no indication that the patient requires supplemental oxygen. Option D is the best choice because it acknowledges the potential for the infection to spread to the lungs and prompts transport to the hospital for further evaluation and treatment.

Question 12

You are transporting a 4-year-old female who you found sitting in a chair with labored respirations, inspiratory stridor, and drooling. Which one of the following signs would warrant immediate reassessment?

Accepted Answer

Inspiratory stridor can be a sign of airway obstruction, which is a medical emergency. If the stridor disappears, it may indicate that the obstruction has become complete, which can lead to respiratory arrest. Therefore, immediate reassessment is necessary to ensure that the airway remains patent.

Question 13

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?

Accepted Answer

While pertussis can cause significant respiratory distress, the patient in this scenario has clear breath sounds, good oxygenation, and a stable heart rate and respiratory rate. Therefore, the most appropriate action is to monitor the patient and transport to a medical facility for evaluation and potential treatment. Administering oxygen or a metered-dose inhaler is not indicated based on the patient's current presentation. Encouraging the patient not to cough may actually worsen the respiratory distress associated with pertussis.

Question 14

You have been dispatched to a home for a 16-year-old female with shortness of breath. On scene you find the patient in bed with her mother at her side. Her mother states that her daughter has a fever with a past medical history of cystic fibrosis and would like to have her transported to the hospital for evaluation of possible pneumonia. As a knowledgeable EMT, you know that the underlying pathophysiology of cystic fibrosis is a:

Accepted Answer

Cystic fibrosis is a genetic disorder that affects the production and flow of mucus, leading to the accumulation of thick, sticky mucus in the lungs, pancreas, and other organs. In the lungs, this can lead to difficulty breathing, coughing, and susceptibility to infections such as pneumonia. Therefore, choice B is the correct answer. Choices A, C, and D are not accurate descriptions of the underlying pathophysiology of cystic fibrosis.

Question 15

The EMT indicates that he is properly assessing the patient's breath sounds when he gives which one of the following instructions to the patient?

Accepted Answer

Breathing slowly through the mouth allows for better auscultation of breath sounds, as it reduces noise and provides a clearer assessment of lung function.

Question 16

The EMT understands adequate breathing when he states:

Accepted Answer

Normal and adequate breathing is specific to the patient and is determined by assessment. A respiratory rate of 10-20 breaths per minute is a general guideline, but the EMT must take into consideration factors such as the patient's age, medical history, and level of distress. Additionally, the presence of clear breath sounds and an intact airway are important factors to consider when assessing adequacy of breathing.

Question 17

You have been called to an industrial warehouse for a young adult male who was exposed to an unknown chemical gas. The patient was immediately removed from the environment and presents to you with a patent airway, burning to the throat with inspiration, and complaint of shortness of breath. His vital signs are: pulse 120, respirations 28, blood pressure 164/60, and SpO₂ of 90%. In addition, you note bilateral wheezing to the lungs. What should be your first action in caring for this patient?

Accepted Answer

Administering high-concentration oxygen is the best first action for this patient presenting with shortness of breath, bilateral wheezing, and low SpO₂. The patient has potential chemical exposure, but immediate stabilization of oxygenation and ventilation should be managed first.

Question 18

You arrive on scene for a 9-year-old female with a severe cough. Her mother states that she has spoken to her pediatrician who believes that the child may have whooping cough and should be taken to the hospital for evaluation. Her mother states that she is unsure if her daughter has had all her immunizations. Which one of the following statements would be most appropriate in the care of this patient?

Accepted Answer

Whooping cough (pertussis) is highly contagious, so placing a surgical mask on the patient can help prevent the spread of the disease. Option B is incorrect because whooping cough is caused by a bacterium (Bordetella pertussis), not a virus, and patients with the disease are highly contagious. Option C is excessive; while healthcare providers should take appropriate precautions to avoid exposure, full isolation precautions are not necessary. Option D is appropriate, but not the most urgent concern given the presenting complaint.

Question 19

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

Accepted Answer

Pulse oximetry measures the oxygen saturation levels in the blood, which is the most direct and accurate way to monitor the effectiveness of oxygen therapy. Respiratory rate, heart rate, and mental status may also be important indicators of oxygen therapy effectiveness, but they may be affected by other factors such as pain, anxiety, or underlying medical conditions.

Question 20

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:

Accepted Answer

When assessing a patient's breath sounds, it is best practice to compare side to side to detect any asymmetries or abnormalities. Therefore, after listening to the upper right back, the next logical step is to listen to the left upper back.

Quiz 16: Respiratory Emergencies